que se leu este artigo
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"cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Low-dose intravenous tissue-type plasminogen activator for prosthetic valve thrombosis is better than standard dose streptokinase" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "569" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Murat Biteker, Özcan Başaran, Nesrin Filiz Başaran, Funda Sungur Biteker" "autores" => array:4 [ 0 => array:3 [ "nombre" => "Murat" "apellidos" => "Biteker" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:4 [ "nombre" => "Özcan" "apellidos" => "Başaran" "email" => array:1 [ 0 => "basaran_ozcan@yahoo.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 2 => array:3 [ "nombre" => "Nesrin" "apellidos" => "Filiz Başaran" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "Funda" "apellidos" => "Sungur Biteker" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Muğla Sıtkı Koçman University, Faculty of Medicine, Department of Cardiology, Mugla, Turkey" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Muğla Sıtkı Koçman University, Faculty of Medicine, Department of Medical Pharmacology, Mugla, Turkey" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Muğla Sıtkı Koçman University, Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Mugla, Turkey" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Baixas doses de activador de plasminogéneo tecidular intravenoso são preferíveis às doses estandardizadas para trombose de prótese valvular" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We have recently read with great interest the article by Cardoso et al. entitled “Prosthetic mitral valve thrombosis in pregnancy: from thrombolysis to anticoagulation”.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The authors reported a case of mitral prosthetic valve thrombosis (PVT) in early pregnancy, which was successfully treated with streptokinase. Streptokinase was administered using a loading dose of 250<span class="elsevierStyleHsp" style=""></span>000 IU given over 30 min, followed by 100<span class="elsevierStyleHsp" style=""></span>000 IU/h infusion. We congratulate the authors for their successful management strategy of such a high-risk patient, but we would like to comment on a few points of the authors’ paper.</p><p id="par0015" class="elsevierStylePara elsevierViewall">PVT is an uncommon but serious complication of heart valve replacement procedures. Because of associated prothrombotic alterations, pregnancy in women with mechanical heart valves carries a high rate of PVT and thromboembolic complications.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">2–4</span></a> Özkan et al. recently published the results of the largest series of pregnant patients with PVT.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> This single-center, prospective, non-randomized, observational study included 24 consecutive pregnant women (25 pregnancies with 28 PVT episodes over an eight-year period) with left-sided PVT (all mitral; n=27). Patients with obstructive and nonobstructive PVT with recent systemic thromboembolism and a thrombus diameter of >5 mm and patients with asymptomatic mobile nonobstructive PVT with a thrombus diameter of at least 10 mm were included in the study. A specific thrombolytic protocol was used (25 mg tissue-type plasminogen activator infusion for six hours for each thrombolytic session, repeated once after 24 hours up to six times with a maximum total dose of 150 mg). They found a 100% thrombolytic success rate with no maternal mortality. Neonatal mortality in the series by Özkan et al. was 20%, similar to the incidence reported in other studies.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Despite the limitations of the study, this protocol seems to be an effective therapy with an excellent success rate for the treatment of PVT in pregnant women. It also seems to be safer than cardiac surgery or alternative medical strategies published to date. In conclusion, according to the current data, rather than standard dose streptokinase, low-dose, slow-infusion tissue-type plasminogen activator should be considered as the first-line therapy in pregnant patients with PVT.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prosthetic mitral valve thrombosis in pregnancy: from thrombolysis to anticoagulation" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "G. Cardoso" 1 => "C. Aguiar" 2 => "M.J. Andrade" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.repc.2015.01.010" "Revista" => array:6 [ "tituloSerie" => "Rev Port Cardiol" "fecha" => "2015" "volumen" => "34" "paginaInicial" => "71.e1" "paginaFinal" => "71.e5" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26028489" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment of obstructive prosthetic heart valve thrombosis in pregnancy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. Biteker" 1 => "M. Ozkan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1540-8191.2009.00822.x" "Revista" => array:5 [ "tituloSerie" => "J Card Surg" "fecha" => "2010" "volumen" => "25" "paginaInicial" => "206" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19549042" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prosthetic mechanic valve thrombosis in pregnant women" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "M. Ozkan" 1 => "M. Biteker" 2 => "A.E. Oğuz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Turk Kardiyol Dern Ars" "fecha" => "2009" "volumen" => "37" "paginaInicial" => "215" "paginaFinal" => "217" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19553754" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Images in cardiovascular medicine. Huge prosthetic mitral valve thrombosis in a pregnant woman" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "M. Ozkan" 1 => "M. Biteker" 2 => "N.E. Duran" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/CIRCULATIONAHA.109.873786" "Revista" => array:6 [ "tituloSerie" => "Circulation" "fecha" => "2009" "volumen" => "120" "paginaInicial" => "e151" "paginaFinal" => "e152" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19884477" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Thrombolytic therapy for the treatment of prosthetic heart valve thrombosis in pregnancy with low-dose, slow infusion of tissue-type plasminogen activator" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "M. Özkan" 1 => "B. Çakal" 2 => "S. 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2019 Maio | 31 | 5 | 36 |
2019 Abril | 12 | 8 | 20 |
2019 Maro | 52 | 8 | 60 |
2019 Fevereiro | 62 | 9 | 71 |
2019 Janeiro | 15 | 6 | 21 |
2018 Dezembro | 20 | 11 | 31 |
2018 Novembro | 56 | 8 | 64 |
2018 Outubro | 95 | 12 | 107 |
2018 Setembro | 37 | 13 | 50 |
2018 Agosto | 36 | 15 | 51 |
2018 Julho | 18 | 5 | 23 |
2018 Junho | 28 | 4 | 32 |
2018 Maio | 38 | 5 | 43 |
2018 Abril | 48 | 5 | 53 |
2018 Maro | 39 | 8 | 47 |
2018 Fevereiro | 33 | 7 | 40 |
2018 Janeiro | 12 | 8 | 20 |
2017 Dezembro | 51 | 8 | 59 |
2017 Novembro | 23 | 10 | 33 |
2017 Outubro | 23 | 7 | 30 |
2017 Setembro | 30 | 15 | 45 |
2017 Agosto | 32 | 8 | 40 |
2017 Julho | 21 | 9 | 30 |
2017 Junho | 41 | 11 | 52 |
2017 Maio | 36 | 13 | 49 |
2017 Abril | 14 | 4 | 18 |
2017 Maro | 20 | 32 | 52 |
2017 Fevereiro | 15 | 9 | 24 |
2017 Janeiro | 23 | 8 | 31 |
2016 Dezembro | 23 | 3 | 26 |
2016 Novembro | 21 | 7 | 28 |
2016 Outubro | 12 | 10 | 22 |
2016 Setembro | 10 | 3 | 13 |
2016 Agosto | 6 | 0 | 6 |
2016 Julho | 5 | 2 | 7 |
2016 Junho | 8 | 6 | 14 |
2016 Maio | 7 | 0 | 7 |
2016 Abril | 12 | 1 | 13 |
2016 Maro | 26 | 5 | 31 |
2016 Fevereiro | 37 | 17 | 54 |
2016 Janeiro | 25 | 9 | 34 |
2015 Dezembro | 28 | 7 | 35 |
2015 Novembro | 32 | 18 | 50 |
2015 Outubro | 99 | 37 | 136 |
2015 Setembro | 115 | 80 | 195 |