DANIELLE MENOSI GUALANDRO
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119 resultados
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- 3rd GUIDELINE FOR PERIOPERATIVE CARDIOVASCULAR EVALUATION OF THE BRAZILIAN SOCIETY OF CARDIOLOGY(2017) GUALANDRO, D. M.; YU, P. C.; CARAMELLI, B.; MARQUES, A. C.; CALDERARO, D.; FORNARI, L. S.; PINHO, C.; FEITOSA, A. C. R.; POLANCZYK, C. A.; ROCHITTE, C. E.; JARDIM, C.; VIEIRA, C. L. Z.; NAKAMURA, D. Y. M.; IEZZI, D.; SCHREEN, D.; ADAM, Eduardo L.; D'AMICO, E. A.; LIMA, M. Q.; BURDMANN, E. A.; PACHON, E. I. M.; BRAGA, F. G. M.; MACHADO, F. S.; PAULA, F. J.; CARMO, G. A. L.; FEITOSA-FILHO, G. S.; PRADO, G. F.; LOPES, H. F.; FERNANDES, J. R. C.; LIMA, J. J. G.; SACILOTTO, L.; DRAGER, L. F.; VACANTI, L. J.; ROHDE, L. E. P.; PRADA, L. F. L.; GOWDAK, L. H. W.; VIEIRA, M. L. C.; MONACHINI, M. C.; MACATRAO-COSTA, M. F.; PAIXAO, M. R.; OLIVEIRA JR., M. T.; CURY, P.; VILLACA, P. R.; FARSKY, P. S.; SICILIANO, R. F.; HEINISCH, R. H.; SOUZA, R.; GUALANDRO, S. F. M.; ACCORSI, T. A. D.; MATHIAS JR., W.
- International Validation of the Canadian Syncope Risk Score(2022) ZIMMERMANN, Tobias; LAVALLAZ, Jeanne du Fay de; NESTELBERGER, Thomas; GUALANDRO, Danielle M.; LOPEZ-AYALA, Pedro; BADERTSCHER, Patrick; WIDMER, Velina; SHRESTHA, Samyut; STREBEL, Ivo; GLARNER, Noemi; DIEBOLD, Matthias; MIRO, Oscar; CHRIST, Michael; CULLEN, Louise; THAN, Martin; MARTIN-SANCHEZ, F. Javier; SOMMA, Salvatore Di; PEACOCK, W. Frank; I, Dagmar Keller; BILICI, Murat; COSTABEL, Juan Pablo; KUHNE, Michael; BREIDTHARDT, Tobias; THIRUGANASAMBANDAMOORTHY, Venkatesh; MUELLER, ChristianBackground: The Canadian Syncope Risk Score (CSRS) was developed to predict 30-day serious outcomes not evident during emergency department (ED) evaluation. Objective: To externally validate the CSRS and compare it with another validated score, the Osservatorio Epidemiologico della Sincope nel Lazio (OESIL) score. Design: Prospective cohort study. Setting: Large, international, multicenter study recruiting patients in EDs in 8 countries on 3 continents. Participants: Patients with syncope aged 40 years or older presenting to the ED within 12 hours of syncope. Measurements: Composite outcome of serious clinical plus procedural events (primary outcome) and the primary com-posite outcome excluding procedural interventions (second-ary outcome). Results: Among 2283 patients with a mean age of 68 years, the primary composite outcome occurred in 7.2%, and the compos-ite outcome excluding procedural interventions occurred in 3.1% at 30 days. Prognostic performance of the CSRS was good for both 30-day composite outcomes and better compared with the OESIL score (area under the receiver-operating characteristic curve [AUC], 0.85 [95% CI, 0.83 to 0.88] vs. 0.74 [CI, 0.71 to 0.78] and 0.80 [CI, 0.75 to 0.84] vs. 0.69 [CI, 0.64 to 0.75], respectively). Safety of triage, as measured by the frequency of the primary composite outcome in the low-risk group, was higher using the CSRS (19 of 1388 [0.6%]) versus the OESIL score (17 of 1104 [1.5%]). A simplified model including only the clinician clas-sification of syncope (cardiac syncope, vasovagal syncope, or other) variable at ED discharge-a component of the CSRS- achieved similar discrimination as the CSRS (AUC, 0.83 [CI, 0.80 to 0.87] for the primary composite outcome). Limitation: Unable to disentangle the influence of other CSRS components on clinician classification of syncope at ED discharge. Conclusion: This international external validation of the CSRS showed good performance in identifying patients at low risk for serious outcomes outside of Canada and superior performance compared with the OESIL score. However, clinician classification of syncope at ED discharge seems to explain much of the per-formance of the CSRS in this study. The clinical utility of the CSRS remains uncertain. Primary Funding Source: Swiss National Science Foundation & Swiss Heart Foundation.
- Daytime variation of perioperative myocardial injury in non-cardiac surgery and effect on outcome(2019) LAVALLAZ, Jeanne du Fay de; PUELACHER, Christian; BUSE, Giovanna Lurati; BOLLIGER, Daniel; GERMANIER, Dominic; HIDVEGI, Reka; WALTER, Joan Elias; TWERENBOLD, Raphael; STREBEL, Ivo; BADERTSCHER, Patrick; SAZGARY, Lorraine; LAMPART, Andreas; ESPINOLA, Jaqueline; KINDLER, Christoph; HAMMERER-LERCHER, Angelika; THAMBIPILLAI, Saranya; GUERKE, Lorenz; RENTSCH, Katharina; BUSER, Andreas; GUALANDRO, Danielle; JAKOB, Marcel; MUELLER, Christian; HUCK, Claudia; FREESE, Michael; MEISSNER, Kathrin; NESTELBERGER, Thomas; WUSSLER, Desiree; BOEDDINGHAUS, Jasper; KOZHUHAROV, Nikola; KAISER, Christoph; FAHRNI, Gregor; OSSWALD, Stefan; STEINER, Luzius; SEEBERGER, Manfred; MAFOUZ, RihamObjective Recently, daytime variation in perioperative myocardial injury (PMI) has been observed in patients undergoing cardiac surgery. We aim at investigating whether daytime variation also occurs in patients undergoing non-cardiac surgery. Methods In a prospective diagnostic study, we evaluated the presence of daytime variation in PMI in patients at increased cardiovascular risk undergoing non-cardiac surgery, as well as its possible impact on the incidence of acute myocardial infarction (AMI), and death during 1-year follow-up in a propensity score-matched cohort. PMI was defined as an absolute increase in high-sensitivity cardiac troponin T (hs-cTnT) concentration of >= 14 ng/L from preoperative to postoperative measurements. Results Of 1641 patients, propensity score matching defined 630 with similar baseline characteristics, half undergoing non-cardiac surgery in the morning (starting from 8: 00 to 11: 00) and half in the afternoon (starting from 14: 00 to 17: 00). There was no difference in PMI incidence between both groups (morning: 50, 15.8% (95% CI 12.3 to 20.3); afternoon: 52, 16.4% (95% CI 12.7 to 20.9), p=0.94), nor if analysing hs-cTnT release as a quantitative variable (median morning group: 3 ng/L (95% CI 1 to 7 ng/L); median afternoon group: 2 ng/L (95% CI 0 to 7 ng/L; p=0.16). During 1-year follow-up, the incidence of AMI was 1.2% (95% CI 0.4% to 3.2%) among morning surgeries versus 4.1% (95% CI 2.3% to 6.9%) among the afternoon surgeries (corrected HR for afternoon surgery 3.44, bootstrapped 95% CI 1.33 to 10.49, p log-rank=0.03), whereas no difference in mortality emerged (p=0.70). Conclusions Although there is no daytime variation in PMI in patients undergoing non-cardiac surgery, the incidence of AMI during follow-up is increased in afternoon surgeries and requires further study.
conferenceObject Acute anemia and cardiovascular events after vascular surgery(2013) CALDERARO, D.; GUALANDRO, S. M.; GUALANDRO, D. M.; YU, P. C.; CARMO, G. L. A.; MARQUES, A. C.; D'AMICO, E. A.; ROCHA, T. R. F.; CARAMELLI, B.; PASTANA, A. F.bookPart Manejo dos anticoagulantes no perioperatório(2016) GUALANDRO, Danielle Menosi; YU, Pai Ching- The value of B-type natriuretic peptide as a predictor of mortality in patients with constrictive pericarditis undergoing pericardiectomy(2016) MELO, Dirceu Thiago Pessoa de; MADY, Charles; RAMIRES, Felix Jose Alvarez; DIAS, Ricardo Ribeiro; GUALANDRO, Danielle Menosi; CARAMELLI, Bruno; KALIL FILHO, Roberto; FERNANDES, Fabio
conferenceObject The role of high-sensitivity troponin I for risk prediction in patients with systemic autoimmune myopathies(2018) GUALANDRO, D. M.; SHINJO, S. K.; SANTORO, J.; CALDERARO, D.; YU, P. C.; STRUNZ, C.; SILVA, M. G.; CARAMELLI, B.- Impact of cardiology referral: clinical outcomes and factors associated with physicians' adherence to recommendations(2014) MARQUES, Andre C.; CALDERARO, Daniela; YU, Pai C.; GUALANDRO, Danielle M.; CARMO, Gabriel A. L.; AZEVEDO, Fernanda R.; PASTANA, Adriana F.; LIMA, Eneas M. O.; MONACHINI, Maristela; CARAMELLI, BrunoOBJECTIVES: Cardiology referral is common for patients admitted for non-cardiac diseases. Recommendations from cardiologists may involve complex and aggressive treatments that could be ignored or denied by other physicians. The purpose of this study was to compare the outcomes of patients who were given recommendations during cardiology referrals and to examine the clinical outcomes of patients who did not follow the recommendations. METHODS: We enrolled 589 consecutive patients who received in-hospital cardiology consultations. Data on recommendations, implementation of suggestions and outcomes were collected. RESULTS: Regarding adherence of the referring service to the recommendations, 77% of patients were classified in the adherence group and 23% were classified in the non-adherence group. Membership in the non-adherence group (p<0.001; odds ratio: 10.25; 95% CI: 4.45-23.62) and advanced age (p = 0.017; OR: 1.04; 95% CI: 1.01-1.07) were associated with unfavorable outcomes. Multivariate analysis identified four independent predictors of adherence to recommendations: follow-up notes in the medical chart (p<0.001; OR: 2.43; 95% CI: 1.48-4.01); verbal reinforcement (p = 0.001; OR: 1.86; 95% CI: 1.23-2.81); a small number of recommendation (p = 0.001; OR: 0.87; 95% CI: 0.80-0.94); and a younger patient age (p = 0.002; OR: 0.98; 95% CI: 0.96-0.99). CONCLUSIONS: Poor adherence to cardiology referral recommendations was associated with unfavorable clinical outcomes. Follow-up notes in the medical chart, verbal reinforcement, a limited number of recommendations and a patient age were associated with greater adherence to recommendations.
conferenceObject Etiology of perioperative myocardial injuries after non-cardiac surgery and associated outcomes(2019) PUELACHER, C.; GUALANDRO, D. M.; BUSE, G. Lurati; MARBOT, S.; GUECKEL, J.; HIDVEGI, R.; WILDI, K.; ESPINOLA, J.; KINDLER, C.; LAMPART, A.; BOLLIGER, D.; OSSWALD, S.; MUELLER, C.- Hypertension, mitral valve disease, atrial fibrillation and low education level predict delirium and worst outcome after cardiac surgery in older adults(2018) OLIVEIRA, Fatima R.; OLIVEIRA, Victor H.; OLIVEIRA, Italo M.; LIMA, Jose W.; CALDERARO, Daniela; GUALANDRO, Danielle M.; CARAMELLI, BrunoBackground: Delirium is a common complication after cardiac surgery in older adult patients. However, risk factors and the influence of delirium on patient outcomes are not well established. We aimed to determine the incidence, predisposing and triggering factors of delirium following cardiac surgery. Methods: One hundred seventy-three consecutive patients aged >= 60 years were studied. Patients' characteristics and two cognitive function assessment tests were recorded preoperatively. Perioperative variables were blood transfusion, orotracheal intubation time (OIT), renal dysfunction, and hypoxemia. Delirium was assessed using the Confusion Assessment Method for the Intensive Care Unit. The composite outcome consisted of death, infection, and perioperative myocardial infarction until hospital discharge or 30 days after surgery, and for up to 18 months. Results: One hundred six patients (61.27%) were men and the age was 69.5 +/- 5.8 years. EuroSCORE II index was 4. 06 +/- 3.86. Hypertension was present in 75.14%, diabetes in 39.88%, and 30.06% were illiterate. Delirium occurred in 59 patients (34.1%). Education level (OR 0.81, 0.71-0.92), hypertension (OR 2.73, 1.16-6.40), and mitral valve disease (OR 2.93, 1.32-6.50) were independent predisposing factors for delirium, and atrial fibrillation after surgery (OR 2.49, 1.20-5.20) represented the potential triggering factor. Delirium (OR 2.35, 1.20-4.58) and OIT >= 900 min (OR 2.50; 1. 30-4.80) were independently associated with the composite outcome. Conclusions: In older adult patients submitted to cardiac surgery, delirium is a frequent complication that is associated with worst outcome. Independent risk factors for delirium included education level, hypertension, mitral valve disease, and atrial fibrillation after cardiac surgery.