oalib

Publish in OALib Journal

ISSN: 2333-9721

APC: Only $99

Submit

Any time

2019 ( 151 )

2018 ( 320 )

2017 ( 346 )

2016 ( 360 )

Custom range...

Search Results: 1 - 10 of 181854 matches for " Rodrigo Renda de;Rueda "
All listed articles are free for downloading (OA Articles)
Page 1 /181854
Display every page Item
Perfil clínico-cirúrgico de pacientes operados por ruptura do septo interventricular pós-infarto do miocárdio
, Michel Pompeu Barros de Oliveira;Sá, Marcus Villander Barros de Oliveira;Barbosa, Caio Henrique;Silva, Niedjon Peixoto de Carvalho;Escobar, Rodrigo Renda de;Rueda, Fábio Gon?alves de;Silva, Frederico Pires Vasconcelos;Lima, Ricardo de Carvalho;
Revista Brasileira de Cirurgia Cardiovascular , 2010, DOI: 10.1590/S0102-76382010000300010
Abstract: objectives: to study clinical features, complications and in-hospital outcomes of patients operated for postinfarction ventricular septal rupture. methods: a retrospective study involving 21 patients between january/1996 and june/2009. all operations were performed at the division of cardiovascular surgery of complexo hospitalar huoc/procape. results: mean age of patients was 62.81 years (± 8.21), 61.9% (n = 13) were male. rupture occurred on average 4.8 days after infarction. cardiogenic shock was observed in 57.1% (n = 12), being risk factor for death (100% with shock vs. 22.2% without shock; p<0.001). survivors had a higher mean ejection fraction compared to deaths (66.29% ± 4.61% versus 42.71% ± 4.79%, p <0.001). all were classified as high risk by the euroscore, and the survivors had lower average score compared to deaths (6.57 ± 0.53 versus 10.93 ± 2.23; p <0.001). the majority (76.2%, n = 16) of the patients needed to use vasoactive drugs and 57.1% (n = 12) considered hemodynamically unstable. need for vasoactive drugs was a risk factor for death (81.3% with vasoactive drugs versus 20% without vasoactive drugs, p = 0.025). hemodynamic instability was also a risk factor for death (100% in the unstable group versus 22.2% in the stable group; p <0.001). the rate of in-hospital mortality was 66.7% (n = 14). conclusions: the need for vasoactive drugs, hemodynamic instability and cardiogenic shock were associated with higher rates of mortality. patients who had adverse outcomes had less ventricular function and higher score in the euroscore. mortality remains high
Estudo comparativo entre cirurgia de revasculariza??o miocárdica com e sem circula??o extracorpórea em mulheres
, Michel Pompeu Barros de Oliveira;Lima, Leonardo Pontual;Rueda, Fábio Gon?alves de;Escobar, Rodrigo Renda de;Cavalcanti, Paulo Ernando Ferraz;Thé, Emmanuel Callou da Silva;Escobar, Mozart Augusto Soares de;Lima, Ricardo de Carvalho;
Revista Brasileira de Cirurgia Cardiovascular , 2010, DOI: 10.1590/S0102-76382010000200018
Abstract: background: it has been well documented that women have higher morbidity and mortality rates than men following coronary artery bypass graft (cabg) surgery. in view of this evidence, it is necessary to know if there is benefit to off-pump cabg surgery in women in comparison to on-pump cabg. objectives: compare outcomes between off-pump cabg and on-pump cabg in women. methods: retrospective study. our investigation analyzes comparatively clinical profile, thirteen procedure complications and mortality of a population of 941 consecutive women undergoing cabg surgery (549 off-pump and 392 on-pump) at two hospitals for the period january 2000 to december 2005. results: mortality rate for women undergoing off-pump cabg surgery is lower than for women undergoing on-pump surgery, however, not statistically significant (3.1% vs 5.3%; p=0.134). the complication rates analyzed (hemorrhagic shock, neurologic, respiratory, acute renal failure, adult respiratory distress syndrome, septicemia, pneumonia, atrial fibrillation) were lower (significant statistically difference) for women off-pump than women on-pump, with the exception of low cardiac output and wound infection. conclusions: evidence suggests that off-pump cabg surgery may be better for women than on-pump cabg surgery because it appears to reduce morbimortality rates. ten of 13 complications investigated demonstrated an advantage for women undergoing off-pump surgery relative to those receiving on-pump surgery.
Mediastinite no pós-operatório de cirurgia cardiovascular: análise de 1038 cirurgias consecutivas
, Michel Pompeu Barros de Oliveira;Silva, Débora Oliveira;Lima, érika Nibbering de Souza;Lima, Ricardo de Carvalho;Silva, Frederico Pires Vasconcelos;Rueda, Fábio Gon?alves de;Escobar, Rodrigo Renda de;Cavalcanti, Paulo Ernando Ferraz;
Revista Brasileira de Cirurgia Cardiovascular , 2010, DOI: 10.1590/S0102-76382010000100008
Abstract: objective: to report the incidence of mediastinitis in cardiovascular surgery postoperation. methods: the records of all 1038 patients who underwent cardiovascular surgical procedures between may/2007 and june/2009 were reviewed. all operations were performed in division of cardiovascular surgery of pronto socorro cardiológico de pernambuco - procape. results: the complication occurred within, on average, 13 days after operation, in total of 25 (2.4%), eight (32%) deaths occurred. several risk factors mediastinitis were identified: 56% diabetes, 56% smokers, 20% obeses, 16% with chronic obstructive pulmonary disease and 8% of chronic renal failure. mediastinitis were reported in 21 (84%) cases of patients submitted to coronary artery bypass grafting, being associated to major risk of infection development (ic 3.448.30, p=0.0001). high rates of complications were observed: respiratory insufficiency (44%), stroke (16%), cardiogenic shock (12%), acute renal failure (28%), pulmonary infection (36%), multiple organs failure (16%) and esternal deiscence (48%). bacterial cultures of exudates were positive in 84% of patients; staphylococcus aureus was the most responsible pathogen (28.8%). conclusion: mediastinitis stays a serious surgical complication and difficult management in cardiovascular surgery postoperation. the disease stays with low incidence, but still with high lethality. coronary bypass was associated to major risk of infection development.
Validation of MagedanzSCORE as a predictor of mediastinitis after coronary artery bypass graft surgery
, Michel Pompeu Barros de Oliveira;Figueira, Evelyn Soares;Santos, Cecília Andrade;Figueiredo, Omar Jacobina;Lima, Renato Oliveira Albuquerque;Rueda, Fábio Gon?alves de;Escobar, Rodrigo Renda de;Soares, Alexandre Magno Macário Nunes;Lima, Ricardo de Carvalho;
Revista Brasileira de Cirurgia Cardiovascular , 2011, DOI: 10.5935/1678-9741.20110013
Abstract: objective: the aim of this study is to evaluate the applicability of a new score for predicting mediastinitis - magedanzscore - in patients undergoing coronary artery bypass graft (cabg) surgery in the division of cardiovascular surgery of pronto socorro cardiológico de pernambuco - procape. methods: retrospective study involving 500 patients operated between may/2007 and april/2010. the registers contained all the information used to calculate the magedanzscore. the outcome of interest was mediastinitis. we calculated sensitivity, specificity, positive predictive value, negative predictive value, concordance and accuracy. the accuracy of the model was evaluated by roc (receiver operating characteristic) curve. results: the incidence of mediastinitis was 5.6%, with a lethality rate of 32.1%. in univariate analysis, the five variables of the magedanzscore were predictors of postoperative mediastinitis: chronic obstructive pulmonary disease (or 6.42; 95.0% ci 2.76-14.96; p<0.001), obesity (or 3.06; 95.0% ci 1.32-7.09; p=0.009), surgical reintervention (or 82.40; 95.0% ci 30.40-223.30; p<0.001), multiple transfusion (or 3.33; 95.0% ci 1.52-7.29; p=0.003) and stable angina class iv or unstable (or 2.59; 95.0% ci 1.19-7.64; p=0.016) according to canadian cardiovascular society. the score had a sensitivity of 96.4%, specificity of 90.0%, positive predictive value of 36.5%, negative predictive value of 99.8% and 90.4% concordance. the accuracy measured by the area under the roc curve was 96.2% (95.0% ci 94.5%-97.9%). conclusions: the magedanzscore proved to be a simple and objective index, revealing a satisfactory predictor of development of postoperative mediastinitis in patients undergoing cabg surgery at our institution
Predictors of transfusion of packed red blood cells in coronary artery bypass grafting surgery
, Michel Pompeu Barros de Oliveira;Soares, Evelyn Figueira;Santos, Cecília Andrade;Figueiredo, Omar Jacobina;Lima, Renato Oliveira Albuquerque;Rueda, Fábio Gon?alves de;Escobar, Rodrigo Renda de;Soares, Alexandre Magno Macário Nunes;Lima, Ricardo de Carvalho;
Revista Brasileira de Cirurgia Cardiovascular , 2011, DOI: 10.5935/1678-9741.20110044
Abstract: objectives: finding predictors of blood transfusion may facilitate the most efficient approach for the use of blood bank services in coronary artery bypass grafting procedures. the aim of this retrospective study is to identify preoperative and intraoperative patient characteristics predicting the need for blood transfusion during or after cabg in our local cardiac surgical service. methods: 435 patients undergoing isolated first-time cabg were reviewed for their preoperative and intraoperative variables and analyzed postoperative data. patients were 255 males and 180 females, with mean age 62.01 ± 10.13 years. regression logistic analysis was used for identifying the strongest perioperative predictors of blood transfusion. results: blood transfusion was used in 263 patients (60.5%). the mean number of transfused blood products units per patient was 2.27 ± 3.07 (0-23) units. the total number of transfused units of blood products was 983. univariate analysis identified age >65 years, weight <70 kg, body mass index <25 kg/m2, hemoglobin <13mg/dl, hematocrit < 40% and ejection fraction <50%, use of cardiopulmonary bypass (cpb), not using an internal thoracic artery as a bypass, and multiple bypasses as significant predictors. the strongest predictors using multivariate analysis were hematocrit < 40% (or 2.58; ci 1.62-4.15; p<0.001), cpb use (or 2.00; ci 1.27-3.17; p=0.003) and multiple bypasses (or 2.31; ci 1.31-4.08; p=0.036). conclusions: the identification of these risk factors leads to better identification of patients with a grater probability of using blood, allocation blood bank resources and cost-effectiveness use of blood products.
Risk factors for mediastinitis after coronary artery bypass grafting surgery
, Michel Pompeu Barros de Oliveira;Soares, Evelyn Figueira;Santos, Cecília Andrade;Figueiredo, Omar Jacobina;Lima, Renato Oliveira Albuquerque;Escobar, Rodrigo Renda;Rueda, Fábio Gon?alves de;Lima, Ricardo de Carvalho;
Revista Brasileira de Cirurgia Cardiovascular , 2011, DOI: 10.1590/S0102-76382011000100008
Abstract: objective: mediastinitis is a serious complication of median sternotomy and is associated to significant morbidity and mortality. the aim of this study is to identify risk factors for mediastinitis in patients undergoing coronary artery bypass grafting (cabg), without the use of bilateral internal thoracic artery (ita), at the division of cardiovascular surgery of pronto socorro cardiológico de pernambuco - procape. methods: a retrospective study of 500 consecutive patients operated on between may 2007 and april 2010. ten preoperative variables, seven intraoperative variables and seven postoperative variables possibly involved in the development of postoperative mediastinitis were evaluated. univariate and multivariate logistic regression analyses were performed. results: the incidence of mediastinitis was 5.6% (n=28), with a lethality rate of 32.1% (n=9). in multivariate analysis using logistic regression, five variables remained as independent risk factors: obesity (or 2.60, 95% ci 1.11 to 6.68), diabetes (or 2.71, 95% ci 1.18 to 6.65), smoking (or 2.10, 95% ci 1.12 to 4.67), use of pedicled internal thoracic artery (or 5.17, 95% ci 1.45 to 18.42) and on-pump cabg (or 2.26, 95% ci 1.14 to 5.85). conclusion: this study identified the following independent risk factors for mediastinitis after cabg: obesity, diabetes, smoking, use of pedicled ita and on-pump cabg.
Mortalidade perioperatória em diabéticos submetidos à cirurgia de revasculariza??o miocárdica
, Michel Pompeu Barros de Oliveira;Soares, Evelyn Figueira;Santos, Cecília Andrade;Figueiredo, Omar Jacobina;Lima, Renato Oliveira Albuquerque;Escobar, Rodrigo Renda;Rueda, Fábio Gon?alves de;Lima, Ricardo de Carvalho;
Revista do Colégio Brasileiro de Cirurgi?es , 2012, DOI: 10.1590/S0100-69912012000100006
Abstract: objective: to investigate the risk factors for in-hospital death in diabetic patients undergoing isolated coronary artery bypass grafting (cabg). methods: we conducted a retrospective study with 305 consecutive diabetic patients undergoing cabg in the division of cardiovascular surgery of our institution from april 2004 to april 2010. univariate analysis for categorical variables was performed with the chi-square or fisher's exact test, as appropriate. potential risk factors with p <0.05 in the univariate analysis were included in the multivariate analysis, which was performed by backward logistic regression. values of p <0.05 were considered statistically significant. results: the study population had a mean age of 61.44 years (± 9.81) and 65.6% (n=200) were male. the in-hospital mortality rate was 11.8% (n=36). the following independent risk factors for death were identified: on-pump cabg (or 6.15, 95% ci 1.57 to 24.03, p=0.009) and low cardiac output in the postoperative period (or 34.17, 95% ci 10.46 to 111.62, p <0.001). the use of internal thoracic artery (ita) was an independent protective factor for death (or 0.27, 95% ci 0.08 to 0.093, p=0.038). conclusion: this study identified the following independent risk factors for death after cabg: on-pump cabg and low cardiac output syndrome. the use of ita was an independent protective factor.
Skeletonized left internal thoracic artery is associated with lower rates of mediastinitis in diabetic patients
, Michel Pompeu Barros de Oliveira;Soares, Evelyn Figueira;Santos, Cecília Andrade;Figueiredo, Omar Jacobina;Lima, Renato Oliveira Albuquerque;Escobar, Rodrigo Renda;Rueda, Fábio Gon?alves de;Ferraz, Paulo Ernando;Lima, Ricardo Carvalho;
Revista Brasileira de Cirurgia Cardiovascular , 2011, DOI: 10.1590/S0102-76382011000200007
Abstract: background: mediastinitis is a serious complication of median sternotomy and is associated to significant morbidity and mortality. diabetes is a feared risk factor for mediastinitis and viewed with caution by cardiovascular surgeons. objective: to identify risk factors for mediastinitis in diabetics undergoing cabg surgery with use of unilateral ita in the division of cardiovascular surgery of pronto socorro cardiológico de pernambuco - procape. methods: retrospective study of 157 diabetics operated between may 2007 and april 2010. nine preoperative variables, five intraoperative variables and seven postoperative variables possibly involved in the development of postoperative mediastinitis were evaluated. univariate and multivariate logistic regression analyses were applied. results: the incidence of mediastinitis was 7% (n=11), with a lethality rate of 36.1% (n=4). variables associated with increased risk of mediastinitis were: use of pedicled ita (or 8.25, 95% ci 2.03 to 66.10, p=0.016), postoperative renal complications (or 5.10, 95% ci 1.03 to 25.62, p=0.049) and re-operation (or 7.45, 95% ci 1.24 to 42.17, p=0.023). in multivariate analysis using backward logistic regression, only one variable remained as independent risk factor: use of pedicled ita (or 7.64, 95% ci 1.95 to 61.6, p=0.048), in comparison to skeletonized ita. conclusions: we suggest that diabetics should be considered for strategies to minimize risk of infection. in diabetics that undergo unilateral ita, the problem seems to be related to how ita is harvested. diabetics should always be considered for use of skeletonized ita.
EuroSCORE e mortalidade em cirurgia de revasculariza??o miocárdica no Pronto Socorro Cardiológico de Pernambuco
, Michel Pompeu Barros de Oliveira;Soares, Evelyn Figueira;Santos, Cecília Andrade;Figueredo, Omar Jacobina;Lima, Renato Oliveira Albuquerque;Escobar, Rodrigo Renda;Silva, Frederico Pires Vasconcelos;Lima, Ricardo de Carvalho;
Revista Brasileira de Cirurgia Cardiovascular , 2010, DOI: 10.1590/S0102-76382010000400010
Abstract: objective: the aim of this study is to evaluate the applicability of euroscore in patients undergoing coronary artery bypass graft (cabg) surgery at the division of cardiovascular surgery of pernambuco cardiologic emergency medical services - procape. methods: a retrospective study involving 500 patients operated between may 2007 and april 2010. the registers contained all the information used to calculate the euroscore. the outcome of interest was death. univariate analysis and multivariate analysis by backward logistic regression were applied to assess the association between each variable in the euroscore and deaths. the following parameters were calculated: sensitivity, specificity, positive predictive value, and negative predictive value. the power of concordance between the predicted mortality by the euroscore and the observed mortality was measured using the kappa coefficient. the accuracy of the model was evaluated by the roc (receiver operating characteristic) curve. results: the incidence of death was 13%. in multivariate analysis, nine variables remained independent predictors of death: chronic obstructive pulmonary disease, creatinine >2,3mg/dl, active endocarditis, preoperative critical state, unstable angina, ejection fraction 30% to 50%, acute myocardial infarction < 90 days, emergency surgery and additional surgery. the score had a sensitivity of 88.4%, specificity of 79.3%, positive predictive value of 40.7%, negative predictive value of 97.7% and 80.6% concordance. the accuracy measured by the area under the roc curve was 0.892 (95% ci 0.862-0.922). conclusions: the euroscore proved to be a simple and objective index, revealing a satisfactory discriminator of postoperative evolution in patients undergoing cabg surgery at our institution.
Risk of Second Solid Malignancy among 1000 Kidney Transplanted Patients: A Single Center Study  [PDF]
Michele L. Santangelo, Sergio Spiezia, Nicola Carlomagno, Concetta Dodaro, Cristina La Tessa, Davide De Rosa, Maria Pina Piantadosi, Andrea Renda
Open Journal of Organ Transplant Surgery (OJOTS) , 2012, DOI: 10.4236/ojots.2012.24011
Abstract: In this study we focus on kidney-transplanted patients in order to investigate the correlation between immunodeficiency (ID) induced by immunosuppressive treatments and the incidence of solid multiple primary malignancies (MPM). Material of study: From 1980 to 2010 we followed up 1000 kidney-transplanted patients (637M, 363F). This group was homogeneous for age, immunology (e.g. miss-match index), number of rejection events and for immunosuppressive therapy. Results: Out of 1000 kidney-transplanted patients we observed 70 patients (53M, 17F) with cancer disease and in 22 of them a multiple cancer has been found. Most of multiple cancer were synchronous and the association between cancer and rejection episodes were not significant. Discussion: In general population 1 out of 9 patients with a cancer would develop a second neoplasia during the course of his life, so, it would be logical to conclude that, from a merely theoretical and statistical point of view, long term transplanted patients potentially have a higher risk to develop MPM. But our series and literature review did not confirm it, probably because these patients die before the appearance of a second primary malignancy. Conclusions: Despite many observations regarding different types of tumors/pre-cancerous lesions and their increased incidence in ID patients and despite the fact that immune suppression is a predisposing factor for the multicancer syndrome, at least theoretically, nowadays there are no significant statistical data favouring a correlation between ID and MPM in kidney transplanted patients.
Page 1 /181854
Display every page Item


Home
Copyright © 2008-2017 Open Access Library. All rights reserved.