Shaping classroom social experiences through collaborative small-group discussions.

Background: Students form interpersonal and intrapersonal classroom social experiences with peers. While diverse intervention programmes have been developed, few have integrated social-emotional learning into academic activities to maximize the potential for learning and development.

Aims: This study examined the effects of collaborative small-group discussions on students' classroom social experiences at the interpersonal and intrapersonal levels.

Teacher Scaffolding of Social and Intellectual Collaboration in Small Groups: A Comparative Case Study.

This comparative case study features two small groups of students engaging in collaborative dialog about social issues. Based on social constructivist theories, the two groups were compared across three major components of the small groups system: social dynamics, intellectual collaboration, and teacher scaffolding. Our goal was to holistically analyze these small group processes to understand why some small groups were highly successful while others were not, even within the same intervention and with the same teacher.

Acute kidney injury after transcatheter aortic valve implantation: Impact of contrast agents, predictive factors, and prognostic importance in 203 patients with long-term follow-up.

Background: Acute kidney injury (AKI) frequently occurs following transcatheter aortic valve implantation (TAVI) and has been related to a worse outcome. We investigated the importance of contrast medium composition, either iso-osmolar (IOCM) or low-osmolar (LOCM) and assessed predictors for AKI after TAVI.

Methods And Results: We assessed AKI in 203 TAVI patients treated mainly with trans-femoral implantation and analgosedation.

Transcatheter aortic valve implantation in patients with severely reduced left ventricular systolic function: a single-center experience.

Aims: Current guidelines consider severe systolic left ventricular dysfunction [ejection fraction (EF) ≤20 %; left ventricular dysfunction (LVD)] a contraindication for transcatheter aortic valve implantation (TAVI). The purpose of this study was to evaluate the efficacy and safety of TAVI in this extreme risk subset of patients.

Methods And Results: The study population (253 patients) was divided into two groups; the LVD group [21 patients with left ventricular ejection fraction (LVEF) ≤20 %] and the control group (232 patients with LVEF >20 %).

[Atrial myxoma with clinical signs of systemic inflammatory disease].

Atrial myxomas are detectable in 0.3 % of all autopsies and women are affected three times more often than men. The overall incidence of myxoma is relatively rare with 0.

Transmyocardial laser revascularization combined with intramyocardial endothelial progenitor cell transplantation in patients with intractable ischemic heart disease ineligible for conventional revascularization: preliminary results in a highly selected small patient cohort.

Objective: Transmyocardial laser revascularization for angina relief and intramyocardial autologous endothelial progenitor cell injection for neoangiogenesis may offer a new treatment strategy for patients with intractable ischemic heart disease.

Methods: Transmyocardial laser revascularization and intramyocardial injection of bone marrow-derived CD133+ cells was performed in six highly symptomatic patients. Transmyocardial laser channels were created and isolated CD133+ cells were injected intramyocardially.

Impact of progressive sinotubular junction dilatation on valve competence of the 3F Aortic and Sorin Solo stentless bioprosthetic heart valves.

Objective: The use of stentless bioprostheses for aortic valve replacement provides excellent haemodynamics; however, these valves bear the potential risk of progressive regurgitation over time. To overcome this disadvantage, a new generation of pericardial stentless prostheses has been developed. This study aims to assess the tolerance of such bioprotheses against progressive sinotubular junction dilatation.

Twenty-four-hour holter monitor follow-up does not provide accurate heart rhythm status after surgical atrial fibrillation ablation therapy: up to 12 months experience with a novel permanently implantable heart rhythm monitor device.

Background: Twenty-four-hour Holter monitoring (24HM) is commonly used to assess cardiac rhythm after surgical therapy of atrial fibrillation (AF). However, this "snapshot" documentation leaves a considerable diagnostic window and only stores short-time cardiac rhythm episodes. To improve accuracy of rhythm surveillance after surgical ablation therapy and to compare continuous heart rhythm surveillance versus 24HM follow-up intraindividually, we evaluated a novel implantable continuous cardiac rhythm monitoring (IMD) device (Reveal XT 9525).

Quantification of microembolic signals during transmyocardial laser revascularization.

Transmyocardial laser revascularization (TMLR) is known to induce cerebral microembolic signals (MES). We quantified laser induced MES in patients undergoing TMLR during cardiopulmonary bypass for coronary artery bypass grafting (group A) and during TMLR treatment alone (group B). The total number of MES during a single laser application with identical energy was significantly higher in group A compared to group B (P<0.

Analysis of the myocardial metabolism by microdialysis during open beating heart surgery.

Objectives: Microdialysis allows the in vivo biochemical analysis of interstitial fluids. Our aim was to reveal in vivo reliable data of the myocardium during open beating heart surgery.

Design: In ten patients undergoing routine beating coronary artery bypass grafting a microdialysis catheter was inserted into the left ventricle.

High myocardial lactate concentration is associated with poor myocardial function prior to cardiopulmonary bypass.

Aim: This study was designed to analyse the relationship between myocardial lactate--determined by microdialysis--and hemodynamics during coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB).

Methods: Twenty consecutive patients with coronary artery disease were enrolled for this prospective, observational study. Microdialysis measurements were performed in the apical region of the heart during periods of 15 to 20 min before, during, and after CPB; hemodynamics and plasma lactate concentrations were determined correspondingly.

The extent of akinesis is predictive of the in-hospital mortality from endoaneurysmorrhaphy.

Endoaneurysmorrhaphy (EAR) has become an important therapeutic option in the treatment of patients with left ventricular (LV) aneurysm and congestive heart failure. Today, more and more patients are referred for EAR with a dilated akinetic LV rather than a classic dyskinetic LV aneurysm. Little is known about the contribution of the extent of akinesis to perioperative mortality.

Intramyocardial oxygen monitoring in coronary artery bypass surgery.

Objective: In coronary artery bypass surgery various parameters have been used to monitor patients clinical status. Direct monitoring of myocardial oxygenation can be performed by measuring intramyocardial partial oxygen tension pressure (p ti O2). This study was performed to determine the perioperative time course of this parameter in correlation to standard monitoring parameters.

The relationship between urotensin II plasma immunoreactivity and left ventricular filling pressures in coronary artery disease.

The role of urotensin II (U-II)--a vasoactive, mitogenic, and inotropic, peptide--in the pathophysiology of heart failure is controversial. The present study explores the relationship between plasma U-II immunoreactivity (U-IIIR) and hemodynamics in patients with coronary artery disease (CAD). Thirty-six patients with CAD-3 undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) and 36 medical patients (MED group) with CAD-1 to CAD-3 during right heart catheterization were studied.

Strategies for the reduction of cerebral microembolism during transmyocardial laser revascularization.

Background And Objectives: During transmyocardial laser revascularization (TMLR), multiple microembolic signals (MES) can be detected in cerebral arteries. We sought to characterize composition and clinical relevance of these MES and to evaluate strategies to reduce cerebral microembolization during TMLR.

Study Design/materials And Methods: TMLR was performed in pigs.

High incidence of sudden death late after anterior LV-aneurysm repair.

Objectives: Sudden death due to ventricular arrhythmias occurs frequently among patients with dilated cardiomyopathy and congestive heart failure (CHF). In patients with left ventricular (LV) aneurysms, LV-aneurysm repair (LVAR) reduces LV-size and ameliorates symptoms of CHF, but the incidence of late sudden death is unknown, especially after LVAR without concomitant anti-arrhythmic therapy.

Methods: Between June 1993 and June 1999, 147 patients (70% males; 62+/-9 years) with CHF (median: NYHA III) due to anterior LV-aneurysms underwent LVAR.

Myocardial redox state during coronary artery bypass grafting assessed with microdialysis.

Purpose: Microdialysis allows the biochemical analysis of interstitial fluids of nearly every organ as a bedside procedure. This technique could be useful to reveal data about the myocardial metabolism during cardiopulmonary bypass in human coronary artery bypass graft (CABG) surgery.

Methods: In 17 patients undergoing CABG a myocardial microdialysis catheter (CMA 70, CMA/Microdialysis AB, Sweden) was inserted in the apical region of the beating heart.

Results of endoaneurysmorrhaphy: does the location of the aneurysm matter?

Endoaneurysmorrhaphy is mostly performed on anterior-septal left ventricular (LV) aneurysms. It may also be applied to posterior aneurysms, which is technically more challenging. Whether the surgical risk is the same, irrespective of the location of the aneurysm, has not been studied before.

Intramyocardial partial oxygen pressure in patients undergoing transmyocardial laser revascularization and bypass surgery.

Objective: Numerous investigations could not clarify the exact mechanism of transmyocardial laser revascularization (TMLR). The aim of this study was to investigate, whether TMLR leads to an increase of myocardial oxygenation in comparison to patients undergoing coronary artery bypass grafting (CABG).

Design: Twelve patients (TMLR group) underwent TMLR alone with an 800 W CO2 laser through a left anterior thoracotomy.

Up to 7 years' experience with valve-sparing aortic root remodeling/reimplantation for acute type A dissection.

Background: Aortic valve-sparing operations for acute type A dissection are appealing and innovative but less well defined surgical techniques requiring further evaluation.

Methods: We reviewed all consecutive patients with acute type A dissection who underwent either the remodeling (group 1, n = 21) or the reimplantation valve-sparing technique (group 2, n = 15) since October 1994. Patients were followed up clinically and echocardiographically for as long as 41.

Norepinephrine release is reduced in cardiac tissue of Type 2 diabetic patients.

Aims/hypothesis: The aim of this study was to assess whether cardiac catecholamine release is affected in patients with Type 2 diabetes mellitus.

Methods: A trial tissue was obtained from 19 diabetic (Type 2) and 43 non-diabetic patients undergoing coronary surgery. Endogenous norepinephrine release was examined under baseline conditions as well as during electrical field stimulation (effective voltage 5 V, stimulation frequency 4 Hz, pulse width 2 msec) by high performance liquid chromatography and electrochemical detection.

Remifentanil-clonidine-propofol versus sufentanil-propofol anesthesia for coronary artery bypass surgery.

Objective: To compare a remifentanil-clonidine-propofol regimen with conventional sufentanil-propofol anesthesia.

Design: Randomized, nonblinded trial.

Setting: A single university hospital.

Lung protection during total cardiopulmonary bypass by isolated lung perfusion: preliminary results of a novel perfusion strategy.

Background: The present pilot study was conducted to evaluate the effect of isolated short-term lung perfusion during cardiopulmonary bypass (CPB) on inflammatory response and oxygenation.

Methods: A total of 24 patients undergoing elective cardiac surgery with routine CPB were prospectively assigned to three groups. Group I (n = 7), control subjects receiving neither lung perfusion nor ultrafiltration; group II (n = 9), patients undergoing lung perfusion; and group III (n = 8), patients undergoing lung perfusion plus ultrafiltration.

The structure of health and illness in a Brazilian favela.

The purpose of this study was to describe the understanding of health and illness within the culture of women living in a favela (urban slum) in southeastern Brazil. The methodology described by Spradley structured the study. Interviews were conducted with 10 informants, and multiple interviews were conducted with the key informant.