Pre-clinical Evolution of a Novel Transcatheter Bioabsorbable ASD/PFO Occluder Device

2022 ◽  
Author(s):  
Yuichi Matsuzaki ◽  
Darren P. Berman ◽  
Hirotsugu Kurobe ◽  
John M. Kelly ◽  
Ryuma Iwaki ◽  
...  
Keyword(s):  
Clinical Evolution ◽  
Occluder Device

scholarly journals FRI0495 FOLLOW UP OF INTERSTITIAL PNEUMONIA WITH AUTOIMMUNE FEATURES – THE EXPERIENCE OF ONE CENTRE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 846.3-846
Author(s):  
N. Madeira ◽  
M. Alvarenga Santos ◽  
L. Cunha Miranda ◽  
S. Clemente ◽  
S. Furtado
Keyword(s):  
Interstitial Pneumonia ◽  
Respiratory Symptoms ◽  
Interstitial Lung Diseases ◽  
European Respiratory Society ◽  
High Resolution Computed Tomography ◽  
Disease Evolution ◽  
Clinical Criteria ◽  
Clinical Evolution ◽  
Relative Decline

Background:Interstitial Lung Diseases (ILD) may present features suggesting an underlying autoimmune process, which seem to differentiate them from idiopathic interstitial pneumonias, although without fully meeting the classification criteria (CC) for a specific connective tissue disease. Different terms had been used to describe these conditions and, to reach a consensus, the European Respiratory Society/American Thoracic Society proposed the CC for an entity named Interstitial Pneumonia with Autoimmune Features (IPAF). Clinical evolution and prognosis of this entity are still poorly understood.Objectives:To evaluate clinical evolution and prognosis of a population of patients with IPAF.Methods:Retrospective analysis of clinical files of patients followed by the Pulmonology Department since 02/2012 until 06/2019, who met the CC for IPAF, regarding clinical, functional and radiological evolution. Patients were considered to have a progressive phenotype in 24±3 months from their 1stevaluation if they fulfil 1 of the 4 criteria: relative decline in FVC ≥10% predicted; relative decline in FVC ≥5–<10% predicted and worsened respiratory symptoms; relative decline in FVC ≥5–<10% predicted and increased extent of fibrosis on High-resolution Computed Tomography (HRCT); worsened respiratory symptoms and increased extent of fibrosis on HRCT.Results:22 (7.4%) of 296 ILD patients met IPAF CC. 59.0% were female with an age at the 1stevaluation of 66.7±12.4 years. They were all non-smokers (63.6%) or ex-smokers (36.4%). Serologic and morphologic criteria were both present in 21 (95.4%) and clinical criteria in 5 patients (22.7%). Antinuclear antibodies (ANA) were identified in 19, rheumatoid factor in 4, SSA in 3 and anti-Jo-1 in 1 patient. HRCT patterns were identified in 21 patients: 15 nonspecific interstitial pneumonia (NSIP), 5 organizing pneumonia (OP) and 2 lymphocytic interstitial pneumonia (LIP). One NSIP and 1 LIP identified on HRCT were confirmed by histopathology. Three patients had inflammatory arthritis and 2 had Raynaud’s phenomenon. Immunosuppressive therapy was introduced in most cases (18 patients, including systemic corticotherapy in 17, azathioprine in 4, mycophenolate mofetil in 1), azithromycin was prescribed in 2 patients and 3 remained without therapy. Regarding the follow up at 24±3 months from the 1stevaluation (3 patients were excluded due to too recent follow-up), 4 patients (18.2%) had progressive phenotype, 7 (31.8%) had a favourable evolution and 3 (13.6%) patients had died. During a follow-up of 31.1±19.8 months, this number rose to 6 patients (27.3%), all of them died by respiratory cause and had NSIP pattern. No differences were found in age, last FVC, therapy and time of disease evolution between those who died and the others.Conclusion:Our study showed that a small proportion of IPAF patients had a progressive phenotype and the NSIP pattern seemed to be a poor prognosis factor for survival.References:[1]Ito Y, Arita M, Kumagai S, et al. Serological and morphological prognostic factors in patients with interstitial pneumonia with autoimmune features. BMC Pulm Med 2017; 17:111 10.1186/s12890-017-0453-zDisclosure of Interests:None declared

Development and Validation of a New Scoring Tool to Evaluate the Clinical Evolution of Adult Patients with Nonsegmental Vitiligo

Dermatology ◽  
2021 ◽  
pp. 1-9
Author(s):  
María Luisa Peralta-Pedrero ◽  
Denisse Herrera-Bringas ◽  
Karla Samantha Torres-González ◽  
Martha Alejandra Morales-Sánchez ◽  
Fermín Jurado Santa-Cruz ◽  
...  
Keyword(s):  
Body Surface ◽  
Task Force ◽  
Intraclass Correlation ◽  
The Body ◽  
Response To Treatment ◽  
Similar Response ◽  
Clinical Evolution ◽  
Wide Range ◽  
Patient Reported ◽  
Extreme Groups

<b><i>Background:</i></b> Vitiligo has an unpredictable course and a variable response to treatment. Furthermore, the improvement of some vitiligo lesions cannot be considered a guarantee of a similar response to the other lesions. Instruments for patient-reported outcome measures (PROM) can be an alternative to measure complex constructions such as clinical evolution. <b><i>Objective:</i></b> The aim of this study was to validate a PROM that allows to measure the clinical evolution of patients with nonsegmental vitiligo in a simple but standardized way that serves to gather information for a better understanding of the disease. <b><i>Methods:</i></b> The instrument was created through expert consensus and patient participation. For the validation study, a prospective cohort design was performed. The body surface area affected was measured with the Vitiligo Extension Score (VES), the extension, the stage, and the spread by the evaluation of the Vitiligo European Task Force assessment (VETFa). Reliability was determined with test-retest, construct validity through hypothesis testing, discriminative capacity with extreme groups, and response capacity by comparing initial and final measurements. <b><i>Results:</i></b> Eighteen semi-structured interviews and 7 cognitive interviews were conducted, and 4 dermatologists were consulted. The instrument Clinical Evolution-Vitiligo (CV-6) was answered by 119 patients with a minimum of primary schooling. A wide range was observed in the affected body surface; incident and prevalent cases were included. The average time to answer the CV-6 was 3.08 ± 0.58 min. In the test-retest (<i>n</i> = 53), an intraclass correlation coefficient was obtained: 0.896 (95% CI 0.82–0.94; <i>p</i> &#x3c; 0.001). In extreme groups, the mean score was 2 (2–3) and 5 (4–6); <i>p</i> &#x3c; 0.001. The initial CV-6 score was different from the final one and the change was verified with VES and VETFa (<i>p</i> &#x3c; 0.05, <i>n</i> = 92). <b><i>Conclusions:</i></b> The CV-6 instrument allows patient collaboration, it is simple and brief, and it makes it easier for the doctor to focus attention on injuries that present changes at the time of medical consultation.

Trans-catheter closure of large PDA in adult patients with Amplatzer device: case series

2021 ◽  
pp. 1-4
Author(s):  
Zahra Khajali ◽  
Ata Firouzi ◽  
Homa Ghaderian ◽  
Maryam Aliramezany
Keyword(s):  
Ventricular Septal Defect ◽  
Patent Ductus Arteriosus ◽  
Septal Defect ◽  
Ductus Arteriosus ◽  
Diagnostic Methods ◽  
Adult Patients ◽  
Amplatzer Device ◽  
Occluder Device ◽  
Catheter Closure ◽  
Patent Ductus

Abstract Ductus arteriosus is a physiological structure if not closed after birth, may lead to many complications. Today, trans-catheter closure of patent ductus arteriosus with Occluder devices is the preferred method. Surgical ligation is used only in certain cases such as large symptomatic patent ductus arteriosus in very small infants and premature babies; unfavourable structure of the duct or economic considerations. In this article, we described haemodynamic and morphological characteristics of five patients with large patent ductus arteriosus which were occluded with Amplatzer device. From 23 January, 2010 to 31 July, 2018, five patients referred to our clinic with large patent ductus arteriosus and pulmonary arterial hypertension for further evaluation. After assessing them with various diagnostic methods, we decided to close defect with ventricular septal defect Occluder device. Patients aged 21–44 years and one of them was male. Ductus closure was successfully done with ventricular septal defect Occluder device. Closure was successful for all of them but in one case, whose device was embolized to pulmonary artery after 24 hr and he underwent surgery. Trans-catheter closure of large patent ductus arteriosus in adult patients with pulmonary hypertension is feasible. Despite the fact that complications may occur even with the most experienced hands, the ‘double disk’ Amplatzer ventricular septal defect muscular Occluder could be advantageous in this setting.

Cobra head deformity of atrial septal occluder: blessing in disguise

2020 ◽  
pp. 1-2
Author(s):  
Uma Devi Karuru ◽  
Saurabh Kumar Gupta
Keyword(s):  
Atrial Septal Defect ◽  
Left Atrial ◽  
Septal Defect ◽  
Atrial Septum ◽  
Right Atrial ◽  
Septal Occluder Device ◽  
Occluder Device ◽  
The Right

Abstract It is not uncommon to have prolapse of the atrial septal occluder device despite accurate measurement of atrial septal defect and an appropriately chosen device. This is particularly a problem in cases with large atrial septal defect with absent aortic rim. Various techniques have been described for successful implantation of atrial septal occluder in such a scenario. The essence of all these techniques is to prevent prolapse of the left atrial disc through the defect while the right atrial disc is being deployed. In this brief report, we illustrate the use of cobra head deformity of the device to successfully deploy the device across the atrial septum.

scholarly journals Left Atrial Appendage Closure in a Patient With a Patent Foramen Ovale Septal Occluder Device

2021 ◽  
Vol 3 (3) ◽  
pp. 508-511
Author(s):  
Omar Kousa ◽  
Toufik Mahfood-Haddad ◽  
Shantanu M. Patil ◽  
Himanshu Agarwal ◽  
Hussam Abuissa
Keyword(s):  
Left Atrial ◽  
Patent Foramen Ovale ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Foramen Ovale ◽  
Left Atrial Appendage Closure ◽  
Septal Occluder Device ◽  
Occluder Device

Clinical Evolution of Paracoccidioidomycosis in 38 Children and Teenagers

2006 ◽  
Vol 161 (2) ◽  
pp. 73-81 ◽  
Author(s):  
Maria Gorete dos Santos Nogueira ◽  
Gláucia Manzan Queiroz Andrade ◽  
Edward Tonelli
Keyword(s):  
Clinical Evolution
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