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Incidence and Outcomes of Surgical Site Infections after Adult cardiac surgery: A Single-center Experience

World Journal of Cardiovascular Diseases 2023年第11期13卷 764-779页

作者： Ibraheem H. Alharbi Hasan I. Sandogji Ahmed M. Shabaan Khaled M. Sayed Bilal A. Rahmani Mohamed A. Elmetwali Nouf A. Lami Thikra S. Alkhalaf Shyelene T. Utuanis Ayman R. Abdelrehim Cardiology Department Madinah Cardiac Center Madinah Saudi Arabia cardiac surgery Department Madinah Cardiac Center Madinah Saudi Arabia Cardiothoracic surgery Department Faculty of Medicine Suez Canal University Isma&iumllia Egypt Infection Prevention and Control Department Madinah Cardiac Center Madinah Saudi Arabia Clinical Nurse Unit Cardiac Surgery Department Madinah Cardiac Center Madinah Saudi Arabia Cardiothoracic surgery Department Faculty of Medicine Menoufia University Menoufia Egypt

Background: Surgical site infections (SSIs) remain a challenging medical problem, especially in cardiac surgery patients. There is a lack of studies evaluating the rate of and outcomes of SSIs following cardiac surgeries in Saudi Arabia. Aims: This study aimed to determine the incidence of SSIs after adult cardiac surgeries that were done in Madinah cardiac center, Saudi Arabia. Further, to identify the outcomes and risk factors contributing to death among surgical site infection patients. Methods: This was a 6-year, single-center, retrospective cohort study that included 93 consecutive patients who underwent adult cardiac surgery between August 2016 and August 2022. All adult patients aged 18 years or older who had clinical evidence of postoperative surgical wound infection were included. Preoperative, operative, and postoperative data (early and late) were collected from medical records. Microbiological culture reports and clinical outcomes were also recorded. Results: The study revealed a 9.1% (93/1021) incidence rate of SSIs. Of the 93 patients with SSIs, 60 had superficial incisional infections and 33 had deep infections with incidence rates of 5.9% and 3.2%, respectively. In-hospital mortality due to SSI was recorded in 4 out of 93 patients with an incidence rate of 4.3%. There was a significant association between the in-hospital mortality and the type of SSIs (p = 0.014). All non-survivors had deep SSIs. The type of cardiac surgery also showed a significant association with the in-hospital mortality (p = 0.017). Furthermore, the median duration of antibiotic administration was significantly longer in the non-survivors than in the survivors (72.5 vs 17, respectively, p Conclusions: In conclusion, the incidence of surgical wound infections following cardiac surgery is not low (9.1%);of which 3.2% were deep infections. The in-hospital mortality rate after treatment of SSIs was fortunately low (4.3%), and all non-survivors had deep SSIs. The non- survivors showe

关键词： Surgical Site Infection cardiac surgery Mortality Risk Factors Outcomes

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Evaluation of 100 Cases of Mortality after cardiac surgery: A Single-center Experience in Bangladesh

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World Journal of Cardiovascular surgery 2020年第7期10卷 131-141页

作者： Dharmendra Joshi Mayank Acharya Niraj Bhattarai Md. Abir Tazim Chowdhury Md. Alauddin Md. Rezwanul Hoque Department of cardiac surgery Bangabandhu Sheikh Mujib Medical University Dhaka Bangladesh

Background: Vigilance ensures safety in cardiac surgery. Performance in cardiac surgery is often measured by short-term mortality. Several risk factors like advanced age, female gender, higher body mass index, decreased left ventricular function, emergent, and redo operations have appeared recurrently as poor prognostic variables. Evaluation of postoperative mortality is crucial to find loopholes to provide proper care and reduce preventable mortality after cardiac surgery in developing countries with limited infrastructures and resources. Methods: This is a retrospective study conducted in the Department of Cardiac Surgery, Bangabandhu Sheikh Mujib Medical University. Perioperative data of 100 cases of mortality after cardiac surgery performed from 1 January 2014 to 30 May 2018 were collected from the university medical record. The data on age, gender, body mass index, preoperative investigations, diagnoses, types of operations, details of cardiopulmonary bypass, and postoperative period of the study populations were evaluated. Results: During the study period, about 1627 cases of cardiac surgery were done with an overall mortality rate of 6.15%. The mean age was 41.05 ± 20.19 (0 - 68) years, and 66% of patients were male. Preoperative ejection fraction (EF) of the study

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Long-term outcomes and life quality in the elderly after cardiac surgery:A single-center retrospective analysis

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South China Journal of Cardiology 2019年第3期20卷 182-189页

作者： MEI Bo YANG Song HUANG Sui-qing LIANG Meng-ya CHEN Guang-xian WU Zhong-kai Department of Cardiovascular surgery Affiliated Hospital of North Sichuan Medical CollegeNanchong 637000Sichuan Department of cardiac surgery First Affiliated Hospital of Sun Yat-Sen UniversityGuangzhou 510030China

Background In the past of China,both doctors and patients have historically been reluctant to pursue cardiac surgery in the elderly because of various reasons. Nowadays,this situation is changing. However,few studies have been performed to assess quality of life(QoL)in elderly patients after cardiac surgery in China. In this study,we evaluated long-term surgical outcomes and QoL and identified the factors associated with each in elderly patients who underwent cardiac surgery. Methods We recruited 320 patients aged ≥70 years old who underwent cardiac surgery in our hospital from January 2003 to December 2018. Risk factors for mortality were identified using a logistic regression analysis. Among survivors,QoL was assessed using the Short Form 36,and the results were compared to those in an age-matched population cohort in China. Results Overall hospital mortality was 7.2%. However,it has dropped to 3.7% in the last five years. The 1-,3-,5-,and 10-year survival rates were 95.5%,85.7%,74.7%,and 30.5%,respectively. Cardiopulmonary bypass time and Euro SCOREs significantly predicted in-hospital mortality. Chronic pulmonary disease was the only risk factor for long-term mortality. Scores for bodily pain and role emotional were significantly higher in our population than in the general Chinese aged population. However,scores were lower for physical functions and vitality in our population than in the controls. Conclusions cardiac surgery in elderly patients (≥70 years old)can have low in-hospital mortality,excellent long-term survival and high QoL,which are associated with comprehensive preoperative evaluation assesses and excellent perioperative management and post-surgery cardiac rehabilitation.[S Chin J Cardiol 2019;20(3):182-189]

关键词： cardiovascular outcome cardiovascular surgery survival quality of life SF-36

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Impact of early intensive rehabilitation care in patients undergoing cardiac surgery in a single center:a quasi-experimental study

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中国循环杂志 2018年第S1期33卷 173-173页

作者： Lin Zhao Qingyin Li Chunying Huo Yunxia Hao Li Shi Lin Liu National center for Cardiovascular Diseases Fuwai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

Objective To evaluate the impact of early intensive rehabilitation care in adults undergoing cardiac *** This was a quasi-experimental study using assessor blinding in 252 cardiac surgery patients recruited from Fuwai *** awaiting cardiac surgery were divided into the experiment group and the control *** control group received routine rehabilitation care postoperatively,including the exercise training,deep breathing exercises,nutrition direction,medication instruction,psychological education,pain management and sleep conditioning.

关键词： adults undergoing cardiac surgery early intensive rehabilitation care routine rehabilitation care postoperatively

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Exploring the Role of Serum Cystatin C in Early Detection of Acute Kidney Injury among On-Pump cardiac surgery Patients: A Single-center Investigation in Bangladesh

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World Journal of Cardiovascular Diseases 2024年第6期14卷 363-373页

作者： Md. Ahaduzzaman Md. Abir Tazim Chowdhury Munama Magdum Md. Saiful Islam Khan Satyajit Sharma Monoj Tiwari Md. Abul Bashar Maruf Md. Alauddin Omar Sadeque Khan Md. Mostafizur Rahman Mirza Md. Nazmus Saquib Department of Cardiothoracic and Vascular surgery Evercare Hospital Dhaka Dhaka Bangladesh Department of Preventive and Social Medicine National Institute of Preventive and Social Medicine Dhaka Bangladesh Department of Cardiothoracic Anesthesia Evercare Hospital Dhaka Dhaka Bangladesh Department of cardiac surgery National Heart Foundation Hospital & Research Institute Dhaka Bangladesh Department of Cardiovascular and Thoracic surgery B.P. Koirala Memorial Cancer Hospital Bharatpur Chitwan Nepal Department of cardiac surgery United Hospital Limited Dhaka Bangladesh Department of cardiac surgery Bangabandhu Sheikh Mujib Medical University Dhaka Bangladesh Department of cardiac surgery Ibrahim Cardiac Hospital & Research Institute Dhaka Bangladesh

Background: Acute Kidney Injury (AKI) stands as a prominent postoperative complication in on-pump cardiac surgery, with repercussions on morbidity, mortality, and hospitalization duration. Current diagnostic criteria relying on serum creatinine levels exhibit a delayed identification of AKI, prompting an exploration of alternative biomarkers. Aims and Objectives: This study is designed to overcome diagnostic constraints and explore the viability of serum Cystatin C as an early predictor of Acute Kidney Injury (AKI) in individuals undergoing on-pump cardiac surgery. The investigation aims to establish the relationship between serum Cystatin C levels and the onset of AKI in patients subjected to on-pump cardiac surgery. Primary objectives involve the assessment of the diagnostic effectiveness of serum Cystatin C, its comparison with serum creatinine, and the exploration of its potential for the early identification and treatment of AKI. Methodology: Conducted as a single-center study at the cardiac surgery department of BSMMU in Bangladesh from September 2020 to August 2022, a comparative cross-sectional analysis involved 31 participants categorized into No AKI and AKI groups based on Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Data collection encompassed preoperative, post-CBP (cardiopulmonary bypass) conclusion at 2 hours, postoperative day 1, and postoperative day 2 intervals. Statistical analyses included Chi-squared tests, independent Student’s t-tests, and one-sample t-tests. Significance was set at P Results: The study revealed no significant differences in baseline characteristics between the No AKI and AKI groups, except for CPB time and cross-clamp time. Serum Cystatin C levels in the AKI group exhibited statistical significance at various time points, highlighting its potential as an early detector. Conversely, Serum Creatinine levels in the AKI group showed no statistical significance. The Receiver Operating Characteristic (ROC) curve analy

关键词： Acute Kidney Injury (AKI) On-Pump cardiac surgery Serum Cystatin C Serum Creatinine Diagnostic Biomarkers Early Detection Cardiopulmonary Bypass Single-center Study Bangladesh

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cardiac surgery in Octogenarians and Beyond: Single center Experience

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Open Journal of Thoracic surgery 2013年第2期3卷 51-56页

作者： Reda E. Al-Refaie Hashem Aliter Ricardo Gallo Ali Youssef Mushabab Al-Murayeh Edwin Ravikumar Department of cardiac surgery and Car- diology Armed Forces Hospitals Southern Region Khamis Mushayt KSA Department of Cardiothoracic surgery Mansoura University Hospitals Mansoura Egypt

Background: Increasing numbers of octogenarians and improvements in surgical techniques and postoperative care have resulted in increasing cardiac operations in this age. The aim is to analyze our experience of cardiac surgery on octogenarians and beyond concerning postoperative morbidities and mortality. Methods: 67 octogenarians and nonagenarians underwent open heart surgery in our hospital between 2001 to 2009 were retrospectively reviewed. Data included baseline preoperative status, intraoperative and perioperative course, and immediate outcomes. Results: The mean age was 86.22 ± 6.1 years. 86.6% patients were males. Symptoms were dyspnea;Class II in 13.4%, Class III in 55.2%, Class IV in 31.4% patients;angina in 82.1%, and CHF in 25.4% patients. The mean EF was 37.8% ± 10. Risk factors include smoking in 52.2%, DM in 37.3%, hypertension in 28.4%, obesity in 25.4%, previous MI in 22.4%, COPD in 17.9%, renal insufficiency in 11.9%, pulmonary hypertension in 7.5%, PVD in 6%, and cerebrovascular disease in 3% patients. The procedures were isolated CABG in 73%, AVR in 9%, MVR in 6%, CABG/valve in 9%, and MVR and AVR in 3% patients. Complications were 18%. It included renal impairment in 18%, arrhythmias in 14.9%, bleeding in 6%, prolonged ventilation in 13.4%, CHF in 4.5%, gastrointestinal bleeding in 4.5%, wound infection in 7.5%, and cerebrovascular accident in 3%. Hospital mortality was 9% patients. Conclusions: cardiac surgery can be performed safely with acceptable hospital morbidity and mortality in octogenarians and beyond. Early referral and proper selection of patients are mandatory to improve immediate postoperative survival.

关键词： Coronary Artery Bypass Graft Valve Octogenarians Nonagenarian

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Success of intravenous immunoglobulin and steroids in managing severe COVID-19 following lung transplantation:A case report

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World Journal of Transplantation 2025年第1期15卷 178-184页

作者： Yen-Shou Kuo Kuan-Hsun Lin Ying-Yi Chen Yuan-Ming Tsai Ti-Hui Wu Hsu-Kai Huang Tsai-Wang Huang Division of Thoracic surgery Department of SurgeryTri-Service General HospitalNational Defense Medical CenterTaipei 114202Taiwan

BACKGROUND Coronavirus disease 2019(COVID-19)pneumonia with severe septic shock and acute respiratory distress syndrome(ARDS)are critical illnesses for patients following *** immunoglobulin(IVIG)plays a role in both immune support and inflammation control,especially in immunocompromised *** case report describes the first successful experience using IVIG and pulse steroids to manage this critical condition following lung *** SUMMARY A 65-year-old male patient reported a history of chronic obstructive pulmonary disease and poor lung function and received bilateral sequential lung ***,he developed COVID-19 pneumonia,severe septic shock,and *** recovered from this critical condition after empirical antibiotics administration and veno-venous extracorporeal membrane oxygenation,in addition to IVIG and pulse *** IVIG is a valuable adjunct in managing severe sepsis in lung transplant recipients after COVID-19 *** aim,for the first time,to report the success of such a management approach for COVID-19 ARDS and sepsis in the post-lung transplant *** further investigations,this is a starting point for wider analysis of such an approach in this setting and consequently helps guide clinical practice for such a challenging patient population moving forward.

关键词： COVID-19 Septic shock Intravenous immunoglobulin Lung transplantation Post-transplant complications Case report

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Evolution of cardiovascular surgery in China: A historical perspective

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中华医学杂志(英文版) 2025年第03期

作者： Wu Qingyu cardiac surgery Cardiac Center The First Hospital of Tsinghua University Chaoyang District Beijing China

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Understanding the link between type 2 diabetes mellitus and Parkinson's disease:role of brain insulin resistance

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Neural Regeneration Research 2025年第11期20卷 3113-3123页

作者： Theodora Ntetsika Sergiu-Bogdan Catrina Ioanna Markaki Department of Clinical Neuroscience Karolinska InstituteStockholmSweden Department of Neurology Karolinska University HospitalStockholmSweden Department of Molecular Medicine and surgery Karolinska InstituteStockholmSweden center for Diabetes Academic Specialist CenterStockholmSweden center for Neurology Academic Specialist CenterStockholmSweden

Type 2 diabetes mellitus and Parkinson's disease are chronic diseases linked to a growing pandemic that affects older adults and causes significant socio-economic *** data supporting a close relationship between these two aging-related diseases have resulted in the investigation of shared pathophysiological molecular *** insulin signaling in the brain has gained increasing attention during the last decade and has been suggested to contribute to the development of Parkinson's disease through the dysregulation of several pathological *** contribution of type 2 diabetes mellitus and insulin resistance in neurodegeneration in Parkinson's disease,with emphasis on brain insulin resistance,is extensively discussed in this article and new therapeutic strategies targeting this pathological link are presented and reviewed.

关键词： brain insulin resistance brain insulin signaling diabetes type 2 GLP-1 receptor agonists GLP-1 signaling insulin resistance insulin signaling neurodegeneration Parkinson's disease targeted therapy

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Three-dimensional models:from cell culture to Patient-Derived Organoid and its application to future liposarcoma research

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Oncology Research 2025年第1期33卷 1-13页

作者： SAYUMI TAHARA SYDNEY RENTSCH FERNANDA COSTAS CASAL DE FARIA PATRICIA SARCHET ROMA KARNA FEDERICA CALORE RAPHAEL E.POLLOCK Department of surgery Division of Surgical OncologyThe James Comprehensive Cancer CenterThe Ohio State University Wexner Medical CenterColumbusOH 43210USA Department of Cancer Biology and Genetics The James Comprehensive Cancer CenterThe Ohio State University Wexner Medical CenterColumbusOH 43210USA

Liposarcoma is one of the most common soft tissue sarcomas,however,its occurrence rate is still rare compared to other *** to its rarity,in vitro experiments are an essential approach to elucidate liposarcoma *** cell culture-based research(2D cell culture)is still playing a pivotal role,while several shortcomings have been recently under *** vivo,mouse models are usually adopted for pre-clinical analyses with expectations to overcome the issues of 2D cell ***,they do not fully recapitulate human dedifferentiated liposarcoma(DDLPS)***,three-dimensional(3D)culture systems have been the recent research focus in the cell biology field with the expectation to overcome at the same time the disadvantages of 2D cell culture and in vivo animal models and fill in the gap between *** the liposarcoma rarity,we believe that 3D cell culture techniques,including 3D cell cultures/co-cultures,and Patient-Derived tumor Organoids(PDOs),represent a promising approach to facilitate liposarcoma investigation and elucidate its molecular mechanisms and effective therapy *** this review,we first provide a general overview of 3D cell cultures compared to 2D cell *** then focus on one of the recent 3D cell culture applications,Patient-Derived Organoids(PDOs),summarizing and discussing several PDO ***,we discuss the current and future applications of PDOs to sarcoma,particularly in the field of liposarcoma.

关键词： Cell culture Liposarcoma Patient-Derived Organoid(PDO) Spheroid Three-dimensional(3D)cell culture

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