Acute kidney injury based on the KDIGO criteria among ST elevation myocardial infarction patients treated by primary percutaneous intervention.

Background: Acute kidney injury (AKI) following acute ST elevation myocardial infarction (STEMI) is associated with adverse outcomes. The recently proposed KDIGO criteria suggested modifications to the consensus classification system for AKI, namely lowering the threshold of increase in absolute serum creatinine and extending the time frame for AKI detection to 7 days. We evaluated the incidence, risk factors, and long-term mortality associated with AKI as classified by the KDIGO definition in a large single center cohort of consecutive STEMI patients.

Postoperative Outcomes, Weight Loss Predictors, and Late Gastrointestinal Symptoms Following Laparoscopic Sleeve Gastrectomy.

Objective: To evaluate the outcomes, weight loss predictors, and gastrointestinal symptoms of patients after laparoscopic sleeve gastrectomy (LSG).

Methods: The postoperative medical status of the patients was obtained retrospectively using a questionnaire and was compared to existing medical data before the surgery.

Results: We included 201 candidates, 178 patients completed mean of 3 years of follow-up.

Relation of subclinical serum creatinine elevation to adverse in-hospital outcomes among myocardial infarction patients.

Background:: Acute kidney injury is associated with adverse outcomes after acute ST elevation myocardial infarction (STEMI). It remains unclear, however, whether subclinical increase in serum creatinine that does not reach the consensus criteria for acute kidney injury is also related to adverse outcomes in STEMI patients undergoing primary percutaneous coronary intervention.

Methods:: We conducted a retrospective study of 1897 consecutive STEMI patients between January 2008 and May 2016 who underwent primary percutaneous coronary intervention, and in whom acute kidney injury was not diagnosed throughout hospitalization.

Prognostic Implications of Chronic Kidney Disease on Patients Presenting with ST-Segment Elevation Myocardial Infarction with versus without Stent Thrombosis.

Background: Limited data is present regarding long-term outcomes in chronic kidney disease (CKD) patients presenting with stent thrombosis (ST). We evaluated the possible implications of CKD on long-term mortality in patients presenting with ST-segment elevation myocardial infarction (STEMI) and treated with primary percutaneous coronary intervention (PCI), and its interaction with the presence of ST.

Methods: We retrospectively studied 1,722 STEMI patients treated with primary PCI.

Prognostic Implications of Mid-Range Left Ventricular Ejection Fraction on Patients Presenting With ST-Segment Elevation Myocardial Infarction.

The new European Society of Cardiology guidelines reclassified heart failure according to left ventricular ejection fraction, recognizing patients with mid-range EF (mrEF; 40% to 49%) as a distinct group. We sought to investigate the clinical profile, in-hospital outcomes, and long-term mortality of ST-elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention who had mrEF. We conducted a retrospective study of 2,086 consecutive patients with STEMI between December 2007 and June 2016 who underwent primary percutaneous coronary intervention and had a comprehensive echocardiographic examination performed within 72 hours of hospital admission.

Relation of positive fluid balance to the severity of renal impairment and recovery among ST elevation myocardial infarction complicated by cardiogenic shock.

Purpose: We analyzed the relationship between a positive fluid balance and its persistence over time on acute kidney injury (AKI) development, severity and resolution among ST elevation myocardial infarction (STEMI) patients complicated by cardiogenic shock.

Methods: We retrospectively studied the cumulative fluid balance intake and output at 96h following hospital admission in 84 consecutive adult patients with STEMI complicated by cardiogenic shock. The cohort was stratified into two groups, based on the presence or absence of positive fluid balance on day 4.

Accuracy and inter-operator variability of small bowel length measurement at laparoscopy.

Background: Measurement of bowel length is an essential surgical skill for laparoscopic and open gastrointestinal surgery in order to achieve favorable outcomes and avoid long-term complications. Variations in accuracy between the two surgical approaches may exist. However, only few studies have tried to assess these differences.

Differential pattern of deposition of nanoparticles in the airways of exposed workers.

Ultrafine particles (UFP) have been postulated to significantly contribute to the adverse health effects associated with exposure to particulate matter (PM). Due to their extremely small size (aerodynamic diameter <100 nm), UFP are able to deposit deep within the lung after inhalation and evade many mechanisms responsible for the clearance of larger particles. There is a lack of biologically relevant personal exposure metrics for exposure to occupational- and environmental-related micro- and nano-sized PM.

Comparison of the Edwards SAPIEN S3 Versus Medtronic Evolut-R Devices for Transcatheter Aortic Valve Implantation.

New generation of the most widely used devices for transcatheter aortic valve implantation have been recently introduced into practice. We compare the short-term outcomes of transcatheter aortic valve implantation with the Edwards SAPIEN S3 and the Medtronic Evolut-R. We performed a retrospective analysis from a single high-volume tertiary center.

Prevalence and outcomes of early versus late stent thrombosis presenting as ST-segment elevation myocardial infarction.

Objectives: Previous reports showed inconsistencies in the outcomes and prognosis of stent thrombosis (ST) when stratified according to the timing of its occurrence. We evaluated the incidence and possible prognostic implications of early and late ST presenting as ST-segment elevation myocardial infarction (STEMI) in a large cohort of consecutive patients undergoing a primary percutaneous coronary intervention.

Materials And Methods: We retrospectively studied 1722 STEMI patients treated by primary percutaneous coronary intervention.

Echocardiographic correlates of left ventricular filling pressures and acute cardio-renal syndrome in ST segment elevation myocardial infarction patients.

Objective: Increased transmitral flow velocity (E) to the early mitral annulus velocity (e') ratio (E/e'), signifying increased cardiac filling pressure, was previously found to be associated with deterioration of renal function in patients with congestive heart failure. No study, however, included patients with acute myocardial ischemia. We hypothesized that elevated E/e' ratio would be associated with an increased risk of acute kidney injury (AKI) in ST elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI).

Prognostic implications of fluid balance in ST elevation myocardial infarction complicated by cardiogenic shock.

Background: Positive fluid balance has been associated with adverse outcomes in patients admitted to general intensive care units. We analysed the relationship between a positive fluid balance and its persistence over time in terms of in-hospital outcomes among ST elevation myocardial infarction (STEMI) patients complicated by cardiogenic shock.

Methods: We retrospectively studied fluid intake and output for 96 hours following hospital admission in 48 consecutive adult patients with STEMI complicated by cardiogenic shock, all undergoing primary angioplasty.

Serum Uric Acid Levels and Renal Impairment among ST-Segment Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Intervention.

Background: Elevated serum uric acid (UA) levels are associated with adverse outcomes in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI). However, the relation between UA and acute kidney injury (AKI) in this population is unclear. We evaluated the effect of elevated UA levels on the risk to develop AKI among consecutive STEMI patients treated with primary PCI.

Serial Echocardiographic Assessment of Left Ventricular Filling Pressure and Remodeling among ST-Segment Elevation Myocardial Infarction Patients Treated by Primary Percutaneous Intervention.

Background: Acute myocardial infarction and remodeling of the left ventricle is associated with significant changes in systolic and diastolic echocardiographic derived indices. The investigators have tried to determine whether persistence of increased ratio of transmitral flow velocity (E) to early mitral annulus velocity (e'), signifying increased cardiac filling pressure, is associated with left ventricular (LV) remodeling and increased chamber size among patients presenting with ST-segment elevation myocardial infarction, who underwent successful reperfusion with primary percutaneous coronary intervention.

Methods: Fifty-two patients (76% men; mean age, 61 ± 10 years) with first ST-segment elevation myocardial infarctions who underwent primary percutaneous coronary intervention were retrospectively studied.

Prognostic Implications of Acute Renal Impairment among ST Elevation Myocardial Infarction Patients with Preserved Left Ventricular Function.

Background: Only limited data is present regarding the incidence and prognostic implications of acute kidney injury (AKI) in ST elevation myocardial infarction (STEMI) patients with preserved left ventricular (LV) function in the primary percutaneous coronary intervention (PCI) era.

Methods: We conducted a retrospective study of 842 consecutive STEMI patients with preserved LV function (ejection fraction ≥50%, assessed by echocardiography) who underwent primary PCI between January 2008 and January 2015. AKI was defined as an increase of ≥0.

Relation of Pulmonary Artery Pressure and Renal Impairment in ST Segment Elevation Myocardial Infarction Patients.

Background: Recent reports have demonstrated the adverse effects of venous congestion on renal function in patients having heart failure. None of the above trials, however, included patients with acute ischemia.

Hypothesis: Echocardiographic correlates of increased right ventricular afterload would be associated with an increased risk of acute kidney injury (AKI) in ST elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI).

Comparison of Triggering and Nontriggering Factors in ST-Segment Elevation Myocardial Infarction and Extent of Coronary Arterial Narrowing.

Various physical, emotional, and extrinsic triggers have been attributed to acute coronary syndrome. Whether a correlation can be drawn between identifiable ischemic triggers and the nature of coronary artery disease (CAD) still remains unclear. In the present study, we evaluated the correlation between triggered versus nontriggered ischemic symptoms and the extent of CAD in patients with ST-segment elevation myocardial infarction (STEMI).

Acute kidney injury among ST elevation myocardial infarction patients treated by primary percutaneous coronary intervention: a multifactorial entity.

Acute kidney injury is a frequent complication among ST segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI), and is associated with adverse outcomes. While contrast nephropathy is considered the most important reason for worsening of renal function, recent data have suggested the role of other important factors among this specific patient population. In the present review, we examine the various factors leading to renal impairment in STEMI patients and place the findings in the context of this specific patient population in the era of primary PCI.

Impact of routine manual aspiration thrombectomy on outcomes of patients undergoing primary percutaneous coronary intervention for acute myocardial infarction: A meta-analysis.

Background: The efficacy and safety of thrombectomy as an adjunct to primary percutaneous intervention (PCI) in the management of acute myocardial infarction (AMI) are debated. We performed a meta-analysis of randomized trials comparing primary PCI performed with versus without routine aspiration thrombectomy (AT).

Methods: A meta-analysis of randomized AT trials reporting clinical outcomes was done in accordance with the PRISMA guidelines.

Seated postural hypotension.

Most studies of postural hypotension (PH) have focused on standing PH. Less is known about PH after transition from a supine to sitting position. Moreover, seated PH has not been previously reviewed in the English literature.

Admission Glucose Levels and the Risk of Acute Kidney Injury in Nondiabetic ST Segment Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention.

Background: Hyperglycemia upon admission is associated with an increased risk for acute kidney injury (AKI) in ST segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI). However, the relation of this association to the absence of diabetes mellitus (DM) is less studied. We evaluated the effect of acute hyperglycemia levels on the risk of AKI among STEMI patients without DM who were all treated with primary PCI.

Acute Cardio-Renal Syndrome as a Cause for Renal Deterioration Among Myocardial Infarction Patients Treated With Primary Percutaneous Intervention.

Background: Early hemodynamic impairment frequently complicates myocardial injury, however, limited data are present regarding its direct association with acute kidney injury (AKI) after ST segment elevation myocardial infarction (STEMI) in patients who undergo primary percutaneous coronary intervention (PCI). We evaluated the effect of acute hemodynamic derangement on the risk of AKI among STEMI patients who undergo primary PCI.

Methods: We performed a retrospective analysis of 1656 consecutive patients admitted with the diagnosis of STEMI between January 2008 and December 2014, and treated with primary PCI.

Safer trocar insertion for closed laparoscopic access: ex vivo assessment of an improved Veress needle.

Introduction: Laparoscopic surgery is widely practiced surgical technique in the modern surgical toolbox. The Veress needle insertion technique, while faster and easier, is associated with higher rates of iatrogenic complications (injury to internal organs, major blood vessels, etc.), morbidity and even mortality with a reported overall risk of 0.