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Introduction and Objectives: Evaluating patient outcomes following cardiac surgery is a means of measuring the quality of that surgery. The present study analyzes survival and the risk factors associated with mid-term mortality of patients undergoing cardiac surgery in Son Dureta University Hospital (Palma, Balearic Islands, Spain)., Methods: From November 2002 thru December 2007, 1938 patients underwent interventions. Patients were stratified in 4 age groups. Of 1900 patients discharged from hospital, 1844 were followed until December 31, 2008. Following discharge, we constructed Kaplan-Meier survival curves and performed Cox regression analysis to determine which variables associated with mid-term mortality., Results: In-hospital mortality of the 1,938 patients was 1.96% (CI 95%, 1.36%-2.6%). Survival probability at 1, 3 and 5 years follow-up was 98%, 94% and 90%, respectively. Mean follow-up was 3.2 (0.01-6.06) years. Patients aged ≥ 70 years showed a lower survival rate than those aged <70 (log rank test, P <.0001). At the end of follow-up, mortality was 6.5% (CI 95%, 5.4%-7.7%). Age ≥ 70 years, a history of severe ventricular dysfunction (ejection fraction < 30%), severe pulmonary hypertension, diabetes mellitus, preoperative anemia, postoperative stroke, and hospital stay were independently associated with mid-term mortality., Conclusions: Mid-term survival after discharge was highly satisfactory. Mid-term mortality varied with age and other pre- and postoperative factors., (Copyright © 2010 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.)

Introduction and Objectives: Preoperative anemia as a risk factor of adverse outcomes after coronary surgery has not been well-established. This study has aimed to analyze the association between preoperative anemia and postoperative adverse events and in-hospital mortality in the patients undergoing isolated coronary artery bypass graft surgery in the Son Dureta hospital., Methods: All the patients undergoing isolated coronary artery bypass graft surgery with extracorporeal circulation from November 2002 to June 2007 were included. Preoperative anemia was defined as hemoglobin (Hb)<13g/dL in men and Hb<12g/dL in women. The association between postoperative cardiac and noncardiac adverse events and the presence or absence of preoperative anemia and concomitant surgical risk, assessed by logistic EuroScore, were analyzed., Results: A total of 623 patients were included. The rate of preoperative anemia was 34.5%. Patients with Euroscore > or =4 had higher incidence of preoperative anemia than patients with Euroscore<4 (41% vs. 27%; p=0.0001). There were no statistically significant differences in the rate of postoperative adverse events related to the presence or absence of preoperative anemia. Median ICU and hospital length of stay were longer in patients with preoperative anemia than in patients without preoperative anemia (ICU: 3.2+/-2.5 days vs. 3.7+/-2.8, p=0.004; in-hospital: 17.5+/-11.3 days vs. 14.7+/-10.2, p=0.001). Hospital mortality rate was 0.8% (95% CI 0.3-1.9). There were no differences in the mortality rate of the patients with and without preoperative anemia (0.9% vs 0.7%, p=0.8)., Conclusions: In this study, preoperative anemia in patients undergoing coronary artery bypass graft surgery was not associated with increased hospital morbidity-mortality. However, ICU and hospital length of stay were longer in patients with preoperative anemia. The limitation of the sample size prevents us from confirming whether preoperative anemia is a risk factor after coronary surgery or not.

Introduction and Objectives: The aim was to investigate etiologic and cardiovascular risk factors in obese children from Extremadura, Spain, and their relationship with insulin resistance and plasma adipocytokine levels., Methods: The study included 373 children (age, 3-13 years) who were randomly selected from schools in the city and province of Badajoz and from two health centers in the Spanish autonomous community of Extremadura., Results: Some 9.5% of children were obese. Compared with normal weight children, obese children exhibited a greater weight gain in the first year of life (7.3+/-1.5 kg vs. 6.3+/-0.8 kg), were less physically active (9.6+/-7.2 h/week vs. 13.1+/-8.1 h/week), and had more screen time (18.0+/-12.4 h/week vs. 12.8+/-8.2 h/week), a lower high-density lipoprotein cholesterol level (46.0+/-11.4 mg/dL vs. 64.6+/-22.9 mg/dL), higher arterial systolic pressure (102.3+/-8.5 mmHg vs. 89.9+/-13.4 mmHg), increased insulin resistance (6.2+/-3.6 vs. 4.6+/-4.5), a higher level of leptinemia (24.8+/-13.8 ng/mL vs. 12.9+/-10.8 ng/mL) and a lower level of adiponectinemia (8.4+/-5.7 microg/mL vs. 15.6+/-7.9 microg/mL)., Conclusions: Our findings demonstrate that there is a relationship between a sedentary lifestyle and the development of insulin resistance and altered adipocytokines levels in obese children, and that these changes are related to a number of cardiovascular risk factors.

Focal nodular hyperplasia is a benign liver tumor that usually follows an asymptomatic course. Hemorrhage of hepatic focal nodular hyperplasia is exceptional and occurs in tumors such as hepatocellular carcinoma and hepatic adenoma. We report the case of a woman with spontaneous rupture and hemorrhage of focal nodular hyperplasia. Hemodynamic stabilization was achieved by selective hepatic arterial embolization. Elective hepatic resection was subsequently performed. This clinical course is extremely rare. We describe the therapeutic management of these complications using hepatic transarterial embolization, which could avoid potentially harmful aggressive treatments.