Thomas St Martin Norris
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PROVIDER: S-EPMC1123690 | biostudies-literature | 2002 Jul
REPOSITORIES: biostudies-literature
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Project description: Not available
| S-EPMC1125739 | biostudies-literature
Project description:BackgroundThere is a lack of consensus on the appropriate St. Thomas cardioplegia solution interval for cardiac surgeries. The objective of this study was to determine a safe cardioplegia interval.MethodA total of 340 patients who underwent mitral valve surgery with St. Thomas solution were assessed and divided into 2 groups according to the average cardioplegia interval. In Group A, the average cardioplegia interval was < = 30 min; in Group B, the average cardioplegia interval was greater than 30 min. Propensity score matching was used to adjust for confounders between the two groups. After propensity score matching, Groups A and B contained 125 patients each. The primary endpoints were creatine kinase MB, left ventricular ejection fraction, and troponin levels after surgery. Threshold effect analysis was used to assess the association of the cardioplegia interval with the postoperative CK-MB mass level.ResultsAfter propensity score matching, postoperative CK-MB mass significantly differed between the two groups, and CK-MB levels were significantly greater in group B than in group A(Group A vs. Group B: 46.1 [46.1;48.3] ng/ml vs. 49.9 [46.1;62.7] ng/ml, p < 0.001). According to the threshold effect analysis, the interval needs to be above 27.6 min before it is associated with an increased risk of CK-MB mass level, and the interval needs to be above 31 min before it is associated with an increased risk of CK-MB mass level 7 h after surgery. There were no other significant differences between the two groups.ConclusionsThe multidose cardioplegia interval above 30 min during mitral valve surgery is associated with a greater risk of myocardial damage. The relationships between the cardioplegia interval and other myocardial markers require further research.
| S-EPMC11583754 | biostudies-literature
Project description: Not available
| S-EPMC1125266 | biostudies-literature
Project description:Managing waterborne and water-related diseases is one of the most critical factors in the aftermath of hurricane-induced natural disasters. The goal of the study was to identify water-quality impairments in order to set the priorities for post-hurricane relief and to guide future decisions on disaster preparation and relief administration. Field investigations were carried out on St. Thomas, U.S. Virgin Islands as soon as the disaster area became accessible after the back-to-back hurricane strikes by Irma and Maria in 2017. Water samples were collected from individual household rain cisterns, the coastal ocean, and street-surface runoffs for microbial concentration. The microbial community structure and the occurrence of potential human pathogens were investigated in samples using next generation sequencing. Loop mediated isothermal amplification was employed to detect fecal indicator bacteria, Enterococcus faecalis. The results showed both fecal indicator bacteria and Legionella genetic markers were prevalent but were low in concentration in the water samples. Among the 22 cistern samples, 86% were positive for Legionella and 82% for Escherichia-Shigella. Enterococcus faecalis was detected in over 68% of the rain cisterns and in 60% of the coastal waters (n = 20). Microbial community composition in coastal water samples was significantly different from cistern water and runoff water. Although identification at bacterial genus level is not direct evidence of human pathogens, our results suggest cistern water quality needs more organized attention for protection of human health, and that preparation and prevention measures should be taken before natural disasters strike.
| S-EPMC7001102 | biostudies-literature
Project description:BackgroundDel Nido cardioplegia (DNC) is a single-dose, high potassium, low-volume cardioplegia solution that has grown in favor recently. However, the use of DNC in the Asian population may be associated with certain challenges.MethodsBetween January 2017 and April 2022, DNC was used for myocardial protection in this single-center retrospective study. In total, 5731 patients underwent open heart surgeries, where 310 patients received DNC for single or multiple procedures. A total of 307 pair of propensity-matched patients from DNC and cold blood St. Thomas cardioplegia (STC) were compared.ResultsIn total, 5085 patients with STC and 310 patients with DNC from the cohort were matched, reflecting the initial group sizes before propensity matching. About 307 patient pairs were included in the final analysis after propensity matching with the interest variables. In the STC group, the requirement for an immediate postoperative intra-aortic balloon pump (IABP) was significantly higher [18 (5.9%) in DNC versus 28 (9.1%) in STC, p = 0.021]. A 30-day mortality was comparable between the DNC and STC groups (2.9% versus 3.3%, p = 1.00). Major adverse cardiac events (MACE) (2.6% versus 3.6%, p = 0.648) showed no difference between the groups. In both single and multiple procedure subgroups, there were no statistically significant differences in 30-day mortality and MACE incidences when comparing STC and DNC.ConclusionThe use of DNC in adults is acceptable and adaptable. Comparable clinical outcomes between STC patients and DNC were revealed by our investigation. There were no appreciable differences in 30-day mortality or MACE despite the STC group having a much higher need for immediate postoperative IABP.
| S-EPMC10666688 | biostudies-literature