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1.
J Cardiol ; 69(1): 308-313, 2017 01.
Artigo em Inglês | MEDLINE | ID: mdl-27372183

RESUMO

BACKGROUND: Adaptive servo-ventilation (ASV) at home has been used for patients with chronic heart failure. However, its effect on acute cardiogenic pulmonary edema (ACPE) is not clear. The aim of this study was to elucidate the effect of ASV use in the emergency room in patients with ACPE. METHODS: We enrolled 198 consecutive patients with ACPE. Eighty patients received standard therapies, such as oxygen inhalation and vasodilators (conventional therapy group), and 118 received ASV in addition to standard therapy (ASV therapy group). ASV was initiated in the emergency room immediately after diagnosis. The procedure was switched over from ASV to endotracheal intubation (ETI) when oxygenation was insufficient. RESULTS: The ETI rate in the ASV therapy group was significantly lower than that in the conventional therapy group (3% vs. 21%, p<0.01). The intensive care unit and/or high care unit length of stay in the ASV therapy group was also significantly shorter than that in the conventional therapy group (1.9±2.1 days vs. 5.3±6.8 days, p<0.01). Consequently, the hospitalization period in the ASV therapy group was shorter than that in the conventional therapy group (19.3±11.0 days vs. 26.3±16.6 days, p<0.01). CONCLUSION: In patients with ACPE, rapid introduction of ASV in the emergency room reduces the need for ETI and decreases the hospitalization period.


Assuntos
Tratamento de Emergência/métodos , Oxigenoterapia/métodos , Respiração com Pressão Positiva/métodos , Edema Pulmonar/terapia , Choque Cardiogênico/terapia , Doença Aguda , Idoso , Feminino , Humanos , Unidades de Terapia Intensiva/estatística & dados numéricos , Intubação Intratraqueal/métodos , Intubação Intratraqueal/estatística & dados numéricos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Edema Pulmonar/etiologia , Tempo para o Tratamento , Resultado do Tratamento
2.
J Med Ultrason (2001) ; 43(1): 141-3, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26703182

RESUMO

A 65-year-old male in the dilated phase of hypertrophic cardiomyopathy and with persistent atrial fibrillation was admitted to our hospital because of an episode of ventricular fibrillation following an appropriate shock from an implantable cardiac defibrillator (ICD). At admission, electrocardiography showed a normal sinus rhythm. He had complained of back pain 7 days after the ICD shock. Renal infarction was suspected, although computed tomography and magnetic resonance imaging could not be performed because of chronic renal failure and the presence of his ICD. We, therefore, used contrast-enhanced ultrasonography with a contrast agent to evaluate his acute kidney injury. This showed the left kidney contained a wedge-shaped area that was not enhanced by the contrast agent, indicating an area of infarction.


Assuntos
Meios de Contraste , Compostos Férricos , Infarto/diagnóstico por imagem , Ferro , Rim/irrigação sanguínea , Rim/diagnóstico por imagem , Óxidos , Idoso , Fibrilação Atrial/complicações , Fibrilação Atrial/diagnóstico por imagem , Dor nas Costas/diagnóstico por imagem , Dor nas Costas/etiologia , Eletrocardiografia , Humanos , Infarto/complicações , Falência Renal Crônica/complicações , Falência Renal Crônica/diagnóstico por imagem , Masculino , Ultrassonografia
3.
J Echocardiogr ; 13(4): 148-50, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26585959

RESUMO

We report a rare case of a hemodialysis patient with a calcified amorphous tumor (CAT) on both sides of the atrioventricular valve annulus. A 70-year-old female who had received hemodialysis for 23 years because of chronic glomerulonephritis presented to our hospital with acute heart failure. Echocardiography indicated the presence of mobile cardiac masses on the mitral valve and tricuspid valve annulus. We suspected the presence of a cardiac tumor or vegetation. The patient received 3 g/day sulbactam-ampicillin and 60 mg/day gentamicin. Surgery was performed on the 14th day after hospital admission. The patient underwent mitral valve replacement, tricuspid annuloplasty, and tumor resection. Based on the pathological findings, the cardiac tumor was diagnosed as a CAT.


Assuntos
Calcinose/diagnóstico por imagem , Neoplasias Cardíacas/diagnóstico por imagem , Idoso , Valva Aórtica , Ecocardiografia , Feminino , Próteses Valvulares Cardíacas , Humanos , Valva Mitral , Insuficiência da Valva Mitral , Valva Tricúspide , Insuficiência da Valva Tricúspide
4.
Cardiovasc Interv Ther ; 25(2): 65-71, 2010 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24122464

RESUMO

Recently, drug-eluting stent (DES) has been recommended as the first choice in those patients who need stent implantation in unprotected left main coronary artery (ULMCA) stenosis. However, the long-term safety and efficacy of this procedure is still controversial. The objective of this study was to evaluate the safety and efficacy of bare metal stent (BMS) implantation in ULMCA stenting in the DES era. We implanted BMS (mainly 4 mm-diameter) in large-sized ULMCA after December 2004 when DES became available. The results of BMS implantation (n = 19) were compared with those of DES implantation (n = 39). There was no significant difference between the 2 groups regarding age, gender and coronary risk factors. Emergency procedures were more frequently performed in the BMS group than in the DES group (53% vs. 26%, p = 0.08). The initial mortality was 10.5% (n = 2) in the BMS group and 2.6% (n = 1) in the DES group (p = 0.25). There was no stent thrombosis, Q-wave myocardial infarction or emergent bypass surgery in either group during their hospital stay. The restenosis rate was 0% (n = 45) in both groups, and the target vessel revascularization rate was 5.9% in the BMS group (1/17) and 2.6% (1/38) in the DES group (p = 0.53). Therefore, there were no statistically significant differences in outcomes between the two study groups. These results indicate that BMS implantation in a large-sized ULMCA may be a safe and effective treatment even in the DES era.

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