We examined our own institutional experience with transplantation for failed Fontan.
Methods: The records
of 155 patients transplanted for congenital heart disease at a single institution from June 1984 to September 2007 were reviewed. Of these patients, 43 had undergone a previous Fontan procedure (25 male, 15 female; median age, 14.5 years; range, 1-47; 23 classic Fontan, 13 lateral tunnel, 4 extracardiac conduit, and 3 revised to shunt). The predictors of short-and long-term survival were evaluated, and the Fontan patients were compared with all other patients with congenital heart disease (n = 129, 78 male, 51 female).
Results: The most common indications for transplantation included protein-losing enteropathy Galunisertib (PLE) (39.5%), chronic heart failure (41.8%), and acute post-Fontan failure (9.3%). The transplants performed in Fontan patients were more likely to require pulmonary artery reconstruction (85.4% vs 42.9%; P < .0001) and had longer cardiopulmonary bypass times (278 vs 179 minutes; P < .0001). The 90-day mortality rate was greater in the Fontan group (35.0% vs 20.0%; P = .055). No correlation was observed between the interval
from Fontan to transplantation and morality; however, renal failure was a strong predictor of early mortality (odds ratio, 10.8; 95% confidence interval, 1.5-75.7).
Conclusions: Transplantation is an acceptable treatment for CX-6258 cost patients with a failed Fontan. Clinical factors (instead of the indication for transplantation) appear to have the greatest correlation with early mortality. (J Thorac Cardiovasc 3-deazaneplanocin A concentration Surg 2012; 143: 1183-92)”
“Objective: The aim of this meta-analysis is to evaluate the effect of aerobic training and strength training as a treatment for depression in patients diagnosed with
major depressive disorder. Methods: PubMed (Medline), ISI knowledge (Institute for Scientific Information), SciELO (Scientific Electronic Library) and Scopus databases were consulted from January 1970 to September 2011. Data were collected on variables as follows: total number of patients (pre- and postintervention), age, randomized (yes or no), diagnostic criteria, assessment instruments, and the percentage of remission and treatment response. Subsequently, we collected information on time intervention, intensity, duration, frequency, method of training (aerobic training and strength training) and type of supervision. Standardized mean differences were used for pooling continuous variables as end-point scores. Binary outcomes, such as proportion of remission (no symptoms) and at least 50% reduction of initial scores (response), were pooled using relative risks. Random effects models were used that take into account the variance within and between studies. Results: Ten articles were selected and subdivided by their interventions, controlled training modality and levels of intensity.