- [Myocardial revascularization among patients with severe left ventricular dysfunction: a comparison between on-pump beating-heart and off-pump coronary artery bypass grafting]. [Journal Article]
- ZWZhonghua Wai Ke Za Zhi 2018 Apr 01; 56(4):294-298
- Objective: To evaluate the impacts of an on-pump beating-heart versus an off-pump coronary artery bypass grafting (CABG) technique for surgical revascularization on the early clin...
Objective: To evaluate the impacts of an on-pump beating-heart versus an off-pump coronary artery bypass grafting (CABG) technique for surgical revascularization on the early clinical outcomes in patients with a left ventricular ejection fraction (EF) of 35% or less.Methods:A total of 216 consecutive patients with an echocardiographic estimated EF of 35% or less who underwent non-emergency, primary, isolated CABG from January 2010 to December 2014 at Department of Cardiovascular Surgery, Zhongshan Hospital, Fudan University were included in this study and were divided into either an OBCAB group (patients who received on-pump beating-heart CABG surgery,n=88) or an OPCAB group (patients who received off-pump CABG surgery,n=128). The early clinical outcomes were investigated and compared. The outcomes were compared between groups byt-test, χ2test or Fisher's exact test, when appropriate.Results:No significant differences emerged between the two groups in baseline characteristics of the entire cohort except for more patients with diabetes and a larger left ventricular endo-diastolic diameter in the OBCAB group. Patients in the OBCAB group compared to the OPCAB group had a similar in-hospital mortality (3.4%vs. 4.7%,P= 0.741). Mean EF, as measured preoperatively and early postoperatively (before discharge), significantly improved from (31.0±2.8)% to (35.6±2.9)% (t=10.61,P=0.000) in the OBCAB group and from (31.0±2.9)% to (34.8±3.3)% (t=9.68,P=0.000) in the OPCAB group, respectively. The improvement of mean LVEF in the OBCAB group was significantly higher than that in the OPCAB group ((4.7±0.2)%vs. (3.6±0.3)%,t=29.53,P=0.000). Patients in the OBCAB group compared to the OPCAB group had a significant higher early postoperative EF ((35.6±2.9)%vs.(34.8±3.3)%,t=1.892,P=0.034) but shared a similar baseline EF ((31.0±2.8)%vs. (31.0±2.9)%,t=0.012,P=0.930). Patients in the OBCAB group compared to the OPCAB group received a greater number of grafts and an increased amount of drainage during the first 24 h (3.7±0.8vs. 2.8±0.6,t=9.442,P=0.000; (715±187) mlvs. (520±148) ml,t=8.544,P=0.000, respectively), without evidence of worse in-hospital mortality or major postoperative morbidity.Conclusion:The on-pump beating-heart technique may be an acceptable alternative to the off-pump technique for surgical revascularization in patients with an estimated EF of 35% or less.
- The Belgian Association for Study of the Liver Guidance Document on the Management of Adult and Paediatric Non-Alcoholic Fatty Liver Disease. [Journal Article]
- AGActa Gastroenterol Belg 2018 Jan-Mar; 81(1):55-81
- Non-Alcoholic Fatty Liver Disease (NAFLD) is highly prevalent and associated with considerable liver-related and non-liverrelated morbidity and mortality. There is, however, a lot of uncertainty on h...
Non-Alcoholic Fatty Liver Disease (NAFLD) is highly prevalent and associated with considerable liver-related and non-liverrelated morbidity and mortality. There is, however, a lot of uncertainty on how to handle NAFLD in clinical practice. The current guidance document, compiled under the aegis of the Belgian Association for the Study of the Liver by a panel of experts in NAFLD, from a broad range of different specialties, covers many questions encountered in daily clinical practice regarding diagnosis, screening, therapy and follow-up in adult and paediatric patients. Guidance statements in this document are based on the available evidence whenever possible. In case of absence of evidence or inconsistency of the data, guidance statements were formulated based on consensus of the expert panel. This guidance document is intended as a help for clinicians (general practitioners and all involved specialties) to implement the most recent evidence and insights in the field of NAFLD within a Belgian perspective.
- The efficacy and adverse events of testosterone replacement therapy in hypogonadal men: A systematic review and meta-analysis of randomized, placebo-controlled trials. [Journal Article]
- JCJ Clin Endocrinol Metab 2018 Mar 17
- CONCLUSIONS: In hypogonadal men TRT improves sexual desire, erectile function, and sexual satisfaction, however it increases the risk of erythrocytosis.
- The Combined Effect of Cancer and Cardio-Metabolic Conditions on the Mortality Burden in Older Adults. [Journal Article]
- JGJ Gerontol A Biol Sci Med Sci 2018 Mar 19
- CONCLUSIONS: Combinations of cancer and cardio-metabolic conditions accelerate mortality rates in older adults differently. While most studies investigating mortality associated with multi-morbidity used disease counts, these provide little guidance for managing complex patients as they age.
- Impaired Mitochondrial Energetics Characterize Poor Early Recovery Of Muscle Mass Following Hind Limb Unloading In Old Mice. [Journal Article]
- JGJ Gerontol A Biol Sci Med Sci 2018 Mar 19
- The progression of age-related sarcopenia can be accelerated by impaired recovery of muscle mass following periods of disuse due to illness or immobilization. However, the mechanisms underlying poor ...
The progression of age-related sarcopenia can be accelerated by impaired recovery of muscle mass following periods of disuse due to illness or immobilization. However, the mechanisms underlying poor recovery of aged muscle following disuse remain to be delineated. Recent evidence suggests that mitochondrial energetics play an important role in regulation of muscle mass. Here, we report that 22-24 month old mice with low muscle mass and low glucose clearance rate also display poor early recovery of muscle mass following 10 days of hind limb unloading. We used unbiased and targeted approaches to identify changes in energy metabolism gene expression, metabolite pools and mitochondrial phenotype and show for the first time that persistent mitochondrial dysfunction, dysregulated fatty acid β-oxidation and elevated H2O2 emission occur concomitantly with poor early recovery of muscle mass following a period of disuse in old mice. Importantly, this is linked to more severe whole-body insulin resistance, as determined by insulin tolerance test. The findings suggest that muscle fuel metabolism and mitochondrial energetics could be a focus for mining therapeutic targets to improve recovery of muscle mass following periods of disuse in older animals.
- Insulin resistance in cavefish as an adaptation to a nutrient-limited environment. [Journal Article]
- NatNature 2018 Mar 21
- Periodic food shortages are a major challenge faced by organisms in natural habitats. Cave-dwelling animals must withstand long periods of nutrient deprivation, as-in the absence of photosynthesis-ca...
Periodic food shortages are a major challenge faced by organisms in natural habitats. Cave-dwelling animals must withstand long periods of nutrient deprivation, as-in the absence of photosynthesis-caves depend on external energy sources such as seasonal floods. Here we show that cave-adapted populations of the Mexican tetra, Astyanax mexicanus, have dysregulated blood glucose homeostasis and are insulin-resistant compared to river-adapted populations. We found that multiple cave populations carry a mutation in the insulin receptor that leads to decreased insulin binding in vitro and contributes to hyperglycaemia. Hybrid fish from surface-cave crosses carrying this mutation weigh more than non-carriers, and zebrafish genetically engineered to carry the mutation have increased body weight and insulin resistance. Higher body weight may be advantageous in caves as a strategy to cope with an infrequent food supply. In humans, the identical mutation in the insulin receptor leads to a severe form of insulin resistance and reduced lifespan. However, cavefish have a similar lifespan to surface fish and do not accumulate the advanced glycation end-products in the blood that are typically associated with the progression of diabetes-associated pathologies. Our findings suggest that diminished insulin signalling is beneficial in a nutrient-limited environment and that cavefish may have acquired compensatory mechanisms that enable them to circumvent the typical negative effects associated with failure to regulate blood glucose levels.
- Autoimmune Polyendocrine Syndromes. [Journal Article]
- NEJMN Engl J Med 2018 Mar 22; 378(12):1132-1141
- Evaluation of the satisfaction of users of a service specialized in diabetes mellitus. [Journal Article]
- RBRev Bras Enferm 2018; 71(suppl 1):599-606
- to evaluate the satisfaction of users of a service that specializes in diabetes mellitus.
to evaluate the satisfaction of users of a service that specializes in diabetes mellitus.
- Characterization of users at risk of developing diabetes: a cross-sectional study. [Journal Article]
- RBRev Bras Enferm 2018; 71(suppl 1):475-482
- CONCLUSIONS: The results showed that many risk factors for developing diabetes mellitus type 2 were among the population of the study.
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- COMPARISON OF THE LEVELS OF C-REACTIVE PROTEIN, GLP-1 AND GLP-2 AMONG INDIVIDUALS WITH DIABETES, MORBID OBESITY AND HEALTHY CONTROLS: AN EXPLORATORY STUDY. [Journal Article]
- AGArq Gastroenterol 2018 Jan-Mar; 55(1):72-77
- CONCLUSIONS: GLP-2 levels were impaired in the individuals with obesity and diabetes. This mechanism seems to be enrolled in preventing the worsening of the glucose homeostasis in these individuals.