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      11Scopus© Citations 121
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    Growth factors for treating diabetic foot ulcers
    (2015)
    Arturo J Martí-Carvajal
    ;
    Christian Gluud
    ;
    Susana Nicola
    ;
    Daniel Simancas-Racines
    ;
    Ludovic Reveiz
      13Scopus© Citations 184
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      43
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    A non-randomized multicentre trial of human immune plasma for treatment of hantavirus cardiopulmonary syndrome caused by Andes virus
    (2015)
    VIAL CLARO, PABLO AGUSTIN  
    ;
    Francisca Valdivieso
    ;
    Mario Calvo
    ;
    M Luisa Rioseco
    ;
    Raul Riquelme
    <jats:sec><jats:title>Background</jats:title><jats:p> In Chile, Andes virus (ANDV) is the sole aetiological agent of hantavirus cardiopulmonary syndrome (HCPS) with mean annual incidence of 55 cases, 32% case fatality rate (CFR) and no specific treatment. Neutralizing antibody (NAb) titres at hospital admission correlate inversely with HCPS severity. We designed an open trial to explore safety and efficacy and evaluate pharmacokinetics of immune plasma as a treatment strategy for this disease. </jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p> We performed plasmapheresis on donors at least 6 months after HCPS and measured NAb titres through a focus-reduction neutralization test. Subjects admitted to 10 study sites with suspected/confirmed HCPS were eligible for treatment with immune plasma by intravenous infusion at an ANDV NAb dose of 5,000 U/kg. HCPS was confirmed through immunoglobulin M serology or reverse transcriptase-PCR. The main outcome was mortality within 30 days. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> From 2008–2012, we enrolled and treated 32 cases and confirmed HCPS in 29. CFR of hantavirus plasma-treated cases was 4/29 (14%); CFR of non-treated cases in the same period in Chile was 63/199 (32%; P=0.049, OR=0.35, CI=0.12, 0.99); CFR of non-treated cases at the same study sites between 2005–2012 was 18/66 (27%; ( P=0.15, OR=0.43, CI=0.14, 1.34) and CFR in a previous methylprednisolone treatment study was 20/60 (33%; P=0.052, OR=0.32, CI=0.10, 1.00). We detected no serious adverse events associated to plasma infusion. Plasma NAb titres reached in recipients were variable and viral load remained stable. </jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p> Human ANDV immune plasma infusion appears safe for HCPS. We observed a decrease in CFR in treated cases with borderline significance that will require further studies for confirmation. </jats:p></jats:sec>
    Scopus© Citations 56  2
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    Secondary spontaneous pneumothorax in patients with sarcoma treated with Pazopanib, a case control study
    (2018)
    Bruce Sabath
    ;
    Hasan A Muhammad
    ;
    Amulya Balagani
    ;
    David E Ost
    ;
    Erik Vakil
      8Scopus© Citations 19
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    Diaphragm-sparing nerve blocks for shoulder surgery, revisited
    (2020)
    De Q Tran
    ;
    Sebastián Layera
    ;
    Daniela Bravo
    ;
    Iver Cristi-Sanchéz
    ;
    Loreley Bermudéz
    <jats:p>Although interscalene brachial plexus block (ISB) remains the gold standard for analgesia after shoulder surgery, the inherent risks of ipsilateral phrenic nerve block and hemidiaphragmatic paralysis (HDP) limit its use in patients with preexisting pulmonary compromise. In a previous Daring Discourse (2017), our research team has identified potential diaphragm-sparing alternatives to ISB for patients undergoing shoulder surgery. In recent years, the field has been fertile with research, with the publication of multiple randomized controlled trials investigating supraclavicular blocks, upper trunk blocks, anterior suprascapular nerve blocks, costoclavicular blocks, and combined infraclavicular-suprascapular blocks. To date, the cumulative evidence (pre-2017 and post-2017) suggests that costoclavicular blocks may provide similar postoperative analgesia to ISB coupled with a 0%-incidence of HDP. However, in light of the small number of patients recruited by the single study investigating costoclavicular blocks, further confirmatory trials are required. Moreover, future investigation should also be undertaken to determine if costoclavicular blocks could achieve surgical anesthesia for shoulder surgery. Anterior suprascapular nerve blocks have been demonstrated to provide surgical anesthesia and similar analgesia to ISB. However, their risk of HDP has not been formally quantified. Of the remaining diaphragm-sparing nerve blocks, supraclavicular blocks (with local anesthetic injection posterolateral to the brachial plexus), upper trunk blocks, and combined infraclavicular-anterior suprascapular blocks merit further investigation, as they have been shown to achieve similar analgesia to ISB, coupled with an HDP incidence &lt;10%.</jats:p>
      11Scopus© Citations 55