Incidence of complications related to multiple Central Venous Access in the internal jugular vein: multicenter randomized non-inferiority clinical trial

Start Date01 Jul 2024

Sponsor / Collaborator

Irmandade Da SAnta Casa De Misericórdia De Porto Alegre

NCT06365528 / RecruitingNot ApplicableIIT

Tunneled Versus Non-Tunneled Peripherally Inserted Central Catheter and Their Effects on Reducing Combined or Isolated Outcomes (Obstruction, Infection, Thrombosis, and Dislodgement): Multicenter Randomized Clinical Trial

The aim of this multicenter randomized clinical trial is to compare the tunneling technique of PICC insertion with the non-tunneled insertion technique in the incidence of the combined or isolated outcome of catheter-related bloodstream primary infection, thrombosis, obstruction, and accidental dislodgement in the adult population within a period of up to 30 days.

Start Date06 May 2024

Sponsor / Collaborator

Hospital de Clínicas de Porto Alegre HCPA

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100 Clinical Results associated with Irmandade Da SAnta Casa De Misericórdia De Porto Alegre

0 Patents (Medical) associated with Irmandade Da SAnta Casa De Misericórdia De Porto Alegre

Literatures (Medical) associated with Irmandade Da SAnta Casa De Misericórdia De Porto Alegre

01 May 2024·European Journal of Gastroenterology & Hepatology

A new and simple score to predict adequate and deep response to ursodeoxycholic acid in patients with primary biliary cholangitis: the ALP-A score

Article

Author: Borges, Valéria Ferreira de Almeida e ; Mendes, Liliana Sampaio Costa ; Cançado, Guilherme Grossi Lopes ; Pace, Fabio Heleno de Lima ; Ferraz, Maria Lucia Gomes ; Oliveira, Elze Maria Gomes ; Pessôa, Mário Guimarães ; Filho, Roberto José de Carvalho ; Codes, Liana ; Terrabuio, Debora Raquel Benedita ; Oliveira, Maria Beatriz ; Signorelli, Izabelle Venturini ; Cunha, Simone Muniz Carvalho Fernandes da ; Gomes, Nathalia Mota de Faria ; Rotman, Vivian ; Nardelli, Mateus Jorge ; Ivantes, Claudia Alexandra Pontes ; Fucuta, Patrícia ; Mazo, Daniel Ferraz de Campos ; Coral, Gabriela Perdomo ; Couto, Cláudia Alves ; Bittencourt, Paulo Lisboa ; Braga, Michelle Harriz ; Cançado, Eduardo Luiz Rachid ; Villela-Nogueira, Cristiane Alves ; Faria, Luciana Costa

BackgroundUrsodeoxycholic acid (UDCA) is the standard treatment for primary biliary cholangitis (PBC), but a significant proportion of patients do not respond adequately, leading to increased risk of adverse outcomes. This study aims to develop a new and straightforward predictive score to identify PBC patients likely to achieve a complete response to UDCA.MethodsA logistic regression analysis was conducted using a derivation cohort of PBC patients to identify pre-treatment variables associated with response to UDCA. This analysis led to the development of the ALP-A score, calculated as: Age at diagnosis divided by (alkaline phosphatase at diagnosis/upper limit of normal). ALP-A score accuracy was evaluated using the area under the ROC curve, validated with a large external cohort from Brazil. Additionally, the correlation between the ALP-A score and the previously validated UDCA response score (URS) was assessed.ResultsALP-A score had good predictive power for adequate (AUC 0.794; 95% CI, 0.737–0.852) and deep (0.76; 95% CI, 0.69–0.83) UDCA response at 1 year of treatment. A cutoff score of 17 and 23 points was determined to be the optimal threshold for distinguishing adequate and deep responders, respectively, from non-responders. ALP-A score demonstrated a sensitivity of 73%, specificity of 71%, positive predictive value of 65%, negative predictive value of 78%, and overall accuracy of 72% for biochemical response. The URS displayed similar discriminative ability (AUC 0.798; 95% CI, 0.741–0.855).ConclusionALP-A score performs comparably to URS but offers the great advantage of simplicity for routine clinical use. It serves as a valuable tool to identify PBC patients less likely to respond to UDCA treatment, facilitating early consideration of alternative therapeutic approaches.

01 Mar 2024·Journal of Pediatric Genetics

Laryngotracheomalacia in a Patient with Mosaic Trisomy 8

Article

Author: Zottis, Laira F F ; Rosa, Ernani B da ; Rosa, Rafael F M ; de Souza, Mateus A ; Zen, Paulo R G ; Gama, Thiago K K ; Hartmann, Jéssica K

AbstractMosaic trisomy 8 is a condition characterized by a great phenotypic and cytogenetic variability whose incidence ranges around 1 in 25,000 to 50,000 live births. Here, we report a mosaic trisomy 8 patient presenting laryngotracheomalacia, an uncommon finding, analyzing its possible role over morbidity, and mortality. The patient was a boy who, after birth, had tachypnea and paleness. He presented periods of respiratory dysfunction with need of ventilatory support. Respiratory syncytial virus test was positive. Naso fibrobronchoscopy showed moderate laryngotracheomalacia. He also had recurrent episodes of pneumonia and difficulty in withdrawing continuous positive airway pressure. The patient also presented leucoma, abnormal and low-set ears, pectus excavatum, clenched fists with overlapping fingers, cryptorchidism, clubfeet, and deep longitudinal plantar creases. G-bands by Trypsin using giemsa (GTG-banding) karyotype from a peripheral blood sample revealed a mosaic trisomy 8: mos 47,XY, + 8[15]/46,XY[7]. At 4 months, the patient developed respiratory failure, and a chest computed tomography scan showed areas of atelectasis and gross fibroatelectatic striae. He ended up presenting clinical worsening and died at 4 months and 8 days. In our literature review, we found some reports describing patients with mosaic trisomy 8 and laryngotracheomalacia. However, we cannot rule out the possibility that this association could be casual, since laryngotracheomalacia is a relatively common finding in children. Therefore, more studies are still necessary to understand the possible relation between both conditions and the role of laryngotracheomalacia over morbidity and prognosis of mosaic trisomy 8 patients.

01 Nov 2023·Neuroradiology

"Bunch of acai berries sign": a new radiological sign in patients with CNS involvement in Chagas disease.

Article

Author: Pincerato, Rita de Cassia Maciel ; Roca, Federico ; da Rocha, Antonio José ; Rodrigues, Vanille ; Soares, Cândida Maria Alves ; Fonseca, Ana Paula Alves ; Menezes, Tereza ; Alves, Ronnie Peterson Marcondes ; de Melo, Rodolfo Ferreira Queiroz

Chagas disease is an infection caused by Trypanosoma cruzi, a parasite endemic in Latin America. Acute involvement of the CNS by Chagas has been considered rare, but presumed reactivation of chronic disease in immunosuppressed patients has been the subject of recent reports. Our objective is to describe the clinical and imaging characteristics of four patients with Chagas disease and CNS involvement, and the patients had to have available MRI and a diagnosis confirmed by biopsy. The imaging findings were similar, highlighting the presence of focal cerebral lesions with hypointensity on T2-WI, and these lesions assume a "bunch of acai berries appearance", a fruit involved in the transmission of T. cruzi. The post Gd T1-WI shows punctate enhancement. Knowledge of this pattern may be crucial to recognize this disease in immunocompromised patients from endemic areas.

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