Short- and long-term outcome of patients aged 65 and over after cardiac surgery

To analyze the short and long-term outcome of patients aged 65 years and over, after cardiac surgery. Over a 12-year period we analyzed 1750 patients with a mean age of 70.09 3.94 years. They were classified into three age groups: between 65 and 69 (n = 709), between 70 and 74 (n = 695) and 75 years and above (n = 346). Follow-up information was obtained by telephone conversation after a 6-month and 3-year period of discharge from the hospital. Included in the follow-up were 1235 patients and an interview was conducted with 501 (40.6%) patients or their next of kin. Even though the in-hospital morbidity was highest in the oldest age group, there were no significant differences between groups (p = 0.051). There was no significant difference between groups in the length of hospital stay. The greatest in-hospital mortality was noted in the oldest age group (p = 0.046) compared to patients in the age groups between 65 and 69 and between 70 and 74 years old (p = 0.023 and p = 0.036). In the follow-up study, there was a significantly smaller telephone feedback response in the oldest age group compared to the youngest group (p = 0.003). There were no differences between the groups with respect to mortality and cardiac death after the 6-month and 3-year periods of discharge from hospital. Our data showed that despite a poor short – and long-term outcome in patients aged 75 and over, all patients had an acceptable operative risk

Electrical impedance tomography as ventilation monitoring in ICU patients

Electrical impedance tomography (EIT), as a monitoring tool of regional lung ventilation, is radiation-free imaging with high temporal resolution. Te most important purpose of EIT is to visualize the distribution of tidal volume in diferent lung regions especially between dependent (dorsal in supine patients) and non-dependent (ventral in supine patients) regions. Many clinical studies evaluated the applicability of PulmoVista® 500 (Dräger Medical GmbH, Lübeck, Germany) and similar EIT devices in estimating optimal PEEP afer recruitment maneuvers (RM) in lung healthy patients and acute respiratory distress syndrome (ARDS), ventilation distribution in cystic fbrosis, COPB, pneumonia and respiratory diseases syndrome in infants

Cell Death and Ultrastructural Morphology of Femtosecond Laser-Assisted Anterior Capsulotomy

PURPOSE. To evaluate cell death and ultrastructural effects on capsulotomy specimens derived from femtosecond laser-assisted cataract surgery. METHODS. In 26 eyes, an anterior capsulotomy was performed using a femtosecond laser. In 10 eyes (group 1), the laser-pulse energy was set to 15 lJ using a rigid curved interface and in another 10 eyes (group 2) to 5 lJ using a curved interface combined with a soft contact lens. The control group (6 eyes, group 3) underwent manual anterior capsulorhexis using forceps. All extracted capsule specimens underwent cell death analysis using the TUNEL kit, ultrastructural analyses using atomic force microscopy (AFM), and scanning electron microscopy (SEM). Counterstaining was performed with 4 0 ,6-diamidino-2-phenylindol (DAPI) and hematoxylin-eosin (HE). RESULTS. Cell death was found in all capsule specimens along the cutting edge but was significantly more pronounced in group 1. DAPI and HE staining showed regular epithelial cell distribution with a demarcation line along the cutting edge of both laser groups, which was more pronounced in group 1. In AFM analysis, laser spot size in the femtosecond laser groups were in accordance with the preoperative planned size (P < 0.01). Cutting edges in SEM observations were smoother and more roundly shaped using 5 lJ (group 2). CONCLUSIONS. Cutting edges of femtosecond laser-performed capsulotomies are precise and laser spot lesions are within planned size. Cell death reaction depends on the laser pulse energy settings and can be reduced to the level observed in a manual capsulorhexis. Keywords: femtosecond laser, capsulotomy, capsulorhexis, laser energy, cell death, apoptosis, atomic force microscopy, scanning electron microscopy A precise and well-performed capsulorhexis is crucial to perform an uncomplicated cataract extraction, intraocular lens implantation, and centration. 1-3 This main step in cataract surgery and refractive lens exchange surgery is commonly performed manually. Femtosecond lasers are now changing how lens surgery is performed by becoming involved in the main steps of the surgical process: corneal incisions, capsulotomy, and lens fragmentation. Dick et al. 2 recently suggested a new terminology for opening the anterior lens capsule with a femtosecond laser: capsulotomy instead of capsulorhexis, as the femtosecond laser operates as a cutting knife by using focal photodisruption. Recent studies have already demonstrated that femtosecond laser-performed capsulotomies allow repeatable and precise sizing and centration; furthermore, they improve the safety of hydrodissection, nuclear fragmentation, and cortical cleanup. 10 During capsulotomy, the anterior capsule is being injured and epithelial cell death is induced. This effect might be stronger with the assistance of femtosecond lasers. Therefore, the purpose of this study was to investigate cell death reaction after anterior capsulotomy either performed by a femtosecond laser using different energy levels or manually by using forceps. Furthermore, laser spot lesions and cutting edge of all capsulotomy specimens were investigated on the ultrastructural level. METHODS The experimental study was approved by the ethics committee of the Goethe-University, Frankfurt am Main, Germany, and was performed in accordance with the Declaration of Helsinki at the Department of Ophthalmology, Goethe-University. In 26 eyes of 26 patients diagnosed with corticonuclear cataract formation anterior femtosecond laser-assisted capsulotomy (n ¼ 20) or manual capsulorhexis (n ¼ 6) using forceps was performed. In 10 eyes (group 1) that underwent femtosecond laser capsulotomy, the laser pulse energy was set to 15 lJ and applanation to the ocular surface was performed using a rigid curved interface. For another 10 eye

A more fine-grained measure towards animal welfare: a study with regards to gender differences in Spanish students

The environmental issue is nowadays taking more importance in the environmental awareness all around the world, and in this field, animal consideration is more and more spread. A highlighted part in globalisation is the animal welfare awareness. This article presents a study comparing attitudes towards animals among secondary and university students in reference to gender. It was carried out on 1394 Spanish participants from 11 to 26 years. The instrument used in the study is the reviewed version of the Animal Welfare Attitude Scale which was renamed as “Animal Welfare Attitude-Revised Scale” (AWA-R Scale), with a Cronbach a reliability value of 0.85. It is subdivided into four components namely C1: animal abuse for pleasure or due to ignorance; C2: leisure with animals; C3: farm animals; and C4: animal abandonment. These components have been deeply detailed by a confirmatory factor analysis (CFA), which highly contributes to define the position of participants for the different dimensions of animal welfare. It is concluded that significant differences exist between males’ and females’ attitudes in all components of the AWA-R Scale. It is also suggested that two social characteristics—people’s attitudes towards animals and towards environmental protection—are, at the very least, coexistent and may indeed be interdependent. These differences between gender in matters of socialisation could thus be reflected in environmental attitudes, and also in others related to them, i.e. animal welfare attitudes