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J Barba J A Gómez A C Abecia I Iglesias C Díaz A Pellicelli D Lozano J Herreros R Llorens D Martínez Caro 《Revista espa?ola de cardiología》1992,45(10):652-656
In acute cardiac rejection, left ventricular diastolic function is altered. To study these abnormalities and their utility in cardiac allograft rejection, we studied 56 cardiac transplant recipients. All patients were assessed with endomyocardial biopsy and Doppler echocardiography done in the same day. A total of 163 Doppler studies were recollected. Cardiac transplant recipients were excluded during the early 6 weeks postoperative period. Totally, 100 biopsies were normal, 48 positive for mild rejection (Billingham Gde I-II) and 15 positive for moderate or severe rejection (Billingham Gde III-IV). Compared to negative biopsies, during acute rejection left ventricular wald thickness significantly increased (p < 0.05); isovolumic relaxation period and pressure half-time significantly decreased (p < 0.05, p < 0.001 respectively). Nevertheless, increase in peak early mitral flow velocity was only significantly associated with severe rejection (p < 0.001). Correlating only progressive shortening of isovolumic relaxation period parameter in the diagnosis of graft rejection, we forward a high sensibility (85%) and low specificity (57%). Thus, Doppler echocardiographic evaluation of left ventricular diastolic function provides a non-invasive tool for early detection of acute rejection monitoring after the early postoperative period. 相似文献
3.
Ana T Timóteo Miguel Mendes Carlos T Aguiar Ana Barba?a Ricardo Seabra-Gomes 《Revista portuguesa de cardiologia》2004,23(12):1519-1530
BACKGROUND: The exercise test has a recognized lower risk of complications when used in the general population and in coronary artery diseased patients, but from a theoretical point of view should have a higher rate of complications when performed in patients with chronic heart failure (CHF). AIMS: To characterize and assess the type and incidence of complications during cardiopulmonary stress test (CPX) in patients with depressed left ventricular systolic function in comparison with a group of patients and individuals with normal function. METHODS: Retrospective analysis of the 334 consecutive CPX performed for risk stratification in 198 patients with a left ventricular ejection fraction below 40% (Group A) and 180 consecutive CPX performed in 78 subjects with normal function (Group B). The two groups were compared with respect to demographic data, CPX parameters and specific complications. Results: Major complications during the tests occurred only in 14 tests of Group A (4.2%, p = 0.012). Non-sustained ventricular tachycardia, <6 beats, occurred in 7 group A and 2 group B tests. The absence of coronary artery disease was the only independent predictor for complications. CONCLUSIONS: Major CPX complications occurred only in patients with impaired left ventricular systolic function. Heart failure patients showed a low probability (around 4%) for complications during CPX, significantly higher and more severe than the risk in the group of patients with normal ventricular function, allowing us to recommend that CPX in patients with heart failure should be performed in a hospital setting under the supervision of a physician with specific training. 相似文献
4.
A Barba D Schena G C Chieregato A Riela G Brocco L A Scuro G Cavallini 《Dermatologica》1988,176(2):101-105
25 patients with chronic urticaria suspected to be of 'alimentary origin', were studied for a quantitative or qualitative deficiency of pancreatic enzyme secretion. All showed a normal fecal chymotrypsin excretion and 23/25 a normal bentiromide (PABA) and pancreolauryl test. In 2 females the urinary PABA and pancreolauryl tests were borderline pathological. This does not support the hypothesis that a pancreatic deficiency (of the kind which could be identified with the methods used) is associated with chronic urticaria in patients in whom improvement of urticaria occurs under a hydric or low antigenic diet. 相似文献
5.
The clinical efficacy and the safety of ciprofloxacin was studied in 92 patients (aged 26 to 83 years; mean 57.5 years) affected by urinary tract infections (UTI) and respiratory tract infections (RTI) suffering also with various liver diseases. Ciprofloxacin was given orally at different dose regimens: 500 mg b.i.d. (22 cases), 250 mg b.i.d. (20 cases), 500 mg s.i.d. (20 cases) for the treatment of UTIs; 500 mg b.i.d. (ten cases) and 250 mg b.i.d. (20 cases) for the treatment of RTIs. The doses were not correlated to the severity of the infections. Patients were treated for five to 15 days. All the bacteria isolated from sputum or urine before treatment were sensitive to ciprofloxacin (MIC range 0.015 mg/1 to 8 mg/1). The clinical and bacteriological responses were favourable in a high percentage of patients both for RTIs and UTIs, irrespective of the dose. Side effects were infrequent (7%) and mild (nausea, gastralgia, oral candidosis), never requiring the interruption of the treatment. No change in the blood chemistry tests was observed at any dose.Die klinische Wirksamkeit und Sicherheit von Ciprofloxacin wurde bei 92 Patienten (Alter 26 bis 83 Jahre, im Mittel 57,5 Jahre), die an verschiedenen Leberkrankheiten litten, bei interkurrent aufgetretenen Harnwegs- und Atemwegsinfektionen geprüft. Ciprofloxacin wurde in verschiedenen Dosierungen oral verabreicht. Zur Behandlung von Harnwegsinfektionen wurden Dosierungen von 500 mg zweimal täglich (22 Fälle), 250 mg zweimal täglich (20 Fälle) oder 500 mg in einer täglichen Einzeldosis (20 Fälle) verabreicht. Atemwegsinfektionen wurden mit zweimal täglich 500 mg (10 Fälle) oder mit zweimal täglich 250 mg (20 Fälle) behandelt. Die Dosen wurden nicht nach dem Schweregrad der Erkrankung gewählt. Die Behandlungsdauer betrug fünf bis 15 Tage. Alle aus Sputum oder Urin vor der Therapie isolierten Bakterien waren für Ciprofloxacin empfindlich (MHK-Werte 0,015 mg/l bis 8 mg/l). Bei einem hohen Prozentsatz der Patienten mit Atemwegs- und Harnwegsinfektionen wurden unabhängig von der Dosierung günstige klinische und bakteriologische Ergebnisse erzielt. Nebenwirkungen traten selten auf (7%) und waren leicht (Übelkeit, Magenschmerzen, orale Candidiasis). Ein Therapieabbruch war in keinem Fall nötig. Bei keiner der angewandten Dosierungen waren Änderungen in den klinisch-chemischen Parametern festzustellen. 相似文献
6.
Thomas Barba Romain Fort Vincent Cottin Steeve Provencher Isabelle Durieu Sabine Jardel Arnaud Hot Quitterie Reynaud Jean-Christophe Lega 《Autoimmunity reviews》2019,18(2):113-122
Objective
Interstitial lung disease (ILD) is the most severe complication of idiopathic inflammatory myositis (IIM), resulting in significant increase in morbidity and mortality and for which the best treatment remains controversial. We conducted a meta-analysis to evaluate the efficacy of therapies used for the management of IIM-related ILD.Methods
Studies were selected from MEDLINE up to July 2017. Two investigators independently extracted data on study design, patient characteristics, clinical features, treatment, follow-up and outcomes. Global survival rates and objectively confirmed lung function improvements were extracted as the main outcome for rapidly progressive IIM-related ILD (RP-ILD) and chronic forms of ILD (C-ILD), respectively, and pooled using the weighted mean proportion with fixed or random-effects models in case of significant heterogeneity (I2?>?50%).Results
Twenty-seven studies encompassing 553 patients (male: 30.5%, age: 53.5?±?5.5?years) were included in the meta-analysis. Globally, retrieved studies were of limited methodological quality (no controlled studies and only 2 prospective studies). Dermatomyositis (40%) and anti-tRNA synthetase syndrome (45%) were the most represented IIM subtypes. In C-ILD, functional improvement rates were 89.2% (95%CI 82.5–93.6; 7 studies, n?=?124) for corticosteroids alone, 80.7% (95%CI 49.6–94; 6 studies, n?=?38) for cyclosporine A, 64.1% (95%CI 46.3–78.7; 4 studies, n?=?32) for azathioprine, 86.2% (95%CI 61.5–96; 2 studies, n?=?23) for tacrolimus, 56.4% (95%CI 44–68.0; 8 studies, n?=?71) for cyclophosphamide, and 76.6% (95%CI 50.4–96.0; 2 studies, n?=?20) for rituximab. In RP-ILD, survival rates at 3?months were 51.7% (95%CI 24.2–78.1; 2 studies, n?=?11) for corticosteroids alone, 69.2% (95%CI 55.0–80.5; 8 studies, n?=?146) for cyclosporine A and 72.4% (95%CI 6.4–99.0, 2 studies, n?=?16) for cyclophosphamide.Conclusion
Despite aggressive immunosuppressive therapies, the short-term mortality of RP-ILD remains high. While immunosuppressive therapies are associated with significant functional improvements in most patients with C-ILD, substantial uncertainty remains about the best treatment strategy in the absence of good quality evidence. 相似文献7.
Massimiliano Valeriani Domenico Restuccia Vincenzo Di Lazzaro Domenica Le Pera Carmen Barba Pietro Tonali François Mauguiere 《Experimental brain research. Experimentelle Hirnforschung. Expérimentation cérébrale》1998,120(3):306-315
Brain electrical source analysis (BESA) of the scalp electroencephalographic activity is well adapted to distinguish neighbouring
cerebral generators precisely. Therefore, we performed dipolar source modelling in scalp medium nerve somatosensory evoked
potentials (SEPs) recorded at 1.5-Hz stimulation rate, where all the early components should be identifiable. We built a four-dipole
model, which was issued from the grand average, and applied it also to recordings from single individuals. Our model included
a dipole at the base of the skull and three other perirolandic dipoles. The first of the latter dipoles was tangentially oriented
and was active at the same latencies as the N20/P20 potential and, with opposite polarity, the P24/N24 response. The second
perirolandic dipole showed an initial peak of activity slightly earlier than that of the N20/P20 dipolar source and, later,
it was active at the same latency as the central P22 potential. Lastly, the third perirolandic dipole exaplaining the fronto-central
N30 potential scalp distribution was constantly more posterior than the first one. In order to evaluate the effect of an increasing
repetition frequency on the activity of SEP dipolar sources, we applied the model built from 1.5-Hz SEPs to traces recorded
at 3-Hz and 10-Hz repetition rates. We found that the 10-Hz stimulus frequency reduced selectively the later of the two activity
phases of the first perirolandic dipole. The decrement in strength of this dipolar source can be explained if we assume that:
(a) the later activity of the first perirolandic dipole can represent the inhibitory phase of a “primary response”; (b) two
different clusters of cells generate the opposite activities of the tangential perirolandic dipole. An additional finding
in our model was that two different perirolandic dipoles contribute to the centro-parietal N20 potential generation.
Received: 5 August 1997 / Accepted: 26 November 1997 相似文献
8.
9.
Carlos Solano Lourdes Vázquez Estela Giménez Rafael de la Cámara Eliseo Albert Montserrat Rovira Ildefonso Espigado Carmen M. Calvo Javier López-Jiménez María Suárez-Lledó Anabella Chinea Albert Esquirol Ariadna Pérez Aránzazu Bermúdez Raquel Saldaña Inmaculada Heras Ana J. González-Huerta Tamara Torrado Guiomar Bautista Montserrat Batlle Santiago Jiménez Carlos Vallejo Pere Barba María Á. Cuesta José L. Piñana David Navarro 《American journal of transplantation》2021,21(1):258-271
The net impact of cytomegalovirus (CMV) DNAemia on overall mortality (OM) and nonrelapse mortality (NRM) following allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains a matter of debate. This was a retrospective, multicenter, noninterventional study finally including 749 patients. CMV DNA monitoring was conducted by real-time polymerase chain reaction (PCR) assays. Clinical outcomes of interest were OM and NRM through day 365 after allo-HSCT. The cumulative incidence of CMV DNAemia in this cohort was 52.6%. A total of 306 out of 382 patients with CMV DNAemia received preemptive antiviral therapy (PET). PET use for CMV DNAemia, but not the occurrence of CMV DNAemia, taken as a qualitative variable, was associated with increased OM and NRM in univariate but not in adjusted models. A subcohort analysis including patients monitored by the COBAS Ampliprep/COBAS Taqman CMV Test showed that OM and NRM were comparable in patients in whom either low or high plasma CMV DNA threshold (<500 vs ≥500 IU/mL) was used for PET initiation. In conclusion, CMV DNAemia was not associated with increased OM and NRM in allo-HSCT recipients. The potential impact of PET use on mortality was not proven but merits further research. 相似文献
10.
Chamberlain M Kormanik P Barba D Saunders W Fuller B Shea W Smith D 《International journal of oncology》1997,11(1):199-205
Toxicity and safety study of concurrent carboplatin chemotherapy and iodine-125 (I-125) brachytherapy. I-125 brachy therapy has an established albeit limited role in surgically accessible recurrent gliomas. Carboplatin has anti-tumoral; activity against gliomas and demonstrated sensitization of tumor to radiotherapy. In 15 patients (age range 30-77 years; median 53) with recurrent glioblastoma multiforme, stereotactically placed catheters were afterloaded with I-125 sources. A median 50 Gy minimum treatment volume dose was delivered during a 100 h period in conjunction with continuous infusion carboplatin (100 mg/m(2)/20 h x 5). Tumor volumes ranged from 13 to 63 cm(3) (median, 32 cm(3)). Early complications included: headache (n=7), transient exacerbations of pre existing neurologic deficits (n=5), seizures (n=2), nausea/vomiting (n=2), myelosuppression (n=2) and a catheter site wound CSF leak (n=1). Late complications included: steroid dependency (n=10), carcinomatous meningitis in association with hydrocephalus (n=1) and radiation-induced necrosis requiring reoperation (n=6). All patients were evaluable with a median survival of 10 months. In 12 patients, best clinical and neuroradiographic response was stable disease all of whom died of recurrent tumor (local recurrence in 11; CSF dissemination in 1). In 3 patients best response was either complete (n=2) or partial (n=1) all of whom are alive with a median follow-up of 31 months. I-125 brachytherapy with concurrent carboplatin chemotherapy is associated with an acceptable level of toxicity, has anti-tumoral activity and warrants further investigation in carefully selected patients with recurrent gliomas. 相似文献