Base de dados : MEDLINE
Pesquisa : A07.541.510 [Categoria DeCS]
Referências encontradas : 4787 [refinar]
Mostrando: 1 .. 10   no formato [Detalhado]

página 1 de 479 ir para página                         

  1 / 4787 MEDLINE  
              next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:27774838
[Au] Autor:Myles PS; Smith JA; Forbes A; Silbert B; Jayarajah M; Painter T; Cooper DJ; Marasco S; McNeil J; Bussières JS; McGuinness S; Byrne K; Chan MT; Landoni G; Wallace S; ATACAS Investigators of the ANZCA Clinical Trials Network
[Ad] Endereço:From the Alfred Hospital (P.S.M., D.J.C., S. Marasco, S.W.) and Monash University (P.S.M., J.A.S., A.F., D.J.C., S. Marasco, J.M., S.W.), Melbourne, VIC, St. Vincent's Hospital, Fitzroy, VIC (B.S.), and the Royal Adelaide Hospital, Adelaide, SA (T.P.) - all in Australia; South West Cardiac Centre, D
[Ti] Título:Tranexamic Acid in Patients Undergoing Coronary-Artery Surgery.
[So] Source:N Engl J Med;376(2):136-148, 2017 01 12.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Tranexamic acid reduces the risk of bleeding among patients undergoing cardiac surgery, but it is unclear whether this leads to improved outcomes. Furthermore, there are concerns that tranexamic acid may have prothrombotic and proconvulsant effects. METHODS: In a trial with a 2-by-2 factorial design, we randomly assigned patients who were scheduled to undergo coronary-artery surgery and were at risk for perioperative complications to receive aspirin or placebo and tranexamic acid or placebo. The results of the tranexamic acid comparison are reported here. The primary outcome was a composite of death and thrombotic complications (nonfatal myocardial infarction, stroke, pulmonary embolism, renal failure, or bowel infarction) within 30 days after surgery. RESULTS: Of the 4662 patients who were enrolled and provided consent, 4631 underwent surgery and had available outcomes data; 2311 were assigned to the tranexamic acid group and 2320 to the placebo group. A primary outcome event occurred in 386 patients (16.7%) in the tranexamic acid group and in 420 patients (18.1%) in the placebo group (relative risk, 0.92; 95% confidence interval, 0.81 to 1.05; P=0.22). The total number of units of blood products that were transfused during hospitalization was 4331 in the tranexamic acid group and 7994 in the placebo group (P<0.001). Major hemorrhage or cardiac tamponade leading to reoperation occurred in 1.4% of the patients in the tranexamic acid group and in 2.8% of the patients in the placebo group (P=0.001), and seizures occurred in 0.7% and 0.1%, respectively (P=0.002 by Fisher's exact test). CONCLUSIONS: Among patients undergoing coronary-artery surgery, tranexamic acid was associated with a lower risk of bleeding than was placebo, without a higher risk of death or thrombotic complications within 30 days after surgery. Tranexamic acid was associated with a higher risk of postoperative seizures. (Funded by the Australian National Health and Medical Research Council and others; ATACAS Australia New Zealand Clinical Trials Registry number, ACTRN12605000557639 .).
[Mh] Termos MeSH primário: Antifibrinolíticos/uso terapêutico
Ponte de Artéria Coronária
Hemorragia/prevenção & controle
Complicações Intraoperatórias/prevenção & controle
Ácido Tranexâmico/uso terapêutico
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Antifibrinolíticos/efeitos adversos
Aspirina/uso terapêutico
Transfusão de Sangue/estatística & dados numéricos
Doença da Artéria Coronariana/mortalidade
Doença da Artéria Coronariana/cirurgia
Método Duplo-Cego
Feminino
Valvas Cardíacas/cirurgia
Hemorragia/induzido quimicamente
Seres Humanos
Masculino
Meia-Idade
Inibidores da Agregação de Plaquetas/uso terapêutico
Complicações Pós-Operatórias/induzido quimicamente
Reoperação/estatística & dados numéricos
Convulsões/induzido quimicamente
Trombose/induzido quimicamente
Ácido Tranexâmico/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Antifibrinolytic Agents); 0 (Platelet Aggregation Inhibitors); 6T84R30KC1 (Tranexamic Acid); R16CO5Y76E (Aspirin)
[Em] Mês de entrada:1701
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMoa1606424


  2 / 4787 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28452558
[Au] Autor:Abreu A
[Ad] Endereço:Department of Cardiology, Santa Marta Hospital, CHLC, Lisbon, Portugal.
[Ti] Título:Cardiac rehabilitation in cardiac valve surgery patients: Beyond cost-effectiveness.
[So] Source:Eur J Prev Cardiol;24(11):1145-1147, 2017 07.
[Is] ISSN:2047-4881
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Reabilitação Cardíaca
Análise Custo-Benefício
[Mh] Termos MeSH secundário: Implante de Prótese de Valva Cardíaca/reabilitação
Valvas Cardíacas/cirurgia
Seres Humanos
Pacientes
[Pt] Tipo de publicação:JOURNAL ARTICLE; COMMENT
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180131
[Lr] Data última revisão:
180131
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1177/2047487317706180


  3 / 4787 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28917493
[Au] Autor:Alenezi F; Brummett BH; Boyle SH; Samad Z; Babyak MA; Alzaeim N; Wilson J; Romano MMD; Sun JL; Ersboll M; O'Connor CM; Velazquez EJ; Jiang W
[Ad] Endereço:Division of Cardiology, Department of Medicine, Duke University, Durham, North Carolina.
[Ti] Título:Usefulness of Myocardial Annular Velocity Change During Mental Stress to Predict Cardiovascular Outcome in Patients With Coronary Artery Disease (From the Responses of Mental Stress-Induced Myocardial Ischemia to Escitalopram Treatment Trial).
[So] Source:Am J Cardiol;120(9):1495-1500, 2017 Nov 01.
[Is] ISSN:1879-1913
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Mental stress-induced myocardial ischemia is common and a prognostic factor of adverse cardiovascular outcomes in patients with coronary artery disease (CAD). The present study aimed at examining associations between mental stress-induced myocardial annular velocity (MAV) and cardiovascular outcome in patients with CAD. MAV, specifically, diastolic early (e'), diastolic late (a'), and systolic (s') velocities were obtained at rest and during mental stress testing in 224 patients with clinically stable CAD. Using Cox regression models, age, sex, and baseline-adjusted mental stress-induced MAV measures were examined as predictors of a priori defined composite event term that comprised all-cause mortality and/or nonfatal cardiovascular events, resulting in an unplanned hospitalization (major adverse cardiovascular events [MACE]). Median follow-up was 4 years. The sample was predominantly male, Caucasian with New York Heart Association functional class I and a mean age of 63 ± 10.2 years. MS-induced changes in e' (hazard ratio [HR] = .73) and s' (HR = .73) were significant (p <0.05) predictors of MACE, and the change in a' (HR = .74) was marginal (p = 0.05). The pattern of the relation for each MAV measure was such that patients with a greater decrease in e' and/or s' velocity had a higher probability of experiencing an MACE, and the association of the change in a' and MACE was marginal (p = 0.05), but the same tendency. The associations between MS-induced values of e' and a' for MACE were independent of resting levels. Mental stress-induced MAV changes independently predict an adverse cardiovascular outcome in patients with stable CAD.
[Mh] Termos MeSH primário: Doença da Artéria Coronariana/fisiopatologia
Doença da Artéria Coronariana/psicologia
Valvas Cardíacas/fisiopatologia
Estresse Psicológico/fisiopatologia
[Mh] Termos MeSH secundário: Idoso
Antidepressivos de Segunda Geração/uso terapêutico
Velocidade do Fluxo Sanguíneo/fisiologia
Citalopram/uso terapêutico
Doença da Artéria Coronariana/complicações
Diástole/fisiologia
Feminino
Seres Humanos
Masculino
Meia-Idade
Valor Preditivo dos Testes
Estresse Psicológico/complicações
Estresse Psicológico/tratamento farmacológico
Sístole/fisiologia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Antidepressive Agents, Second-Generation); 0DHU5B8D6V (Citalopram)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171020
[Lr] Data última revisão:
171020
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170918
[St] Status:MEDLINE


  4 / 4787 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28821336
[Au] Autor:Koch CG; Sessler DI; Mascha EJ; Sabik JF; Li L; Duncan AI; Zimmerman NM; Blackstone EH
[Ad] Endereço:Department of Cardiothoracic Anesthesiology, Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio. Electronic address: ckoch11@jhmi.edu.
[Ti] Título:A Randomized Clinical Trial of Red Blood Cell Transfusion Triggers in Cardiac Surgery.
[So] Source:Ann Thorac Surg;104(4):1243-1250, 2017 Oct.
[Is] ISSN:1552-6259
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Class I evidence supporting a threshold for transfusion in the cardiac surgical setting is scarce. We randomly allocated patients to a transfusion hematocrit trigger of 24% versus 28% to compare morbidity, mortality, and resource use. METHODS: From March 2007 to August 2014, two centers randomly assigned 722 adults undergoing coronary artery bypass graft surgery or valve procedures to a 24% hematocrit trigger (n = 363, low group) or 28% trigger (n = 354, high group). One unit of red blood cells was transfused if the hematocrit fell below the designated threshold. The primary endpoint was a composite of postoperative morbidities and mortality. Treatment effect was primarily assessed using an average relative effect generalized estimating equation model. RESULTS: At the second planned interim analysis, the a priori futility boundary was crossed, and the study was stopped. There was no detected treatment effect on the composite outcome (average relative effect odds ratio, low versus high, 0.86, 95% confidence interval: 0.29 to 2.54, p = 0.71). However, the low group received fewer red blood cell transfusions than the high group (54% versus 75%, p < 0.001), mostly administered in the operating room (low group, 112 [31%]; high group, 208 [59%]), followed by intensive care unit (low, 105 [31%]; high, 115 [34%]) and floor (low, 41 [12%]; high, 42 [13%]). The low group was exposed to lower hematocrits: median before transfusion, 22% (Q1 = 21%, Q3 = 23%) versus 24% (Q1 = 22%, Q3 = 25%). CONCLUSIONS: Negative exposures differed between treatment groups, with lower hematocrit in the 24% trigger group and more red blood cells used in the 28% group, but adverse outcomes did not differ. Because red blood cell use was less with a 24% trigger without adverse effects, our randomized trial results support aggressive blood conservation efforts in cardiac surgery.
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos Cardíacos
Transfusão de Eritrócitos
Hematócrito
[Mh] Termos MeSH secundário: Adulto
Idoso
Procedimentos Médicos e Cirúrgicos de Sangue
Procedimentos Cirúrgicos Cardíacos/métodos
Ponte de Artéria Coronária
Transfusão de Eritrócitos/efeitos adversos
Feminino
Valvas Cardíacas/cirurgia
Seres Humanos
Tempo de Internação
Masculino
Meia-Idade
Complicações Pós-Operatórias
Qualidade de Vida
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170820
[St] Status:MEDLINE


  5 / 4787 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28790122
[Au] Autor:Thaden JJ; Tsang MY; Ayoub C; Padang R; Nkomo VT; Tucker SF; Cassidy CS; Bremer M; Kane GC; Pellikka PA
[Ad] Endereço:From the Division of Cardiovascular Ultrasound, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN. thaden.jeremy@mayo.edu.
[Ti] Título:Association Between Echocardiography Laboratory Accreditation and the Quality of Imaging and Reporting for Valvular Heart Disease.
[So] Source:Circ Cardiovasc Imaging;10(8), 2017 Aug.
[Is] ISSN:1942-0080
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: It is presumed that echocardiographic laboratory accreditation leads to improved quality, but there are few data. We sought to compare the quality of echocardiographic examinations performed at accredited versus nonaccredited laboratories for the evaluation of valvular heart disease. METHODS AND RESULTS: We enrolled 335 consecutive valvular heart disease subjects who underwent echocardiography at our institution and an external accredited or nonaccredited institution within 6 months. Completeness and quality of echocardiographic reports and images were assessed by investigators blinded to the external laboratory accreditation status and echocardiographic results. Compared with nonaccredited laboratories, accredited sites more frequently reported patient sex (94% versus 78%; <0.001), height and weight (96% versus 63%; <0.001), blood pressure (86% versus 39%; <0.001), left ventricular size (96% versus 83%; <0.001), right ventricular size (94% versus 80%; =0.001), and right ventricular function (87% versus 73%; =0.006). Accredited laboratories had higher rates of complete and diagnostic color (58% versus 35%; =0.002) and spectral Doppler imaging (45% versus 21%; <0.0001). Concordance between external and internal grading of external studies was improved when diagnostic quantification was performed (85% versus 69%; =0.003), and in patients with mitral regurgitation, reproducibility was improved with higher quality color Doppler imaging. CONCLUSIONS: Accredited echocardiographic laboratories had more complete reporting and better image quality, while echocardiographic quantification and color Doppler image quality were associated with improved concordance in grading valvular heart disease. Future quality improvement initiatives should highlight the importance of high-quality color Doppler imaging and echocardiographic quantification to improve the accuracy, reproducibility, and quality of echocardiographic studies for valvular heart disease.
[Mh] Termos MeSH primário: Acreditação/normas
Ecocardiografia Doppler/normas
Disparidades em Assistência à Saúde/normas
Doenças das Valvas Cardíacas/diagnóstico por imagem
Valvas Cardíacas/diagnóstico por imagem
Ensaio de Proficiência Laboratorial/normas
Indicadores de Qualidade em Assistência à Saúde/normas
[Mh] Termos MeSH secundário: Competência Clínica/normas
Ecocardiografia Doppler em Cores/normas
Seres Humanos
Variações Dependentes do Observador
Padrões de Prática Médica/normas
Valor Preditivo dos Testes
Prognóstico
Estudos Prospectivos
Melhoria de Qualidade/normas
Reprodutibilidade dos Testes
Índice de Gravidade de Doença
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170821
[Lr] Data última revisão:
170821
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170810
[St] Status:MEDLINE


  6 / 4787 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28724752
[Au] Autor:Midha PA; Raghav V; Sharma R; Condado JF; Okafor IU; Rami T; Kumar G; Thourani VH; Jilaihawi H; Babaliaros V; Makkar RR; Yoganathan AP
[Ad] Endereço:From Georgia Institute of Technology, Atlanta (P.A.M., V.R., I.U.O., A.P.Y.); Cedars-Sinai Heart Institute, Los Angeles, CA (R.S., T.R., R.R.M.); Emory University, Atlanta, GA (J.F.C., G.K., V.H.T., V.B.); Exponent, Inc., Philadelphia, PA (I.U.O.); Atlanta Veterans Affairs Medical Center, Decatur, G
[Ti] Título:The Fluid Mechanics of Transcatheter Heart Valve Leaflet Thrombosis in the Neosinus.
[So] Source:Circulation;136(17):1598-1609, 2017 Oct 24.
[Is] ISSN:1524-4539
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Transcatheter heart valve (THV) thrombosis has been increasingly reported. In these studies, thrombus quantification has been based on a 2-dimensional assessment of a 3-dimensional phenomenon. METHODS: Postprocedural, 4-dimensional, volume-rendered CT data of patients with CoreValve, Evolut R, and SAPIEN 3 transcatheter aortic valve replacement enrolled in the RESOLVE study (Assessment of Transcatheter and Surgical Aortic Bioprosthetic Valve Dysfunction With Multimodality Imaging and Its Treatment with Anticoagulation) were included in this analysis. Patients on anticoagulation were excluded. SAPIEN 3 and CoreValve/Evolut R patients with and without hypoattenuated leaflet thickening were included to study differences between groups. Patients were classified as having THV thrombosis if there was any evidence of hypoattenuated leaflet thickening. Anatomic and THV deployment geometries were analyzed, and thrombus volumes were computed through manual 3-dimensional reconstruction. We aimed to identify and evaluate risk factors that contribute to THV thrombosis through the combination of retrospective clinical data analysis and in vitro imaging in the space between the native and THV leaflets (neosinus). RESULTS: SAPIEN 3 valves with leaflet thrombosis were on average 10% further expanded (by diameter) than those without (95.5±5.2% versus 85.4±3.9%; <0.001). However, this relationship was not evident with the CoreValve/Evolut R. In CoreValve/Evolut Rs with thrombosis, the thrombus volume increased linearly with implant depth ( =0.7, <0.001). This finding was not seen in the SAPIEN 3. The in vitro analysis showed that a supraannular THV deployment resulted in a nearly 7-fold decrease in stagnation zone size (velocities <0.1 m/s) when compared with an intraannular deployment. In addition, the in vitro model indicated that the size of the stagnation zone increased as cardiac output decreased. CONCLUSIONS: Although transcatheter aortic valve replacement thrombosis is a multifactorial process involving foreign materials, patient-specific blood chemistry, and complex flow patterns, our study indicates that deployed THV geometry may have implications on the occurrence of thrombosis. In addition, a supraannular neosinus may reduce thrombosis risk because of reduced flow stasis. Although additional prospective studies are needed to further develop strategies for minimizing thrombus burden, these results may help identify patients at higher thrombosis risk and aid in the development of next-generation devices with reduced thrombosis risk.
[Mh] Termos MeSH primário: Valvas Cardíacas/cirurgia
Hemodinâmica
Modelos Cardiovasculares
Trombose/fisiopatologia
Substituição da Valva Aórtica Transcateter/efeitos adversos
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Masculino
Trombose/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171027
[Lr] Data última revisão:
171027
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170721
[St] Status:MEDLINE
[do] DOI:10.1161/CIRCULATIONAHA.117.029479


  7 / 4787 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28674029
[Au] Autor:Jung CJ; Hsu RB; Shun CT; Hsu CC; Chia JS
[Ad] Endereço:Department of Microbiology and Immunology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, Republic of China cjjung@tmu.edu.tw chiajs@ntu.edu.tw.
[Ti] Título:AtlA Mediates Extracellular DNA Release, Which Contributes to Streptococcus mutans Biofilm Formation in an Experimental Rat Model of Infective Endocarditis.
[So] Source:Infect Immun;85(9), 2017 Sep.
[Is] ISSN:1098-5522
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Host factors, such as platelets, have been shown to enhance biofilm formation by oral commensal streptococci, inducing infective endocarditis (IE), but how bacterial components contribute to biofilm formation is still not clear. We demonstrated previously that an isogenic mutant strain of deficient in autolysin AtlA (Δ ) showed a reduced ability to cause vegetation in a rat model of bacterial endocarditis. However, the role of AtlA in bacterial biofilm formation is unclear. In this study, confocal laser scanning microscopy analysis showed that extracellular DNA (eDNA) was embedded in GS5 floes during biofilm formation on damaged heart valves, but an Δ strain could not form bacterial aggregates. Semiquantification of eDNA by PCR with bacterial 16S rRNA primers demonstrated that the Δ mutant strain produced dramatically less eDNA than the wild type. Similar results were observed with biofilm models. The addition of polyanethol sulfonate, a chemical lysis inhibitor, revealed that eDNA release mediated by bacterial cell lysis is required for biofilm initiation and maturation in the wild-type strain. Supplementation of cultures with calcium ions reduced wild-type growth but increased eDNA release and biofilm mass. The effect of calcium ions on biofilm formation was abolished in Δ cultures and by the addition of polyanethol sulfonate. The VicK sensor, but not CiaH, was found to be required for the induction of eDNA release or the stimulation of biofilm formation by calcium ions. These data suggest that calcium ion-regulated AtlA maturation mediates the release of eDNA by , which contributes to biofilm formation in infective endocarditis.
[Mh] Termos MeSH primário: Proteínas de Bactérias/metabolismo
Biofilmes/crescimento & desenvolvimento
DNA Bacteriano/metabolismo
Endocardite/microbiologia
Endocardite/patologia
N-Acetil-Muramil-L-Alanina Amidase/metabolismo
Streptococcus mutans/fisiologia
[Mh] Termos MeSH secundário: Animais
Proteínas de Bactérias/genética
DNA Ribossômico/análise
Modelos Animais de Doenças
Deleção de Genes
Valvas Cardíacas/microbiologia
Valvas Cardíacas/patologia
Microscopia Confocal
N-Acetil-Muramil-L-Alanina Amidase/genética
RNA Ribossômico 16S/genética
Ratos Wistar
Reação em Cadeia da Polimerase em Tempo Real
Streptococcus mutans/metabolismo
Fatores de Virulência/genética
Fatores de Virulência/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Bacterial Proteins); 0 (DNA, Bacterial); 0 (DNA, Ribosomal); 0 (RNA, Ribosomal, 16S); 0 (Virulence Factors); EC 3.5.1.28 (N-Acetylmuramoyl-L-alanine Amidase)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170705
[St] Status:MEDLINE


  8 / 4787 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28667558
[Au] Autor:Generali E; Folci M; Selmi C; Riboldi P
[Ad] Endereço:Rheumatology and Clinical Immunology, Humanitas Research Hospital, Rozzano, Milan, Italy.
[Ti] Título:Immune-Mediated Heart Disease.
[So] Source:Adv Exp Med Biol;1003:145-171, 2017.
[Is] ISSN:0065-2598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The heart involvement in systemic autoimmune diseases represents a growing burden for patients and health systems. Cardiac function can be impaired as a consequence of systemic conditions and manifests with threatening clinical pictures or chronic myocardial damage. Direct injuries are mediated by the presence of inflammatory infiltrate which, even though unusual, is one of the most danger manifestations requiring prompt recognition and treatment. On the other hand, a not well-managed inflammatory status leads to accelerated atherosclerosis that precipitates ischemic disease. All cardiac structures may be damaged with different grades of intensity; moreover, lesions can appear simultaneously or more frequently at a short distance from each other leading to the onset of varied clinical pictures. The pathogenesis of heart damages in systemic autoimmune conditions is not yet completely understood for the great part of situations, even if several mechanisms have been investigated. The principal biochemical circuits refer to the damaging role of autoantibodies on cardiac tissues and the precipitation of immune complexes on endocardium. These events are finally responsible of inflammatory infiltration which leads to subsequent worsening of the previous damage. For these reasons, it appears of paramount importance a regular and deepened cardiovascular assessment to prevent a progressive evolution toward heart failure in patient affected by autoimmune diseases.
[Mh] Termos MeSH primário: Doenças Autoimunes/imunologia
Autoimunidade
Cardiopatias/imunologia
Valvas Cardíacas/imunologia
Miocárdio/imunologia
Pericárdio/imunologia
[Mh] Termos MeSH secundário: Animais
Doenças Autoimunes/metabolismo
Doenças Autoimunes/patologia
Cardiopatias/metabolismo
Cardiopatias/patologia
Valvas Cardíacas/metabolismo
Valvas Cardíacas/patologia
Seres Humanos
Miocárdio/metabolismo
Miocárdio/patologia
Pericárdio/metabolismo
Pericárdio/patologia
Transdução de Sinais
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170702
[St] Status:MEDLINE
[do] DOI:10.1007/978-3-319-57613-8_8


  9 / 4787 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28594865
[Au] Autor:Maimaituxun G; Shimabukuro M; Salim HM; Tabata M; Yuji D; Morimoto Y; Akasaka T; Matsuura T; Yagi S; Fukuda D; Yamada H; Soeki T; Sugimoto T; Tanaka M; Takanashi S; Sata M
[Ad] Endereço:Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
[Ti] Título:Gender-linked impact of epicardial adipose tissue volume in patients who underwent coronary artery bypass graft surgery or non-coronary valve surgery.
[So] Source:PLoS One;12(6):e0177170, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Traditional and non-traditional risk factors for atherosclerotic cardiovascular disease (ASCVD) are different between men and women. Gender-linked impact of epicardial adipose tissue volume (EATV) in patients undergoing coronary artery bypass grafting (CABG) remains unknown. METHODS: Gender-linked impact of EATV, abdominal fat distribution and other traditional ASCVD risk factors were compared in 172 patients (men: 115; women: 57) who underwent CABG or non-coronary valvular surgery (non-CABG). RESULTS: In men, EATV, EATV index (EATV/body surface area) and the markers of adiposity such as body mass index, waist circumference and visceral fat area were higher in the CABG group than in the non-CABG group. Traditional ASCVD risk factors were also prevalent in the CABG group. In women, EATV and EATV index were higher in the CABG group, but other adiposity markers were comparable between CABG and non-CABG groups. Multivariate logistic regression analysis showed that in men, CABG was determined by EATV Index and other ASCVD risk factors including hypertension, dyslipidemia, adiponectin, high sensitive C-reactive protein (hsCRP) and type 2 diabetes mellitus (Corrected R2 = 0.262, p < 0.0001), while in women, type 2 diabetes mellitus is a single strong predictor for CABG, excluding EATV Index (Corrected R2 = 0.266, p = 0.005). CONCLUSIONS: Our study found that multiple risk factors, including epicardial adipose tissue volume and traditional ASCVD factors are determinants for CABG in men, but type 2 diabetes mellitus was the sole determinant in women. Gender-specific disparities in risk factors of CABG prompt us to evaluate new diagnostic and treatment strategies and to seek underlying mechanisms.
[Mh] Termos MeSH primário: Tecido Adiposo/patologia
Ponte de Artéria Coronária
Valvas Cardíacas/cirurgia
Pericárdio/patologia
Caracteres Sexuais
[Mh] Termos MeSH secundário: Idoso
Feminino
Seres Humanos
Masculino
Análise Multivariada
Tamanho do Órgão
Análise de Regressão
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170609
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0177170


  10 / 4787 MEDLINE  
              first record previous record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28580776
[Au] Autor:Doenst T; Lamelas J
[Ad] Endereço:Department of Cardiothoracic Surgery, Jena University Hospital, Friedrich Schiller University of Jena, Jena, Germany - doenst@med.uni-jena.de.
[Ti] Título:Do we have enough evidence for minimally-invasive cardiac surgery? A critical review of scientific and non-scientific information.
[So] Source:J Cardiovasc Surg (Torino);58(4):613-623, 2017 Aug.
[Is] ISSN:1827-191X
[Cp] País de publicação:Italy
[La] Idioma:eng
[Ab] Resumo:Reducing surgical trauma by minimizing skin incisions has transformed abdominal surgery resulting in significant improvements in outcome. In cardiac surgery, such efforts have also been made, but similar benefits could not be demonstrated. In addition, any potential benefit comes at the cost of increased cardiopulmonary bypass and clamp times, leading to questions regarding the safety of minimally invasive cardiac surgery (MICS). Nevertheless, outcomes have been equivalent to matched sternotomy cases and there is no doubt that the number of patients undergoing minimally-invasive mitral or aortic procedures is slowly increasing. To date almost half of all isolated mitral cases in Germany and roughly one fourth in the USA are performed through a minimized access. These numbers were less than half 10 years ago. So how can this development be justified, if the evidence for it seems to be questionable or even missing? We will attempt to provide some answers to this question by critically reviewing the available publications and by looking at the topic from other perspectives, including from a competitive and a patient standpoint. We will conclude that there is enough evidence to support minimally-invasive access as the primary approach to a valve in the majority of patients. We will further suggest that modern cardiac surgery may have difficulties to prevail in its full width, if these novel techniques are not embraced. Finally, we will demonstrate that minimally invasive cardiac surgery is associated with substantial improvements in patient care, however, in areas that are unlikely to be tested with randomized controlled trials.
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos Cardíacos/métodos
Medicina Baseada em Evidências
Doenças das Valvas Cardíacas/cirurgia
Valvas Cardíacas/cirurgia
Procedimentos Cirúrgicos Minimamente Invasivos/métodos
[Mh] Termos MeSH secundário: Procedimentos Cirúrgicos Cardíacos/efeitos adversos
Procedimentos Cirúrgicos Cardíacos/mortalidade
Conversão para Cirurgia Aberta
Difusão de Inovações
Doenças das Valvas Cardíacas/mortalidade
Seres Humanos
Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos
Procedimentos Cirúrgicos Minimamente Invasivos/mortalidade
Duração da Cirurgia
Complicações Pós-Operatórias/etiologia
Fatores de Risco
Esternotomia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170619
[Lr] Data última revisão:
170619
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170606
[St] Status:MEDLINE
[do] DOI:10.23736/S0021-9509.16.09446-5



página 1 de 479 ir para página                         
   


Refinar a pesquisa
  Base de dados : MEDLINE Formulário avançado   

    Pesquisar no campo  
1  
2
3
 
           



Search engine: iAH v2.6 powered by WWWISIS

BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde