Percutaneous Occlusion of Vascular Malformations in Pediatric and Adult Patients: 20-Year Experience of a Single Center

OBJECTIVE: A case series on different vascular malformations (VM) treated with percutaneous occlusion in children and adults is presented. BACKGROUND: Percutaneous occlusion is usually the preferred treatment method for VM. Previous series have mostly focused on single types of devices and/or VM. METHODS: Retrospective analysis of all patients who underwent percutaneous occlusion of VM in a single center, from 1995 to 2014, excluding patent ductus arteriosus. Clinical and angiographic data, procedural details, implanted devices, and complications were assessed. Procedural success was defined as effective device deployment with none or minimal residual flow. Predictors of procedural failure and complications were determined by multivariate analysis. RESULTS: A total of 123 VM were intervened in 47 patients with median age of 12 years (25 days-76 years). The VM included 55 pulmonary arteriovenous fistulae, 39 aortopulmonary collaterals, 10 systemic venovenous collaterals, 8 peripheral arteriovenous fistulae, 5 Blalock-Taussig shunts, 4 coronary fistulae, and 2 Fontan fenestrations. The 143 devices used included 80 vascular plugs, 38 coils, 22 duct occluders, and 3 foramen ovale or atrial septal defect occluders. Median vessel size was 4.5 (2.0-16.0) mm and device/vessel size ratio was 1.4 (1.1-2.0). Successful occlusion was achieved in 118 (95.9%) VM, including three reinterventions. Four (3.3%) clinically relevant complications occurred, without permanent sequelae. Lower body weight was independently associated with procedural failure and complications. CONCLUSION: To our knowledge, this is the largest series on different VM occluded percutaneously in children and adults, excluding patent ductus arteriosus. Percutaneous occlusion was effective and safe, using different devices.info:eu-repo/semantics/publishedVersio

Selective ablating urologic cancers with cold atmospheric plasma

info:eu-repo/semantics/publishedVersio

Combinações entre cultivares, ambientes, preparo e cobertura do solo em características agronômicas de alface.

Objetivou-se identificar combinações entre cultivares, ambientes de cultivo e preparo e cobertura de solo capazes de melhorar o desempenho agronômico e aumentar a produtividade da cultura da alface em cultivo orgânico. A pesquisa foi conduzida na Universidade Federal do Acre, utilizando o delineamento experimental de blocos casualizados, com parcelas subdivididas para cada experimento (campo e casa de vegetação), com quatro repetições. Em cada experimento, três cultivares de alface (Simpson, Marisa e Vera), constituindo as sub-parcelas, foram sorteadas nas parcelas, representadas por quatro preparos e cobertura do solo (encanteiramento com cobertura de palha de arroz, polietileno prateado, solo descoberto e plantio direto). A produtividade comercial de alface foi de 12,3 t ha-1 em cultivo protegido e de 7,9 t ha-1 em campo. O cultivo protegido promoveu melhor desenvolvimento das plantas, caracterizado por maior massa da matéria fresca e seca da parte aérea, massa da matéria fresca comercial e melhor classificação comercial, além de promover bom desempenho agronômico e maior produtividade em qualquer um dos preparos de solo. As cultivares Simpson e Marisa apresentaram massa da matéria seca da parte aérea semelhante e superior à ‘Vera’, porém, o crescimento do caule da ‘Simpson’ foi elevado, caracterizando pendoamento precoce, fato que reduz sua qualidade comercial. As cultivares Marisa e Vera não alongaram o caule indicando serem tolerantes às condições ambientais de Rio Branco. A cobertura do solo com casca de arroz ou plástico prateado contribuiu para minimizar os efeitos climáticos prejudiciais ao cultivo da alface em campo. O plantio direto orgânico não diferiu do plantio em canteiro descoberto

Prognostic Power of Anaerobic Threshold Parameters in Patients with Transposition of the Great Arteries and Systemic Right Ventricle

INTRODUCTION: Both transposition of the great arteries (TGA) previously submitted to a Senning/Mustard procedure and congenitally corrected TGA (cc-TGA) have the systemic circulation supported by the morphological right ventricle, thereby rendering these patients to heart failure events risk. The aim of this study was to evaluate cardiopulmonary exercise test parameters for stratifying the risk of heart failure events in TGA patients. METHODS: Retrospective evaluation of adult TGA patients with systemic circulation supported by the morphological right ventricle submitted to cardiopulmonary exercise test in a tertiary centre. Patients were followed up for at least 1 year for the primary endpoint of cardiac death or heart failure hospitalisation. Several cardiopulmonary exercise test parameters were analysed as potential predictors of the combined endpoint and their predictive power were compared (area under the curve). RESULTS: Cardiopulmonary exercise test was performed in 44 TGA patients (8 cc-TGA), with a mean age of 35.1 ± 8.4 years. The primary endpoint was reached by 10 (22.7%) patients, with a mean follow-up of 36.7 ± 26.8 months. Heart rate at anaerobic threshold had the highest area under the curve value (0.864), followed by peak oxygen consumption (pVO2) (0.838). Heart rate at anaerobic threshold ≤95 bpm and pVO2 ≤20 ml/kg/min had a sensitivity of 87.5 and 80.0% and a specificity of 82.4 and 76.5%, respectively, for the primary outcome. CONCLUSION: Heart rate at anaerobic threshold ≤95 bpm had the highest predictive power of all cardiopulmonary exercise test parameters analysed for heart failure events in TGA patients with systemic circulation supported by the morphological right ventricle.info:eu-repo/semantics/publishedVersio

The future of selective oncology therapy applied to urological tumors - plasma medicine (preliminary results)

info:eu-repo/semantics/publishedVersio