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1.
JTCVS Tech ; 24: 137-144, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38835571

RESUMEN

Objective: The aim of our study was to evaluate the safety and effectiveness of the hybrid method off-pump for closure of isolated ventricular septal defect (VSD) compared with the traditional method of on-pump of children. Methods: This research was a retrospective cohort study. Data were collected from 500 patients with isolated VSD (or residual VSD after a previous repair) who underwent surgery at the National Scientific Medical Center from May 2016 to December 2020. Patients were operated with 1 of 2 methods of surgery: the traditional method of on-pump or the hybrid method of off-pump. This study assessed the safety and efficacy of the hybrid method by comparing it with the traditional method for the treatment of patients with isolated VSD. Results: The procedural success rate reached 93.2% in the hybrid method, with a 6.4% conversion rate to the traditional method and 0.4% hospital mortality. The mean operation time was 84 minutes (31; 160 minutes) in the hybrid group (n = 250) and 168 minutes (70; 300 minutes) in the traditional group (n = 250) (P = .000). Hospital mortality was 0.43% in the first group and 1.5% in the second group (P = .000). Conclusions: The hybrid method of VSD closure is safe and effective in a selected group of patients. The advantages of the hybrid method are improved cosmetics and shorter operation time and overall hospital stay.

2.
Exp Clin Transplant ; 22(Suppl 1): 281-284, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38385413

RESUMEN

OBJECTIVES: Our goal was to determine levels of sex hormones in men with type 1 diabetes mellitus and type 2 diabetes mellitus after autologous mesenchymal stem cell transplant. MATERIALS AND METHODS: We examined 10 male patients (32-56 years old) with type 1 diabetes mellitus and type 2 diabetes mellitus, whom we subsequently divided into 2 groups and examined. Group 1 comprised 5 male patients who received autologous mesenchymal stem cell transplant (cells were obtained from patient's iliac crest and cultured for 3-4 weeks) by intravenous infusion. Group 2 comprised 5 male patients (control group) who were on hypoglycemic tablet therapy or insulin therapy. The quantity of autologous mesenchymal stem cells infused was 95 × 106 to 97 × 106 cells. We analyzed levels of testosterone, luteinizing hormone, estradiol, and glycated hemoglobin in patients both before and 3 months after the autologous mesenchymal stem cell transplant procedure. RESULTS: In men with type 1 diabetes mellitus and type 2 diabetes mellitus, autologous mesenchymal stem cell transplant led to an increase in testosterone levels from 5.31 ± 2.12 to 6.33 ± 2.12 ng/mL (P = .82), a decrease in luteinizing hormone from 8.43 ± 1.25 to 5.94 ± 1.57 mIU/mL (P = .04), and a decrease in glycated hemoglobin from 9.45 ± 1.24% to 8.53 ± 1.08% (P = .25) after 3 months. The increase in testosterone in men with autologous mesenchymal stem cell transplant group of 6.33 ± 2.12 ng/mL was significant compared with men in the control group (3.9 ± 1.18 ng/mL; P = .01). CONCLUSIONS: Testosterone level increased and luteinizing hormone level decreased within 3 months after autologous mesenchymal stem cell transplant in men with diabetes mellitus.


Asunto(s)
Diabetes Mellitus Tipo 1 , Diabetes Mellitus Tipo 2 , Trasplante de Células Madre Mesenquimatosas , Células Madre Mesenquimatosas , Humanos , Masculino , Adulto , Persona de Mediana Edad , Diabetes Mellitus Tipo 1/diagnóstico , Diabetes Mellitus Tipo 1/cirugía , Diabetes Mellitus Tipo 2/diagnóstico , Hemoglobina Glucada , Trasplante de Células Madre Mesenquimatosas/efectos adversos , Hormonas Esteroides Gonadales/metabolismo , Hormona Luteinizante/metabolismo , Células Madre Mesenquimatosas/metabolismo , Testosterona
3.
Int J Rheum Dis ; 27(1): e14904, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37784218

RESUMEN

Rheumatoid arthritis is a systemic inflammatory disorder primarily affecting joints but not limited to the joints alone. Extra-articular manifestations involve skin, ocular, gastrointestinal, pulmonary, cardiac, renal, neurological, and hematological systems. Among them, skin manifestations (20%) are most common, presenting as nodules on the extensor surfaces of the upper and lower extremities. In rare cases these nodules can also be detected within the heart and lungs. Interestingly, rheumatoid nodules are often seen in patients on leflunomide, methotrexate, or tumor necrosis factor-alpha antagonists. Nevertheless, definitive diagnosis requires a histopathological analysis. In this case report, we presented a 49-year-old male patient with a relatively short period of disease activity leading to rheumatoid nodules in the lungs. Considering the ongoing COVID-19 pandemic and that tuberculosis was still endemic in Kazakhstan, achieving the definite diagnosis was challenging. Initial imaging study revealed bilateral polysegmental pneumonia. The tests for COVID-19 and pulmonary tuberculosis were negative. A follow-up chest computed tomography scan had signs of disseminated lung lesions of unknown origin. Lung biopsy showed a morphological picture of productive granulomas characteristic for tuberculosis. However, at the second look, typical scarring granulomas typically seen in rheumatoid nodules were observed.


Asunto(s)
Artritis Reumatoide , Nódulo Reumatoide , Tuberculosis , Masculino , Humanos , Persona de Mediana Edad , Nódulo Reumatoide/diagnóstico , Nódulo Reumatoide/tratamiento farmacológico , Nódulo Reumatoide/etiología , Pandemias , Artritis Reumatoide/diagnóstico , Artritis Reumatoide/tratamiento farmacológico , Artritis Reumatoide/patología , Pulmón/diagnóstico por imagen , Pulmón/patología , Tomografía Computarizada por Rayos X , Granuloma/patología
4.
Clin Transl Allergy ; 9: 57, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31695865

RESUMEN

BACKGROUND: The Nature Step to Respiratory Health was the overarching theme of the 12th General Meeting of the Global Alliance against Chronic Respiratory Diseases (GARD) in Helsinki, August 2018. New approaches are needed to improve respiratory health and reduce premature mortality of chronic diseases by 30% till 2030 (UN Sustainable Development Goals, SDGs). Planetary health is defined as the health of human civilization and the state of the natural systems on which it depends. Planetary health and human health are interconnected, and both need to be considered by individuals and governments while addressing several SDGs. RESULTS: The concept of the Nature Step has evolved from innovative research indicating, how changed lifestyle in urban surroundings reduces contact with biodiverse environments, impoverishes microbiota, affects immune regulation and increases risk of NCDs. The Nature Step calls for strengthening connections to nature. Physical activity in natural environments should be promoted, use of fresh vegetables, fruits and water increased, and consumption of sugary drinks, tobacco and alcohol restricted. Nature relatedness should be part of everyday life and especially emphasized in the care of children and the elderly. Taking "nature" to modern cities in a controlled way is possible but a challenge for urban planning, nature conservation, housing, traffic arrangements, energy production, and importantly for supplying and distributing food. Actions against the well-known respiratory risk factors, air pollution and smoking, should be taken simultaneously. CONCLUSIONS: In Finland and elsewhere in Europe, successful programmes have been implemented to reduce the burden of respiratory disorders and other NCDs. Unhealthy behaviour can be changed by well-coordinated actions involving all stakeholders. The growing public health concern caused by NCDs in urban surroundings cannot be solved by health care alone; a multidisciplinary approach is mandatory.

5.
Exp Clin Transplant ; 16 Suppl 1(Suppl 1): 168-170, 2018 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-29528020

RESUMEN

OBJECTIVES: Our objective was to determine transforming growth factor ß1 levels in patients with type 2 diabetes mellitus after fetal pancreatic stem cell transplant. MATERIALS AND METHODS: We examined 10 patients (age range, 41-65 y) with type 2 diabetes mellitus, which we subsequently divided into 2 groups. Group 1 comprised 5 patients who received fetal pancreatic stem cell transplant (cells were 16-18 wk gestation) performed by intravenous infusion. Group 2 comprised 5 patients (control group) who were on hypoglycemic tablet therapy or insulin therapy. The quantity of fetal stem cells infused was 5 to 6 × 106. We analyzed transforming growth factor ß1, C-peptide, and glycated hemoglobin levels in patients before and 3 months after fetal pancreatic stem cell transplant. RESULTS: In patients with type 2 diabetes mellitus, fetal pancreatic stem cell transplant led to a significant increase in transforming growth factor ß1 levels, from 16 364.8 to 35 730.4 ng/mL (P = .008), with trend in decreased glycated hemoglobin levels, from 7.96% to 6.98% (P = .088) after 3 months. CONCLUSIONS: Transforming growth factor ß1 levels increased significantly within 3 months after fetal pancreatic stem cell transplant in patients with type 2 diabetes mellitus.


Asunto(s)
Diabetes Mellitus Tipo 2/cirugía , Células Madre Fetales/trasplante , Trasplante de Páncreas/métodos , Factor de Crecimiento Transformador beta1/sangre , Adulto , Anciano , Biomarcadores/sangre , Glucemia/metabolismo , Péptido C/sangre , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/diagnóstico , Células Madre Fetales/metabolismo , Hemoglobina Glucada/metabolismo , Humanos , Persona de Mediana Edad , Trasplante de Páncreas/efectos adversos , Fenotipo , Estudios Prospectivos , Recuperación de la Función , Factores de Tiempo , Resultado del Tratamiento
6.
Exp Clin Transplant ; 15(Suppl 1): 194-195, 2017 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-28260466

RESUMEN

OBJECTIVES: Our objective was to determine leptin levels in patients with type 1 diabetes mellitus after fetal pancreatic stem cell transplant. MATERIALS AND METHODS: Seven patients, aged 20 to 42 years, with type 1 diabetes mellitus received a fetal pancreatic stem cell transplant by intravenous infusion. The quantity of fetal stem cells infused was ≥ 5 × 106, and the cells were of 12 to 14 weeks of gestation. We analyzed the levels of leptin, C-peptide, and antibodies to the islets of Langerhans before and 3 months after the transplant procedure. RESULTS: Fetal pancreatic stem cell transplant led to significant increases in leptin and C-peptide levels, from 4.63 ± 1.17 ng/mL and 0.09 ± 0.02 ng/mL to 7.71 ± 1.45 ng/mL (P < .05) and 0.22 ± 0.05 ng/mL (P < .005), respectively, without an increase in antibodies to the islets of Langerhans, which measured 0.64 ± 0.13 U/mL before transplant and 0.57 ± 0.18 U/mL 3 months later (P > .05). CONCLUSIONS: Leptin levels increase significantly within 3 months of fetal pancreatic stem cell transplant in patients with type 1 diabetes mellitus.


Asunto(s)
Diabetes Mellitus Tipo 1/cirugía , Células Madre Fetales/trasplante , Leptina/sangre , Trasplante de Páncreas/métodos , Adulto , Biomarcadores/sangre , Péptido C/sangre , Diabetes Mellitus Tipo 1/sangre , Diabetes Mellitus Tipo 1/diagnóstico , Femenino , Humanos , Masculino , Factores de Tiempo , Resultado del Tratamiento , Regulación hacia Arriba , Adulto Joven
7.
Exp Clin Transplant ; 13 Suppl 3: 62-5, 2015 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-26640915

RESUMEN

OBJECTIVES: The aim of this study was to evaluate the kidney allograft after transplant to assess restoration of blood flow, the time required to functionally recovery after surgery, and the ability to differentiate normal from pathologic grafts using color Doppler ultrasonography in the early posttransplant period. MATERIALS AND METHODS: Sixteen kidney recipients underwent renal color Doppler ultrasonography examinations 1, 2, 3, 7, 15, and 30 days after transplant. We evaluated the clinical and biochemical test results of recipients and the functioning allografts and evaluated the acute pathology. Results of resistive index in color Doppler ultrasonography were compared with blood test results. RESULTS: During the early postoperative period after kidney transplant, the average size of the kidney was 10.7 × 5.1 cm, with parenchyma at 1.7 cm. The structure of the parenchyma was nonhomogeneous in 14 patients and homogeneous in 2 patients. The medullary pyramid layer was prominent in 6 patients, moderately prominent in 7 patients, and not prominent in 3 patients. The pyelocaliceal system was condensed in 1 patient. Hematoma in the perinephrium was found in 5 patients, and free fluid was found in 5 patients. Satisfactory vascularization of allografts occurred in 14 patients, with resistive index sensitivity of 93% and specificity of 83%. CONCLUSIONS: Color Doppler ultrasonography and resistive index results were useful in evaluating kidney allografts during the early postoperative period and in confirming their condition despite excessive blood parameter values.


Asunto(s)
Trasplante de Riñón , Riñón/irrigación sanguínea , Riñón/diagnóstico por imagen , Arteria Renal/diagnóstico por imagen , Ultrasonografía Doppler en Color , Adolescente , Adulto , Aloinjertos , Velocidad del Flujo Sanguíneo , Femenino , Humanos , Riñón/cirugía , Trasplante de Riñón/efectos adversos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Recuperación de la Función , Flujo Sanguíneo Regional , Arteria Renal/fisiopatología , Arteria Renal/cirugía , Circulación Renal , Factores de Tiempo , Resultado del Tratamiento , Resistencia Vascular , Adulto Joven
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