Renal dysfunction and long-term risk of ischemic and hemorrhagic stroke following coronary artery bypass grafting.

Background: Renal dysfunction is associated with increased long-term mortality and incidence of myocardial infarction following coronary artery bypass grafting (CABG). Little is known about the relationship between renal dysfunction and long-term risk of stroke following CABG.

Methods And Results: All 29 057 patients who underwent primary isolated CABG from 2000 through 2008 in Sweden, with no myocardial infarction within 14 days before surgery and no prior stroke, were included from the SWEDEHEART registry.

Reduced expression of NLRP3 and MEFV in human ischemic heart tissue.

The innate immune system and, in particular, activation of the multi-protein complex known as the inflammasome complex are involved in ischemic injury in myocardial cells. The nucleotide-binding leucine-rich repeat-containing pyrin receptor 3 (NLRP3) inflammasome has been linked to inflammation and NLRP3 is especially important for increased inflammation in atherosclerosis, which may lead to myocardial infarction. Here we investigated how inflammasome molecules are affected in human ischemic heart tissue.

Sampling conditions influence multiple electrode platelet aggregometry in cardiac surgery patients.

Objectives: To investigate the importance of blood sampling conditions for multiple electrode platelet aggregometry (MEA) in cardiac surgery patients.

Design: Eighty-one patients undergoing first time CABG surgery were included in three prospective, observational studies. MEA was used to analyze platelet aggregability after addition of adenosine-diphosphate (ADP) or thrombin activating peptide 6 (TRAP).

Prevalence, indications and appropriateness of antiplatelet therapy in patients operated for acute aortic dissection: associations with bleeding complications and mortality.

Objective: To assess the prevalence, indications and appropriateness of antiplatelet therapy in patients operated for acute aortic dissection and its associations with bleeding complications and mortality.

Design: A retrospective single-centre study comparing patients with and without ongoing antiplatelet therapy.

Setting: University Hospital in Western Sweden.

Prospective longitudinal study of thromboelastography and standard hemostatic laboratory tests in healthy women during normal pregnancy.

Background: Hemostatic disorders are common in obstetric complications. Thromboelastography (TEG®) simultaneously measures coagulation and fibrinolysis within 10 to 20 minutes. Our primary aim in this prospective longitudinal study was to obtain knowledge about physiological changes in TEG® variables during normal pregnancy and 8 weeks postpartum.

High expression of arachidonate 15-lipoxygenase and proinflammatory markers in human ischemic heart tissue.

A common feature of the ischemic heart and atherosclerotic plaques is the presence of hypoxia (insufficient levels of oxygen in the tissue). Hypoxia has pronounced effects on almost every aspect of cell physiology, and the nuclear transcription factor hypoxia inducible factor-1α (HIF-1α) regulates adaptive responses to low concentrations of oxygen in mammalian cells. In our recent work, we observed that hypoxia increases the proinflammatory enzyme arachidonate 15-lipoxygenase (ALOX15B) in human carotid plaques.

Monitoring of acetyl salicylic acid-induced platelet inhibition with impedance aggregometry in children with systemic-to-pulmonary shunts.

Background: Shunt thrombosis after implantation of systemic-to-pulmonary shunts in paediatric patients is common. Acetyl salicylic acid is used for anti-thrombotic treatment; however, the effect is rarely monitored, although it is known that the response varies. The aim was to determine the effects of acetyl salicylic acid medication on platelet aggregation in children with systemic-to-pulmonary shunts.

Left atrium of the human adult heart contains a population of side population cells.

Cardiac "side population" (SP) cells have previously been found to differentiate into both endothelial cells and cardiomyocytes in mice and rats, but there are no data on SP cells in the human adult heart. Therefore, human cardiac atrial biopsies were dissociated, stained for SP cells and analyzed with FACS. Identified cell populations were analyzed for gene expression by quantitative real-time PCR and subjected to in vitro differentiation.

Sustained heparin effect contributes to reduced plasma thrombin generation capacity early after cardiac surgery.

Introduction: Thrombin is a key component in the coagulation cascade, and impaired thrombin generation has been linked to increased bleeding after surgical procedures. The aim was to evaluate postoperative thrombin generation capacity in plasma after cardiac surgery, and its potential associations to activity of individual coagulation factors and heparin.

Material And Methods: Forty-eight coronary artery bypass grafting patients were included in a prospective observational cohort study.

Comparison of human cardiac gene expression profiles in paired samples of right atrium and left ventricle collected in vivo.

Studies of expressed genes in human heart provide insight into both physiological and pathophysiological mechanisms. This is of importance for extended understanding of cardiac function as well as development of new therapeutic drugs. Heart tissue for gene expression studies is generally hard to obtain, particularly from the ventricles.

Small calibre biosynthetic bacterial cellulose blood vessels: 13-months patency in a sheep model.

Objectives: Many patients in need of bypass surgery lack graft material and current synthetic alternatives have poor performance. A 4 mm vascular graft composed of bacterial cellulose (BC) was developed and tested in pilot study in a large animal model.

Design: BC is a biopolymer made by the bacteria acetobacter xylinum.

The VLDL receptor promotes lipotoxicity and increases mortality in mice following an acute myocardial infarction.

Impaired cardiac function is associated with myocardial triglyceride accumulation, but it is not clear how the lipids accumulate or whether this accumulation is detrimental. Here we show that hypoxia/ischemia-induced accumulation of lipids in HL-1 cardiomyocytes and mouse hearts is dependent on expression of the VLDL receptor (VLDLR). Hypoxia-induced VLDLR expression in HL-1 cells was dependent on HIF-1α through its interaction with a hypoxia-responsive element in the Vldlr promoter, and VLDLR promoted the endocytosis of lipoproteins.

Acute aortic dissection in a patient with extremely low body mass index due to anorexia nervosa.

We report a case of successful surgical repair of an acute aortic dissection (Stanford Type A) in a severely malnourished 39-year old patient with anorexia nervosa (body mass index [BMI] 11.3 kg/m2) and essential hypertension. The case is of interest since 1) acute aortic dissection in patients with anorexia nervosa has not previously been described; 2) hypertension is extremely rare in patients with eating disorders; and 3) successful aortic repair in a patient with so low BMI has not been reported before.

Strategic Challenges of PMTCT Program Implementation in Ethiopia.

Objectives: The objective of this study is to evaluate the achievement of the prevent mother-to-child transmission (PMTCT) program and to describe the strategic challenges of its implementation in the the Oromia region, Ethiopia.

Methods: PMTCT program reports were collected over a period of 12 months from 25 zones of Oromia region. The health facilities in these zones include 28 hospitals and 84 health centers.

Barriers to antiretroviral treatment in ethiopia: a qualitative study.

Objective: Ethiopia has made meaningful headway in improving access to HIV care and treatment but client attrition remains a daunting challenge. The objective of this study was to describe the major reasons of patient attrition from treatment at hospital and health center levels in Oromia region of Ethiopia.

Methods: This qualitatively designed study was based on semistructured interview with antiretroviral therapy (ART) service providers and focus group discussions with ART clients.

Dilatation of the pulmonary autograft and native aorta after the Ross procedure: a comprehensive echocardiographic study.

Objectives: Dilatation of the pulmonary autograft has been observed after the Ross procedure. Whether the remaining native aorta dilates is not known. The aim of the study was to describe the prevalence and severity of autograft and native aortic dilatation over time and to identify possible determinants.

Weight after childbirth: a 2-year follow-up of obese women in a weight-gain restriction program.

Objective: To investigate the effects of a weight-gain restriction program on weight development or weight maintenance 2 years after childbirth.

Design: A case-control intervention study.

Setting: Antenatal care clinics in the southeast of Sweden.

Survival and quality of life after aortic root replacement with homografts in acute endocarditis.

Background: Treatment of prosthetic aortic valve endocarditis and native aortic valve endocarditis with abscess formation is associated with high mortality and morbidity. Aortic root replacement with a freestanding aortic homograft is an attractive alternative. We report outcome and quality of life after homograft replacement for infective endocarditis.

Preoperative fibrinogen plasma concentration is associated with perioperative bleeding and transfusion requirements in scoliosis surgery.

Study Design: Prospective observational study.

Objective: To investigate the potential association between fibrinogen, bleeding, and transfusion requirements after scoliosis surgery.

Summary Of Background Data: Bleeding complications during and after orthopedic surgery are associated with increased morbidity and mortality.

Intraoperative thromboelastometry is associated with reduced transfusion prevalence in pediatric cardiac surgery.

Background: The majority of pediatric cardiac surgery patients receive blood transfusions. We hypothesized that the routine use of intraoperative thromboelastometry to guide transfusion decisions would reduce the overall proportion of patients receiving transfusions in pediatric cardiac surgery.

Methods: One hundred pediatric cardiac surgery patients were included in the study.