Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 35
Filtrar
1.
Cardiol Young ; 32(12): 1966-1983, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35227341

RESUMO

BACKGROUND: Limited data exist on training of European paediatric and adult congenital cardiologists. METHODS: A structured and approved questionnaire was circulated to national delegates of Association for European Paediatric and Congenital Cardiology in 33 European countries. RESULTS: Delegates from 30 countries (91%) responded. Paediatric cardiology was not recognised as a distinct speciality by the respective ministry of Health in seven countries (23%). Twenty countries (67%) have formally accredited paediatric cardiology training programmes, seven (23%) have substantial informal (not accredited or certified) training, and three (10%) have very limited or no programme. Twenty-two countries have a curriculum. Twelve countries have a national training director. There was one paediatric cardiology centre per 2.66 million population (range 0.87-9.64 million), one cardiac surgical centre per 4.73 million population (range 1.63-10.72 million), and one training centre per 4.29 million population (range 1.63-10.72 million population). The median number of paediatric cardiology fellows per training programme was 4 (range 1-17), and duration of training was 3 years (range 2-5 years). An exit examination in paediatric cardiology was conducted in 16 countries (53%) and certification provided by 20 countries (67%). Paediatric cardiologist number is affected by gross domestic product (R2 = 0.41). CONCLUSION: Training varies markedly across European countries. Although formal fellowship programmes exist in many countries, several countries have informal training or no training. Only a minority of countries provide both exit examination and certification. Harmonisation of training and standardisation of exit examination and certification could reduce variation in training thereby promoting high-quality care by European congenital cardiologists.


Assuntos
Cardiologia , Humanos , Adulto , Criança , Cardiologia/educação , Certificação , Currículo , Bolsas de Estudo , Europa (Continente)
2.
Cardiol Young ; 28(2): 175-181, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28851468

RESUMO

Persistence of the embryonic "fifth aortic arch" in postnatal life is a rare, enigmatic - and at times controversial - condition, with variable anatomical forms and physiological consequences. First described in humans over 40 years ago by Van Praagh, the condition was labelled the "great pretender" by Gerlis 25 years later, because of its apparent propensity to mimic anatomically similar structures. Despite many subsequent case reports citing the condition, the true developmental origin of these structures remains unresolved, and has been the subject of debate among embryologists for more than a century. A persistent fifth aortic arch has been defined as an extrapericardial structure, arising from the ascending aorta opposite or proximal to the brachiocephalic artery, and terminating in the dorsal aorta or pulmonary arteries via a persistently patent arterial duct. This description may therefore encompass various anatomical forms, such as a unilateral double-lumen aortic arch, an unrestrictive aortopulmonary shunt, or a critical vascular channel for either the systemic or pulmonary circulation. The physiological properties of these vessels, such as their response to prostaglandins, may also be unpredictable. In this article, we demonstrate a number of cases that fulfil the contemporary definition of "persistent fifth aortic arch" while acknowledging the embryological controversies associated with this term. We also outline the key diagnostic features, particularly with respect to the use of new cross-sectional imaging techniques.


Assuntos
Aorta Torácica/anormalidades , Doenças da Aorta/congênito , Malformações Vasculares/diagnóstico , Aorta Torácica/diagnóstico por imagem , Doenças da Aorta/diagnóstico , Ecocardiografia , Humanos , Imageamento Tridimensional , Tomografia Computadorizada por Raios X
3.
Catheter Cardiovasc Interv ; 90(7): 1158-1160, 2017 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-28557188

RESUMO

Here, we report a four-day old neonate presenting with cardiovascular collapse secondary to a descending aorta to right atrial fistula. Echocardiography was suggestive of the diagnosis and confirmed with computed tomographic (CT) imaging. The fistula was successfully occluded via cardiac catheterization using an Amplatzer Vascular Plug II implanted from the right atrial aspect. This report includes the first CT imaging of this extremely rare congenital defect as well as detailing the first successful transcatheter occlusion of this particular lesion.


Assuntos
Aorta Torácica/anormalidades , Cateterismo Cardíaco/instrumentação , Átrios do Coração/anormalidades , Cardiopatias Congênitas/terapia , Fístula Vascular/terapia , Aorta Torácica/diagnóstico por imagem , Aorta Torácica/fisiopatologia , Aortografia/métodos , Angiografia por Tomografia Computadorizada , Angiografia Coronária/métodos , Ecocardiografia Doppler em Cores , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/fisiopatologia , Cardiopatias Congênitas/diagnóstico por imagem , Cardiopatias Congênitas/fisiopatologia , Humanos , Recém-Nascido , Masculino , Resultado do Tratamento , Fístula Vascular/diagnóstico por imagem , Fístula Vascular/fisiopatologia
4.
Catheter Cardiovasc Interv ; 89(4): 690-698, 2017 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-27860188

RESUMO

AIMS: To gather current experience in Occlutech ASD device retrieval, to determine whether snaring is an effective technique and to highlight alternative retrieval techniques; METHODS AND RESULTS: United Kingdom and European Occlutech ASD device implanters reported their experience in dealing with device embolization and retrieval. Six operators reported 12 retrieval cases. Retrieval was successful in 92% (11/12), although in most cases it was not straightforward and required multiple attempts using different techniques and equipment. When each different technique or equipment combination was considered separately, there were a total of 23 retrieval attempts. Fifteen attempts involved snaring the ball on the right atrial disc of the device ("the RA pin"). In 12/15 of these attempts the snare slipped off the RA pin. In 8/15 attempts snaring eventually failed. In two cases retrieval was facilitated by elongating the device in a blood vessel. In three cases retrieval was achieved by grasping the RA pin with the jaws of the Occlutech Flex II delivery cable; CONCLUSIONS: Snares do not grip the RA pin sufficiently to reliably retrieve the device. Funnelling the device into a blood vessel or grasping the RA pin with the jaws of the delivery cable may be successful alternatives. © 2016 Wiley Periodicals, Inc.


Assuntos
Cateterismo Cardíaco/métodos , Remoção de Dispositivo/métodos , Dispositivo para Oclusão Septal/efeitos adversos , Ecocardiografia Transesofagiana , Falha de Equipamento , Europa (Continente) , Seguimentos , Comunicação Interatrial/diagnóstico , Comunicação Interatrial/cirurgia , Humanos , Estudos Retrospectivos
5.
Cardiol Young ; 27(5): 846-850, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27680401

RESUMO

Aims The pathophysiological entity of a persisting left-sided superior caval vein draining into the roof of the left atrium represents an extreme form of coronary sinus de-roofing. This is an uncommon, but well-documented condition associated with systemic desaturation due to a right-to-left shunt. Depending on the size of the coronary ostium, the defect may also present with right-sided volume loading. We describe two patients, both of whom presented with desaturation, and highlight the important anatomical features underscoring management. Methods and Results Both patients were managed interventionally with previous assessment of the size of the coronary sinus ostium through cross-sectional imaging. This revealed a restrictive interatrial communication at the right atrial mouth of the coronary sinus in both patients, which permitted an interventional approach, as the residual left-to-right shunt subsequent to closure of the aberrant vessel would be negligible. At intervention, test occlusion of the left superior caval vein allowed assessment of decompressing vessels before successful occlusion using an Amplatzer Vascular Plug. CONCLUSIONS: Persistence of a left superior caval vein draining to the left atrium may be associated with an interatrial communication at the mouth of the unroofed coronary sinus. The ostium of the de-roofed coronary sinus can be atretic, restrictive, normally sized, or enlarged. Careful assessment of the size of this defect is required before treatment. In view of its importance, which has received little attention in the literature to date, we suggest an additional consideration to the classification of unroofed coronary sinus.


Assuntos
Seio Coronário/diagnóstico por imagem , Malformações Vasculares/diagnóstico por imagem , Malformações Vasculares/fisiopatologia , Malformações Vasculares/cirurgia , Veia Cava Superior/diagnóstico por imagem , Adulto , Seio Coronário/anormalidades , Ecocardiografia , Feminino , Humanos , Masculino , Dispositivo para Oclusão Septal , Tomografia Computadorizada por Raios X , Veia Cava Superior/anormalidades , Teste de Caminhada
6.
Cardiol Young ; 26(4): 787-9, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26361220

RESUMO

CHD is associated with poor growth, delayed motor and language skills development, and increased length of hospital stay; 28.2% of infants were stunted, with z-scores<-2. The severity of surgery score was not associated with an increased length of stay, suggesting that a low weight-for-age z-score at the time of surgery may impact on length of stay.


Assuntos
Transtornos do Crescimento/epidemiologia , Adolescente , Serviço Hospitalar de Cardiologia , Criança , Pré-Escolar , Estudos Transversais , Transtornos do Crescimento/etiologia , Cardiopatias Congênitas/complicações , Humanos , Lactente , Recém-Nascido , Pediatria , Prevalência , Adulto Jovem
7.
Cardiol Young ; 24(2): 366-8, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23458266

RESUMO

We present a neonate with an antenatal diagnosis of Scimitar syndrome and aortic arch hypoplasia. After delivery, computerised tomography scan additionally revealed an anomalous origin of the circumflex coronary artery from the main pulmonary artery. The management of this rare combination is discussed.


Assuntos
Aorta Torácica/anormalidades , Anomalias dos Vasos Coronários/diagnóstico por imagem , Artéria Pulmonar/anormalidades , Síndrome de Cimitarra/diagnóstico por imagem , Angiografia , Aorta Torácica/diagnóstico por imagem , Anomalias dos Vasos Coronários/complicações , Feminino , Humanos , Recém-Nascido , Artéria Pulmonar/diagnóstico por imagem , Síndrome de Cimitarra/complicações , Tomografia Computadorizada por Raios X
8.
Genome Res ; 20(12): 1700-10, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20978141

RESUMO

Point mutations result from errors made during DNA replication or repair, so they are usually expected to be homogeneous across all regions of a genome. However, we have found a region of chloroplast DNA in plants related to sweetpea (Lathyrus) whose local point mutation rate is at least 20 times higher than elsewhere in the same molecule. There are very few precedents for such heterogeneity in any genome, and we suspect that the hypermutable region may be subject to an unusual process such as repeated DNA breakage and repair. The region is 1.5 kb long and coincides with a gene, ycf4, whose rate of evolution has increased dramatically. The product of ycf4, a photosystem I assembly protein, is more divergent within the single genus Lathyrus than between cyanobacteria and other angiosperms. Moreover, ycf4 has been lost from the chloroplast genome in Lathyrus odoratus and separately in three other groups of legumes. Each of the four consecutive genes ycf4-psaI-accD-rps16 has been lost in at least one member of the legume "inverted repeat loss" clade, despite the rarity of chloroplast gene losses in angiosperms. We established that accD has relocated to the nucleus in Trifolium species, but were unable to find nuclear copies of ycf4 or psaI in Lathyrus. Our results suggest that, as well as accelerating sequence evolution, localized hypermutation has contributed to the phenomenon of gene loss or relocation to the nucleus.


Assuntos
Evolução Molecular , Genes de Plantas/genética , Variação Genética , Genoma de Cloroplastos/genética , Lathyrus/genética , Mutação/genética , Complexo de Proteína do Fotossistema I/genética , Sequência de Aminoácidos , Sequência de Bases , Primers do DNA/genética , Dados de Sequência Molecular , Alinhamento de Sequência , Análise de Sequência de DNA
9.
Catheter Cardiovasc Interv ; 79(7): 1176-7, 2012 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-22109833

RESUMO

Complex atrial septal anatomy can continue to present a challenge for transcatheter closure. We present the successful use of overlapping GORE HELEX atrial septal defect occluders in an adult patient with five distinct fenestrations in an aneurismal septum and how 3D echo can aid device positioning.


Assuntos
Cateterismo Cardíaco/instrumentação , Aneurisma Cardíaco/terapia , Comunicação Interatrial/terapia , Dispositivo para Oclusão Septal , Ecocardiografia Tridimensional , Ecocardiografia Transesofagiana , Feminino , Aneurisma Cardíaco/diagnóstico por imagem , Comunicação Interatrial/diagnóstico por imagem , Humanos , Pessoa de Meia-Idade , Desenho de Prótese , Resultado do Tratamento
10.
Open Heart ; 8(2)2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34244358

RESUMO

OBJECTIVES: To report the numbers of consultant congenital cardiac surgeons and cardiologists who have joined and left UK practice over the last 10 years and explore the reasons for leaving. METHODS: Retrospective observational questionnaire study completed between 11 June 2019 and 1 July 2020 by UK level 1 congenital cardiac centres of 10-year consultant staff movement and reasons suggested for leaving UK practice. RESULTS: At survey completion there were 218 (202 whole time equivalent (WTE)) consultant cardiologists and surgeons working within level 1 centres made up of 39 (38 WTE) surgeons, 137 (128.5 WTE) paediatric cardiologists, 42 (35.5 WTE) adult congenital heart disease (ACHD) cardiologists. 161 (74%) consultants joined in the last 10 years of whom 103 (64%) were UK trained. There were 91 leavers giving a staff turnover rate 42% (surgeons 56%, paediatric cardiologists 42%, ACHD cardiologists 29%). Of those, leaving 43% moved to work abroad (surgeons 55%, paediatric cardiologists 40%, ACHD cardiologists 67%). Among the 65 reported reasons for leaving 16 were financial, 9 for work life balance, 6 to working conditions within the National Health Service (NHS) and 12 related to the profession in the UK including six specifically highlighting the national review process. CONCLUSIONS: There has been a high turnover rate of consultant staff within UK congenital cardiac services over the last 10 years with almost half of those leaving moving to work overseas. Financial reasons and pressures relating to working in the NHS or the specialty in the UK were commonly reported themes for leaving. This has major implications for future planning and staff retention within this specialised service.


Assuntos
Cardiologia , Consultores/estatística & dados numéricos , Cardiopatias Congênitas/terapia , Encaminhamento e Consulta/estatística & dados numéricos , Equilíbrio Trabalho-Vida/organização & administração , Recursos Humanos/estatística & dados numéricos , Criança , Humanos , Estudos Retrospectivos , Medicina Estatal , Inquéritos e Questionários , Reino Unido
11.
Hum Mutat ; 30(12): 1650-6, 2009 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-19777576

RESUMO

Polymorphisms in folate-related genes have emerged as important risk factors in a range of diseases including neural tube defects (NTDs), cancer, and coronary artery disease (CAD). Having previously identified a polymorphism within the cytoplasmic folate enzyme, MTHFD1, as a maternal risk factor for NTDs, we considered the more recently identified mitochondrial paralogue, MTHFD1L, as a candidate gene for NTD association. We identified a common deletion/insertion polymorphism, rs3832406, c.781-6823ATT(7-9), which influences splicing efficiency and is strongly associated with NTD risk. Three alleles of rs3832406 were detected in the Irish population with varying numbers of ATT repeats: Allele 1 consists of ATT(7), whereas Alleles 2 and 3 consist of ATT(8) and ATT(9), respectively. Allele 2 of this triallelic polymorphism showed a decreased case risk as demonstrated by case-control logistic regression (P=0.002) and by transmission disequilibrium test (TDT) (P=0.001), whereas Allele 1 showed an increased case risk. Allele 3 showed no influence on NTD risk and represents the lowest frequency allele (0.15). Additional single nucleotide polymorphism (SNP) genotyping in the same genomic region provides additional supportive evidence of an association. We demonstrate that two of the three alleles of rs3832406 are functionally different and influence the splicing efficiency of the alternate MTHFD1L mRNA transcripts.


Assuntos
Processamento Alternativo/genética , Predisposição Genética para Doença , Metilenotetra-Hidrofolato Desidrogenase (NADP)/genética , Defeitos do Tubo Neural/enzimologia , Defeitos do Tubo Neural/genética , Polimorfismo de Nucleotídeo Único/genética , Sequência de Bases , Estudos de Casos e Controles , Frequência do Gene/genética , Haplótipos/genética , Humanos , Desequilíbrio de Ligação/genética , Antígenos de Histocompatibilidade Menor , Modelos Biológicos , Dados de Sequência Molecular
12.
Eur J Echocardiogr ; 10(1): 160-2, 2009 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-18757861

RESUMO

Persistent left-sided superior caval veins (SVC) are present in 0.4% of the population. In the majority of cases, the persistent left SVC drains into the right atrium via the coronary sinus, but direct connection to the left atrium is also recognized. Previous reports have described re-opening of persistent left SVCs in patients with congenital heart disease following bidirectional cavopulmonary connection or Fontan-type procedures, suggesting that the lumen of the left SVC obliterates during embryological development, rather than disappears. The case described in this report is, to our knowledge, the first description of obliteration of the left SVC in post-natal life, associated with spontaneous closure of a ventricular septal defect. Our observation lends further support to the hypothesis that venous structures obliterate but do not completely disappear in foetal life.


Assuntos
Ecocardiografia Doppler em Cores , Cardiopatias Congênitas/diagnóstico por imagem , Comunicação Interventricular/diagnóstico por imagem , Veia Cava Superior/anormalidades , Feminino , Seguimentos , Átrios do Coração/anormalidades , Cardiopatias Congênitas/fisiopatologia , Comunicação Interventricular/fisiopatologia , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Remissão Espontânea , Medição de Risco
13.
Ann Pediatr Cardiol ; 12(2): 144-146, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31143042

RESUMO

Transcatheter therapy for partial anomalous pulmonary venous connection with dual drainage is unique and rarely reported. We report a 69-year-old female with recurrent brain abscess and partial anomalous connection of the left upper pulmonary vein with dual drainage to the vertical vein (VV) and left atrium (LA). Transcatheter occlusion of the VV was done using an 18-mm St. Jude Amplatzer Vascular Plug II, thus redirecting the left-sided pulmonary venous drainage to LA. Careful evaluation of partial anomalous pulmonary venous drainage with cross-sectional imaging is essential to allow the delineation of dual connections, enabling a less invasive transcatheter treatment approach.

14.
Forensic Sci Int Genet ; 34: 152-161, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29482105

RESUMO

During an investigation, the question of interest might be whether or not a person has worn a given garment. Wearer DNA studies have contributed to our knowledge and understanding of DNA transfer and persistence on items of worn clothing. However, there is currently no extensive dataset on DNA profiling outcomes from a variety of upper garments. Therefore we investigated the DNA profiling outcomes from the collars and/or cuffs of forty-four upper garments of worn clothing and determined the quantity of wearer and non-wearer DNA recovered. Interpretable DNA profiles were more likely to be obtained from collars than cuffs (84% versus 71%). The wearer was detected in all interpretable profiles and a major profile corresponding to the wearer was the most common outcome from both collar and cuff samples (48% and 50%, respectively). There was large variation in the amount of wearer DNA recovered and the average recovered was approximately 20 ng. Usually more wearer DNA was found on collars than cuffs of the same garment and, on average, more non-wearer DNA was found on cuffs than collars. No DNA was recovered from the cuffs of two garments despite these garments being worn for three and four hours, respectively. On one occasion a non-wearer contributed more DNA to a cuff sample than the wearer. We found no correlation between wearing time and the amount of wearer DNA recovered which indicates that other factors (e.g. shedder status and/or the manner of contact between the garment and skin) have a greater influence, than wearing time, on the amount of DNA transferred. However, there was a positive correlation between wearing time and the likelihood of obtaining interpretable profiles. This work has generated data to support the evaluation of DNA evidence from clothing and we provide a case example to demonstrate this.


Assuntos
Vestuário , Impressões Digitais de DNA , DNA/isolamento & purificação , Humanos , Reação em Cadeia da Polimerase , Fatores de Tempo , Tato
15.
Forensic Sci Int Genet ; 34: 11-24, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29367014

RESUMO

We report a large compilation of the internal validations of the probabilistic genotyping software STRmix™. Thirty one laboratories contributed data resulting in 2825 mixtures comprising three to six donors and a wide range of multiplex, equipment, mixture proportions and templates. Previously reported trends in the LR were confirmed including less discriminatory LRs occurring both for donors and non-donors at low template (for the donor in question) and at high contributor number. We were unable to isolate an effect of allelic sharing. Any apparent effect appears to be largely confounded with increased contributor number.


Assuntos
DNA/genética , Genótipo , Repetições de Microssatélites , Probabilidade , Software , Alelos , Impressões Digitais de DNA , Humanos , Laboratórios , Funções Verossimilhança
18.
Int J Cardiol ; 100(2): 267-73, 2005 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-15823634

RESUMO

OBJECTIVE: Sildenafil is a selective Phosphodiesterase-5 inhibitor that has been reported to be a potent pulmonary vasodilator. We evaluated the safety, efficacy and pharmacokinetics of oral Sildenafil in a case series of children with pulmonary hypertension. METHODS: Three children, 1 with primary pulmonary hypertension (patient 1) and 2 with pulmonary hypertension associated with congenital heart disease (patients 2 and 3) were enrolled. Sildenafil was started at 0.5 mg/kg 4-hourly and the dose increased to 1.0 and then to 2.0 mg/kg/dose. Patients were assessed at baseline and then monthly for a total of 6 visits. RESULTS: All patients reported increased exercise capacity with improvement in New York Heart Association functional class. The distance walked during the 6-min test increased by 74% (patient 1), 75% (patient 2) and 25% (patient 3) and oxyhaemoglobin saturations increased from 79%, 97% and 80% to 93%, 100% and 93%, respectively. There were no side effects and no fall in systemic blood pressure. Sildenafil plasma levels 1 h after a 0.5, 1.0 and 2 mg/kg dose of Sildenafil were 109+/-87, 150+/-62 and 368+/-200 ng/ml, respectively. They fell to 211+/-106 ng/ml 3 h after the 2.0 mg/kg dose. CONCLUSIONS: Medium term Sildenafil therapy improves oxyhaemoglobin saturations and exercise tolerance in children with pulmonary hypertension without any side effects. Mean plasma levels 1 h after doses of 0.5-2.0 mg/kg are similar to the maximum plasma concentrations reported in adults receiving doses within the therapeutic range. Sildenafil use in children appears to be safe and may be beneficial in the management of pulmonary arterial hypertension.


Assuntos
Hipertensão Pulmonar/tratamento farmacológico , Inibidores de Fosfodiesterase/uso terapêutico , Piperazinas/uso terapêutico , Administração Oral , Adolescente , Criança , Doença Crônica , Feminino , Cardiopatias Congênitas/complicações , Humanos , Hipertensão Pulmonar/etiologia , Masculino , Inibidores de Fosfodiesterase/efeitos adversos , Inibidores de Fosfodiesterase/farmacocinética , Piperazinas/efeitos adversos , Piperazinas/farmacocinética , Purinas , Segurança , Citrato de Sildenafila , Sulfonas
19.
Expert Opin Drug Saf ; 14(5): 633-42, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25746065

RESUMO

INTRODUCTION: Sildenafil (Revatio®) and tadalafil (Adcirca®) are specific inhibitors of the phosphodiesterase-5 enzyme and produce pulmonary vasodilation by inhibiting the breakdown of cyclic guanosine monophosphate (cGMP) in the walls of pulmonary arterioles. AREAS COVERED: We focus on the efficacy and safety of sildenafil and tadalafil in the treatment of pulmonary hypertension (PH) in children through a PubMed literature search. EXPERT OPINION: Although used since 1999 in the treatment of PH in children, it is only in the past few years that robust evidence for the use of sildenafil has emerged principally in the pivotal STARTS-1 study. The open-label extension of this study, STARTS-2, has revealed safety concerns substantiated by FDA post marketing surveillance leading to recommendations to use lower doses. More recently, tadalafil has been introduced allowing once daily dosing with apparently similar efficacy to sildenafil in children. Recently there have been suggestions that sildenafil and tadalafil may have a place in treating muscular dystrophy.


Assuntos
Hipertensão Pulmonar/tratamento farmacológico , Inibidores da Fosfodiesterase 5/uso terapêutico , Animais , Criança , GMP Cíclico/metabolismo , Relação Dose-Resposta a Droga , Humanos , Inibidores da Fosfodiesterase 5/administração & dosagem , Inibidores da Fosfodiesterase 5/efeitos adversos , Citrato de Sildenafila/administração & dosagem , Citrato de Sildenafila/efeitos adversos , Citrato de Sildenafila/uso terapêutico , Tadalafila/administração & dosagem , Tadalafila/efeitos adversos , Tadalafila/uso terapêutico
SELEÇÃO DE REFERÊNCIAS
Detalhe da pesquisa