Optimal repair timing and predictors of death in patients with ventricular septal rupture post myocardial infarction / 中华胸心血管外科杂志

Objective:The main objective of this study was to analyze the optimal timing for repair of post-AMI ventricular septal rupture(VSR). Secondary endpoints were to determine which factors could influence in-hospital mortality in the patients with VSR.Methods:We designed an observational, retrospective study, selecting 100 patients with post-AMI VSR between January 1, 2019 and August 31, 2023, with inclusion and exclusion criteria. Analyzed the usefulness and appropriate timing of surgery in this patient cohort. Compared the background characteristics, treatment and laboratory data between survival and death group. The risk factors for in-hospital mortality were assessed using multivariate analysis with a logistic regression model. Results:The overall in-hospital mortality rate was 56%, the mortality rate of surgical patients was 34.9%, and the mortality rate of conservative patients was 91.9%. Patients operated on very early(0-3 days) had significantly poor results with a mortality rate of 63.6% while those operated within 2 weeks, had a mortality rate of 38.1%, and those operated later(>14 days) showed 22.6% mortality.There were statistically significant differences between the two groups in terms of heart rate, ratio of revascularization , size of VSR, shock stage and severity of coronary artery lesions( P<0.05), and the C-reactive protein, WBC count, BNP level, creatinine level and blood lactate level in the death group were higher than those in the survival group( P<0.05). Logistic regression analysis revealed that the level of white blood cell count, lactate and brain natriuretic peptide were independent risk factors for in-hospital mortality. Conclusion:In our study, we observed that surgery is the definitive therapy for the majority of patients.For patients who are hemodynamically stable and have compensated heart failure, there may be more benefit from delayed ventricular septal rupture repair. The risk factors for in-hospital mortality were the elevated lactate levels, BNP levels and WBC count.

Self-initiated error-repairs in cluttering.

The aim of the study is the analysis of the error-repairs of people with cluttering (PWC), whether they repair their speech errors similarly to control speakers or not. Error-repairs were analysed in spontaneous speech samples of 13 PWC and 13 age- and sex-matched control speakers. Error-to-cutoff time, duration of the editing phase, and error-to-repair time were measured. Strategies of repairs (point of interruption, proportion of delays, and types of editing terms and phases) were also examined. Results of the two groups were compared. Results show that there are no differences between the two groups in the total duration of error-repairs. However, there might be differences between the two groups in the self-repair strategies. Results suggest that control speakers might try to plan the error-repairs in parallel with the speech production and they interrupt the speech when the repair is available. In contrast, PWC interrupt speaking earlier perhaps to focus on planning self-repairs.

Epidemiologic Profile of Brachial Plexus Traumatic Lesions in Adults at an Outpatient Clinic in Minas Gerais

This study aimed to raise demographic and epidemiological aspects as well as the time until surgery in patients with brachial plexus injury in Minas Gerais, Brazil. Forty-seven patients who underwent surgery were evaluated retrospectively in the period 2010 to 2011. The majority (91.5%) were male, mean age 34.4 years; 56.5% were single or separated; 55.3%, from the countryside of Minas Gerais. With regard to schooling, 47.8% had not completed elementary school level. Most of them (43.5%) had a heavy duty job, including houseworking, agriculture, industry. Traffic accidents were the main cause of the injury (97.9%); and motorcycle accidents accounted for 68.1% of the lesions. The time between the accident and the first view by brachial plexus specialist ranged from 1 month to 30 months. The time between query and specialized surgical treatment ranged from 5 to 18 months, mean 10 months. This study points out the epidemiological characteristics of patients with brachial plexus injuries in Minas Gerais, Brazil. Most of the injuries occurred after motorcycle accident in male patients with unfavorable social and economic conditions. In addition, the surgical timing was far above the recommended, resulting in an unfavorable prognosis for functional recovery.

O presente estudo objetivou levantar aspectos sociodemográficos e epidemiológicos, bem como o intervalo de tempo até a cirurgia, dos pacientes com trauma do plexo braquial em Belo Horizonte (MG). Quarenta e sete pacientes submetidos à cirurgia foram avaliados retrospectivamente no período de 2010 a 2011. A maioria (91,5%) era do sexo masculino, com média de idade de 34,4 anos; 56,5% eram solteiros ou separados; 55,3%, provenientes do interior do estado de Minas Gerais. No que se refere ao nível de escolaridade, 47,8% não haviam completado o nível de ensino fundamental. A maioria deles (43,5%) exercia atividade braçal (serviços gerais, agricultura, indústria e construção civil). Os acidentes de trânsito foram os principais causadores de trauma (97,9%), sendo os acidentes de motocicleta responsáveis por 68,1% das lesões. O tempo entre o acidente e o atendimento pelo médico especialista variou de 1 mês a 30 meses. O tempo entre a consulta especializada e o tratamento cirúrgico variou de 5 a 18 meses com média de 10 meses. O presente estudo aponta as características epidemiológicas dos pacientes com lesões de plexo braquial em Minas Gerais. A maior parte das lesões ocorreu após acidente de moto, em pacientes do sexo masculino, com condições sociais e econômicas desfavoráveis. Além disso, o tempo até o reparo das lesões foi bem acima do preconizado, implicando em prognóstico desfavorável para recuperação funcional.