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Andre Briosa e Gala MD Michael T. B. Pope BM James D. Newton MD Sam Dawkins MD PhD Timothy R. Betts MD 《Journal of cardiovascular electrophysiology》2021,32(6):1655-1657
Percutaneous mechanical closure of the left atrial appendage (LAA) is a valuable stroke prevention strategy in patients with atrial fibrillation and contraindication to oral anticoagulation. LAA thrombus is a common finding in patients with atrial fibrillation and frequently fails to resolve despite therapeutic anticoagulation. In this scenario, LAA occlusion device implant is generally discouraged due to the high risk of thrombus dislodgement and embolization; however, alternative management options are limited. We report the first case of a successful LAA occlusion device (Watchman-FLX) implant in the presence of a proximal thrombus. 相似文献
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Matthew. B. Miller Julienne Brackett Eric S. Schafer Rachel E. Rau 《Pediatric blood & cancer》2019,66(4)
Skewing of mercaptopurine (6‐MP) metabolism preferentially toward the 6‐methylmercaptopurine (6‐MMP) metabolite over the antileukemic metabolite 6‐thioguanine (6‐TGN) is associated with 6‐MP‐related hepatotoxocity. Allopurinol when coadministered with 6‐MP can reduce this skewing and ameliorate the associated adverse effects. The cases we report here demonstrate that aberrant overproduction of 6‐MMP is also associated with profound 6‐MP‐associated hypoglycemia, which can be reversed by administration of allopurinol. This case series contributes to the scant literature on 6‐MP‐induced hypoglycemia and provides evidence that addition of allopurinol to reduced dose 6‐MP can successfully manage this severe toxicity. 相似文献
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Justin E. Karr Holly K. Rau Jane B. Shofer Rebecca C. Hendrickson Elaine R. Peskind Kathleen F. Pagulayan 《Journal of clinical and experimental neuropsychology》2019,41(7):680-693
Introduction: This study investigated variables associated with subjective decline in executive function among Veterans of Operations Enduring Freedom, Iraqi Freedom, and New Dawn (OEF/OIF/OND) following a history of blast-related mild traumatic brain injury (mTBI).Method: Fifty-six male U.S. Veterans (MAge = 35.3 ± 8.8 years) with a history of blast-related mTBI (6.6 ± 3.2 years post injury) completed a battery of self-report questionnaires and neuropsychological measures. Participants rated current and retrospectively estimated pre-mTBI executive function difficulties on the Frontal Systems Behavior Scale (FrSBe). A difference score (post- minus pre-mTBI ratings) was the dependent variable (?FrSBe). Linear regression models examined variables predicting ?FrSBe, including: pre-injury characteristics (education, premorbid intelligence), injury-related characteristics (number of blast exposures, losses of consciousness), post-injury clinical symptoms (PTSD Checklist–Military version; Pittsburgh Sleep Quality Index), and post-injury neuropsychological performances on executive function measures (Trail Making Test Part B; Controlled Oral Word Association Test; Auditory Consonant Trigrams; Wisconsin Card Sorting Test).Results: While 11% of participants had a clinically elevated pre-injury FrSBe total score, 82% had a clinically elevated post-injury FrSBe total score. Only self-reported PTSD symptom severity independently predicted perceived change in executive function.Conclusions: Many OEF/OIF/OND Veterans with a history of blast-related mTBI experience subjective decline in executive function following injury. Perceived executive function decline was associated with higher PTSD symptom severity, aligning with previous research associating PTSD with cognitive complaints. Results did not support a correspondence between perceived cognitive change and neuropsychological performances. 相似文献
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Kirsi Murtomäki MD Tuomas Mertsalmi MD Elina Jaakkola MD PhD Elina Mäkinen MD PhD Reeta Levo RN Tanja Nojonen RN Mikael Eklund BM Simo Nuuttila BM Kari Lindholm RN Eero Pekkonen MD PhD Juho Joutsa MD PhD Tommi Noponen PhD Toni Ihalainen PhD Valtteri Kaasinen MD PhD Filip Scheperjans MD PhD 《Movement disorders》2022,37(6):1284-1289
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Postoperative Strokes and Intracranial Bleeds in Patients With Atrial Fibrillation: The FibStroke Study 下载免费PDF全文
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Johannes Weiss Monika Rau Jan Meertens Ilona Hering Lisa Reichert Theodor Kudlich 《Scandinavian journal of gastroenterology》2016,51(10):1263-1268
Objective: Prevalence of non-alcoholic fatty liver disease is rising in the Western world and reaches up to 90% in patients undergoing bariatric surgery. Fibroscan® as a non-invasive tool for liver stiffness measurement (LSM) has several limitations in morbidly obese patients. Only few data exist about the technical feasibility and accuracy of LSM in these patients. We aimed to analyse the feasibility of LSM by Fibroscan® in bariatric patients.Materials and methods: In morbidly obese patients, LSM was performed using XL probe. Measurements were termed reliable if 10 successful measurements with a success rate ≥60% and an interquartile range/median (IQR/M) <0.3 were obtained, unreliable if 10 successful measurements were obtained but the IQR/M was >0.3, and they were termed failed if they were neither reliable nor unreliable.Results: A total of 149 patients were included (87 with liver biopsies); mean BMI was 51.6?±?8.5?kg/m2. In 41% LSM using XL-probe was reliable, in 22% unreliable and in 37% failed. Failed LSM was significantly more frequent in patients with higher BMI compared to reliable and unreliable measurements (p?0.05). In patients with failed measurement, sonographic paramedian and intercostal distances were significantly higher compared to reliable measurements. All three patients with F4 fibrosis could successfully be differentiated by LSM from patients without fibrosis.Conclusions: LSM with XL probe is feasible in almost two-thirds of morbidly obese patients with a BMI?≥50?kg/m2. Reliable prediction of advanced fibrosis appears to be possible even if formal criteria of successful measurements are not met. 相似文献
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