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1.
Artigo em Inglês | MEDLINE | ID: mdl-36301132

RESUMO

The surgical repair of the bicuspid aortic valve in children has been shown to have good outcomes. The repair can be done by the delicate use of native valve tissue without using patch material. The patient is an 8-year-old boy diagnosed with a stenotic bicuspid aortic valve and supravalvular aortic stenosis. He had a balloon valvuloplasty when he was 6 years old. This video tutorial gives detailed information on how to repair the aortic valve by reshaping the aortic cusps and reconstructing the aortic commissures.


Assuntos
Insuficiência da Valva Aórtica , Estenose da Valva Aórtica , Valvuloplastia com Balão , Doença da Válvula Aórtica Bicúspide , Criança , Masculino , Humanos , Estenose da Valva Aórtica/cirurgia , Valva Aórtica/cirurgia , Insuficiência da Valva Aórtica/cirurgia
2.
Polymers (Basel) ; 14(13)2022 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-35808690

RESUMO

Three-dimensional (3D) printing is one of the most futuristic manufacturing technologies, allowing on-demand manufacturing of products with highly complex geometries and tunable material properties. Among the different 3D-printing technologies, fused deposition modeling (FDM) is the most popular one due to its affordability, adaptability, and pertinency in many areas, including the biomedical field. Yet, only limited amounts of materials are commercially available for FDM, which hampers their application potential. Polybutylene succinate (PBS) is one of the biocompatible and biodegradable thermoplastics that could be subjected to FDM printing for healthcare applications. However, microbial contamination and the formation of biofilms is a critical issue during direct usage of thermoplastics, including PBS. Herein, we developed a composite filament containing polybutylene succinate (PBS) and lignin for FDM printing. Compared to pure PBS, the PBS/lignin composite with 2.5~3.5% lignin showed better printability and antioxidant and antimicrobial properties. We further coated silver/zinc oxide on the printed graft to enhance their antimicrobial performance and obtain the strain-specific antimicrobial activity. We expect that the developed approach can be used in biomedical applications such as patient-specific orthoses.

3.
J Card Surg ; 37(9): 2642-2650, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35661255

RESUMO

OBJECTIVE: This study aims to compare both the pericardial roll technique with the patch augmentation technique of the unifocalization, and single-stage complete repair with the unifocalization and shunt for the repair of the ventricular septal defect, pulmonary atresia, and major aortopulmonary collateral arteries. METHODS: This was a retrospective review of the 48 patients undergoing unifocalization of the ventricular septal defect, pulmonary atresia, and major aorticopulmonary collateral arteries from a single center. Our cohort had two surgical pathways, including single-stage midline unifocalization (n = 40), unifocalization after pulmonary artery rehabilitation by creating an aortopulmonary window or central shunt (n = 8). There were two surgical techniques in single-stage midline unifocalizaton, including widening of the pulmonary arteries with a patch (n = 30), and connecting pulmonary arteries with a pericardial roll (n = 10). RESULTS: A total of 14 (29.2%) of 48 patients underwent single-stage complete repair, 26 patients underwent shunt palliation with unifocalization. Combined early and late mortality was seen in seven patients in those who underwent shunt palliation with unifocalization, while it was seen in one patient in those who underwent a single-stage complete repair (mortality ratio 26.8% vs. 7.1%, p = .22). There was no statistically significant difference between the pericardial roll and patch augmentation techniques in terms of pulmonary artery reintervention (p = .65). Although all pulmonary artery reinterventions were for unilateral pulmonary artery in the roll technique group, 41.7% of reinterventions were for bilateral pulmonary arteries in the pericardial augmentation group. CONCLUSION: Single-stage complete repair of the ventricular septal defect, pulmonary atresia, and major aorticopulmonary collateral arteries has better results than unifocalization with a shunt. In terms of nonvaluable raw material, the use of the pericardial roll technique is a considerable alternative for unifocalization.


Assuntos
Defeito do Septo Aortopulmonar , Comunicação Interventricular , Atresia Pulmonar , Aorta/anormalidades , Aorta/cirurgia , Defeito do Septo Aortopulmonar/cirurgia , Circulação Colateral , Defeitos dos Septos Cardíacos , Comunicação Interventricular/cirurgia , Humanos , Lactente , Artéria Pulmonar/anormalidades , Artéria Pulmonar/cirurgia , Atresia Pulmonar/cirurgia , Estudos Retrospectivos
4.
BMC Nephrol ; 23(1): 54, 2022 02 07.
Artigo em Inglês | MEDLINE | ID: mdl-35125093

RESUMO

BACKGROUND: During the month of Ramadan, Muslims abstain from daytime consumption of fluids and foods, although some high-risk individuals are exempt. Because fasting's effects on the risk of acute kidney injury (AKI) have not been established, this study assesses the relationship between fasting and risk of AKI and identifies patients at high risk. METHODS: A single-center, retrospective, propensity-score matched, cohort study was conducted with data collected from adult patients admitted to the emergency room during Ramadan and the following month over two consecutive years (2016 and 2017). AKI was diagnosed based on the 2012 definition from the Kidney Disease: Improving Global Outcomes clinical practice guideline. Multivariable logistic regression analyses were used to examine the correlation and measure the effect of fasting on the incidence of AKI, and assess the effect of different variables on the incidence of AKI between the matching cohorts. RESULTS: A total of 1199 patients were included; after matching, each cohort had 499 patients. In the fasting cohort, the incidence of AKI and the risk of developing AKI were significantly lower (adjusted odds ratio (AOR) 0.65;95% confidence interval (CI) 0.44-0.98). The most indicative risk factors for AKI were hypertension (AOR 2.17; 95% CI 1.48-3.18), history of AKI (AOR 5.05; 95% CI 3.46-7.39), and liver cirrhosis (AOR 3.01; 95% CI 1.04-8.70). Patients with these factors or most other comorbidities in the fasting cohort had a lower risk of AKI as compared with their nonfasting counterparts. CONCLUSION: The data show a strong reduction in the risk of developing AKI as a benefit of fasting, particularly in patients with comorbid conditions. Therefore, most patients with comorbid conditions are not harmed from fasting during Ramadan. However, larger prospective studies are needed to investigate the benefit of fasting in reducing the risk of developing AKI.


Assuntos
Injúria Renal Aguda/etiologia , Jejum/efeitos adversos , Islamismo , Injúria Renal Aguda/epidemiologia , Fatores Etários , Feminino , Humanos , Hipertensão/complicações , Incidência , Cirrose Hepática/complicações , Masculino , Pessoa de Meia-Idade , Pontuação de Propensão , Estudos Retrospectivos , Fatores de Risco , Arábia Saudita/epidemiologia
5.
Cardiol Young ; : 1-8, 2021 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-34743778

RESUMO

BACKGROUND: We aimed to compare the results of two surgical methods for the treatment of congenital supravalvular aortic stenosis. METHODS: From May 2004 to January 2020, 29 patients underwent surgical repair for supravalvular aportic stenosis in a single centre. The perioperative evaluation of the patients was retrospectively reviewed. RESULTS: Fifteen (51.7%) and 14 (48.2%) patients were treated with the Doty and the McGoon methods, respectively. The median age of our cohort was 4.5 (3.0-9.9) years. Ten (34.5%) patients had Williams-Beuren syndrome, and pulmonary stenosis was observed in 12 (41.3%) patients. The median follow-up time was 2.5 (0.7-7.3) years. On follow-up, five patients had residual stenosis with the McGoon technique and one with the Doty technique (p = 0.05). One patient died early in the post-operative period in the Doty group, and three patients were re-operated on due to restenosis in the McGoon group. Freedom from re-operation in the Doty group at 1, 3, 5, and 10 years was 100%. In the McGoon group, freedom from re-operation rates at the 1-, 3-, and 7-year follow-up were 100, 88.9, and 44.4%, respectively (p = 0.08). CONCLUSION: Our results with both surgical techniques suggest that supravalvular aortic stenosis can be treated with good results. The Doty method provided better relief for the supravalvular aortic segment, considering the residual stenosis and the re-operation rates.

6.
J Card Surg ; 36(9): 3147-3152, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34056764

RESUMO

OBJECTIVE: To describe our short- and medium-term outcomes using the BioIntegral pulmonic conduit. METHODS: Between August 2018 and September 2019, the BioIntegral pulmonic valved conduit was used for right ventricular outflow tract reconstruction in 48 patients. The data were retrospectively retrieved from the patient charts. RESULTS: The median age at surgery was 36 months (interquartile range [IQR] = 18-62 months). The diagnoses were pulmonary atresia-ventricular septal defect in 28 patients, absent pulmonary valve in four patients, truncus arteriosus in six patients, TGA-VSD-PS in five patients, conduit stenosis in three patients, and left venticular outflow tract obstruction requiring a Ross operation in two patients. In the postoperative short-term follow-up, 15 patients out of 48 had a high fever. Of these, 12 patients had concomitantly elevated C-reactive protein levels. There were no patients with blood culture positivity. The median postoperative length of hospital stay was 14 days (IQR = 8-21 days). The overall mortality was 4% in two patients, one died of right ventricular failure and multiple organ failure and one died of pulmonary embolism. The two patients who died were not among the 15 patients with fever. However, four patients with fever underwent balloon angioplasty for conduit restenosis in their medium-term follow-up. CONCLUSION: There was a high incidence of fever and adverse outcomes in the short-term postoperative follow-up of patients in whom the BioIntegral pulmonic valved conduit was implanted. Caution is advisable in using these conduits until there is convincing evidence about the sterilization and storage standards of these grafts.


Assuntos
Bioprótese , Cardiopatias Congênitas , Próteses Valvulares Cardíacas , Obstrução do Fluxo Ventricular Externo , Pré-Escolar , Cardiopatias Congênitas/cirurgia , Próteses Valvulares Cardíacas/efeitos adversos , Humanos , Incidência , Lactente , Reoperação , Estudos Retrospectivos , Resultado do Tratamento , Obstrução do Fluxo Ventricular Externo/cirurgia
7.
Cardiol Young ; 31(6): 985-991, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33504380

RESUMO

OBJECTIVE: The aim of this study is to report on the short-term and mid-term outcomes of preterm infants who underwent patent ductus arteriosus ligation through anterior mini-thoracotomy. METHODS: Data for 103 preterm infants who underwent patent ductus arteriosus clipping through an anterior mini-thoracotomy at the 2nd intercostal space between 2009 and 2019 were retrospectively reviewed. The patients were divided into two groups according to their weight at the time of surgery. The complications, morbidity, and mortality rates of each group were compared at postoperative day 30 and at the end of 1 year after surgery. RESULTS: During the operation, the median weight of the patients was 900 g (IQR 800-1125 g), the median age was 21 days (IQR 14.5-29 days). The lowest body weight was 460 g. In three patients (3%), there was intraoperative bleeding from the patent ductus arteriosus that required transition to median sternotomy. In one patient (1%) a residual patent ductus arteriosus that required reoperation was observed. Twelve patients (12%) died in the first 30 days postoperatively. Six patients (6%) died between the postoperative day 30 and 1 year. There was no statistically significant difference in the rates of mortality, morbidity, and complication between the groups. CONCLUSIONS: Based on our observations of over a hundred preterm infants with patent ductus arteriosus over a decade, ligation through anterior mini-thoracotomy is the main surgical procedure of choice for this patient group in our clinic. Our findings demonstrate the safety of this approach and we believe that it can be successfully replicated in other institutions.


Assuntos
Permeabilidade do Canal Arterial , Adulto , Permeabilidade do Canal Arterial/cirurgia , Humanos , Lactente , Recém-Nascido , Recém-Nascido Prematuro , Ligadura , Estudos Retrospectivos , Toracotomia , Resultado do Tratamento , Adulto Jovem
8.
Saudi J Kidney Dis Transpl ; 32(5): 1365-1373, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-35532706

RESUMO

One of the tools used to measure the quality of life in hemodialysis (HD) patients is the Kidney Disease Quality of Life (KDQOL) survey. The KDQOL has been through several developmental processes, with the most recent one being the KDQOL-36™. Our study evaluated the validity and reliability of the Arabic-translated KDQOL-36™ survey in Saudi chronic dialysis patients. This cross-sectional study was conducted at four HD centers in Saudi Arabia. The KDQOL-36™ survey was translated into Arabic according to the RAND Corporation's basic guidelines for translating surveys. The validation process was achieved by assessing reliability and validity. The reliability of the translated survey was established by Cronbach's alpha to measure internal consistency and the intra-class correlation coefficient (ICC) to measure the test-retest reliability. The validity of the translated survey was established based on content validity and convergent validity. The study included 184 patients (36-65 years; 60.9% of men). Regarding reliability, Cronbach's alpha for the subscales ranged from 0.63 to 0.89, and ICCs ranged from 0.60 to 0.88. For content validity, an expert panel reviewed the questions in depth. In addition, we found a positive relationship between all sub- and overall health-rated scores (P <0.01). The Arabic-translated version of the KDQOL-36™ survey is reliable and valid for evaluating the quality of life in Saudi chronic dialysis patients.


Assuntos
Nefropatias , Diálise Renal , Estudos Transversais , Feminino , Humanos , Masculino , Psicometria , Qualidade de Vida , Reprodutibilidade dos Testes , Arábia Saudita , Inquéritos e Questionários
9.
J Card Surg ; 36(2): 530-535, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33331064

RESUMO

OBJECTIVE: This study aims to present the midterm outcomes of surgical correction of the anomalous left coronary artery from the pulmonary artery (ALCAPA) with a focus on mitral regurgitation (MR). METHODS: Medical records of 36 ALCAPA patients who underwent surgery in a single center were retrospectively reviewed. RESULTS: There were one (2.7%) neonate, 19 (52.7%) infants, 15 (41.6%) children, and 1 (2.7%) adult patient operated. Coronary reimplantation, tube reconstruction, and coronary artery bypass surgery techniques were performed in 29 (80.5%), 6 (16.6%), and 1 (2.7%) patient, respectively. Sixteen (44.4%) patients had a low ejection fraction and 13 (36.1%) patients had at least moderate MR preoperatively. None of our patients underwent a concomitant mitral surgery during the initial repair. Three and two patients died in the early and late postoperative period, respectively. Two patients underwent reoperation due to MR and pulmonary stenosis, separately. Preoperative MR was the only factor associated with at least moderate MR at the final follow-up (p < .01) and the presence of preoperative moderate or over-moderate MR estimated at least moderate MR at the final follow-up with 100% sensitivity and 80% specificity. CONCLUSION: Although the mitral valve was not repaired in the first operation, the reoperation rate is low. However, a moderate or higher preoperative MR predicted MR at the last follow-up. Performing annuloplasty in such patients can be a strategy to be researched.


Assuntos
Artéria Coronária Esquerda Anormal , Síndrome de Bland-White-Garland , Anomalias dos Vasos Coronários , Insuficiência da Valva Mitral , Adulto , Criança , Anomalias dos Vasos Coronários/complicações , Anomalias dos Vasos Coronários/cirurgia , Seguimentos , Humanos , Lactente , Recém-Nascido , Insuficiência da Valva Mitral/cirurgia , Artéria Pulmonar/diagnóstico por imagem , Artéria Pulmonar/cirurgia , Estudos Retrospectivos , Resultado do Tratamento
10.
Cardiol Young ; 30(12): 1874-1879, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32988422

RESUMO

OBJECTIVES: This study aimed to evaluate the early outcomes of patients who underwent a concomitant therapeutic maze procedure for congenital heart surgery. MATERIALS AND METHODS: Between 2019 and 2020, eight patients underwent surgical cryoablation by using the same type of cryoablation probe. RESULTS: Three patients had atrial flutter, two had Wolf-Parkinson-White syndrome, two intra-atrial reentrant tachycardia, and one had atrial fibrillation. Four patients underwent electrophysiological study. Preoperatively, one patient was on 3, two were on 2, five were on 1 antiarrhythmic drug. Six patients underwent right atrial maze and two underwent bilateral atrial maze. Five out of six right atrial maze patients underwent right atrial reduction. Nine different lesion sets were used. Some of the lesions were combined and applied as one lesion. In Ebstein's anomaly patients, the lesion from coronary sinus to displaced tricuspid annulus was delicately performed. The single ventricle patient with heterotaxy had junctional rhythm at the time of discharge and was the only patient who experienced atrial extrasystoles 2 months after discharge. Seven of the eight patients were on sinus rhythm. No patient needed permanent pacemaker placement. CONCLUSION: Cryomaze procedure can be applied in congenital heart diseases with acceptable arrhythmia-free rates by selecting the appropriate materials and suitable lesion sets. The application of cryomaze in heterotaxy patients can be challenging due to differences in the conduction system and complex anatomy. Consensus with the electrophysiology team about the choice of the right-left or biatrial maze procedure is mandatory for operational success.


Assuntos
Fibrilação Atrial , Ablação por Cateter , Criocirurgia , Cardiopatias Congênitas , Taquicardia Supraventricular , Fibrilação Atrial/cirurgia , Átrios do Coração/cirurgia , Cardiopatias Congênitas/cirurgia , Humanos , Taquicardia Supraventricular/cirurgia , Resultado do Tratamento
11.
Can J Ophthalmol ; 53(1): 76-80, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29426446

RESUMO

OBJECTIVE: To compare the percentage of patients at risk for obstructive sleep apnea (OSA) in open-angle glaucoma (OAG) versus controls using the STOP-Bang questionnaire. METHODS: This study used a cross-sectional survey. Patients with OAG and controls completed the STOP-Bang questionnaire-a validated tool to identify patients at high risk for OSA. Patients were considered at risk if they scored 3 or more points or at high risk for moderate/severe OSA if they scored 5 or more out of the maximum 8 points. Demographic information, medical history, and previous diagnosis of OSA were recorded. Details regarding the patients' glaucoma were obtained from their medical records. RESULTS: A total of 437 patients with OAG and 441 controls were included. The mean STOP-Bang score was 3.01 ± 1.3 for the glaucoma group and 3.03 ± 1.4 for the control group (p = 0.92). There was no significant difference between the percentage of subjects considered at risk for OSA (62.7% OAG vs 59.4% controls, p = 0.37) or at high risk for moderate/severe OSA (12.6% OAG vs 16.5% controls, p = 0.1). Significantly more patients in the control group had a previous diagnosis of OSA (p = 0.01). More patients with OAG reported feeling tired compared with controls (p = 0.003). A risk/high risk for OSA was not associated with glaucoma severity, progression, intraocular pressure control, or glaucoma type. CONCLUSIONS: Our results indicate that a risk or high risk for moderate/severe OSA as measured by the STOP-Bang questionnaire is not correlated with the presence or absence of glaucoma (regardless of the type), glaucoma severity, glaucoma progression, or IOP control.


Assuntos
Glaucoma de Ângulo Aberto/complicações , Programas de Rastreamento/métodos , Apneia Obstrutiva do Sono/epidemiologia , Inquéritos e Questionários , Idoso , Estudos Transversais , Feminino , Glaucoma de Ângulo Aberto/fisiopatologia , Humanos , Incidência , Masculino , Ontário/epidemiologia , Polissonografia , Fatores de Risco , Apneia Obstrutiva do Sono/etiologia
12.
Andrologia ; 50(2)2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28766734

RESUMO

The pressure pattern in varicocele veins of infertile patients and its correlation with semen quality and testicular blood flow was determined. Consecutive patients at andro-urology clinic of a teaching hospital undergoing microsurgical varicocelectomy were included. Their semen quality and testicular blood flow were determined. Peak systolic velocity (PSV) and resistive index (RI) of subcapsular and intraparenchymal branches of testicular artery were noted by colour Doppler ultrasonography. During surgery before ligation of varicocele veins, intravenous pressures of internal spermatic (ISV) and external spermatic (ESV) veins were determined at baseline and after Valsalva manoeuvre. Thirty patients, 20-45 years old, were evaluated. Baseline pressure for maximum dilated ISV (A), less dilated ISV (B) and ESV was 15.93 ± 6.34, 12.38 ± 4.60 and 12.92 ± 5.65 mm. Hg, respectively, which increased after Valsalva by 104.4%, 116.2% and 38.22% respectively. Correlation (r = -.71; p < .05) was appreciated between percentage increase in pressure of ISV B with PSV of intraparenchymal testicular arteries and progressive motility (r = -.759; p < .05), nonprogressive motility (r = -.738; p < .05) and morphology (r = -.653; p = .07) of spermatozoa. In conclusion, ISV develops higher pressure on Valsalva as compared to ESV and has correlation with semen quality and testicular blood flow.


Assuntos
Infertilidade Masculina/fisiopatologia , Sêmen/fisiologia , Testículo/irrigação sanguínea , Varicocele/fisiopatologia , Veias/fisiopatologia , Adulto , Velocidade do Fluxo Sanguíneo , Humanos , Infertilidade Masculina/prevenção & controle , Masculino , Microcirurgia/métodos , Análise do Sêmen , Espermatozoides/fisiologia , Testículo/diagnóstico por imagem , Testículo/fisiopatologia , Ultrassonografia Doppler em Cores , Manobra de Valsalva , Varicocele/diagnóstico por imagem , Varicocele/cirurgia , Procedimentos Cirúrgicos Vasculares/métodos , Veias/diagnóstico por imagem , Veias/cirurgia , Pressão Venosa , Adulto Jovem
15.
PLoS One ; 11(5): e0156093, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27228169

RESUMO

Laser ablation of dental hard tissues is one of the most important laser applications in dentistry. Many works have reported the interaction of laser radiations with tooth material to optimize laser parameters such as wavelength, energy density, etc. This work has focused on determining the relationship between energy density and ablation thresholds using pulsed, 5 nanosecond, neodymium-doped yttrium aluminum garnet; Nd:Y3Al5O12 (Nd:YAG) laser at 1064 nanometer. For enamel and dentin tissues, the ablations have been performed using laser-induced breakdown spectroscopy (LIBS) technique. The ablation thresholds and relationship between energy densities and peak areas of calcium lines, which appeared in LIBS, were determined using data fitting. Furthermore, the morphological changes were studied using Scanning Electron Microscope (SEM). Moreover, the chemical stability of the tooth material after ablation has been studied using Energy-Dispersive X-Ray Spectroscopy (EDX). The differences between carbon atomic % of non-irradiated and irradiated samples were tested using statistical t-test. Results revealed that the best fitting between energy densities and peak areas of calcium lines were exponential and linear for enamel and dentin, respectively. In addition, the ablation threshold of Nd:YAG lasers in enamel was higher than that of dentin. The morphology of the surrounded ablated region of enamel showed thermal damages. For enamel, the EDX quantitative analysis showed that the atomic % of carbon increased significantly when laser energy density increased.


Assuntos
Interpretação Estatística de Dados , Esmalte Dentário/efeitos da radiação , Dentina/efeitos da radiação , Terapia a Laser , Lasers , Extração Dentária/métodos , Dureza , Humanos , Nanotecnologia , Espectrometria por Raios X
16.
Head Neck ; 37(9): 1246-53, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24801106

RESUMO

BACKGROUND: A significant fraction of oropharyngeal squamous cell carcinoma (SCC) cases is associated with traditional carcinogens; in these patients, treatment response and clinical outcomes remain poor. METHODS: We evaluated patient, tumor, and treatment characteristics for 200 veterans with oropharyngeal SCC treated at the Michael E. DeBakey Veterans Affairs Medical Center (MEDVAMC) between 2000 and 2012. RESULTS: Most patients (77%) were white and heavy smokers. Twenty-seven patients required tracheostomy and 63 required gastrostomy placement during treatment. Overall survival (OS) at 5 years was 40%. Survival was impacted by T classification, treatment intensity, completion of treatment, and p16 tumor status. Almost 30% of patients were unable to complete a treatment regimen consistent with National Comprehensive Cancer Network (NCCN) guidelines. CONCLUSION: Oropharyngeal SCC in veterans is associated with traditional carcinogens and poor clinical outcomes. Despite heavy smoking exposure, p16 tumor status significantly impacts survival. Careful consideration must be given to improving treatment paradigms for this cohort given their limited tolerance for treatment escalation.


Assuntos
Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/terapia , Quimiorradioterapia/métodos , Neoplasias Orofaríngeas/mortalidade , Neoplasias Orofaríngeas/terapia , Adulto , Idoso , Alcoolismo/complicações , Carcinógenos , Carcinoma de Células Escamosas/etiologia , Carcinoma de Células Escamosas/patologia , Estudos de Coortes , Intervalo Livre de Doença , Hospitais de Veteranos , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Invasividade Neoplásica/patologia , Recidiva Local de Neoplasia/mortalidade , Recidiva Local de Neoplasia/fisiopatologia , Recidiva Local de Neoplasia/terapia , Estadiamento de Neoplasias , Neoplasias Orofaríngeas/etiologia , Neoplasias Orofaríngeas/patologia , Prognóstico , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Medição de Risco , Fumar/efeitos adversos , Análise de Sobrevida , Veteranos/estatística & dados numéricos
17.
Pharmacotherapy ; 34(7): 695-702, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24851819

RESUMO

STUDY OBJECTIVES: The effect of chronic kidney disease (CKD) on warfarin has gained attention because of an increased risk of thromboembolism and an increased risk of bleeding associated with warfarin treatment in these patients. Data suggest that patients with reduced kidney function require lower warfarin doses; however, relatively few patients with end-stage renal disease (ESRD) were included in previous studies. The goal of this study was to evaluate warfarin dosing requirements and time to reach therapeutic international normalized ratio (INR) in patients with CKD stages 3-5 and ESRD compared with patients with normal kidney function (NKF). METHODS: A historical cohort was identified to evaluate warfarin response in 210 hospitalized adults with varying degrees of kidney function initiated or maintained on warfarin for 4 or more consecutive days including 49 patients with NKF (glomerular filtration rate [GFR] higher than 60 ml/min/1.73 m(2) ), 44 with CKD stage 3, 27 with CKD stage 4/5, and 90 with ESRD. The average daily dose (ADD), time to achieve a therapeutic INR, and adverse effects were compared. MEASUREMENTS AND MAIN RESULTS: The ADD to maintain a therapeutic INR was 5.6 ± 1.7 mg in the NKF group, 4.3 ± 1.6 mg in CKD stage 3, 4.6 ± 1.9 mg in CKD stage 4/5, and 4.8 ± 1.9 mg in ESRD. The ADD was lower in CKD/ESRD patients compared with NKF patients (p=0.001), especially among whites. The time to reach a therapeutic INR in patients newly initiated on warfarin was significantly lower in the CKD/ESRD group when compared with the NKF group (p=0.02). No differences in bleeding episodes were observed during hospitalization or within 30 days of discharge in patients with CKD stage 3 or higher compared with patients with NKF. CONCLUSIONS: Our findings suggest that CKD and ESRD patients require ~20% lower warfarin doses to maintain a therapeutic INR and may require less time to achieve a therapeutic INR compared with patients with NKF.


Assuntos
Anticoagulantes/administração & dosagem , Hospitalização , Falência Renal Crônica/tratamento farmacológico , Varfarina/administração & dosagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Relação Dose-Resposta a Droga , Avaliação de Medicamentos/métodos , Feminino , Hospitalização/tendências , Humanos , Falência Renal Crônica/diagnóstico , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
18.
Int J Nanomedicine ; 8: 3875-81, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24143091

RESUMO

High-quality single-crystalline SnO2 nanorods were synthesized using a microwave-assisted solution method. The nanorods were characterized using X-ray diffraction (XRD), field-emission scanning electron microscopy (FE-SEM), transmission electron microscopy (TEM), ultraviolet-visible and Raman spectroscopy, Brunauer-Emmett-Teller (BET), and electrical resistance measurements. The XRD pattern indicated the formation of single-phase SnO2 nanorods with rutile structure. FE-SEM and TEM images revealed tetragonal nanorods of about 450-500 nm in length and 60-80 nm in diameter. The nanorods showed a higher BET surface area of 288 m²/g, much higher than that of previously reported work. The Raman scattering spectra indicated a typical rutile phase of the SnO2. The absorption spectrum showed an absorption peak centered at 340 nm, and the band-gap value was found to be 3.64 eV. The gas-sensing properties of the SnO2 nanorods for oxygen gas with different concentrations were measured at room temperature. It was found that the value of resistance increased with the increase in oxygen gas concentration in the test chamber. The SnO2 nanorods exhibited high sensitivity and rapid response-recovery characteristics to oxygen gas, and could detect oxygen concentration as low as 1, 3, 5, and 10 ppm.


Assuntos
Condutometria/instrumentação , Cristalização/métodos , Gases/análise , Nanotubos/química , Oxigênio/análise , Compostos de Estanho/química , Compostos de Estanho/efeitos da radiação , Absorção/efeitos da radiação , Desenho de Equipamento , Análise de Falha de Equipamento , Teste de Materiais , Micro-Ondas , Nanotubos/ultraestrutura , Oxigênio/química , Tamanho da Partícula
19.
Congenit Heart Dis ; 3(5): 352-4, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18837815

RESUMO

Translocation of the coronary arteries remains a technical challenge in anatomic correction of transposition of great arteries. Myocardial ischemia related to the difficulties with coronary relocation is an important factor in perioperative and postoperative morbidity and mortality, particularly in the patients with complex coronary artery anatomy. Intramural coronary artery is a rare anatomic variety which may complicate the arterial switch operation in 2% to 4.6% of the reported cases. Even in the hands of experts, the mortality rate may be in twofold in this subset of patients compared with simple transposition of great artery procedures. In this report, 2 successful translocation techniques for intramural coronary arteries in the setting of arterial switch operation are described.


Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Transposição dos Grandes Vasos/cirurgia , Anastomose Cirúrgica/métodos , Aorta Torácica/cirurgia , Humanos , Recém-Nascido , Masculino , Artéria Pulmonar/cirurgia , Transposição dos Grandes Vasos/patologia
20.
Int. j. morphol ; 26(2): 407-410, jun. 2008. tab
Artigo em Inglês | LILACS | ID: lil-549967

RESUMO

Anthropometric measurements, such as craniofacial forms especially in the first days after birth are important for the assessment of neonatal health status and results obtained from such measurements are used in pediatrics, orofacial surgery and diagnostic comprehension between patient and normal populations. There is no published literature about the types of head and face shapes in the Kanuri and Babur/Bura newborns of Maiduguri metropolis. Henee, this study was undertaken to document the various craniofacial forms of newborns of Maiduguri metropolis. Head length, head width, head circumference, face length, face width, prosopic and cephalic indices were measured in 120 newborns of the Maiduguri metropolis. The mean cephalic index in Kanuri male and female newborns were 70.03 percent and 77.15 percent respectively while that of the Babur/Bura males and females newborns were 73.60 percent and 77.23 percent, respectively. The mean prosopic index in Kanuri male and female newborns were 83.77 percent and 82.84 percent, respectively, while that of the Babur/Bura males and females newborns were 80.74 percent and 81.03 percent, respectively. On comparison with existing literature the Kanuri males and females are dolicocephalic, Babur/Bura males and females are mesocephalic, while both the Kanuri and Babur/Bura newborns have the hypereuryprosopic type of face shape thus the data obtained from this study can be used as local standards for diagnostic and anthropometric evaluation.


Las medidas antropométricas, tales como las formas craneofaciales especialmente en los primeros días después del nacimiento, son importantes para la evaluación del estado de salud neonatal y los resultados obtenidos a partir de estas mediciones se utilizan en pediatría, cirugía orofacial y la comprensión diagnóstica entre el paciente y la población normal. No hay literatura publicada sobre los tipos de formas de cabeza y rostro en los los Kanuri y Babur/Bura recién nacidos de Maiduguri. Este estudio se llevó a cabo para documentar las diversas formas craneofaciales de los recién nacidos de Maiduguri. Fueron medidos la longitud, ancho y circunferencia de la cabeza, altura facial, ancho de la cara, índice prosopo y cefálico en 120 recién nacidos de Maiduguri. La media del índice cefálico en hombres y mujeres Kanuri recién nacidos fueron 70,03 por ciento y 77,15 por ciento, respectivamente; mientras que la de hombres y mujeres Babur / Bura recién nacidos fueron de 73,60 por ciento y 77,23 por ciento respectivamente. La media del índice prosop en hombres y mujeres kanuri recién nacidos fueron 83,77 por ciento y 82,84 por ciento, respectivamente, mientras que la de la hombres y mujeres Babur / Bura recién nacidos fueron 80,74 por ciento y 81,03 por ciento, respectivamente. En comparación con la literatura existente, los hombres y mujeres Kanuri son dolicocéfalos, hombres y mujeres Babur / Bura son mesocéfalos, mientras que los hombres y mujeres Kanuri y Babur / Bura recién nacidos tienen tienen la cara hipereuriprosopo. Los datos obtenidos de este estudio pueden ser utilizados como las normas locales para el diagnóstico y evaluación antropométrica.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Cefalometria , Cabeça/anatomia & histologia , Antropometria , Face/anatomia & histologia , Etnicidade , Nigéria
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