George J. Magovern

Bio: George J. Magovern is an academic researcher from Allegheny General Hospital. The author has contributed to research in topics: Cardiomyoplasty & Cardiogenic shock. The author has an hindex of 35, co-authored 128 publications receiving 4179 citations. Previous affiliations of George J. Magovern include Deborah Heart and Lung Center & Drexel University.

Optimism and rehospitalization after coronary artery bypass graft surgery

Abstract: Objective: To determine whether optimism predicts lower rates of rehospitalization after coronary artery bypass graft surgery for the 6 months after surgery. Methods: A prospective, inception cohort design was used. The sample consisted of all consenting patients (N = 309) from a consecutive series of patients scheduled for elective coronary artery bypass graft surgery at a large, metropolitan hospital in Pittsburgh, Pa. To be eligible, patients could not be scheduled for any other coincidental surgery (eg, valve replacement) and could not be in the cardiac intensive care unit or experiencing angina at the time of the referral. Participants were predominantly men (69.9%) and married (80.3%), and averaged 62.8 years of age. Recruitment occurred between January 1992 and January 1994. Results: Compared with pessimistic persons, optimistic persons were significantly less likely to be rehospitalized for a broad range of aggregated problems (including postsurgical sternal wound infection, angina, myocardial infarction, and the need for another bypass surgery or percutaneous transluminal coronary angioplasty) generally indicative of a poor response to the initial surgery (odds ratio = 0.50, 95% confidence interval = 0.33-0.76; P = .001). The effect of optimism was independent of traditional sociodemographic and medical control variables, as well as independent of the effects of self-esteem, depression, and neuroticism. Allcause rehospitalization also tended to be less frequent for optimistic than for pessimistic persons (odds ratio = 0.77, 95% confidence interval = 0.57-1.05; P = .07). Conclusions: Optimism predicts a lower rate of rehospitalization after coronary artery bypass graft surgery. Fostering positive expectations may promote better recovery. Arch Intern Med. 1999;159:829-835

Effect of glucagon-like peptide-1 (GLP-1) on glycemic control and left ventricular function in patients undergoing coronary artery bypass grafting.

Abstract: Increasing evidence suggests that tight glycemic control improves clinical outcomes after coronary artery bypass grafting (CABG). However, the risk for hypoglycemia with insulin often results in less aggressive glycemic control. Glucagon-like peptide–1 (GLP-1) is a naturally occurring peptide whose insulinotropic effects are predicated on the glucose concentration, minimizing the risk for hypoglycemia. This study was conducted to examine whether perioperative treatment with GLP-1 would affect glycemic control and improve hemodynamic recovery after CABG. Twenty patients with coronary heart disease and preserved left ventricular function who were scheduled to undergo CABG were randomized to receive standard therapy at the discretion of the surgeon or treatment with GLP-1 (1.5 pmol/kg/min) as a continuous infusion beginning 12 hours before CABG and continuing for 48 hours. Perioperative hemodynamics, the left ventricular ejection fraction, plasma glucose, and requirements for insulin drips and inotropic support were monitored. There were no differences between groups in the preoperative, postoperative, or 7-day left ventricular ejection fraction (GLP-1 61 ± 4%, control 59 ± 3%) or cardiac index at 18 hours (GLP-1 3.0 ± 0.2 L/min/m 2 , control 3.3 ± 0.4 L/min/m 2 ). However, the control group required greater use of inotropic and vasoactive infusions during the 48 hours after the operation to achieve the same hemodynamic result. There were also more frequent arrhythmias requiring antiarrhythmic agents in the control group. GLP-1 resulted in better glycemic control in the pre- and perioperative periods (GLP-1 95 ± 3 mg/dl, control 140 ± 10 mg/dl, p ≤0.02), with 45% less insulin requirements to achieve the same glycemic control in the postoperative period (GLP-1 139 ± 4 mg/dl, control 140 ± 3 mg/dl). In conclusion, the perioperative use of GLP-1 achieves better glycemic control and comparable hemodynamic recovery without the requirements for high-dose insulin or inotropes.

Out of the Crisis

Abstract: According to W. Edwards Deming, American companies require nothing less than a transformation of management style and of governmental relations with industry. In Out of the Crisis, originally published in 1982, Deming offers a theory of management based on his famous 14 Points for Management. Management's failure to plan for the future, he claims, brings about loss of market, which brings about loss of jobs. Management must be judged not only by the quarterly dividend, but by innovative plans to stay in business, protect investment, ensure future dividends, and provide more jobs through improved product and service. In simple, direct language, he explains the principles of management transformation and how to apply them.

ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult

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2009 Focused Update Incorporated Into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: Developed in Collaboration With the International Society for Heart and Lung Transplantation

Abstract: Mariell Jessup, MD, FACC, FAHA, Chair [*][1] William T. Abraham, MD, FACC, FAHA[†][2] Donald E. Casey, MD, MPH, MBA[‡][3] Arthur M. Feldman, MD, PhD, FACC, FAHA[§][4] Gary S. Francis, MD, FACC, FAHA[§][4] Theodore G. Ganiats, MD[∥][5] Marvin A. Konstam, MD, FACC[¶][6] Donna M.