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Jesse Mez MD MS Daniel H. Daneshvar MD PhD Bobak Abdolmohammadi BA Alicia S. Chua MS Michael L. Alosco PhD Patrick T. Kiernan BA Laney Evers BA Laura Marshall BA Brett M. Martin MS Joseph N. Palmisano MS Christopher J. Nowinski PhD Ian Mahar PhD Jonathan D. Cherry PhD Victor E. Alvarez MD Brigid Dwyer MD Bertrand R. Huber MD PhD Thor D. Stein MD PhD Lee E. Goldstein MD PhD Douglas I. Katz MD Robert C. Cantu MD Rhoda Au PhD Neil W. Kowall MD Robert A. Stern PhD Michael D. McClean MS ScD Jennifer Weuve MPH ScD Yorghos Tripodis PhD Ann C. McKee MD 《Annals of neurology》2020,87(1):116-131
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Todd Woodard Sigurdur Sigurdsson John D. Gotal Alyssa A. Torjesen Lesley A. Inker Thor Aspelund Gudny Eiriksdottir Vilmundur Gudnason Tamara B. Harris Lenore J. Launer Andrew S. Levey Gary F. Mitchell 《Journal of the American Society of Nephrology : JASN》2015,26(5):1181-1187
Aortic stiffening, assessed by carotid-femoral pulse wave velocity, is associated with CKD. Transmission of excessive flow pulsatility into the low-impedance renal microvasculature may mediate this association. However, direct analyses of macrovascular–microvascular relations in the kidney are limited. Using arterial tonometry, iohexol clearance, and magnetic resonance imaging, we related arterial stiffness, GFR, urinary albumin excretion, and potential mediators, including renal artery pulsatility index, renal vascular resistance, and arterial volume in the cortex, in 367 older adults (ages 72–92 years) participating in the Age, Gene/Environment Susceptibility-Reykjavik Study. In a model adjusted for age, sex, heart rate, and body size, aortic stiffness was related to GFR (Slope of regression B=−2.28±0.85 ml/min per SD, P=0.008) but not urine albumin (P=0.09). After accounting for pulsatility index, the relation between aortic stiffness and GFR was no longer significant (P=0.10). Mediation analysis showed that 34% of the relation between aortic stiffness and GFR was mediated by pulsatility index (95% confidence interval of indirect effect, −1.35 to −0.29). An additional 20% or 36% of the relation was mediated by lower arterial volume in the cortex or higher renal vascular resistance, respectively, when offered as mediators downstream from higher pulsatility index (95% confidence interval of indirect effect including arterial volume in the cortex, −2.22 to −0.40; 95% confidence interval of indirect effect including renal vascular resistance, −2.51 to −0.76). These analyses provide the first evidence that aortic stiffness may contribute to lower GFR by transferring excessive flow pulsatility into the susceptible renal microvasculature, leading to dynamic constriction or vessel loss. 相似文献
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Nina Lundegren Melvin M Sohrabi Margareta Molin Thorén Sigvard Åkerman 《Acta odontologica Scandinavica》2019,77(4):296-302
Objective: To determine the prevalence of dental prosthetic restorations in an adult population, to study the agreement between self-reports and clinical findings of prosthetic restorations, and to study answers from a questionnaire in relation to the prevalence of prosthetic restorations.Material and methods: A questionnaire was sent to a sample of 10,000 adults. A further sample of 1000 individuals was invited to answer the questionnaire and also participate in a clinical study. The agreement between self-report and clinical findings was analyzed, as were the associations between prosthetic restorations and questionnaire responses, using the chi2 test.Results: A total of 40% of the sample had fixed dental prostheses (FDP), 2.7% had removable dentures. The agreement between self-report and clinical findings was 93%. 34.7% of the individuals with no prosthetic restorations were university graduates and 4% of individuals with removable complete dentures. Oral health had the greatest impact on the quality of life of younger individuals with FDP, with an OHIP-14 (Oral Health Impact Profile) score of 7.3 for the age group 20–39 years compared to 4.9 for the age group 65–89 years. Conclusion: The questionnaire method can be a cost-effective way to determine the prevalence of prosthetic restorations. 相似文献
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Friberg B Jisander S Widmark G Lundgren A Ivanoff CJ Sennerby L Thorén C 《Clinical implant dentistry and related research》2003,5(2):71-77
Background: Oral implant treatment ad modum Brånemark has been used for decades in the rehabilitation of edentate and partially dentate patients. Posterior jaw regions frequently exhibit bone of poor texture, and it is often difficult to obtain primary stability. Thus, it may prove beneficial to deviate from the original protocol and to use implants with a modified design, for example, with a slightly tapered geometry. Purpose: The purpose of the investigation was to compare the early behavior of a modified (prototype Mk IV, Branemark System, Nobel Biocare AB, Gothenburg, Sweden; test) implant with that of the standard Brånemark implant (control) in regions of mainly type 4 bone. Materials and Methods: Three Swedish centers participated, and a total of 44 patients were treated with oral implants for 39 maxillas and 5 mandibles. The study focused on the most distal right and left implant sites (88 implants), which were randomized to receive either a test or a control implant. Various parameters were recorded, such as registered insertion torque (OsseoCare, Nobel Biocare AB), wobbling during insertion, primary and secondary stability (as measured with resonance frequency), and marginal bone loss. The implants were followed up for 1 year. Results.: The test implant more frequently required a higher insertion torque and showed a significantly higher primary stability than the control implant. This difference in stability leveled out over time, and test and control implants exhibited similar secondary stability at abutment operation and at the 1‐year visit. Wobbling during insertion was rarely recorded for either of the implant designs. The 1‐year cumulative success rate was 93.1% for test implants and 88.4% for control implants. Conclusions: The modified implant design resulted in an increased primary stability, which may be important when placing implants in jaw regions of type 4 bone. However, independent of the achieved primary stability, successful implants tended to approach similar secondary stability in the two designs tested. 相似文献
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Thor A. Wagner 《Current HIV/AIDS reports》2018,15(2):147-154
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Plasma immunological markers in pregnancy and cord blood: A possible link between macrophage chemo‐attractants and risk of childhood type 1 diabetes 下载免费PDF全文
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Survival from pediatric cardiac arrest due to trauma has been reported to be 0.0%–8.8%. Some argue that resuscitation efforts in the case of trauma-related cardiac arrests are futile. We describe a successful outcome in the case of a child who suffered cardiac arrest caused by external traumatic airway obstruction. Our case illustrates how to deal with pediatric traumatic cardiac arrests in an out-of-hospital environment. It also illustrates how good clinical treatment in these situations may be supported by correct treatment after hospital admission when it is impossible to ventilate the patient to provide sufficient oxygen delivery to vital organs. This case relates to a lifeless child of 3–5 years, blue, and trapped by an electrically operated garage door. The first ambulance arrived to find several men trying to bend the frame and the door apart in order to extricate the child, who was hanging in the air with head and neck squeezed between the horizontally-moving garage door and the vertical door frame. One paramedic found a car jack and used it to push the door and the frame apart, allowing the lifeless child to be extricated. Basic life support was then initiated. Intubation was performed by the anesthesiologist without drugs. With FiO2 1.0 the first documented SaO2 was <50%. Restoration of Spontaneous Circulation was achieved after thirty minutes, and she was transported to the hospital. After a few hours she was put on venous-arterial ECMO for 5.5 days and discharged home after two months. Outpatient examinations during the rest of 2013 were positive, and the child found not to be suffering from any injuries, either physical or mental. The last follow-up in October 2014 demonstrated she had made a 100% recovery and she started school in August 2014. 相似文献