| 1 | 肾功能不全可预测首次适当除颤器电击时间显示文摘Background: Indications for implantable cardioverter defibrillator(ICD) implantation are expanding, but many primary and secondary ICD trials have excluded patients with advanced renal insufficiency. We investigated the effect of renal function on the incidence and time to first appropriate ICD shock. Method: We analyzed data from all new ICD implantations at a tertiary care center from July 2001 to December 2002. Results: During a mean follow-up time of 445±285 days, 29(13%) of 230 patients(age 63±14 years, 79%men, 77%white, 75%coronary artery disease, left ventricular ejection fraction 0.28±0.14) received 41 appropriate shocks. Patients were divided into tertiles according to their serum creatinine level. The 1-year incidence of appropriate ICD shock was 3.8%, 10.8%, and 22.7%in the first, second, and third tertiles, respectively(P=.003). Using the same cut off values of serum creatinine, the 1-year incidence of appropriate ICD therapy(shock and antitachycardia pacing)was 8.8%, 20.8%, and 26.3%(P=.02). After correcting for age, sex, race, left ventricular ejection fraction, indication for ICD implantation, and use of β-blockers in a Cox regression model, serum creatinine was still an independent predictor of the time to first appropriate ICD shock(hazard ratio 6.0 for the third compared with the first tertile, P=.001). Conclusion: Renal insufficiency is a strong predictor of appropriate ICD shocks. Defibrillator therapy should therefore not be withheld based on the presence of this comorbidity. The mechanisms underlying the relationship between renal function and ventricular arrhythmias deserve further investigation. | Hreybe H. Ezzeddine R. Bedi M. S.Saba 杨海涛 | 2006 | 世界核心医学期刊文摘(心脏病学分册)2006，2，9： | 0 |
| 2 | Microdebrider complications in sinus surgery:Analysis of the openFDA database显示文摘Objective:Functional endoscopic sinus surgery is a commonly performed otolaryngologic procedure that often uses the microdebrider device for tissue removal.Given the ubiquitous nature of the instrument,we sought to better define the patterns of device failure using the postmarket surveillance openFDA database.Methods:The openFDA database was queried for all microdebrider‐related adverse events from January 1,2000 to November 1,2020.Descriptive information on the nature of device failure and any associated patient injury was compiled.Reports not directly related to device failure were excluded from the analysis.Results:A total of 641 events were included in the analysis.The most common device failure was overheating(n=348,54.3%),followed by material separation(n=173,27%),and inconsistent device activation(n=52,8.1%).Of the reported events,the vast majority did not result in patient harm(n=579,90.3%).On review of the remaining cases,only 24 events(3.7%)resulted in true harm to the patient,defined as a temporary or permanent injury or>30 min of additional anesthesia time.Of these cases,the need to reschedule surgical cases(n=5,0.8%),retained foreign body(n=5,0.8%),and thermal tissue injury(n=3,0.5%)were the most common.Five patients suffered an injury due to surgeon error unrelated to device malfunction(n=5,0.8%).Conclusions:Microdebrider device failures are extremely rare.When they do occur,less than 10%result in patient harm.In cases of patient harm related to microdebrider failure,preoperative testing of the device before use could prevent many of the reported malfunctions. | Elias S.Saba Jacob Hoerter Jeremy Chang David W.Chou Chris Xiao Jacob G.Eide Rijul S.Kshirsagar James N.Palmer Nithin D.Adappa | 2023 | World Journal of Otorhinolaryngology-Head and Neck Surgery2023，9，4： | 0 |
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