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991.
Davide Carino MD Alejandro Fernández-Cisneros MD Marta Hernández-Meneses MD Elena Sandoval MD FECTS Jaume Llopis MD PhD Carlos Falces MD PhD José M. Miró MD PhD Eduard Quintana MD PhD FECTS Grup d'Estudi d'Endocarditis Infecciosa de l'Hospital Clínic de Barcelona 《Journal of cardiac surgery》2020,35(11):3034-3040
992.
Daniele Doná Juan Torres Canizales Elisa Benetti Mara Cananzi Federica De Corti Elisabetta Calore Loreto Hierro Esther Ramos Boluda Marta Melgosa Hijosa Luis Garcia Guereta Antonio Pérez Martínez Maribel Barrios Patricia Costa Reis Ana Teixeira Maria Francelina Lopes Piotr Kaliciński Sophie Branchereau Olivia Boyer Dominque Debray Marco Sciveres Lars Wennberg Björn Fischler Peter Barany Alastair Baker Ulrich Baumann Nicolaus Schwerk Emanuele Nicastro Manila Candusso Jacek Toporski Etienne Sokal Xavier Stephenne Caroline Lindemans Marius Miglinas Jelena Rascon Paloma Jara ERN TransplantChild 《Clinical transplantation》2020,34(10):e14063
The current pandemic SARS-CoV-2 has required an unusual allocation of resources that can negatively impact chronically ill patients and high-complexity procedures. Across the European Reference Network on Pediatric Transplantation (ERN TransplantChild), we conducted a survey to investigate the impact of the COVID-19 outbreak on pediatric transplant activity and healthcare practices in both solid organ transplantation (SOT) and hematopoietic stem cell transplantation (HSCT). The replies of 30 professionals from 18 centers in Europe were collected. Twelve of 18 centers (67%) showed a reduction in their usual transplant activity. Additionally, outpatient visits have been modified and restricted to selected ones, and the use of telemedicine tools has increased. Additionally, a total of 14 COVID-19 pediatric transplanted patients were identified at the time of the survey, including eight transplant recipients and six candidates for transplantation. Only two moderate-severe cases were reported, both in HSCT setting. These survey results demonstrate the limitations in healthcare resources for pediatric transplantation patients during early stages of this pandemic. COVID-19 disease is a major worldwide challenge for the field of pediatric transplantation, where there will be a need for systematic data collection, encouraging regular discussions to address the long-term consequences for pediatric transplantation candidates, recipients, and their families. 相似文献
993.
Bibiana Escobar Pilar Taurá Graciela Martínez-Palli Constatino Fondevila Jaume Balust Joan Beltrán Javier Fernández Juan Carlos García-Pagán Juan Carlos García-Valdecasas 《World journal of surgery》2014,38(4):927-935
Introduction
In patients with advanced cirrhosis, stressful stimuli may reveal a silent reduced cardiac performance. During liver transplantation (LT), graft reperfusion strongly stresses the heart and may unmask latent myocardial dysfunction.Aim
The objective of this study was to assess heart response to acutely increased preload after liver graft reperfusion and correlate this response with preoperative data and outcome.Methods
Preoperative clinical, echocardiographic, and hemodynamic data, and patient outcome were retrospectively recorded for 235 liver recipients who had no known cardiac disease. Myocardial dysfunction was defined as less than 10 % increase of stroke volume after graft reperfusion (non-responder).Results
We found 84 (35.7 %) non-responder patients. The non-responders showed higher Model for end-stage liver disease scores (p = 0.046), left atrial diameter (LAD) (p = 0.040), hepatic vein pressure gradient (p = 0.055), and hyperdynamic state than responders. The percentages of patients with hyponatremia (p = 0.048) and alcohol etiology (p = 0.025) were also higher among non-responders. Independent predictors of inadequate cardiac response in the multivariate analysis were low preoperative systemic vascular resistance (SVRI) [odds ratio (OR) 3.09, 95 % CI 1.15–4.82; p = 0.027] and enlargement of LAD (OR 2.08, 95 % CI 1.49–2.74; p = 0.044). Non-response was associated with higher rates of early cardiovascular events [hazard ratio (HR) 2.84, 95 % CI 1.09–4.22; p = 0.039] and higher length of intensive care unit stay (p = 0.038). No differences were found in 1-year survival rates.Conclusions
Latent cardiac dysfunction among LT recipients, considered to be abnormal stroke volume response to unclamping of portal vein, is very prevalent. SVRI and LAD were independent predictors of inadequate responses. This condition deserves special attention since it may aggravate the early postoperative course of LT. 相似文献994.
Almudena Vega Soledad García de Vinuesa Marian Goicoechea Úrsula Verdalles María Luz Martínez-Pueyo Ana Chacón Borja Quiroga José Luño 《International urology and nephrology》2014,46(6):1161-1167
Purpose
Estimated glomerular filtration rate (GFR) is a useful tool for the detection of chronic kidney disease (CKD). Several methods have been proposed, but findings can vary in specific groups such as patients with diabetes, elderly and high and low body mass index and, also, with the stage of CKD. The objective of this study was comparing the accuracy of the currently used equations for estimating GFR with that of the gold standard technetium-(99m)-diethylene triamine pentaacetic acid (99mTc-DTPA).Methods
We performed a cross-sectional study of 129 patients with all five CKD stages. GFR was estimated using the following: 24-h urine creatinine clearance, Cockcroft–Gault equation, MDRD equation, CKD-EPI equation, Hoek’s cystatin C equation, and isotopic 99mTc-DTPA (as gold standard). We evaluated agreement in the whole study population and according to age, sex, weight, and diabetes.Results
All methods had good agreement. The best agreement was observed with the cystatin C [intraclass coefficient correlation (ICC) 95 % confidence interval (95 % CI), 0.87 (0.82–0.91)], followed by CKD-EPI [ICC 0.83 (0.77–0.88)]. Twenty-four-hour urine creatinine clearance showed the worst agreement in patients older than 65 years [ICC 0.70 (0.56–0.79)]. The Cockcroft–Gault equation showed the worst agreement in younger than 65 years [ICC 0.64 (0.42–0.79)]. The best agreement for classification in the correct CKD stage was with the cystatin C equation [κ = 0.80 (0.74–0.87)]. GFR was overestimated with all methods in CKD stages 4 and 5.Conclusions
The methods used in clinical practice are adequate for classification of CKD. Cystatin C is the most accurate method, followed by CKD-EPI. The Cockcroft–Gault equation is not accurate in young patients. Twenty-four-hour urine creatinine clearance loses accuracy in patients aged older than 65 years. 相似文献995.
996.
Constrained Markov control processes with randomized discounted cost criteria: infinite linear programming approach
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Juan González‐Hernández Raquiel R. López‐Martínez J. Adolfo Minjárez‐Sosa J. Rigoberto Gabriel‐Arguelles 《Optimal control applications & methods.》2014,35(5):575-591
In this paper, we study constrained Markov control processes on Borel spaces with possibly unbounded one‐stage cost, under a discounted optimality criterion with random discount factor and restrictions of the same kind. We prove that the corresponding optimal control problem is equivalent to an infinite‐dimensional linear programming problem. In addition, considering the dual program, we show that there is no duality gap, and moreover, the strong duality condition holds. Hence, both programs are solvable, and their optimal values coincide. Copyright © 2013 John Wiley & Sons, Ltd. 相似文献
997.
Iñigo Gabilondo MD Elena H. Martínez‐Lapiscina MD Eloy Martínez‐Heras MSc Elena Fraga‐Pumar BO Sara Llufriu MD Santiago Ortiz MD Santiago Bullich PhD Maria Sepulveda MD Carles Falcon PhD Joan Berenguer MD Albert Saiz MD Bernardo Sanchez‐Dalmau MD Pablo Villoslada MD 《Annals of neurology》2014,75(1):98-107
998.
David F. Schneider MD MS Philip E. Sonderman BA Michaela F. Jones BS Kristin A. Ojomo MD Herbert Chen MD Juan C. Jaume MD Diane F. Elson MD Scott B. Perlman MD Rebecca S. Sippel MD 《Annals of surgical oncology》2014,21(13):4174-4180
Background
Persistent or recurrent hyperthyroidism after treatment with radioactive iodine (RAI) is common and many patiedlxnts require either additional doses or surgery before they are cured. The purpose of this study was to identify patterns and predictors of failure of RAI in patients with hyperthyroidism.Methods
We conducted a retrospective review of patients treated with RAI from 2007 to 2010. Failure of RAI was defined as receipt of additional dose(s) and/or total thyroidectomy. Using a Cox proportional hazards model, we conducted univariate analysis to identify factors associated with failure of RAI. A final multivariate model was then constructed with significant (p < 0.05) variables from the univariate analysis.Results
Of the 325 patients analyzed, 74 patients (22.8 %) failed initial RAI treatment, 53 (71.6 %) received additional RAI, 13 (17.6 %) received additional RAI followed by surgery, and the remaining 8 (10.8 %) were cured after thyroidectomy. The percentage of patients who failed decreased in a stepwise fashion as RAI dose increased. Similarly, the incidence of failure increased as the presenting T3 level increased. Sensitivity analysis revealed that RAI doses <12.5 mCi were associated with failure while initial T3 and free T4 levels of at least 4.5 pg/mL and 2.3 ng/dL, respectively, were associated with failure. In the final multivariate analysis, higher T4 (hazard ratio [HR] 1.13; 95 % confidence interval [CI] 1.02–1.26; p = 0.02) and methimazole treatment (HR 2.55; 95 % CI 1.22–5.33; p = 0.01) were associated with failure.Conclusions
Laboratory values at presentation can predict which patients with hyperthyroidism are at risk for failing RAI treatment. Higher doses of RAI or surgical referral may prevent the need for repeat RAI in selected patients. 相似文献999.
Rafael A. Casuso Emilio Martínez-López Fidel Hita-Contreras Irene Ruiz-Cazalilla David Cruz-Díaz Antonio Martínez-Amat 《Journal of Sports Science and Medicine》2014,13(4):958-963
The aim of the present study is to test the hypothesis that sprint swimming performance is enhanced by in-water passive recovery (IN) after sprint swimming bouts in well-trained adolescent swimmers. Using a randomized crossover study design, twelve well-trained adolescent swimmers performed two tests at the swimming pool after preliminary testing. They performed 5 bouts of 100m all-out swimming separated by 5 minutes of passive rest. Their individual in- or out-of-water passive recovery condition was randomized on the first day. In their second visit to the swimming pool the opposite recovery condition was indicated. More than 60% of the subjects which rested in-water were faster in the 5th bout when compared to the OUT group. However, no significant differences were found in blood lactate when IN and OUT were compared. After the first bout peak heart rate (HR peak) was lower in subsequent bouts for IN recovery when compared with OUT (p < 0.001). Thus, coaches and researchers should take into account that IN passive recovery may decrease loss of performance and diminish HR peak during sprint swimming bouts. This is particularly important given the use that many coaches give to HR as a tool in daily training.
Key points
- In-water passive recovery minimizes the loss of performance during high intensity swimming
- Maximal HR is significantly reduced by in-water recovery
- Coaches should take this information into account when using HR to control swimming intensity
- Future research should study long-term effects induced by in-water passive recovery
1000.
Joaquin Calatayud Sebastien Borreani Juan C. Colado Fernando F Martín Michael E. Rogers David G. Behm Lars L. Andersen 《Journal of Sports Science and Medicine》2014,13(3):502-510
The purpose of this study was to analyze upper extremity and core muscle activation when performing push-ups with different suspension devices. Young fit male university students (n = 29) performed 3 push-ups each with 4 different suspension systems. Push-up speed was controlled using a metronome and testing order was randomized. Average amplitude of the electromyographic root mean square of Triceps Brachii, Upper Trapezius, Anterior Deltoid, Clavicular Pectoralis, Rectus Abdominis, Rectus Femoris, and Lumbar Erector Spinae was recorded. Electromyographic signals were normalized to the maximum voluntary isometric contraction (MVIC). Electromyographic data were analyzed with repeated-measures analysis of variance with a Bonferroni post hoc. Based upon global arithmetic mean of all muscles analyzed, the suspended push-up with a pulley system provided the greatest activity (37.76% of MVIC; p < 0.001). Individually, the suspended push-up with a pulley system also provided the greatest triceps brachii, upper trapezius, rectus femoris and erector lumbar spinae muscle activation. In contrast, more stable conditions seem more appropriate for pectoralis major and anterior deltoid muscles. Independent of the type of design, all suspension systems were especially effective training tools for reaching high levels of rectus abdominis activation.
Key Points
- Compared with standard push-ups on the floor, suspended push-ups increase core muscle activation.
- A one-anchor system with a pulley is the best option to increase TRICEP, TRAPS, LUMB and FEM muscle activity.
- More stable conditions such as the standard push-up or a parallel band system provide greater increases in DELT and PEC muscle activation.
- A suspended push-up is an effective method to achieve high muscle activity levels in the ABS.