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Letteratura scientifica selezionata sul tema "Residual obstruction"

Autore: Grafiati

Pubblicato: 16 novembre 2024

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Articoli di riviste sul tema "Residual obstruction"

Pesavento, Raffaele, Lucia Filippi, Antonio Palla, Adriana Visonà, Carlo Bova, Marco Marzolo, Fernando Porro et al. "Impact of residual pulmonary obstruction on the long-term outcome of patients with pulmonary embolism". European Respiratory Journal 49, n. 5 (maggio 2017): 1601980. http://dx.doi.org/10.1183/13993003.01980-2016.

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The impact of residual pulmonary obstruction on the outcome of patients with pulmonary embolism is uncertain.We recruited 647 consecutive symptomatic patients with a first episode of pulmonary embolism, with or without concomitant deep venous thrombosis. They received conventional anticoagulation, were assessed for residual pulmonary obstruction through perfusion lung scanning after 6 months and then were followed up for up to 3 years. Recurrent venous thromboembolism and chronic thromboembolic pulmonary hypertension were assessed according to widely accepted criteria.Residual pulmonary obstruction was detected in 324 patients (50.1%, 95% CI 46.2–54.0%). Patients with residual pulmonary obstruction were more likely to be older and to have an unprovoked episode. After a 3-year follow-up, recurrent venous thromboembolism and/or chronic thromboembolic pulmonary hypertension developed in 34 out of the 324 patients (10.5%) with residual pulmonary obstruction and in 15 out of the 323 patients (4.6%) without residual pulmonary obstruction, leading to an adjusted hazard ratio of 2.26 (95% CI 1.23–4.16).Residual pulmonary obstruction, as detected with perfusion lung scanning at 6 months after a first episode of pulmonary embolism, is an independent predictor of recurrent venous thromboembolism and/or chronic thromboembolic pulmonary hypertension.

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Kroft, Lucia J. M., Petra M. G. Erkens, Renée A. Douma, Inge C. M. Mos, Gé Jonkers, Marcel M. C. Hovens, Marc F. Durian et al. "Thromboembolic resolution assessed by CT pulmonary angiography after treatment for acute pulmonary embolism". Thrombosis and Haemostasis 114, n. 07 (2015): 26–34. http://dx.doi.org/10.1160/th14-10-0842.

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SummaryThe systematic assessment of residual thromboembolic obstruction after treatment for acute pulmonary embolism (PE) has been under-studied. This assessment is of potential clinical importance, should clinically suspected recurrent PE occur, or as tool for risk stratification of cardiopulmonary complications or recurrent venous thromboembolism (VTE). This study aimed to assess the rate of PE resolution and its implications for clinical outcome. In this prospective, multi-center cohort study, 157 patients with acute PE diagnosed by CT pulmonary angiography (CTPA) underwent follow-up CTPA-imaging after six months of anticoagulant treatment. Two expert thoracic radiologists independently assessed the presence of residual thromboembolic obstruction. The degree of obstruction at baseline and follow-up was calculated using the Qanadli obstruction index. All patients were followed-up for 2.5 years. At baseline, the median obstruction index was 27.5 %. After six months of treatment, complete PE resolution had occurred in 84.1 % of the patients (95 % confidence interval (CI): 77.4–89.4 %). The median obstruction index of the 25 patients with residual thrombotic obstruction was 5.0 %. During follow-up, 16 (10.2 %) patients experienced recurrent VTE. The presence of residual thromboembolic obstruction was not associated with recurrent VTE (adjusted hazard ratio: 0.92; 95 % CI: 0.2–4.1). This study indicates that the incidence of residual thrombotic obstruction following treatment for PE is considerably lower than currently anticipated. These findings, combined with the absence of a correlation between residual thrombotic obstruction and recurrent VTE, do not support the routine use of follow-up CTPA-imaging in patients treated for acute PE.

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Ulualp, Seckin. "Outcomes of Tongue Base Reduction and Lingual Tonsillectomy for Residual Pediatric Obstructive Sleep Apnea after Adenotonsillectomy". International Archives of Otorhinolaryngology 23, n. 04 (28 maggio 2019): e415-e421. http://dx.doi.org/10.1055/s-0039-1685156.

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Introduction Upper airway obstruction at multiple sites, including the velum, the oropharynx, the tongue base, the lingual tonsils, or the supraglottis, has been resulting in residual obstructive sleep apnea (OSA) after tonsillectomy and adenoidectomy (TA). The role of combined lingual tonsillectomy and tongue base volume reduction for treatment of OSA has not been studied in nonsyndromic children with residual OSA after TA. Objective To evaluate the outcomes of tongue base volume reduction and lingual tonsillectomy in children with residual OSA after TA. Methods A retrospective chart review was conducted to obtain information on history and physical examination, past medical history, findings of drug-induced sleep endoscopy (DISE), of polysomnography (PSG), and surgical management. Pre- and postoperative PSGs were evaluated to assess the resolution of OSA and to determine the improvement in the obstructive apnea-hypopnea index (oAHI) before and after the surgery. Results A total of 10 children (5 male, 5 female, age range: 10–17 years old, mean age: 14.5 ± 2.6 years old) underwent tongue base reduction and lingual tonsillectomy. Drug-induced sleep endoscopy (DISE) revealed airway obstruction due to posterior displacement of the tongue and to the hypertrophy of the lingual tonsils. All of the patients reported subjective improvement in the OSA symptoms. All of the patients had improvement in the oAHI. The postoperative oAHI was lower than the preoperative oAHI (p < 0.002). The postoperative apnea-hypopnea index during rapid eye movement sleep (REM-AHI) was lower than the preoperative REM-AHI (p = 0.004). Obstructive sleep apnea was resolved in children with normal weight. Overweight and obese children had residual OSA. Nonsyndromic children had resolution of OSA or mild OSA after the surgery. Conclusions Tongue base reduction and lingual tonsillectomy resulted in subjective and objective improvement of OSA in children with airway obstruction due to posterior displacement of the tongue and to hypertrophy of the lingual tonsils.

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Awolaran, Olugbenga, Kirsty Brennan, Iain Yardley e Hemanshoo Thakkar. "Water beads ingestion presenting with repeated bowel obstruction in an infant". BMJ Case Reports 17, n. 2 (febbraio 2024): e257875. http://dx.doi.org/10.1136/bcr-2023-257875.

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An infant presented repeatedly with features of transient bowel obstruction 72 hours after unwitnessed ingestion of water beads. At the third presentation 5 days later, he underwent laparotomy and jejunal enterotomy for retrieval of obstructing water bead in the duodenum. Four other water beads were retrieved. Due to persistent obstructive symptoms, he had a relaparotomy on fourth postoperative day. A further obstructing bead at the duodenojejunal flexure was retrieved. Antegrade upper gastrointestinal endoscopy and retrograde endoscopy through the enterotomy were performed to ensure no further retained water beads. The patient progressed well postoperatively and was discharged home 5 days later. This case highlights the challenges involved in the diagnosis and management of water bead ingestion in children. Children under 2 years are at a higher risk of complications and most require intervention. Palpation alone can miss residual water beads at surgery. Endoscopy including intraoperative enteroscopy could be a useful adjunct.

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Afanasyev, A. V., A. V. Bogachev-Prokophiev, S. I. Zheleznev, R. M. Sharifulin, A. S. Zalesov, D. Yu Kozmin e A. M. Karaskov. "SEPTAL MYECTOMY WITH SUBVALVULAR APPARATUS INTERVENTION IN PATIENTS WITH HYPERTROPHIC OBSTRUCTIVE CARDIOMYOPATHY: IMMEDIATE RESULTS". Siberian Medical Journal 33, n. 3 (28 novembre 2018): 71–77. http://dx.doi.org/10.29001/2073-8552-2018-33-3-71-77.

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Aim. Surgical septal myectomy is a standard treatment option for patients with hypertrophic obstructive cardiomyopathy. Subvalvular abnormalities of the mitral valve may play an important role in residual left ventricular outflow tract obstruction. This study aimed to evaluate the surgical outcomes of septal myectomy with subvalvular interventions.Material and Methods. Between July, 2015 and December, 2016, 40 eligible patients underwent septal myectomy with subvalvular intervention. The peak gradient was 92.3±16.9 mm Hg. The mean septum thickness was 26.8±4.5 mm. Moderate or severe systolic anterior motion syndrome-mediated mitral regurgitation was observed in all patients.Results. There was no residual mitral regurgitation. Residual systolic anterior motion syndrome was observed in 5%. The postoperative gradient was 8.7±4.5 mm Hg. At 12-month follow-up, all patients were alive. According to the New York Heart Association (NYHA) classification, 87.5 and 12.5% of patients had NYHA functional classes I and II, respectively. The prevalence rate of residual mitral regurgitation was 10%.Conclusions. Concomitant subvalvular intervention during septal myectomy effectively eliminated left ventricular outflow tract obstruction and provided high freedom from residual mitral regurgitation one year after surgery.

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Bang, Ole. "SIGNIFICANCE OF RESIDUAL URINE IN PROSTATIC OBSTRUCTION". Acta Medica Scandinavica 142, S266 (24 aprile 2009): 199–202. http://dx.doi.org/10.1111/j.0954-6820.1952.tb13367.x.

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Delestre, M., J. Barbieux e A. Paisant. "Small bowel obstruction due to residual appendix". Journal of Visceral Surgery 156, n. 6 (dicembre 2019): 527–28. http://dx.doi.org/10.1016/j.jviscsurg.2019.07.008.

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Bahl, Ajay, Bhupesh Kumar, Shyam KS Thingam e Sunder Lal Negi. "Midventricular Hypertrophic Obstructive Cardiomyopathy with Left Ventricular Aneurysm and Clot: The Role of Transesophageal Echocardiogram in Assessment and Management of Myomectomy". Journal of Perioperative Echocardiography 2, n. 2 (2014): 58–60. http://dx.doi.org/10.5005/jp-journals-10034-1022.

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ABSTRACT Hypertrophic obstructive cardiomyopathy (HOCM) with mid ventricular obstruction leading to apical aneurysm and clot is very rare. Intraoperative transesophageal echocardiogram (TEE) can be used to know the maximum thickness of the septum, its distance from the aortic annulus and the apical extent of septal bulge. Postresection TEE can provide information about residual obstruction or any complications. We present a case of 65-year-old male patient who underwent CABG, septal myectomy, Dor's procedure for aneurysm and clot removal. Septal resection was done under TEE guidance. How to cite this article Dutta V, Raj R, Kumar B, Bahl A, Thingam SKS, Negi SL, Puri GD. Midventricular Hypertrophic Obstructive Cardiomyopathy with Left Ventricular Aneurysm and Clot: The Role of Transesophageal Echocardiogram in Assessment and Management of Myomectomy. J Perioper Echocardiogr 2014;2(2):58-60.

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Mylavarapu, Goutham, Dhananjay Subramaniam, Raghuvir Jonnagiri, Ephraim J. Gutmark, Robert J. Fleck, Raouf S. Amin, Mohamed Mahmoud, Stacey L. Ishman e Sally R. Shott. "Computational Modeling of Airway Obstruction in Sleep Apnea in Down Syndrome". Otolaryngology–Head and Neck Surgery 155, n. 1 (5 aprile 2016): 184–87. http://dx.doi.org/10.1177/0194599816639544.

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Current treatment options are successful in 40% to 60% of children with persistent obstructive sleep apnea after adenotonsillectomy. Residual obstruction assessments are largely subjective and do not clearly define multilevel obstruction. We endeavor to use computational fluid dynamics to perform virtual surgery and assess airflow changes in patients with Down syndrome and persistent obstructive sleep apnea. Three-dimensional airway models were reconstructed from respiratory-gated computed tomography and magnetic resonance imaging. Virtual surgeries were performed on 10 patients, mirroring actual surgeries. They demonstrated how surgical changes affect airflow resistance. Airflow and upper airway resistance was calculated from computational fluid dynamics. Virtual and actual surgery outcomes were compared with obstructive apnea-hypopnea index values. Actual surgery successfully treated 6 of 10 patients (postoperative obstructive apnea-hypopnea index <5). In 8 of 10 subjects, both apnea-hypopnea index and the calculated upper airway resistance after virtual surgery decreased as compared with baseline values. This is a feasibility and proof-of-concept study. Further studies are needed before using these techniques in surgical planning.

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Gumbiene, Lina, Lina Kapleriene, Dovile Jancauskaite, Monika Laukyte-Sleniene, Elena Jureviciene, Virginija Rudiene, Egle Paleviciute, Mindaugas Mataciunas e Virginija Sileikiene. "Insights to correlations and discrepancies between impaired lung function and heart failure in Eisenmenger patients". Pulmonary Circulation 10, n. 1 (gennaio 2020): 135065012090972. http://dx.doi.org/10.1177/2045894019899239.

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Impaired lung function and spirometric signs of airway obstruction without common risk factors for chronic obstructive pulmonary disease could be found in patients with Eisenmenger syndrome. This study aimed to analyse the association between lung function parameters and disease severity (including heart failure markers, associated congenital heart defect) as well as the possible reasons for airflow obstruction in Eisenmenger syndrome. The data of 25 patients with Eisenmenger syndrome were retrospectively evaluated. The patients were divided into groups according to airflow obstruction and a type of congenital heart defect. Airflow obstruction was found in nearly third (32%) of our cases and was associated with older age and worse survival. No relation was found between airway obstruction, B-type natriuretic peptide level, complexity of congenital heart defect and bronchial compression. Most of the patients (88%) had gas diffusion abnormalities. A weak negative correlation was noticed between gas diffusion (diffusing capacity of the lung for carbon monoxide) and B-type natriuretic peptide level (r = −0.437, p = 0.033). Increased residual volume was associated with higher mortality (p = 0.047 and p = 0.021, respectively). A link between B-type natriuretic peptide and lung diffusion, but not airway obstruction, was found. Further research and larger multicentre studies are needed to evaluate the importance of pulmonary function parameters and mechanisms of airflow obstruction in Eisenmenger syndrome.

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Più fonti

Tesi sul tema "Residual obstruction"

Danguy, des Déserts Marc. "Impact de l'inflammation, de la dysfonction endothéliale et de la fibrinolyse sur le risque de séquelles perfusionnelles". Electronic Thesis or Diss., Brest, 2024. http://www.theses.fr/2024BRES0034.

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La maladie thromboembolique veineuse (MTEV) est la troisième cause de mortalité cardiovasculaire. L’embolie pulmonaire (EP) est la forme la plus grave de thrombose veineuse. Les patients présentant une EP d’origine non provoquée ont un risque élevé de développer une obstruction vasculaire pulmonaire résiduelle (OVPR). La non-résolution du thrombus augmente le risque de survenue de récidive thromboembolique. Ce travail a pour objectif d’évaluer l’impact de trois mécanismes potentiellement impliqués dans la persistance de thrombus : l’inflammation, la dysfonction endothéliale et la fibrinolyse au sein d’une population atteinte d’EP non provoquée. Un premier travail montre que l’hypofibrinolyse et la dysfonction endothéliale sont impliqués dans les séquelles perfusionnelles au sein d’une population de patients présentant un premier épisode d’EP non provoquée. Un test d’évaluation de coagulation et de fibrinolyse Clôt Lysis Assay (CLA) semi automatisé a été mis en place et les taux de TGFβ1 évalués dans le plasma. Les taux de TGFβ1 mesurés un mois après l’arrêt du traitement anticoagulant sont associés à l’OVPR, tandis que les paramètres de fibrinolyse ne le sont pas. Des paramètres de formation du caillot mesurés par CLA étaient associés à la récidive de la MTEV. Ces résultats permettent de mieux comprendre la physiopathologie de l’OVPR et de la récidive de MTEV afin d’optimiser le traitement de l'EP non provoquée
Venous thromboembolism (VTE) is the third leading cause of cardiovascular death. Pulmonary embolism (PE) is the most severe form of venous thrombosis. Patients with unprovoked PE are at high risk of residual pulmonary vascular obstruction (RPVO). Failure to resolve the thrombus increases the risk of thromboembolie recurrence. The aim of this work was to assess the impact of three mechanisms potentially involved in thrombus persistence: inflammation, endothelialdysfunction and fibrinolysis in patients with unprovoked PE.A preliminary study shows that fibrinolysis defect and endothelial dysfunction are involved in perfusion sequelae in a population of patients presenting with a first episode of unprovoked PE.A semi-automated Clôt Lysis Assay (CLA) was set up to assess coagulation and fibrinolysis and plasma levels of TGFβ1 are quantified. TGFβ1 plasma levels measured one month after anticoagulant discontinuation are associated with RPVO, while fibrinolysis parameters are not. Clôt formation parameters measured by CLA are associated with VTE recurrence. These results provide a better understanding of the pathophysiology of RVPO and VTE recurrence to optimise the treatment of unprovoked PE

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Yasuda, Isao. "Pulmonary Stenosis with Intact Ventricular Septum: Assessment and Indication of Reconstructive Surgery for Residual Right-Ventricular Outflow Tract Obstruction". Thesis, Georg Thieme, 1991. http://hdl.handle.net/2237/16685.

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Planquette, Benjamin. "Séquelles perfusionnelles après une embolie pulmonaire : pronostic, prédiction et mécanismes physiopathologiques". Thesis, Sorbonne Paris Cité, 2016. http://www.theses.fr/2016USPCB254/document.

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Au décours d'une première embolie pulmonaire (EP), certains patients présentent un syndrome post EP : un tiers des patients ont une obstruction persistante de la vascularisation pulmonaire, associée à la persistance d'une dyspnée et une limitation des performances à l'effort. Certains patients présenteront une récidive d'EP ou, plus rarement, une hypertension pulmonaire, dont les séquelles perfusionnelles sont un critère diagnostique indispensable. Le rôle et la physiopathologie des séquelles perfusionnelles au cours du syndrome post EP est incomprise. Ce travail a mis en évidence l'existence d'un risque majoré de récidive d'EP (odds ratio 1,9) chez les patients présentant des séquelles perfusionnelles >10% à la vascularisation pulmonaire. L'analyse des propriétés fonctionnelles du fibrinogène purifié à partir du plasma de patients suivis pour une première EP améliore la prédiction de séquelles perfusionnelles confirmant le rôle clé de celui-ci dans la physiopathologie de la maladie. Ainsi, une forte proportion de chaine Bβ porteuse d'un seul résidu acide sialique majore le risque de séquelles. L'étude des cellules endothéliales circulantes à la phase aigüe et après une EP montre que les patients qui développeront des séquelles mobilisent peu de cellules endothéliales, témoignant d'une forte altération des processus de réparation de l'endothélium pulmonaire. L'interaction de la fibrine avec les progéniteurs endothéliaux dans cette anomalie de la régulation est possible : les progéniteurs expriment le récepteur VLDLr dont l'épitope β15-42 de la fibrine est un ligand impliqué dans la régulation du cycle cellulaire et l'inhibition de l'angiogenèse
Pulmonary vascular sequels after pulmonary embolism: prognosis, prediction and physiopathologyAbstract: Post Pulmonary Embolism (PE) syndrome is not rare after PE: one third of the patients presents residual pulmonary vascular obstruction (RPVO) traducing sequels associated with increased dyspnea and impaired exercise capacity. Some of these patients will suffer PE recurrence or, more rarely, chronic thromboembolic pulmonary hypertension, whose one the diagnosis criteria is persistent perfusion defect. Prognosis value and mechanisms underlying vascular sequels are still unclear. The present work shows that RPVO > 10% after a first PE is associated with an increased risk for venous thromboembolism recurrence (odds ratio 1.9). Secondly, fibrinogen properties were investigated in PE patients. Patients with RPVO >10% presented more monosialiated Bβchain form. Prediction models for RPVO that include fibrinogen analysis were more accurate than those without fibrinogen data; This results highlights the key role of fibrin in the pathophysiology of chronic venous thromboembolism. Interestingly, the present work shows that patient who will present RPVO had an impaired endothelial cells mobilization. Compared to patients without RPVO, patients with RPVO had lower circulating endothelial cells at the acute phase of PE. This endothelial dysfunction is probably triggered by endothelial progenitors that expressed the very low density lipoprotein receptor (VLDLr), implicated in the inhibition of angiogenesis and able to bind the β15-42 N terminal sequence of the fibrin Bβ chain

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Libri sul tema "Residual obstruction"

Hedenstierna, Göran, e João Batista Borges. Normal physiology of the respiratory system. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0071.

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The lungs contain 200–300 million alveoli that are reached via 23 generations of airways. The volume in the lungs after an ordinary expiration is called functional residual capacity (FRC) and is approximately 3–4 L. The lung is elastic and force (pressure) is needed to expand it and to overcome the resistance to gas flow in the airways. This pressure can be measured as pleural minus alveolar pressure. The inspired volume goes mainly to dependent, lower lung regions, but with increasing age and in obstructive lung disease airways may close in dependent lung regions during expiration, impeding oxygenation of the blood. With lowered functional residual capacity,airways may be continuously closed with subsequent gas adsorbtion from the closed off alveoli. Perfusion of the lung goes also mainly to dependent regions, but there is in addition, possibly more important, a non-gravitational inhomogeneity. A ventilation-perfusion mismatch may ensue that impedes oxygenation and CO2 removal, but can to some extent be corrected for by hypoxic pulmonary vasoconstriction.

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Capitoli di libri sul tema "Residual obstruction"

Ebert, P. A. "Reoperations for Residual/Recurrent Left Ventricular Outflow Tract Obstruction". In Reoperations in Cardiac Surgery, 249–57. London: Springer London, 1989. http://dx.doi.org/10.1007/978-1-4471-1688-2_18.

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Benoist, Linda B. L., Maurits H. T. de Ruiter, Jan de Lange e Nico de Vries. "Residual POSA After Maxillomandibular Advancement in Patients with Severe OSA". In Positional Therapy in Obstructive Sleep Apnea, 321–29. Cham: Springer International Publishing, 2014. http://dx.doi.org/10.1007/978-3-319-09626-1_29.

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Garthwaite, Mary, e John Hayes. "Benign prostatic hyperplasia and urinary retention". In Oxford Textbook of Fundamentals of Surgery, a cura di Ian Eardley, 378–83. Oxford University PressOxford, 2016. http://dx.doi.org/10.1093/med/9780199665549.003.0049_update_001.

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Abstract Benign prostate hyperplasia (BPH) refers to the actual histological changes of stromal-glandular hyperplasia seen within the prostate. The condition becomes clinically significant when this overgrowth of benign tissue is associated with bothersome lower urinary tract symptoms (LUTS) with or without bladder outflow obstruction (BOO). Although the causes of LUTS are multifactorial, a significant proportion will be secondary to benign enlargement of the prostate due to BPH. The prevalence of LUTS and BPH increases with age. Epidemiological studies suggest that >80% of 80 year-olds have the disease. With our ageing population the need for medical and surgical treatment will continue to increase. Progression of the disease can result in complications such as acute or chronic urinary retention, recurrent urinary tract infections, haematuria and bladder stone formation. The aims of treatment are to reduce the severity of LUTS and to prevent the development of complications. Medical therapy including alpha-blockers and 5-alpha reductase inhibitors are the most commonly used. A myriad of surgical treatments now exist and are indicated if maximal medical therapy is insufficient to alleviate symptoms and improve quality of life, or if complications arise. The initial management of acute urinary retention involves prompt catheterization, either urethral or suprapubic, to swiftly alleviate the obstruction, ensure the patient is comfortable, and allow the resolution of any secondary renal impairment. A measurement of bladder residual volume, examination of the prostate via digital rectal examination, and exclusion of obstructive uropathy are important in the initial work-up. Catheterization is usually temporary until surgery can be performed as definitive management, but may be required in the long term if the patient is unfit for surgery or there is detrusor failure secondary to the chronic retention of urine.

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Robinson, Chapman. "Pregnancy and breathlessness". In Oxford Handbook of Respiratory Medicine, a cura di Stephen J. Chapman, Grace V. Robinson, Rahul Shrimanker, Chris D. Turnbull e John M. Wrightson, 69–72. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198837114.003.0010.

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Elevated serum progesterone levels stimulate respiratory drive and lead to an increased tidal volume and raised minute ventilation, with only a modest increase in O₂ consumption. Any cause of maternal hypercapnia leads quickly to foetal respiratory acidosis. Elevation of the diaphragm occurs due to the enlarging uterus, leading to a reduced functional residual capacity (FRC). Raised levels of coagulation factors and impaired fibrinolysis, combined with venous stasis, result in a significantly increased risk of venous thromboembolism (VTE). Upper airway oedema, particularly in the setting of pre-eclampsia, may predispose to upper airway obstruction during sleep, but rarely frank OSA. OSA tends to occur in obese women and may be associated with impaired foetal growth and pre-eclampsia. Snoring in pregnancy is a poor predictor of OSA.

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Yoo, Shi-Joon, e Willem A. Helbing. "Double-outlet right ventricle". In The EACVI Textbook of Cardiovascular Magnetic Resonance, a cura di Massimo Lombardi, Sven Plein, Steffen Petersen, Chiara Bucciarelli-Ducci, Emanuela R. Valsangiacomo Buechel, Cristina Basso e Victor Ferrari, 560–65. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198779735.003.0056.

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Double-outlet right ventricle (DORV) encompasses a wide variety of abnormalities and requires precise demonstration of the cardiovascular abnormalities using a segmental approach for surgical decision and planning. The most important is whether the left ventricle can be directed surgically to the aorta without obstruction of the pulmonary outflow tract of the right ventricle. Echocardiography is the baseline imaging modality in preoperative assessment of DORV. In complex cases, cardiovascular magnetic resonance (CMR) provides comprehensive information regarding important surgical anatomy, blood flow, and ventricular volumes. Three-dimensional (3D) angiograms and 3D print models may provide undisputable information regarding surgical anatomy and allows practice surgery on the models prior to actual surgery. DORV is frequently associated with post-operative residual findings that require reintervention. CMR is particularly useful in post-operative assessment, as it provides accurate quantitative information regarding ventricular volumes and blood flow for decision and timing of surgical or interventional procedures.

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Fogel, Mark A., e Willem A. Helbing. "The single ventricle and surgical palliation". In The EACVI Textbook of Cardiovascular Magnetic Resonance, a cura di Massimo Lombardi, Sven Plein, Steffen Petersen, Chiara Bucciarelli-Ducci, Emanuela R. Valsangiacomo Buechel, Cristina Basso e Victor Ferrari, 566–76. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198779735.003.0057.

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About 10% of patients with congenital heart disease have a univentricular heart, which includes a wide variation of diagnoses. These may occur in the setting of anomalies of cardiac and visceral situs. When considering treatment options, a practical approach has been to define univentricular heart disease as the heart in which just one ventricle is present that can sustain the circulation, whether anatomically or functionally. Treatment consists of staged palliation, starting with an aortic-to-pulmonary anastomosis, if required, and of stepwise separation of the systemic and pulmonary circulation, culminating in a total cavopulmonary connection where caval return passively flows into the lungs, bypassing the heart (called the Fontan procedure). Detailed anatomic, haemodynamic, and functional imaging is required throughout the staged treatment and during long-term follow-up. Cardiovascular magnetic resonance (CMR) is a widely recommended tool for this purpose. CMR imaging should include assessment of the pulmonary artery, the aortic arch to assess for arch obstruction, the ventricular outflow tract, systemic-to-pulmonary collaterals (aortic–pulmonary, veno-veno), anomalous venous structures, pulmonary or systemic veins, systemic venous return, ventricular size/function and blood flow, and tissue characterization for myocardial scarring. The focus of imaging may shift, depending on the stage of treatment. During staged palliation, CMR can be used to detect residual findings requiring additional interstage interventions. CMR is recommended after Fontan completion for serial follow-up of ventricular function, haemodynamics, physiology, and anatomical assessment of the Fontan pathway.

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Davies, Simon. "Peritoneal dialysis". In Oxford Textbook of Medicine, a cura di John D. Firth, 4874–79. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780198746690.003.0480.

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Peritoneal dialysis is achieved by repeated cycles of instillation and drainage of dialysis fluid within the peritoneal cavity, with the two main functions of dialysis—solute and fluid removal—occurring due to the contact between dialysis fluid and the capillary circulation of the parietal and visceral peritoneum across the peritoneal membrane. It can be used to provide renal replacement therapy in acute kidney injury or chronic kidney disease. Practical aspects—choice of peritoneal dialysis as an effective modality for renal replacement in the short to medium term (i.e. several years) is, for most patients, a lifestyle issue. Typically, a patient on continuous ambulatory peritoneal dialysis will require three to four exchanges of 1.5 to 2.5 litres of dialysate per day. Automated peritoneal dialysis and use of the glucose polymer dialysis solution icodextrin enables flexibility of prescription that can mitigate the effects of membrane function (high solute transport). Peritonitis—this remains the most common complication of peritoneal dialysis, presenting with cloudy dialysis effluent, with or without abdominal pain and/or fever, and confirmed by a leucocyte count greater than 100 cells/µl in the peritoneal fluid. Empirical antibiotic treatment, either intraperitoneal or systemic, with cover for both Gram-positive and Gram-negative organisms, should be commenced immediately while awaiting specific cultures and sensitivities. Long-term changes in peritoneal membrane function influence survival on peritoneal dialysis if fluid removal is less efficient (ultrafiltration failure), especially in the absence of residual kidney function. This is the main limitation of treatment, along with avoiding the risk of encapsulating peritoneal sclerosis—a life-threatening complication of peritoneal dialysis, particularly if of long duration (15–20% incidence after 10 years), that is characterized by severe inflammatory thickening, especially of the mesenteric peritoneum, resulting in an encapsulation and progressive obstruction of the bowel.

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Hierlmeier, Bryan J., e Anesh Rugnath. "Obstructive Lung Disease". In Advanced Anesthesia Review, a cura di Alaa Abd-Elsayed, 237—C92.S8. Oxford University PressNew York, 2023. http://dx.doi.org/10.1093/med/9780197584521.003.0091.

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Abstract Obstructive airway diseases are a commonly tested topic in anesthesia for both the written and oral examinations and are separated into upper airway (obstructive sleep apnea [OSA]), tracheobronchial (foreign body), and parenchymal disorders (mediastinal masses). Obstructive disorders have resistance to airflow which leads to air trapping and in turn increases the residual lung volume and total lung capacity. Obstructive sleep apnea patients typically have daytime somnolence, increased incidence of hypoxia, dysrhythmias, hypertension, myocardial ischemia, and pulmonary hypertension and have increased sensitivity to narcotics with respect to respiratory depression. Foreign body aspiration and mediastinal masses can be an anesthetic dilemma; serous preparation should be completed prior to induction of anesthesia as the consequences can possibly lead to loss of airway and cardiovascular collapse. This chapter concentrates on a few disorders in each major category that are commonly encountered.

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Blasberg, Elizabeth A., Tania L. Kraai e Madeleine Grigg-Damberger. "Our Baby Can’t Eat, Can’t Breathe, and Can’t Sleep!" In Sleep Disorders, 686–704. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780190671099.003.0040.

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An infant with severe congenital laryngomalacia presented with inspiratory stridor when feeding, crying, or supine, relieved by prone or upright repositioning. Suprasternal retractions, hypoxemia, feeding difficulties, and failure to thrive prompted admission to the pediatric intensive care unit. Symptoms of sleep disordered breathing contributed to the severity of her laryngomalacia. Overnight polysomnography confirmed severe obstructive sleep apnea and sleep-related hypoxemia. The patient underwent supraglottoplasty with resolution of the wake hypoxemia but with residual stridor and apnea. Revision supraglottoplasty led to remission of the stridor and obstructive sleep apnea but emergence of central sleep apnea. This case discusses the clinical features, diagnostic evaluation, and management of congenital laryngomalacia. Supraglottoplasty, reserved for infants with moderate or severe laryngomalacia, is the treatment of choice. Obstructive sleep apnea improves but usually does not fully remit after supraglottoplasty. Central sleep apnea is not uncommon in infants with laryngomalacia and may reflect immature or abnormal brainstem nuclei regulating regulation of respiration during sleep.

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Bernstein, David I. "Hypersensitivity Pneumonitis". In Asthma, 3–11. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199918065.003.0001.

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Hypersensitivity pneumonitis (HP), also referred to as extrinsic allergic alveolitis, is an allergic inflammatory parenchymal lung disease usually caused by inhalational exposure to organic antigens from microbial bioaerosols or animal sources encountered in the work or home environment. Patients with HP can present with wheezing and obstructive abnormalities leading to an incorrect asthma diagnosis. The presence of a gas exchange abnormality, bronchoalveolar lavage lymphocytosis, and characteristic infiltrative changes on high-resolution computed tomography of the chest can be used to distinguish HP from asthma. The early diagnosis of HP and cessation of exposure to causative antigens result in remission of the disease and no residual impairment.

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Atti di convegni sul tema "Residual obstruction"

Couturaud, Francis, Gael Picart, Philippe Robin, Cécile Tromeur, Raphael Le Mao, Leela Raj e Christophe Leroyer. "Predictors of Residual Pulmonary Vascular Obstruction after Pulmonary Embolism: results from a prospective cohort study". In ERS International Congress 2020 abstracts. European Respiratory Society, 2020. http://dx.doi.org/10.1183/13993003.congress-2020.1860.

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Ho, T. A. A., J. M. Pescatore, K. U. Lio, G. J. Criner, P. Rali e S. Gayen. "Predictors of Residual Pulmonary Vascular Obstruction After Acute Pulmonary Embolism Based on Patient Variables and Treatment Modality". In American Thoracic Society 2024 International Conference, May 17-22, 2024 - San Diego, CA. American Thoracic Society, 2024. http://dx.doi.org/10.1164/ajrccm-conference.2024.209.1_meetingabstracts.a2169.

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Barbosa, Ana Carolina Silva, Cristiano Augusto Andrade de Resende, Henrique Carvalho Rocha e Andreza Karine de Barros Almeida Souto. "Case report: sinusoidal obstruction syndrome post-treatment with trastuzumab emtansine in breast cancer". In Brazilian Breast Cancer Symposium 2024, 104. Mastology, 2024. http://dx.doi.org/10.29289/259453942024v34s1104.

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Objective: Trastuzumab emtansine (T-DM1) is an anti-HER2 antibody-drug conjugate indicated for the treatment of HER2- positive breast cancer. One of the most severe adverse events reported with T-DM1 is hepatotoxicity. More recently, some cases of noncirrhotic portal hypertension have been described in patients with long-term T-DM1. The underlying liver condition is usually sinusoidal obstruction syndrome. Methodology: Here, we present the case of a patient with early-stage HER2-positive breast cancer who received adjuvant T-DM1 and developed hepatotoxicity due to this condition. Results: We report a case of a 46-year-old woman with early-stage (stage III) HER2-positive breast cancer who started adjuvant T-DM1 therapy for residual disease after HER2-directed therapy. After 3 cycles of T-DM1, the patient started a new-onset elevation of liver tests and there was focal hepatic steatosis on abdominal CT. A reduction in platelet count was also apparent during the T-DM1 therapy. Liver elastography was performed and showed signs of moderate liver fibrosis. The patient underwent a liver biopsy which revealed sinusoidal obstruction, and so T-DM1 has been suspended. Thereafter, the patient had normalization of liver tests and platelet count. After discussion with a Hepatologist, we opted to definitively suspend T-DM1 therapy due to the risk of progression to noncirrhotic portal hypertension. Conclusion: We presented a rare case of sinusoidal obstruction syndrome induced by T-DM1 in a patient with breast cancer. Hepatotoxicity is one of the main adverse events of T-DM1. A high index of suspicion for liver injury must be maintained for patients who develop liver test abnormalities and/or signs of portal hypertension during treatment with T-DM1. This shows the usual complexity in treating patients with new drugs for breast cancer and the importance of multidisciplinary monitoring.

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Lee, Po-Chih, Charles Ledonio, A. Noelle Larson, Arthur Erdman e David Polly. "Thoracic Volumes Correlated With Pulmonary Function Tests in Adult Scoliosis Patients Following Different Treatments in Adolescence". In 2017 Design of Medical Devices Conference. American Society of Mechanical Engineers, 2017. http://dx.doi.org/10.1115/dmd2017-3364.

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In clinical settings, doctors classify pulmonary disorders into two main categories, obstructive lung disease and restrictive lung disease. The former is characterized by the airway obstruction which is associated with several disorders like chronic bronchitis, asthma, bronchiectasis, and emphysema [1]. The latter is caused by different conditions where one of the triggers is tied to the spine deformity. In general, a pulmonary function test (PFT) [2] is used to evaluate and diagnose lung function, and physicians depend on the test results to identify the disease patterns of the patients (obstructive or restrictive lung disease). In the PFT, some parameters including total lung capacity (TLC), vital capacity (VC), and residual volume (RV) can infer the lung volume and lung capacity. Other parameters, such as forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1), are often employed to assess the pulmonary mechanics. Scoliosis is an abnormal lateral curvature of the spine which involves not only the curvature from side to side but also an axial rotation of the vertebrae. Restrictive lung disease often happens in scoliosis patients, especially with severe spine deformity. Spine deformity if left untreated may lead to progression of the spinal curve, respiratory complications, and the reduction of life expectancy due to the decrease in thoracic volume for lung expansion. However, the relationship between thoracic volume and pulmonary function is not broadly discussed, and anatomic abnormalities in spine deformity (ex: scoliosis, kyphosis, and osteoporosis) can affect thoracic volume. Adequate thoracic volume is needed to promote pulmonary function. Previous literature has shown that the deformity of the thoracic rib cage will have detrimental effects on the respiratory function in adolescent idiopathic scoliosis patients [3–4]. In this paper, we aim to correlate thoracic volume and the parameters in PFTs in adult scoliosis patients 25–35 years after receiving treatments during their adolescence, either with physical bracing or spinal fusion surgery.

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Kaini, Navin, Sajid Saraf, Eric Gartman, Brian Casserly e F. Dennis McCool. "Relationship Between Functional Residual Capacity And Obstructive Sleep Apnea". In American Thoracic Society 2010 International Conference, May 14-19, 2010 • New Orleans. American Thoracic Society, 2010. http://dx.doi.org/10.1164/ajrccm-conference.2010.181.1_meetingabstracts.a2199.

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Lim, Michael T. C., Daniel Y. T. Goh, Woei Shyang Loh, Maria Jimenez e Mahesh Babu Ramamurthy. "Residual obstructive sleep apnoea symptoms after adenotonsillectomy in children". In ERS International Congress 2018 abstracts. European Respiratory Society, 2018. http://dx.doi.org/10.1183/13993003.congress-2018.pa550.

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Thomas, Asha Sara, e E. Sasikala. "Identifying Lung Cancer and Chronic Obstructive Pulmonary Diseases using Residual Neural Network". In 2021 Emerging Trends in Industry 4.0 (ETI 4.0). IEEE, 2021. http://dx.doi.org/10.1109/eti4.051663.2021.9619350.

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Taelman, L., J. Bols, J. Degroote, V. Muthurangu, J. Panzer, A. Swillens, J. Vierendeels e P. Segers. "Predicting the Functional Impact of Residual Aortic Coarctation Lesions Using Fluid-Structure Interaction Simulations". In ASME 2012 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2012. http://dx.doi.org/10.1115/sbc2012-80177.

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Aortic coarctation is a congenital disease, characterized by a narrowing of the upper descending aorta, obstructing the blood flow from the heart towards the lower part of the body. The treatment can be minimally invasive using a stent and/or a balloon catheter to dilate the coarctation zone, or the narrow section can be removed surgically. Even after a successful treatment, a high risk of cardiovascular morbidity and mortality remains. Two aspects contribute to this increased risk: (1) a residual narrowing, leading to an additional resistance in the arterial system and (2) a local stiffening after treatment, disturbing the buffer function of the aorta. Moreover, these residual narrowing and stiffening lead to an impedance mismatch and are a source of wave reflections that reach the heart fast, given the short distance to the heart.

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Ziherl, Kristina, Irena Sarc e Matevz Podlipnik. "Residual insomnia in patients with obstructive sleep apnoea on positive airway pressure therapy". In ERS/ESRS Sleep and Breathing Conference 2017 abstracts. European Respiratory Society, 2017. http://dx.doi.org/10.1183/23120541.sleepandbreathing-2017.p47.

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Mosseray, Astrid, Daniel Rodenstein e Gimbada Benny Mwenge. "Predictive factors of residual events after weight loss in Obstructive Sleep Apnea Syndrome." In ERS International Congress 2018 abstracts. European Respiratory Society, 2018. http://dx.doi.org/10.1183/13993003.congress-2018.pa2551.

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