RESUMO
BACKGROUND: Plasma exchange (PE) is used to treat severe episodes of CNS demyelination unresponsive to corticosteroids. Predictors of long-term response are not well known. METHODS: We retrospectively reviewed the medical records of 41 patients consecutively treated by PE between January 1995 and July 2007. The primary outcome was improvement at 6 months after PE defined as decrease of >or=1 point in the Expanded Disability Status Scale (EDSS) score for patients with EDSS
Assuntos
Encéfalo/patologia , Doenças Desmielinizantes/terapia , Troca Plasmática/estatística & dados numéricos , Medula Espinal/patologia , Doença Aguda/terapia , Adolescente , Adulto , Animais , Encéfalo/fisiopatologia , Doenças Desmielinizantes/patologia , Doenças Desmielinizantes/fisiopatologia , Avaliação da Deficiência , Progressão da Doença , Feminino , Humanos , Masculino , Doença do Vírus de Marburg/patologia , Doença do Vírus de Marburg/fisiopatologia , Doença do Vírus de Marburg/terapia , Pessoa de Meia-Idade , Esclerose Múltipla/patologia , Esclerose Múltipla/fisiopatologia , Esclerose Múltipla/terapia , Mielite Transversa/patologia , Mielite Transversa/fisiopatologia , Mielite Transversa/terapia , Neuromielite Óptica/patologia , Neuromielite Óptica/fisiopatologia , Neuromielite Óptica/terapia , Troca Plasmática/métodos , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Medula Espinal/fisiopatologia , Fatores de Tempo , Resultado do Tratamento , Adulto JovemRESUMO
Comprehensive imaging evaluation of kidney donor anatomy is crucial for selecting candidates for living kidney transplantation and for determining the surgical technique to procure the renal graft. In 76 living renal donors we compared the results of preoperative magnetic resonance angiography (MRA) with the intraoperative findings of arterial anatomy. Donors were evaluated for the number of main renal arteries and the presence of any polar arteries. A total of 80 main renal arteries and five polar arteries were observed at MRA. At surgery, 90 main renal arteries and eight polar arteries were identified. MRA demonstrated a sensitivity, specificity, and overall accuracy of 18%, 98%, and 87%, respectively, for main arteries and 25%, 96%, and 88% for polar arteries. Eleven (14.5%) kidneys displayed more than one main artery and MRA only detected two cases. Eight kidneys had polar arteries and MRA only detected two cases. MRA is a reliable method for presurgical evaluation of renal arteries in potential donors, providing valuable information required by the surgeon. But, as the technique misses small-diameter vessels, it cannot be recommended as the sole diagnostic tool in unclear cases.