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Browsing by Issue Date, starting with "2021-11"

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  • Screw Away from Arteries, Please
    Publication . Correia, R; Garcia, A
    2021-11Journal article Open access Show more
  • Major Pulmonary Surgery in Patients with Compromised Lung Function
    Publication . Gonçalves Pereira, R; Branco, J; Narciso Rocha, F; Figueiredo, C; Costa, AR; Santos Silva, J; Eurico Reis, J; Calvinho, P
    Introduction: The risk stratification of lung resection is fundamentally based on the results of pulmonary function tests. In patients considered to be at risk, major surgery is generally denied, opting for potentially less curative therapies. Objective: To evaluate the postoperative outcomes of major lung surgery in a group of patients deemed high risk. Methods: We performed a retrospective review of clinical records of all patients submitted to lobectomy, bilobectomy or pneumonectomy in a 3-year period in a reference Thoracic Surgery Unit. The patients were then divided in two groups: group A composed of patients with normal preoperative pulmonary function and group B which included patients with impaired lung function, defined as FEV1 and/or DLCO ≤60%. Results: A total of 234 patients were included, 181 (77.4%) in group A and 53 (22.6%) in group B. In group B, patients had more smoking habits, were more often associated with chronic obstructive pulmonary disease and were also more frequently submitted to thoracotomy. When surgery was motivated by primary lung cancer this group had a more advanced clinical stage of the disease. In the postoperative period, these patients had longer hospital stay, longer chest drainage time and greater need for oxygen therapy at home, however, no statistically significant difference was noted in morbidity or mortality. Conclusions: Major thoracic surgery can be safely performed in selected patients considered to be high risk for resection by pulmonary function tests. A potentially curative surgery should not be denied based on respiratory function tests alone.
    2021-11Journal article Open access Show more
  • Characteristics and Outcomes of Patients With Cerebral Venous Sinus Thrombosis in SARS-CoV-2 Vaccine–Induced Immune Thrombotic Thrombocytopenia
    Publication . Sánchez van Kammen, M; Aguiar de Sousa, D; Poli, S; Cordonnier, C; Heldner, M; van de Munckhof, A; Krzywicka, K; van Haaps, T; Ciccone, A; Middeldorp, S; Levi, M; Kremer Hovinga, J; Silvis, S; Hiltunen, S; Mansour, M; Arauz, A; Barboza, M; Field, T; Tsivgoulis, G; Nagel, S; Lindgren, E; Tatlisumak, T; Jood, K; Putaala, J; Ferro, J; Arnold, M; Coutinho, J; Sharma, A; Elkady, A; Negro, A; Günther, A; Gutschalk, A; Schönenberger, S; Buture, A; Murphy, S; Paiva Nunes, A; Tiede, A; Puthuppallil Philip, A; Mengel, A; Medina, A; Hellström Vogel, Å; Tawa, A; Aujayeb, A; Casolla, B; Buck, B; Zanferrari, C; Garcia-Esperon, C; Vayne, C; Legault, C; Pfrepper, C; Tracol, C; Soriano, C; Guisado-Alonso, D; Bougon, D; Zimatore, D; Michalski, D; Blacquiere, D; Johansson, E; Cuadrado-Godia, E; De Maistre, E; Carrera, E; Vuillier, F; Bonneville, F; Giammello, F; Bode, F; Zimmerman, J; d’Onofrio, F; Grillo, F; Cotton, F; Caparros, F; Puy, L; Maier, F; Gulli, G; Frisullo, G; Polkinghorne, G; Franchineau, G; Cangür, H; Katzberg, H; Sibon, I; Baharoglu, I; Brar, J; Payen, JF; Burrow, J; Fernandes, J; Schouten, J; Althaus, K; Garambois, K; Derex, L; Humbertjean, L; Lebrato Hernandez, L; Kellermair, L; Morin Martin, M; Petruzzellis, M; Cotelli, M; Dubois, MC; Carvalho, M; Wittstock, M; Miranda, M; Skjelland, M; Bandettini di Poggio, M; Scholz, M; Raposo, N; Kahnis, R; Kruyt, N; Huet, O; Sharma, P; Candelaresi, P; Reiner, P; Vieira, R; Acampora, R; Kern, R; Leker, R; Coutts, S; Bal, S; Sharma, S; Susen, S; Cox, T; Geeraerts, T; Gattringer, T; Bartsch, T; Kleinig, T; Dizonno, V; Arslan, Y
    Importance: Thrombosis with thrombocytopenia syndrome (TTS) has been reported after vaccination with the SARS-CoV-2 vaccines ChAdOx1 nCov-19 (Oxford-AstraZeneca) and Ad26.COV2.S (Janssen/Johnson & Johnson). Objective: To describe the clinical characteristics and outcome of patients with cerebral venous sinus thrombosis (CVST) after SARS-CoV-2 vaccination with and without TTS. Design, setting, and participants: This cohort study used data from an international registry of consecutive patients with CVST within 28 days of SARS-CoV-2 vaccination included between March 29 and June 18, 2021, from 81 hospitals in 19 countries. For reference, data from patients with CVST between 2015 and 2018 were derived from an existing international registry. Clinical characteristics and mortality rate were described for adults with (1) CVST in the setting of SARS-CoV-2 vaccine-induced immune thrombotic thrombocytopenia, (2) CVST after SARS-CoV-2 vaccination not fulling criteria for TTS, and (3) CVST unrelated to SARS-CoV-2 vaccination. Exposures: Patients were classified as having TTS if they had new-onset thrombocytopenia without recent exposure to heparin, in accordance with the Brighton Collaboration interim criteria. Main outcomes and measures: Clinical characteristics and mortality rate. Results: Of 116 patients with postvaccination CVST, 78 (67.2%) had TTS, of whom 76 had been vaccinated with ChAdOx1 nCov-19; 38 (32.8%) had no indication of TTS. The control group included 207 patients with CVST before the COVID-19 pandemic. A total of 63 of 78 (81%), 30 of 38 (79%), and 145 of 207 (70.0%) patients, respectively, were female, and the mean (SD) age was 45 (14), 55 (20), and 42 (16) years, respectively. Concomitant thromboembolism occurred in 25 of 70 patients (36%) in the TTS group, 2 of 35 (6%) in the no TTS group, and 10 of 206 (4.9%) in the control group, and in-hospital mortality rates were 47% (36 of 76; 95% CI, 37-58), 5% (2 of 37; 95% CI, 1-18), and 3.9% (8 of 207; 95% CI, 2.0-7.4), respectively. The mortality rate was 61% (14 of 23) among patients in the TTS group diagnosed before the condition garnered attention in the scientific community and 42% (22 of 53) among patients diagnosed later. Conclusions and relevance: In this cohort study of patients with CVST, a distinct clinical profile and high mortality rate was observed in patients meeting criteria for TTS after SARS-CoV-2 vaccination.
    2021-11Journal article Open access Show more
  • Manuel Machado Macedo
    Publication . Fragata, J; Roquette, J
    2021-11Journal article Open access Show more
  • Equilibrating SSC Guidelines with Individualized Care
    Publication . Vincent, JL; Singer, M; Einav, S; Moreno, R; Wendon, J; Teboul, JL; Bakker, J; Hernandez, G; Annane, D; de Man, A; Monnet, X; Ranieri, V; Hamzaoui, O; Takala, J; Juffermans, N; Chiche, JD; Myatra, S; De Backer, D
    2021-11Other Open access Show more