Ten-year long-term outcomes of conventional and eversion carotid endarterectomy. Multicenter study

Aim. To analyze the immediate and long-term outcomes of eversion and conventional carotid endarterectomy (CE) with patch angioplasty.Material and methods. For the period from February 1, 2006 to September 1, 2021, the present retrospective multicenter open comparative study included 25106 patients who underwent CE. Depending on the technique of operation, the following groups were formed: group 1 (n=18362) — eversion CE; group 2 (n=6744) — conventional CE with patch angioplasty. The long-term follow-up period was 124,7±53,8 months.Results. In the hospital postoperative period, the groups were comparable in incidence of all complications: lethal outcome (group 1: 0,19%, n=36; group 2: 0,17%, n=12; p=0,89; odds ratio (OR) =1,1; 95% confidence interval (CI) =0,57- 2,11); myocardial infarction (MI) (group 1: 0,15%, n=28; group 2: 0,13%, n=9; p=0,87; OR=1,14; 95% CI=0,53-2,42); stroke (group 1: 0,33%, n=62; group 2: 0,4%, n=27; p=0,53; OR=0,84; 95% CI=0,53-1,32); bleeding with hematoma formation (group 1: 0,39%, n=73; group 2: 0,41%, n=28; p=0,93; OR=0,95; 95% CI=0,61-1,48); internal carotid artery (ICA) thrombosis (group 1: 0,05%, n=11; group 2: 0,07%, n=5, p=0,9; OR=0,8; 95% CI=0,28-2,32). In the long-term follow-up, the groups were comparable only in MI incidence: group 1: 0,56%, n=103; group 2: 0,66%, n=45; p=0,37; OR=0,84; 95% CI=0,59-1,19. All other complications were more frequent after conventional CE with patch angioplasty: all-cause death (group 1: 2,7%, n=492; group 2: 9,1%, n=616; p<0,0001; OR=0,27; 95% CI=0,24-0,3); lethal ischemic stroke (group 1: 1,0%, n=180; group 2: 5,5%, n=371; p<0,0001; OR=0,17; 95% CI=0,14-0,21); non-lethal ischemic stroke (group 1: 0,62%, n=114; group 2: 7,0%, n=472; p<0,0001; OR=0,08; 95% CI=0,06-0,1); ICA restenosis >60%, requiring re-revascularization (group 1: 1,6%, n=296; group 2: 12,6%, n=851; p<0,0001; OR=0,11; 95% CI=0,09-0,12). Thus, the composite endpoint (lethal ischemic stroke + non-lethal ischemic stroke + MI) after conventional CE with patch angioplasty was more than 6 times higher than this parameter of eversion CE: group 1: 2,2%, n=397; group 2: 13,2%, n=888; p<0,0001; OR=0,14; 95% CI=0,12-1,16.Conclusion. Conventional CE with patch angioplasty is not prefer for cerebral revascularization in the presence of hemodynamically significant ICA stenosis due to the high prevalence of deaths, stroke, and ICA restenosis in the long-term follow-up

Surgical Site Infections in Cardiac Surgery, Open-Heart Surgery Infections

Relevance. Cardiac surgery is a direction that is currently being actively developed. The number of operations performed on an openheart is growing annually, and the number of postoperative complications, including infectious ones, is correspondingly increasing. The purpose of the work is to identify the frequency of surgical site infections (SSI) in open-heart surgery, to study the leading risk factors, to identify possible sources of infection. Materials and methods. Basic information was obtained from medical records, as well as using the medical information system, which allows to track the patient's repeated hospitalization in the hospital, and the laboratory information system. Additional forms have been developed to account for intraoperative risk factors. The follow-up period was 3 years (2016-2018). A total of 433 surgical interventions and their outcomes were analyzed, the duration of follow-up f o r patients was 1 year from the time of surgery. Identified 19 cases of SSI. Results and discussion. The frequency of SSI in open-heart surgery was 4.4 per 100 operations (2.6-6.7). Up to 74% of all SSI occurred in the period up to 30 days from the moment of surgery. The relative risk index was calculated for such factors as the length of stay in the intensive care unit in the postoperative period, the timing of drainage of the postoperative wound, and diabetes mellitus. It has been established that for cardiosurgical operations on the 1st class of wounds, diabetes mellitus is a significant risk factor for SSI. The analysis pathogens in patients with acute respiratory infections and the microbiological landscape of the departments made it possible to establish cases of possible infection of patients in the hospital, and in some cases put forward an assumption of endogenous infection. Conclusions. An epidemiological investigation, the development, and implementation of anti-epidemic measures require a complete consideration of possible risk factors, the participation of cardiac surgeons in identifying, and analyzing each case of SSI, and the mandatory exchange of information about the outcome of the disease between medical organizations that are involved in the management of a cardiac surgical patient in the postoperative period

Changes in the chemical and sensorial profile of extra virgin olive oils flavored with herbs and spices during storage

A study is reported on the chemical and sensorial characteristics of extra virgin olive oil flavored with hot pepper, garlic, oregano and rosemary during 7 months of storage. The oils were prepared by addition of the spice oily extracts at three different levels of concentration to an extra virgin olive oil. The following parameters were monitored: acidity, peroxide value (PV), K232, K270, (E)-2-hexenal/hexanal ratio and sensorial characteristics. At the end of the storage, all samples showed PV and K232 values lower than the control, whereas similar values of acidity, K270 and (E)-2-hexenal/hexanal ratio were observed. These results demonstrated that the herb and spice extracts improved the stability of the extra virgin olive oil. Tasters were able to distinguish among the levels of addition, and at the end of the storage, they preferred the oils flavored with 20 g/L of rosemary, 40 g/L of hot pepper, 40 g/L of oregano and 30 g/L of garlic