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排序方式: 共有178条查询结果,搜索用时 31 毫秒
1.
Andrew Small Peter Klinke Anthony Della Siega Eric Fretz David Kinloch Richard Mildenberger Malcolm Williams David Hilton 《Catheterization and cardiovascular interventions》2007,70(7):907-912
OBJECTIVES: To assess the timeframe of postprocedural complications following transradial percutaneous intervention in selected nonlow-risk risk patients as a feasibility study for same day discharge. BACKGROUND: Percutaneous coronary intervention (PCI) is traditionally performed as an inpatient procedure. Transradial access with its lower complication rate facilitates safe and same day discharge. We hypothesize that with current standards of pharmacotherapy and intervention, complications post transradial percutaneous coronary angioplasty even in a nonlow-risk patient cohort will be evident within 6 hr or occur more than 24 hr post procedure. Under these circumstances, overnight stay results in no improvement in patient safety. METHODS: 2,189 patients underwent transradial PCI at our institution between January 2005 and June 2006. Of these 1,174 were assessed as intermediate or high risk and admitted postprocedure. The remaining 1,015 were assessed as low risk and discharged the day of procedure. All 1,174 inpatients were entered into our study database. Information was collected on patient demographics, angiographic characteristics, post procedural complications, and timing of post procedural events. RESULTS: 1,543 ACC type B2 or C lesions were treated in 1,174 patients. All post-procedural complications were identified within 6 hr of the intervention or occurred more than 24 hr later when patients would have been discharged according to overnight admission protocols. CONCLUSIONS: Day case transradial percutaneous intervention with a 6-hr period of post procedure observation is a safe and feasible practice. The presence of higher-risk features should not be considered an absolute indication for overnight admission in patients considered clinically appropriate for discharge. 相似文献
2.
Comparison of the radial and femoral approaches in left main PCI: a retrospective study 总被引:4,自引:0,他引:4
Ziakas A Klinke P Mildenberger R Fretz E Williams MB Della Siega A Kinloch RD Hilton JD 《The Journal of invasive cardiology》2004,16(3):129-132
Transradial percutaneous coronary intervention (PCI) is a safe and effective method of percutaneous revascularization. However, there are no data on the efficacy of the transradial approach in left main (LM) PCI. We studied 80 patients (pts) who underwent LM PCI between February 1994 and January 2002, and compared the radial (27 pts) and femoral (53 pts) approaches. Patients were considered free of restenosis if they were free of angina and had a negative treadmill or nuclear imaging study 6 months post-PCI. Mean follow-up time was 27.4+/-23.0 months. Reason for PCI (stable angina, unstable angina, acute myocardial infarction) and lesion location (ostial, mid, distal) were similar in both groups (p>0.05), whereas mean ejection fraction was higher in the radial group (56.5+/-11.1% versus 49.2+/-14.7%, respectively; p<0.05). Sheath size (7 or 8 French; 44.4% radial versus 77.3% femoral) and amount of heparin used (9,192+/-3,645 IU versus 11,468+/-5,083 IU) were significantly larger in the femoral group (p<0.05), and the use of intra-aortic balloon pump was significantly more frequent (3.7% versus 22.6%). Mean fluoroscopy time (21.3+/-12.8 minutes versus 16.7+/-8.5 minutes), amount of contrast used (227+/-92 ml versus 225+/-85 ml), mean procedural time (67.0+/-27.6 minutes versus 73.4+/-32.7 minutes), procedure success (96.3% versus 98.1%), in-hospital major adverse cardiac events (MACE; 7.4% versus 5.6%) and 6-month MACE (14.8% versus 25.5%) were similar in the 2 groups (p>0.05). However, major vascular complications occurred only in the femoral group (5.7%). Radial LM PCI is as fast and successful as the femoral approach and results in fewer vascular complications. 相似文献
3.
Focal congenital alveolar proteinosis associated with abnormal surfactant protein B messenger RNA 总被引:3,自引:0,他引:3
Two siblings presented with typical clinical features of congenital pulmonary alveolar proteinosis (PAP). Necropsy of one sibling revealed scattered foci of the diagnostic histologic changes in the lung tissue. In contrast to infantile and adult PAP, focal distribution is uncommon in congenital PAP. Defective expression of the granulocyte-macrophage colony-stimulating factor receptor was ruled out. The surfactant protein B (SP-B) content in the lung tissue of the autopsied patient was low, and a deletion in the SP-B messenger RNA was detected. We speculate that the PAP in our patients was related to the reduced quantity and/or to the altered quality of SP-B. 相似文献
4.
Ziakas A Klinke P Mildenberger R Fretz E Williams M Siega AD Kinloch D Hilton D 《International heart journal》2007,48(5):569-578
To check the safety of same day discharge radial PCI in patients under or over 75 years of age. A total of 943 patients who had same day discharge radial PCI between April 1998 and March 2001 were contacted. Patient health status, entry site complications, and repeat interventions during the first month after the procedure were compared in patients under 75 years of age (< 75) with those 75 or over (> or = 75). Responses were received from 811 patients (694 aged < 75 and 117 aged > or = 75 years). Two hundred and thirty-eight patients (34.3%) aged < 75 years and 36 patients (30.7%) aged > or = 75years reported one or more access site complications during the first 24 hours postdischarge, and 105 (15.1%) and 12 patients (10.3%), respectively, during the first month, (P > 0.05). However, all complications in both groups were minor and none of the patients required admission to the hospital. During the first 24 hours postdischarge only one patient (0.1%) aged < 75 years had a repeat angiogram showing a normal patent vessel, while during the first month 4 patients (0.6%) aged < 75 years and none aged > or = 75 years had target vessel closure. Out of the 132 patients who did not respond to our questionnaire, 1 patient aged < 75 and 1 patient aged > or = 75 years had subacute stent thrombosis within a month and died. There were no major entry site complications, and target vessel closure (0.6% versus 0.7%) was similar in patients aged < 75 and > or = 75 years. Thus, same day discharge radial PCI is safe in patients 75 years old or over. 相似文献
5.
Prof. Dr. F.G. Mildenberger 《Manuelle Medizin》2014,52(4):324-326
Despite an invasive medical bureaucracy, a widespread alternative healing culture and the world’s best bacteriology and surgery, German doctors avoided developments in back pain research before 1945. This wilful neglect was the product of contemporary social norms and ideologies about the importance of a straight spine, which represented strength and health. The only patients who were allowed to have back pains had been seen as genetically worthless (e.g. Jews and criminals). All the veterans from World War I suffering from the trauma of trench warfare were identified as hysterical. Only when all the e4ugenic and militaristic preconditions in medical discourse faded away in 1945 were German doctors able to find new ways in back pain therapy. 相似文献
6.
7.
Intravenous perhexiline maleate in a canine preparation with fixed coronary flow increases coronary diastolic pressure. It also redistributes coronary flow so as to preserve endocardial flow. Myocardial oxygen consumption was reduced and lactate uptake enhanced by the drug. It had no effect upon the threshold for ischemic-induced left ventricular failure. 相似文献
8.
A L'Abbate R R Mildenberger D T Zborowska-Sluis G A Klassen 《Circulation research》1976,39(2):276-281
The amount of tissue perfused, as determined from the difference in volume of distribution between a diffusible indicator (125I-antipyrine) and an intravascular indicator (131 I-albumin) was measured at different values of coronary flow, perfusion pressure, and vasomotor tone in the working left ventricle of an open-chest dog. Coronary pressure and flow were regulated independently from the systemic circulation and coronary vasomotor tone was reduced by dipyridamole. At each flow vasomotor tone was assessed by using as a reference the maximal vasodilation induced by arrest of flow. Measured tissue space was considered to be related to the capillary surface area available for tracer diffusion and therefore to the number of perfused capillaries per volume of muscle. A relationship between coronary blood flow and tissue volume was observed. It was found to be independent of vasomotor tone. Vasodilation was found to increase available exchanging capillary surface at a constant perfusion pressure. 相似文献
9.
10.
Dr. D. Pinto dos Santos F. Jungmann C. Friese C. Düber P. Mildenberger 《Der Radiologe》2013,53(3):257-260
Due to increasing amounts of data in radiology methods for image compression appear both economically and technically interesting. Irreversible image compression allows markedly higher reduction of data volume in comparison with reversible compression algorithms but is, however, accompanied by a certain amount of mathematical and visual loss of information. Various national and international radiological societies have published recommendations for the use of irreversible image compression. The degree of acceptable compression varies across modalities and regions of interest. The DICOM standard supports JPEG, which achieves compression through tiling, DCT/DWT and quantization. Although mathematical loss due to rounding up errors and reduction of high frequency information occurs this results in relatively low visual degradation. It is still unclear where to implement irreversible compression in the radiological workflow as only few studies analyzed the impact of irreversible compression on specialized image postprocessing. As long as this is within the limits recommended by the German Radiological Society irreversible image compression could be implemented directly at the imaging modality as it would comply with § 28 of the roentgen act (RöV). 相似文献