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de Oliveira Adilson J M Solla Davi J. F. de Oliveira Klever F. Amaral Bruno S. Andrade Almir F. Kolias Angelos G. Paiva Wellingson S. 《Neurological sciences》2022,43(1):427-434
Neurological Sciences - Chronic subdural haematoma (CSDH) is one of the most common neurosurgical pathologies. The recurrence of chronic subdural haematomas is an important concern, considering... 相似文献
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D. J. Clark A. G. Kolias E. A. Corteen S. C. Ingham J. Piercy S. J. Crick D. K. Menon P. J. Hutchinson 《Acta neurochirurgica》2013,155(7):1329-1334
Background
Uncertainty remains as to the role of decompressive craniectomy (DC) for primary evacuation of an acute subdural haematoma (ASDH). In 2011, a collaborative group of neurosurgeons, neuro-intensive care physicians and trial methodologists was formed in the UK with the aim of answering the following question: “What is the clinical- and cost-effectiveness of DC, in comparison to simple craniotomy for adult patients undergoing primary evacuation of an ASDH?” The proposed RESCUE-ASDH trial (Randomised Evaluation of Surgery with Craniectomy for patients Undergoing Evacuation of Acute Subdural Haematoma) is a multi-centre, pragmatic, parallel group randomised trial of DC versus simple craniotomy for adult head-injured patients with an ASDH. Clinical trials in the emergency setting face the problem that potential participants may be incapacitated and their next of kin initially unavailable. As a result, consent and enrolment of participants can often be difficult.Method
In the current study, we aimed to assess public opinion regarding participation in the RESCUE-ASDH trial and acceptability of surrogate consent by conducting a pre-protocol community consultation survey.Results
One hundred and seventy-one subjects completed the survey. Eighty-four percent of participants responded positively when asked if they would participate in the proposed trial. Ninety-six percent and 91 % answered positively when asked if they found surrogate consent by their next of kin and an independent doctor acceptable, respectively. None of the characteristics of the study population were found to affect the decision to participate or the acceptability of surrogate consent by the next of kin. Being religious showed a trend towards higher acceptability of surrogate consent by a doctor. Conversely, an education to degree level and above showed a trend towards reduced acceptability of surrogate consent by a doctor.Conclusions
Our community consultation survey shows that the proposed trial is acceptable to the public. In addition, the results suggest high levels of acceptability of surrogate consent by next of kin or independent doctor amongst our community. 相似文献7.
Karvandi Elika Hanrahan John Gerrard Khan Danyal Zaman Boloux Pierre-Marc Bremner Fion Cabrilo Ivan Dorward Neil Grieve Joan Jackson Sue Jimenez Glenda Serrano Inma Nowak Victoria Anne Kolias Angelos Baldeweg Stephanie E. Marcus Hani Joseph 《Pituitary》2022,25(4):673-683
Pituitary - Pituitary adenomas affect patients’ quality-of-life (QoL) across several domains, with long-term implications even following gross-total resection or disease remission. While... 相似文献
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Matthew C. Konerman Joshua C. Greenberg Theodore J. Kolias James R. Corbett Ravi V. Shah Venkatesh L. Murthy Scott L. Hummel 《Journal of cardiac failure》2018,24(2):90-100
Introduction
Coronary microvascular dysfunction (MVD) may contribute to the pathogenesis of heart failure with preserved ejection fraction (HFpEF). Using myocardial flow reserve (MFR) measured by positron emission tomography (PET) as an assessment of microvascular function, we hypothesized that abnormal MFR is associated with LV diastolic dysfunction (DD) and reduced LV and LA strain in patients with risk factors for HFpEF and normal epicardial perfusion on cardiac PET.Methods and Results
Retrospective study of patients without heart failure who underwent cardiac rubidium-82 PET and echocardiography. Global MFR was calculated as the ratio of global stress to rest myocardial blood flow. Echocardiographic measures of diastolic function were recorded. Global longitudinal LA and LV strain were measured with a 2-dimensional speckle-tracking technique. Relationships among MFR and echocardiographic measures were assessed with linear regression, analysis of variance, and test for trend. Seventy-three patients (age 64 ± 11 years, 52% male) were identified with no epicardial perfusion defect on cardiac PET and an ejection fraction ≥50%. Decreased MFR was associated with LV DD (P = .02) and increased E/e', an estimation of LV filling pressure (low E/e' [<8] vs. high E/e' [>15], P < .001). MFR was associated with LA strain independent of age, gender, and common comorbidities (adjusted β = 2.6% per unit MFR, P = 0.046); however, MFR was only marginally related to LV strain.Conclusions
In patients with risk factors for HFpEF, MVD assessed with MFR was associated with DD, increased estimated LV filling pressure, and abnormal LA strain. 相似文献9.
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Congenital erythropoietic porphyria is a rare autosomal recessive disease due to the deficient activity of uroporphyrinogen III synthase, the fourth enzyme in the porphyrin-heme synthetic pathway. Of the porphyrias, it is the most mutilating type, usually presenting early in life. We present a patient who developed skin fragility of sun-exposed skin and red urine at the age of 72 years. Porphyrin profile showed plasma maximum fluorescence at neutral pH of 617 nm. In plasma, urine and erythrocytes, the predominant porphyrins were uroporphyrin and coproporphyrin. In all specimens, isomer I predominated. Urine δ-aminolevulinic acid and porphobilinogen, and erythrocyte uroporphyrinogen decarboxylase levels were within nomal limits. These finding were consistent with congenital erythropoietic porphyria. Thrombocytopenia and myelodysplasia with bone-marrow sideroblasts were also incidentally discovered. Including our patient, only 12 cases of late onset congenital erythropoietic porphyria have been reported worldwide, with our patient being the oldest. Patients who develop late onset congenital erythropoietic porphyria develop less severe manifestations, possibly due to heterogeneous mutations in the defective enzyme. Of the 12 reported cases, seven had thrombocytopenia, six of which also had myelodysplasia. 相似文献