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Effect of multicomponent rehabilitation on independence and functioning in elderly patients with common age-associated diseases: protocol for a scoping review (REHOLD)
Introduction Elderly patients after hospitalisation for acute events on account of age-related diseases (eg, joint or heart valve replacement surgery) are often characterised by a remarkably reduced functional health. Multicomponent rehabilitation (MR) is considered an appropriate approach to restore the functioning of these patients. However, its efficacy in improving functioning-related outcomes such as care dependency, activities of daily living (ADL), physical function and health-related quality of life (HRQL) remains unclarified. We outline the research framework of a scoping review designed to map the available evide...
Source: BMJ Open - May 18, 2023 Category: General Medicine Authors: Baritello, O., Stein, H., Wolff, L. L., Hamann, M., Völler, H., Salzwedel, A. Tags: Open access, Rehabilitation medicine Source Type: research

Efficacy and safety of carbon dioxide insufflation for brain protection for patients undergoing planned left-sided open heart valve surgery: protocol for a multicentre, placebo-controlled, blinded, randomised controlled trial (the CO2 Study)
Introduction Brain injury is common following open heart valve surgery. Carbon dioxide insufflation (CDI) has been proposed to reduce the incidence of brain injury by reducing the number of air microemboli entering the bloodstream in surgery. The CO2 Study will evaluate the efficacy and safety of CDI in patients undergoing planned left-sided open heart valve surgery. Methods and analysis The CO2 Study is a multicentre, blinded, placebo-controlled, randomised controlled trial. Seven-hundred and four patients aged 50 years and over undergoing planned left-sided heart valve surgery will be recruited to the study, from at lea...
Source: BMJ Open - May 17, 2023 Category: General Medicine Authors: Todd, R., Rogers, C. A., Pufulete, M., Culliford, L., Pretorius, P., Voets, N., Akowuah, E., Sayeed, R., Lazaroo, M., Kaur, S., Angelini, G. D., Gibbison, B. Tags: Open access, Surgery Source Type: research

Atorvastatin and the influence on postoperative atrial fibrillation after surgical aortic valve replacement (STARC) in adults at Odense University Hospital, Denmark: study protocol for a randomised controlled trial
Introduction Atrial fibrillation (AF) is the most common postoperative complication after surgical aortic valve replacement (SAVR) and occurs in up to 50% of the patients. Development of postoperative AF (POAF) is associated with a 2–3 fold increased risk of adverse events, including stroke, myocardial infarction and death. Several studies have implied that prophylactic Atorvastatin therapy could prevent POAF in patients undergoing coronary artery bypass graft. These studies suggest that Atorvastatin has rapid and significant pleiotropic actions that reduce the risk of POAF. However, prophylactic treatment with stati...
Source: BMJ Open - May 10, 2023 Category: General Medicine Authors: Krasniqi, L., Brandes, A., Mortensen, P. E., Dahl, J. S., Gerke, O., Ali, M., Riber, L. P. S. Tags: Open access, Cardiovascular medicine Source Type: research

Transcatheter aortic valve implantation versus surgical aortic valve replacement in patients with severe aortic stenosis: a systematic review and meta-analysis
Conclusions No overall change in the risk of death from any cause or cardiovascular mortality was identified but 95% CIs were often wide, indicating uncertainty. TAVI may reduce the risk of certain side effects while SAVR may reduce the risk of others. Most long-term (5-year) results are limited to older patients at high surgical risk (ie, early trials), therefore more data are required for low risk populations. Ultimately, neither surgical technique was considered dominant, and these results suggest that every patient with SAS should be individually engaged in SDM to make evidence-based, personalised decisions around thei...
Source: BMJ Open - December 6, 2021 Category: General Medicine Authors: Swift, S. L., Puehler, T., Misso, K., Lang, S. H., Forbes, C., Kleijnen, J., Danner, M., Kuhn, C., Haneya, A., Seoudy, H., Cremer, J., Frey, N., Lutter, G., Wolff, R., Scheibler, F., Wehkamp, K., Frank, D. Tags: Open access, Cardiovascular medicine Source Type: research

Efficacy of a glucagon-like peptide-1 agonist and restrictive versus liberal oxygen supply in patients undergoing coronary artery bypass grafting or aortic valve replacement: study protocol for a 2-by-2 factorial designed, randomised clinical trial
The objective of this study is to determine the efficacy of the GLP-1-analogue exenatide versus placebo and restrictive oxygenation (50% fractional inspired oxygen, FiO2) versus liberal oxygenation (100% FiO2) in patients undergoing open heart surgery. Methods and analysis A randomised, placebo-controlled, double blind (for the exenatide intervention)/single blind (for the oxygenation strategy), 2x2 factorial designed single-centre trial on adult patients undergoing elective or subacute CABG and/or surgical AVR. Patients will be randomised in a 1:1 and 1:1 ratio to a 6-hour and 15 min infusion of 17.4 µg of exenatid...
Source: BMJ Open - November 5, 2021 Category: General Medicine Authors: Wiberg, S., Kjaergaard, J., Mogelvang, R., Moller, C. H., Kandler, K., Ravn, H., Hassager, C., Kober, L., Nilsson, J. C. Tags: Open access, Surgery Source Type: research

Surgical aortic valve replacement in the era of transcatheter aortic valve implantation: a review of the UK national database
Conclusions Surgical SAVR±CABG has low mortality risk and a low level of complications in the UK in people of all ages and risk factors. These results should inform consideration of treatment options in people with aortic valve disease.
Source: BMJ Open - October 28, 2021 Category: General Medicine Authors: Jahangiri, M., Bilkhu, R., Embleton-Thirsk, A., Dehbi, H.-M., Mani, K., Anderson, J., Avlonitis, V., Baghai, M., Birdi, I., Booth, K., Bose, A., Briffa, N., Buchan, K., Bhudia, S., Cale, A., Deglurkar, I., Farid, S., Hadjinikolaou, L., Jarvis, M., Javadpo Tags: Open access, Cardiovascular medicine Source Type: research

Deriving literature-based benchmarks for surgical complications in high-income countries: a protocol for a systematic review and meta-analysis
This study of secondary data does not require ethics approval. It will be presented internationally and published in the peer-reviewed literature. Results will inform a future quality improvement tool and provide benchmarks of surgical complication rates within HICs. Trial registration International Prospective Register of Systematic Reviews (PROSPERO). Registration number CRD42016037519.
Source: BMJ Open - May 9, 2017 Category: General Medicine Authors: Brindle, M. E., Roberts, D. J., Daodu, O., Haynes, A. B., Cauley, C., Dixon, E., La Flamme, C., Bain, P., Berry, W. Tags: Open access, Health policy Protocol Source Type: research