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1.
Sensors (Basel) ; 20(9)2020 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-32397557

RESUMO

This work reports the development of arrays of infrared sensors (microbolometers) using a hydrogenated polymorphous silicon-germanium alloy (pm-SixGe1-x:H). Basically, polymorphous semiconductors consist of an amorphous semiconductor matrix with embedded nanocrystals of about 2-3 nm. The pm-SixGe1-x:H alloy studied has a high temperature coefficient of resistance (TCR) of 4.08%/K and conductivity of 1.5 × 10-5 S∙cm-1. Deposition of thermosensing film was made by plasma-enhanced chemical vapor deposition (PECVD) at 200 °C, while the area of the devices is 50 × 50 µm2 with a fill factor of 81%. Finally, an array of 19 × 20 microbolometers was packaged for electrical characterization. Voltage responsivity values were obtained in the range of 4 × 104 V/W and detectivity around 2 × 107 cm∙Hz1/2/W with a polarization current of 70 µA at a chopper frequency of 30 Hz. A minimum value of 2 × 10-10 W/Hz1/2 noise equivalent power was obtained at room temperature. In addition, it was found that all the tested devices responded to incident infrared radiation, proving that the structure and mechanical stability are excellent.

2.
Colorectal Dis ; 2017 Dec 06.
Artigo em Inglês | MEDLINE | ID: mdl-29211327

RESUMO

A correct preoperative strategy is crucial when surgery is needed for retrorectal tumours (RRT).[1] Surgical approaches may be purely anterior-abdominal, posterior-sacrococcygeal or combined depending on the tumour's size and location.[2] We present the case of an 18-year-old female with Currarino Syndrome who underwent surgery by a combined abdominal laparoscopic-posterior Kraske approach for the resection of a large RRT. This article is protected by copyright. All rights reserved.

3.
Rev Esp Enferm Dig ; 109(5): 372, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28480725

RESUMO

Omental torsion is an infrecuent cause of acute abdomen. It is related to obesity, abdominal surgery and abdominal trauma. Urgent exploratory laparotomy allows diagnosis and prevents complications as intrabdominal abcess. We present CT imaging of a Omenat torsion clinical case.


Assuntos
Dor Abdominal/etiologia , Omento/diagnóstico por imagem , Doenças Peritoneais/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Anormalidade Torcional/diagnóstico por imagem , Idoso , Humanos , Masculino , Doenças Peritoneais/complicações , Anormalidade Torcional/complicações
4.
BMC Cancer ; 16(1): 860, 2016 11 08.
Artigo em Inglês | MEDLINE | ID: mdl-27821086

RESUMO

BACKGROUND: Breast cancer is the most deadly malignancy in Mexican women. Although treatment has improved, it may significantly affect bone mineral status in those who receive it. The aim of this study was to assess the impact of cancer treatment on bone mineral density (BMD) and bone mineral content (BMC), in patients with breast cancer and explore the interaction of menopausal status and clinical stage with cancer treatment on such changes. METHODS: A quasi-experimental design was applied with measurements before and after a chemotherapy treatment in 40 patients with primary diagnosis of invasive breast cancer. BMD and body composition measurements were taken by dual X-ray absorptiometry (DXA) and changes in these variables due to therapy were analyzed using mixed regression for repeated measurements. RESULTS: Significant loss was found in femoral neck and L2-L4 BMD (p < 0.001). Patients diagnosed with osteopenia or osteoporosis received calcium + vitamin D supplementation (600 mg/200 IU day). It showed a protective effect in the decrease of femoral neck BMD and total BMC. BMD loss in both femoral neck and L2-L4 BMD was higher in premenopausal women: 0.023 g/cm2 in femoral neck and 0.063 g/cm2 in L2-L4 (p < 0.001), while in postmenopausal women BMD loss was 0.015 g/cm2 in femoral neck and 0.035 g/cm2 in L2-L4 (p = 0.021 and p = 0.001 respectively). Change in lumbar spine BMD was prominent in premenopausal women with advanced clinical stage (IIB, IIIA, IIIB): 0.066 g/cm2 (p = 0.003). CONCLUSION: The antineoplastic breast cancer treatment with chemotherapy had a negative impact on BMD, in premenopausal women overall, although a differential effect was found according to clinical stage and calcium supplementation status.


Assuntos
Antineoplásicos/efeitos adversos , Densidade Óssea , Doenças Ósseas/etiologia , Doenças Ósseas/patologia , Neoplasias da Mama/complicações , Adulto , Antineoplásicos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biomarcadores Tumorais , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/metabolismo , Feminino , Humanos , Menopausa , México , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Fatores de Risco
5.
Heliyon ; 10(4): e26298, 2024 Feb 29.
Artigo em Inglês | MEDLINE | ID: mdl-38404892

RESUMO

Electroencephalography (EEG) has been a fundamental technique in the identification of health conditions since its discovery. This analysis specifically centers on machine learning (ML) and deep learning (DL) methodologies designed for the analysis of electroencephalogram (EEG) data to categorize individuals with Alzheimer's Disease (AD) into two groups: Moderate or Advanced Alzheimer's dementia. Our study is based on a comprehensive database comprising 668 volunteers from 5 different hospitals, collected over a decade. This diverse dataset enables better training and validation of our results. Among the methods evaluated, the CNN (deep learning) approach outperformed others, achieving a remarkable classification accuracy of 97.45% for patients with Moderate Alzheimer's Dementia (ADM) and 97.03% for patients with Advanced Alzheimer's Dementia (ADA). Importantly, all the compared methods were rigorously assessed under identical conditions. The proposed DL model, specifically CNN, effectively extracts time domain features from EEG data in time, resulting in a significant reduction in learnable parameters and data redundancy.

6.
Environ Monit Assess ; 185(1): 335-46, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22331454

RESUMO

This study analysed airborne pollen counts for allergenic herb taxa in Toledo (central Spain), a major tourist city receiving over 2 million visitors per year, located in the region of Castilla-La Mancha. The taxa selected were Chenopodiaceae-Amaranthaceae, Plantago, Poaceae and Urticaceae, all of which produce allergenic pollen giving rise to serious symptoms in pollen-allergy sufferers. Aerobiological data were recorded over a 6-year period (2005 to 2010) using the sampling and analysis procedures recommended by the Spanish Aerobiology Network. The abundance and the temporal (annual, daily and intradiurnal) distribution of these pollen types were analysed, and the influence of weather-related factors on airborne pollen counts was assessed. Pollen from herbaceous species accounted for 20.9% of total airborne pollen in Toledo, the largest contributor being Poaceae, with 8.5% of the total pollen count; this family was also the leading cause of respiratory allergies. Examination of intradiurnal variation revealed three distinct distribution patterns: (1) peak daily counts for Chenopodiaceae-Amaranthaceae and Plantago were recorded during the hottest part of the day, i.e. from 1400 to 1600 hours; (2) Urticaceae displayed two peaks (1400-1600 and 2200 hours); and (3) Poaceae counts remained fairly stable throughout the day. Two main risk periods were identified for allergies: spring, with allergies caused by Urticaceae, Plantago and Poaceae pollen, and summer, due to Chenopodiaceae-Amaranthaceae pollen.


Assuntos
Poluentes Atmosféricos/análise , Poluição do Ar/estatística & dados numéricos , Alérgenos/análise , Monitoramento Ambiental , Pólen , Cidades , Espanha
7.
J Alzheimers Dis ; 95(4): 1667-1683, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37718814

RESUMO

BACKGROUND: In pursuit of diagnostic tools capable of targeting distinct stages of Alzheimer's disease (AD), this study explores the potential of electroencephalography (EEG) combined with machine learning (ML) algorithms to identify patients with mild or moderate AD (ADM) and advanced AD (ADA). OBJECTIVE: This study aims to assess the classification accuracy of six classical ML algorithms using a dataset of 668 patients from multiple hospitals. METHODS: The dataset comprised measurements obtained from 668 patients, distributed among control, ADM, and ADA groups, collected from five distinct hospitals between 2011 and 2022. For classification purposes, six classical ML algorithms were employed: support vector machine, Bayesian linear discriminant analysis, decision tree, Gaussian Naïve Bayes, K-nearest neighbor and random forest. RESULTS: The RF algorithm exhibited outstanding performance, achieving a remarkable balanced accuracy of 93.55% for ADA classification and 93.25% for ADM classification. The consistent reliability in distinguishing ADA and ADM patients underscores the potential of the EEG-based approach for AD diagnosis. CONCLUSIONS: By leveraging a dataset sourced from multiple hospitals and encompassing a substantial patient cohort, coupled with the straightforwardness of the implemented models, it is feasible to attain notably robust results in AD classification.

8.
JACC Cardiovasc Interv ; 16(14): 1794-1803, 2023 07 24.
Artigo em Inglês | MEDLINE | ID: mdl-37495352

RESUMO

BACKGROUND: Drug-coated balloons (DCB) represent 1 of the most promising innovations in interventional cardiology and may represent a valid alternative to drug-eluting stents. Currently, some sirolimus-coated balloons (SCB) are being investigated for several coronary artery disease applications. OBJECTIVES: This study sought to understand the role of a novel SCB for the treatment of coronary artery disease. METHODS: EASTBOURNE (All-Comers Sirolimus-Coated Balloon European Registry) is a prospective, multicenter, investigator-driven clinical study that enrolled real-world patients treated with SCB. Primary endpoint was target lesion revascularization (TLR) at 12 months. Secondary endpoints were procedural success, myocardial infarction (MI), all-cause death, and major adverse clinical events (a composite of death, MI, and TLR). All adverse events were censored and adjudicated by an independent clinical events committee. RESULTS: A total population of 2,123 patients (2,440 lesions) was enrolled at 38 study centers in Europe and Asia. The average age was 66.6 ± 11.3 years, and diabetic patients were 41.5%. De novo lesions (small vessels) were 56%, in-stent restenosis (ISR) 44%, and bailout stenting occurred in 7.7% of the patients. After 12 months, TLR occurred in 5.9% of the lesions, major adverse clinical events in 9.9%, and spontaneous MI in 2.4% of the patients. The rates of cardiac/all-cause death were 1.5% and 2.5%, respectively. The primary outcome occurred more frequently in the ISR cohort (10.5% vs 2.0%; risk ratio: 1.90; 95% CI: 1.13-3.19). After multivariate Cox regression model, the main determinant for occurrence of the primary endpoint was ISR (OR: 5.5; 95% CI: 3.382-8.881). CONCLUSIONS: EASTBOURNE, the largest DCB study in the coronary field, shows the safety and efficacy of a novel SCB in a broad population of coronary artery disease including small vessels and ISR patients at mid-term follow-up. (The All-Comers Sirolimus-Coated Balloon European Registry [EASTBOURNE]; NCT03085823).


Assuntos
Angioplastia Coronária com Balão , Doença da Artéria Coronariana , Reestenose Coronária , Infarto do Miocárdio , Humanos , Pessoa de Meia-Idade , Idoso , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/terapia , Doença da Artéria Coronariana/complicações , Angioplastia Coronária com Balão/efeitos adversos , Sirolimo/efeitos adversos , Resultado do Tratamento , Infarto do Miocárdio/complicações , Sistema de Registros , Reestenose Coronária/diagnóstico por imagem , Reestenose Coronária/etiologia
9.
Obes Surg ; 32(4): 1289-1299, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35143011

RESUMO

PURPOSE: The effectiveness of enhanced recovery after surgery (ERAS) pathways in patients undergoing bariatric surgery remains unclear. Our objective was to determine the effect of the ERAS elements on patient outcomes following elective bariatric surgery. MATERIALS AND METHODS: Prospective cohort study in adult patients undergoing elective bariatric surgery. Each participating center selected a single 3-month data collection period between October 2019 and September 2020. We assessed the 24 individual components of the ERAS pathways in all patients. We used a multivariable and multilevel logistic regression model to adjust for baseline risk factors, ERAS elements, and center differences RESULTS: We included 1419 patients. One hundred and fourteen patients (8%) developed postoperative complications. There were no differences in the incidence of overall postoperative complications between the self-designated ERAS and non-ERAS groups (54 (8.7%) vs. 60 (7.6%); OR, 1.14; 95% CI, 0.73-1.79; P = .56), neither for moderate-to-severe complications, readmissions, re-interventions, mortality, or hospital stay (2 [IQR 2-3] vs. 3 [IQR 2-4] days, 0.85; 95% CI, 0.62-1.17; P = .33) Adherence to the ERAS elements in the highest adherence quartile (Q1) was greater than 72.2%, while in the lowest adherence quartile (Q4) it was less than 55%. Patients with the highest adherence rates had shorter hospital stay (2 [IQR 2-3] vs. 3 [IQR 2-4] days, 1.54; 95% CI, 1.09-2.17; P = .015), while there were no differences in the other outcomes CONCLUSIONS: Higher adherence to ERAS Society® recommendations was associated with a shorter hospital stay without an increase in postoperative complications or readmissions. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03864861.


Assuntos
Cirurgia Bariátrica , Recuperação Pós-Cirúrgica Melhorada , Obesidade Mórbida , Adulto , Cirurgia Bariátrica/efeitos adversos , Humanos , Tempo de Internação , Obesidade Mórbida/cirurgia , Readmissão do Paciente , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Estudos Prospectivos
10.
Materials (Basel) ; 14(22)2021 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-34832349

RESUMO

Hydrogenated microcrystalline silicon (µc-Si:H) and epitaxial silicon (epi-Si) films have been produced from SiF4, H2 and Ar mixtures by plasma enhanced chemical vapor deposition (PECVD) at 200 °C. Here, both films were produced using identical deposition conditions, to determine if the conditions for producing µc-Si with the largest crystalline fraction (XC), will also result in epi-Si films that encompass the best quality and largest crystalline silicon (c-Si) fraction. Both characteristics are of importance for the development of thin film transistors (TFTs), thin film solar cells and novel 3D devices since epi-Si films can be grown or etched in a selective manner. Therefore, we have distinguished that the H2/SiF4 ratio affects the XC of µc-Si, the c-Si fraction in epi-Si films, and the structure of the epi-Si/c-Si interface. Raman and UV-Vis ellipsometry were used to evaluate the crystalline volume fraction (Xc) and composition of the deposited layers, while the structure of the films were inspected by high resolution transmission electron microscopy (HRTEM). Notably, the conditions for producing µc-Si with the largest XC are different in comparison to the fabrication conditions of epi-Si films with the best quality and largest c-Si fraction.

11.
Artigo em Inglês | MEDLINE | ID: mdl-35002013

RESUMO

sUAS (small-Unmanned Aircraft System) and advanced surface energy balance models allow detailed assessment and monitoring (at plant scale) of different (agricultural, urban, and natural) environments. Significant progress has been made in the understanding and modeling of atmosphere-plant-soil interactions and numerical quantification of the internal processes at plant scale. Similarly, progress has been made in ground truth information comparison and validation models. An example of this progress is the application of sUAS information using the Two-Source Surface Energy Balance (TSEB) model in commercial vineyards by the Grape Remote sensing Atmospheric Profile and Evapotranspiration eXperiment - GRAPEX Project in California. With advances in frequent sUAS data collection for larger areas, sUAS information processing becomes computationally expensive on local computers. Additionally, fragmentation of different models and tools necessary to process the data and validate the results is a limiting factor. For example, in the referred GRAPEX project, commercial software (ArcGIS and MS Excel) and Python and Matlab code are needed to complete the analysis. There is a need to assess and integrate research conducted with sUAS and surface energy balance models in a sharing platform to be easily migrated to high performance computing (HPC) resources. This research, sponsored by the National Science Foundation FAIR Cyber Training Fellowships, is integrating disparate software and code under a unified language (Python). The Python code for estimating the surface energy fluxes using TSEB2T model as well as the EC footprint analysis code for ground truth information comparison were hosted in myGeoHub site https://mygeohub.org/ to be reproducible and replicable.

12.
J Cardiovasc Med (Hagerstown) ; 22(2): 94-100, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-32740442

RESUMO

AIMS: The purpose of the EASTBOURNE registry is to evaluate the immediate and long-term clinical performance of a novel sirolimus-coated balloon (SCB) in a real-world population of patients with coronary artery disease. We here present the prespecified interim analysis after the enrollment of the first 642 patients who obtained 1-year clinical follow-up. METHODS: EASTBOURNE is a prospective, international, multicenter, all-comer investigator-driven clinical registry, which is enrolling consecutive patients treated with SCB at 42 European and Asiatic centers. Primary study endpoint is target-lesion revascularization (TLR) at 12 months. Secondary endpoints are procedural success and major adverse cardiac events through 36 months. RESULTS: Diabetes mellitus was present in 41% of patients. Acute coronary syndrome was present in 45% of patients and de novo lesions were 55%; 83% of the in-stent restenosis (ISR) patients had drug-eluting stents restenosis. Lesion predilatation was performed in 95% of the cases and bailout stenting occurred in 7.5%. So far, 642 patients have a complete 12-month follow-up. TLR occurred in 2.5%, myocardial infarction in 2.3%, total death in 1% and major adverse cardiac events in 5.8% of patients. A prespecified analysis of comparison between ISR and de-novo lesions showed a significantly higher occurrence of TLR in the ISR population (5.4 vs. 0.2%, P = 0.0008). CONCLUSION: The current interim analysis of 12-month follow-up of the EASTBOURNE registry shows good immediate performance and an adequate and encouraging safety profile through 12 months for this novel SCB.


Assuntos
Angioplastia Coronária com Balão/instrumentação , Materiais Revestidos Biocompatíveis , Doença da Artéria Coronariana/cirurgia , Stents Farmacológicos , Sistema de Registros , Sirolimo/farmacologia , Idoso , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico , Feminino , Seguimentos , Humanos , Imunossupressores/farmacologia , Masculino , Estudos Prospectivos , Fatores de Tempo , Resultado do Tratamento
13.
Cardiovasc Revasc Med ; 31: 1-6, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-33060037

RESUMO

OBJECTIVES: We sought to evaluate clinical outcomes in patients treated with the drug-eluting stent ihtDEStiny BD. BACKGROUND: The ihtDEStiny BD stent is a metallic sirolimus eluting stent with a biodegradable polymer with both drug and polymer coating the abluminal surface of the stent and balloon. METHODS: In this study, the clinical outcomes of a multicenter prospective registry of patients treated with this stent (DEStiny group) were analyzed and compared with those of a control group of patients treated with durable polymer everolimus or zotarolimus eluting stents (CONTROL group) paired by propensity score matching. Primary outcome was the target vessel failure (TVF) at 12 months defined as a composite of cardiac death, target vessel myocardial infarction (TV-MI) and target vessel revascularization (TVR). RESULTS: A total of 350 patients were included in the DESTtiny group. The control group consisted initially of 1368 patients, but after matching (1:1) 350 patients were selected as CONTROL group. The baseline clinical, angiographic and procedural characteristics were quite comparable in both groups. At 12 months follow up the TVF was 6.6% in DEStiny group and 6.3% in CONTROL group (p = 0.8). No differences were observed for any of the individual components of the primary endpoint: cardiac death 1.1% vs. 1.4%, TV-MI 3.4% vs. 3.7% and TVR 2.6% vs. 2.3% respectively. CONCLUSIONS: The use of ihtDEStiny stent in real practice is associated with a clinical performance at 12 months follow up that appears to be non-inferior to the most widely used and largely evidence supported durable polymer drug eluting stents. A longer follow up is warranted.


Assuntos
Stents Farmacológicos , Intervenção Coronária Percutânea , Implantes Absorvíveis , Everolimo/efeitos adversos , Humanos , Intervenção Coronária Percutânea/efeitos adversos , Polímeros , Pontuação de Propensão , Desenho de Prótese , Sirolimo/efeitos adversos , Sirolimo/análogos & derivados , Resultado do Tratamento
14.
Rev Invest Clin ; 62(6): 583, 585-605, 2010.
Artigo em Espanhol | MEDLINE | ID: mdl-21416918

RESUMO

INTRODUCTION: Endometrial cancer (EC) is the second most common gynecologic malignancy worldwide in the peri and postmenopausal period. Most often for the endometrioid variety. In early clinical stages long-term survival is greater than 80%, while in advanced stages it is less than 50%. In our country there is not a standard management between institutions. GICOM collaborative group under the auspice of different institutions have made the following consensus in order to make recommendations for the management of patients with this type of neoplasm. MATERIAL AND METHODS: The following recommendations were made by independent professionals in the field of Gynecologic Oncology, questions and statements were based on a comprehensive and systematic review of literature. It took place in the context of a meeting of four days in which a debate was held. These statements are the conclusions reached by agreement of the participant members. RESULTS: Screening should be performed women at high risk (diabetics, family history of inherited colon cancer, Lynch S. type II). Endometrial thickness in postmenopausal patients is best evaluated by transvaginal US, a thickness greater than or equal to 5 mm must be evaluated. Women taking tamoxifen should be monitored using this method. Abnormal bleeding in the usual main symptom, all post menopausal women with vaginal bleeding should be evaluated. Diagnosis is made by histerescopy-guided biopsy. Magnetic resonance is the best image method as preoperative evaluation. Frozen section evaluates histologic grade, myometrial invasion, cervical and adnexal involvement. Total abdominal hysterectomy, bilateral salpingo oophorectomy, pelvic and para-aortic lymphadenectomy should be performed except in endometrial histology grades 1 and 2, less than 50% invasion of the myometrium without evidence of disease out of the uterus. Omentectomy should be done in histologies other than endometriod. Surgery should be always performed by a Gynecologic Oncologist or Surgical Oncologist, laparoscopy is an alternative, especially in patients with hypertension and diabetes for being less morbid. Adjuvant treatment after surgery includes radiation therapy to the pelvis, brachytherapy, and chemotherapy. Patients with Stages III and IV should have surgery with intention to achieve optimal cytoreduction because of the impact on survival (51 m vs. 14 m), the treatment of recurrence can be with surgery depending on the pattern of relapse, systemic chemotherapy or hormonal therapy. Follow-up of patients is basically clinical in a regular basis. CONCLUSIONS: Screening programme is only for high risk patients. Multidisciplinary treatment impacts on survival and local control of the disease, including surgery, radiation therapy and chemotherapy, hormonal treatment is reserved to selected cases of recurrence. This is the first attempt of a Mexican Collaborative Group in Gynecology to give recommendations is a special type of neoplasm.


Assuntos
Carcinoma , Neoplasias do Endométrio , Antineoplásicos/uso terapêutico , Carcinoma/diagnóstico , Carcinoma/epidemiologia , Carcinoma/patologia , Carcinoma/terapia , Quimioterapia Adjuvante , Terapia Combinada , Diagnóstico por Imagem , Neoplasias do Endométrio/diagnóstico , Neoplasias do Endométrio/epidemiologia , Neoplasias do Endométrio/patologia , Neoplasias do Endométrio/terapia , Antagonistas de Estrogênios/efeitos adversos , Terapia de Reposição de Estrogênios/efeitos adversos , Estrogênios/efeitos adversos , Medicina Baseada em Evidências , Feminino , Humanos , Histerectomia/métodos , Laparoscopia , Excisão de Linfonodo , Programas de Rastreamento , México , Estadiamento de Neoplasias/métodos , Radioterapia Adjuvante , Fatores de Risco , Terapia de Salvação , Tamoxifeno/efeitos adversos
15.
Cardiovasc Revasc Med ; 21(4): 508-513, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31401071

RESUMO

OBJECTIVES: This study sought to assess the efficacy of the drug-coated balloon (DCB) ESSENTIAL for the treatment of in-stent restenosis (ISR). BACKGROUND: DCBs have proven a valid therapeutic option for the management of ISR in several clinical trials, yet no class effect can be claimed. Accordingly, every new DCB model has to be individually evaluated through clinical studies. METHODS: This is a prospective, multicenter study including consecutive patients undergoing percutaneous coronary intervention for ISR with the ESSENTIAL DCB. A 6-month quantitative coronary angiography (QCA)/optical coherence tomography (OCT) follow-up was scheduled. The primary endpoint was OCT-derived in-segment maximal area stenosis. Secondary endpoints included QCA-derived in-segment late lumen loss (LLL) and target lesion failure (TLF) rates at 6, 12, and 24 months. TLF was defined as the composite of cardiac death, target vessel myocardial infarction, and target lesion revascularization. RESULTS: A total of 31 patients were successfully treated with DCB, with 67% of ISR corresponding to drug-eluting stents (DES). At 6 months, 26 patients underwent the scheduled angiographic follow-up. The mean value for in-segment maximal area stenosis was 51.4 ±â€¯13% and the median value was 53% (IQR 46.4-59.5). In the DES-ISR subgroup, these parameters were 52.6 ±â€¯10% and 55.2% (IQR 49.3-58.5), respectively. In-segment LLL was 0.25 ±â€¯0.43 mm with only 2 (7.7%) patients showing binary restenosis (>50%). The incidence of TLF was 10% at 6 months, 13.3% at 12 months, and 13.3% at 24 months. CONCLUSIONS: In this study, the ESSENTIAL DCB showed sustained efficacy in the prevention of recurrent restenosis after treatment of ISR. SUMMARY: We sought to assess the efficacy of the drug-coated balloon ESSENTIAL for the treatment of in-stent restenosis through a prospective, multicenter study including QCA and OCT assessment at 6-month follow-up. The primary endpoint was in-segment maximal area stenosis. Among the 31 patients successfully treated with the ESSENTIAL DCB, an angiographic follow-up was conducted in 26. Mean in-segment maximal area stenosis was 51.4 ±â€¯13% and the median value was 53% (IQR 46.4-59.5). In the DES-ISR subgroup, corresponding values were 52.6 ±â€¯10% and 55.2% (IQR 49.3-58.5), respectively. The observed in-segment LLL was 0.25 ±â€¯0.43 mm and binary restenosis rate was 7.7%. TLF was 10% at 6 months and 13.3% at 12 and 24 months.


Assuntos
Angioplastia Coronária com Balão/instrumentação , Fármacos Cardiovasculares/administração & dosagem , Materiais Revestidos Biocompatíveis , Angiografia Coronária , Doença da Artéria Coronariana/terapia , Reestenose Coronária/terapia , Vasos Coronários/diagnóstico por imagem , Paclitaxel/administração & dosagem , Intervenção Coronária Percutânea/instrumentação , Stents , Tomografia de Coerência Óptica , Idoso , Angioplastia Coronária com Balão/efeitos adversos , Angioplastia Coronária com Balão/mortalidade , Fármacos Cardiovasculares/efeitos adversos , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/mortalidade , Reestenose Coronária/diagnóstico por imagem , Reestenose Coronária/etiologia , Reestenose Coronária/mortalidade , Desenho de Equipamento , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Paclitaxel/efeitos adversos , Intervenção Coronária Percutânea/efeitos adversos , Intervenção Coronária Percutânea/mortalidade , Valor Preditivo dos Testes , Estudos Prospectivos , Fatores de Risco , Espanha , Resultado do Tratamento
16.
Phys Sportsmed ; 37(1): 71-9, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-20048490

RESUMO

Skeletal muscle breakdown occurs normally with exercise, followed by muscle repair and physiologic adaptation. Strenuous, unaccustomed, prolonged, and repetitive exercise, particularly when associated with other risk factors such as hot and humid climate or sickle cell trait can cause clinically significant exertional rhabdomyolysis (ER). Although most cases are asymptomatic and resolve without sequelae, ER is the most common cause of exercise-related myoglobinuric acute renal injury and acute renal failure in athletes. Exercise-related muscle pain, elevated serum creatine kinase (CK), and "cola-colored" urine have been described as a classic presentation of ER. The exact mechanism of ER has not been clearly elucidated. Most studies suggest a cascade of events that include depletion of adenosine triphosphate (ATP), impaired function of the Na+- K+ ATPase system, intracellular excess calcium accumulation, sarcolemma damage, and release of intracellular proteins and other substances into blood. Excess myoglobin that is filtered at the glomerulus can lead to myoglobinuric acute renal injury. Cessation of physical activity, relative rest during clinical recovery, and early aggressive fluid replacement are mainstays of treatment. Return to play after recovery from ER is influenced by associated risk factors that may predispose the athlete to recurrence and is guided by signs, symptoms, and CK levels. This article reviews the definitions, pathophysiology, diagnosis, and management of ER with specific relevance to acute kidney injury.


Assuntos
Injúria Renal Aguda/etiologia , Transtornos Traumáticos Cumulativos/etiologia , Esforço Físico , Rabdomiólise/etiologia , Injúria Renal Aguda/diagnóstico , Injúria Renal Aguda/fisiopatologia , Biomarcadores/análise , Transtornos Traumáticos Cumulativos/diagnóstico , Transtornos Traumáticos Cumulativos/fisiopatologia , Guias como Assunto , Humanos , Valor Preditivo dos Testes , Recuperação de Função Fisiológica , Rabdomiólise/diagnóstico , Rabdomiólise/fisiopatologia , Fatores de Risco , Traço Falciforme/complicações
17.
Phys Sportsmed ; 37(3): 11-9, 2009 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-20048524

RESUMO

Individuals with chronic kidney disease have poor exercise tolerance and are easily fatigued compared with their healthy peers. The primary reasons for poor exercise tolerance include anemia, effects of chronic uremia and metabolic acidosis on the heart and skeletal muscles, and lower levels of physical activity. Studies suggest that regular and early implementation of both aerobic and resistance exercise programs in persons with chronic kidney disease have positive effects on muscle function, exercise tolerance, and quality of life. Before starting any exercise program, a medical assessment and exercise testing are generally recommended. No consensus exists regarding allowing young athletes with a solitary kidney who want to participate in contact or collision sports. Decisions to allow participation in different sports and leisure activities should be made on an individual basis, considering multiple factors. This article reviews factors that affect exercise tolerance in persons with chronic kidney disease, the effects of exercise, and exercise recommendations.


Assuntos
Tolerância ao Exercício , Exercício Físico , Falência Renal Crônica/fisiopatologia , Esportes , Adolescente , Adulto , Criança , Fadiga/etiologia , Fadiga/prevenção & controle , Humanos , Qualidade de Vida , Fatores de Risco
20.
Fed Pract ; 35(9): 24-26, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30766383

RESUMO

Consider flexible bronchoscopy as an option to retrieve aspirated foreign bodies in the airway.

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