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31.
32.
Veloso-Guedes CA Rosalen ST Thobias CM Andreotti RM Galhardo FD Oliveira da Silva AM Araujo O Boin IF 《Transplantation proceedings》2011,43(4):1322-1324
Background
Guidelines established by the American Thoracic Society recommend the use of corridors 30 m in length for the 6-minute walk test (6MWT). However, not all institutions have such long corridors, which hinders or prevents 6MWT performance and use of its benefits.Objective
To compare the distances walked by male patients with cirrhosis on the liver transplantation waiting list, we performed 6MWT on corridors 20 and 30 m long.Methods
This prospective study included 10 patients on the waiting list for liver transplantation. They underwent 2 walk tests: the first test in a 20 m corridor and the second in a 30 m corridor. We assessed physiologic variables (heart rate, oxygen saturation, arterial blood pressure) and the subjective sensation of dyspnea at rest at 6 and 9 minutes after each walk. Statistical analysis was performed using the Wilcoxon test.Results
Data are expressed as mean ± sd. Patient age was 59 ± 10 years. The distances walked by the patients were shorter than those predicted for their age and gender (586 ± 45 m) in both tests, no significant difference was observed between the first and the second 6MWT (437 ± 101 m vs 465 ± 80 m; P = .131) or among the physiologic variables.Conclusion
We concluded that a 20 m corridor can be used safely and effectively as an alternative to 30 m for the 6MWT for male patients with cirrhosis on the liver transplantation waiting list. 相似文献33.
Sampaio AM Thomasini RL Guardia AC Stucchi RS Rossi CL Costa SC Boin IF 《Transplantation proceedings》2011,43(4):1357-1359
Human herpesvirus (HHV)-6, HHV-7, and cytomegalovirus (CMV) that remain latent after primary infection can be reactivated during immunosuppression following organ transplantation in liver transplant recipients. The aim of this study was to monitor active infections for HHV-6, HHV-7, and CMV among adult liver transplantation recipients using antigenemia detected by an immunoperoxidase staining. Twenty-eight adult liver transplant patients were monitored using antigenemia in blood samples obtained at the time of transplantation, as well as weekly in the first month and once a month for 6 months. Of these patients, 28.5% showed positive CMV antigenemia; 39.2%, HHV-6 antigenemia; and 14.2%, HHV-7 antigenemia. The detection of the three viruses was considered to be independent of one another (P>.05). The results described above showed that few patients remain free of beta herpesviruses after liver transplantation. Most patients were infected sequentially and not concurrently. Antigenemia has been considered useful to detect active HHV-6 and HHV-7 infections. Antigenemia can be more efficiently interpreted when compared with polymerase chain reaction results, although other studies are necessary to establish the reference of HHV-6 and HHV-7 antigenemia. 相似文献
34.
Marcos Vinicius de Sousa Ricardo de Lima Zollner Raquel Silveira Bello Stucchi Ilka de Ftima Santana Ferreira Boin Elaine Cristina de Ataide Marilda Mazzali 《Transplant infectious disease》2019,21(5)
Yellow fever (YF) is a viral disease, with clinical presentation among immunosuppressed patients not fully understood. YF vaccination (YFV), a live vaccine, is contraindicated in patients receiving immunosuppressive treatment due to the risk of developing the disease after vaccination. We report a case of a 50‐year‐old male recipient who presented wild‐type YF five years after a deceased donor kidney transplant. He lived in a YF endemic area and inadvertently received YFV. One day after YFV, the patient presented nausea, vomiting, fever, diarrhea, polyarthralgia, thrombocytopenia, and increased levels of liver function enzymes. The serological test was compatible with YF disease, and quantitative viral load confirmed the diagnosis of wild‐type YF. The patient received supportive care for twelve days, with hospital discharge in good clinical condition and stable renal function. One month after discharge, the patient developed de novo donor‐specific anti‐HLA antibodies (DSA) and histological evidence of endothelial lesion, with a diagnosis of acute antibody‐mediated rejection (AMR), treated with plasmapheresis and human IVIg therapy. Six months after therapy, he presented normal renal function with a reduction of DSA MFI. In the reported case, we observed a clinical wild‐type YF diagnosed even after YF vaccine administration, with good clinical outcome. De novo DSA and AMR occurred after the recovering of disease, with an adequate response to therapy and preserved allograft function. We reviewed the published literature on YF and YFV in solid organ transplantation. 相似文献
35.
R.P. Duarte A.C. Sentanin A.M.O. da Silva R.M. Tonella G.L. Duarte L.S.R. Ratti I.F.S.F. Boin 《Transplantation proceedings》2017,49(4):829-831
Introduction
Liver disease induces many organic and metabolic changes, leading to malnutrition and weight and muscular function loss. Surface electromyography is an easily applicable, noninvasive study, through which the magnitudes of the peaks on the charts depict voluntary muscle activity.Aim
To evaluate the diaphragmatic surface electromyography of postoperative liver transplantation subjects.Methods
Subjects were patients who underwent liver transplantation and extubation in the Clinical Hospital of State University of Campinas. Electromyography data were collected with support pressure of ≤10 cm H2O, Glasgow Coma Scale = 11, and minimum dosages of vasoactive drugs, and data were collected again 30 minutes after extubation. Signal collection was performed with sEMG System Brazil SAS1000V3 electromyograph and electrode stickers. Statistical analysis was performed using R software.Results
The average time of surgery was 345.36 ± 125.62 minutes. Time from spontaneous mode until extubation was 417.14 ± 362.97 minutes. The RMS (root mean square) values of the right and left domes in spontaneous mode with minimal ventilation parameters were 26.68 ± 10.92 and 26.55 ± 10.53, respectively, and the RMS values after extubation were 31.93 ± 18.69 to 34.62 ± 13.55, for right and left domes. The last calculated pretransplant Model for End-stage Liver Disease score averaged 19.64 ± 8.41.Conclusion
There were significant differences between the RMS of the diaphragm domes under mechanical ventilation and after extubation, showing lower effectiveness of the diaphragm muscle against resistance, without the aid of positive pressure and the existing overload of the left dome. 相似文献36.
Mecoli Christopher A. Shah Ami A. Boin Francesco Wigley Fredrick M. Hummers Laura K. 《Clinical rheumatology》2018,37(9):2429-2437
Clinical Rheumatology - Two major complications in scleroderma patients that cause substantial morbidity and mortality are ischemic digital lesions (DL) and pulmonary hypertension (PH). The... 相似文献
37.
38.
We report the case of an adult patient recently diagnosed with cirrhosis. The ultrasound evaluation described a multinodular inhomogeneous liver, requiring a magnetic resonance imaging scan for further characterization. The performed magnetic resonance imaging examination confirmed the diagnosis of cirrhosis associated with portal hypertension and detected a vascular left transdiaphragmatic hernia. Although various types of diaphragmatic hernias have been described - congenital or acquired - to the best of our knowledge, this type of pathology has never been reported. 相似文献
39.
Magnetic resonance (MR) imaging of jugular venous thrombosis was investigated in three patients who had symptoms suggestive of this condition; the diagnosis was later confirmed by computed tomography, by venography, and clinically. Bright intraluminal signal intensity was seen throughout the course of the affected jugular vein on MR images in all three patients, in sharp contrast to the lack of signal from the corresponding site in the uninvolved venous system. Temporal changes in signal intensity from the acute to subacute stage of thrombosis were evaluated for one patient. A relative increase in signal intensity for the subacute phase was believed to be related to a decrease in the T1 relaxation time. MR may be the imaging modality of choice in the investigation of venous thrombosis. 相似文献
40.
G. de Lourdes Jorge R. dos Reis Tártaro C.A. Fazzio Escanhoela I.F.S.F. Boin 《Transplantation proceedings》2017,49(4):898-901