Zobrazení zdroje stránky Mccallumkane3094

Objectives There is no firm treatment strategy of coronary artery bypass grafting in hemodialysis patients. We investigated postoperative outcomes in hemodialysis patients undergoing isolated coronary artery bypass grafting using in situ skeletonized gastroepiploic artery. Methods From January 2002 to December 2019, 143 hemodialysis patients underwent isolated coronary artery bypass grafting in our institution. Among them, 49 consecutive patients with gastroepiploic artery grafting were retrospectively analyzed. Results No patient was converted from off-pump to on-pump surgery. The mean distal anastomoses were 3.6 ± 1.0 per patients. Seven patients (14.3%) required proximal anastomosis to aorta. Thirty-day mortality was 4.1% (2 of 49). The early (3-20 days after surgery) patency rate of the gastroepiploic artery was 96.9% (63 of 65 anastomoses). The adjusted rates of survival free from overall death at 1, 5 and 10 years after surgery were 91.7%, 72.6% and 32.5%, respectively. Multivariate Cox proportional hazard regression analysis showed that age (hazard ratio 1.131, 95% confidence interval 1.055-1.212, p less then 0.001) and LVEF less then 40% (hazard ratio 9.411, 95% confidence interval 1.963-45.919, p = 0.005) were independent predictors of mid-term death from all causes (Table 6). Conclusions Short and mid-term outcomes were acceptable. The use of in situ skeletonized gastroepiploic artery can decrease the time of touching aorta, so gastroepiploic artery grafting may be an important option for coronary artery bypass grafting in hemodialysis patients with limited conduits.Background Oxidized regenerated cellulose (ORC) sheet, in surgery of primary spontaneous pneumothorax, is used to reinforce the visceral pleura around the staple line coverage aiming to prevent a postoperative recurrence. We evaluated the effect of ORC on recurrence within 2 years after surgery. Methods A total of 201 patients aged less then 40 years who underwent bullectomy for primary spontaneous pneumothorax at our institution were retrospectively reviewed. They were classified into an ORC sheet coverage group (ORC group, n = 100) and a non-coverage group (n-ORC group, n = 101). Two-year recurrence-free survival rates are assessed between the two groups with associated analysis of radiographical and operative findings. [https://www.selleckchem.com/products/cx-5461.html this website] Results ORC had no effect on the recurrence rate. CT images and re-operative findings showed regenerated bullae in 19 and 14 patients, close to staple lines in 14 and 11 patients, respectively. White pleural thickening within the covered area was observed in all patients of the ORC group. Pathological findings also showed pleural thickening in eight patients and bulla regeneration under pleural thickening in six patients. Conclusions Coverage with an ORC sheet after bullectomy did not prevent the regeneration of bullae and postoperative recurrence, regardless of exerting a reinforcement effect on the visceral pleura histologically.Coronavirus disease 2019 (COVID-19) is currently causing a pandemic and will likely persist in endemic form in the foreseeable future. Physicians need to correctly approach this new disease, often representing a challenge in terms of differential diagnosis. Although COVID-19 lacks specific signs and symptoms, we believe internists should develop specific skills to recognize the disease, learning its 'semeiotic'. In this review article, we summarize the key clinical features that may guide in differentiating a COVID-19 case, requiring specific testing, from upper respiratory and/or influenza-like illnesses of other aetiology. We consider two different clinical settings, where availability of the different diagnostic strategies differs widely outpatient and inpatient. Our reasoning highlights how challenging a balanced approach to a patient with fever and flu-like symptoms can be. At present, clinical workup of COVID-19 remains a hard task to accomplish. However, knowledge of the natural history of the disease may aid the internist in putting common and unspecific symptoms into the correct clinical context.Analysis of coagulation disorders and assessment of rebalanced hemostasis with the use of traditional coagulation assays is challenging in cirrhotic patients. Therefore, alternative tests are under investigation for the evaluation of coagulopathy in this specific setting. Aim of this study was to analyze the modifications of clot structure and function in cirrhotic patients with different degrees of severity. Cirrhotic patients referred to our Unit were consecutively enrolled. Global test measurements, including clot and lysis assays, clot lysis time, and determination of other fibrinolytic parameters, were performed. Analyses of clot formation, morphology, and lysis were performed with a turbidimetric clotting and lysis assay (EuroCLOT). Lysis of a tissue factor-induced clot by exogenous tissue plasminogen activator was analyzed by studying the modifications of turbidity during clot formation and the following lysis. We evaluated coagulative and fibrinolytic parameters in both plasma and ascites. Urokinase pcites. Ascitic levels of uPA and MMP2 are reduced and inversely related to the severity of liver disease.The aim of this study was to determine the prevalence of Streptococcus mutans and its serotypes in samples from oral cavity of young Galician population and their relationship with the oral health state. The variables generally associated with dental caries, such as salivary flow rate, buffering capacity, eating habits, and lifestyle, were also analysed. No relationship was found between the variables studied and the presence of S. mutans in the oral cavity or the existence of dental caries. Presumptive strains of S. mutans were isolated from saliva samples from 48% of the analysed population. The use of conventional microbiological methods, API 20 Strep system, and species-specific polymerase chain reaction (PCR) allowed to substantiate the identity of the strains as S. mutans. Multiplex PCR protocols, developed in this study for the simultaneous detection of S. mutans and serotypes c, e, and f and for detection of S. mutans and serotype k, also confirmed this result and demonstrated that serotype c was predominant in the studied young Galician population (86%).