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12.
A new technique is described for reversing the direction of the catheter tip during translumbar aortography, without the need for partial withdrawal of the catheter from the aortic lumen. The method ensures optimal delivery of contrast medium at the desired level, while avoiding the risk of retroperitoneal bleeding or dislodgement during catheter manipulation. 相似文献
13.
Veloso CA Boin IF Dragosavac D Leonardi LS Figueiredo LC Araújo S Terzi RG 《Transplantation proceedings》2004,36(4):938-940
INTRODUCTION: Pulmonary hypertension (PH) (mean pulmonary arterial pressure [mPAP] > 25 mm Hg) is frequently observed during the postoperative period after liver transplantation (LT). OBJECTIVE: The objective was to compare respiratory function, intensive care unit (ICU) length of stay (LOS), and 30-day survival rates among patients evolving with PH with those who do versus do not develop it during the postoperative period after LT. METHODS: Fifty-seven patients undergoing LT from January 1999 to December 2000 were divided into 2 groups: Group 1 (G1; n = 26), without PH; and Group 2 (G2; n = 31), with moderate PH. Preoperative parameters were Child-Pugh's classification, pulmonary function tests, mPAP, and P(A-a)O(2). During the intraoperative period, warm and cold ischemic times and the amount of blood transfusion were evaluated, whereas mPAP, PaO(2)/FiO(2) ratio, weaning time, ICU LOS, and 30-day survival rates were evaluated postoperatively. RESULTS: mPAP in early postoperative period was 21 +/- 13 mm Hg and 32 +/- 4 mm Hg in G1 and G2, respectively (P <.0001). PaO(2)/FiO(2) was 310 +/- 82 mm Hg in G1 and 272 +/- 84 mm Hg in G2 (P =.48). In G1 and G2, 77% and 74% of patients, respectively, were successfully weaned in the first 24 hours postoperative (P =.10). ICU LOS was 111 hours (range, 45-1098 hours) in G1 and 102 hours (range, 59-284 hours) in G2 (P =.36). The 30-day survival rate was 20 of 26 (77%) in G1 and 26 of 31 (84%) in G2 (P =.44). CONCLUSION: Our data suggest that moderate PH during the early postoperative phases of LT cannot be considered an additional risk factor for pulmonary dysfunction, and for an increased ICU LOS or 30-day mortality rate. 相似文献
14.
Closure of diaphragmatic defects, regardless of their cause, can often be achieved by direct suture. However, when a large defect secondary to tissue destruction has been observed, direct closure is likely to be difficult. The glutaraldehyde-preserved bovine pericardium is a biological material with high resistance and allows for easy surgical manipulation. This case report shows the use of these prostheses applied in a patient after massive diaphragm resection due to hepatectomy by colon metastasis invasion in the diaphragm muscle. To replace diaphragm muscle, the glutaraldehyde-preserved bovine pericardium prostheses showed a good result even after four laparotomies. 相似文献
15.
The use of the Bene-Anthony Family Relations Test is described and illustrated by three examples of child abuse. This test should be considered in the investigation of definite or suspected cases of abuse and as part of the preparation of court evidence. 相似文献
16.
E.C. de Ataide S. Reges Perales M.A. de Oliveira Peres L. Bastos Eloy da Costa F. Quarella F.G. Valerini F. Chueiri Neto R. Silveira Bello Stucchi I. de Fátima Santana Ferreira Boin 《Transplantation proceedings》2018,50(2):476-477
Background
Acute liver failure (ALF) is a clinical syndrome that results from the abrupt loss of liver function in a patient without previous liver disease. The most frequent causes are viral hepatitis, drug induced, and autoimmune disease, but in 20% of cases no cause is identified. Carthamus tinctorius (safflower) oil is used as a dietary supplement for weight loss and antioxidant. There are 4 cases described in the literature of ALF induced by the use of this substance. The objective of this study was to report 3 cases of ALF treated at the Clinical Hospital of the State University of Campinas that suggest the use of C tinctorius oil as a probable etiologic factor.Case Reports
The 3 patients had a diagnosis of ALF according to the King's College criteria. All had a history of ingestion of this oil for weight loss. During etiologic evaluation, viral hepatitis, autoimmune diseases, or any other drug cause were excluded, thus pointing to C tinctorius oil as the triggering factor. All 3 patients underwent liver transplantation: 2 had good postoperative evolution, and 1 died 12 days after the procedure.Conclusions
Two cases are described in which the hepatic insufficiency induced by C tinctorius oil was successfully treated through liver transplantation. This highlights the risk of misuse of this substance for weight loss. 相似文献17.
Maria L. Barjas‐Castro Rodrigo N. Angerami Mariana S. Cunha Akemi Suzuki Juliana S. Nogueira Iray M. Rocco Adriana Y. Maeda Fernanda G.S. Vasami Gizelda Katz Ilka F.S.F. Boin Raquel S.B. Stucchi Mariângela R. Resende Danillo L.A. Esposito Renato P. de Souza Benedito A. da Fonseca Marcelo Addas‐Carvalho 《Transfusion》2016,56(7):1684-1688
18.
Introduction
The Brazilian National System of Transplantation and the Ministry of Health in Brazil establish procedures and effective actions for occupational health care so that there are increasing numbers of organ and tissue donations.Objective
This study analyzes the performance of social workers at the Intrahospital Donation of Organs and Tissues for Transplantation, Clinical Hospital, State University of Campinas, Brazil (CIHDOTT).Methods
We retrospectively analyzed the number of potential cornea donors, effective donations, family refusal, and the reasons for nonimplementation of the donations in 2009 (period studied with the presence of social workers) compared with 2006 (period studied without the presence of social workers).Results
Data analysis revealed that in 2006 there were 141 potential cornea donors achieving 35 (25%) donations and 106 (75%) refusals. In 2009 there were 73 potential donors with 25 (34%) donations and 48 (66%) refusals. The causes of family refusal prevalent in both periods were similar: 65% from indecision and 25% from the family's wishes to maintain the patient's body intact.Conclusion
The performance of social workers in this case was satisfactory, achieving an increase in donations and reducing the number of patients awaiting corneal transplantation while promoting their quality of life. 相似文献19.
Palmiero HO Kajikawa P Boin IF Coria S Pereira LA 《Transplantation proceedings》2010,42(10):4113-4115
Background
The progressive increase in the demand for liver transplantation has led to changes in donor selection and allocation, such as the Model for End-Stage Liver Disease Score (MELD). Characteristics related to the donor, recipient, and transplantation procedure influence the results. The use of expanded-criteria donors (ECDs) and the donor risk index (DRI) are strategies that have been proposed to increase the donors pool.Objective
We sought to study liver recipient survival before and after MELD implementation as well as the use of DRI.Methods
This retrospective study of prospectively collected data analyzed 1,786 liver recipients and their donors according to gender, age, cause of brain death, intensive care unit time, split liver, infection, ECD, cardiac arrest, cold ischemia time, waiting list time, and donor origin. MELD (without special scoring) and DRI were calculated from the recorded data. The periods of this study were 2004–2006 (pre-MELD) and 2006–2008 (post-MELD). For survival times, we performed the Kaplan-Meier method with log-rank tests and Cox regression analysis (prediction). The Kolmogorov-Sminorv test was used for sample comparisons.Results
The 1-year survivals were similar in the 2 periods (65.4% vs 67.6%). The predictive factors for death among the whole population were DRI >1.5, cold ischemia time ≥9 hours, MELD ≥25, female recipient, and longer waiting list time.Conclusions
MELD is an important tool for allocation, resulting in a reduced waiting list, increased number of split-liver procedures, and use of ECDs without deterioration of survival times. DRI >1.7 was associated with shorter survival. 相似文献20.
Araújo MB Leonardi LS Leonardi MI Boin IF Magna LA Donadi EA Kraemer MH 《Transplant immunology》2009,20(3):195-198
After liver transplantation, migration of donor-derived hematopoietic cells to recipient can be detected in peripheral blood. This state is termed microchimerism. The aim of this study was to investigate prospectively the presence of allogeneic microchimerism, the occurrence of acute cellular rejection and the level of immunosuppression in transplanted patients. Microchimerism occurrence between 10 days and 12 months after liver transplantation was analyzed in 47 patients aged between 15 and 65 by a two-stage nested PCR/SSP technique to detect donor MHC HLA-DR gene specifically. A pre-transplant blood sample was collected from each patient to serve as individual negative control. Microchimerism was demonstrated in 32 (68%) of the 47 patients; of these, only 10 patients (31.2%) presented rejection. Early microchimerism was observed in 25 patients (78.12%) and late microchimerism in 7 patients (21.8%). Among the patients with microchimerism, 14 were given CyA and 18 were given FK506. In the group without microchimerism, 12 patients were given CyA and 03 were given FK506. There was a significant association between the presence of microchimerism and the absence of rejection (p=0.02) and also between microchimerism and the type of immunosuppression used. Our data indicate that microchimerism and probably differentiation of donor-derived leukocytes can have relevant immunologic effects both in terms of sensitization of recipient and in terms of immunomodulation toward tolerance induction. 相似文献