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1.
Ngai-Yin Chan Chi-Chung Choy Ho-Chuen Yuen Hoi-Fan Chow Ho-Fai Fong 《The Canadian journal of cardiology》2019,35(4):396-404
Background
Persistent iatrogenic atrial septal defect (iASD) is a common but poorly characterized complication after cryoballoon (CB) pulmonary vein isolation (PVI) procedures. We therefore investigate its prevalence, evolution, risk factors, and clinical outcomes in a prospective longitudinal study.Methods
A total of 108 patients (41 women, mean age 57 ± 11.3) underwent CB PVI for AF. Serial transesophageal echocardiography (TEE) was performed 9 months and then annually until 6 years after the procedure to study the characteristics of persistent iASD.Results
Persistent iASD occurred in 33 (30.6%) patients 9 months after CB PVI. Spontaneous closure of iASD was found in 6 (22.2%) and 3 (15.8%) patients 2 and 3 years after the procedures, respectively. No spontaneous closure was observed on 4, 5, and 6-year TEE follow-up. The projected long-term persistence rate of iASD after CB PVI was therefore 20% (30.6% × 0.778 × 0.842). Using multivariate logistic regression, a higher number of cryoapplications (≥ 2 minutes) was the only independent predictor of persistent iASD 9 months after CB PVI (odds ratio [OR] 1.207; 95% confidence interval [CI], 1.033-1.411, P = 0.018). Two (1.9%) patients with significantly larger iASD size than the others (long diameter 12.6 ± 0.8 vs 3.7 ± 1.5 mm, P < 0.001; short diameter 10.9 ± 0.2 vs 3 ± 1.1 mm, P < 0.001) required percutaneous closure because of exertional dyspnea and right ventricular enlargement. Over 129.7 patient-years follow-up, during which iASD persisted, there was no occurrence of neurologic events.Conclusions
Approximately one fifth of patients undergoing CB PVI will have permanently persistent iASD. Patients with defect sizes of greater than 10 mm may need percutaneous closure due to significant left-to-right shunting. 相似文献2.
ObjectiveThe purpose of this paper is to review the efficacy and safety profile in children treated with topical 0.03% Tacrolimus ointment for vernal keratoconjunctivitis in Middle East and to propose a treatment posology. According to recent studies, a complex non-IgE dependent mechanism plays a relevant role in the pathogenesis of vernal keratoconjunctivitis. Numerous cells and mediators have been found in the serum, conjunctiva and tears of patients with Vernal keratoconjunctivitis.DesignThis case series included 10 patients from a single centre, pediatric department of a tertiary hospital with active symptomatic vernal keratoconjunctivitis. All the patients had proliferative lesions and corneal involvement despite conventional medications, including topical steroids. All other medications, systemic and topical: steroids, antihistamines and cyclosporine, were unsuccessful. Patients were treated with topical 0.03% Tacrolimus ointment twice daily for 8 weeks and then once a day for the next two month followed by thrice a week for two months. The changes in symptoms and signs after treatment were evaluated, also the development of possible complications was assessed.ResultsThe results showed a significant reduction in signs and symptoms after 4 weeks of the treatment. Clinical resolution of giant papillae and corneal lesions were seen within eight weeks and no additional drug was required during that period, except tear substitutes. Treatment was continued for period of two months and then slowly reduced.ConclusionThe use of 0.03% Tacrolimus ointment is safe and effective in children refractory to conventional treatment of vernal keratoconjunctivitis even in high temperature climate as Middle East. Due to the effectiveness of the treatment, the dosage used may be proposed for conventional use. 相似文献
3.
Alessandro De Cassai Tommaso Tonetti Helmut Galligioni Carlo Ori 《Brazilian Journal of Anesthesiology》2019,69(1):95-98
Background and objective
Erector spinae plane block is a valid technique to provide simultaneously analgesia for combined thoracic and abdominal surgery.Case report
A patient underwent open esophagectomy followed by reconstructive esophagogastroplasty but refused thoracic epidural analgesia; a multi‐modal analgesia with a multiple erector spinae plane block was then planned. Three erector spinae plane catheters (T5 and T10 on the right side and T9 on the left side) for continuous analgesia were placed before surgery. During the first 48 h pain was never reported in the thoracic area but the patient reported multiple times to feel a pain well localized in epigastrium, but never localized in any other abdominal quadrant.Discussion
Erector spinae plane block is a valid technique to provide analgesia simultaneously for combined thoracic and abdominal surgery and could be a valid alternative strategy if the use of epidural analgesia is contraindicated. 相似文献4.
目的 探讨星状神经节阻滞 (stellate ganglion block,SGB)加服药物对偏头痛的治疗作用。方法 2 4 0例偏头痛患者按就诊顺序分为观察组与对照组 ,观察组接受 SGB治疗的同时 ,口服尼莫地平等药物。结果 观察组有效率达89.2 % ,高于对照组 (P<0 .0 5 ) ,其中治疗后完全无痛的病例 5 1.7% ,高于对照组 (P<0 .0 1) ,观察发现病程对于 SGB治疗偏头痛疗效影响较大 (P<0 .0 5 )。结论 SGB加服药物治疗偏头痛具有操作简单 ,起效快 ,疗效确切 ,副作用少等优点 ,值得临床推广应用。 相似文献
5.
目的总结锁骨下血管旁间隙臂丛神经阻滞麻醉的体会及效果。方法分析1997年以来行锁骨下血管旁间隙臂丛神经阻滞麻醉100例患者的临床资料。结果无1例出现并发症,麻醉效果佳。结论此法切实可取。 相似文献
6.
Key words axillary - block 相似文献
7.
S H Block 《The Journal of allergy and clinical immunology》1974,53(4):243-244
Cromolyn sodium, a recently introduced antiasthmatic medication, is known occasionally to produce maculopapular and urticarial rashes, and increased bronchospasm. A patient is reported with a previously unpublished side effect of this medication, i.e., severe nasal congestion. 相似文献
8.
mPEG表面修饰的PLGA嵌段共聚物的血液相容性评价 总被引:3,自引:0,他引:3
本实验室设计合成了三种不同LA/GA比例的mPEG修饰PLGA(PELGA,含15%mPEG),为了评价它们的血液相容性,我们以硅化玻璃试管为阴性对照,未硅化的试管为阳性对照,参照国际标准(ISO10993)和《中华人民共和国国家标准GB/T16886医疗器械生物学评价》方法进行了体外评价实验。试验包括溶血率实验,血小板黏附实验,动态凝血时间实验,凝血时间实验,血浆复钙时间实验和凝血酶原时间实验等综合评价指标。结果表明,合成材料具有优良的血液相容性,材料制成的纳米粒有望应用于静脉注射。 相似文献
9.
10.
Reliability of erector spinae oxygenation and blood volume responses using near-infrared spectroscopy in healthy males 总被引:1,自引:1,他引:1
The purpose of this investigation was to (1) describe the trends in oxygenation (OXY) and blood volume (BV) of the right and left paraspinal muscles during the Biering-Sorensen muscle endurance (BSME) test using near infrared spectroscopy (NIRS), and (2) assess the test-retest reliability of OXY and BV changes during the BSME in healthy males. Seventeen healthy males [age=28.4 (9.8) years, height=1.75 (0.05) m, body mass=82.7 (9.1) kg; mean (SD)] completed two BSME trials within 1 week. NIRS probes were placed bilaterally at lumbar 3. The test was performed with the subject in the prone position using the following protocol: 2 min baseline, BSME, and 4 min recovery. The delta and range values of OXY and BV were used for analysis. Acceptable intra-class correlations were observed for endurance time and all the NIRS variables at the point of fatigue and at each 10% segment of the BSME during the two trials. Bland-Altman plots confirmed the reproducibility of the bilateral NIRS responses of the paravertebral muscles. The BV responses were more reliable than the OXY responses during the two trials. The OXY and BV responses of the paravertebral muscles during static contractions can be measured reliably using NIRS. Future studies should focus primarily on BV for analysis. 相似文献