Serum NGAL is elevated particularly in active IBD and correlates with established markers of inflammation and disease activity, implicating its role in the pathophysiology of IBD.

Cardiovascular disease is the largest cause of death in Western societies and it primarily results from atherosclerosis of large and medium-sized vessels. Atherosclerosis leads to myocardial infarction, when it occurs in the coronary arteries, or stroke, when it occurs in the cerebral arteries. Pathological processes involved in macrovascular disease include the accumulation of lipids which are retained by extracellular matrix (ECM) molecules, especially by the chondroitin sulfate/dermatan sulfate (CS/DS) proteoglycans (CS/DSPGs), such as versican, biglycan and decorin. The sulfation pattern of CS is a key player in protein interactions causing atherosclerosis. Several studies have shown that lipoproteins bind CSPGs via their glycosaminoglycan chains. Galactosaminoglycans, such as CS and DS, bind low density lipoproteins (LDL), affecting the role of these molecules in the arterial wall. In this article, the role of CS and versican in atherosclerosis and hyaluronan in atherogenesis as well as the up to date known mechanisms that provoke this pathological condition are presented and discussed.

ObjectiveThe aim of the present study was to evaluate the efficacy of autologous blood pleurodesis in the management of persistent air leak in spontaneous pneumothorax.Patients and methodsA number of 15 patients (10 male and 5 female) were included in this prospective study between March 2005 and December 2009. The duration of the air leak exceeded 7 days in all patients. The application of blood pleurodesis was used as the last preoperative conservative method of treatment in 12 patients. One patient refused surgery and two were ineligible for operation due to their comorbidities. A blood sample of 50 ml was obtained from the patient's femoral vein and immediately introduced into the chest tube.ResultsA success rate of 27% was observed having the air leak sealed in 4 patients in less than 24 hours.ConclusionDespite our disappointingly poor outcome, the authors believe that the procedure's safety, convenience and low cost establish it as a worth trying method of conservative treatment for patients with the aforementioned pathology for whom no other alternative than surgery would be a choice.

Purpose: Deep sternal wound complications after cardiac surgery have an incidence of 2 to 8% and carry a significant mortality. The aim of this study was to evaluate the effect of thermo-reactive Nitinol clips on the incidence of postoperative deep sternal wound complications. Methods: We retrospectively reviewed 1119 consecutive patients that underwent major cardiac surgery via median sternotomy in our centre. Sternal closure was performed using Nitinol clips in 235 patients (Group I) and standard stainless steel wires in 884 patients (Group II). The risk factors that were identified between the two groups were age, EuroSCORE, body mass index, diabetes and pulmonary comorbidity. Results: The overall incidence of deep sternal wound complications was 2.2% (25/1119). The incidence was higher in Group II (2.3%) compared to Group I (1.7%) (p = 0�8). Mechanical sternal dehiscence occurred in 2 patients in Group II. Mortality related to sternal wound complications was 8% (2/21) in Group II whereas in Group I was 0%. Conclusion: The incidence of sternal wound complications and the mortality related to them were lower in patients undergoing sternal closure with Nitinol clips. A randomized study to further evaluate the possible advantages of Nitinol clips is warranted.Keywords: wound closure, mediastinal infection, wound infection, wound dehiscence, sternum IntroductionMedian sternotomy is the standard approach in cardiothoracic surgery. Closure of this incision is simple and the method of choice worldwide is the use of standard steel wires placed either parasternally or directly through the bone. Healing complications such as osteomyelitis, mediastinitis, dehiscence, sinuses formation and superficial wound infection may occur and have a significant impact on postoperative recovery. The incidence of deep sternal wound complications (DSWC) after cardiac surgery varies from 0.5% to 5% 1-3� but is associated with a significant mortality in all studies. The surgical management of these complications has evolved over recent decades from closed mediastinal antibiotic irrigation, by Mandelbaum and Schumaker in 1963, to the primary use of pectoralis muscle flaps in 1980, by Jurkiewicz and associates. 3�Today, established treatment protocols include aggressive surgical debridement, the application of vacuumassisted closure (VAC) devices, delayed rewiring or plastic reconstruction with muscle and omental flaps, depending on the severity of infection. Apart from well described inherent patient risks, we believe the technique of primary sternal closure is an important risk factor for the subsequent incidence of dehiscence and wound infection. The aim of this study was to evaluate the effect of thermo-reactive Nitinol clips (Praesidia, Bologna, Italy) on the incidence of postoperative DSWC (Fig. 1). Purpose: Deep sternal wound complications after cardiac surgery have an incidence of 2 to 8% and carry a significant mortality. The aim of this study was to evaluate the effect of thermo-reactive Nitinol clips on the incidence of postoper...

Regarding operative mortality, EuroSCORE II showed in this study a slightly higher discriminatory accuracy than EuroSCORE I. There were no significant differences in the calibration of the two model versions in "low-" and "moderate-risk" patients regarding early as well as mid-term mortality. Analyses in larger patient populations will contribute to further model improvement.

IntroductionAchondroplasia is a musculoskeletal disorder associated with short stature. Despite an estimated prevalence of 1:25,000 in the general population, there is little literature concerning the diagnostic and treatment challenges faced by doctors dealing with a heart operation on a patient with this condition.Case presentationWe present the case of a 41-year-old Caucasian man of Greek ethnicity with achondroplasia, who underwent bypass heart surgery.ConclusionsThe surgery was successful and did not present particular difficulties, showing that heart surgery can be safely performed on people with achondroplasia.

BackgroundThe aortic Dacron wrapping technique is a surgical technique used under certain circumstances in cases of ascending aorta dilatation. Herein, we are presenting our experience on the method performed on multimorbid patients who denied major aortic surgery.MethodsWe included in our series 7 patients (5 male-2 female) with mild to moderate ascending aortic dilatation, who were operated with the wrapping technique. One patient was submitted to biological aortic valve replacement during the same procedure. The number of conventionally operated patients during the same period (2 years) was 21.ResultsMortality during the 18-months follow-up control was 0%. One patient had to be operated with biological aortic valve replacement 18 months after the initial wrapping operation, although the diameter of her ascending aorta remained stable.ConclusionsThe Dacron wrapping technique is a method that can alternatively be used in multimorbid patients with mild to moderate ascending aortic dilatation without dissecting elements and has generally good results.

Background and Aims: To focus through a related literature research and the authors' personal experience on the issue of gastrointestinal complications after heart surgery. Methods: We included in our review article selected studies dealing with the issue of gastrointestinal complications after heart surgery. Results: All related studies concluded to a relative small incidence for gastrointestinal complications after heart surgery of about 0.5 to 1.0%. [1]. However, the overall mortality was estimated to be disproportionally high, making the impact of these postoperative pathologies a significant one. Conclusions: Gastrointestinal complications consist a quite rare and often difficult to diagnose category of complications after heart surgery, which despite their small incidence, influence the overall mortality rate of cardiac operations. Time-sparing, meticulous performance of the operations and early diagnosis are the best measures against these complications.