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[PMID]:28459983
[Au] Autor:Chan JL; Kobashigawa JA; Aintablian TL; Li Y; Perry PA; Patel JK; Kittleson MM; Czer LS; Zarrini P; Velleca A; Rush J; Arabia FA; Trento A; Esmailian F
[Ad] Endereço:Cedars-Sinai Heart Institute, Los Angeles, CA, USA.
[Ti] Título:Vasoplegia after heart transplantation: outcomes at 1 year.
[So] Source:Interact Cardiovasc Thorac Surg;25(2):212-217, 2017 08 01.
[Is] ISSN:1569-9285
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Vasoplegia syndrome is a potentially life-threatening condition that can occur following cardiopulmonary bypass. Heart transplantation is a recognized risk factor for developing this vasodilatory state. The objective of this study was to determine the effects of vasoplegia syndrome on 1-year heart transplant outcomes. METHODS: A retrospective review of orthotopic heart transplants at a single institution between November 2010 and December 2014 was performed. Of the 347 consecutive adult patients, 107 patients (30.8%) met criteria for vasoplegia syndrome. Preoperative factors and intraoperative variables were collected and compared between vasoplegia and non-vasoplegia cohorts. The incidence of postoperative complications, transplant rejection and patient survival within 1 year were evaluated. RESULTS: Demographics and preoperative medication profiles were similar in both groups, while mechanical circulatory support device use was associated with vasoplegia syndrome (30.8% vs 20.0%; P = 0.039). Perioperative characteristics such as longer cardiopulmonary bypass [165.0 (interquartile range [IQR] 74) min vs 140.0 (IQR 42.7) min; P < 0.001] and increased blood product usage (24.7 ± 17.2 units vs 17.7 ± 14.3 units; P < 0.001) were associated with vasoplegia. Non-vasoplegia patients were more likely to be extubated [42.9 (IQR 37.3) h vs 66.8 (IQR 50.2) h; P < 0.001] and discharged earlier [10.0 (IQR 6) days vs 14.0 (IQR 11.5) days; P < 0.001]. One-year patient survival (92.0% vs 88.6%; P = 0.338) and any-treated rejection rates (82.7% vs 84.3%; P = 0.569) were not significantly different between groups. CONCLUSIONS: Although vasoplegia syndrome was associated with an increase in perioperative morbidity, including greater mechanical ventilation time and hospital length of stay, no significant differences in survival or allograft rejection at 1 year was demonstrated.
[Mh] Termos MeSH primário: Ponte Cardiopulmonar/efeitos adversos
Transplante de Coração/efeitos adversos
Complicações Pós-Operatórias
Vasoplegia/etiologia
[Mh] Termos MeSH secundário: Adulto
Feminino
Seguimentos
Cardiopatias/cirurgia
Seres Humanos
Incidência
Masculino
Meia-Idade
Estudos Retrospectivos
Fatores de Risco
Taxa de Sobrevida/tendências
Fatores de Tempo
Estados Unidos/epidemiologia
Vasoplegia/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE
[do] DOI:10.1093/icvts/ivx081


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[PMID]:28453795
[Au] Autor:De Rita F; Griselli M; Sandica E; Miera O; Karimova A; d'Udekem Y; Goldwasser R; Januszewska K; Amodeo A; Jurrmann N; Ersel S; Menon AK
[Ad] Endereço:Department of Paediatric Heart Surgery, Freeman Hospital, Newcastle upon Tyne, UK.
[Ti] Título:Closing the gap in paediatric ventricular assist device therapy with the Berlin Heart EXCOR® 15-ml pump.
[So] Source:Interact Cardiovasc Thorac Surg;24(5):768-771, 2017 05 01.
[Is] ISSN:1569-9285
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: The Berlin Heart EXCOR ® (EXCOR) paediatric ventricular assist device is used worldwide for mechanical support of infants and small children with end-stage heart failure. A clinically important gap between the smallest EXCOR blood pump (10 ml) and the next larger size (25 ml) limited the choice of pump size in patients with a body surface area (BSA) between 0.33 and 0.5 m 2 . We present the first clinical experience from the early product surveillance (EPS) of the new EXCOR 15-ml blood pump. METHODS: After CE and U.S. Food and Drug Administration approval in January 2013, 20 patients with a mean age of 1.6 years (range 0.5-3.5 years) and a mean BSA of 0.45 m 2 (range 0.33-0.59 m 2 ) were enrolled in the EPS. The main diagnosis was idiopathic cardiomyopathy in 13 patients; the majority ( n = 16) of children were in INTERMACS level 1 or 2. Data from high-volume paediatric transplant centres were collected prospectively for a defined follow-up period of 60 days after device implantation. RESULTS: Mean time on the EXCOR 15-ml blood pump was 43 days; the survival rate was 100% at the end of the EPS period. Seven patients underwent a heart transplant from the device; 2 children were weaned; and 11 patients remained on support. Infection of cannula exit sites occurred in 3 patients. Two patients had minor thromboembolic strokes but made a complete neurological recovery. CONCLUSIONS: The new EXCOR 15-ml blood pump demonstrated optimal ventricular assist device support of children with a BSA of 0.33-0.5 m 2 .
[Mh] Termos MeSH primário: Oxigenação por Membrana Extracorpórea/métodos
Insuficiência Cardíaca/cirurgia
Transplante de Coração
Coração Auxiliar
[Mh] Termos MeSH secundário: Pré-Escolar
Feminino
Alemanha/epidemiologia
Insuficiência Cardíaca/mortalidade
Seres Humanos
Lactente
Masculino
Estudos Prospectivos
Resultado do Tratamento
Reino Unido/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; OBSERVATIONAL STUDY; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1709
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1093/icvts/ivw437


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[PMID]:29428031
[Au] Autor:Rosati CM; Gaudino M; Vardas PN; Weber DJ; Blitzer D; Hameedi F; Koniaris LG; Girardi LN
[Ti] Título:Academic Clinical Productivity of Cardiac Surgeons in the State of New York: Who Publishes More and Who Operates More.
[So] Source:Am Surg;84(1):71-79, 2018 Jan 01.
[Is] ISSN:1555-9823
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We investigated whether/how cardiac surgeons can be productive both academically and clinically. Using online resources (New York State Adult Cardiac Surgery database, SCOPUS), we collected individual clinical volumes (operations performed/year), academic metrics (ongoing publications, role as author), practice setting, and seniority for all cardiac surgeons in the State of New York from 1994 to 2011. Over time, individual clinical volumes decreased (median operations/year: 193 in 1995 vs 126 in 2010; P < 0.001), whereas academic productivity remained unchanged (median publications/year: 0.7 vs 0.3; P = 0.55). There was no correlation (Spearman's correlation coefficient: -0.061; P = 0.08) between the number of new publications and operations/year for the whole population. More operations/year (median: 155 vs 144; P = 0.03) were performed by surgeons without versus with publications during that same year. Who published more worked at hospitals with higher clinical volumes (Spearman's correlation coefficient: 0.16; P < 0.001) and was more likely affiliated with thoracic surgery fellowship programs (median publications/year: 1.7 for affiliated vs 0 for nonaffiliated surgeons; P < 0.001). Cardiac surgeons could be classified into four categories: ∼40 per cent clinically busy, but not publishing at all; ∼45 per cent operating less, but publishing a little; ∼15 per cent clinically very productive (operating as much as the nonpublishers) and publishing a lot; and ∼1 per cent operating the least, but publishing the most.
[Mh] Termos MeSH primário: Academias e Institutos
Eficiência
Transplante de Coração/estatística & dados numéricos
Hospitais Universitários/estatística & dados numéricos
Editoração/estatística & dados numéricos
Cirurgia Torácica/recursos humanos
Cirurgia Torácica/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
Procedimentos Cirúrgicos Cardíacos/estatística & dados numéricos
Bases de Dados Factuais
Hospitais/estatística & dados numéricos
Seres Humanos
New York
Procedimentos Cirúrgicos Torácicos/estatística & dados numéricos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180212
[St] Status:MEDLINE


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[PMID]:27776988
[Au] Autor:Dobarro D; Urban M; Booth K; Wrightson N; Castrodeza J; Jungschleger J; Robinson-Smith N; Woods A; Parry G; Schueler S; MacGowan GA
[Ad] Endereço:Cardiothoracic Directorate, Freeman Hospital, Newcastle upon Tyne Hospitals. NHS Foundation Trust, Newcastle upon Tyne, United Kingdom; Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico Universitario, Valladolid, Spain; Department of Medicine, Universidad de Valladolid, Valladolid, Spain.
[Ti] Título:Impact of aortic valve closure on adverse events and outcomes with the HeartWare ventricular assist device.
[So] Source:J Heart Lung Transplant;36(1):42-49, 2017 Jan.
[Is] ISSN:1557-3117
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: This study examined whether aortic valve opening (AVO) and other echocardiographic parameters influence outcomes in patients on left ventricular (LV) assist device (LVAD) support. Pump thrombosis (PT) and ischemic stroke (IS) are known complications of LVAD, but mechanisms that could influence them are not completely understood. METHODS: This was a retrospective analysis of 147 patients who received a HeartWare Ventricular Assist Device ( HeartWare International) as a bridge to transplant or to candidacy between July 2009 and August 2015, of whom 126 had at least 30 days of follow-up before the first event (30-days-out cohort). Outcomes included survival, PT, IS, and PT+IS (combined thrombotic event; CTE). RESULTS: Median time on support was 518 days. Of the 30-days-out cohort, 29% had a first PT and 19% a first IS. AVO was associated with longer survival on device (1,081 vs 723 days; p = 0.01) in the entire cohort. In the 30-days-out cohort, the aortic valve was more frequently closed in patients with lower ejection fractions on support (14% ± 6% vs 18% ± 9%; p = 0.009), more dilated pre-event echocardiogram (LV end-diastolic diameter, 66 ± 12 mm vs 62 ± 10 mm; p = 0.04), and pre-implant LV end-diastolic diameter (70 ± 10 mm vs 66 ± 9 mm; p = 0.06). CTE-free survival on the device was lower with a closed aortic valve (897 vs 1,314 days; p = 0.003) as was PT-free survival on the device (1,070 vs 1,457 days; p = 0.02). Cox regression analysis showed that AVO was an independent predictor of CTE (p = 0.03) CONCLUSIONS: Thrombotic events are relatively frequent in patients on long-term LVAD support. A closed aortic valve was associated with decreased overall survival, thrombosis-free survival, and poorer LV function on support. These are high-risk patients, so whether they require more intense anti-coagulation or prioritizing for transplantation requires further research.
[Mh] Termos MeSH primário: Valva Aórtica/fisiopatologia
Insuficiência Cardíaca/terapia
Ventrículos do Coração/fisiopatologia
Coração Auxiliar/efeitos adversos
Trombose/epidemiologia
Função Ventricular Esquerda/fisiologia
[Mh] Termos MeSH secundário: Valva Aórtica/diagnóstico por imagem
Diástole
Intervalo Livre de Doença
Ecocardiografia
Feminino
Seguimentos
Insuficiência Cardíaca/mortalidade
Insuficiência Cardíaca/fisiopatologia
Transplante de Coração
Ventrículos do Coração/diagnóstico por imagem
Seres Humanos
Incidência
Masculino
Meia-Idade
Prognóstico
Falha de Prótese
Estudos Retrospectivos
Taxa de Sobrevida/tendências
Trombose/etiologia
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE


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[PMID]:28455909
[Au] Autor:Wittlieb-Weber CA; Rossano JW; Weber DR; Lin KY; Ravishankar C; Mascio CE; Shaddy RE; O'Connor MJ
[Ad] Endereço:Division of Pediatric Cardiology, University of Rochester Medical Center, Rochester, NY, USA.
[Ti] Título:Emergency department utilization in pediatric heart transplant recipients.
[So] Source:Pediatr Transplant;21(4), 2017 Jun.
[Is] ISSN:1399-3046
[Cp] País de publicação:Denmark
[La] Idioma:eng
[Ab] Resumo:We used the NEDS database (2010) to evaluate ED utilization in PED HT recipients compared to other patient populations with focus on characteristics of ED visits, risk factors for admission, and charges. We analyzed 433 ED visits by PED HT recipients (median age 8 [range: 0-18] years). The most common primary diagnosis category was infectious (n=163, 37.6%), with pneumonia being the most common infectious etiology. When compared to all PED visits, HT visits were more likely to result in hospital admission (32.6% versus 3.9%, P<.001), had greater hospital LOS (median of 3 days [IQR 2-4] versus 2 days [IQR 1-4], P=.001), and accumulated greater total hospital charges (median $26 317 [IQR $11 438-$46 407] versus $12 332 [IQR $7092-$22 583], P<.001). When compared to visits by other SOT recipients, results varied with similar rates of hospital admission for HT, LUNGT, and KT visits and similar LOS for HT and KT visits but differing total hospital charges. Although PED HT recipients account for a small percentage of overall ED visits, they are more likely to be hospitalized and require greater resource utilization compared to the general PED population, but not when compared to other SOT recipients.
[Mh] Termos MeSH primário: Serviço Hospitalar de Emergência/utilização
Transplante de Coração
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Bases de Dados Factuais
Serviço Hospitalar de Emergência/economia
Serviço Hospitalar de Emergência/estatística & dados numéricos
Feminino
Preços Hospitalares/estatística & dados numéricos
Seres Humanos
Lactente
Recém-Nascido
Tempo de Internação/economia
Tempo de Internação/estatística & dados numéricos
Modelos Logísticos
Masculino
Admissão do Paciente/economia
Admissão do Paciente/estatística & dados numéricos
Complicações Pós-Operatórias/economia
Complicações Pós-Operatórias/epidemiologia
Complicações Pós-Operatórias/terapia
Estudos Retrospectivos
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170430
[St] Status:MEDLINE
[do] DOI:10.1111/petr.12936


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[PMID]:27773449
[Au] Autor:Cajita MI; Denhaerynck K; Dobbels F; Berben L; Russell CL; Davidson PM; De Geest S; BRIGHT study team
[Ad] Endereço:School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA.
[Ti] Título:Health literacy in heart transplantation: Prevalence, correlates and associations with health behaviors-Findings from the international BRIGHT study.
[So] Source:J Heart Lung Transplant;36(3):272-279, 2017 03.
[Is] ISSN:1557-3117
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Health literacy (HL) is a major determinant of health outcomes; however, there are few studies exploring the role of HL among heart transplant recipients. The objectives of this study were to: (1) explore and compare the prevalence of inadequate HL among heart transplant recipients internationally; (2) determine the correlates of HL; and (3) assess the relationship between HL and health-related behaviors. METHODS: A secondary analysis was conducted using data of the 1,365 adult patients from the BRIGHT study, an international multicenter, cross-sectional study that surveyed heart transplant recipients across 11 countries and 4 continents. Using the Subjective Health Literacy Screener, inadequate HL was operationalized as being confident in filling out medical forms none/a little/some of the time (HL score of 0 to 2). Correlates of HL were determined using backward stepwise logistic regression. The relationship between HL and the health-related behaviors were examined using hierarchical logistic regression. RESULTS: Overall, 33.1% of the heart transplant recipients had inadequate HL. Lower education level (adjusted odds ratio [AOR] 0.24, p < 0.001), unemployment (AOR 0.69, p = 0.012) and country (residing in Brazil, AOR 0.25, p < 0.001) were shown to be associated with inadequate HL. Heart transplant recipients with adequate HL had higher odds of engaging in sufficient physical activity (AOR 1.6, p = 0.016). HL was not significantly associated with the other health behaviors. CONCLUSIONS: Clinicians should recognize that almost one third of heart transplant participants have inadequate health literacy. Furthermore, they should adopt communication strategies that could mitigate the potential negative impact of inadequate HL.
[Mh] Termos MeSH primário: Rejeição de Enxerto/etiologia
Comportamentos Relacionados com a Saúde
Alfabetização em Saúde
Transplante de Coração/métodos
Imunossupressores/administração & dosagem
[Mh] Termos MeSH secundário: Adulto
Fatores Etários
Idoso
Intervalos de Confiança
Estudos Transversais
Feminino
Rejeição de Enxerto/mortalidade
Rejeição de Enxerto/fisiopatologia
Transplante de Coração/efeitos adversos
Transplante de Coração/mortalidade
Seres Humanos
Internacionalidade
Estilo de Vida
Modelos Logísticos
Masculino
Meia-Idade
Determinação de Necessidades de Cuidados de Saúde
Cooperação do Paciente
Prevalência
Prognóstico
Fatores Sexuais
Taxa de Sobrevida
Imunologia de Transplantes
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Immunosuppressive Agents)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


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[PMID]:27773450
[Au] Autor:Kovarik JJ; Kopecky C; Antlanger M; Domenig O; Kaltenecker CC; Werzowa J; Hecking M; Mahr S; Grömmer M; Wallner C; Aumayr K; Kain R; Zuckermann A; Poglitsch M; Säemann MD
[Ad] Endereço:Department of Internal Medicine III, Clinical Division of Nephrology and Dialysis, Medical University of Vienna, Vienna, Austria.
[Ti] Título:Effects of angiotensin-converting-enzyme inhibitor therapy on the regulation of the plasma and cardiac tissue renin-angiotensin system in heart transplant patients.
[So] Source:J Heart Lung Transplant;36(3):355-365, 2017 Mar.
[Is] ISSN:1557-3117
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Angiotensin-converting enzyme (ACE) inhibitors (ACEis) are beneficial in patients with heart failure, yet their role after heart transplantation (HTx) remains ambiguous. Particularly, the effects of ACEis on plasma and cardiac metabolites of the "classical" and "alternative" renin-angiotensin system (RAS) in HTx patients are unknown. METHODS: This cross-sectional study used a novel mass spectrometry-based approach to analyze plasma and tissue RAS regulation in homogenates of heart biopsy specimens from 10 stable HTx patients without RAS blockade and in 15 patients with ACEi therapy. Angiotensin (Ang) levels in plasma and Ang formation rates in biopsy tissue homogenates were measured. RESULTS: Plasma Ang II formation is exclusively ACE dependent, whereas cardiac Ang II formation is primarily chymase dependent in HTx patients. ACEi therapy substantially increased plasma Ang-(1-7), the key effector of the alternative RAS, leaving plasma Ang II largely intact. Importantly, neprilysin and prolyl-carboxypeptidase but not angiotensin converting enzyme 2 are essential for cardiac tissue Ang-(1-7) formation. CONCLUSION: ACE is the key enzyme for the generation of plasma Ang II, whereas chymase is responsible for cardiac tissue production of Ang II. Furthermore, our findings reveal that neprilysin and prolyl-carboxypeptidase are the essential cardiac enzymes for the alternative RAS after HTx. These novel insights into the versatile regulation of the RAS in HTx patients might affect future therapeutic avenues, such as chymase and neprilysin inhibition, beyond classical Ang II blockade.
[Mh] Termos MeSH primário: Inibidores da Enzima Conversora de Angiotensina/administração & dosagem
Rejeição de Enxerto/prevenção & controle
Insuficiência Cardíaca/sangue
Transplante de Coração/métodos
Sistema Renina-Angiotensina/efeitos dos fármacos
[Mh] Termos MeSH secundário: Idoso
Áustria
Biópsia por Agulha
Estudos Transversais
Ecocardiografia
Feminino
Seguimentos
Sobrevivência de Enxerto
Insuficiência Cardíaca/diagnóstico por imagem
Insuficiência Cardíaca/cirurgia
Transplante de Coração/efeitos adversos
Seres Humanos
Imuno-Histoquímica
Masculino
Meia-Idade
Valores de Referência
Medição de Risco
Papel (Figurativo)
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Angiotensin-Converting Enzyme Inhibitors)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


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[PMID]:28746253
[Au] Autor:Schear MJ; Rodgers R
[Ad] Endereço:Hofstra Northwell Health School of Medicine, Department of Ophthalmology, Great Neck and Department of Ophthalmology, Mount Sinai Healthcare System, New York, New York, U.S.A.
[Ti] Título:A Case of Everolimus-Induced Eyelid Edema.
[So] Source:Ophthal Plast Reconstr Surg;34(1):e21-e22, 2018 Jan/Feb.
[Is] ISSN:1537-2677
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Everolimus is a newer generation mammalian target of rapamycin inhibitor approved for immunosuppressive use in a number of advanced medical conditions. The authors report a unique case of persistent eyelid edema believed to be related to the immunosuppressive therapy. The therapy was being well tolerated despite the persistent eyelid edema, so the patient underwent a bilateral upper eyelid blepharoplasty. The patient responded well with resolution of her eyelid dermatochalasis and markedly decreased edema. Everolimus-induced eyelid edema should be recognized by clinicians as a potential side effect of the medication. Surgical excision of excess eyelid tissue by blepharoplasty can be a successful way to manage this side effect.Everolimus (zortress) was initially approved as an immunosuppressive agent for renal transplantation patients. Approval for the treatment of subependymal giant cell astrocytomas associated with tuberous sclerosis, progressive metastatic pancreatic neuroendocrine tumors, human epidermal growth factor receptor 2 negative breast cancer in postmenopausal woman, liver transplantation patients, and well-differentiated neuroendocrine tumors of gastrointestinal or pulmonary origin has followed., Everolimus is a derivative of sirolimus (rapamune), and similar to sirolimus acts as an inhibitor of mammalian target of rapamycin. Few prior studies have reported eyelid edema from sirolomus. Many prior medications have been implicated in eyelid edema formation. To date, periocular edema has not been reported as a side effect of everolimus. We report a patient with bilateral upper eyelid edema associated with everolimus therapy requiring surgical intervention to ameliorate the significant skin redundancy and the visual field defect. This report complies with the Declaration of Helsinki and Health Insurance Portability and Accountability Act regulations.
[Mh] Termos MeSH primário: Edema/induzido quimicamente
Everolimo/efeitos adversos
Doenças Palpebrais/induzido quimicamente
Rejeição de Enxerto/tratamento farmacológico
[Mh] Termos MeSH secundário: Idoso
Blefaroplastia
Edema/diagnóstico
Edema/cirurgia
Everolimo/uso terapêutico
Doenças Palpebrais/diagnóstico
Doenças Palpebrais/cirurgia
Feminino
Transplante de Coração/efeitos adversos
Seres Humanos
Imunossupressores/efeitos adversos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Immunosuppressive Agents); 9HW64Q8G6G (Everolimus)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180219
[Lr] Data última revisão:
180219
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170727
[St] Status:MEDLINE
[do] DOI:10.1097/IOP.0000000000000974


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[PMID]:29381937
[Au] Autor:Moon SH; Kim JW; Byun JH; Kim SH; Kim KN; Choi JY; Jang IS; Lee CE; Yang JH; Kang DH; Park HO
[Ad] Endereço:Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Changwon.
[Ti] Título:Case of a cardiac arrest patient who survived after extracorporeal cardiopulmonary resuscitation and 1.5 hours of resuscitation: A case report.
[So] Source:Medicine (Baltimore);96(47):e8646, 2017 Nov.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Per the American Heart Association guidelines, extracorporeal cardiopulmonary resuscitation should be considered for in-hospital patients with easily reversible cardiac arrest. However, there are currently no consensus recommendations regarding resuscitation for prolonged cardiac arrest cases. PATIENT CONCERNS AND DIAGNOSIS: We encountered a 48-year-old man who survived a cardiac arrest that lasted approximately 1.5 hours. He visited a local hospital's emergency department complaining of chest pain and dyspnea that had started 3 days earlier. Immediately after arriving in the emergency department, a cardiac arrest occurred; he was transferred to our hospital for extracorporeal membrane oxygenation (ECMO). INTERVENTIONS: Resuscitation was performed with strict adherence to the American Heart Association/American College of Cardiology advanced cardiac life support guidelines until ECMO could be placed. OUTCOMES: On hospital day 7, he had a full neurologic recovery. On hospital day 58, additional treatments, including orthotopic heart transplantation, were considered necessary; he was transferred to another hospital. LESSONS: To our knowledge, this is the first case in South Korea of patient survival with good neurologic outcomes after resuscitation that lasted as long as 1.5 hours. Documenting cases of prolonged resuscitation may lead to updated guidelines and improvement of outcomes of similar cases in future.
[Mh] Termos MeSH primário: Oxigenação por Membrana Extracorpórea/métodos
Parada Cardíaca/terapia
Doenças do Sistema Nervoso
[Mh] Termos MeSH secundário: Reanimação Cardiopulmonar/efeitos adversos
Reanimação Cardiopulmonar/métodos
Transplante de Coração/métodos
Hospitalização
Seres Humanos
Masculino
Meia-Idade
Doenças do Sistema Nervoso/etiologia
Doenças do Sistema Nervoso/prevenção & controle
República da Coreia
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008646


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[PMID]:29227072
[Au] Autor:Tanoue Y; Shiose A
[Ti] Título:The Present Situation and Clinical Topics of Ventricular Assist Device and Heart Transplantation in Japan.
[So] Source:Fukuoka Igaku Zasshi;107(12):213-22, 2016 12.
[Is] ISSN:0016-254X
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:Surgical treatment for heart failure includes coronary artery bypass grafting to ischemic heart disease, valvular disease surgery such as mitral valvuloplasty, left ventricular restoration, ventricular assist device (VAD), and heart transplantation. In addition, HeartSheet which is regenerative medicine using autologous skeletal myoblast sheets has been started from the spring of 2016. Formal insurance reimbursement of implantable LVAD was obtained in April 2011, and the life prognosis of patients with severe heart failure improved markedly. However, the indication for implantable LVAD is limited to bridge use for heart transplantation. Implantable LVAD cannot be implanted in patients over 65 years old under health insurance because the adaptive age of heart transplantation in Japan is under 65 years old. It is a problem that the indication of implantable LVAD is identical to that of heart transplantation. Clinical trial of destination therapy is in progress for the purpose of optimizing the implantable LVAD indication. I strongly pray that VAD treatment including destination therapy (DT) and transplant medical treatment based on good intentions will be accepted socially as general treatment.
[Mh] Termos MeSH primário: Cardiopatias/cirurgia
Transplante de Coração
Coração Auxiliar
[Mh] Termos MeSH secundário: Morte Encefálica
Seres Humanos
Japão
Doadores de Tecidos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW; ENGLISH ABSTRACT
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171212
[St] Status:MEDLINE



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