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Francesco Paolo Caronia Alfonso Fiorelli Mario Santini Sergio Castorina 《General thoracic and cardiovascular surgery》2016,64(10):625-628
Persistent tracheal fistula after tracheostomy decannulation is a recognized sequel to long-term tracheostomy use, causing important morbidity including difficult to vocalization and control of air secretions, recurrent pulmonary infections, and cosmetic and social problems. Herein, we reported a new method for closure of persistent tracheocutaneous fistula with rib cartilages. Compared to other techniques previously reported, the variations of our strategy were the use of temporary metal-covered tracheal stent and the hinged turnover skin bi-flaps reinforced with rib cartilage grafts. Rib cartilages were useful in order to reconstruct the trachea and prevent stenosis. Since it become difficult to obtain the maintenance of the trachea stability until healing of suture was well established, a covered metallic stent was also inserted to avoid flap collapse. The stent was removed 3 months later. Six months follow-up showed normal tracheal patency. 相似文献
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Emanuele Angelucci Valeria Santini Anna Angela Di Tucci Giulia Quaresmini Carlo Finelli Antonio Volpe Giovanni Quarta Flavia Rivellini Grazia Sanpaolo Daniela Cilloni Flavia Salvi Giovanni Caocci Alfredo Molteni Daniele Vallisa Maria Teresa Voso Susanna Fenu Lorenza Borin Giancarlo Latte Giuliana Alimena Sergio Storti Alfonso Piciocchi Paola Fazi Marco Vignetti Sante Tura 《European journal of haematology》2014,92(6):527-536
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Licia Iaccarino Tiziana Ottone Valentina Alfonso Laura Cicconi Mariadomenica Divona Serena Lavorgna Serena Travaglini Aleandra Ferrantini Giulia Falconi Constance Baer Monica Usai Fabio Forghieri Adriano Venditti Maria Ilaria Del Principe William Arcese Maria Teresa Voso Torsten Haferlach Francesco Lo-Coco 《American journal of hematology》2019,94(10):1091-1097
Despite the high probability of cure of patients with acute promyelocytic leukemia (APL), mechanisms of relapse are still largely unclear. Mutational profiling at diagnosis and/or relapse may help to identify APL patients needing frequent molecular monitoring and early treatment intervention. Using an NGS approach including a 31 myeloid gene-panel, we tested BM samples of 44 APLs at the time of diagnosis, and of 31 at relapse. Mutations in PML and RARA genes were studied using a customized-NGS-RNA panel. Patients relapsing after ATRA-chemotherapy rarely had additional mutations (P = .009). In patients relapsing after ATRA/ATO, the PML gene was a preferential mutation target. We then evaluated the predictive value of mutations at APL diagnosis. A median of two mutations was detectable in 9/11 patients who later relapsed, vs one mutation in 21/33 patients who remained in CCR (P = .0032). This corresponded to a significantly lower risk of relapse in patients with one or less mutations (HR 0.046; 95% CI 0.011-0.197; P < .0001). NGS-analysis at the time of APL diagnosis may inform treatment decisions, including alternative treatments for cases with an unfavorable mutation profile. 相似文献
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José M. de la Torre Hernández Salvatore Brugaletta Joan A. Gómez Hospital José A. Baz Armando Pérez de Prado Ramón López Palop Belen Cid Tamara García Camarero Alejandro Diego Hipólito Gutiérrez José A. Fernández Diaz Juan Sanchis Fernando Alfonso Roberto Blanco Javier Botas Javier Navarro Cuartero José Moreu Francisco Bosa Antonio J. Domínguez 《Revista espa?ola de cardiología》2019,72(12):1005-1011
Background and objectivesPatients older than 75 years with ST-segment elevation myocardial infarction undergoing primary angioplasty in cardiogenic shock have high mortality. Identification of preprocedural predictors of short- and long-term mortality could be useful to guide decision-making and further interventions.MethodsWe analyzed a nationwide registry of primary angioplasty in the elderly (ESTROFA MI + 75) comprising 3576 patients. The characteristics and outcomes of the subgroup of patients in cardiogenic shock were analyzed to identify associated factors and prognostic predictors in order to derive a baseline risk prediction score for 1-year mortality. The score was validated in an independent cohort.ResultsA total of 332 patients were included. Baseline independent predictors of mortality were anterior myocardial infarction (HR 2.8, 95%CI, 1.4-6.0; P = .005), ejection fraction < 40% (HR 2.3, 95%CI, 1.14-4.50; P = .018), and time from symptom onset to angioplasty > 6 hours (HR 3.2, 95%CI, 1.6-7.5; P = .001). A score was designed that included these predictive factors (score “6-ANT-40”). Survival at 1 year was 54.5% for patients with score 0, 32.3% for score 1, 27.4% for score 2 and 17% for score 3 (P = .004, c-statistic 0.70). The score was validated in an independent cohort of 124 patients, showing 1-year survival rates of 64.5%, 40.0%, 28.9%, and 22.2%, respectively (P = .008, c-statistic 0.68).ConclusionsA preprocedural score based on 3 simple clinical variables (anterior location, ejection fraction < 40%, and delay time > 6 hours) may be used to estimate survival after primary angioplasty in elderly patients with cardiogenic shock and to guide preinterventional decision-making. 相似文献
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José García-Cosamalón Javier Fernández-Fernández Emilio González-Martínez Javier Ibáñez-Plágaro Javier Robla Costales Milton Martínez-Madrigal Alfonso López Muñíz Miguel Enrique del Valle José Antonio Vega 《Neurocirugía (Asturias, Spain)》2013,24(3):121-129
Until very recently, intervertebral disc innervation was a subject of considerable debate.Nowadays, the introduction of inmunohistochemical techniques associated to specific antibodies and studies with retrograde tracers in nerves have allowed greater understanding of disc innervation in physiological and pathological conditions and also endings characteristics and their patterns of distribution in both situations. The existing controversies regarding structural basis of discogenic pain, have raised the interest of knowing the influence of innervation in back pain from discal origin and its characteristics.Today, we know that pathologic neoinnervation accompanying radial fissures is an important factor in the genesis of discogenic pain; within a complex mechanism in which other neurobiomechemical, inflammatory and biomechanical factors are involved. 相似文献