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1.
Port J Card Thorac Vasc Surg ; 30(4): 59-62, 2024 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-38345879

RESUMO

Q fever is an ubiquitous zoonosis caused by Coxiella burnetii, an intracellular bacterium that can produce acute or chronic infections in humans. These forms are characterized by different evolution, serological profile and treatment that must be very long to achieve a cure in chronic forms. However, the serological profile for diagnosis and the real value of serology for predicting outcome are controversial, and management dilemmas for many patients with Q fever infection are continuously emerging. In this case report, we present a 20-year-old man from Nicaragua who worked as a farmer with a culture-negative infective endocarditis who presented with a mycotic aneurysm. The present report reviews the clinical presentation and diagnosis of Q fever IE.


Assuntos
Aneurisma Infectado , Coxiella burnetii , Endocardite , Aneurisma Intracraniano , Febre Q , Masculino , Humanos , Adulto Jovem , Adulto , Febre Q/complicações , Aneurisma Infectado/diagnóstico , Aneurisma Intracraniano/complicações
2.
J Thorac Cardiovasc Surg ; 165(2): 609-617.e7, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-33712230

RESUMO

OBJECTIVES: Long-term real-world outcomes are critical for informing decisions about biological (Bio) or mechanical (Mech) prostheses for aortic valve replacement, particularly in patients aged between 50 and 65 years. The objective was to compare long-term survival and major adverse cardiac and cardiovascular events (ie, stroke, reoperation, and major bleeding) within this population. METHODS: This was a multicenter observational study including all patients aged between 50 and 65 years who underwent an aortic valve replacement because of severe isolated aortic stenosis between the years 2000 and 2018. A total of 5215 patients from 27 Spanish hospitals were registered with a follow-up of 15 years. Multivariable analyses, including a 2:1 propensity score matching (1822 Mech and 911 Bio) and competing risks analyses were applied. RESULTS: Bio prostheses were implanted in 19% of patients (n = 992). No significant differences were observed between matched groups in long-term survival (hazard ratio [HR], 1.14; 95% confidence interval [CI], 0.88-1.47; P = .33). Stroke rates were higher for Mech prostheses, but not significant (HR, 0.72; 95% CI, 0.50-1.03; P = .07). Finally, higher rates of major bleeding were found in the Mech group (HR, 0.65; 95% CI, 0.49-0.87; P = .004), whereas reoperation was more frequent among the Bio group (HR, 3.04; 95% CI, 1.80-5.14; P < .001). Bio prostheses increased from 13% in the period from 2000 to 2008 to 24% in 2009 to 2018. CONCLUSIONS: Long-term survival was comparable among groups in patients between 50 and 65 years of age. Mech prostheses were associated with a higher risk of major bleeding, whereas Bio prostheses entailed higher reoperation rates. Bio prostheses seem a reasonable choice for patients between 50 and 65 years in Spain.


Assuntos
Bioprótese , Implante de Prótese de Valva Cardíaca , Próteses Valvulares Cardíacas , Acidente Vascular Cerebral , Humanos , Pessoa de Meia-Idade , Idoso , Valva Aórtica/cirurgia , Implante de Prótese de Valva Cardíaca/efeitos adversos , Resultado do Tratamento , Bioprótese/efeitos adversos , Próteses Valvulares Cardíacas/efeitos adversos , Acidente Vascular Cerebral/etiologia , Hemorragia/etiologia , Reoperação/efeitos adversos , Estudos Retrospectivos
3.
Port J Card Thorac Vasc Surg ; 30(3): 71-75, 2023 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-38499024

RESUMO

Coronary artery stent infection (CSI) is one of the rarest complications associated with the percutaneous coronary intervention (PCI), usually requiring surgical intervention. Reaching and confirming the diagnosis remains the most challenging aspect of this complication. We describe a case of drug-eluting stents (DES) infection after several repeated procedures of primary angioplasty and stent implantation in the context of myocardial infarction. In the current era of growth of coronary stent implantation, it's important for clinicians to consider and to prevent such potentially fatal events. The diagnosis process remains difficult and requires the association of multiple clinical, biological and imaging parameters. Although medical treatment may be the only possible approach in some cases, we present a clinical case where surgical treatment was successful.


Assuntos
Stents Farmacológicos , Infarto do Miocárdio , Intervenção Coronária Percutânea , Humanos , Intervenção Coronária Percutânea/efeitos adversos , Resultado do Tratamento , Stents/efeitos adversos , Stents Farmacológicos/efeitos adversos , Infarto do Miocárdio/etiologia
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