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1.
Curr Probl Cardiol ; 49(2): 102239, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38056515

RESUMO

INTRODUCTION: Our aim was to investigate the prevalence of atrial fibrillation (AF) and recently diagnosed lung cancer in the outpatient oncology clinic and to describe the clinical profile, management and outcomes of this population. METHODS: Among 6984 patients visited at the outpatient oncology clinics attending lung cancer patients in five university hospitals from 2017 to 2019, all consecutive subjects with recently diagnosed (<1 year) disease and AF were retrospectively selected and events in follow up were registered. RESULTS: A total of 269 patients (3.9 % of all attended, 71 ± 8 years, 91 % male) were included. Charlson, CHA2DS2-VASc and HAS-BLED indexes were 6.7 ± 2.9, 2.9 ± 1.5 y 2.5 ± 1.2, respectively. Tumour stage was I, II, III and IV in 11 %, 11 %, 33 % and 45 % of them, respectively. Anticoagulants were prescribed to 226 patients (84 %): direct anticoagulants (n = 99;44 %), low molecular weight heparins (n = 69;30 %) and vitamin K antagonists (n = 58;26 %). After 46 months of maximum follow-up, 186 patients died (69 %). Cumulative incidences of events at 3 years were 3.3 ± 1.3 % for stroke/systemic embolism (n = 7); 8.9 ± 2.2 % for thrombotic events (n = 18); 9.9 ± 2.6 % for major bleeding (n = 16), and 15.9 ± 3,0 % for cardiovascular events (n = 33). In patients with early stages of cancer (I-II), 2-year mortality was significantly higher in those with cardiovascular events or major bleeding (85 % vs 25 %, p = 0.01). CONCLUSION: Nearly 4 % or all outpatients in the oncology clinic attending lung cancer present recently diagnosed disease and AF. Major bleeding and cardiovascular event rates are high in this population, with an impact on mortality in early stages of cancer.


Assuntos
Fibrilação Atrial , Neoplasias Pulmonares , Acidente Vascular Cerebral , Humanos , Masculino , Feminino , Fibrilação Atrial/complicações , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/epidemiologia , Pacientes Ambulatoriais , Estudos Retrospectivos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/induzido quimicamente , Hemorragia/induzido quimicamente , Acidente Vascular Cerebral/epidemiologia , Anticoagulantes/uso terapêutico , Fatores de Risco , Medição de Risco
2.
Sensors (Basel) ; 23(22)2023 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-38005457

RESUMO

Brushless synchronous machines (BSMs) are replacing conventional synchronous machines with static excitation in generation facilities due to the absence of sparking and lower maintenance. However, this excitation system makes measuring electric parameters in the rotor challenging. It is highly difficult to detect ground faults, which are the most common type of electrical fault in electric machines. In this paper, a ground fault detection method for BSMs is proposed. It is based on an inductive AC/DC rotating current sensor installed in the shaft. In the case of a ground fault in the rotating parts of the BSM, a fault current will flow through the rotor's sensor, inducing voltage in its stator. By analyzing the frequency components of the induced voltage, the detection of a ground fault in the rotating elements is possible. The ground faults detection method proposed covers the whole rotor and discerns between DC and AC sides. This method does not need any additional power source, slip ring, or brush, which is an important advantage in comparison with the existing methods. To corroborate the detection method, experimental tests have been performed using a prototype of this sensor connected to laboratory synchronous machines, achieving satisfactory results.

3.
Polymers (Basel) ; 15(6)2023 Mar 09.
Artigo em Inglês | MEDLINE | ID: mdl-36987146

RESUMO

Supramolecular structures are of great interest due to their applicability in various scientific and industrial fields. The sensible definition of supramolecular molecules is being set by investigators who, because of the different sensitivities of their methods and observational timescales, may have different views on as to what constitutes these supramolecular structures. Furthermore, diverse polymers have been found to offer unique avenues for multifunctional systems with properties in industrial medicine applications. Aspects of this review provide different conceptual strategies to address the molecular design, properties, and potential applications of self-assembly materials and the use of metal coordination as a feasible and useful strategy for constructing complex supramolecular structures. This review also addresses systems that are based on hydrogel chemistry and the enormous opportunities to design specific structures for applications that demand enormous specificity. According to the current research status on supramolecular hydrogels, the central ideas in the present review are classic topics that, however, are and will be of great importance, especially the hydrogels that have substantial potential applications in drug delivery systems, ophthalmic products, adhesive hydrogels, and electrically conductive hydrogels. The potential interest shown in the technology involving supramolecular hydrogels is clear from what we can retrieve from the Web of Science.

4.
Eur J Clin Invest ; 53(5): e13941, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-36573310

RESUMO

BACKGROUND: Heart failure (HF) admission in chronic coronary syndrome (CCS) patients has a prognostic impact. Stratification schemes have been described for predicting this endpoint, but none of them has been externally validated. OBJECTIVES: Our aim was to develop point scores for predicting incident HF admission with data from previous studies, to perform an external validation in an independent prospective cohort and to compare their discriminative ability for this event. METHODS: Independent predictive variables of HF admission in CCS patients without baseline HF were selected from four previous prospective studies (CARE, PEACE, CORONOR and CLARIFY), generating scores based on the relative magnitude of the coefficients of Cox of each variable. Finally, the scores were validated and compared in a monocentric prospective cohort. RESULTS: The validation cohort included 1212 patients followed for up to 17 years, with 171 patients suffering at least one HF admission in the follow-up. Discriminative ability for predicting HF admission was statistically significant for all, and paired comparisons among them were all nonsignificant except for CORONOR score was superior to CLARIFY score (C-statistic 0.73, 95%CI 0.69-0.76 vs. 0.69, 95% CI 0.65-0.73; p = 0.03). CONCLUSION: All tested scores showed significant discriminative ability for predicting incident HF admission in this independent validation study. Their discriminative ability was similar, with significant differences only between the two scores with higher and lower performance.


Assuntos
Insuficiência Cardíaca , Humanos , Estudos Prospectivos , Estudos de Coortes , Síndrome , Fatores de Risco , Insuficiência Cardíaca/epidemiologia , Prognóstico , Medição de Risco
5.
J Womens Health (Larchmt) ; 32(1): 63-70, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36459621

RESUMO

Background: Women and men with chronic coronary syndrome (CCS) have different clinical features and management, and studies on mid-term prognosis have reported conflicting results. Our objective was to investigate the impact of the female sex in the prognosis of the disease in the very long term. Methods and Results: We investigated differential features and very long-term prognosis in 1268 consecutive outpatients with CCS (337 [27%] women and 931 [73%] men). Women were older than men, more likely to have hypertension, diabetes, angina, and atrial fibrillation, and less likely to be exsmoker/active smoker and to have been treated with coronary revascularization (p < 0.05 for all). The prescription of statins, antiplatelets, and betablockers was similar in both groups. After up to 17 years of follow-up (median = 11 years, interquartile range = 4-15 years), cumulative incidences of acute myocardial infarction (10.2% vs. 11.8%) or stroke (11% vs. 10%) at median follow-up were similar, but the risks of major cardiovascular events (acute myocardial infarction, stroke, or cardiovascular death, 41.2% vs. 33.6%), hospital admission for heart failure (20.9% vs. 11.9%), or cardiovascular death (32.3% vs. 22.1%) were significantly higher for women (p < 0.0005), with a nonsignificant trend to higher overall mortality (45.2% vs. 39.1%, p = 0.07). However, after multivariate adjustment, all these differences disappeared. Conclusion: Although women and men with CCS presented a different clinical profile, and crude rates of major cardiovascular events, heart failure and cardiovascular death were higher in women, female sex was not an independent prognostic factor in this study with up to 17 years of follow-up.


Assuntos
Insuficiência Cardíaca , Infarto do Miocárdio , Acidente Vascular Cerebral , Masculino , Humanos , Feminino , Prognóstico , Estudos Prospectivos , Fatores de Risco , Fatores Sexuais
6.
Nanomaterials (Basel) ; 14(1)2023 Dec 26.
Artigo em Inglês | MEDLINE | ID: mdl-38202528

RESUMO

This study investigates electrospun fibers of metal-organic frameworks (MOFs), particularly CuBTC and ZIF-8, in polyacrylonitrile (PAN) for the solid-phase extraction (SPE) of Tamoxifen (TAM) and its metabolites (NDTAM, ENDO, and 4OHT) from human blood plasma. The focus is on the isolation, pre-concentration, and extraction of the analytes, aiming to provide a more accessible and affordable breast cancer patient-monitoring technology. The unique physicochemical properties of MOFs, such as high porosity and surface area, combined with PAN's stability and low density, are leveraged to improve SPE efficiency. The study meticulously examines the interactions of these MOFs with the analytes under various conditions, including elution solvents and protein precipitators. Results reveal that ZIF-8/PAN composites outperform CuBTC/PAN and PAN alone, especially when methanol is used as the protein precipitator. This superior performance is attributed to the physicochemical compatibility between the analytes' properties, like solubility and polarity, and the MOFs' structural features, including pore flexibility, active site availability, surface polarity, and surface area. The findings underscore MOFs' potential in SPE applications and provide valuable insights into the selectivity and sensitivity of different MOFs towards specific analytes, advancing more efficient targeted extraction methods in biomedical analysis.

8.
J Clin Med ; 11(17)2022 Aug 25.
Artigo em Inglês | MEDLINE | ID: mdl-36078920

RESUMO

Our aim was to investigate the role of left atrial longitudinal strain (LALS) in the non-invasive diagnosis of acute cellular rejection (ACR) episodes in heart transplant (HTx) recipients. Methods: We performed successive echocardiographic exams in 18 consecutive adult HTx recipients in their first year after HTx within 3 h of the routine surveillance endomyocardial biopsies (EMB) in a single center. LALS parameters were analyzed with two different software. We investigated LALS association with ACR presence, as well as inter-vendor variability in comparable LALS values. Results: A total of 147 pairs of EMB and echo exams were carried out. Lower values of LALS were significantly associated with any grade of ACR presence. Peak atrial longitudinal strain (PALS) offered the best diagnostic value for any grade of ACR, with a C statistic of 0.77 using one software (95% CI 0.68−0.84, p < 0.0005) and 0.64 with the other (95% CI 0.54−0.73, p = 0.013) (p = 0.02 for comparison between both curves). Reproducibility between comparable LALS parameters was poor (intraclass correlation coefficients were 0.60 for PALS, 95% CI 0.42−0.73, p < 0.0005; and 0.42 for PALS rate, 95% CI −0.13−0.68, p < 0.0005). Conclusions: LALS variables might be a sensitive marker of ACR in HTx recipients, principally discriminating between those studies without rejection and those with any grade of ACR. Inter-vendor variability was significant.

9.
Int J Mol Sci ; 23(14)2022 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-35887350

RESUMO

Photosensitive supramolecular systems have garnered attention due to their potential to catalyze highly specific tasks through structural changes triggered by a light stimulus. The tunability of their chemical structure and charge transfer properties provides opportunities for designing and developing smart materials for multidisciplinary applications. This review focuses on the approaches reported in the literature for tailoring properties of the photosensitive supramolecular systems, including MOFs, MOPs, and HOFs. We discuss relevant aspects regarding their chemical structure, action mechanisms, design principles, applications, and future perspectives.

10.
Polymers (Basel) ; 13(17)2021 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-34502967

RESUMO

In recent years, researchers working in biomedical science and technology have investigated alternatives for enhancing the mechanical properties of biomedical materials. In this work, sodium alginate (SA) hydrogel-reinforced nanoparticles (NPs) of hydroxyapatite (HA) were prepared to enhance the mechanical properties of this polymer. Compression tests showed an increase of 354.54% in ultimate compressive strength (UCS), and 154.36% in Young's modulus with the addition of these NPs compared with pure SA. Thermogravimetric analysis (TGA) revealed that the amount of residual water is not negligible and covered a range from 20 to 35 wt%, and the decomposition degree of the alginate depends on the hydroxyapatite content, possibly due to the displacement of sodium ions by the hydroxyapatite and not by calcium chloride. Further, there is an important effect possibly due to the existence of an interaction of hydrogen bonds between the hydroxyl of the alginate and the oxygen atoms of the hydroxyapatite, so signals appear upfield in nuclear magnetic resonance (NMR) data. An increase in the accumulation of HA particles was observed with the use of X-ray microtomography, in which the quantified volume of particles per reconstructed volume corresponded accordingly to the increase in the mechanical properties of the hydrogel.

11.
Sensors (Basel) ; 20(23)2020 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-33260646

RESUMO

There are several techniques for current measurement. Most of them are capable of measuring both alternating and direct current (AC/DC) components. However, they have severe drawbacks for rotating applications (large size, sensitivity to external fields, and low signal amplitude). In addition to these weaknesses, measured signals should be transmitted to a stationary part. In order to contribute solving these difficulties, this paper presents a sensor that can measure AC/DC simultaneously based on the electromagnetic coupling of two coils. To this aim, the measured waveform is analysed. In this paper, the design of such a sensor is presented. This design is validated through computer simulations and a prototype is built. The performance of this sensor prototype is analysed through experimental tests.

12.
Sensors (Basel) ; 20(15)2020 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-32722589

RESUMO

Electrical industry uses oils for cooling and insulation of several machines, such as power transformers. In addition, it uses water for cooling some synchronous generators. To avoid malfunctions in these assets, fluid quality should be preserved. To contribute to this aim, a sensor that detects changes in fluid composition is presented. The designed sensor is like a single-phase transformer whose magnetic core is the fluid whose properties will be measured. The response of this device to a frequency sweep is recorded. Through a comparison between any measurement and a reference one corresponding to a healthy state, pollutants presence, such as water in oil or salt in water, can be measured. The performance of the sensor was analyzed through simulation. In addition, a prototype was built and tested measuring water concentration in oil and salt content in water. The correlation between pollutant concentration measured with the sensor and known pollutant concentrations is good.

13.
J Neurol ; 267(10): 3061-3068, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32529579

RESUMO

BACKGROUND: Cerebrovascular and coronary artery disease share risk factors. The aim was to study CHA2DS2-VASc score as predictor of stroke incidence and death in a sample of patients with sinus rhythm and stable ischemic heart disease (sIHD) during long-term follow-up. METHODS: 1184 patients with sIHD and without atrial fibrillation were included in this single-centre prospective cohort study between February 2000 and January 2004. Stroke and death prediction abilities of CHA2DS2-VASc score in this population were investigated. RESULTS: The median age was 66 (interquartile range (IQR), 60-73 years). The mean follow-up was 11.2 ± 10 years (maximum 17 years). Along this period, 137 patients (11.6% of the sample) suffered a stroke. The mean value of CHA2DS2-VASc score was 3.04 ± 1.36, with CHA2DS2-VASc score ≤ 4 in 85.5% of the sample. Higher CHA2DS2-VASc score at baseline was associated with higher risk of suffering stroke (Hazard Ratio = 1.36, 95% CI 1.20-1.54, p < 0,001) and all-cause death during follow-up (Hazard Ratio = 1.49, 95% CI 1.40-1.58, p < 0,001). CONCLUSIONS: Higher CHA2DS2-VASc score values were associated with higher risk of stroke and all-cause mortality during long-term follow-up in this real-world sample of patients with sIHD in sinus rhythm.


Assuntos
Fibrilação Atrial , Isquemia Miocárdica , Acidente Vascular Cerebral , Idoso , Fibrilação Atrial/complicações , Fibrilação Atrial/epidemiologia , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Acidente Vascular Cerebral/epidemiologia
14.
Sensors (Basel) ; 20(11)2020 May 26.
Artigo em Inglês | MEDLINE | ID: mdl-32466611

RESUMO

Nowadays, non-toroidal shape primary pass-through current transformers are commonly used for large current machines with several cables per phase. As these transformers exhibit no radial symmetry, it is not clear if they can be tested using the indirect test described in the IEC 61869 standard. In order to answer this question, two non-toroidal shaped current transformers of different secondary winding designs have been tested and simulated. One transformer has a uniformly distributed secondary winding and the other has a partially distributed secondary winding. Both transformers have the same nameplate characteristics. Both perform correctly in the indirect test. However, only the transformer with the uniformly distributed secondary winding performs correctly in a direct test. A finite element simulation shows that the iron core of the partially distributed secondary winding transformer was saturated, while the iron core of the uniformly distributed one was not. This result explains their different performance. The main conclusion is that the indirect test is not sensitive enough to cover all cases and therefore under doubtful situations, the transformers should be tested using the direct test.

15.
Int J Cardiovasc Imaging ; 36(8): 1455-1464, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32297099

RESUMO

To investigate the value of tissue Doppler velocities for ruling out treatment-requiring acute cellular rejection (TR-ACR), in the context of myocardial deformation analysis performed by means of speckle tracking echocardiography. We performed serial echocardiograms in 37 heart transplant recipients in their first year post-transplantation within 3 h of the routine surveillance endomyocardial biopsies (EMB). The association of the sum of lateral mitral annulus systolic (s') and early diastolic (e') velocities, in absolute values, measured by tissue Doppler echocardiography (s'+ e'), with TR-ACR (ACR grade ≥ 2R) was investigated by multivariate analysis, including classic echocardiographic parameters and myocardial deformation variables. A total of 251 pairs of EMB and echo exams were performed, 35 (14%) with rejection grade ≥ 2R (TR-ACR). s' + e' was independently associated to TR-ACR (OR 0.80, 95%CI 0.72-0.89, p < 0.0005), with a C statistic of 0.79 (95%CI 0.71-0.87, p < 0.0005) by ROC curve analysis. An s'+ e' value ≥ 23 cm/s, present in 43% of studies, had a negative predictive value of 98% for ruling out TR-ACR. Moreover, in the same patients, s'+ e' significantly decreased when TR-ACR occurred after a study without this condition (- 3.7 ± 3.3 cm/s, p = 0.003), but it was similar when rejection status was the same in the present versus the previous study. A drop in s'+ e' value < 2.7 cm/s from the previous echocardiogram, had a 99% negative predictive value for ruling out TR-ACR. Tissue Doppler velocities, a widely available echo parameter, were found to be a valuable marker for ruling out TR-ACR in this multivariate study which included myocardial deformation variables.


Assuntos
Ecocardiografia Doppler , Rejeição de Enxerto/diagnóstico por imagem , Transplante de Coração/efeitos adversos , Ventrículos do Coração/diagnóstico por imagem , Valva Mitral/diagnóstico por imagem , Doença Aguda , Adulto , Idoso , Feminino , Rejeição de Enxerto/imunologia , Rejeição de Enxerto/fisiopatologia , Ventrículos do Coração/imunologia , Ventrículos do Coração/fisiopatologia , Hemodinâmica , Humanos , Imunidade Celular , Masculino , Pessoa de Meia-Idade , Valva Mitral/imunologia , Valva Mitral/fisiopatologia , Análise Multivariada , Miocárdio/imunologia , Valor Preditivo dos Testes , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Resultado do Tratamento , Função Ventricular Esquerda
16.
Rev. esp. cardiol. (Ed. impr.) ; 72(10): 827-834, oct. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-189321

RESUMO

Introducción y objetivos: La información sobre el pronóstico de la cardiopatía isquémica crónica (CIC) es escasa. El objetivo es analizar los predictores de la mortalidad y la supervivencia a largo plazo de estos pacientes. Métodos: Estudio de cohortes prospectivo y monocéntrico que reclutó a 1.268 pacientes con CIC desde enero de 2000 hasta febrero de 2004. Se registraron los fallecimientos durante el seguimiento. Se compararon las tasas de mortalidad total y cardiovascular ajustadas con la población española. Se investigó la asociación de variables basales con la mortalidad. Resultados: La media de edad fue 68+/-10 años; el 73% eran varones. Tras 17 años de seguimiento máximo (mediana, 11 años), murieron 629 pacientes (50%). La edad (HR=1,08; IC95%, 1,07-1,11; p<0,001), la diabetes (HR=1,36; IC95%, 1,14-1,63; p <0,001), la frecuencia cardiaca (HR=1,01; IC95%, 1,00-1,02; p <0,001), la fibrilación auricular (HR=1,61; IC95%, 1,22-2,14); p=0,001), las alteraciones electrocardiográficas (HR=1,23; IC95%, 1,02-1,49; p=0,02) y el tabaquismo (HR=1,85; IC95%, 1,31-2,80; p=0,001) han resultado predictores independientes de la mortalidad total. La tasa de mortalidad total fue mayor que en la población española (47,81 frente a 36,29/1.000 pacientes/año; razón de mortalidad estandarizada=1,31; IC95%, 1,21-1,41). La tasa de mortalidad cardiovascular fue 15,25 frente a 6,94/1.000 pacientes/año de la población general (razón de mortalidad estandarizada=2,19; IC95%, 1,88-2,50). Conclusiones: En esta muestra de pacientes con CIC, la tasa de mortalidad fue significativamente mayor que en la población general. Las variables clínicas identifican a los pacientes con mayor riesgo de muerte en el seguimiento


Introduction and objectives: Data are lacking on the long-term prognosis of stable ischemic heart disease (SIHD). Our aim was to analyze long-term survival in patients with SIHD and to identify predictors of mortality. Methods: A total of 1268 outpatients with SIHD were recruited in this single-center prospective cohort study from January 2000 to February 2004. Cardiovascular and all-cause death during follow-up were registered. All-cause and cardiovascular mortality rates were compared with those in the Spanish population adjusted by age, sex, and year. Predictors of these events were investigated. Results: The mean age was 68+/-10 years and 73% of the patients were male. After a follow-up lasting up to 17 years (median 11 years), 629 (50%) patients died. Independent predictors of all-cause mortality were age (HR, 1.08; 95%CI, 1.07-1.11; P <.001), diabetes (HR, 1.36; 95%CI, 1.14-1.63; P <.001), resting heart rate (HR, 1.01; 95%CI, 1.00-1.02; P <.001), atrial fibrillation (HR, 1.61; 95%CI, 1.22-2.14; P=.001), electrocardiographic changes (HR, 1.23; 95%CI, 1.02-1.49; P=.02) and active smoking (HR, 1.85; 95%CI, 1.31-2.80; P=.001). All-cause mortality and cardiovascular mortality rates were significantly higher in the sample than in the general Spanish population (47.81/1000 patients/y vs 36.29/1000 patients/y (standardized mortality rate, 1.31; 95%CI, 1.21-1.41) and 15.25/1000 patients/y vs 6.94/1000 patients/y (standardized mortality rate, 2.19; 95%CI, 1.88-2.50, respectively). Conclusions: The mortality rate was higher in this sample of patients with SIHD than in the general population. Several clinical variables can identify patients at higher risk of death during follow-up


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Intervalo Livre de Progressão , Isquemia Miocárdica/epidemiologia , Progressão da Doença , Síndrome Coronariana Aguda/epidemiologia , Infarto do Miocárdio/epidemiologia , Sobreviventes/estatística & dados numéricos , Espanha/epidemiologia , Doença Crônica/epidemiologia , Indicadores de Morbimortalidade , Estudos Prospectivos , Fatores de Risco
17.
Int J Cardiovasc Imaging ; 35(5): 827-836, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30661140

RESUMO

Prosthesis-patient mismatch (PPM) occurs when the effective orifice area of the prosthesis is too small in relation to the patient's body surface area. There are few data available on the frequency and prognostic impact of PPM after transcatheter aortic valve implantation (TAVI). Our aim was to determine the prevalence of PPM and to investigate its association with medium-term clinical course of patients undergoing TAVI. We included 185 patients undergoing TAVI (79 ± 5 years, 49% male, 98% CoreValve) between April-2008 and December-2014. The effective orifice area (EOA) was determined by transthoracic echocardiography prior and after the procedure. We defined PPM as indexed EOA ≤ 0.85 cm2/m2 (severe PPM if ≤ 0.65 cm2/m2). All cause death, stroke and hospitalization for heart failure were considered as major clinical events. 45 patients (24%) showed PPM (severe 11 patients, 6%). PPM was associated with a higher EuroSCORE (OR 1.06, IC 95% 1.01-1.12, p = 0.03), body surface area ≥ 1.72 m2 (OR 3.58, IC 95% 1.30-9.87, p = 0.01) and small aortic annulus (OR 0.73, IC 95% 0.55-0.92, p = 0.03); and severe PPM with small prostheses size (OR 17.79, IC 95% 1.87-169.78, p = 0.012). The mean event-free survival was 34 ± 26 months. Patients with severe PPM showed lower rates of event free survival than the rest of the series (52% vs. 84%, p = 0.04) at 34 months follow up. In our series, PPM was present in a quarter of the patients after TAVI. Higher EuroSCORE, smaller prosthesis size, larger body surface area and smaller aortic annulus diameter were associated with PPM. Severe PPM was an independent factor associated with major events at medium-term follow up.


Assuntos
Estenose da Valva Aórtica/cirurgia , Valva Aórtica/cirurgia , Próteses Valvulares Cardíacas , Complicações Pós-Operatórias/epidemiologia , Substituição da Valva Aórtica Transcateter/efeitos adversos , Substituição da Valva Aórtica Transcateter/instrumentação , Idoso , Idoso de 80 Anos ou mais , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/fisiopatologia , Estenose da Valva Aórtica/diagnóstico por imagem , Estenose da Valva Aórtica/mortalidade , Estenose da Valva Aórtica/fisiopatologia , Ecocardiografia , Feminino , Humanos , Incidência , Masculino , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/mortalidade , Complicações Pós-Operatórias/fisiopatologia , Prevalência , Intervalo Livre de Progressão , Desenho de Prótese , Sistema de Registros , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Espanha/epidemiologia , Fatores de Tempo , Substituição da Valva Aórtica Transcateter/mortalidade , Resultado do Tratamento
18.
Rev Esp Cardiol (Engl Ed) ; 72(10): 827-834, 2019 Oct.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30268655

RESUMO

INTRODUCTION AND OBJECTIVES: Data are lacking on the long-term prognosis of stable ischemic heart disease (SIHD). Our aim was to analyze long-term survival in patients with SIHD and to identify predictors of mortality. METHODS: A total of 1268 outpatients with SIHD were recruited in this single-center prospective cohort study from January 2000 to February 2004. Cardiovascular and all-cause death during follow-up were registered. All-cause and cardiovascular mortality rates were compared with those in the Spanish population adjusted by age, sex, and year. Predictors of these events were investigated. RESULTS: The mean age was 68±10 years and 73% of the patients were male. After a follow-up lasting up to 17 years (median 11 years), 629 (50%) patients died. Independent predictors of all-cause mortality were age (HR, 1.08; 95%CI, 1.07-1.11; P <.001), diabetes (HR, 1.36; 95%CI, 1.14-1.63; P <.001), resting heart rate (HR, 1.01; 95%CI, 1.00-1.02; P <.001), atrial fibrillation (HR, 1.61; 95%CI, 1.22-2.14; P=.001), electrocardiographic changes (HR, 1.23; 95%CI, 1.02-1.49; P=.02) and active smoking (HR, 1.85; 95%CI, 1.31-2.80; P=.001). All-cause mortality and cardiovascular mortality rates were significantly higher in the sample than in the general Spanish population (47.81/1000 patients/y vs 36.29/1000 patients/y (standardized mortality rate, 1.31; 95%CI, 1.21-1.41) and 15.25/1000 patients/y vs 6.94/1000 patients/y (standardized mortality rate, 2.19; 95%CI, 1.88-2.50, respectively). CONCLUSIONS: The mortality rate was higher in this sample of patients with SIHD than in the general population. Several clinical variables can identify patients at higher risk of death during follow-up.


Assuntos
Isquemia Miocárdica/mortalidade , Sistema de Registros , Medição de Risco/métodos , Idoso , Causas de Morte/tendências , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Fatores de Risco , Espanha/epidemiologia , Taxa de Sobrevida/tendências , Fatores de Tempo
19.
Acta Otolaryngol ; 137(4): 375-383, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27910733

RESUMO

CONCLUSIONS: Human-rat geniculate ganglion (GG) have multiple origins: (1) An initial proximity (20 µm) to the endocranial foramen of the IAM, suggests neural crest induction; and (2) The influence of epibranchial placodes: the tensor tympani muscle (TTM) and the otic apical coil. OBJECTIVES: This study was undertaken to determine the comparative development of human-rat GG. MATERIALS AND METHODS: A light microscopic study of the GG in human material obtained from spontaneous abortions at 9, 13, 14, 17, 18, and 30 weeks, and one neonate was done. This study examined Webster rat embryos and a post-natal series. Specimens were fixed in Bouin fluid, embedded in paraffin, cut, and stained with H&E. The histomorphometric data were obtained with image analysis software. RESULTS: The human fetus of 9 weeks presents two neuronal groups in the VII nerve: one near (20 µm) the IAM endocranial foramen, foraminal, and the other, tympanic. Neonate GG is located between the TTM and the cochlear apex (inwards). In the 16 day old rat embryo GG is placed within a canal containing the stapedial artery. In the adult rat the GG and the stapedial artery are placed within the IAM.


Assuntos
Gânglio Geniculado/embriologia , Animais , Biometria , Desenvolvimento Fetal , Humanos , Ratos
20.
Acta Otolaryngol ; 133(4): 352-60, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23350596

RESUMO

CONCLUSION: In Scarpa neurons the cell and nuclear area increases and nuclear/cytoplasm ratio decreases with fetal age (p < 0.0001). There are statistically significant differences in cell area between all fetal groups, except for the interval 45-74 mm crown-rump-length (CRL). Displacement of a neuron within the internal auditory meatus (IAM) occurs from 9 weeks in the fetus until the neonate. METHODS: A light microscopic histomorphometric study of the Scarpa ganglion in human fetuses from spontaneous abortions measuring 45, 74, 90, 134, 145 and 270 mm CRL and a from a 1-day-old neonate (360 mm) was carried out. Cell and nuclear area, ganglion area and distances from the Scarpa ganglion neurons to the endocranial porus of the IAM were measured. RESULTS: In the 45, 74, 90 and 134 mm CRL human fetuses the cartilaginous labyrinthine capsule appears divided by the facial nerve and the Scarpa ganglion into two compartments: rostral and dorsal. Ovoidal Scarpa ganglion in the 45 mm CRL lies within the IAM near its endocranial porus (15 µm). In the otic capsule of the 145 mm CRL fetus an endochondral ossification appears in the IAM base, where Scarpa ganglion neurons are displayed in two groups: superior and inferior divided by a vascular-connective septum. This anatomy remains from this specimen until the neonate specimen.


Assuntos
Estatura Cabeça-Cóccix , Nervo Vestibular/anatomia & histologia , Nervo Vestibular/embriologia , Análise de Variância , Feminino , Desenvolvimento Fetal/fisiologia , Feto/anatomia & histologia , Feto/embriologia , Idade Gestacional , Humanos , Imuno-Histoquímica , Masculino , Gravidez
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