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1.
Xiaohui Lin Sebastiaan W F Meenderink Glenna Stomackin Timothy T Jung Glen K Martin Wei Dong 《Journal of the Association for Research in Otolaryngology》2021,22(3):261
Tympanic membranes (TM) that have healed spontaneously after perforation present abnormalities in their structural and mechanical properties; i.e., they are thickened and abnormally dense. These changes result in a deterioration of middle ear (ME) sound transmission, which is clinically presented as a conductive hearing loss (CHL). To fully understand the ME sound transmission under TM pathological conditions, we created a gerbil model with a controlled 50% pars tensa perforation, which was left to heal spontaneously for up to 4 weeks (TM perforations had fully sealed after 2 weeks). After the recovery period, the ME sound transmission, both in the forward and reverse directions, was directly measured with two-tone stimulation. Measurements were performed at the input, the ossicular chain, and output of the ME system, i.e., at the TM, umbo, and scala vestibuli (SV) next to the stapes. We found that variations in ME transmission in forward and reverse directions were not symmetric. In the forward direction, the ME pressure gain decreased in a frequency-dependent manner, with smaller loss (within 10 dB) at low frequencies and more dramatic loss at high frequency regions. The loss pattern was mainly from the less efficient acoustical to mechanical coupling between the TM and umbo, with little changes along the ossicular chain. In the reverse direction, the variations in these ears are relatively smaller. Our results provide detailed functional observations that explain CHL seen in clinical patients with abnormal TM, e.g., caused by otitis media, that have healed spontaneously after perforation or post-tympanoplasty, especially at high frequencies. In addition, our data demonstrate that changes in distortion product otoacoustic emissions (DPOAEs) result from altered ME transmission in both the forward and reverse direction by a reduction of the effective stimulus levels and less efficient transfer of DPs from the ME into the ear canal. This confirms that DPOAEs can be used to assess both the health of the cochlea and the middle ear. 相似文献
2.
Lucia Taramasso Paolo Bonfanti Elena Ricci Paolo Maggi Giancarlo Orofino Nicola Squillace Barbara Menzaghi Giordano Madeddu Chiara Molteni Francesca Vichi Erika Riguccini Annalisa Saracino Carmen Santoro Marta Guastavigna Daniela Francisci Antonio Di Biagio Giuseppe Vittorio De Socio 《HIV medicine》2022,23(1):70-79
3.
目的分析低分子肝素钙抗凝对多囊卵巢综合征(PCOS)所致不孕症患者来曲唑诱导排卵疗效的影响。方法选取2014年1月—2019年1月九江市第三人民医院和彭泽县妇幼保健院收治的156例PCOS所致不孕症患者,采用随机数字表分成两组,每组78例。对照组口服来曲唑治疗,观察组采取口服来曲唑联合低分子肝素钙注射液治疗。比较两组的疗效、子宫内膜容受性、凝血功能指标、促排卵结局及不良反应。结果观察组总有效率[94.87%(74/78)]显著高于对照组[80.77%(63/78)],差异有统计学意义(χ2=7.252,P=0.007)。治疗后,观察组子宫内膜厚度、子宫动脉搏动指数(PI)及阻力指数(RI)分别为(9.75±1.03)mm、(1.30±0.26)及(0.58±0.12),对照组子宫内膜厚度、PI及RI分别为(7.48±0.95)mm、(1.71±0.33)及(0.66±0.11),两组比较差异均有统计学意义(t=14.308,8.619,4.340,均P<0.05)。治疗后,两组凝血功能指标比较差异均有统计学意义(均P<0.05)。观察组妊娠率[52.56%(41/78)]显著高于对照组[32.05%(25/78)],自然流产率[2.44%(1/41)]显著低于对照组[16.00%(4/25)],差异均有统计学意义(均P<0.05)。观察组不良反应发生率[16.67%(13/78)]与对照组[12.82%(10/78)]比较差异无统计学意义(χ2=0.459,P=0.498)。结论PCOS所致不孕症患者在应用来曲唑诱导排卵的同时联合低分子肝素钙抗凝治疗能有效改善患者的凝血-纤溶状态,明显提高患者的子宫内膜容受性,改善促排卵结局。 相似文献
4.
Keith B. Diamond Ivan J. Golub Asad M. Ashraf Samuel J. Swiggett Paul V. Romeo Jack Choueka 《Seminars in Arthroplasty》2022,32(1):15-22
BackgroundWhile studies have demonstrated favorable outcomes in utilization of primary total shoulder arthroplasty (TSA) for the treatment of glenohumeral osteoarthritis (OA), adverse events such as infections can still occur. Periprosthetic joint infections (PJIs) are associated with worse outcomes and patient morbidity. The purpose of this study was to: (1) compare patient demographics amongst TSA patients with and without PJIs following primary TSA; and (2) identify patient-related risk factors for PJIs following primary TSA.MethodsPatients undergoing primary TSA for the treatment of glenohumeral OA were identified using the Mariner administrative claims database by CPT code 23,472. Laterality modifiers were utilized to ensure PJIs were developing in the correct laterality as those patients undergoing primary TSA. Inclusion for the study group consisted of patients who developed PJIs within 2-years after the index procedure, whereas patients who did not develop PJIs served as the comparison cohort. Primary outcomes analyzed included patient demographics and patient-related risk factors for PJIs following primary TSA. A stepwise backwards elimination multivariate binomial logistic regression analyses was performed to determine the odds (OR) of PJIs in patients undergoing primary TSA. A P value less than .05 was considered statistically significant.ResultsThe query yielded 15,396 patients who underwent primary TSA for glenohumeral OA, of which 191 patients developed PJIs and 15,205 did not develop PJIs. The study found statistically significant differences amongst patients who did and did not develop PJIs following primary TSA with respect to age, sex, and presence of comorbid conditions. Risk factors associated with developing PJIs following primary TSA included: pathologic weight loss (OR: 2.06, P < .0001), obesity (OR: 1.56, P = .0001), male sex (OR: 1.52, P = .007), and peripheral vascular disease (OR: 1.46, P = .022).ConclusionAs the number of primary TSAs for the treatment of glenohumeral OA increase worldwide, identifying modifiable risk-factors to reduce the incidence of infection is critical. The study found various modifiable and non-modifiable risk factors associated with developing PJIs following primary TSA. This study is valuable to orthopedists in order to identify and risk-stratify patients with regard to PJI in the setting of primary TSA for OA.Level of EvidenceLevel III; Case-Control Study 相似文献
5.
Francesca Bodega Anita Russi Francesco Melillo Fabiana Blunda Claudia Rubino Giulio Leo Alberto Cappelletti Patrizio Mazzone Paolo Mattiello Paolo Della Bella Alessandro Castiglioni Ottavio Alfieri Michele De Bonis Matteo Montorfano Moreno Tresoldi Massimo Filippi Anna Salerno Michela Cera Alberto Zangrillo Margonato Alberto Cosmo Godino 《European journal of clinical investigation》2022,52(1):e13658
6.
目的:探讨袋鼠式护理对使用无创呼吸机早产儿住院期间母乳喂养、喂养不耐受、体质量增长速率及住院费用的影响。方法:选取2019年8月至2020年8月入住NICU的早产儿为研究对象,随机分为干预组(30例)和对照组(30例)。对照组实施常规早产儿发育支持护理,干预组在常规发育支持护理的基础上实施袋鼠式护理。结果:干预组早产儿母乳喂养比例及纯母乳喂养率高于对照组,喂养不耐受发生率低于对照组,体质量增长速率高于对照组,住院时间短于对照组,住院费用低于对照组,差异均有统计学意义(P<0.05)。结论:袋鼠式护理可提高使用无创呼吸机早产儿住院期间的母乳喂养比例及纯母乳喂养率,降低使用无创呼吸机早产儿喂养不耐受发生率,提高恢复至出生体质量速率,缩短住院时间,节省住院费用。 相似文献
7.
目的探讨低分子量肝素在子痫前期患者中的应用效果。方法回顾性调查我院2019年1~4月290例子痫前期患者,根据产后1 d采用的治疗方法分为肝素组(190例)及对照组(100例),分析比较两组的一般资料和凝血指标差异。结果肝素组的新生儿体重和Apgar评分(1 min)低于对照组(P<0.05)。肝素组与对照组在产前仅凝血酶时间、D-二聚体、血小板体积分布宽度有差异,产后1 d肝素组纤维蛋白原含量、血小板计数、血小板压积低于对照组,凝血酶时间、D-二聚体、血小板体积分布宽度高于对照组(P<0.05)。产后3 d仅D-二聚体有差异。结论在产后1 d应用低分子量肝素有助于子痫前期患者产后凝血状态向正常恢复。 相似文献
8.
新生儿重症监护病房中早产儿的侵袭性真菌感染(invasive fungal infection,IFI)发生率较高,且早期临床诊断困难,一旦发生,病情重,疗程长,花费高,病死率较高,预后差。因此预防IFI尤为重要。目前临床常选氟康唑作为预防早产儿IFI的一线药物,但具体剂量、疗程尚不统一,使用对象及预防效果也存在争议。该文对近年来新生儿重症监护病房中药物预防早产儿IFI的研究进展进行综述,供临床医生参考。 相似文献
9.
美国心脏协会在Circulation杂志上发布了2021年促进心血管健康膳食指南。在这一最新的膳食指南中提出控制能量平衡、保持健康体质量、增加水果蔬菜的摄入、偏向选择全谷物食品、减少精加工食品的摄入、避免摄入超加工食品、合理使用植物油、尽量减少含糖食物、选择低盐饮食、合理控制饮酒等建议,对保护心血管系统具有重要的意义。本文针对这一最新的膳食指南进行解读,并结合东方饮食习惯以及近年来中国人群膳食习惯的改变,提出切合中国人群的健康膳食建议。 相似文献
10.
产前预测胎儿出生体质量可评价胎儿宫内生长发育,指导分娩方式。MRI能清楚显示胎儿解剖结构和异常情况,通过测量胎儿体积(FBV)可以计算获得胎儿体质量预测值(EFW),有助于高危儿的诊断和监测。综述MRI预测胎儿体质量的扫描技术、FBV的测量方法及EFW的计算方法,介绍其在识别大于胎龄儿及小于胎龄儿、高危产妇(糖尿病妊娠以及双胎妊娠)中的应用,展望MRI产前预测胎儿出生体质量的临床应用。 相似文献