Former long-term use of combined hormonal contraception and glucose metabolism disorders in perimenopausal women: A prospective, population-based cohort study.

Introduction: Current use of combined hormonal contraceptives worsens glucose tolerance and increases the risk of type 2 diabetes mellitus at late fertile age, but the impact of their former use on the risk of glucose metabolism disorders is still controversial.

Material And Methods: This was a prospective, longitudinal birth cohort study with long-term follow-up consisting of 5889 women. The cohort population has been followed at birth, and at ages of 1, 14, 31 and 46.

Oral and Vaginal Hormonal Contraceptives Induce Similar Unfavorable Metabolic Effects in Women with PCOS: A Randomized Controlled Trial.

This clinical trial aims to compare hormonal and metabolic changes after a 9-week continuous use of oral or vaginal combined hormonal contraceptives (CHCs) in women with polycystic ovary syndrome (PCOS). We recruited 24 women with PCOS and randomized them to use either combined oral (COC, = 13) or vaginal (CVC, = 11) contraception. At baseline and 9 weeks, blood samples were collected and a 2 h glucose tolerance test (OGTT) was performed to evaluate hormonal and metabolic outcomes.

The Standard Point-of-Care Hemochron Jr. ACT+ Test in Monitoring Heparin Administration for Cardiopulmonary Bypass in Severe Factor XII Deficiency.

Coagulation factor XII (FXII) is a plasma serine protease that belongs to the contact activation complex responsible for initiating the intrinsic coagulation pathway. FXII deficiency is a rare congenital disorder that is not associated with an increased tendency for bleeding. However, as contact activation is impaired in FXII deficiency, both the celite- and kaolin-initiated activated clotting time (ACT) measurements are prolonged markedly, which poses a challenge for anticoagulation monitoring in patients undergoing cardiac surgery.

Current use of combined hormonal contraception is associated with glucose metabolism disorders in perimenopausal women.

Objective: The use of combined hormonal contraceptives (CHCs) worsens glucose tolerance, but the risk for glucose metabolism disorders remains controversial.

Design: The study is a prospective longitudinal population-based cohort study.

Methods: The study was based on a cohort population that comprised 1879 women born in 1966.

Outcome after procedures for retained blood syndrome in coronary surgery.

Objectives: Incomplete drainage of blood from around the heart and lungs can lead to retained blood syndrome (RBS) after cardiac surgery. The aim of this study was to assess the incidence of and the outcome after procedures for RBS in patients undergoing isolated coronary artery bypass grafting (CABG).

Methods: A total of 2764 consecutive patients who underwent isolated CABG from 2006 to 2013 were investigated retrospectively.

Validation of a New Classification Method of Postoperative Complications in Patients Undergoing Coronary Artery Surgery.

Objective: The authors aimed to validate the European Multicenter Study on Coronary Artery Bypass Grafting (E-CABG) classification of postoperative complications in patients undergoing coronary artery bypass grafting (CABG).

Design: Retrospective, observational study.

Setting: University hospital.

Outcome of emergency coronary artery bypass grafting.

Objectives: The aim of this study was to evaluate the immediate and late outcome of emergency coronary artery bypass grafting (CABG) in a multicenter setting.

Design: Multicenter, retrospective study.

Setting: Four university hospitals.

Five-Year Outcome after Coronary Artery Bypass Surgery in Survivors of Out-of-Hospital Cardiac Arrest.

Objective: The aim of this study was to evaluate the role of coronary artery bypass grafting (CABG) in patients with out-of-hospital cardiac arrest (OHCA).

Methods: The immediate and 5-year outcome after CABG of a consecutive series of 48 patients who survived OHCA was compared with those of control patients having had a recent myocardial infarction without ventricular arrhythmias.

Results: All OHCA patients were found to have suffered myocardial infarction-related cardiac arrest.

Comparison of the use of minimized cardiopulmonary bypass with conventional techniques on the incidence of retinal microemboli during aortic valve replacement surgery.

Objectives: Minimized cardiopulmonary bypass (MCPB) circuits have been shown to reduce cerebral and retinal microembolisation during coronary artery bypass graft (CABG) surgery compared to conventional CPB (CCPB) circuits. Our aim was to evaluate whether the reduction of microembolisation is sustained in aortic valve surgery, as well as to evaluate the effects of MCPB on inflammatory, endothelial, and platelet activation markers.

Material And Methods: Patients were randomized to undergo aortic valve replacement (AVR), with or without CABG, with MPCB (n=20) or CCPB (n=20).

Immediate and 5-year outcome after coronary artery bypass surgery in very high risk patients (additive EuroSCORE ≥ 10).

Aim: We have evaluated the outcome after coronary artery bypass surgery in very high risk patients (additive EuroSCORE ≥ 10). The impact of beating heart coronary artery bypass surgery (BHCAB) on their outcome has been evaluated.

Methods: Retrospective study including 160 consecutive patients with additive EuroSCORE ≥ 10.

Minimized cardiopulmonary bypass reduces retinal microembolization: a randomized clinical study using fluorescein angiography.

Background: The use of minimized cardiopulmonary bypass (MCPB) circuits has recently increased in an attempt to reduce the adverse effects of CPB. This prospective randomized study aimed to determine the effects of MCPB on retinal microembolization and related inflammatory, coagulation, and endothelial markers compared with conventional extracorporeal circulation (CCPB) among patients undergoing coronary artery bypass graft surgery.

Methods: Forty patients entered, and 37 patients completed the study.

Deep pericardial sling versus lateral pericardial sutures in off-pump coronary artery bypass surgery.

Aim: The aim of this study was to evaluate the safety and efficacy of deep pericardial sling (DPS) versus lateral pericardial sutures (LPSs) for heart stabilization and adequate coronary artery exposure during off-pump coronary artery bypass surgery (OPCAB).

Methods: One surgeon employed in 101 consecutive patients a series of four to six 2-0 polyglactin sutures placed laterally between the left phrenic nerve and the left pulmonary veins (LPS). Two other surgeons used in 104 consecutive patients a single 0-0 braided silk suture with moistened gauze placed in the oblique sinus of the posterior pericardium, between the inferior vena cava and the right lower pulmonary vein (DPS).

Immediate and intermediate outcome after off-pump and on-pump coronary artery bypass surgery in patients with unstable angina pectoris.

Background: We have evaluated the immediate and intermediate outcome after off-pump (OPCAB) and conventional on-pump coronary artery bypass surgery (CCAB) in patients with unstable angina pectoris requiring nitrates infusion until arrival in the operating room.

Methods: A consecutive series of 153 and 161 patients with unrelenting angina pectoris underwent CCAB and OPCAB, respectively. Conversion from OPCAB to beating heart surgery with perfusion occurred in 4 patients.

The use of statins and fate of small abdominal aortic aneurysms.

The aim of this study was to evaluate the value of statins in reducing abdominal aortic aneurysm (AAA) growth rate and improving freedom from aneurysm repair or rupture. One hundred and twenty-one patients with AAA undergoing ultrasonographic surveillance for at least one year were included in this retrospective study. Patients treated with statins had a decreased linear aneurysm growth rate than those not receiving statins (1.

Risk of retinal microembolism after off-pump and on-pump coronary artery bypass surgery.

Aim: In order to investigate the neuroprotective efficacy of off-pump coronary artery bypass surgery (OPCAB) over conventional on-pump coronary artery bypass surgery (CCAB), we have performed a prospective randomized study evaluating retinal circulation changes after OPCAB and CCAB.

Methods: Twenty patients were randomized to OPCAB or CCAB. Retinal fluorescein angiography and 60 degrees black-and-white as well as color fundus photographs of both eyes of each patient were taken 1 to 24 h before and 5 to 6 days after the operation.

Spyder aortic connector system in off-pump coronary artery bypass surgery.

Purpose: The Spyder aortic connector (Medtronic, Minneapolis, MN) is a new, promising connector device and its safety and efficacy have been evaluated in this study.

Description: Twenty-two patients were randomized to proximal vein graft anastomosis with the Spyder aortic connector (Medtronic) or hand-sewn technique.

Evaluation: Twenty patients underwent multi-detector computed tomographic scans of the chest 6 months after surgery to evaluate vein graft patency.

Predicting immediate and late outcome after surgery for mitral valve regurgitation with EuroSCORE.

Background And Aim Of The Study: The European system for cardiac operative risk evaluation score (EuroSCORE) has been shown to be a valid tool for predicting immediate and late outcome after coronary artery bypass surgery. As evidence also suggests its value in heart valve surgery, this issue was investigated in a series of patients who underwent surgery for mitral valve regurgitation.

Methods: Data obtained from 180 patients who underwent mitral valve repair (MVRep) or mitral valve replacement (MVR) were reviewed, and the patients' additive and logistic EuroSCOREs calculated.

Off-pump versus on-pump coronary artery bypass surgery in high-risk patients (EuroSCORE >/= 6).

Objective: The aim of this study was to review the results of off-pump (OPCAB) versus conventional on-pump coronary artery bypass surgery (CCAB) in high-risk patients.

Methods: In a cohort of patients with an additive EuroSCORE >/= 6, 67 underwent OPCAB and 112 underwent CCAB.

Results: Thirty-day postoperative death and stroke rates were 7.

Postoperative stroke after off-pump versus on-pump coronary artery bypass surgery.

Objective: The value of off-pump over conventional coronary artery bypass surgery in reducing the risk of postoperative stroke is controversial. This issue has been evaluated in light of our recent clinical experience.

Methods: Off-pump coronary artery bypass surgery was performed in 557 patients, and conventional coronary artery bypass surgery was performed in 445 patients.

Predictors of diseased ascending aorta in patients undergoing off-pump coronary artery bypass surgery.

Objective: To identify the preoperative risk factors associated with increased prevalence of atherosclerotic lesions of the ascending aorta among patients undergoing off-pump coronary artery bypass surgery (OPCAB).

Material And Methods: OPCAB was performed in 241 patients who were intraoperatively investigated by epiaortic ultrasound for the presence of atherosclerotic lesions of the ascending aorta. The Northern New England Cardiovascular Disease Study Group (NNECVDSG) and the Multicenter Study of Perioperative Ischemia (McSPI) stroke risk scores were retrospectively calculated.

Pulmonary embolism after off-pump coronary artery bypass surgery as detected by computed tomography.

Background: The incidence of pulmonary embolism (PE) after coronary artery bypass surgery is ill defined.

Methods: Twenty-four patients undergoing off-pump coronary artery bypass surgery were enrolled in a prospective randomized study evaluating a new proximal aortic anastomotic device. Computed tomography was performed postoperatively about 1 week after surgery.

Results with the Heartstring anastomotic device in patients with diseased ascending aorta.

Background: Avoidance of manipulation of diseased ascending aorta has been shown to be associated with a reduced risk of postoperative stroke after off-pump coronary artery bypass surgery (OPCAB). The use of the Heartstring device (Guidant, Indianapolis, USA) to accomplish a proximal aortic anastomosis without aortic clamping has been suggested in such patients.

Patients And Methods: From April 2004 to December 2005, proximal aortic anastomoses have been accomplished employing the Heartstring device in 19 patients with calcified ascending aorta who underwent OPCAB.

Lower limb ischemic complications after the use of arterial puncture closure devices.

We report three cases of lower limb ischemia occurring after the use of arterial puncture closure devices (APCDs). In two patients, who have undergone percutaneous angioplasty of lower limb arteries, the Angio-Seal APCD led to thrombosis of the common femoral artery. In another patient who has undergone coronary angiography, this device has led to dissection of the common femoral artery.

Prospective, randomized study on the use of the cardica PAS-port aortic connector system in off-pump coronary artery bypass surgery.

Background: The use of aortic connector devices for proximal vein graft anastomosis has been shown to be associated with a relevant rate of early graft complications. Cardica PAS-Port is a new aortic connector whose preliminary clinical results seem promising. The safety and efficacy of this aortic connector device have been evaluated in this prospective, randomized study.