A randomized, controlled trial was conducted to examine the effects of perioperative neuromuscular electrical stimulation on muscle proteolysis and physical function using blinded assessment of physical function. Consecutive patients undergoing cardiovascular surgery were screened for eligibility as study subjects. Participants were randomly assigned to receive either neuromuscular electrical stimulation or the usual postoperative mobilization program. The intervention group received neuromuscular electrical stimulation on bilateral legs 8 times before and after surgery. The primary outcomes were the mean 3-methylhistidine concentration corrected for urinary creatinine content from baseline to postoperative day 6, and knee extensor isometric muscle strength on postoperative day 7. Secondary outcomes were usual walking speed and grip strength. Physical therapists blinded to patient allocation performed measurements of physical function. Of 498 consecutive patients screened for eligibility, 119 participants (intervention group, n = 60; control group, n = 59) were enrolled. In the overall subjects, there were no differences in any outcomes between the intervention and control groups. The results demonstrated no significant effects of neuromuscular electrical stimulation on muscle proteolysis and physical function after cardiovascular surgery, suggesting the need to explore indications for neuromuscular electrical stimulation and to clarify the effects in terms of the dose-response relationship.
An inflammatory myofibroblastic tumor (IMFT) is recognized as benign tissue proliferative response comprising a variety of inflammatory and mesenchymal cells, and presents commonly at a young age. Although it occurs most frequently in the lung, it has also been observed in other organs and tissues such as the liver, spleen, bladder, and lymph nodes. However, IMFT of the heart is rare, and previously only 38 cases have been reported in the English literature. We herein report the case of a 65-year-old woman with asymptomatic IMFT in the right ventricular outflow tract. Previously reported cases are reviewed.
Background: The coexistence of Leriche syndrome and thoracoabdominal aortic aneurysm is rare and challenging for surgeons especially if there are no distal anastomosis sites. Case Report: A 56-year-old man with past medical histories of coronary artery bypass grafting and total arch replacement was planned to the surgery for thoracoabdominal aneurysm. His abdominal aorta was occluded just below the renal arteries and his terminal aorta, iliac and femoral arteries were hypoplastic. Right internal thoracic artery and visceral arteries provided collateral blood supply to the legs. The aneurysm was successfully repaired using a quadrifurcated graft without distal anastomoses. Conclusion: A quadrifurcated graft can be a therapeutic option for repair of thoracoabdominal aneurysm accompanied by Leriche syndrome without distal anastomosis sites.
An increased preoperative haemoglobin A1c level was strongly associated with early VGF after CABG. Thus, VGF happened more frequently in patients with poorly controlled diabetes mellitus.
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