RESUMEN
Prior research has shown that females are less field independent (FI) than males. However, when gender identity is salient, performance on tests assessing constructs similar to FI may be hindered, because of stereotype threat. This study examined the impact of stereotype threat on gender differences in FI. We expected that (a) reporting one's own gender prior to FI testing and (b) having an opposite-gender experimenter would activate stereotype threat, and in turn result in lower performance on a test of FI among females. Overall, 170 participants were randomly assigned to one of eight conditions in a between-participants design varying the participant's gender, experimenter's gender and timing of the gender question (before vs. after test). Results showed that reporting one's gender before the FI test led to lower FI performance among females. Furthermore, females achieved higher FI when experimenters were females and gender questions were administered after the FI test.
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Factores Sexuales , Adolescente , Adulto , Femenino , Humanos , Masculino , Estereotipo , Adulto JovenRESUMEN
BACKGROUND: Postoperative complications are integral to cardiac surgery. The most serious ones are stroke, which develops in about 7.5% of the patients, and postoperative encephalopathy, which affects 10-30% of the patients. According to bibliographical data, the number of complications is increasing. AIM: To analyse the risk factors and the types of neurological complications in patients undergoing heart surgery. METHODS: We assessed retrospectively 323 consecutive patients undergoing surgery at the Department of Cardiac Surgery, University Teaching Hospital, Medical University of Bialystok, Poland, between July 2007 and June 2008. Group 1 comprised patients without neurological complications (n = 287; 89%) and Group 2 consisted of patients with neurological complications (n = 36; 11%). Our analysis included the following: preoperative status (age, sex, co-morbidities), intraoperative course (surgery type, duration of cardiopulmonary bypass [CPB], duration of aortic cross-clamping, types of medications administered, necessity of reinfusion from the cardiotomy reservoir and the necessity of tranexamic acid infusion) and the postoperative course (time to regaining consciousness, duration of mechanical ventilation, development of complications, types of complications). The results were then analysed statistically: arithmetic means and standard deviations were calculated for quantitative variables and the quantitative and percentage distributions were calculated for qualitative variables. The between- group comparisons of the quantitative variables were carried out using the t-Student test, while the qualitative variables were compared using the χ(2) test. The variables that proved significant in the univariate comparisons were included in the multivariate model. Regression analysis was the final step of the analysis of the risk factors for neurological complications. Based on the analysis of the ROC curve we calculated the cutoff values for the continuous variables. We calculated odds ratios with their 95% confidence intervals. P values of less than 0.05 were considered statistically significant. RESULTS: Among the 36 patients in Group 2, postoperative encephalopathy developed in 22 patients, transient ischaemic attacks in 7 patients, ischaemic stroke in 6 patients (associated with right hemisphere damage in 3 patients and with left hemisphere damage in 3 patients) and haemorrhagic stroke in 1 patient (right hemisphere). Early mortality was 5% with 2 (0.69%) patients dying in Group 1 and 14 (38.9%) in Group 2. Univariate analysis revealed that the preoperative risk factors of neurological complications were: age >68 years (with a cutoff value of 58.5 years), a history of stroke with paresis, atrial fibrillation (AF) and a euroSCORE of >6 (with a cutoff value of 4.5). The peri- and postoperative risk factors included: surgery type (complex coronary and valvular surgeries aortic valve surgeries), duration of CPB of >142 min, duration of aortic crossclamping of >88 min, mean perfusion pressure during CPB of <70 mm Hg, haemodilution manifested by a haematocrit (HCT) of <28%, perfusate supply, time to regaining consciousness of >14.5 h and duration of artificial ventilation of >30.5 h. Multivariate analysis revealed the following factors to increase the risk of neurological complications: long duration of ventilation, a history of stroke with paresis, AF, low HCT values and long duration of aortic cross-clamping. The Nagelkerke R2 coefficient of determination was 0.636, the sensitivity was 74.36%, the specificity was 97.545% and the accuracy was 94.74%. CONCLUSIONS: In patients undergoing heart surgery, the independent risk factors of neurological complications in the first 30 days include: long duration of ventilation, a history of stroke with paresis, AF, haemodilution manifested by an HCT of <28% and long duration of aortic cross-clamping. Neurological complications are associated with high postoperative mortality.
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Procedimientos Quirúrgicos Cardíacos/estadística & datos numéricos , Enfermedades del Sistema Nervioso/clasificación , Enfermedades del Sistema Nervioso/epidemiología , Distribución por Edad , Factores de Edad , Anciano , Encefalopatías/epidemiología , Procedimientos Quirúrgicos Cardíacos/efectos adversos , Procedimientos Quirúrgicos Cardíacos/clasificación , Comorbilidad , Femenino , Humanos , Incidencia , Masculino , Enfermedades del Sistema Nervioso/etiología , Paresia/epidemiología , Polonia/epidemiología , Análisis de Regresión , Estudios Retrospectivos , Factores de Riesgo , Accidente Cerebrovascular/epidemiologíaRESUMEN
Intracardiac masses present an important problem in cardiology. Echocardiography became a main non-invasive diagnostic method in identifying these abnormalities. Most often there are thrombuses, less often - vegetations in course of infective endocarditis, and rarely - tumours or congenital abnormalities. This case report presents difficulties in diagnosing intracardiac mass in a 70-year-old female presenting with atypical chest pain.
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Neoplasias Cardíacas/diagnóstico por imagen , Neoplasias Cardíacas/cirugía , Trombosis de la Vena/diagnóstico por imagen , Trombosis de la Vena/cirugía , Anciano , Dolor en el Pecho/etiología , Disnea/etiología , Ecocardiografía , Femenino , Atrios Cardíacos/diagnóstico por imagen , Humanos , Resultado del TratamientoRESUMEN
We describe a case of 67-year-old man suffering from chronic aortic arch aneurysm complicated by rupture and hemorrhage to the left pleural cavity. The patient underwent emergency hybrid operation: extraanatomical transposition of aortic arch branches to ascending aorta and implantation of stentgraft into the arch without the extracorporeal circulation.
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Aorta Torácica/cirugía , Aneurisma de la Aorta Torácica/cirugía , Rotura de la Aorta/cirugía , Anciano , Procedimientos Quirúrgicos Cardíacos/métodos , Humanos , Masculino , Stents , Resultado del TratamientoRESUMEN
A case of a 42-year old man with aortic valve endocarditis with peri-anular multi-chamber abscess formation and fistulous communication between right sinus of Valsalva and right ventricle, is presented. Transthoracic echocardiography revealed abnormal flow through the fistula confirmed at surgery. Intraoperatively the aortic valve was severely damaged with massive calcifications on the leaflets, anulus, right sinus of Valsalva and interventricular septum surrounded by fresh vegetations. Surgical procedure consisted of removal of calcification and infected tissues, followed by reconstruction of interventricular septum and aorta with pericardial patch and aortic valve replacement. Postoperative course was uneventful.
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Enfermedades de la Aorta/etiología , Válvula Aórtica , Cardiomiopatías/etiología , Endocarditis Bacteriana/complicaciones , Enfermedades de las Válvulas Cardíacas/complicaciones , Infecciones Estafilocócicas/complicaciones , Fístula Vascular/etiología , Adulto , Válvula Aórtica/cirugía , Calcinosis/diagnóstico , Calcinosis/etiología , Calcinosis/cirugía , Cardiomiopatías/diagnóstico , Cardiomiopatías/cirugía , Endocarditis Bacteriana/cirugía , Tabiques Cardíacos/cirugía , Enfermedades de las Válvulas Cardíacas/diagnóstico , Enfermedades de las Válvulas Cardíacas/cirugía , Implantación de Prótesis de Válvulas Cardíacas , Ventrículos Cardíacos/cirugía , Humanos , Masculino , Seno Aórtico/diagnóstico por imagen , Ultrasonografía , Fístula Vascular/cirugíaRESUMEN
Aneurysm of the sinus of Valsalva is a rare congenital heart disease. It constitutes about 0.14%-1.5% of congenital heart surgery cases. Aneurysm of the sinus of Valsalva can be asymptomatic for many years. Only rupture of the sinus of Valsalva aneurysm leads to hemodynamic disturbances which in turn causes rapid deterioration of patient clinical condition. Some of the congenital heart diseases can be complicated by of infective endocarditis. This case report concerns the rupture of the sinus of Valsalva aneurysm in a 45 year old woman, which caused infective endocarditis on the tricuspid valve, which has been initially diagnosed as a complication of congenital heart disease in the form of the intraventricular defect.
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Rotura de la Aorta/complicaciones , Rotura de la Aorta/diagnóstico , Endocarditis Bacteriana/complicaciones , Endocarditis Bacteriana/diagnóstico por imagen , Seno Aórtico/diagnóstico por imagen , Rotura de la Aorta/cirugía , Diagnóstico Diferencial , Electrocardiografía , Femenino , Humanos , Persona de Mediana Edad , Seno Aórtico/cirugía , Colgajos Quirúrgicos , UltrasonografíaRESUMEN
The influence of cadium from cigarette intoxication on selected lipid metabolism parameters in smokers with stable coronary artery disease scheduled for coronary artery bypass grafting (CABG) was studied. It has been shown that concentration of cadmium leads to an increase in the lipid peroxidation and changes in the lipid metabolism. In our study, there was a significant higher cadmium concentration in smokers with stable angina pectoris (20.90+/-0.18) compared to stable angina pectoris non-smokers (7.71 +/-0,45), p<0.0001. We have not found correlations between cadmium concentration in smokers and non-smokers with stable angina pectoris patients and total cholesterol, LDL, HDL, and triglicerydes concentrations. Total cholesterol, LDL, HDL and TG concentrations in smokers scheduled for CABG were respectively: 221.60+/-10.26 mg/dl; 148.40+/-8.71 mg/dl; 41.16+/-2.12 mg/dl, 159.10+/-14.49 mg/dl. All of these lipid parameters in stable angina pectoris smokers did not differ significantly from non-smokers.