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end organ Recovery and Survival with the QuadroxD Oxygenator in Adults on Extracorporeal Membran Oxygenation

World Journal of Cardiovascular Surgery 2012年第4期2卷 73-80页

作者： Joshua K. Wong Vei Shaun Siow Hitoshi Hirose Pawel Karbowski Joseph Miessau Michael Baram Matthew DeCaro Harrison T. Pitcher Nicholas C. Cavarocchi Division of Cardiology Department of Medicine Thomas Jefferson University Philadelphia USA Division of Cardiothoracic Surgery Department of Surgery Thomas Jefferson University Philadelphia USA Division of Pulmonary Medicine and Critical Care Department of Medicine Thomas Jefferson University Philadelphia USA

Introduction: Extracorporeal Membrane Oxygenation (ECMO) is used in selected patient with cardiogenic and/or re- spiratory shock. We report our experience with standardized management protocols and the application of the Qua- droxD oxygenator with a centrifugal pump to maximize end-organ recovery and improve survival. Methods: This is an Internal Review Board (IRB) approved, single institution retrospective study of end-organ recovery and survival in pa- tients who required ECMO for cardiogenic and/or respiratory shock between July 2010 and June 2011. Results: Sixteen patients (median age: 46 years) were initiated on either Veno-Arterial (VA) or Veno-Venous (VV) ECMO. Cardiogenic shock, acute respiratory distress syndrome (ARDS) and a combined respiratory and cardiogenic compromise were the primary indications for ECMO in 8 (50%), 5 (31%) and 3 (19%) patients respectively. The median time on ECMO was 8 days (range: 4 - 26 days). Twelve patients (75%) were successfully weaned off ECMO, of which four (25%) were bridged to a ventricular assist device (VAD) and eight (50%) were weaned to recovery. All eight patients (100%) that were weaned to recovery and two patients (50%) that were bridged to a VAD were successfully discharged from the hospital, resulting in a discharge rate of 63%. There was an improvement in pre- vs. post-ECMO AST (449 IU/L vs. 63 IU/L, p Conclusion: ECMO using the QuadroxD oxygenator and a centrifugal pump, coupled with standardized management protocols is beneficial in carefully selected patients. Improvement or main- tenance of end-organ function is associated with successful bridge to device therapy and/or increased survival.

关键词： Extracorporeal Membrane Oxygenation Adults end-organ Recovery Mechanical Circulatory Support

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MGUS:Proposal for outpatient management

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World Journal of Hematology 2012年第2期1卷 5-7页

作者： Paolo Savini Giorgio Marano Arianna Lanzi Barbara Castagnari Giuseppe Musardo Annalia Molinari Claudia Cellini Giuseppe Francesco Stefanini Department of Internal Medicine Faenza Hospital viale Stradone 9 48018 FaenzaItaly Department of Haematology Ravenna Hospital viale Randi 5 48100 Ravenna Italy Haematology Unit Rimini Hospital via L.Settembrini 2 47900 Rimini Italy

The term monoclonal gammopathy of undetermined significance(MGUS) indicates the presence of a monoclonal protein(M-protein) without features of multiple myeloma, Waldenstrom's macroglobulinemia, primary amyloidosis or malignant lymphoproliferative disorders(LPD). While several guidelines on the treatment of LPD exist, many doubts and perplexities still exist on who should treat a MGUS, when and how. Even where MGUS does not require any therapy, the risk of progression to a LPD is 1% per year. This risk does not diminish over time and persists even in patients(pts) whose condition has remained stable for decades, and a prolonged follow up is, therefore, recommended. We met primary care doctors to share and agree on criteria for the management of outpatients with MGUS. Our aim is to draw up guidelines or, at least, suggestions that may help to determine which MGUS pts could be cared for by the primary care doctor and which should be followed by the hematologist. We suggest that once a MGUS is diagnosed, the primary care physician will attend patients with M-protein end-organ damage and without signs and symptoms of LPD. However, a hematological evaluation is recommended for patients with M-protein Ig G > 15 g/L, or M-protein Ig A > 10 g/L, or Ig M > 10 g/L, or any M-protein with end-organ damage(not attributable to any others causes) or with signs and symptoms of LPD, or rapidly increasing M-protein(> 5 g/L per year).

关键词： Monoclonal gammopathy Multiple myeloma Macroglobulinaemia end-organ damage Serum protein electrophoresis

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Clinical implication of hematological indices in the essential hypertension

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World Journal of Hypertension 2015年第2期5卷 93-97页

作者： Ahmet Karabulut Aytac Karadag Department of Cardiology Acibadem University School of MedicineAcibadem Atakent Hospital Department of Internal Medicine Acibadem Atakent Hospital

Prognostic value of haematological indices,especially red cell distribution width,neutrophil lymphocyte ratio and mean platelet volume,was reported with numerous investigations in miscellaneous cardiovascular *** major prognostic value was linked to oxidative stress and inflammation since their level was correlated with major inflammatory markers such as high sensitive C-reactive protein and *** stress and chronic inflammation are also postulated as the main pathophysiologic mechanism of essential hypertension(HT) and its vascular ***,correlation between HT and haematological parameters was searched in numerous studies,which has made the topic more ***,we reveal the correlation between haematological indices and HT and we also demonstrate the clinical implication of this *** haematological parameters may strongly indicate hypertensive end-organ damage.

关键词： Hypertension Inflammation end-organ damage Haematological indice Platelet activation

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