Texas Heart Institute journal
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Case Reports
Pericardial tamponade consequent to a dynamite explosion: blast overpressure injury without penetrating trauma.
Acute cardiac tamponade is a life-threatening emergency that requires prompt treatment by either percutaneous or surgical pericardiocentesis. It may occur after penetrating or blunt chest trauma. ⋯ Physicians should be aware of the possibility of pericardial tamponade in victims of barotraumatic events such as dynamite or bomb explosions, even in the absence of penetrating trauma. Cardiac tamponade, although life-threatening, is easy to treat when recognized.
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There are few published reports of the results of supravalvular aortic stenosis correction with the use of Brom's 3-patch technique. Herein, we report our use of this procedure and the short-term results therefrom. From 2002 through 2007, 9 children underwent surgical correction of localized supravalvular aortic stenosis at our hospital. ⋯ In all 8 patients who survived, postoperative transaortic blood pressure gradients were improved (range, 0-16 mmHg), and no repeat operations were needed after 6 to 55 months' follow-up. We consider Brom's technique to be safe in the repair of supravalvular aortic stenosis. In our limited series, it produced effective anatomic restoration, with good short-term and potentially good long-term results.
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Review Meta Analysis
Statin therapy may influence the incidence of postoperative atrial fibrillation: what is the evidence?
Atrial fibrillation is the most common postoperative arrhythmia in patients who undergo cardiac surgery. We sought to determine whether the administration of statins reduces the incidence of postoperative atrial fibrillation in cardiac surgery patients. We performed a meta-analysis on all studies published between 2004 and 2008 that reported comparisons between statin treatment or nontreatment in these patients. ⋯ In studies wherein only coronary artery bypass grafting was performed, statin treatment decreased postoperative atrial fibrillation (OR, 0.64; 95% CI, 0.43-0.95). We conclude that statin administration results in a reduction in the incidence of atrial fibrillation in patients who undergo cardiac surgery. Further research into the underlying mechanism can elucidate possible relationships between the dosage and type of statin used.
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Multicenter Study
Progesterone levels and carotid intima-media thickness: a negative association in older northern Chinese men.
In experimental research, progesterone has been found to be beneficial to the central nervous and cardiovascular systems; however, its potential role in preventing atherosclerosis in elderly men remains unclear. In this prospective study, we analyzed data in 385 older men and women from 6 communities in Beijing, China, in order to discover whether progesterone is associated with carotid intima-media thickness and plaque occurrence. Intima-media thickness and atherosclerotic plaques were determined by use of ultrasonography. ⋯ However, no such association was found in women (P = 0.304 and P = 0.247, respectively). In the logistic regression model that was adjusted for the confounding factors of atherosclerosis, men with progesterone levels in the lowest quartile (<1.87 nmol/L) had more risk of higher intima-media thickness (odds ratio, 2.15; P = 0.042). Although further experimental and prospective studies are warranted in order to determine the mechanism of progesterone's function in atherosclerosis prevention, we conclude that progesterone concentrations are negatively associated with carotid artery atherosclerosis in northern Chinese men 60 years of age or older.