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Impact of musculoskeletal disorders in patients using orthopedic equipment on sternotomy wound healing after cardiac surgery - preliminary report. 使用矫形设备的患者的肌肉骨骼疾病对心脏手术后胸骨切开伤口愈合的影响--初步报告。
Pub Date : 2024-07-17 DOI: 10.5603/cj.95753
Krzysztof Greberski, Maciej Łuczak, Cezary Danielecki, Karol Buszkiewicz, Olga Kazimierczak, Paweł Burchardt, Bartłomiej Perek, Przemysław Lisiński, Paweł Bugajski

Background: The presence of locomotive disorders may negatively impact the outcome of cardiac surgeries. This retrospective study aimed to assess the effect of preoperative diagnosis of locomotive disorders requiring the continuous use of orthopedic devices on postoperative rehabilitation and stable sternum adhesion.

Material and methods: The study included 122 patients who underwent cardiac surgery, with 68 patients in the study group having a musculoskeletal disorder and 54 patients in the control group without such disorders. Preoperative demographic, clinical, and laboratory data as well as postoperative rehabilitation and sternum adhesion were evaluated.

Results: The results showed that patients in the study group had lower levels of calcium (p < 0.001), vitamin D (p < 0.001), and creatine kinase (p = 0.022) prior to the surgery. In the early postoperative period, 8 patients from the study group and 4 from the control group required reoperation due to sternal instability (p = ns). In the late postoperative period, sternal instability was present in 2 patients from the study group and 3 from the control group (p = ns). The survey study revealed a significantly better (p = 0.029) evaluation of postoperative rehabilitation among the study group patients.

Conclusions: Overall, the results indicated that a preoperative locomotive disorder has no significant impact on sternal instability in the early or late postoperative periods. However, patients with such disorders have a better understanding of the importance, purpose, and course of rehabilitation after cardiac surgery and exhibit lower levels of calcium, vitamin D, and creatinine.

背景:运动障碍的存在可能会对心脏手术的结果产生负面影响。这项回顾性研究旨在评估术前诊断出需要持续使用矫形器的运动障碍对术后康复和稳定胸骨粘连的影响:研究对象包括122名接受心脏手术的患者,研究组中有68名患者患有肌肉骨骼疾病,对照组中有54名患者没有此类疾病。对术前人口统计学、临床和实验室数据以及术后康复和胸骨粘连情况进行了评估:结果显示,研究组患者术前的钙水平(p < 0.001)、维生素 D 水平(p < 0.001)和肌酸激酶水平(p = 0.022)均较低。术后早期,研究组和对照组分别有8名和4名患者因胸骨不稳而需要再次手术(P = ns)。在术后晚期,研究组有 2 名患者出现胸骨不稳,对照组有 3 名患者出现胸骨不稳(P = ns)。调查研究显示,研究组患者对术后康复的评价明显更好(p = 0.029):总体而言,研究结果表明,术前运动障碍对术后早期或晚期胸骨不稳没有明显影响。然而,有此类障碍的患者对心脏手术后康复的重要性、目的和过程有更好的理解,并表现出较低的钙、维生素 D 和肌酐水平。
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引用次数: 0
Correlations between soluble ST2 concentration and the nutritional status in patients with heart failure with reduced ejection fraction - cross-sectional study. 射血分数降低型心力衰竭患者体内可溶性 ST2 浓度与营养状况的相关性--横断面研究。
Pub Date : 2024-05-14 DOI: 10.5603/cj.96062
Marta Kałużna-Oleksy, Filip Waśniewski, Magdalena Szczechla, Filip Sawczak, Agata Kukfisz, Helena Krysztofiak, Katarzyna Przytarska, Ewa Straburzyńska-Migaj, Magdalena Dudek

Background: Heart failure (HF) is a global problem that stimulates research on markers associated with the diagnosis and course of the disease. Soluble suppression of tumorigenicity-2 (sST2) is a receptor for interleukin-33 and is associated with increased mortality rates in HF patients. Malnutrition in HF is also connected with inflammation and is associated with worse prognosis. The present study aimed to evaluate the relationship between sST2 concentration and the nutritional status of patients with HF with reduced ejection fraction (HFrEF).

Material and methods: 138 patients with HFrEF were enrolled in this cross-sectional study. Nutritional status was assessed using Geriatric Nutritional Risk Index (GNRI) and Controlling Nutritional Status (CONUT). The mean age was 53.6 ± 10.8 years.

Results: In the group with sST2 > 32.9 ng/mL, the GNRI score was higher and the associated risk of malnutrition was more common (29% vs. 12%; p = 0.011). Coherently in the group with sST2 > 32.9 ng/mL the median CONUT score was worse (2 [IQR 1-3] vs. 1 [IQR 0-2]; p = 0.0016) and the risk of malnutrition defined by this tool was also more prevalent (p = 0.0079). This relationship was independent of the concentration of natriuretic peptides, age and sex.

Conclusions: According to available research, this research is the first study showing that sST2 concentration is related with nutritional status in HFrEF patients. sST2 may help to evaluate the necessity for nutritional intervention in HFrEF patients.

背景:心力衰竭(HF)是一个全球性问题,促使人们对与该疾病诊断和病程相关的标志物进行研究。可溶性抑制肿瘤生成-2(sST2)是白细胞介素-33的受体,与心力衰竭患者死亡率的增加有关。心房颤动患者营养不良也与炎症有关,并与预后恶化相关。本研究旨在评估 sST2 浓度与射血分数降低的心房颤动患者(HFrEF)营养状况之间的关系。营养状况采用老年营养风险指数(GNRI)和营养控制状况(CONUT)进行评估。平均年龄为 53.6 ± 10.8 岁:在 sST2 > 32.9 纳克/毫升的组中,GNRI 分数更高,营养不良的相关风险也更常见(29% 对 12%;P = 0.011)。同样,在 sST2 > 32.9 纳克/毫升的组别中,CONUT 中位数得分更低(2 [IQR 1-3] vs. 1 [IQR 0-2];p = 0.0016),该工具定义的营养不良风险也更普遍(p = 0.0079)。这种关系与钠尿肽浓度、年龄和性别无关:根据现有研究,该研究首次表明 sST2 浓度与高房颤患者的营养状况有关。
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引用次数: 0
Effect of COVID-19 on the prevalence of bystanders performing cardiopulmonary resuscitation: A systematic review and meta-analysis. COVID-19 对旁观者实施心肺复苏率的影响:系统回顾和荟萃分析。
Pub Date : 2024-01-22 DOI: 10.5603/cj.98616
Artur Krawczyk, Krzysztof Kurek, Gabriella Nucera, Michal Pruc, Damian Swieczkowski, Dawid Kacprzyk, Ewa Skrzypek, Nicola Luigi Bragazzi, Kamil Safiejko, Lukasz Szarpak

Background: The importance of bystander cardiopulmonary resuscitation (CPR) during out-of-hospital cardiac arrests is especially important in the context of coronavirus disease 2029 (COVID-19) because it can significantly influence survival outcomes. The objective of this meta-analysis was to examine the primary outcomes of bystander CPR during the pandemic and pre-pandemic periods.

Methods: A search was conducted in the PubMed Central, Scopus, and EMBASE databases, as well as the Cochrane Central Register of Controlled Trials database, up to December 10, 2023. In cases where the value of I² was greater than or equal to 50% or the Q-test indicated that the p-value was less than or equal to 0.05, the studies were considered to be heterogeneous. Sensitivity assessment was performed using the leave-one-out methodology. The study protocol was registered in PROSPERO with the ID number CRD42023494912.

Results: Twenty-five articles were included in this meta-analysis. Pooled analysis showed that bystander CPR frequency during the COVID-19 pandemic was 38.8%, compared to 44.8% for the pre-pandemic period (odds ratio: 1.04; 95% confidence interval: 0.93-1.16; p = 0.48).

Conclusions: The article's conclusions indicate that the COVID-19 pandemic influenced a reduction in bystander CPR compared to the pre-pandemic period, but this difference was not statistically significant. Further research is recommended to understand attitudes, including the fears of witnesses, before performing CPR on patients with suspected or confirmed infectious diseases. The study highlights the importance of bystander intervention in emergency situations and the impact of a pandemic on public health response behaviors.

背景:院外心脏骤停时旁观者心肺复苏(CPR)的重要性在冠状病毒疾病 2029(COVID-19)的背景下尤为重要,因为它能显著影响生存结果。本荟萃分析旨在研究大流行期间和大流行前旁观者心肺复苏的主要结果:方法:在 PubMed Central、Scopus 和 EMBASE 数据库以及 Cochrane Central Register of Controlled Trials 数据库中进行检索,检索时间截至 2023 年 12 月 10 日。如果 I² 值大于或等于 50%,或 Q 检验表明 p 值小于或等于 0.05,则认为研究具有异质性。敏感性评估采用 "留一剔除 "方法进行。研究方案已在 PROSPERO 注册,ID 号为 CRD42023494912:本次荟萃分析共纳入 25 篇文章。汇总分析显示,在 COVID-19 大流行期间,旁观者心肺复苏的频率为 38.8%,而在大流行前为 44.8%(几率比:1.04;95% 置信区间:0.93-1.16;P = 0.48):文章的结论表明,受 COVID-19 大流行的影响,旁观者心肺复苏与大流行前相比有所减少,但这一差异在统计学上并不显著。建议开展进一步研究,以了解对疑似或确诊传染病患者实施心肺复苏前的态度,包括目击者的恐惧。这项研究强调了在紧急情况下旁观者干预的重要性以及大流行对公共卫生应对行为的影响。
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引用次数: 0
Murray law-based quantitative flow ratio for assessment of nonculprit lesions in patients with ST-segment elevation myocardial infarction. 基于默里定律的定量血流比率用于评估 ST 段抬高型心肌梗死患者的非病灶。
Pub Date : 2024-01-01 Epub Date: 2024-07-08 DOI: 10.5603/cj.93499
Xinjian Li, Lin Mi, Juntao Duan, Liyuan Tao, Xinye Xu, Guisong Wang

Introduction: Revascularization of nonculprit arteries in patients with ST-Segment Elevation Myocardial Infarction (STEMI) is now recommended based on several trials. However, the optimal therapeutic strategy of nonculprit lesions remains unknown. Murray law-based Quantitative Flow Ratio (μQFR) is a novel, non-invasive, vasodilator-free method for evaluating the functional severity of coronary artery stenosis, which has potential applications for nonculprit lesion assessment in STEMI patients.

Material and methods: Patients with STEMI who received staged PCI before hospital discharge were enrolled retrospectively. μQFR analyses of nonculprit vessels were performed based on both acute and staged angiography.

Results: Eighty-four patients with 110 nonculprit arteries were included. The mean acute μQFR was 0.76 ± 0.18, and the mean staged μQFR was 0.75 ± 0.19. The average period between acute and staged evaluation was 8 days. There was a good correlation (r = 0.719, P < 0.001) between acute μQFR and staged μQFR. The classification agreement was 89.09%. The area under the receiver operator characteristic (ROC) curve for detecting staged μQFR ≤ 0.80 was 0.931.

Conclusions: It is feasible to calculate the μQFR during the acute phase of STEMI patients. Acute μQFR and staged μQFR have a good correlation and agreement. The μQFR could be a valuable method for assessing functional significance of nonculprit arteries in STEMI patients.

导言:根据多项试验,目前推荐对 ST 段抬高型心肌梗死(STEMI)患者的非微血管动脉进行血管重建。然而,非微血管病变的最佳治疗策略仍是未知数。基于默里定律的定量血流比(μQFR)是一种新型、无创、无血管扩张剂的冠状动脉狭窄功能严重程度评估方法,有望应用于 STEMI 患者的非微小病变评估:根据急性和分期血管造影对非冠状动脉血管进行μQFR分析:结果:共纳入 81 名患者,110 条非微创动脉。急性期平均μQFR为0.76 ± 0.18,分期平均μQFR为0.75 ± 0.19。急性期和分期评估之间的平均间隔时间为 8 天。急性μQFR与分期μQFR之间存在良好的相关性(r = 0.719,P < 0.001)。分类一致性为 89.09%。检测分期μQFR≤0.80的接收者操作者特征曲线下面积为0.931:在 STEMI 患者的急性期计算 μQFR 是可行的。急性期μQFR与分期μQFR具有良好的相关性和一致性。μQFR可能是评估STEMI患者非冠状动脉功能重要性的一种有价值的方法。
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引用次数: 0
SELECT semaglutide to improve outcomes in patients with obesity and cardiovascular disease, also without diabetes. SELECT semaglutide 可改善肥胖和心血管疾病患者(也包括非糖尿病患者)的治疗效果。
Pub Date : 2024-01-01 Epub Date: 2024-09-17 DOI: 10.5603/cj.102158
Grzegorz Gajos
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引用次数: 0
Veno-arterial extracorporeal membrane oxygenation circuit as second vascular access for transcatheter aortic valve replacement. 静脉-动脉体外膜氧合回路作为经导管主动脉瓣置换术的第二血管通路。
Pub Date : 2024-01-01 DOI: 10.5603/cj.97144
Raphaël Giraud, Benjamin Assouline, Nils Perrin, Karim Bendjelid, Stéphane Noble
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引用次数: 0
Electrocardiogram recording vest: A useful tool in explaining recurrent syncope. 心电图记录背心:解释反复晕厥的有用工具。
Pub Date : 2024-01-01 Epub Date: 2023-12-28 DOI: 10.5603/cj.87231
Justyna Suchecka, Michał Świątczak, Mikołaj Młyński, Ludmiła Daniłowicz-Szymanowicz, Dariusz Kozłowski
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引用次数: 0
Low-temperature electrocautery for high-risk cardiac implantable electronic device procedures. 用于高风险心脏植入式电子装置手术的低温电烧。
Pub Date : 2024-01-01 Epub Date: 2023-12-27 DOI: 10.5603/cj.94123
Maciej Dyrbuś, Anna Kurek, Katarzyna Sokoła, Jacek T Niedziela, Mateusz Ostręga, Daniel Cieśla, Mariusz Gąsior, Mateusz Tajstra
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引用次数: 0
Lipoprotein(a): an important consideration for DAPT therapy after PCI. 脂蛋白(a):PCI 后 DAPT 治疗的重要考虑因素。
Pub Date : 2024-01-01 DOI: 10.5603/cj.98494
Kongyong Cui, Kefei Dou
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引用次数: 0
The role of the neutrophil-lymphocyte ratio in predicting poor outcomes in COVID-19 patients. 中性粒细胞-淋巴细胞比值在预测 COVID-19 患者不良预后中的作用。
Pub Date : 2024-01-01 Epub Date: 2023-12-27 DOI: 10.5603/cj.98214
Raymond Farah, Rola Khamisy-Farah, Kacper Dziedzic, Ewa Skrzypek, Michal Pruc, Nicola Luigi Bragazzi, Lukasz Szarpak, Mahmoud Jomah

Background: This study examines how the neutrophil-lymphocyte ratio (NLR) predicts coronavirus disease 2019 (COVID-19) hospitalization, severity, length, and mortality in adult patients.

Methods: A study was done using a retrospective, single-center, observational design. A total of 400 patients who were admitted to the Ziv Medical Center (Safed, Israel) from April 2020 to December 2021 with a confirmed diagnosis of COVID-19 through RT-PCR testing were included in the analysis. Two complete blood count laboratory tests were conducted for each patient. The first test was administered upon admission to the hospital, while the second test was conducted prior to the patient's discharge from the hospital or a few days before their death.

Results: Four hundred patients were included in the study, 206 males (51.5%) and 194 females (48.5%). The mean age was 64.5 ± 17.1 years. In the group of cases, there were 102 deaths, and 296 survivors were recorded, with a fatality rate of 25.5%. The median NLR was 6.9 ± 5.8 at the beginning of hospitalization and 15.1 ± 32.9 at the end of hospitalization (p < 0.001). The median length of hospital stay was 9.4 ± 8.8 days. NLR in the fatality group was 34.0 ± 49.9 compared to 8.4 ± 20.4 in the survivor group (p < 0.001). Comparison between the NLR at the time of admission of the patient and before discharge/death was 6.9 ± 5.8 vs. 15.1 ± 32.9 (p < 0.001).

Conclusions: The analyses conducted revealed a statistically significant correlation between the NLR and the severity, mortality rates, and the duration of hospitalization. The consideration of NLR should commence during the initial phases of the disease when assessing individuals afflicted with COVID-19.

背景:本研究探讨了中性粒细胞-淋巴细胞比值(NLR)如何预测2019年冠状病毒病(COVID-19)成年患者的住院时间、严重程度、病程和死亡率:研究采用回顾性、单中心、观察性设计。共有 400 名患者在 2020 年 4 月至 2021 年 12 月期间入住 Ziv 医疗中心(以色列萨菲德),并通过 RT-PCR 检测确诊感染 COVID-19。对每位患者进行了两次全血细胞计数实验室检测。第一次检测在患者入院时进行,第二次检测在患者出院前或死亡前几天进行:研究共纳入 400 名患者,其中男性 206 名(51.5%),女性 194 名(48.5%)。平均年龄为 64.5 ± 17.1 岁。病例组中有 102 人死亡,296 人存活,死亡率为 25.5%。住院初期的中位 NLR 为 6.9 ± 5.8,住院末期为 15.1 ± 32.9(P < 0.001)。住院时间中位数为 9.4 ± 8.8 天。死亡组的 NLR 为 34.0 ± 49.9,而存活组为 8.4 ± 20.4(P < 0.001)。患者入院时和出院/死亡前的 NLR 比较为 6.9 ± 5.8 vs. 15.1 ± 32.9(p < 0.001):分析表明,NLR 与病情严重程度、死亡率和住院时间之间存在统计学意义上的显著相关性。在评估 COVID-19 患者时,应从疾病的初期阶段开始考虑 NLR。
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引用次数: 0
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Cardiology journal
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