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1.
Chenna Deepika Mohandoss Murugesan Shamee Shastry 《Transfusion and apheresis science》2018,57(1):54-57
Background
Fluid shifts from interstitial to intravascular space during blood donation helps in compensating the lost blood volume. We aimed to determine the volume of fluid shift following donation in donors with and without pre-donation fluid intake.Methods
We studied the fluid shift in 325 blood donors prospectively. Donors were divided in groups- with no fluid intake (GI) and either water (GII) or oral rehydrating fluids (GIII) before donation. Fluid shift following donation was calculated based on the difference between the pre and post donation blood volume. The influence of oral fluid intake, age, gender and body mass index (BMI) on volume of fluid shift was analyzed.Results
The fluid shift was significant between donors without fluids (GI: 127?±?81?ml) and donors with fluid intake (GII & III: 96?±?45?ml) (p?<?0.05). The difference was not significant between donors with water intake (GII: 106?±?52?ml) and oral rehydrating fluid intake (GIII: 87?±?41?ml). The shifted fluid volume increased with increasing BMI and decreased with increasing age in females. The fluid shift increased in females than in males.Conclusion
The age, gender, BMI and VVR did not significantly contribute to the volume of fluid shift following donation. As per our observation, the oral fluids before donation might not contribute to increase in fluid shift in blood donors after donation. 相似文献2.
Background
A number of factors cause increases in the number of cell-derived microparticles (MPs) in blood components. However, the overall effects of these factors on the concentration of MPs during routine blood-component preparation have not fully been elucidated.Aim
To evaluate the effects of donor age, donor sex, blood-component preparation, and storage on MP concentrations.Methods
Flow cytometry was used to quantitate the number of whole blood-derived MPs.Results
The total MP concentration was similar in male and female donors (26,044?±?1254 particles/μL vs. 27,696?±?1584 particles/μL). The total MP concentration did not differ significantly among the different age groups: 18–30 years (28,730?±?1600 particles/μL), 31–40 years (24,972?±?5947 particles/μL), and 41–58 years (25,195?±?1727 particles/μL). However, the total number of MPs in fresh plasma (152,110?±?46,716 particles/μL) was significantly higher (p?<? 0.05) than that in unprocessed whole blood (26,752 ± 985 particles/μL), fresh packed red blood cells (PRBCs) (28,574 ± 1028 particles/μL), and platelet concentrate (PC) (33,072 ± 1858 particles/μL). Furthermore, the total numbers of MPs in stored PRBCs and fresh-frozen plasma (FFP) were significantly higher (p?<? 0.05) than those in fresh PRBCs and fresh plasma, respectively.Conclusions
The study suggests that donor factors, blood-component processing and storage contribute to the MP concentration in routine blood-product preparation. The findings can improve quality control and management of blood-product manufacturing in routine transfusion laboratories. 相似文献3.
Wei Chen Jennifer P. Ha Hong Hong Robert W. Maitta 《Transfusion and apheresis science》2018,57(4):507-511
Background
Heparin-induced-thrombocytopenia (HIT) is a disease mediated by antibodies to platelet factor 4 (PF4)-heparin complexes. Immature platelet fraction (%-IPF) and absolute immature platelet count (A-IPC) measure newly-released platelets into circulation and can prove useful in differentiating patients with thrombocytopenic presentations due to consumptive or hypoproduction processes. Therefore, we evaluated utility of A-IPC in a cohort of thrombocytopenic patients suspected of HIT.Patients and Methods
Twenty-six thrombocytopenic patients (<150?×?109/L) tested for anti-PF4-heparin and 36 non-thrombocytopenic controls were included. Platelet count, %-IPF, and A-IPC were determined at time of anti-PF4-heparin testing.Results
Sixteen patients tested anti-PF4-heparin negative and 10 tested positive. Patients with positive anti-PF4-heparin did not differ in A-IPC from normal range (7.2?±?2.9?×?109/L vs. 7.1?±?3.2?×?109/L respectively; p?=?0.97). However, there was a significant A-IPC decrease in patients negative for anti-PF4-heparin compared to normal range and those testing anti-PF4-heparin positive (4.2?±?3.1?×?109/L vs. 7.1?±?3.2?×?109/L vs. 7.2?±?2.9?×?109/L respectively, p?<?0.01). An A-IPC of greater than 5?×?109/L characterized 80% of anti-PF4-heparin positive cases.Conclusion
A-IPC measurements can complement anti-PF4-heparin testing of patients suspected of HIT while potentially predicting anti-PF4-heparin immunoassay results. 相似文献4.
Su’e Yuan Yun Qian De’ming Tan Dan Mo Xue’bing Li 《Transfusion and apheresis science》2018,57(2):253-258
Objective
To compare two means of performing therapeutic plasma exchange (TPE) in patients with liver failure.Method
This open-label monocentric randomized trial, conducted in a single prestigious general healthcare facility, recruited liver failure patients with an indication to receive artificial liver support therapy for TPE. All patients underwent TPE procedures and were administered in a random sequence: heparin-free or systemic heparinization with unfractionated heparin. The primary endpoint was completion of TPE sessions, and the secondary endpoints included the safety and efficacy.Results
In the period of the studying, there were 164 patients being recruited in and underwent total of 398 randomized TPEs: 168 with unfractionated heparin and 230 with heparin-free. In unfractionated heparin group, there were 3 cases (1.79%) being interrupted due to uncontrollable intraoperative pulmonary hemorrhages and gastrointestinal bleeding. In heparin-free group, 228 (99.13%) were completed successfully and 2 of them (0.87%) were switched from heparin-free to unfractionated heparin eventually. No significant differences were found between the two groups for either RRs or IRs (P?>?0.05).Conclusion
Heparin-free regimen is feasible and safer than systemic heparinization with unfractionated heparin in the process of TPEs in patients with liver failure. 相似文献5.
Gordon McGregor Eric J. Stöhr David Oxborough Peter Kimani Rob Shave 《Annals of physical and rehabilitation medicine》2018,61(3):119-124
Background
Cardiac rehabilitation (CR) exercise training is beneficial after myocardial infarction (MI). Whilst the peripheral adaptations to training are well defined, little is known regarding the effect on left ventricular (LV) remodelling, particularly LV function. Efficient LV ejection and filling is achieved through deformation and rotation of the myocardium in systole and diastole – LV mechanics. The response of LV mechanics to CR exercise training in MI patients is unknown.Methods
In this observational exploratory study, 36 (of 40 enrolled) male, MI patients completed either 10-weeks of twice-weekly gym based cardiovascular exercise at 60–80% VO2peak (n = 18), or a non-exercise control period (n = 18). Cardiopulmonary exercise testing and speckle tracking echocardiography were performed at baseline and 10 weeks.Results
Compared to the non-exercise group, VO2peak improved with CR exercise training (Difference: +4.28 [95% CI: 1.34 to 7.23] ml.kg?1.min?1, P = 0.01). Neither conventional LV structural or functional indices, nor LV global longitudinal strain, significantly changed in either group. In contrast, LV twist and twist velocity decreased in the exercise group and increased in the non-exercise group (Difference: ?3.95° [95% CI: ?7.92 to 0.03°], P = 0.05 and ?19.2°.s?1 [95% CI: ?35.9 to ?2.7°.s?1], P = 0.02, respectively).Conclusion
In MI patients who completed CR exercise training, LV twist and twist velocity decreased, whereas these parameters increased in patients who did not exercise. These preliminary data may indicate reverse LV functional remodelling and improved functional reserve. The assessment of LV twist may serve as an indicator of the therapeutic benefit of CR exercise training and should be investigated in larger trials. 相似文献6.
Background
For Australian apheresis platelet donations, in-centre haematology analysers provided the platelet count used to program the platelet collection machines. When the haematology analysers were not functional, historical platelet counts from previous donations were used. This study aimed to confirm that the routine use of historical platelet counts for programming apheresis collection machines would maintain platelet yields within the donated units and that haematology analysers could be removed.Study design
A staggered implementation for the routine use of mean historical platelet counts to program apheresis platelet collection machines was conducted. The donors’ full blood counts following donation were tested centrally for comparison to the historical mean. The component yields when using on-the-day platelet counts to program platelet collection were compared with those collected using historical platelet counts. For historical platelet counts to be deemed successful, the target was for 90% of the mean historical donor platelet counts to have less than 20% variance from the on-the-day platelet count.Results
Over 96% of the mean historical platelet counts were within 20% variance of the platelet count on the day of donation. The component yield (platelet count x109 cell/unit) before analyser removal was 273.3?±?32.0 (n?=?2639) and post-removal was 282.8?±?38.8 (n?=?2689).Conclusion
The removal of haematology analysers from donor centres and replacement with mean historical platelet counts was successful in maintaining platelet yields. Replacement of the haematology analysers with historical platelet counts simplified regulatory compliance, reduced staff workload and costs associated with analyser registration. 相似文献7.
Elias Kyriakou Nikolaos Nearchakos Stefanos Bonovas Efstathia Makri Katerina Pantavou Georgios K. Nikolopoulos Christine Kottaridi Argyri Gialeraki Panagiota Douramani Maria Taichert Violetta Kapsimali Argirios E. Tsantes 《Transfusion and apheresis science》2018,57(4):544-548
Background
Flow cytometry (FC) and Nageotte hemocytometry represent the most widely accepted methods for counting residual white blood cells (rWBCs) in leucocyte-reduced (LR) blood components. Our aim was to study the agreement between the two methods, under real working blood bank conditions.Materials and methods
94 freshly produced LR red blood cell (RBC) units were tested for rWBC concentrations by FC and Nageotte. To assess the precision of each method, we calculated the intra-assay coefficients of variation (CV), and followed the Bland-Altman methodology to study the agreement between the two methods.Results
CV was 18.5% and 26.2% for the Nageotte and the FC, respectively. However, the agreement between the duplicate observations, using the binary cut-off threshold of 1?×?106 WBCs per unit to define the results as “pass/fail”, was 71.9% for the Nageotte and 93.3% for the FC. Linear regression analysis did not show any correlation (R-squared?=?0.01, p?=?0.35) between the two methods, while the Bland-Altman analysis for the measuring agreement showed a bias toward a higher Nageotte count of 0.77?×?106 leucocytes per unit (p?<?0.001) with the 95% limits of agreement (d ± 2?sd) ranging from –0.40?×?106 to 1.94?×?106 leucocytes per unit.Conclusion
The absence of agreement between Nageotte and FC method, with the differences within d ± 2?sd being of high clinical importance, suggests that the two methods cannot be used for clinical purposes interchangeably. The Nageotte seems unsuitable for quality control even with a pass-fail criterion, under real working blood bank conditions. 相似文献8.
Hyun-Ji Lee Kyung-Hwa Shin Duyeal Song Sun-Min Lee Chulhun L. Chang Chong Woo Chu Je Ho Ryu Tae Bum Lee Yong-Mok Park Kwang Ho Yang Byung Hyun Choi Hyung-Hoi Kim 《Transfusion and apheresis science》2017,56(3):385-388
Introduction
Therapeutic plasma exchange (TPE) is used for temporary support of liver function in patients presenting with early graft dysfunction after liver transplantation (LT) or liver surgery. We analyzed the effect of therapeutic apheresis on patients with liver disease.Methods
Between January 2011 and August 2016, 93 apheresis procedures were performed for 26 patients at our institution. Anti-ABO isoagglutination immunoglobulin (Ig) M titer was checked using a type A and type B 3% red blood cell (RBC) suspension in saline with two-fold serial dilutions of patient serum. Anti-ABO isoagglutination IgG titer was checked by a type A and B 0.8% RBC suspension using a low-ionic strength/Coombs card.Results
ABO-incompatible (ABOi) LT was the most common (n = 10, 38.5%) indication for apheresis; early graft dysfunction after LT (n = 8, 30.7%) was the second most common. Median initial IgM and IgG anti-ABO titers for ABOi LT recipients were 1:16 (range, 1:8–1:128) and 1:48 (range, 1:8–1:2048). We performed preoperative TPE in 10 recipients (median number of sessions, 1.5; range, 1–11). Among patients with early graft dysfunction, those who underwent living donor LT had better survival (4/4; 100%) than those who underwent nonliving donor LT (0/3; 0%). Patients who underwent living donor LT first and then additional LT also survived after three TPE sessions.Conclusion
Therapeutic apheresis is associated with a good survival rate and is essential for liver support in patients with early graft dysfunction after LT or posthepatectomy liver failure and during preparation for ABOi LT. 相似文献9.
Lia Ferreira Isabel Palma Conceição Bacelar José Alexandre Queirós Anselmo Madureira José Carlos Oliveira Maria Helena Ramos Helena Cardoso 《Transfusion and apheresis science》2018,57(5):676-680
Background
Low-density lipoprotein cholesterol (LDL-C) and lipoprotein(a) (Lp(a)) are established causal risk factors for cardiovascular disease (CVD). Lipoprotein apheresis is often required for treatment of patients with a high risk for CVD due to hypercholesterolemia and/or hyperlipoproteinemia(a).Aim
To describe our experience with lipoprotein apheresis in patients with severe hypercholesterolemia or with hyperlipoproteinemia(a).Methods
We retrospectively investigated patients treated with Lipoprotein apheresis using direct adsorption of lipoproteins (DALI) technique, between December 2008 and March 2018, in our center. Adverse events, acute and long term reductions in lipid parameters were analyzed.Results
Between December 2008 and March 2018, a total of 950 treatments were performed in five patients, four with heterozygous familial hypercholesterolemia (HeFH), all on maximally tolerated cholesterol-lowering drug therapy and in one patient with hyperlipoproteinemia(a) and progressive CVD.In the four patients with HeFH we obtained mean acute reductions in LDL-C and non-high-density lipoprotein cholesterol (non-HDL-C) of 62.0?±?7.8% and 60.4?±?6.8%, respectively. Regarding long-term efficacy we achieved a mean reduction of 43.1% in LDL-C and of 41.2% in non-HDL-C. In the patient with hyperlipoproteinemia(a) we attained mean acute reductions of 60.4?±?6.4% in Lp(a) and of 75.4?±?7.3% in LDL-C per session and long term reductions in Lp(a) and LDL-C of 67.4% and 40.5%, respectively. Adverse events were recorded in only 1.2% of treatments.Conclusion
Lipoprotein apheresis is an efficient and safe treatment in severely hypercholesterolemic patients who are refractory to conservative lipid-lowering therapy or with hyperlipoproteinemia(a) and progressive CVD. 相似文献10.
Rainer Moog Remo Rothe Nicole Arlt Thomas Burkhardt 《Transfusion and apheresis science》2018,57(2):228-232
Introduction
Platelet additive solutions (PAS) allow to maintain platelet storage properties in platelet concentrates (PCs). The aim of the present study was to evaluate the in-vitro quality of irradiated and non-irradiated PCs, suspended in PAS, over a storage period of 6 days.Methods
Plateletpheresis donors fulfilling current eligibility criteria underwent plateletpheresis with the MCS+ blood cell separator. The PAS SSP+ was used to store platelets (PLT) for up to 6 days. Aliquots were drawn from the PCs after collection, at day 4, 5 and 6 of storage. A battery of tests was performed to analyse the quality of the PCs: PLT count, mean PLT volume (MPV), PLT activation marker CD 62, swirl, RBC and WBC contamination, pH, citrate, glucose, lactate and lactate dehydrogenase.Results
An average of 2.53?±?0.21?×?1011 PLT were collected in a product volume of 231?±?5?mL in irradiated and 233?±?6?mL in non-irradiated PCs, respectively. RBC- and WBC-contamination were within the allowed ranges. Δ CD62 steadily decreased in irradiated and non-irradiated PCs while the pH was well maintained over storage time. Glucose and lactate levels of irradiated and non-irradiated PCs showed characteristic pattern of PC storage within acceptable ranges.Conclusion
Our data demonstrate that parameters of PC quality were well maintained over a storage period of 6?days using PAS. Irradiation had no impact on the quality of PCs. The product quality of irradiated and non-irradiated PCs met national and European guidelines. 相似文献11.
Question
What is the effectiveness and what are the adverse effects.Design
Systematic review with meta-analysis.Participants
Patients with shoulder or upper extremity pain or dysfunction.Intervention
Trigger point dry needling (TDN) compared to control, another intervention or another needling technique.Outcome measures
Primary outcome measures included shoulder or upper limb pain, shoulder or upper limb dysfunction.Results
Eleven randomized trials involving 496 participants were appraised. There was very low evidence that trigger point dry needling of the shoulder region is effective for reducing pain and improving function in the short term. There is some evidence that needling both active and latent trigger points is more effective than needling an active trigger point alone for pain immediately and 1-week after treatment (SMD = ?0.74, 95%CI = ?1.2 to ?0.3; and SMD = ?1.0, 95%CI = ?1.52 to ?0.59).Conclusion
There is very low evidence to support the use of TDN in the shoulder region for treating patients with upper extremity pain or dysfunction. Two studies reported adverse effects to TDN interventions. Most common adverse effects included bruising, bleeding, and pain during or after treatment. Future studies are likely to change the estimates of the effectiveness of TDN for patients with upper extremity pain or dysfunction.PROSPERO: CRD42016045639. 相似文献
12.
Krzysztof Bartnik Martyna Maciejewska Roiya Farhan Elżbieta Urbanowska Małgorzata Król Maria Król Magdalena Feliksbrot Wiesław Wiktor-Jędrzejczak Emilian Snarski 《Transfusion and apheresis science》2018,57(3):401-405
Background
Recently, novel protocol utilizing Continuous Mononuclear Cell Collection (cMNC) have been introduced for leukapheresis. We compared the efficacy of cMNC with an older protocol – mononuclear cell collection (MNC) for CD34+ cell collection in unrelated donors with negative stem cell collection predictors.Material and methods
Retrospective data from a series of 258 consecutive unrelated hematopoietic stem cell donors was included in this single-center study (80 donors collected with cMNC and 178 with MNC). The donors with poor predictors for collection such as low number of circulating CD34+ cells and/or weight disproportion were assigned to the cMNC arm.Results
The cMNC protocol yielded a higher number of CD34?+?cells per donor body weight (7.63?×?106/kg vs 6.82?×?106/kg, p?=?0.027). One apheresis was sufficient for collection of target cell number in 89% individuals from both groups despite negative predictors in the cMNC group. In donors with CD34?+?cell count <100/μL and a body weight disproportion between donor and recipient one apheresis was sufficient in 83% of donors in cMNC group and in 58% in MNC group (p?=?0.0345) with collection efficiency CE2% values of 61% for cMNC and 62% for MNC (p?=?0.77).Conclusion
cMNC protocol is more efficient in donors with low pre-apheresis CD34+ cell count and weight disproportion between donor and recipient. This suggests that the use of cMNC in unrelated donors could possibly further improve the results of HSC collections. 相似文献13.
Objective
This systematic review to aimed to evaluate the effects of orthopaedic manual therapy (OMT) on pain, improving function, and physical performance in patients with knee osteoarthritis (OA).Data sources
Four databases (PubMed, Web of Science, CENTRAL, and CINAHL) were searched.Study selection
Trials were required to compare OMT alone or OMT in combination with exercise therapy, with exercise therapy alone or control.Data extraction
Data extraction and risk assessment were done by two independent reviewers. Outcome measures were visual analogue scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score, WOMAC function score, WOMAC global score, and stairs ascending-descending time.Results
Eleven randomized controlled trials were included (494 subjects), four of which had a PEDro score of 6 or higher, indicating adequate quality. The results of the meta-analysis indicated that reduction of VAS score in OMT compared with the control group was statistically insignificant (SDM: ?0.59; 95% CI: ?1.54 to ?0.36; P = 0.224). The reduction of VAS score in OMT compared with exercise therapy group was statistically significant (SDM: ?0.78; 95% CI: ?1.42 to ?0.17; P = 0.013). The reduction of WOMAC pain score in OMT compared with the exercise therapy group was statistically significant (SDM: ?0.79; 95% CI: ?1.14 to ?0.43; P = 0.001). Similarly, the reduction of WOMAC function score in OMT compared with the exercise therapy group was statistically significant (SDM: ?0.85; 95% CI: ?1.20 to ?0.50; P = 0.001). However, the reduction of WOMAC global score in OMT compared with the exercise therapy group was statistically insignificant (SDM: ?0.23; 95% CI: ?0.54 to ?0.09; P = 0.164). The reduction of stairs ascending-descending time in OMT compared with the exercise therapy group was statistically significant (SDM: ?0.88; 95% CI: ?1.48 to ?0.29; P = 0.004).Conclusions
This review indicated OMT compared with exercise therapy alone provides short-term benefits in reducing pain, improving function, and physical performance in patients with knee OA.Review registration
PROSPERO 2016:CRD42016032799. 相似文献14.
J.Manuel Bello–López Carlos Bonilla Cisneros Angel Martínez-Albarrán 《Transfusion and apheresis science》2018,57(1):82-87
Introduction
Oncohematological disorders are the main cause of morbidity in the Mexican population from 1 to 19 years old, where megakaryoblastic and promyelocitic leukemias are more frequent. Considering that the success of a transplant is multifactorial, the criterion of compatibility in the HLA system is crucial and even more so when the source of HSC is bone marrow.Objective
To determine the frequency of the HLA genotype in Mexican candidates who require a bone marrow transplant from related donors and the probability to find donors.Materials and methods
One hundred twenty-six candidates for bone marrow transplant and related donors were tested for HLA class I (–A*, ?B* alleles) and class II (–DRB1* allele) in intermediate–resolution, as the first phase in the choice of the possible donor. The criteria to identify donors were determined by antigen–matched in each HLA haplotype as follows: 4/6, 5/6 and 6/6 at the HLA–A*, HLA–B*, and HLA–DRB1* alleles.Results
Of all the candidates analyzed, 57.93%, at least one bone marrow donor was identified; in 53 cases, no donor was found. The average size of the families was 4.79?±?1.06 members. A higher percentage of compatibility with grade 6/6 (31.6%) was identified with brothers, followed by sisters in 25.3%. The probability to find at least one compatible potential donor was 1.51?±?0.92 donors.Conclusion
In the first phase to select donors, Mexican patients studied in this work, have a compatible donor, however the grade of resolution test influenced in the probability identified. 相似文献15.
Andreea-Iuliana Ceanga Mihai Ceanga Maria Eveslage Edwin Herrmann Dania Fischer Axel Haferkamp Maria Wittmann Stefan Müller Hugo Van Aken Andrea Ulrike Steinbicker 《Transfusion and apheresis science》2018,57(6):739-745
Background
Preoperative anemia and allogeneic blood transfusions (ABTs) may affect outcomes in cancer surgery. The prevalence of anemia, the use of ABTs, the risks of transfusions, lengths of stay and mortality of oncological patients undergoing radical cystectomy were investigated in three University Hospitals in Germany.Patients and Methods
Hospital records of 220 consecutive patients undergoing radical cystectomy from 2010 to 2012 were retrospectively analyzed for independent risk factors of ABT and unfavorable outcomes (readmission, increased length of stay (LOS) or death) using multivariate regression analysis.Results
Preoperative anemia was present in 40%. 70% of patients received blood transfusions. Low preoperative and intraoperative nadir hemoglobin levels were associated with receipt of ABT (OR 1.33, P?=?0.04 and OR 2.94, P?<?0.001 respectively). Transfusion of ten or more red blood cell units (RBCs) during the entire hospital stay was a predictor of an increased LOS (P?<?0.001) and death (OR 52, 95%CI [5.9, 461.3], P?<?0.001), compared to non-transfused patients. Preoperative ABT and ASA scores were associated with ≥10RBCs.Conclusion
Anemic patients undergoing radical cystectomy had a high risk to receive ABTs. Preoperative transfusions and transfusion of ≥10RBCs during the entire hospital stay may increase patient`s mortality.Prospective, randomized controlled studies have to follow this study. 相似文献16.
Naoki Akazawa Kazuhiro Harada Naomi Okawa Kimiyuki Tamura Atsushi Hayase Hideki Moriyama 《Physiotherapy》2018,104(4):438-445
Objective
To examine the relationships between muscle mass, intramuscular adipose and fibrous tissues of the quadriceps, and gait independence in chronic stroke survivors.Design
Cross-sectional study.Setting
Hospital-based research.Participants
Seventeen chronic stroke survivors who were unable to walk independently (non-independent walker group) and 11 chronic stroke survivors who were able to walk independently (independent walker group) participated in this study. In addition, 25 healthy older adults (healthy group) were enrolled.Interventions
None.Main outcome measures
The muscle mass and intramuscular adipose and fibrous tissues of the rectus femoris and vastus intermedius were assessed based on muscle thickness and echo intensity of ultrasound images, respectively.Results
The thicknesses of the rectus femoris and vastus intermedius on the paretic and non-paretic sides in the non-independent walker group were significantly lower than those in the healthy group (mean difference ?0.5 to ?0.2 cm; P < 0.001–0.037). The paretic side in the non-independent walker group had significantly higher rectus femoris and vastus intermedius echo intensity compared with the healthy group (mean difference 15.8–17.4; P = 0.007–0.025). The thickness of the rectus femoris on the non-paretic side was significantly lower in the independent walker group than in the healthy group (mean difference ?0.3 cm; P = 0.001).Conclusions
These results suggest that chronic stroke survivors who are unable to walk independently are likely to experience secondary changes in skeletal muscle on both the paretic and non-paretic sides. 相似文献17.
Background
Chest physiotherapy (CPT) is implemented before and after congenital heart disease (CHD) surgery in paediatrics to prevent and treat postoperative pulmonary complications (PPC). Currently, there are no systematic reviews or meta-analyses on the efficacy of CPT in this population.Objective
To conduct a systematic review and meta-analysis to determine whether peri-operative CPT is safe and effective for paediatric patients with CHD.Data sources
A literature search was conducted on PEDro, MEDLINE, CINAHL, Informit, The Cochrane Library and Scopus in March and April 2016.Eligibility criteria
English peer-reviewed articles that utilised CPT before or after cardiac surgery for paediatric CHD. Systematic reviews were excluded.Data extraction and synthesis
Completed by two independent researchers using the Crowe Critical Appraisal Tool. Data were collated using a piloted data extraction tool. Mix Version 2.0.1.4 was used for meta-analysis, and data were extracted using an odds ratio (with a random effects model).Results
Eleven studies met the inclusion criteria for the systematic review. Variable results were found regarding the effect of CPT on peripheral oxygen saturation and pain. Meta-analysis showed that CPT did not prevent pneumonia (odds ratio (OR) 2.01; 95% confidence interval (CI) 0.80 to 5.05; P = 0.13), and did not prevent or treat atelectasis (OR 1.27; 95% CI 0.18 to 8.87; P = 0.81).Limitations
There was a lack of high-quality studies. The included studies were comprised of heterogeneous treatment, limiting external validity.Conclusion
Active therapies such as mobilisation, deep breathing and incentive spirometry were more effective than passive treatment. Percussion led to oxygen desaturation, and percussion, vibration and suctioning increased the risk of developing atelectasis.Systematic review registration number CRD42015024768. 相似文献
18.
19.
Federico Bigazzi Francesco Sbrana Daniele Berretti Sabina Zambon Antonia Fabris Maurizio Fonda Giovanni B. Vigna Giovanna D’Alessandri Stefano Passalacqua Beatrice Dal Pino Mascia Pianelli Roberta Luciani Andrea Ripoli Daniela Rafanelli Enzo Manzato Luigi Cattin Tiziana Sampietro 《Transfusion and apheresis science》2018,57(5):661-664
Background
Lipoprotein apheresis (LA) is the elective therapy for homozygous and other forms of Familial Hypercholesterolemia, Familial Combined Hypercholesterolemia, resistant/intolerant to lipid lowering drugs, and hyper-lipoproteinemia(a). Lipoprotein(a) [Lp(a)] has been classified as the most prevalent genetic risk factor for coronary artery disease and aortic valve stenosis.Aim
Our multicenter retrospective study has the aim to analyze the incidence of adverse cardiovascular events (ACVE) before and during the LA treatment, in subjects with elevated level of Lp(a) (>60?mg/dL) [hyper-Lp(a)] and chronic ischemic heart disease.Methods
We collected data of 23 patients (mean age 63?±?9 years, male 77%; from hospital of Pisa 11/23, Pistoia 7/23, Verona 2/23, Padova 2/23 and Ferrara 1/23), with hyper-Lp(a), pre-apheresis LDL-cholesterol <100?mg/dL, cardiovascular disease, on maximally tolerated lipid lowering therapy and LA treatment (median 7 years, interquartile range 3–9 years). The LA treatment was performed by heparin-induced LDL precipitation apheresis (16/23), dextran-sulphate (4/23), cascade filtration (2/23) and immunoadsorption (1/23). The time lapse between first cardiovascular event and beginning of apheresis was 6 years (interquartile range 1–12 years).Results
The recorded ACVE, before and after the LA treatment inception, were 40 and 10 respectively (p?<?0.05), notably, the AVCE rates/year were 0.43 and 0.11 respectively (p?<?0.05) with a 74% reduction of event occurrence.Conclusions
Our data confirm long-term efficacy and positive impact of LA on morbidity in patients with hyper-Lp(a) and chronic ischemic heart disease on maximally tolerated lipid lowering therapy. 相似文献20.
Dong Hoon Lee Ji Young Kim Mi Kyung Lee Choae Lee Ji-Hee Min Duck Hyoun Jeong Ji-Won Lee Sang Hui Chu Jeffrey A. Meyerhardt Jennifer Ligibel Lee W. Jones Nam Kyu Kim Justin Y. Jeon 《Supportive care in cancer》2013,21(9):2537-2545