ABSTRACT
Red blood cell distribution width (RDW) has been shown to have prognostic value in a number of different clinical settings, such as cardiovascular disease, including heart failure. However, its prognostic value in heart transplant (HT) recipients remains unknown. The aim of this systematic review is to determine the prognostic value of pre-transplant RDW for mortality in HT recipients. There is a pre-published protocol of this review. The terms "Heart transplant", "Red cell distribution width" and their synonyms were used in the search strategy. PubMed/Medline, Embase, Scopus, Web of Science and LILACS were searched until May 17th, 2022, without date or language restrictions. Two authors independently carried out the selection, first by title and abstract, second by full-text revision. Discrepancies were discussed and resolved with three other authors. Quality of individual studies was assessed with Newcastle Ottawa Scale (NOS) for cohorts. After removing the duplicates, 3885 articles were identified. Four articles were included in the qualitative synthesis. Three studies were classified as "good quality": whereas one as "poor quality" according to NOS scale. All the included articles evaluated long-term mortality and one study also evaluated short-term mortality. In this one, a correlation between higher RDW values and short-term mortality was reported. Meanwhile, in all the studies, a high pre-HT RDW was a marker of long-term mortality following cardiac transplantation. Our review shows that an elevated on-admission RDW is associated with long-term mortality in heart transplantation recipients.
Subject(s)
Heart Failure , Heart Transplantation , Humans , Erythrocyte Indices , Prognosis , ErythrocytesABSTRACT
Objetivo: Evaluar factores asociados a la efectividad de la safenectomía parcial (SP) y total (ST) en pacientes intervenidos en el Hospital Militar Central (HMC) "Luis Arias Schreiber" durante el año 2017. Materiales y métodos: Estudio transversal. Se evaluaron historias clínicas de pacientes operados por insuficiencia venosa periférica en el HMC durante el periodo de enero - diciembre del año 2017. Se evaluaron variables como edad, género, comorbilidades (diabetes tipo 2, hipertensión arterial y obesidad), tiempo de enfermedad (en años), ubicación quirúrgica, tiempo operatorio, presencia de complicaciones (hematoma, infección de sitio operatorio y lesión del nervio safeno), días de hospitalización y mejoría clínica referida. Se buscó asociación entre estas variables y el tipo de safenectomía realizada (SP o ST) mediante la prueba de Chi cuadrado, prueba exacta de Fisher, razones de prevalencias (RP) y U de Mann- Whitney. Adicionalmente se evaluaron factores asociados a la lesión del nervio safeno en el grupo de ST, mediante regresión logística. Resultados: Se evaluaron 107 historias clínicas, 43 personas se sometieron a SP (40,2%) y 64 a ST (59.8%), con una mediana de edad de 58 años, en su mayor parte varones (64,5%). No hubo diferencias significativas entre las características clínico-epidemiológicas prequirúrgicas y el tipo de cirugía a la que se sometieron. Se encontró una menor proporción de complicaciones posoperatorias (RP (IC95%): 0,06 (0,01- 0,22)), lesión del nervio safeno (RP (IC95%): 0,02 (0,00-0,19)) y días de hospitalización (p<0,05) en los pacientes con SP. Conclusión: pacientes con SP presentaron mejores desenlaces posoperatorios (frecuencia de complicaciones posoperatorias, lesión del nervio safeno y días de hospitalización) en comparación con los que recibieron ST. Futuros estudios deberían estudiar las posibles variables intervinientes en estos desenlaces.
Objective: To assess associated factors for the effectiveness of partial (PS) and total (TS) saphenectomy performed in patients from the Luis Arias-Schereiber Central Military Hospital (CMH) during 2017. Materials and methods: This is a cross-sectional study. Clinical records from CMH patients who underwent surgery because of peripheral venous insufficiency from January to December 2017 were reviewed. The following variables were assessed: age, gender, comorbidities (type 2 diabetes, high blood pressure, and obesity), time with the disease (in years), surgical location, operative time, occurrence of complications (hematoma, operative site infection, and saphenous nerve lesion), days of hospital stay, and declared clinical improvement. Associations amongst these variables and the type of performed saphenectomy (PS or TS) were sought for by using the Chi-square test, Fisher's exact test, prevalence rates (PR), and the Mann-Whitney U test. Also, factor associated to a lesion in the saphenous nerve were assessed in the TS group using logistic regression. Results: One-hundred and seven clinical records were reviewed, 43 persons underwent PS (40.2%) and 64 underwent TS (59.8%), their mean age was 58 years, and nearly two-thirds of all patients were male (64.5%). There were no significant differences with respect to presurgical clinical and epidemiological characteristics and the type of surgical procedure performed. There were low rates of postoperative complications (PR (95% CI): 0.06 (0.01- 0.22)), saphenous nerve lesions (PR (95% CI): 0.02 (0.00-0.19)), and days hospitalized (p<0.05) in patients who underwent PS. Conclusion: Patients who underwent PS had better postoperative outcomes (frequency of postoperative complications, saphenous nerve lesions and hospitalization days) compared to those who had undergone TS. Future studies should assess the variables that might lead to these outcomes.
ABSTRACT
Introducción: En la mayoría de casos de Tuberculosis Pulmonar (TBC) el tratamiento farmacológico es la primera opción terapéutica. Sin embargo, con la emergencia de los casos de Tuberculosis Multidrogoresistente (TB MDR) y Extensamente Resistente (TB XDR), la resección quirúrgica se ha convertido en una opción terapéutica para lograr la conversión de pacientes con BK positivo de forma persistente. El objetivo principal de este estudio es determinar cuáles son los Resultados del Tratamiento Quirúrgico de la Tuberculosis Pulmonar Activa y sus Formas Secuelares en el Hospital Nacional Edgardo Rebagliati Martins entre Enero 2005 y Diciembre 2010. Materiales y Métodos: Estudio descriptivo, transversal. Entre Enero del 2005 y Diciembre del 2010 fueron operados 71 pacientes con lesiones secuelares, TB MDR y TB XDR. Mediante el uso de frecuencias y porcentajes se estudiaron las características epidemiológicas de los pacientes, características clínicas, técnica quirúrgica, complicaciones postoperatorias y mortalidad en este grupo de pacientes. Resultados: La intervención quirúrgica realizada a la gran mayoría de los pacientes fue la Lobectomía (n=63; 88.7 por ciento), seguido por un número menor de Neumonectomías (n=6; 8.5 por ciento). La lesión que se presenta con más frecuencia es la del lóbulo superior derecho (n=41; 57.7 por ciento), seguido de la lesión en el lóbulo superior izquierdo (n=ll; 15.5 por ciento). En los casos con TBC activa (n=ll) se logró conversión del BK en 72.7 por ciento (n=8). Se encontraron complicaciones en el 45 por ciento de los casos (n=32). La complicación quirúrgica más frecuente fue la infección de herida operatoria que se presentó en el 28.2 por ciento de los casos (n=20). La tasa de mortalidad fue de 4.2 por ciento. Conclusiones: La intervención quirúrgica es una buena opción de tratamiento con un porcentaje de curación mayor al 70 por ciento y un porcentaje bajo de complicaciones y mortalidad postoperatorias; en pacientes TB MDR/XDR...
Introduction: In most cases of pulmonary tuberculosis (TB) drug therapy is the first treatment option. However, with increasing cases Multidrug-resistant tuberculosis (MDR TB) and extensively drug-resistant tuberculosis (XDR TB). Surgical resection has become a therapeutic option for achieving the conversion of patients with persistent positive BK. The main objective of this study is to identify the results of the Surgical Treatment of Active Pulmonary Tuberculosis and its Sequelae Forms in Edgardo Rebagliati Martins Hospital from January 2005 to December 2010. Materials and Methods: A descriptive, cross-sectional study. Between January 2005 and December 2010, 71 patients were operated with bronchiectasis, MDR TB and XDR TB. By using frequencies and percentages epidemiological characteristics of patients, clinical characteristics, surgical technique, postoperative complications and mortality in this group of patients were studied. Results: The surgical procedure most commonly performed was lobectomy (n=63; 88.7 per cent), followed by a smaller number of pneumonectomy (n=6; 8.5 per cent). The injury that occurs most frequently is in right upper lobe (n=41; 57.7 per cent), in 45 per cent of cases (n=32) were found. The most common surgical complication was wound infection that occurred in 28.2 per cent of cases (n=20). The mortality rate was 4.2 per cent. Conclusions: Surgery is a good option to treatment with a higher cure rate of 70 per cent and a low incidence of postoperative complications and mortality; in patients whit MDR/XDR TB and bronchiectasis post TB.
