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Success rates and predictors of outcomes of type I tympanoplasty performed by residents in a teaching tertiary hospital

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中华耳科学杂志:英文版 2023年第4期18卷 214-219页

作者： Lucas Resende Lucinda Mangia nicole Tassia Amadeu Maurício da Silva Oliveira Lucas Santin Patzer Eduardo de souza Somensi Rogerio Hamerschmidt department of Otolaryngology and Head and Neck Surgery Complexo Hospital de Clínicas-Universidade Federal Do Parana(CHC-UFPR)CuritibaBrazil Complexo Hospital de Clínicas-Universidade Federal Do Parana(CHC-UFPR) Curso de MedicinaCuritibaBrazil

Several technical variations of tympanoplasty have been reported,usually involving the type of graft and/or instruments *** studies have focused on the outcome of type-1 tympanoplasty specifically in teaching *** aimed to describe the results of type-1 tympanoplasty performed by residents,and to investigate potential predictive factors of surgical *** do so,we did a retrospective analysis of medical records of patients who underwent type-1 tympanoplasty in a tertiary university *** evaluated the tympanic membrane closure and audiometric outcomes during the first year of follow-up,and compared the results according to some clinical and surgical factors.130 operated ears were included in the *** closure rate reached 84.12%after one month and 72.72%after twelve months of *** mean air-bone gap was 22.98 dB preoperatively,and reached 10.55 dB after *** closure rates were 85%and 57.14%for those operated by endoscopic and microscopic-assisted approaches,respectively(p?0.004).The use of cartilage grafts and time without otorrhea of more than three months prior to surgery were also predictors of surgical success(p?0.002 and 0.041,respectively).Gender,age,perforation size,contralateral disease,operated side,reoperation,and degree of hearing loss did not significantly interfere with *** showed good overall results when performed by residents,although inferior to those reported by experienced *** use of the endoscope,cartilage grafting,and longer preoperative time without otorrhea were predictors of surgical success in this scenario.

关键词： Tympanoplasty Treatment outcome Video-assisted surgery

Outcomes after asystole events occurring during wearable defibrillator-cardioverter use

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World Journal of Cardiology 2018年第4期10卷 21-25页

作者： Jackson J Liang nicole R Bianco Daniele Muser Andres Enriquez Pasquale Santangeli Benjamin A D'souza department of Cardiology University of Pennsylvania Perelman School of Medicine ZOLL

AIM To examine whether wearable cardioverter defibrillator(WCD) alarms for asystole improve patient outcomes and *** All asystole episodes recorded by the WCD in 2013 were retrospectively analyzed from a database of device and medical record documentation and customer call reports. Events were classified as asystole episodes if initial presenting arrhythmia was asystole(defined as recovery at the scene or arrival to a medical facility alive, or not requiring immediate medical attention. Episodes occurring in hospitals, nursing homes, or ambulances were considered to be under medical care. Serious asystole episodes were defined as resulting in unconsciousness, hospital transfer, or *** Of the total 51933 patients having worn the WCD in 2013, there were 257 patients(0.5%) who had asystole episodes and comprised the study cohort. Among the 257 patients(74% male, median age 69 years), there were 264 asystole episodes. Overall patient survival was 42%. Most asystoles were considered "serious"(n = 201 in 201 patients, 76%), with a 26% survival rate. All 56 patients with "non-serious" asystole episodes survived. Being under medical care was associated with worse survival of serious asystoles. Among acute survivors, 20% later died during WCD use(a median 4 days post asystole episode). Of the 86 living patients at the end of WCD use period, 48(56%) received ICD/pacemaker and 17(20%) improved their *** Survival rates after asystole in patients with WCD are higher than historically reported survival rates. Those under medical care at time of asystole exhibited lower survival.

关键词： Asystole Bradycardia Cardiac arrest defibrillator LifeVest

Intestinal Microbiota, Obesity and Insulin Resistance—What Are the Relationships?

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Health 2018年第4期10卷 365-373页

作者： Lígia Maria Cordeiro Misurini nicole do Prado Olbrzymek do Prado Olbrzymek Cicera Aparecida Mendes Letícia Godoy Dias Sanderson Renata Florenzano Flores Luiz Henrique Corrêa Portari Portari Luciana Corrêa de souza Rodrigues Diana Aristotelis Rocha de Sá Larissa Bianca Paiva Cunha de Sá Alberto Krayyem Arbex Endocrinology Division IPEMED Medical School Sao Paulo Brazil Diabetology department Malteser Krankenhaus St. Franziskus Hospital Flensburg Germany Harvard T. H. Chan School of Public Health Boston MA USA

Obesity is a public health problem and its prevalence increases every year, resulting from a complex interaction between genetic, metabolic and environmental factors, as well as cultural influences. The Intestinal Microbiota is composed of trillions of microorganisms by forming a symbiotic relationship with the host and helping the absorption of various nutrients, increasing the extraction of components of the diet, the lipogenesis and intestinal permeability. Studies show that there is difference between the composition of the intestinal microbiota of an obese person and a healthy one. The purpose of this article is to review the literature on the relationship between the Intestinal Microbiota, Obesity and Insulin Resistance and also illustrate some studies on the subject.

关键词： Obesity Intestinal Microbiota Insulin Resistance

Accuracy of gestalt perception of acute chest pain in predicting coronary artery disease

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World Journal of Cardiology 2017年第3期9卷 241-247页

作者： Cláudio Marcelo Bittencourt das Virgens Laudenor Lemos Jr Márcia Noya-Rabelo Manuela Campelo Carvalhal Antonio Maurício dos Santos Cerqueira Junior Fernanda Oliveira de Andrade Lopes nicole Cruz de Sá Jéssica Gonzalez Suerdieck Thiago Menezes Barbosa de souza Vitor Calixto de Almeida Correia Gabriella Sant’Ana Sodré AndréBarcelos da Silva Felipe Kalil Beirao Alexandre Felipe Rodrigues Marques Ferreira Luís Cláudio Lemos Correia department of Cardiology Hospital Sao Rafael department of Cardiology Hospital Português Bahiana School of Medicine and Public Health

AIM To test accuracy and reproducibility of gestalt to predict obstructive coronary artery disease(CAD)in patients with acute chest *** We studied individuals who were consecutively admitted to our Chest Pain *** admission,investigators performed a standardized interview and recorded14 chest pain *** on these features,a cardiologist who was blind to other clinical characteristics made unstructured judgment of CAD probability,both numerically and *** the reference standard for testing the accuracy of gestalt,angiography was required to rule-in CAD,while either angiography or non-invasive test could be used to *** order to assess reproducibility,a second cardiologist did the same *** In a sample of 330 patients,the prevalence of obstructive CAD was 48%.Gestalt’s numerical probability was associated with CAD,but the area under the curve of0.61(95%CI:0.55-0.67)indicated low level of ***,categorical definition of typical chest pain had a sensitivity of 48%(95%CI:40%-55%)and specificity of 66%(95%CI:59%-73%),yielding a negligible positive likelihood ratio of 1.4(95%CI:0.65-2.0)and negative likelihood ratio of 0.79(95%CI:0.62-1.02).Agreement between the two cardiologists was poor in the numerical classification(95%limits of agreement=-71%to 51%)and categorical definition of typical pain(Kappa=0.29;95%CI:0.21-0.37).CONCLUSION Clinical judgment based on a combination of chest pain features is neither accurate nor reproducible in predicting obstructive CAD in the acute setting.

关键词： Acute chest pain Clinical judgment Gestalt Coronary artery disease Acute coronary syndrome