Browsing by Author "Neves, C"
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- Comparison of diabetic retinopathy classification using fluorescein angiography and optical coherence tomography angiographyPublication . Soares, M; Neves, C; Marques, I; Pires, I; Schwartz, C; Costa, MÂ; Santos, T; Durbin, M; Cunha-Vaz, JPURPOSE: To analyse and compare the classification of eyes with diabetic retinopathy using fluorescein angiography (FA) and optical coherence tomography angiography (OCTA) performed either with AngioPlex or AngioVue. METHODS: This was an observational cross-sectional study of 50 eyes from 26 diabetic subjects. Two independent graders classified the FA angiograms, to assess the presence and severity of several characteristics according to the ETDRS Report 11, and a similar evaluation was performed for each 3×3 mm OCTA image from the superficial retinal layer and for the full retina slab. RESULTS: Percentages of non-gradable images for the outline of foveal avascular zone (FAZ) in the central subfield (CSF) were 29.0% for FA, 12.0% for AngioVue and 3.0% for AngioPlex. For capillary loss, percentages of non-gradable images in the CSF were 25.0% for FA, 11% for AngioVue and 0.0% for AngioPlex. For the inner ring (IR), percentages of non-gradable images were 12.5% for FA, 11.5% for AngioVue and 0.5% for AngioPlex. Agreement between graders was substantial for outline of FAZ. For capillary loss, the agreement was fair for the CSF, and moderate for the IR. CONCLUSIONS: The OCTA allows better discrimination of the CSF and parafoveal macular microvasculature than FA, especially for FAZ disruption and capillary dropout, without the need of an intravenous injection of fluorescein. In addition, FA had also a higher number of non-gradable images. The OCTA can replace with advantage the FA, as a non-invasive and more sensitive procedure for detailed morphological evaluation of central macular vascular changes. TRIAL REGISTRATION NUMBER: NCT02391558, Pre-results.
- Heart transplantation from donors of different ABO blood typePublication . Neves, C; Prieto, D; Sola, E; Antunes, MJINTRODUCTION: ABO blood group compatibility between donors and recipients of heart transplants is required to reduce the risk of hyperacute rejection. Ideally, ABO-identical cardiac grafts should be used but transplantating using ABO compatible types allows reduced waiting times among recipients with rarer types without a significant increase in hyperacute rejection. However, previous reports have indicated that use of donors with minor ABO mismatches may adversely influence late outcomes, although more recent studies do not confirm this suggestion. Our purpose was to analyze this practice in our center. METHODS: We analyzed 121 patients who underwent heart transplantation between November 2003 and May 2008. One hundred nine patients (90.0%) received ABO-matched grafts (population 1 [P1]) and 12 (9.9%) received ABO-compatible grafts (population 2 [P2]). P1 included 60 group A, 44 group 0, and 5 group B patients; P2 included 5 group A, 5 group B, and 2 group AB patients. The populations did not differ statistically in age, gender, urgency status, surgical technique, ischemic time, donor features, or immunosuppression. They were assessed for left ventricle ejection fraction (LVEF), rejection, and mortality. RESULTS: There were no significant differences in total mortality (P1, 13.7%; P2, 8.3%), rejection grade > or =2R (P1, 21.1%; P2, 33.3%), or LVEF (6 months: P1, 65%; P2, 71%; 1 year: P1, 68%; P2, 69%). CONCLUSION: Minor ABO mismatches did not adversely affect 1-year outcomes of heart transplantation. This practice may facilitate organ allocation for end-stage heart failure patients, thereby reducing waiting time for heart transplantation