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  1. Article ; Online: Ten-year improved survival in patients with multi-vessel coronary disease and poor left ventricular function following surgery: A retrospective cohort study.

    Cummings, Ian G / Lucchese, Gianluca / Garg, Sheena / Soni, Manish / Majid, Akbar F / Marczin, Nandor / Panoulas, Vasileios / Raja, Shahzad G

    International journal of surgery (London, England)

    2020  Volume 76, Page(s) 146–152

    Abstract: Objective: Patients with multi-vessel coronary artery disease and poor left ventricular (LV) function (ejection fraction [EF] < 30%) requiring revascularization are considered 'high-risk'. Limited long-term survival data exists comparing percutaneous ... ...

    Abstract Objective: Patients with multi-vessel coronary artery disease and poor left ventricular (LV) function (ejection fraction [EF] < 30%) requiring revascularization are considered 'high-risk'. Limited long-term survival data exists comparing percutaneous coronary intervention (PCI) with second-generation drug-eluting stents (DES) versus surgery for this cohort of patients.
    Methods: We retrospectively reviewed our data for 321 patients with EF < 30% who underwent multi-vessel revascularization from January 2005 to December 2015 using Cox regression analyses and inverse probability treatment weighted (IPTW) methods. We stratified patients that underwent surgical revascularization into on-pump coronary artery bypass grafting (CABG) and off-pump CABG and analyzed all-cause mortality at 10 years compared to PCI.
    Results: 214 patients underwent CABG (n [on-pump CABG] = 94; n [off-pump CABG] = 120) and 107 patients had PCI with second generation DES. PCI with DES had higher 10-year mortality compared with on-pump CABG (Hazard ratio [HR] = 1.86, 95% confidence interval [CI] = 1.46-2.42; p < 0.001) and off-pump CABG (HR = 2.32, 95% CI = 1.75-3.15; p < 0.001). This was confirmed in IPTW analyses. When adjusting for both measured and unmeasured factors using instrumental variable analyses, PCI with DES had higher 10-year mortality compared with on-pump CABG (Δ = 13.5, 95% CI = 3.2-24.5; p = 0.012) and off-pump CABG (Δ = 16.1, 95% CI = 5.9-25.8; p < 0.001).
    Conclusion: Surgical revascularization, preferably off-pump CABG, results in better long-term survival compared with PCI using second generation DES for patients with multi-vessel coronary artery disease and poor left ventricular function. Randomized controlled trials in this patient group should be undertaken.
    MeSH term(s) Aged ; Cohort Studies ; Coronary Artery Bypass ; Coronary Artery Bypass, Off-Pump ; Coronary Artery Disease/surgery ; Drug-Eluting Stents ; Female ; Humans ; Male ; Middle Aged ; Percutaneous Coronary Intervention ; Proportional Hazards Models ; Retrospective Studies ; Treatment Outcome ; Ventricular Function, Left
    Language English
    Publishing date 2020-03-13
    Publishing country England
    Document type Journal Article
    ZDB-ID 2212038-5
    ISSN 1743-9159 ; 1743-9191
    ISSN (online) 1743-9159
    ISSN 1743-9191
    DOI 10.1016/j.ijsu.2020.03.008
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 6502: Show issues Location:
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  2. Article ; Online: Red to far-red ratio correction in plant growth chambers - growth responses and influence of thermal load on garden pea.

    Cummings, Ian G / Reid, James B / Koutoulis, Anthony

    Physiologia plantarum

    2008  Volume 131, Issue 2, Page(s) 171–179

    Abstract: Plant growth chambers are commonly used to minimize environmental variation but the light sources used vary considerably from natural light and from each other. Incandescent globes are often used to add more far-red light, with the aim of producing a ... ...

    Abstract Plant growth chambers are commonly used to minimize environmental variation but the light sources used vary considerably from natural light and from each other. Incandescent globes are often used to add more far-red light, with the aim of producing a more natural red to far-red ratio (R:FR), but also add to thermal load. High-intensity discharge lamps are often used to produce higher irradiances, more akin to natural light, but the thermal implications are rarely considered because air temperature is controlled. This paper examines the spectral properties and thermal implications of growth chamber light sources and takes a whole-plant physiology approach, by examining growth responses of a photoperiodic pea line (Pisum sativum L. cv. Torsdag) in the same growth chamber type under different light sources - in essence using plants to study the controlled environments rather than vice-versa. High R:FR delayed flowering and inhibited internode extension in pea. However, the addition of far-red-rich incandescent globes in the proportions provided in the growth chambers (400-500 W) did little to reduce R:FR, did not induce earlier flowering and actually further inhibited internode length. Leaflet size and yield were significantly reduced. While air temperature was maintained at 20 degrees C in all experiments, radiant temperature was significantly higher under high irradiance and/or with incandescent added, and soil temperatures were elevated. Growth responses under these lights were similar to the effect caused by elevating the air temperature. An alternative method of controlling R:FR, without thermal load implications, using light-emitting diodes is described.
    MeSH term(s) Light ; Pisum sativum/growth & development ; Pisum sativum/radiation effects ; Plant Leaves/growth & development ; Plant Leaves/radiation effects ; Temperature
    Language English
    Publishing date 2008-01-18
    Publishing country Denmark
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2020837-6
    ISSN 1399-3054 ; 0031-9317
    ISSN (online) 1399-3054
    ISSN 0031-9317
    DOI 10.1111/j.1399-3054.2007.00958.x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Red to far-red ratio correction in plant growth chambers - growth responses and influence of thermal load on garden pea

    Cummings, Ian G / Reid, James B / Koutoulis, Anthony

    Physiologia plantarum. 2007 Oct., v. 131, no. 2

    2007  

    Abstract: Plant growth chambers are commonly used to minimize environmental variation but the light sources used vary considerably from natural light and from each other. Incandescent globes are often used to add more far-red light, with the aim of producing a ... ...

    Abstract Plant growth chambers are commonly used to minimize environmental variation but the light sources used vary considerably from natural light and from each other. Incandescent globes are often used to add more far-red light, with the aim of producing a more natural red to far-red ratio (R:FR), but also add to thermal load. High-intensity discharge lamps are often used to produce higher irradiances, more akin to natural light, but the thermal implications are rarely considered because air temperature is controlled. This paper examines the spectral properties and thermal implications of growth chamber light sources and takes a whole-plant physiology approach, by examining growth responses of a photoperiodic pea line (Pisum sativum L. cv. Torsdag) in the same growth chamber type under different light sources - in essence using plants to study the controlled environments rather than vice-versa. High R:FR delayed flowering and inhibited internode extension in pea. However, the addition of far-red-rich incandescent globes in the proportions provided in the growth chambers (400-500 W) did little to reduce R:FR, did not induce earlier flowering and actually further inhibited internode length. Leaflet size and yield were significantly reduced. While air temperature was maintained at 20°C in all experiments, radiant temperature was significantly higher under high irradiance and/or with incandescent added, and soil temperatures were elevated. Growth responses under these lights were similar to the effect caused by elevating the air temperature. An alternative method of controlling R:FR, without thermal load implications, using light-emitting diodes is described.
    Keywords Pisum sativum subsp. sativum var. sativum ; air temperature ; far-red light ; flowering ; growth chambers ; internodes ; lamps ; light intensity ; peas ; plant growth ; soil temperature ; solar radiation
    Language English
    Dates of publication 2007-10
    Size p. 171-179.
    Publisher Blackwell Publishing Ltd
    Publishing place Oxford, UK
    Document type Article
    ZDB-ID 2020837-6
    ISSN 1399-3054 ; 0031-9317
    ISSN (online) 1399-3054
    ISSN 0031-9317
    DOI 10.1111/j.1399-3054.2007.00958.x
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  4. Article ; Online: Does surgery improve prognosis in patients with small-cell lung carcinoma?

    Jones, Christopher D / Cummings, Ian G / Shipolini, Alex R / McCormack, David J

    Interactive cardiovascular and thoracic surgery

    2012  Volume 16, Issue 3, Page(s) 375–380

    Abstract: A best evidence topic was written according to a structured protocol, asking 'does surgery improve prognosis in patients with small-cell lung carcinoma (SCLC)?' One hundred and thirteen papers were identified, of which the nine papers best able to answer ...

    Abstract A best evidence topic was written according to a structured protocol, asking 'does surgery improve prognosis in patients with small-cell lung carcinoma (SCLC)?' One hundred and thirteen papers were identified, of which the nine papers best able to answer the question were selected and the details of each tabulated. The prohibitive attitude of clinicians toward surgery in SCLC has prevailed since the 1960s, informed by a prospective randomized trial in which 144 patients were assigned to surgical treatment or to radical radiotherapy. Surgery conferred no survival benefit when compared with radical radiotherapy as assessed at 6 monthly intervals up to 10 years post-treatment. Patients with metastatic disease were excluded; however, diagnostic advances subsequent to these trials justify a re-evaluation of the issue, given the greater degree of accuracy with which sub-groups of patients who might benefit from surgery can now be defined. Only one further prospective, randomized trial features in the literature. This study also discerned that no survival benefit was accrued by adding surgery to chemotherapy. However, this study only included patients who responded to an initial course of chemotherapy and also excluded patients with peripheral nodules only. Subsequent investigators have asserted the value of surgery in SCLC. A retrospective case-control study found that surgery significantly improved median survival in patients with stage I disease when compared with patients undergoing medical therapy. One British centre reported survival rates of 52% at 5 years amongst patients undergoing resection and nodal dissection for stage II-IIIA disease. In a retrospective analysis of the Norwegian cancer database, 5-year survival for patients with stage I undergoing surgery was 44.9%, as opposed to 11.3% amongst those treated medically. This finding was echoed in the analysis of the surveillance epidemiology and end results database in the USA, which found improved median survival amongst patients undergoing surgery for limited SCLC. Prospective studies of carefully selected patients have documented good median survival in patients whose tumour was completely resected. We conclude that surgery for early-stage SCLC improves prognosis as part of a multi-modality approach. This echoes the advice of the 2011 national institute of health and clinical excellence guidelines regarding surgery in SCLC.
    MeSH term(s) Benchmarking ; Chemotherapy, Adjuvant ; Evidence-Based Medicine ; Humans ; Lung Neoplasms/mortality ; Lung Neoplasms/pathology ; Lung Neoplasms/surgery ; Neoplasm Staging ; Patient Selection ; Pneumonectomy/adverse effects ; Pneumonectomy/mortality ; Radiotherapy, Adjuvant ; Small Cell Lung Carcinoma/mortality ; Small Cell Lung Carcinoma/secondary ; Small Cell Lung Carcinoma/surgery ; Time Factors ; Treatment Outcome
    Language English
    Publishing date 2012-11-20
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2095298-3
    ISSN 1569-9285 ; 1569-9293
    ISSN (online) 1569-9285
    ISSN 1569-9293
    DOI 10.1093/icvts/ivs475
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5730: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (2.OG)
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  5. Article ; Online: Is heparin needed for patients with an intra-aortic balloon pump?

    Pucher, Philip H / Cummings, Ian G / Shipolini, Alex R / McCormack, David J

    Interactive cardiovascular and thoracic surgery

    2012  Volume 15, Issue 1, Page(s) 136–139

    Abstract: We addressed the question of whether or not the currently available evidence base supports heparinization in the context of a patient requiring cardiovascular support with an intra-aortic balloon pump (IABP). A best evidence topic was written according ... ...

    Abstract We addressed the question of whether or not the currently available evidence base supports heparinization in the context of a patient requiring cardiovascular support with an intra-aortic balloon pump (IABP). A best evidence topic was written according to a previously defined structured protocol. A literature search returned 443 papers, 3 of which were deemed relevant. Jiang et al. randomized 153 patients requiring IABP to heparin or no heparin, matched for age, sex and comorbidities. There was no significant difference in limb ischaemia; however, incidence of bleeding was significantly increased in the heparinized group (14.1 vs 2.4%). One cohort study compared two management strategies of IABP in which patients either received heparin universally or selectively with heparin only given for certain pre-defined indications. They reported increased bleeding with universal heparinization (39.2 vs 31.8%) but similar other complication rates. Another cohort study in which patients with IABP were initially treated with glycoprotein IIb/IIIa antagonists only, reported bleeding and ischaemia rates within accepted ranges for heparinized patients. The use of anticoagulation with IABP is intended to reduce the risk of thrombus, thromboembolus or limb ischaemia whilst generating an increased risk of bleeding as a side-effect. The aforementioned studies demonstrate that omitting or implementing a selective use strategy of heparinization during IABP counterpulsation can significantly decrease the incidence of bleeding without an increase in ischaemic events. One study also performed angiography prior to IABP insertion on some of their patients, selecting the less diseased side to insert the IABP. Current evidence on this topic is sparse, especially as relates to patients in the context of cardiothoracic surgery. Just one study specifically looked at surgical patients. However, the existing data suggest that it is safe to omit heparinization when using IABP counterpulsation. The decision to heparinize should be weighed in the context of other indications or contraindications rather than being an automatic response to the use of IABP.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Anticoagulants/adverse effects ; Anticoagulants/therapeutic use ; Benchmarking ; Evidence-Based Medicine ; Female ; Hemorrhage/chemically induced ; Heparin/adverse effects ; Heparin/therapeutic use ; Humans ; Intra-Aortic Balloon Pumping/adverse effects ; Ischemia/etiology ; Ischemia/prevention & control ; Male ; Middle Aged ; Risk Assessment ; Risk Factors ; Thromboembolism/etiology ; Thromboembolism/prevention & control ; Thrombosis/etiology ; Thrombosis/prevention & control ; Time Factors ; Treatment Outcome ; Young Adult
    Chemical Substances Anticoagulants ; Heparin (9005-49-6)
    Language English
    Publishing date 2012-04-11
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2095298-3
    ISSN 1569-9285 ; 1569-9293
    ISSN (online) 1569-9285
    ISSN 1569-9293
    DOI 10.1093/icvts/ivs017
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5730: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  6. Article: Blue and red photoselective shadecloths modify pea height through altered blue irradiance perceived by the cry1 photoreceptor

    Cummings, Ian G / Anthony Koutoulis / Eloise Foo / James B. Reid / James L. Weller

    Journal of horticultural science & biotechnology. 2008, v. 83, no. 5

    2008  

    Abstract: The use of shadecloth is common in horticulture to reduce Summer heat load on crops; however, such shading can increase shoot elongation to undesirable levels. A possible solution is to use photoselective shadecloths to overcome the problem of shoot ... ...

    Abstract The use of shadecloth is common in horticulture to reduce Summer heat load on crops; however, such shading can increase shoot elongation to undesirable levels. A possible solution is to use photoselective shadecloths to overcome the problem of shoot elongation.To examine this question, pea (Pisum sativum L.) plants were grown under no shade, 50% neutral shadecloth, or 50% blue, or 50% red photoselective shadecloths. Under the red and blue shadecloths, the blue fraction was altered, but there was little alteration in other wavelengths relative to neutral shadecloth or to sunlight. Relative to neutral shadecloth, shoot length was reduced significantly under blue shadecloth, and increased significantly under red shadecloth.The effect of the red and blue shadecloths appeared to be mediated by alterations in blue irradiance perceived by the blue light cry1 photoreceptor, as, unlike wild-type (WT) peas, cry1 mutant peas did not respond to the shadecloth treatments. Levels of GA1 were reduced under blue shadecloth in WT pea plants compared with neutral shadecloth, but not in cry1 mutant plants. This study demonstrates that photoselective shadecloths can be used to manipulate plant height and flowering in crops with a strong response to blue irradiance.
    Keywords biotechnology ; blue light ; crops ; flowering ; heat ; horticulture ; light intensity ; mutants ; peas ; photoreceptors ; Pisum sativum ; plant height ; shade ; solar radiation ; wavelengths
    Language English
    Size p. 663-667.
    Publishing place Headley Brothers Ltd.
    Document type Article
    ZDB-ID 1416403-6
    ISSN 2380-4084 ; 1462-0316
    ISSN (online) 2380-4084
    ISSN 1462-0316
    DOI 10.1080/14620316.2008.11512440
    Database NAL-Catalogue (AGRICOLA)

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    In stock of ZB MED Bonn / Germany

    Z 2867: Show issues

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