Improving Sternal Closure Outcomes in Cardiac Surgery: Polyethylene Suture Tapes vs. Steel Wires.

Steel wires are often inadequate for sternal closure for patients at high risk of sternal complications. This study compares a novel sternal closure system to conventional steel wires to assess its potential to reduce sternal complication rates and improve clinical outcomes. A retrospective study was conducted on 300 consecutive patients undergoing cardiac surgery via median sternotomy.

Surgical Explantation of an Amplatzer Device for Patent Foramen Ovale Closure in a Patient With Nickel Allergy: A Case Report.

Patent foramen ovale (PFO) closure using percutaneous devices, such as the Amplatzer occluder, is a common treatment for patients with a history of cryptogenic stroke or transient ischemic attack (TIA). Although generally well-tolerated, some patients may develop adverse reactions to the device materials, particularly in the presence of a nickel allergy. Symptoms can include chest pain, rashes, and migraines, which may necessitate surgical removal of the device.

Surgical Management of a Ruptured Giant Right Coronary Artery Aneurysm With Fistulization.

Coronary artery aneurysms (CAAs) are an uncommon condition with severe long-term consequences. We describe the surgical treatment of a right CAA that manifested as a compressive mass adjacent to the right atrium. A 60-year-old female patient presented with mid-sternal chest discomfort and a CT scan showing a 6.

Safety and efficacy of S1P receptor modulators for the induction and maintenance phases in inflammatory bowel disease: A systematic review and meta-analysis of randomized controlled trials.

Background: Inflammatory bowel disease (IBD) is a chronic inflammatory condition that significantly affects quality of life. Conventional treatments have had limited success. this study evaluates the safety and efficacy of Sphingosine 1-phosphate receptor modulators (S1PrMs) as a potential treatment for IBD.

First-in-Man Use of Intraoperative Electrophysiological Mapping to Evaluate the Efficacy of the EnCompass Clamp During a Cox-IV Maze Procedure.

This case report describes the first-in-man use of intraoperative electrophysiological (EP) mapping to evaluate the efficacy of the EnCompass clamp (AtriCure, Inc., Mason, OH) during a Cox-IV Maze procedure. A 53-year-old male with paroxysmal atrial fibrillation and severe mitral valve regurgitation underwent mitral valve repair with concomitant surgical ablation for atrial fibrillation.

Concomitant Tricuspid Valve Ring Annuloplasty During Mitral Valve Surgery Versus Mitral Valve Surgery Alone: A Systematic Review and Meta-Analysis.

Aim: Although current guidelines recommend concomitant tricuspid annuloplasty for moderate or greater tricuspid regurgitation (TR) and/or dilated annulus, there remains significant variation in undertaking concomitant tricuspid valve surgery (TVA) across different centres. This meta-analysis aimed to compare the clinical outcomes of concomitant tricuspid valve surgery for patients with moderate or greater TR and/or dilated annulus at the time of mitral valve (MV) surgery.

Method: A systematic review of the literature using six databases.

Synergistic Effect of Transmyocardial Revascularization and Platelet-Rich Plasma on Improving Cardiac Function After Coronary Artery Bypass Grafting.

Background Coronary artery disease (CAD) is a global health burden, contributing to mortality and morbidity. A proportion of patients with CAD suffer from diffuse CAD, where conventional revascularization techniques such as percutaneous coronary intervention and coronary artery bypass grafting (CABG) may be insufficient to adequately restore myocardial perfusion. Transmyocardial revascularization (TMR) uses a laser to create microscopic channels in the myocardium, inducing inflammation, angiogenesis, and neovascularization to improve perfusion to ischemic regions.

Prophylactic Left Atrial Appendage Ligation During Coronary Artery Bypass Graft Surgery Allows Safe Avoidance of Anticoagulation Regardless of Postoperative Atrial Fibrillation.

Background New-onset postoperative atrial fibrillation (POAF) is the most common arrhythmia following cardiac surgery. POAF increases the risk of thromboembolism and stroke, as well as morbidity and mortality more generally. Despite evidence from the landmark PROTECT-AF and PREVAIL trials, left atrial appendage ligation (LAAL) is not routinely performed for thromboembolism prophylaxis in POAF, and anticoagulation remains the standard of care along with dual antiplatelet therapy.

Sternal Complications Following Coronary Artery Bypass Grafting and Robicsek Repair: Comprehensive Sternal Reconstruction With Sternal Plating and the Use of Novel Biologic Therapies.

Sternal non-union and fractured sternal wires are rare but devastating complications of median sternotomy for cardiac surgery, and these can lead to chronic pain, instability, and impaired quality of life. Patients may present with various symptoms such as clicking sensations, chest wall discomfort, and even respiratory difficulties. The underlying causes are multifactorial, including patient comorbidities, surgical technique, and postoperative management.

Epicardial placement of human placental membrane allografts in coronary artery bypass graft surgery is associated with reduced postoperative atrial fibrillation: a pilot study for a future multi-center randomized controlled trial.

Background: Post-operative atrial fibrillation (POAF) occurs in up to 40% of patients following coronary artery bypass grafting (CABG) and is associated with a higher risk of stroke and mortality. This study investigates how POAF may be mitigated by epicardial placement of aseptically processed human placental membrane allografts (HPMAs) before pericardial closure in CABG surgery. This study was conducted as a pilot feasibility study to collect preliminary for a forthcoming multi-center randomized controlled trial.

Anomalous Right Coronary Artery With Interarterial Course: Risk Stratification and Surgical Decision-Making Using Coronary Computed Tomography Angiography-Derived Fractional Flow Reserve.

An anomalous right coronary artery (RCA) takeoff, a rare congenital condition often characterized by an interarterial RCA course between the pulmonary artery and the ascending aorta, can lead to symptoms of angina pectoris (chest pain) or even sudden cardiac death (SCD) due to compression of the RCA, although most patients remain asymptomatic. In this case report, we highlight the utility of computed tomography angiography (CTA)-derived fractional flow reserve (FFR), a minimally invasive technique used to assess the hemodynamic significance of coronary lesions, in the risk stratification and surgical decision-making process for a 46-year-old female patient presenting with exertional dyspnea and an anomalous RCA takeoff with an interarterial course. The information obtained from this imaging modality was instrumental in determining that surgical repair did not need to be performed urgently and could be scheduled as an elective case in the future.

Pediatric Trauma Recidivism: A Statewide Risk Factor Analysis of the Maryland Health Services Cost Review Commission (HSCRC).

Background: National estimates suggest pediatric trauma recidivism is uncommon but are limited by short follow up and narrow ascertainment. We aimed to quantify the long-term frequency of trauma recidivism in a statewide pediatric population and identify risk factors for re-injury.

Methods: The Maryland Health Services Cost Review Commission Dataset was queried for 0-19-year-old patients with emergency department or inpatient encounters for traumatic injuries between 2013 and 2019.

Risk-based lung cancer screening performance in a universal healthcare setting.

Globally, lung cancer is the leading cause of cancer death. Previous trials demonstrated that low-dose computed tomography lung cancer screening of high-risk individuals can reduce lung cancer mortality by 20% or more. Lung cancer screening has been approved by major guidelines in the United States, and over 4,000 sites offer screening.

Revolutionizing Atrial Fibrillation Treatment: The Robotic Convergent Plus Procedure.

Atrial fibrillation (AF) is widely accepted to be the most common sustained arrhythmia, with an increasing incidence over time. This is thought to be due to the aging population across the world. AF occurs when abnormal electrical foci result in disorganization of atrial depolarization, though the exact pathophysiology leading to these abnormal foci is not well understood.

Combined effect of endophytic Bacillus mycoides and rock phosphate on the amelioration of heavy metal stress in wheat plants.

Background: Zinc (Zn) and nickel (Ni) are nutrients that are crucial for plant growth; however, when they are present at higher concentrations, they can cause toxicity in plants. The present study aimed to isolate plant growth promoting endophytic bacteria from Viburnum grandiflorum and assess its plant and defense promoting potential alone and in combination with RP in zinc (Zn) and nickel (Ni) toxic soil. The isolated endophytic bacteria were identified using 16s rRNA gene sequencing.

Multidisciplinary management of high-grade pediatric liver injuries.

Objective: To present our experience of multidisciplinary management of high-grade pediatric liver injuries.

Introduction: Pediatric high-grade liver injuries pose significant challenge to management due to associated morbidity and mortality. Emergency surgical intervention to control hemorrhage and biliary leak in these patients is usually suboptimal.

Heavy metals mitigation and growth promoting effect of endophytic (MW 979614) in maize plants under zinc and nickel contaminated soil.

Introduction: Heavy metals such as iron, copper, manganese, cobalt, silver, zinc, nickel, and arsenic have accumulated in soils for a long time due to the dumping of industrial waste and sewage. Various techniques have been adapted to overcome metal toxicity in agricultural land but utilizing a biological application using potential microorganisms in heavy metals contaminated soil may be a successful approach to decontaminate heavy metals soil. Therefore, the current study aimed to isolate endophytic bacteria from a medicinal plant () and to investigate the growth-promoting and heavy metal detoxification potential of the isolated endophytic bacteria Agrococus tereus (GenBank accession number MW 979614) under nickel and zinc contamination.

Decolorization of multicomponent dye-laden wastewater by modified waste fly ash: a parametric analysis for an anionic and cationic combination of dyes.

In this research study, waste fly ash (WFA) underwent acid activation and subsequent amine functionalization using ammonia solution. This treatment improves the porosity, thermal tendency and crystallinity of WFA. Modified WFA was tested under different experimental conditions to treat the wastewater consisting of different concentrations of cationic (methylene blue and rhodamine 6G) and anionic (methyl orange) dyes.

Recurrent infection and embolism following tricuspid valve repair for infective endocarditis in an intravenous drug user: A clinical dilemma.

Management of infective endocarditis (IE) in intravenous drug users (IVDUs) can be challenging due to risk of reinfection following surgery. Although complex repair techniques that can be utilized to reconstruct the tricuspid valve after extensive debridement, treatment of active IVDU is incomplete without effective post-operative harm reduction intervention program.

Surfactant modified waste ash for the removal of chloro and nitro group substituted benzene from wastewater.

A surfactant-modified coal fly ash was developed as a multifunctional adsorbent for the removal of organic pollutants from wastewater. Sodium dodecyl sulfate (SDS) was used to modify the surface of coal fly ash (CFA). The modified CFA was characterized using scanning electron microscopy (SEM), surface porosity analyzer, thermogravimetric analysis (TGA) and Fourier transform infrared (FTIR) spectroscopy.

Effectiveness of Community Pharmacy Diabetes and Hypertension Care Program: An Unexplored Opportunity for Community Pharmacists in Pakistan.

The effective management of patients diagnosed with both Diabetes as well as Hypertension is linked with administration of efficacious pharmacological therapy as well as improvement in adherence through counseling and other strategies. Being a part of primary healthcare team, community pharmacists can effectively provide patient care for chronic disease management. The objective of the study was to evaluate the impact of pharmacist counseling on blood pressure and blood glucose control among patients having both hypertension and diabetes attending community pharmacies in Pakistan.