Heart, lung & circulation
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Heart, lung & circulation · Jan 2008
ReviewClinical practice guidelines for improving outcomes in sepsis.
Sepsis is a common medical condition resulting from an infectious stimulus with a variable inflammatory response leading to a spectrum of clinical conditions from mild constitutional symptoms to varying degrees of organ dysfunction and death. The understanding of the patho-physiology of sepsis has lead to better treatment modalities and whilst sepsis is an increasingly more common condition world wide, the mortality from sepsis is nevertheless falling. Treatment algorithms have been promulgated over the years and levels of evidence for these have varied. This review will focus on the early management issues recently updated and released by a multi-national panel of experts based on best evidence, aimed at reducing sepsis related mortality by 25%.
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Arterial grafting for coronary artery disease has been practiced routinely at the Epworth Hospital for 20 years. Bilateral versus single internal thoracic artery grafts is associated with improved survival, which progressively increased over the 20 years of post-surgery. ⋯ Current patency data suggest that there is a marginal advantage of radial artery over saphenous graft patency, particularly between 5 and 10 years after surgery. However, there appears to be improved patency of the saphenous vein when used as a coronary artery bypass with the advent of aspirin, lipid-lowering and anti-hypertensive therapy.
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Heart, lung & circulation · Jan 2005
ReviewAssessment of myocardial viability in ischemic cardiomyopathy.
The number of patients with ischemic cardiomyopathy has increased extensively over recent years. Therapies include medical treatment, cardiac transplantation, cardiac resynchronization therapy and surgery. In the diagnostic and prognostic work-up, the assessment of myocardial viability has become more important over time. ⋯ Over the years, different viability techniques have been developed. In this review, these techniques are discussed. Moreover, the value of these techniques for the prediction of not only improvement of function, but also improvement in exercise capacity, reverse LV remodeling, and long-term prognosis, is discussed.