scholarly journals Household serial interval of COVID-19 and the effect of Variant B.1.1.7: analyses from prospective community cohort study (Virus Watch)

2021 ◽  
Vol 6 ◽  
pp. 224
Author(s):  
Cyril Geismar ◽  
Ellen Fragaszy ◽  
Vincent Nguyen ◽  
Wing Lam Erica Fong ◽  
Madhumita Shrotri ◽  
...  
Keyword(s):  
Cohort Study ◽  
Illness Episode ◽  
Viral Shedding ◽  
Serial Interval ◽  
Significant Difference ◽  
Rapid Spread ◽  
Global Spread ◽  
The Mean ◽  
The Uk ◽  
Rapid Emergence

Introduction: Increased transmissibility of B.1.1.7 variant of concern (VOC) in the UK may explain its rapid emergence and global spread. We analysed data from putative household infector - infectee pairs in the Virus Watch Community cohort study to assess the serial interval of COVID-19 and whether this was affected by emergence of the B.1.1.7 variant. Methods: The Virus Watch study is an online, prospective, community cohort study following up entire households in England and Wales during the COVID-19 pandemic. Putative household infector-infectee pairs were identified where more than one person in the household had a positive swab matched to an illness episode. Data on whether or not individual infections were caused by the B.1.1.7 variant were not available. We therefore developed a classification system based on the percentage of cases estimated to be due to B.1.1.7 in national surveillance data for different English regions and study weeks. Results: Out of 24,887 illnesses reported, 915 tested positive for SARS-CoV-2 and 186 likely ‘infector-infectee’ pairs in 186 households amongst 372 individuals were identified. The mean COVID-19 serial interval was 3.18 (95%CI: 2.55-3.81, sd=4.36) days. There was no significant difference (p=0.267) between the mean serial interval for VOC hotspots (mean = 3.64 days, (95%CI: 2.55 – 4.73)) days and non-VOC hotspots, (mean = 2.72 days, (95%CI: 1.48 – 3.96)). Conclusions: Our estimates of the average serial interval of COVID-19 are broadly similar to estimates from previous studies and we find no evidence that B.1.1.7 is associated with a change in serial intervals.  Alternative explanations such as increased viral load, longer period of viral shedding or improved receptor binding may instead explain the increased transmissibility and rapid spread and should undergo further investigation.

scholarly journals Serial interval of COVID-19 and the effect of Variant B.1.1.7: analyses from a prospective community cohort study (Virus Watch).

2021 ◽  
Author(s):  
Cyril Roman Geismar ◽  
Ellen Fragaszy ◽  
Vincent Grigori Nguyen ◽  
Wing Lam Erica Fong ◽  
Madhumita Shrotri ◽  
...  
Keyword(s):  
Cohort Study ◽  
Illness Episode ◽  
Viral Shedding ◽  
Serial Interval ◽  
Significant Difference ◽  
Rapid Spread ◽  
Global Spread ◽  
The Mean ◽  
The Uk ◽  
Rapid Emergence

Introduction Increased transmissibility of B.1.17 variant of concern (VOC) in the UK may explain its rapid emergence and global spread. We analysed data from putative household infector infectee pairs in the Virus Watch Community cohort study to assess the serial interval of COVID-19 and whether this was affected by emergence of the B.1.17 variant. Methods The Virus Watch study is an online, prospective, community cohort study following up entire households in England and Wales during the COVID-19 pandemic. Putative household infector infectee pairs were identified where more than one person in the household had a positive swab matched to an illness episode. Data on whether individual infections were caused by the B.1.1.7 variant were not available. We therefore developed a classification system based on the percentage of cases estimated to be due to B.1.17 in national surveillance data for different English regions and study weeks. Results Out of 24,887 illnesses reported, 915 tested positive for SARS-CoV-2 and 186 likely infector infectee pairs in 186 households amongst 372 individuals were identified. The mean COVID-19 serial interval was 3.18 (95%CI: 2.55;3.81) days. There was no significant difference (p=0.267) between the mean serial interval for Variants of Concern (VOC) hotspots (mean = 3.64 days, (95%CI: 2.55;4.73)) days and non-VOC hotspots, (mean = 2.72 days, (95%CI: 1.48;3.96)). Conclusions Our estimates of the average serial interval of COVID-19 are broadly similar to estimates from previous studies and we find no evidence that B.1.1.7 is associated with a change in serial intervals. Alternative explanations such as increased viral load, longer period of viral shedding or improved receptor binding may instead explain the increased transmissibility and rapid spread and should undergo further investigation.

scholarly journals Serial interval of COVID-19 and the effect of Variant B.1.1.7: analyses from prospective community cohort study (Virus Watch)

2021 ◽  
Vol 6 ◽  
pp. 224
Author(s):  
Cyril Geismar ◽  
Ellen Fragaszy ◽  
Vincent Nguyen ◽  
Wing Lam Erica Fong ◽  
Madhumita Shrotri ◽  
...  
Keyword(s):  
Cohort Study ◽  
Illness Episode ◽  
Viral Shedding ◽  
Serial Interval ◽  
Significant Difference ◽  
Rapid Spread ◽  
Global Spread ◽  
The Mean ◽  
The Uk ◽  
Rapid Emergence

Introduction: Increased transmissibility of B.1.1.7 variant of concern (VOC) in the UK may explain its rapid emergence and global spread. We analysed data from putative household infector - infectee pairs in the Virus Watch Community cohort study to assess the serial interval of COVID-19 and whether this was affected by emergence of the B.1.1.7 variant. Methods: The Virus Watch study is an online, prospective, community cohort study following up entire households in England and Wales during the COVID-19 pandemic. Putative household infector-infectee pairs were identified where more than one person in the household had a positive swab matched to an illness episode. Data on whether or not individual infections were caused by the B.1.1.7 variant were not available. We therefore developed a classification system based on the percentage of cases estimated to be due to B.1.1.7 in national surveillance data for different English regions and study weeks. Results: Out of 24,887 illnesses reported, 915 tested positive for SARS-CoV-2 and 186 likely ‘infector-infectee’ pairs in 186 households amongst 372 individuals were identified. The mean COVID-19 serial interval was 3.18 (95%CI: 2.55 - 3.81) days. There was no significant difference (p=0.267) between the mean serial interval for VOC hotspots (mean = 3.64 days, (95%CI: 2.55 – 4.73)) days and non-VOC hotspots, (mean = 2.72 days, (95%CI: 1.48 – 3.96)). Conclusions: Our estimates of the average serial interval of COVID-19 are broadly similar to estimates from previous studies and we find no evidence that B.1.1.7 is associated with a change in serial intervals.  Alternative explanations such as increased viral load, longer period of viral shedding or improved receptor binding may instead explain the increased transmissibility and rapid spread and should undergo further investigation.

scholarly journals Breastfeeding self-efficacy: a cohort study

2014 ◽  
Vol 27 (5) ◽  
pp. 465-470 ◽  
Author(s):  
Erdnaxela Fernandes do Carmo Souza ◽  
Rosa Áurea Quintella Fernandes
Keyword(s):  
Cohort Study ◽  
Exclusive Breastfeeding ◽  
Self Efficacy ◽  
Short Form ◽  
Clinical Use ◽  
High Efficacy ◽  
Early Weaning ◽  
Significant Difference ◽  
The Mean ◽  
Postpartum Mothers

Objective Evaluate the clinical use of the Breastfeeding Self-Efficacy Scale as predictive of early weaning and verify if women who had higher self-efficacy scores breastfed for longer periods. Methods Cohort study developed with 100 postpartum mothers. Research instrument used: Breastfeeding Self-Efficacy Scale-Short Form. The feeding was monitored on the 7th, 15th, 30th, 45th and 60th day, by phone. Results The mean duration of exclusive breastfeeding was 53.2 days (SD 14.2). Most mothers (82.3%) had scores compatible with high self-efficacy for breastfeeding, none had low efficacy. There was no statistically significant difference in the comparison of mean duration of exclusive and non-exclusive breastfeeding, with the scores of medium and high efficacy. Conclusion Findings did not enable the confirmation of the use of the scale as a predictor of risk of early weaning. No relation was observed between higher scores of high efficacy and longer periods of exclusive breastfeeding.

scholarly journals KADAR KALIUM DI PACKED RED CELLS SIMPANAN

2018 ◽  
Vol 20 (2) ◽  
pp. 147
Author(s):  
Angeline Sutjianto ◽  
Asvin Nurulita ◽  
Fitriani Mangarengi
Keyword(s):  
Cohort Study ◽  
Blood Transfusion ◽  
Blood Cells ◽  
Potassium Level ◽  
Blood Collection ◽  
Red Cell ◽  
Blood Unit ◽  
Significant Difference ◽  
The Mean ◽  
Transfusion Complications

Blood transfusion, is not only transferring the blood cells to the recipient, but also transferring other components such as: glucose,lactate, and potassium. When the blood is stored, many alterations occur in its cmponents, particularly a decrease of adenosine5-triphosphate (ATP) and pH, hemolysis, and an increase of potassium levels as well. One of the transfusion complications that should beavoided is hyperkalemia due to the accumulation of potassium that leaks during the storage. However, hyperkalemia related to transfusiondepends not only on the potassium level in the blood unit, but also on its volume and the rate of its blood administration as well. Theaim of this study was to know the potassium levels in stored Packed Red Cell (PRC). A cohort study was done from May–July 2010. Theresearchers used 48 samples from 16 PRCs derived from 16 donors. The samples were drawn from the of PRC hose’s plasma that had beensealed. The potassium levels were measured on the first day, 10th day, and 20th day of the blood collection. The mean potassium levelon the first day was 3.79 mmol/L, 10th day was 12.22 mmol/L and 20th day was 19.77 mmol/L. Comparison of the potassium levelsbetween the first and 10th day, between first and 20th day, and between 10th and 20th day showed a significant difference (p=0.00). Theincrease of potassium levels in the PRC coincide with the storagetime.

scholarly journals Impact of vaccination on SARS-CoV-2 cases in the community: a population-based study using the UK’s COVID-19 Infection Survey

2021 ◽  
Author(s):  
Emma Pritchard ◽  
Philippa C. Matthews ◽  
Nicole Stoesser ◽  
David W. Eyre ◽  
Owen Gethings ◽  
...  
Keyword(s):  
Cohort Study ◽  
Single Dose ◽  
Population Based ◽  
Rt Pcr ◽  
Population Based Study ◽  
Viral Shedding ◽  
Asymptomatic Infections ◽  
The Uk ◽  
Prior Infection ◽  
Nose And Throat

AbstractObjectivesTo assess the effectiveness of COVID-19 vaccination in preventing SARS-CoV-2 infection in the community.DesignProspective cohort study.SettingThe UK population-representative longitudinal COVID-19 Infection Survey.Participants373,402 participants aged ≥16 years contributing 1,610,562 RT-PCR results from nose and throat swabs between 1 December 2020 and 3 April 2021.Main outcome measuresNew RT-PCR-positive episodes for SARS-CoV-2 overall, by self-reported symptoms, by cycle threshold (Ct) value (<30 versus ≥30), and by gene positivity (compatible with the B.1.1.7 variant versus not).ResultsOdds of new SARS-CoV-2 infection were reduced 65% (95% CI 60 to 70%; P<0.001) in those ≥21 days since first vaccination with no second dose versus unvaccinated individuals without evidence of prior infection (RT-PCR or antibody). In those vaccinated, the largest reduction in odds was seen post second dose (70%, 95% CI 62 to 77%; P<0.001).There was no evidence that these benefits varied between Oxford-AstraZeneca and Pfizer-BioNTech vaccines (P>0.9).There was no evidence of a difference in odds of new SARS-CoV-2 infection for individuals having received two vaccine doses and with evidence of prior infection but not vaccinated (P=0.89). Vaccination had a greater impact on reducing SARS-CoV-2 infections with evidence of high viral shedding Ct<30 (88% reduction after two doses; 95% CI 80 to 93%; P<0.001) and with self-reported symptoms (90% reduction after two doses; 95% CI 82 to 94%; P<0.001); effects were similar for different gene positivity patterns.ConclusionVaccination with a single dose of Oxford-AstraZeneca or Pfizer-BioNTech vaccines, or two doses of Pfizer-BioNTech, significantly reduced new SARS-CoV-2 infections in this large community surveillance study. Greater reductions in symptomatic infections and/or infections with a higher viral burden are reflected in reduced rates of hospitalisations/deaths, but highlight the potential for limited ongoing transmission from asymptomatic infections in vaccinated individuals.RegistrationThe study is registered with the ISRCTN Registry, ISRCTN21086382.

scholarly journals Metabolic parameters in cord blood of neonate of mothers with obese and non-obese PCOS and controls: retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sanaz Alizadeh ◽  
Shahideh Jahanian Sadatmahalleh ◽  
Fatemeh Razavinia ◽  
Mahnaz Bahri Khomami ◽  
Malihe Nasiri ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cord Blood ◽  
Blood Sugar ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Density Lipoprotein ◽  
Blood Lipid ◽  
Metabolic Parameters ◽  
Significant Difference ◽  
The Mean

Abstract Background Polycystic ovary syndrome (PCOS) is characterized by reproductive disorder and increased risk of metabolic syndrome. This study aimed to assess the metabolic parameters in the cord blood of neonate of mothers with obese PCOS and comparison with non-obese PCOS and controls. Methods This retrospective cohort study was conducted in Arash and Kamali Hospital in 2017–2018. The biochemical test was conducted on 78 neonates from obese PCOS mothers, 78 neonates from non-obese PCOS mothers, and 78 neonates from healthy mothers. Finally, cord blood lipid profile and insulin and blood sugar were determined by specific kits. Correlations between variables were compared with chi-square, Mann-Whitney’s U, Kruskal-Wallis H tests and regression model by SPSS 23 and P < 0.05 was considered significant. Results Triglycerides (TG) and high-density lipoprotein cholesterol (HDL) were higher in cord blood of newborn of obese PCOS women than non-obese PCOS and controls (P = 0.02, P < 0.001, respectively). Also, the mean insulin was higher in cord blood of neonate of non-obese PCOS women than in obese PCOS and controls (12.26 ± 12.79 vs. 11.11 ± 16.51 vs. 6.21 ± 10.66, P = 0.01). But in the study, there was no significant difference between the mean of umbilical cord low-density lipoprotein cholesterol (LDL), total cholesterol and blood sugar in three groups. The logistic regression model showed that metabolic parameters were related to PCOS. Conclusions In the present study, there was a significant difference between the mean of umbilical cord HDL, cholesterol, and the insulin level in the three groups. But, there was no significant association between the mean of blood sugar, LDL, and TG in the groups. The metabolic disorder in PCOS might affect cord blood lipid and insulin and adulthood health.

Two Recombinant Tissue Factor Reagents Compared to Conventional Thromboplastins for Determination of International Normalised Ratio: A Thirty-three-laboratory Collaborative Study

1996 ◽  
Vol 76 (03) ◽  
pp. 372-376 ◽  
Author(s):  
S Kitchen ◽  
I Jennings ◽  
T A L Woods ◽  
I D Walker ◽  
F E Preston ◽  
...  
Keyword(s):  
Tissue Factor ◽  
Collaborative Study ◽  
Routine Clinical Practice ◽  
Significant Difference ◽  
The Mean ◽  
Recombinant Technology ◽  
The Uk ◽  
Local Use ◽  
The Relationship

SummaryRecent advances in recombinant technology have led to the development of prothrombin time (PT) reagents containing recombinant tissue factor which has been lipidated to allow expression of procoagulant activity. In this study we have compared International Normalised Ratios (INRs) determined using two such reagents and conventional thromboplastins in widespread use in the UK.Lyophilised plasma samples from eight different warfarinised patients were distributed to 33 laboratories in the UK. Each participant determined prothrombin times on 20 local fresh normal plasmas (used to derive mean normal PT and calculate INR) and the eight lyophilised samples, using manual technique and the following thromboplastins; Recombiplastin (Ortho Diagnostics Ltd); Innovin (Baxter Diagnostics Ltd); the conventional thromboplastin in local use.For eight plasmas the mean INRs determined with different reagents were as follows: Innovin (33 laboratories) - 3.4; Manchester Reagent (MR = 8 laboratories) - 3.4; Recombiplastin (33 laboratories) - 3.7; Instrumentation Laboratory (IL = 13 laboratories) - 4.4.Mean INR results with Recombiplastin were on average 7% greater than those obtained with Innovin, 8% greater than results with MR and 18% less than INRs with IL thromboplastin. There was no significant difference between results obtained with Innovin and MR. In contrast INRs obtained with IL were markedly (mean 28%) greater than results obtained with Innovin.This study employed lyophilised plasma and it is possible that some of the relationships described are influenced by this. However, the lyo-philisation process employed did not influence the relationship between INRs of warfarinised plasmas obtained by the four main reagents described, indicating that the results are relevant to routine clinical practice.In conclusion, our data show some important differences are present between INRs determined using Recombiplastin, Innovin and two conventional thromboplastins.

Transscleral versus endoscopic cyclophotocoagulation outcomes for refractory glaucoma

2020 ◽  
pp. 112067212091423 ◽  
Author(s):  
Aitor Lanzagorta-Aresti ◽  
Santiago Montolío-Marzo ◽  
Juan María Davó-Cabrera ◽  
Jose Vicente Piá-Ludeña
Keyword(s):  
Cohort Study ◽  
Intraocular Pressure ◽  
Success Rate ◽  
Vision Loss ◽  
Refractory Glaucoma ◽  
Pressure Decrease ◽  
Significant Difference ◽  
Transscleral Cyclophotocoagulation ◽  
The Mean

Objectives: Evaluate the efficacy of transscleral cyclophotocoagulation versus endoscopic cyclophotocoagulation to reduce intraocular pressure. Methods: A retrospective, non-randomized cohort study with 1 year of follow-up included 62 eyes of 62 refractory glaucoma patients who underwent transscleral cyclophotocoagulation or endoscopic cyclophotocoagulation. Results: Thirty-two patients were enrolled in transscleral cyclophotocoagulation group and 30 patients in endoscopic cyclophotocoagulation group, and the follow-up period was 1 year. The mean preoperative intraocular pressure was 35.6 ± 12.9 mm Hg in the transscleral cyclophotocoagulation group and 31.8 ± 8.8 mm Hg in the endoscopic cyclophotocoagulation group without significant difference ( p = 0.18). When we compare both groups, there was no difference at 1 month ( p = 0.46) and 3 months ( p = 0.21) after surgery. However, there was a statistically significant difference at month 6 ( p = 0.0055) and 1 year ( p = 0.0019), finding lower intraocular pressure in the transscleral cyclophotocoagulation group. Cumulative success for intraocular pressure <21 mm Hg was 93.8% in transscleral cyclophotocoagulation group and 83.3% in endoscopic cyclophotocoagulation group after 1 year ( p = 0.2). For intraocular pressure <18 mm Hg, the success rate was 78.1% in transscleral cyclophotocoagulation group and 63.3% in endoscopic cyclophotocoagulation group ( p = 0.06), and for intraocular pressure <16 mm Hg, the success rate was 62.5% in transscleral cyclophotocoagulation group and 43.3% in endoscopic cyclophotocoagulation group ( p = 0.02). Hypotony ( p = 0.01) and vision loss of two lines ( p = 0.01) were statistically significant lower in endoscopic cyclophotocoagulation group. Conclusion: This study demonstrates that both transscleral cyclophotocoagulation and endoscopic cyclophotocoagulation are effective at decreasing intraocular pressure. However, transscleral cyclophotocoagulation is related to more complications than endoscopic cyclophotocoagulation, whereas endoscopic cyclophotocoagulation shows lower intraocular pressure decrease than transscleral cyclophotocoagulation.

scholarly journals Clinical Evaluation of Efficacy of a Herbal Formulation Used in the Treatment of Malaria

2019 ◽  
pp. 1-7
Author(s):  
Bernard K. Turkson ◽  
M. L. K. Mensah ◽  
Kwame Sarpong
Keyword(s):  
Malaria Parasite ◽  
Public Health Problem ◽  
Parasite Load ◽  
Stem Bark ◽  
Government Hospital ◽  
Herbal Formulation ◽  
Significant Difference ◽  
Detailed Medical History ◽  
Rapid Spread ◽  
The Mean

Malaria is a public health problem and continues to be a major cause of morbidity and mortality in most tropical and subtropical countries. A rapid spread of malarial disease globally due to treatment failure has led to an urgent need for new effective antimalarials which medicinal plants have contributed to in medicine. The objective of this research is to determine the effectiveness of Mist Amen Fevermix which is a decoction of the stem bark of Morinda lucida and Parinari robusta in the treatment of uncomplicated malaria in humans, at the Tafo Government Hospital, Kumasi. Clinically established malaria in male and female patients aged, 15-60 years were treated with Mist Amen Fevermix, at the specified dose of 45 mls (0.45 g) three times daily for six days. A total of 50 patients were diagnosed with malaria disease. At the randomization visit, a detailed medical history was obtained and the patients underwent laboratory investigation was done at entry and after completing the study. All the 50 patients completed the study and there was a statistically significant difference between the mean levels of malaria parasite load recorded 28 indicating a significant effectiveness of Mist Amen Fevermix used by the patients. Parasitaemia clearance was 82.35% within the first three days in clients who responded positively to treatment. Results of the study suggest that Mist Amen Fevermix is an effective herbal antimalarial agent when used as specified by the manufacturer.

scholarly journals Outcomes of Mitral Valve Replacement after Closed Mitral Valvotomy: A Retrospective Cohort Study

2019 ◽  
Vol 22 (3) ◽  
pp. E207-E212
Author(s):  
Bineesh K. Radhakrishnan ◽  
Renjith Sreekantan ◽  
Varghese T. Panicker ◽  
Jayakumar Karunakaran
Keyword(s):  
Atrial Fibrillation ◽  
Cohort Study ◽  
Mitral Stenosis ◽  
Retrospective Cohort ◽  
Significant Difference ◽  
Valve Size ◽  
Mitral Valvotomy ◽  
Pulmonary Arterial ◽  
The Mean ◽  
Rv Function

Background: The incidence of rheumatic fever and rheumatic heart disease still remains high in the developing countries. Mitral stenosis is predominantly due to rheumatic origin and affects females more than males. Historically, closed mitral valvotomy (CMV) was the first effective intervention for mitral stenosis. We studied the immediate and early surgical outcomes of MVR in patients with history of CMV to see whether their disease behaves differently, when compared with patients without prior CMV undergoing MVR. Methods: This single center retrospective cohort study was conducted in Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India. Patients who underwent MVR from January 2008 to December 2012 at our institute were studied. The hospital records of 90 patients were analyzed both in the CMV cohort and also in the non-CMV cohort. Preoperative details, intraoperative parameters, immediate postsurgery echocardiography parameters, and follow-up echocardiography details at 1 year and 5 years were studied. Results: Both the cohorts were similar in age, height, weight, and BSA. In the CMV cohort, 67% were females and in the non-CMV cohort 48% were females. Most of the patients in both the cohorts presented with functional classes 2 and 3. The mean duration between onset of symptoms and MVR in the CMV cohort and the non-CMV cohort was 24.6 years and 6.25 years, respectively. Fifty-nine patients in the CMV cohort had preoperative atrial fibrillation, whereas 47 patients in the non-CMV cohort presented with atrial fibrillation. The mean left atrial (LA) size of patients with sinus rhythm and atrial fibrillation was 46.34 (SE, 0.852) and 55.21(SE, 0.808), respectively. Preoperative echocardiographic assessment revealed a mean ejection fraction of 62% and 63%, mean mitral stenosis gradient of 13 mm Hg and 14.7 mm Hg, mean LA size of 53.2 mm and 50.5 mm, and mean right ventricular systolic pressure of 47.5 mm Hg and 43.6 mm Hg in the post-CMV cohort and in the non-CMV cohort, respectively. The CMV cohort had a longer cardiopulmonary bypass time (111.5 minutes) in comparison with the non-CMV cohort (97 minutes). The aortic cross-clamp time remained similar in both the cohorts. Thirty-six percent of the post-CMV cohort patients had a valve size of 25, and 48% of patients belonging to the non-CMV cohort had a valve size of 27. The percent of moderate-to-severe subvalvar pathology was 88 in both the cohorts. Patients belonging to the post-CMV cohort had a median ventilation time of 16.35 hours, and the patients of the non-CMV cohort had a median ventilation time of 13.75 hours. The duration of ICU stay was 4.41 (SE, 0.188) days and 4.13 (SE, 0.153) days, and length of hospital stay was 8.93 (SE, 0.230) days and 9.13 (SE, 0.313) days in the CMV and the non-CMV cohorts, respectively. Inotropic requirement, measured by the vasoactive inotropic score, was higher in the post-CMV group (11.9), when compared to the other cohort (9.7). Right ventricular (RV) function and pulmonary arterial hypertension assessed in the immediate postoperative period, at 1 year, and at 5 years did not show any significant difference. Conclusion: The percentage of females in the CMV cohort is higher. Delaying the valve replacement by performing a surgical palliative procedure like CMV, is beneficial in female patients in the child-bearing age group so that they can complete the families. The disease process started earlier in the CMV cohort, and they had a longer duration of illness before undergoing MVR. Even with the longer duration of disease, the RV function, LA size, PA pressures, and mitral stenosis gradients were comparable. Therefore, CMV prevented progression of the disease in the CMV group. The mean LA size is significantly higher in patients with atrial fibrillation. The CMV cohort had a longer cardiopulmonary bypass time. The duration of ventilation, ICU stay, and hospital stay were similar in both cohorts. Inotrope requirement was higher in the post-CMV group. RV function and pulmonary arterial hypertension assessed in the immediate postoperative period, at 1 year, and at 5 years did not show any significant difference.

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