Displaying publications 1 - 20 of 36 in total

Abstract:
Sort:
  1. Klionsky DJ, Abdelmohsen K, Abe A, Abedin MJ, Abeliovich H, Acevedo Arozena A, et al.
    Autophagy, 2016;12(1):1-222.
    PMID: 26799652 DOI: 10.1080/15548627.2015.1100356
  2. Jiang Y, Zhao L, Ma J, Yang Y, Zhang B, Xu J, et al.
    Phytomedicine, 2024 Jan;123:155229.
    PMID: 38006804 DOI: 10.1016/j.phymed.2023.155229
    BACKGROUND: Triphala (TLP), as a Chinese Tibetan medicine composing of Emblica officinalis, Terminalia chebula and Terminalia bellirica (1.2:1.5:1), exhibited hepatoprotective, hypolipidemic and gut microbiota modulatory effects. Nonetheless, its roles in prevention of high-fat diet (HFD)-induced nonalcoholic fatty liver disease (NAFLD) and the related mechanistic insights involving the interplay of gut microbiota and hepatic inflammation are not known.

    PURPOSE: The present study seeks to determine if TLP would prevent HFD-induced NAFLD in vivo and its underlying mechanisms from the perspectives of gut microbiota, metabolites, and hepatic inflammation.

    METHODS: TLP was subjected to extraction and chemo-profiling, and in vivo evaluation in HFD-fed rats on hepatic lipid and inflammation, intestinal microbiota, short-chain fatty acids (SCFAs) and permeability, and body weight and fat content profiles.

    RESULTS: The TLP was primarily constituted of gallic acid, corilagin and chebulagic acid. Orally administered HFD-fed rats with TLP were characterized by the growth of Ligilactobacillus and Akkermansia, and SCFAs (acetic/propionic/butyric acid) secretion which led to increased claudin-1 and zonula occludens-1 expression that reduced the mucosal permeability to migration of lipopolysaccharides (LPS) into blood and liver. Coupling with hepatic cholesterol and triglyceride lowering actions, the TLP mitigated both inflammatory (ALT, AST, IL-1β, IL-6 and TNF-α) and pro-inflammatory (TLR4, MYD88 and NF-κB P65) activities of liver, and sequel to histopathological development of NAFLD in a dose-dependent fashion.

    CONCLUSION: TLP is promisingly an effective therapy to prevent NAFLD through modulating gut microbiota, mucosal permeability and SCFAs secretion with liver fat and inflammatory responses.

  3. Landoni G, Lomivorotov V, Pisano A, Nigro Neto C, Benedetto U, Biondi Zoccai G, et al.
    Contemp Clin Trials, 2017 08;59:38-43.
    PMID: 28533194 DOI: 10.1016/j.cct.2017.05.011
    OBJECTIVE: There is initial evidence that the use of volatile anesthetics can reduce the postoperative release of cardiac troponin I, the need for inotropic support, and the number of patients requiring prolonged hospitalization following coronary artery bypass graft (CABG) surgery. Nevertheless, small randomized controlled trials have failed to demonstrate a survival advantage. Thus, whether volatile anesthetics improve the postoperative outcome of cardiac surgical patients remains uncertain. An adequately powered randomized controlled trial appears desirable.

    DESIGN: Single blinded, international, multicenter randomized controlled trial with 1:1 allocation ratio.

    SETTING: Tertiary and University hospitals.

    INTERVENTIONS: Patients (n=10,600) undergoing coronary artery bypass graft will be randomized to receive either volatile anesthetic as part of the anesthetic plan, or total intravenous anesthesia.

    MEASUREMENTS AND MAIN RESULTS: The primary end point of the study will be one-year mortality (any cause). Secondary endpoints will be 30-day mortality; 30-day death or non-fatal myocardial infarction (composite endpoint); cardiac mortality at 30day and at one year; incidence of hospital re-admission during the one year follow-up period and duration of intensive care unit, and hospital stay. The sample size is based on the hypothesis that volatile anesthetics will reduce 1-year unadjusted mortality from 3% to 2%, using a two-sided alpha error of 0.05, and a power of 0.9.

    CONCLUSIONS: The trial will determine whether the simple intervention of adding a volatile anesthetic, an intervention that can be implemented by all anesthesiologists, can improve one-year survival in patients undergoing coronary artery bypass graft surgery.

  4. Qureshi MI, Rasli AM, Awan U, Ma J, Ali G, Faridullah, et al.
    Environ Sci Pollut Res Int, 2015 Mar;22(5):3467-76.
    PMID: 25242593 DOI: 10.1007/s11356-014-3584-2
    The objective of the study is to establish the link between air pollution, fossil fuel energy consumption, industrialization, alternative and nuclear energy, combustible renewable and wastes, urbanization, and resulting impact on health services in Malaysia. The study employed two-stage least square regression technique on the time series data from 1975 to 2012 to possibly minimize the problem of endogeniety in the health services model. The results in general show that air pollution and environmental indicators act as a strong contributor to influence Malaysian health services. Urbanization and nuclear energy consumption both significantly increases the life expectancy in Malaysia, while fertility rate decreases along with the increasing urbanization in a country. Fossil fuel energy consumption and industrialization both have an indirect relationship with the infant mortality rate, whereas, carbon dioxide emissions have a direct relationship with the sanitation facility in a country. The results conclude that balancing the air pollution, environment, and health services needs strong policy vistas on the end of the government officials.
  5. Luo D, Li P, Yue Y, Ma J, Yang H
    Sensors (Basel), 2017 May 04;17(5).
    PMID: 28471372 DOI: 10.3390/s17050962
    The protection of concrete structures against corrosion in marine environments has always been a challenge due to the presence of a saline solution-A natural corrosive agent to the concrete paste and steel reinforcements. The concentration of salt is a key parameter influencing the rate of corrosion. In this paper, we propose an optical fiber-based salinity sensor based on bundled multimode plastic optical fiber (POF) as a sensor probe and a concave mirror as a reflector in conjunction with an intensity modulation technique. A refractive index (RI) sensing approach is analytically investigated and the findings are in agreement with the experimental results. A maximum sensitivity of 14,847.486/RIU can be achieved at RI = 1.3525. The proposed technique is suitable for in situ measurement and monitoring of salinity in liquid.
  6. Luszczynska A, Szczuka Z, Abraham C, Baban A, Brooks S, Cipolletta S, et al.
    Ann Behav Med, 2021 Dec 06.
    PMID: 34871341 DOI: 10.1093/abm/kaab102
    BACKGROUND: Patterns of protective health behaviors, such as handwashing and sanitizing during the COVID-19 pandemic, may be predicted by macro-level variables, such as regulations specified by public health policies. Health behavior patterns may also be predicted by micro-level variables, such as self-regulatory cognitions specified by health behavior models, including the Health Action Process Approach (HAPA).

    PURPOSE: This study explored whether strictness of containment and health policies was related to handwashing adherence and whether such associations were mediated by HAPA-specified self-regulatory cognitions.

    METHODS: The study (NCT04367337) was conducted among 1,256 adults from Australia, Canada, China, France, Gambia, Germany, Israel, Italy, Malaysia, Poland, Portugal, Romania, Singapore, and Switzerland. Self-report data on cross-situational handwashing adherence were collected using an online survey at two time points, 4 weeks apart. Values of the index of strictness of containment and health policies, obtained from the Oxford COVID-19 Government Response Tracker database, were retrieved twice for each country (1 week prior to individual data collection).

    RESULTS: Across countries and time, levels of handwashing adherence and strictness of policies were high. Path analysis indicated that stricter containment and health policies were indirectly related to lower handwashing adherence via lower self-efficacy and self-monitoring. Less strict policies were indirectly related to higher handwashing adherence via higher self-efficacy and self-monitoring.

    CONCLUSIONS: When policies are less strict, exposure to the SARS-CoV-2 virus might be higher, triggering more self-regulation and, consequently, more handwashing adherence. Very strict policies may need to be accompanied by enhanced information dissemination or psychosocial interventions to ensure appropriate levels of self-regulation.

  7. Markt SC, Shui IM, Unger RH, Urun Y, Berg CD, Black A, et al.
    Prostate, 2015 Nov;75(15):1677-81.
    PMID: 26268879 DOI: 10.1002/pros.23035
    BACKGROUND: ABO blood group has been associated with risk of cancers of the pancreas, stomach, ovary, kidney, and skin, but has not been evaluated in relation to risk of aggressive prostate cancer.

    METHODS: We used three single nucleotide polymorphisms (SNPs) (rs8176746, rs505922, and rs8176704) to determine ABO genotype in 2,774 aggressive prostate cancer cases and 4,443 controls from the Breast and Prostate Cancer Cohort Consortium (BPC3). Unconditional logistic regression was used to calculate age and study-adjusted odds ratios and 95% confidence intervals for the association between blood type, genotype, and risk of aggressive prostate cancer (Gleason score ≥8 or locally advanced/metastatic disease (stage T3/T4/N1/M1).

    RESULTS: We found no association between ABO blood type and risk of aggressive prostate cancer (Type A: OR = 0.97, 95%CI = 0.87-1.08; Type B: OR = 0.92, 95%CI =n0.77-1.09; Type AB: OR = 1.25, 95%CI = 0.98-1.59, compared to Type O, respectively). Similarly, there was no association between "dose" of A or B alleles and aggressive prostate cancer risk.

    CONCLUSIONS: ABO blood type was not associated with risk of aggressive prostate cancer.

  8. Szulkin R, Karlsson R, Whitington T, Aly M, Gronberg H, Eeles RA, et al.
    Cancer Epidemiol Biomarkers Prev, 2015 Nov;24(11):1796-800.
    PMID: 26307654 DOI: 10.1158/1055-9965.EPI-15-0543
    BACKGROUND: Unnecessary intervention and overtreatment of indolent disease are common challenges in clinical management of prostate cancer. Improved tools to distinguish lethal from indolent disease are critical.

    METHODS: We performed a genome-wide survival analysis of cause-specific death in 24,023 prostate cancer patients (3,513 disease-specific deaths) from the PRACTICAL and BPC3 consortia. Top findings were assessed for replication in a Norwegian cohort (CONOR).

    RESULTS: We observed no significant association between genetic variants and prostate cancer survival.

    CONCLUSIONS: Common genetic variants with large impact on prostate cancer survival were not observed in this study.

    IMPACT: Future studies should be designed for identification of rare variants with large effect sizes or common variants with small effect sizes.

  9. Huang W, Chen X, Guan Q, Zhong Z, Ma J, Yang B, et al.
    Gene, 2019 Mar 20;689:43-50.
    PMID: 30528270 DOI: 10.1016/j.gene.2018.11.083
    Atmospheric CO2 level is one of the most important factors which affect plant growth and crop production. Although many crucial genes and pathways have been identified in response to atmospheric CO2 changes, the integrated and precise mechanisms of plant CO2 response are not well understood. Alternative splicing (AS) is an important gene regulation process that affects many biological processes in plants. However, the AS pattern changes in plants in response to elevated CO2 levels have not yet been investigated. Here, we used RNA-Seq data of Arabidopsis thaliana grown under different CO2 concentration to analyze the global changes in AS. We found that AS increased with the rise in CO2 concentration. Additionally, we identified 345 differentially expressed (DE) genes and 251 differentially alternative splicing (DAS) genes under the elevated CO2 condition. Moreover, the results showed that the expression of most of the DAS genes did not change significantly, indicating that AS can serve as an independent mechanism for gene regulation in response to elevated CO2. Furthermore, our analysis of function categories revealed that the DAS genes were associated mainly with the stimulus response. Overall, this the first study to explore the changes of AS in plants in response to elevated CO2.
  10. Huang T, Su LJ, Zeng NK, Lee SML, Lee SS, Thi BK, et al.
    Front Microbiol, 2022;13:1087756.
    PMID: 36741898 DOI: 10.3389/fmicb.2022.1087756
    Hainan is the second largest island in China with the most extensive and well-preserved tropical forests and is also the largest island of the Indo Burma Biodiversity Hotspot. It provides in situ conservation for the unique ecosystem of the island. Recent studies have shown that there are diverse fungal species in Hainan. In this study, about 40 collections of the genus Amanita have been studied based on the morphology and molecular systematics, including 35 Chinese specimens (24 from Hainan, and eleven from other regions) and three specimens from other countries (Singapore and Malaysia). In total, five new species belonging to Amanita section Validae are described: A. cacaina, A. parvigrisea, A. pseudofritillaria, A. pseudosculpta, and A. yangii. Amanita parvifritillaria is recorded for the first time in Hainan. It is also the first report of this fungus occurring, outside Yunnan Province, China. Among the five new species, two are unique in this section because of the appendiculate pileus margin and the absence of an annulus. Based on these new findings, the diagnosis of the section Validae should be slightly modified to include a few species with appendiculate margin and the lack of annulus.
  11. Ma J, Ma NL, Fei S, Liu G, Wang Y, Su Y, et al.
    Environ Pollut, 2024 Apr 01;346:123646.
    PMID: 38402938 DOI: 10.1016/j.envpol.2024.123646
    Stover and manure are the main solid waste in agricultural industry. The generation of stover and manure could lead to serious environmental pollution if not handled properly. Composting is the potential greener solution to remediate and reduce agricultural solid waste, through which stover and manure could be remediated and converted into organic fertilizer, but the long composting period and low efficiency of humic substance production are the key constraints in such remediation approach. In this study, we explore the effect of lignocellulose selective removal on composting by performing chemical pretreatment on agricultural waste followed by utilization of biochar to assist in the remediation by co-composting treatment and reveal the impacts of different lignocellulose component on organic fertilizer production. Aiming to discover the key factors that influence humification during composting process and improve the composting quality as well as comprehensive utilization of agricultural solid waste. The results demonstrated that the removal of selective lignin or hemicellulose led to the shift of abundances lignocellulose-degrading bacteria, which in turn accelerated the degradation of lignocellulose by almost 51.2%. The process also facilitated the remediation of organic waste via humification and increased the humic acid level and HA/FA ratio in just 22 days. The richness of media relies on their lignocellulose content, which is negatively correlated with total nitrogen content, humic acid (HA) content, germination index (GI), and pH, but positively correlated with fulvic acid (FA) and total organic carbon (TOC). The work provides a potential cost effective and efficient framework for agricultural solid waste remediation and reduction.
  12. Sun C, Molineros JE, Looger LL, Zhou XJ, Kim K, Okada Y, et al.
    Nat Genet, 2016 Mar;48(3):323-30.
    PMID: 26808113 DOI: 10.1038/ng.3496
    Systemic lupus erythematosus (SLE) has a strong but incompletely understood genetic architecture. We conducted an association study with replication in 4,478 SLE cases and 12,656 controls from six East Asian cohorts to identify new SLE susceptibility loci and better localize known loci. We identified ten new loci and confirmed 20 known loci with genome-wide significance. Among the new loci, the most significant locus was GTF2IRD1-GTF2I at 7q11.23 (rs73366469, Pmeta = 3.75 × 10(-117), odds ratio (OR) = 2.38), followed by DEF6, IL12B, TCF7, TERT, CD226, PCNXL3, RASGRP1, SYNGR1 and SIGLEC6. We identified the most likely functional variants at each locus by analyzing epigenetic marks and gene expression data. Ten candidate variants are known to alter gene expression in cis or in trans. Enrichment analysis highlights the importance of these loci in B cell and T cell biology. The new loci, together with previously known loci, increase the explained heritability of SLE to 24%. The new loci share functional and ontological characteristics with previously reported loci and are possible drug targets for SLE therapeutics.
  13. Molineros JE, Yang W, Zhou XJ, Sun C, Okada Y, Zhang H, et al.
    Hum Mol Genet, 2017 03 15;26(6):1205-1216.
    PMID: 28108556 DOI: 10.1093/hmg/ddx026
    We recently identified ten novel SLE susceptibility loci in Asians and uncovered several additional suggestive loci requiring further validation. This study aimed to replicate five of these suggestive loci in a Han Chinese cohort from Hong Kong, followed by meta-analysis (11,656 cases and 23,968 controls) on previously reported Asian and European populations, and to perform bioinformatic analyses on all 82 reported SLE loci to identify shared regulatory signatures. We performed a battery of analyses for these five loci, as well as joint analyses on all 82 SLE loci. All five loci passed genome-wide significance: MYNN (rs10936599, Pmeta = 1.92 × 10-13, OR = 1.14), ATG16L2 (rs11235604, Pmeta = 8.87 × 10 -12, OR = 0.78), CCL22 (rs223881, Pmeta = 5.87 × 10-16, OR = 0.87), ANKS1A (rs2762340, Pmeta = 4.93 × 10-15, OR = 0.87) and RNASEH2C (rs1308020, Pmeta = 2.96 × 10-19, OR = 0.84) and co-located with annotated gene regulatory elements. The novel loci share genetic signatures with other reported SLE loci, including effects on gene expression, transcription factor binding, and epigenetic characteristics. Most (56%) of the correlated (r2 > 0.8) SNPs from the 82 SLE loci were implicated in differential expression (9.81 × 10-198 
  14. Lee SY, Ma J, Khoo TS, Abdullah N, Nik Md Noordin Kahar NNF, Abdul Hamid ZA, et al.
    Front Bioeng Biotechnol, 2021;9:735090.
    PMID: 34733829 DOI: 10.3389/fbioe.2021.735090
    Stem cell-based therapy appears as a promising strategy to induce regeneration of damaged and diseased tissues. However, low survival, poor engraftment and a lack of site-specificity are major drawbacks. Polysaccharide hydrogels can address these issues and offer several advantages as cell delivery vehicles. They have become very popular due to their unique properties such as high-water content, biocompatibility, biodegradability and flexibility. Polysaccharide polymers can be physically or chemically crosslinked to construct biomimetic hydrogels. Their resemblance to living tissues mimics the native three-dimensional extracellular matrix and supports stem cell survival, proliferation and differentiation. Given the intricate nature of communication between hydrogels and stem cells, understanding their interaction is crucial. Cells are incorporated with polysaccharide hydrogels using various microencapsulation techniques, allowing generation of more relevant models and further enhancement of stem cell therapies. This paper provides a comprehensive review of human stem cells and polysaccharide hydrogels most used in regenerative medicine. The recent and advanced stem cell microencapsulation techniques, which include extrusion, emulsion, lithography, microfluidics, superhydrophobic surfaces and bioprinting, are described. This review also discusses current progress in clinical translation of stem-cell encapsulated polysaccharide hydrogels for cell delivery and disease modeling (drug testing and discovery) with focuses on musculoskeletal, nervous, cardiac and cancerous tissues.
  15. Gao D, Chen H, Li H, Yang X, Guo X, Zhang Y, et al.
    Front Nutr, 2023;10:1149137.
    PMID: 37025610 DOI: 10.3389/fnut.2023.1149137
    INTRODUCTION: Arctium lappa L. root has high nutritional and medicinal values and has been identified as a healthy food raw material by the Ministry of Health of the People's Republic of China.

    METHODS: In the present study, an aqueous two-phase system (ATPS) of polyethylene glycol (PEG)-(NH4)2SO4 was used to extract Arctium lappa L. polysaccharides (ALPs) from the Arctium lappa L. roots, the optimal extraction conditions of crude ALPs were optimized by using the single-factor experiment and response surface methodology. The structure and composition of ALPs were determined by fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), and high-performance liquid chromatography (HPLC). At the same time, the antioxidant activity of ALPs was investigated by in vitro antioxidant experiment.

    RESULTS: The optimized extraction parameters for extraction ALPs were as follows: the PEG relative molecular weight of 6,000, a quality fraction of PEG 25%, a quality fraction of (NH4)2SO4 18%, and an extraction temperature of 80°C. Under these conditions, the extraction rate of ALPs could reach 28.83%. FTIR, SEM and HPLC results showed that ALPs were typical acidic heteropolysaccharides and had uneven particle size distribution, an irregular shape, and a rough surface. The ALPs were chiefly composed of glucose, rhamnose, arabinose, and galactose with a molar ratio of 70.19:10.95:11.16:6.90. In addition, the ALPs had intense antioxidant activity in vitro with IC50 values in the ·OH radical (1.732 mg/ml), DPPH radical (0.29 mg/ml), and superoxide anion (0.15 mg/ml) scavenging abilities.

    DISCUSSION: The results showed that ATPS was an efficient method to extract polysaccharides and could be used for the extraction of other polysaccharides. These results indicated that ALPs had great prospects as a functional food and could be exploited in multiple fields.

  16. Li Y, Li S, Wang Y, Zhou J, Yang J, Ma J
    J Fr Ophtalmol, 2021 Dec;44(10):1596-1604.
    PMID: 34454773 DOI: 10.1016/j.jfo.2021.05.005
    BACKGROUND: The main risks for glaucoma are increased intraocular pressure (IOP) and decreased ocular perfusion pressure (OPP). This review aims to examine the potential impact of lower limb isometric resistance exercise on intraocular pressure and ocular perfusion pressure.

    METHOD: A meta-analysis was conducted to determine the potential impact of isometric exercise on IOP and OPP. The literature on the relationship between isometric resistance exercise and IOP was systematically searched according to the "Cochrane Handbook" in the databases of Pubmed, Web of Science, EBSCO, and Scopus through December 31, 2020. The search terms used were "exercise," "train," "isometric," "intraocular pressure," and "ocular perfusion pressure," and the mean differences of the data were analyzed using the Stata 16.0 software, with a 95% confidence interval.

    RESULTS: A total of 13 studies, which included 268 adult participants consisting of 162 men and 106 women, were selected. All the exercise programs that were included were isometric resistance exercises of the lower limbs with intervention times of 1min, 2min, or 6min. The increase in IOP after intervention was as follows: I2=87.1%, P=0.001 using random-effects model combined statistics, SMD=1.03 (0.48, 1.59), and the increase in OPP was as follows: I2=94.5%, P=0.001 using random-effects model combined statistics, SMD=2.94 (1.65, 4.22), with both results showing high heterogeneity.

    CONCLUSION: As isometric exercise may cause an increase in IOP and OPP, therefore, people with glaucoma and related high risk should perform isometric exercise with caution.

  17. He L, Soh KL, Huang F, Khaza'ai H, Geok SK, Vorasiha P, et al.
    J Affect Disord, 2023 Jan 15;321:304-319.
    PMID: 36374719 DOI: 10.1016/j.jad.2022.10.026
    BACKGROUND: No meta-analysis has analyzed the effect of physical activity level, period of physical activity intervention, and duration of intervention, on perinatal depression. This study was to evaluate the impact of physical activity intensity, dose, period, and duration on perinatal depression.

    METHODS: The literature was searched via the PubMed, Embase, Cochrane Library, and Web of Science databases. Weighted mean difference (WMD) or the risk ratio (RR) was used as the effect indicator, and the effect size was represented by the 95 % confidence interval (CI). Subgroup analysis based on the perinatal stage, physical activity intensity, physical activity equivalent, and intervention duration was performed.

    RESULTS: Totally, 35 studies including 5084 women were included. Physical activity could reduce the incidence and severity of depression in perinatal women. Among depressed women with prenatal depression, low-intensity physical activity, with metabolic equivalents (METs)-min/week being <450, was associated with lower levels of depression. In the general population, the risk of postpartum depression was lower in the physical activity group when the duration of intervention was ≥12 weeks, being II, III stage, and ≥450 METs-min/week. Both low and moderate-intensity physical activity were beneficial to an improved depression severity among depressed women with postpartum depression, and moderate exercise intervention could decrease the risk of postpartum depression in general pregnant women.

    LIMITATIONS: Different types of physical activities may affect the effectiveness of interventions.

    CONCLUSION: Our study indicated physical activity specifically targeted at pregnant women could reduce depression risk and severity.

  18. Liew ZS, Ho YC, Lau WJ, Nordin NAHM, Lai SO, Ma J
    Environ Technol, 2024 Feb;45(6):1052-1065.
    PMID: 36250395 DOI: 10.1080/09593330.2022.2137435
    The scarcity of energy and water resources is a major challenge for humanity in the twenty-first century. Engineered osmosis (EO) technologies are extensively researched as a means of producing sustainable water and energy. This study focuses on the modification of substrate properties of thin film nanocomposite (TFN) membrane using aluminium oxide (Al2O3) nanoparticles and further evaluates the performance of resultant membranes for EO process. Different Al2O3 loading ranging from zero to 0.10 wt% was incorporated into the substrate and the results showed that the hydrophilicity of substrate was increased with contact angle reduced from 74.81° to 66.17° upon the Al2O3 incorporation. Furthermore, the addition of Al2O3 resulted in the formation of larger porous structure on the bottom part of substrate which reduced water transport resistance. Using the substrate modified by 0.02 wt% Al2O3, we could produce the TFN membrane that exhibited the highest water permeability (1.32 L/m2.h.bar, DI water as a feed solution at 15 bar), decent salt rejection (96.89%), low structural parameter (532.44 μm) and relatively good pressure withstandability (>25 bar).
  19. Landoni G, Lomivorotov VV, Nigro Neto C, Monaco F, Pasyuga VV, Bradic N, et al.
    N Engl J Med, 2019 03 28;380(13):1214-1225.
    PMID: 30888743 DOI: 10.1056/NEJMoa1816476
    BACKGROUND: Volatile (inhaled) anesthetic agents have cardioprotective effects, which might improve clinical outcomes in patients undergoing coronary-artery bypass grafting (CABG).

    METHODS: We conducted a pragmatic, multicenter, single-blind, controlled trial at 36 centers in 13 countries. Patients scheduled to undergo elective CABG were randomly assigned to an intraoperative anesthetic regimen that included a volatile anesthetic (desflurane, isoflurane, or sevoflurane) or to total intravenous anesthesia. The primary outcome was death from any cause at 1 year.

    RESULTS: A total of 5400 patients were randomly assigned: 2709 to the volatile anesthetics group and 2691 to the total intravenous anesthesia group. On-pump CABG was performed in 64% of patients, with a mean duration of cardiopulmonary bypass of 79 minutes. The two groups were similar with respect to demographic and clinical characteristics at baseline, the duration of cardiopulmonary bypass, and the number of grafts. At the time of the second interim analysis, the data and safety monitoring board advised that the trial should be stopped for futility. No significant difference between the groups with respect to deaths from any cause was seen at 1 year (2.8% in the volatile anesthetics group and 3.0% in the total intravenous anesthesia group; relative risk, 0.94; 95% confidence interval [CI], 0.69 to 1.29; P = 0.71), with data available for 5353 patients (99.1%), or at 30 days (1.4% and 1.3%, respectively; relative risk, 1.11; 95% CI, 0.70 to 1.76), with data available for 5398 patients (99.9%). There were no significant differences between the groups in any of the secondary outcomes or in the incidence of prespecified adverse events, including myocardial infarction.

    CONCLUSIONS: Among patients undergoing elective CABG, anesthesia with a volatile agent did not result in significantly fewer deaths at 1 year than total intravenous anesthesia. (Funded by the Italian Ministry of Health; MYRIAD ClinicalTrials.gov number, NCT02105610.).

  20. Zangrillo A, Lomivorotov VV, Pasyuga VV, Belletti A, Gazivoda G, Monaco F, et al.
    PMID: 35168907 DOI: 10.1053/j.jvca.2022.01.001
    OBJECTIVE: To investigate the effect of volatile anesthetics on the rates of postoperative myocardial infarction (MI) and cardiac death after coronary artery bypass graft (CABG).

    DESIGN: A post hoc analysis of a randomized trial.

    SETTING: Cardiac surgical operating rooms.

    PARTICIPANTS: Patients undergoing elective, isolated CABG.

    INTERVENTIONS: Patients were randomized to receive a volatile anesthetic (desflurane, isoflurane, or sevoflurane) or total intravenous anesthesia (TIVA). The primary outcome was hemodynamically relevant MI (MI requiring high-dose inotropic support or prolonged intensive care unit stay) occurring within 48 hours from surgery. The secondary outcome was 1-year death due to cardiac causes.

    MEASUREMENTS AND MAIN RESULTS: A total of 5,400 patients were enrolled between April 2014 and September 2017 (2,709 patients randomized to the volatile anesthetics group and 2,691 to TIVA). The mean age was 62 ± 8.4 years, and the median baseline ejection fraction was 57% (50-67), without differences between the 2 groups. Patients in the volatile group had a lower incidence of MI with hemodynamic complications both in the per-protocol (14 of 2,530 [0.6%] v 27 of 2,501 [1.1%] in the TIVA group; p = 0.038) and as-treated analyses (16 of 2,708 [0.6%] v 29 of 2,617 [1.1%] in the TIVA group; p = 0.039), but not in the intention-to-treat analysis (17 of 2,663 [0.6%] v 28 of 2,667 [1.0%] in the TIVA group; p = 0.10). Overall, deaths due to cardiac causes were lower in the volatile group (23 of 2,685 [0.9%] v 40 of 2,668 [1.5%] than in the TIVA group; p = 0.03).

    CONCLUSIONS: An anesthetic regimen, including volatile agents, may be associated with a lower rate of postoperative MI with hemodynamic complication in patients undergoing CABG. Furthermore, it may reduce long-term cardiac mortality.

Related Terms
Filters
Contact Us

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links