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  1. Article: Acquired Hemophilia A and ST-Elevation Myocardial Infarction (STEMI): A Rare Presentation and Management Dilemma.

    Yabut, Jevin / Lima, Gian / Vankina, Ritika / Kumar, Swarup / Meng, Joyce

    Cureus

    2023  Volume 15, Issue 5, Page(s) e38549

    Abstract: Thrombotic events are a rare complication of recombinant activated factor VII (rFVIIa) therapy in patients with hemophilia. We present a case of a 71-year-old male who developed ST-elevation myocardial infarction after receiving rFVIIa replacement ... ...

    Abstract Thrombotic events are a rare complication of recombinant activated factor VII (rFVIIa) therapy in patients with hemophilia. We present a case of a 71-year-old male who developed ST-elevation myocardial infarction after receiving rFVIIa replacement therapy for acquired hemophilia A.
    Language English
    Publishing date 2023-05-04
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.38549
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Presumed Alcohol-Induced Ventricular Tachycardia Storm: A Case Report.

    Lima, Gian / Cardoso, Eduardo / Fiscus, Garret

    Cureus

    2020  Volume 12, Issue 5, Page(s) e8097

    Abstract: Alcohol abuse is a widely recognized cause of supra-ventricular fibrillation, but in some patients, it is also associated with ventricular arrhythmias and even sudden death. We describe a case of a 36-year-old patient who, with no risk factors for ... ...

    Abstract Alcohol abuse is a widely recognized cause of supra-ventricular fibrillation, but in some patients, it is also associated with ventricular arrhythmias and even sudden death. We describe a case of a 36-year-old patient who, with no risk factors for coronary disease and with a structurally normal heart, experienced two episodes of cardiac arrest five years apart, with both events occurring after significant alcohol consumption. It is important to recognize that the prognosis of alcohol-induced arrhythmias is usually good in patients who remain compliant with alcohol cessation and to avoid the misdiagnosis of "idiopathic" ventricular tachycardia/ventricular fibrillation (VT/VF).
    Language English
    Publishing date 2020-05-13
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.8097
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: A Mid-Ventricular Variant of Takotsubo Cardiomyopathy: A Case Study and Review of Literature.

    Lima, Gian / Trejo-Paredes, Maria Camila / Cardoso, Eduardo

    Cureus

    2020  Volume 12, Issue 7, Page(s) e9403

    Abstract: Different variants of Takotsubo cardiomyopathy (TC) have been described recently. In the present case, we report a post-menopausal woman who had been experiencing significant emotional distress, admitted with typical chest pain, electrocardiographic ... ...

    Abstract Different variants of Takotsubo cardiomyopathy (TC) have been described recently. In the present case, we report a post-menopausal woman who had been experiencing significant emotional distress, admitted with typical chest pain, electrocardiographic changes, and elevated troponin levels. She underwent left heart catheterization that demonstrated mild non-obstructive coronary disease and mid-ventricular focal wall motion abnormality, consistent with the mid-ventricular variant of TC. One month after her discharge, a repeated echocardiogram showed preserved ejection fraction and no wall motion abnormalities. In the mid-ventricular variant, we usually observe a unique end-systolic appearance that resembles a Greek vase. It is possible that atypical patterns of left ventricle (LV) dysfunction related to TC are being underrecognized. Therefore, this case study highlights the importance of recognizing less frequent variants of TC.
    Language English
    Publishing date 2020-07-26
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.9403
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  4. Article ; Online: Spatial patterns and climatic drivers of leaf spring phenology of maple in eastern North America.

    Buttò, Valentina / Khare, Siddhartha / Jain, Pratiksha / de Lima Santos, Gian / Rossi, Sergio

    The Science of the total environment

    2022  Volume 857, Issue Pt 1, Page(s) 159064

    Abstract: The resurgent frequency of extreme weather events and their strongly distinctive spatial patterns lead to a growing interest in phenology as an indicator of tree susceptibility. Using a long-term chronology of observations collected in situ, we predicted ...

    Abstract The resurgent frequency of extreme weather events and their strongly distinctive spatial patterns lead to a growing interest in phenology as an indicator of tree susceptibility. Using a long-term chronology of observations collected in situ, we predicted and investigated the spatial patterns and environmental drivers of spring leaf phenology across maple stand polygons dominated by Acer saccharum Marsh. and/or Acer rubra L. in eastern North America for 2000-2018. Model' calibration was based on Bayesian ordinal regressions relating the timing of the phenological events' observations to the MODIS vegetation indices EVI, NDVI and LAI. DAYMET data have been extracted to compute temperature and precipitation during spring phenology. Model accuracy increased as the season progressed, with prediction uncertainty spanning from 9 days for bud swelling to 4 days for leaf unfolding. NDVI and LAI were the best predictors for the onset and ending of spring phenology, respectively. Bud swelling occurred at the end of March in the early stands and at the onset of May in the late stands, while leaf unfolding was completed at the beginning of April for the early and in mid-June for the late stands. Early and late stands polarized towards a south-west-north-east gradient. In the south-western regions, which are also the driest, total precipitation and minimum temperature explained respectively 73 % and 25 % of the duration of spring phenology. In the north-eastern regions, precipitation and minimum temperature explained 62 % and 26 % of the duration of spring phenology. Our results suggest high vulnerability to extreme weather events in stands located in the south-west of the species distribution. The increasing incidence of drought in these locations might affect spring phenology, decreasing net primary production in these stands. Warmer nights might expose the buds to late frosts, events that are expected to become more frequent in the coming years.
    MeSH term(s) Seasons ; Acer ; Bayes Theorem ; Plant Leaves ; Temperature ; North America ; Climate Change
    Language English
    Publishing date 2022-09-28
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 121506-1
    ISSN 1879-1026 ; 0048-9697
    ISSN (online) 1879-1026
    ISSN 0048-9697
    DOI 10.1016/j.scitotenv.2022.159064
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 949: Show issues Location:
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  5. Article: Extracorporeal Membrane Oxygenation Support in a Young Patient With COVID-19 Infection.

    Lima, Gian / Cardoso, Eduardo / Paredes, Maria Camila

    Cureus

    2020  Volume 12, Issue 6, Page(s) e8694

    Abstract: Critically ill patients with coronavirus disease 2019 (COVID-19) infection often require mechanical ventilation, and still many of them will progress to worsening hypoxia and death. Veno-venous extracorporeal membrane oxygenation (VV-ECMO) has been used ... ...

    Abstract Critically ill patients with coronavirus disease 2019 (COVID-19) infection often require mechanical ventilation, and still many of them will progress to worsening hypoxia and death. Veno-venous extracorporeal membrane oxygenation (VV-ECMO) has been used in some centers, but its role in the setting of COVID-19 infection is still unclear to date. We describe a case of a young female patient with obesity but otherwise no other underlying medical conditions who was admitted with respiratory failure secondary to COVID-19. Given her severe acute respiratory distress syndrome (ARDS) with refractory hypoxemia, she was treated with VV-ECMO. After a prolonged hospital course, she improved clinically and was able to have VV-ECMO explanted, after 18 days of extracorporeal therapy. The complexity of ECMO therapy requires a well-trained multidisciplinary team present only at expert centers. The high resource cost is a challenge to the health care system in times of a global pandemic. Considering the limitations of this resource-intensive therapy, clinical judgment is crucial to decide whether ECMO is an appropriate option for the patient. However, for young patients with no underlying conditions who are critically ill despite optimized mechanical ventilation, we believe that extracorporeal therapy represents a reasonable option when available.
    Keywords covid19
    Language English
    Publishing date 2020-06-19
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.8694
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  6. Article: Aseptic Meningitis as an Immune-Related Adverse Event after Pembrolizumab.

    Lima, Gian / Kahn, Adriana / Sama, Shashank / Savage, Jacqueline

    Case reports in oncological medicine

    2019  Volume 2019, Page(s) 7183747

    Abstract: Introduction: The management of patients with advanced malignancies is challenging, although recent advances with immunotherapy have shown better outcomes. Pembrolizumab has been associated with a variety of immune-related side effects, but the ... ...

    Abstract Introduction: The management of patients with advanced malignancies is challenging, although recent advances with immunotherapy have shown better outcomes. Pembrolizumab has been associated with a variety of immune-related side effects, but the occurrence of aseptic meningitis is rare.
    Case: A 55-year-old male with a history of metastatic lung adenocarcinoma previously treated with pembrolizumab presented with persistent severe headaches and photophobia. Subsequent workup with cerebrospinal fluid analysis showed elevated opening pressure, increased nucleated cells with 30% lymphocytes, elevated protein levels, and normal glucose levels. The patient was started on high doses of IV steroids and progressed with significant improvement of his symptoms.
    Discussion: Given the rarity of this side effect, this case is a reminder that immune checkpoint inhibitors can cause aseptic meningitis and its early recognition is important for initiation of therapy with steroids and prompt discontinuation of the immunotherapy agent.
    Language English
    Publishing date 2019-11-04
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2629911-2
    ISSN 2090-6714 ; 2090-6706
    ISSN (online) 2090-6714
    ISSN 2090-6706
    DOI 10.1155/2019/7183747
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Lipid profile, changes in laboratory prescriptions are necessary.

    Lima-Oliveira, Gabriel / Valentim, Carlos David / Guidi, Gian Cesare

    Journal of clinical lipidology

    2017  Volume 11, Issue 3, Page(s) 768–769

    MeSH term(s) Humans ; Laboratories ; Lipids
    Chemical Substances Lipids
    Language English
    Publishing date 2017-03-09
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 2365061-8
    ISSN 1876-4789 ; 1933-2874
    ISSN (online) 1876-4789
    ISSN 1933-2874
    DOI 10.1016/j.jacl.2017.03.002
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  8. Article ; Online: [Anatomy-physiology considerations for cardiogenic shock with right ventricular involvement].

    Santos-Martínez, Luis Efrén / Hurtado-Belizario, Karla Sue América / Sánchez-Nieto, Jorge / Jiménez-Rodríguez, Gian Manuel / Baeza-Herrera, Luis Augusto / Romero-Zertuche, Diana / Lima-Carrasco, Olga Patricia / Lazcano-Díaz, Emmanuel Adrián

    Revista medica del Instituto Mexicano del Seguro Social

    2023  Volume 61, Issue 5, Page(s) 623–630

    Abstract: Since the discovery of right ventricular infarction, interest in the characteristics of the right ventricle has been increasing. Right ventricular function is now known to be a predictor of mortality in different settings. The right ventricle is a low- ... ...

    Abstract Since the discovery of right ventricular infarction, interest in the characteristics of the right ventricle has been increasing. Right ventricular function is now known to be a predictor of mortality in different settings. The right ventricle is a low-pressure, high-compliance, high-volume chamber. To carry out its normal function, it is coupled to the pulmonary circulation and the left ventricle. In the face of acute changes in pressure, volume overload and ischemia, it dilates to adapt to its new load. Its manifestation may be ventricular dysfunction and/or failure that will progress to cardiogenic shock due to right ventricular involvement. Various entities may be the cause of acute dysfunction: right ventricular infarction (alterations in contractility due to ischemia) and high-risk pulmonary thromboembolism (increased afterload). Both share a similar ventricular pathophysiology and high mortality without treatment. Understanding anatomy and physiology, dysfunction and acute ventricular failure are important to define a convenient diagnosis and treatment oriented towards pathophysiology. In this first part, the anatomy and physiology, acute right ventricular dysfunction/failure and cardiogenic shock are taken into consideration, from the perspective of these two entities. In another paper, treatment aimed at cardiogenic shock due to right ventricular involvement will be reviewed.
    MeSH term(s) Humans ; Shock, Cardiogenic/diagnosis ; Shock, Cardiogenic/etiology ; Shock, Cardiogenic/therapy ; Heart Ventricles ; Heart Failure/diagnosis ; Ventricular Dysfunction, Right/complications ; Ventricular Dysfunction, Right/diagnosis
    Language Spanish
    Publishing date 2023-09-04
    Publishing country Mexico
    Document type English Abstract ; Journal Article
    ZDB-ID 732133-8
    ISSN 2448-5667 ; 0443-5117 ; 0484-7849
    ISSN (online) 2448-5667
    ISSN 0443-5117 ; 0484-7849
    DOI 10.5281/zenodo.8316455
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.B 2225: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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  9. Article: Discovering Genotype Variants in an Infant with VACTERL through Clinical Exome Sequencing: A Support for Personalized Risk Assessment and Disease Prevention.

    Pelizzo, Gloria / Chiricosta, Luigi / Mazzon, Emanuela / Zuccotti, Gian Vincenzo / Avanzini, Maria Antonietta / Croce, Stefania / Lima, Mario / Bramanti, Placido / Calcaterra, Valeria

    Pediatric reports

    2021  Volume 13, Issue 1, Page(s) 45–56

    Abstract: Congenital anomalies may have an increased risk of noncommunicable diseases (NCDs) We performed a clinical exome analysis in an infant affected by "Vertebral, Anorectal, Cardiac, Tracheoesophageal, Genitourinary, and Limb" (VACTERL) malformation ... ...

    Abstract Congenital anomalies may have an increased risk of noncommunicable diseases (NCDs) We performed a clinical exome analysis in an infant affected by "Vertebral, Anorectal, Cardiac, Tracheoesophageal, Genitourinary, and Limb" (VACTERL) malformation association to identify potential biomarkers that may be helpful for preventing malignancy risk or other chronic processes. Among the variants, six variants that may be linked with VACTERL were identified in the exome analysis. The variants c.501G>C on
    Language English
    Publishing date 2021-01-05
    Publishing country Switzerland
    Document type Case Reports
    ISSN 2036-749X
    ISSN 2036-749X
    DOI 10.3390/pediatric13010006
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  10. Article ; Online: The impact of fist clenching and its maintenance during venipuncture on routine hematology testing.

    Lima-Oliveira, Gabriel / Guidi, Gian Cesare / Salvagno, Gian Luca / Lippi, Giuseppe

    Journal of clinical laboratory analysis

    2016  Volume 31, Issue 5

    Abstract: Background: Prevention of a disturbance of the blood vessel allows phlebotomists to collect a blood specimen by venipuncture that will truly mirror the patient condition. This study was aimed to evaluate the impact of repeated fist clenching and ... ...

    Abstract Background: Prevention of a disturbance of the blood vessel allows phlebotomists to collect a blood specimen by venipuncture that will truly mirror the patient condition. This study was aimed to evaluate the impact of repeated fist clenching and maintenance of the fist during blood collection by venipuncture for routine hematology testing.
    Methods: Blood were collected from 16 healthy volunteers with two separate sequential procedures, entailing standard venipuncture with hand opened throughout blood collection, or clenching the fist six times before venipuncture and maintaining the fist until completion of blood collection. The parameters tested included red blood cell (RBC) count, hemoglobin, hematocrit, mean corpuscular volume (MCV), RBC distribution width, white blood cell count and differential, including neutrophils, lymphocytes, monocytes, eosinophils, basophils, large unstained cells, platelet count, mean platelet volume, and reticulocytes. The results were reported as median and interquartile range. The comparison of data obtained with the two different venipuncture procedures (i.e., with or without fist clenching and closed hand) was performed with Wilcoxon-Mann-Whitney ranked-pairs test. The degree of statistical significance was set at P<.01.
    Results and conclusion: Fist clenching and maintenance during blood collection for routine hematology testing was effective to increase the MCV by 1.2% (P<.001). All others hematological parameters were not significantly biased by fist clenching, though hematocrit, neutrophils, eosinophils, and reticulocytes displayed mindful of trends. We hence advise patients against clenching their fist before blood collection for hematology testing.
    MeSH term(s) Adult ; Female ; Hand/physiology ; Hematologic Tests/standards ; Hematologic Tests/statistics & numerical data ; Humans ; Male ; Middle Aged ; Phlebotomy/methods ; Phlebotomy/standards ; Phlebotomy/statistics & numerical data
    Language English
    Publishing date 2016-11-29
    Publishing country United States
    Document type Journal Article
    ZDB-ID 645095-7
    ISSN 1098-2825 ; 0887-8013
    ISSN (online) 1098-2825
    ISSN 0887-8013
    DOI 10.1002/jcla.22108
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2471: Show issues Location:
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