Outcome of myocardial revascularisation in Iceland

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/Open Allur texti - Full textIn Iceland over 3500 coronary artery bypass operations have been performed, both On-Pump, using cardiopulmonary bypass and Off-Pump, surgery on a beating heart. The aim was to study their outcome. This was a retrospective study on 720 consecutive patients who underwent surgical revascularisation at Landspítali-The National University Hospital of Iceland between 2002-2006; 513 On-Pump and 207 Off-Pump patients. Complications and operative mortality (<30 days) were compared between the groups and predictors of survival identified using multivariate analysis. The number of males was significantly higher in the On-Pump group, but other risk factors of coronary artery disease, including age and high body mass index, were comparable, as were the number of distal anastomoses and EuroSCORE. The Off-Pump procedure took 25 minutes longer on average and chest tube output was significantly increased, but the amount of transfusions administered was similar. The rate of minor complications was higher in the On-Pump group. Of the major complications, stroke rates were similar in both groups (2%) but the rate of reoperation for bleeding was higher in the On-Pump group. Mean length of hospital stay was one day longer for On-Pump patients but operative mortality was similar for both groups (4% vs. 3%, p=0.68) as was 5 year survival (92% in both groups). In multivariate analysis both EuroSCORE and age predicted outcome of operative mortality and long term survival but type of surgery (On-Pump vs. Off-Pump) was not a predictive variant. Outcome of myocardial revascularisation in Iceland is good as regards operative mortality and long term survival. This applies to both conventional On-Pump and Off-Pump procedures.Inngangur: Á Íslandi hafa verið framkvæmdar um 3500 kransæðahjáveituaðgerðir, annað hvort með hjarta- og lungnavél (HLV) eða á sláandi hjarta (SH). Tilgangur rannsóknarinnar var að kanna árangur þessara aðgerða hér á landi. Efniviður og aðferðir: Rannsóknin var afturskyggn og náði til 720 sjúklinga sem gengust undir kransæðahjáveituaðgerð á Landspítala árin 2002-2006 og skiptust þeir í tvo hópa; 513 einstaklinga sem gengust undir aðgerð með HLV (HLV-hópur) og 207 á SH (SH-hópur). Fylgikvillar og dánartíðni innan 30 daga voru borin saman milli hópa og forspárþættir lifunar metnir með ein- og fjölbreytugreiningu. Niðurstöður: Karlar voru fleiri í HLV-hópi en áhættuþættir kransæðasjúkdóma, aldur og líkamsþyngdarstuðull reyndust sambærilegir milli hópa, einnig fjöldi æðatenginga og EuroSCORE. Aðgerðir á sláandi hjarta stóðu 25 mínútum lengur og blæðing í brjóstholskera var marktækt aukin en magn blóðs sem var gefið var sambærilegt í báðum hópum. Minniháttar fylgikvillar voru algengari í HLV-hópi (58% á móti 48%, p<0,05). Af alvarlegum fylgikvillum voru enduraðgerðir vegna blæðinga algengari í HLV-hópi og heildarlegutími rúmum sólarhring lengri. Dánartíðni innan 30 daga var hins vegar áþekk í báðum hópum (4% á móti 3%, p=0,68), einnig 5 ára lifun sem var í kringum 93% í báðum hópum. Í fjölbreytugreiningu spáðu hærra EuroSCORE og aldur fyrir dánartíðni innan 30 daga og langtímalifun en ekki tegund aðgerðar (HLV eða SH). Ályktanir: Árangur kransæðahjáveituaðgerða á Íslandi er góður, bæði hvað varðar dánartíðni innan 30 daga og langtímalifun. Þetta á jafnt við um aðgerðir sem framkvæmdar eru með aðstoð HLV og á sláandi hjarta

Impact of obesity on surgical outcomes following coronary artery bypass graft surgery

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn Skoða/Opna(view/open)Introduction: Obesity has been related to increased postoperative morbidity and mortality following open-heart surgery. However, recent studies have shown no association or even a more favourable outcome in obese patients. This relationship was investigated in a well-defined cohort of patients that underwent myocardial revascularisation in Iceland. Material and methods: A retrospective study including all patients that underwent isolated myocardial revascularisation in Iceland from 2002 to 2006. Alltogether 720 patients were divided into two groups, an obese group, with BMI >30 kg/m2 (n=207, 29%), and a non-obese group with BMI ≤30 kg/m2 (n=513, 71%). Patient demographics, complications, operative mortality and long term survival of both groups were compared. Results: Demographics were comparable between the groups. Obese patients were 2.4 years younger, more likely to use statins (83,3% vs. 71,2%, had a significantly lower EuroSCORE (4.3 vs. 5.0) but a slightly longer operation time. Pleural fluid was less often drained in obese patients (8.2 vs. 15.0%) but rates for other complications were similar in both groups, as was operative mortality ≤30 days (2.0% vs. 3.7%), 1 and 5 year survival. In a multivariate analysis obesity was not an independent risk factor for minor or major complications, operative mortality or long term survival. Conclusion: The rate of complications and operative mortality after myocardial revascularisation is not significantly higher in obese patients and the same applies to long term survival. This is true even after correcting for confounding factors in a multivariate analysis.Tilgangur: Offita hefur almennt verið talin auka tíðni fylgikvilla eftir skurðaðgerðir. Niðurstöður rannsókna á tengslum offitu við opnar hjartaaðgerðir eru þó misvísandi og til eru rannsóknir sem sýna sambærilega og jafnvel lægri tíðni fylgikvilla. Tilgangur þessarar rannsóknar var að kanna tengsl offitu við árangur kransæðahjáveituaðgerða á Íslandi. Efniviður og aðferðir: Afturskyggn rannsókn á 720 sjúklingum sem gengust undir kransæðahjáveituaðgerð á Landspítala frá 2002-2006. Sjúklingum var skipt í tvo hópa; offituhóp með líkams-þyngdarstuðul >30 kg/m2 (n=207, 29%), og viðmiðunarhóp með stuðulinn £30 kg/m2 (n=513, 71%). Hóparnir voru bornir saman með ein- og fjölþáttagreiningu og áhrif offitu metin með tilliti til tíðni fylgikvilla, skurðdauða £30 daga og langtíma lífshorfa. Niðurstöður: Áhættuþættir hjarta- og kransæðasjúkdóma voru sambærilegir í báðum hópum en sjúklingar í offituhópi tóku oftar blóðfitulækkandi lyf (83,3% sbr. 71,2%, voru 2,4 árum yngri, með lægra EuroSCORE (4,3 sbr. 5,0) en aðeins lengri aðgerðartíma. Sjaldnar þurfti að tappa af fleiðruvökva í offituhópi (8,2% sbr. 15,0%), en annars var tíðni fylgikvilla og dánartíðni £30 daga (2,0% sbr. 3,7%) sambærileg. Við fjölþáttagreiningu reyndist offita ekki sjálfstæður áhættuþáttur minniháttar fylgikvilla, alvarlegra fylgikvilla, dánartíðni £30 daga eða langtíma lífshorfa. Ályktun: Fylgikvillar og dánartíðni eftir kransæðahjáveituaðgerð reyndust ekki marktækt aukin hjá offitusjúklingum, jafnvel eftir að leiðrétt var fyrir hugsanlegri valbjögun, eins og lægra EuroSCORE, aldri og notkun statínlyfja í offituhópi. Langtímalifun virðist einnig sambærileg

A comparison of Northeast Atlantic killer whale (Orcinus orca) stereotyped call repertoires

Funding for data collection was provided by the BBC Natural History Unit, Fundação para a Ciência e a Tecnologia (grant number SFRH/BD/30303/2006), the Icelandic Research Fund (i. Rannsóknasjóður) through a START Postdoctoral Fellowship (grant number 120248042) and a Project Grant (grant number 163060‐051), the National Geographic Global Exploration Fund (grant number GEFNE65‐12), a Marie Curie International Incoming Fellowship (project number 297116), the Office of Naval Research (grant number N00014‐08‐1‐0984), and a Russell Trust Award from the University of St. Andrews.Killer whale call repertoires can provide information on social connections among groups and populations. Killer whales in Iceland and Norway exhibit similar ecology and behavior, are genetically related, and are presumed to have been in contact before the collapse of the Atlanto-Scandian herring stock in the 1960s. However, photo-identification suggests no recent movements between Iceland and Norway but regular movement between Iceland and Shetland. Acoustic recordings collected between 2005 and 2016 in Iceland, Norway, and Shetland were used to undertake a comprehensive comparison of call repertoires of Northeast Atlantic killer whales. Measurements of time and frequency parameters of calls from Iceland (n = 4,037) and Norway (n = 1,715) largely overlapped in distribution, and a discriminant function analysis had low correct classification rate. No call type matches were confirmed between Iceland and Norway or Shetland and Norway. Three call types matched between Iceland and Shetland. Therefore, this study suggests overall similarities in time and frequency parameters but some divergence in call type repertoires. This argues against presumed past contact between Icelandic and Norwegian killer whales and suggests that they may not have been one completely mixed population.PostprintPeer reviewe

Low-frequency signals produced by Northeast Atlantic killer whales (Orcinus orca)

Killer whale acoustic behavior has been extensively investigated, however most studies have focused on pulsed calls and whistles. This study reports the production of low-frequency signals by killer whales at frequencies below 300 Hz. Recordings of killer whales were made in Iceland and Norway when whales were observed feeding on herring, and no other cetacean species were nearby. Low-frequency sounds were identified in Iceland and ranged in duration between 0.14 and 2.77 seconds and in frequency between 50 and 270 Hz, well below the previously reported lower limit for killer whale tonal sounds of 500 Hz. LFS appeared to be produced close in time to tail slaps, indicative of feeding attempts, suggesting that these sounds may be related to a feeding context. However, their precise function is unknown and they could be the by-product of a non-vocal behavior, rather than a vocal signal deliberately produced by the whales. Although killer whales in Norway exhibit similar feeding behavior, this sound was not detected in recordings from Norway. This study suggests that, like other delphinids, killer whales also produce low-frequency sounds but further studies will be required to understand whether similar sounds exist in other killer whale populations

Evidence of unidirectional hybridization and second‐generation adult hybrid between the two largest animals on Earth, the fin and blue whales

Biodiversity in the oceans has dramatically declined since the beginning of the industrial era, with accelerated loss of marine biodiversity impairing the ocean's capacity to maintain vital ecosystem services. A few organisms epitomize the damaging and long‐lasting effects of anthropogenic exploitation: some whale species, for instance, were brought to the brink of extinction, with their population sizes reduced to such low levels that may have cause a significant disruption to their reproductive dynamics and facilitated hybridization events. The incidence of hybridization is nevertheless believed to be rare and very little information exist on its directionality. Here, using genetic markers, we show that all but one whale hybrid sample collected in Icelandic waters originated from the successful mating of male fin whale and female blue whale, thus suggesting unidirectional hybridization. We also demonstrate for the first time the existence of a second‐generation adult (male) hybrid resulting from a backcross between a female hybrid and a pure male fin whale. The incidence of hybridization events between fin and blue whales is likely underestimated and the observed unidirectional hybridization (for F1 and F2 hybrids) is likely to induce a reproductive loss in blue whale, which may represent an additional challenge to its recovery in the Atlantic Ocean compared to other rorquals

Recommendations for in vitro evaluation of blood components collected, prepared and stored in non-DEHP medical devices

© 2022 International Society of Blood Transfusion. Funding Information: T.R.L.K., S.B. and D.K. led the working party and contributed to the writing of the manuscript. A.L., O.E.S., M.D.W., C.G., P.J.M.B., R.E., L.L., S.T., T.N., W.B., J.E. and B.M. contributed to the writing of the manuscript. Publisher Copyright: © 2022 International Society of Blood Transfusion.BACKGROUND AND OBJECTIVES: DEHP, di(2-ethylhexyl) phthalate, is the most common member of the class of ortho-phthalates, which are used as plasticizers. The Medical Device Regulation has restricted the use of phthalates in medical devices. Also DEHP has been added to the Annex XIV of REACH, "Registration, Evaluation, Authorisation and Restriction of Chemicals" due to its endocrine disrupting properties to the environment. As such, the sunset date for commercialisation of DEHP-containing blood bags is May 27th 2025. There are major concerns in meeting this deadline as these systems have not yet been fully validated and/or CE-marked. Also, since DEHP is known to affect red cell quality during storage, it is imperative to transit to non-DEHP without affecting blood product quality. Here, EBA members aim to establish common grounds on the evaluation and assessment of blood components collected, prepared and stored in non-DEHP devices. MATERIALS AND METHODS: Based on data as well as the input of relevant stakeholders a rationale for the validation of each component was composed. RESULTS: The red cell components will require the most extensive validation as their quality is directly affected by the absence of DEHP, as opposed to platelet and plasma components. CONCLUSION: Studies in the scope of evaluating the quality of blood products obtained with non-DEHP devices, under the condition that they are carried out according to these recommendations, could be used by all members of the EBA to serve as scientific support in the authorization process specific to their jurisdiction or for their internal validation use.Peer reviewe