The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jul 2013
Effect of intensive care unit environment on in-hospital delirium after cardiac surgery.
The etiology of postcardiac surgery delirium is complex. Our primary objective was to determine the effect of the postoperative environment on the prevalence of delirium by examining the in-hospital delirium rates in 2 postoperative intensive care units with differing physical infrastructure. We further sought to identify other risk factors associated with in-hospital delirium. ⋯ The intensive care unit environment did not have a significant effect on the overall prevalence of delirium. However, that does not preclude the possibility that the intensive care unit environment might interact with other factors, such as age, in a complex manner. Attempts to reduce delirium by adjusting the intensive care unit environment alone will likely not be sufficient, and instead will require a more comprehensive multimodal approach.
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J. Thorac. Cardiovasc. Surg. · Jul 2013
Comparative StudyRestraint to the left ventricle alone is superior to standard restraint.
In standard ventricular restraint therapy, a single level of restraint is applied to the entire ventricular surface. We showed previously that at high restraint levels, cardiac tamponade develops because of the thin-walled right ventricle, even while the left ventricle remains unaffected. We now hypothesize that applying restraint exclusively to the left ventricle permits higher levels of restraint, resulting in increased benefit to the left ventricle. ⋯ We showed previously that, with standard restraint, right ventricle tamponade develops at high restraint levels, limiting restraint therapy. We now show that restraint applied to the left ventricle alone permits increased restraint levels, without causing right ventricle or left ventricle tamponade, for greater therapeutic benefit. We conclude that partial left ventricle restraint may be more effective than standard restraint.
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J. Thorac. Cardiovasc. Surg. · Jul 2013
Comparative StudySolid tumors versus mixed tumors with a ground-glass opacity component in patients with clinical stage IA lung adenocarcinoma: prognostic comparison using high-resolution computed tomography findings.
This study aimed to compare malignant behavior and prognosis between solid tumors and mixed tumors with a ground-glass opacity component on high-resolution computed tomography. ⋯ Solid tumors exhibit more malignant behavior and have a poorer prognosis compared with mixed tumors, even when the solid component size is the same in both tumor types. However, differences in malignant behavior can be identified using maximum standardized uptake values determined by F-18-fluorodeoxyglucose positron emission tomography/computed tomography.