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1.
Locatelli F Gauly A Czekalski S Hannedouche T Jacobson SH Loureiro A Martin-Malo A Papadimitriou M Passlick-Deetjen J Ronco C Vanholder R Wizemann V;Membrane Permeability Outcome 《Blood purification》2008,26(1):100-104
Although results from observational and epidemiological studies suggested a survival benefit associated with high-flux hemodialysis, conclusive evidence from prospective randomized clinical trials has been lacking. Both the HEMO Study in the USA and the Membrane Permeability Outcome Study (MPO Study) in Europe are randomized studies investigating the effect of high- and low-flux hemodialysis on patient outcomes, even though there were some significant differences in the design of the two studies. An earlier randomized clinical trial could not show differences on patient survival between patient groups being treated with membranes of different material and permeability, but this trial was not designed specifically to examine this particular endpoint. Based on these previous experiences, the MPO Study addressed a hemodialysis patient population which was considered to be more susceptible to the intervention with high-flux dialysis. To identify these patients with an elevated risk, low serum albumin levels were chosen as an indicator; low serum albumin is associated with malnutrition, inflammation, atherosclerosis, and with increased risk of morbidity and mortality. Together with low serum albumin, patients had to be new to dialysis to be selected for the MPO Study. These particular considerations on patient selection, together with additional methodological refinements in the study design allow the conclusion that the MPO Study is valid on its own rather than being a European version of the HEMO Study. 相似文献
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Thiago Ninck Valette Silvia Moreira Ayub-Ferreira Luiz Alberto Benvenuti Victor Sarli Issa Fernando Bacal Paulo Roberto Chizzola Germano Emilio Concei??o Souza Alfredo Inácio Fiorelli Ronaldo Honorato Barros dos Santos Edimar Alcides Bocchi 《Arquivos brasileiros de cardiologia》2014,102(5):505-509
Background
Discrepancies between pre and post-mortem diagnoses are reported in the literature, ranging from 4.1 to 49.8 % in cases referred for necropsy, with important impact on patient treatment.Objective
To analyze patients who died after cardiac transplantation and to compare the pre- and post-mortem diagnoses.Methods
Perform a review of medical records and analyze clinical data, comorbidities, immunosuppression regimen, laboratory tests, clinical cause of death and cause of death at the necropsy. Then, the clinical and necroscopic causes of death of each patient were compared.Results
48 deaths undergoing necropsy were analyzed during 2000-2010; 29 (60.4 %) had concordant clinical and necroscopic diagnoses, 16 (33.3%) had discordant diagnoses and three (6.3%) had unclear diagnoses. Among the discordant ones, 15 (31.3%) had possible impact on survival and one (2.1%) had no impact on survival. The main clinical misdiagnosis was infection, with five cases (26.7 % of discordant), followed by hyperacute rejection, with four cases (20 % of the discordant ones), and pulmonary thromboembolism, with three cases (13.3% of discordant ones).Conclusion
Discrepancies between clinical diagnosis and necroscopic findings are commonly found in cardiac transplantation. New strategies to improve clinical diagnosis should be made, considering the results of the necropsy, to improve the treatment of heart failure by heart transplantation. 相似文献3.
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WangHong-tao ShiXiao-dong LiuJing-xing ZhangZhen-hua 《胃肠病学》2000,5(B08):176-176
The 114 H.pylori strains (70 from patients with gastritis, 29 from patients with duodenal ulcer, and 12 from patients with gastric ulcer and 3 from patients with gastric cancer) obtained from patients who had undergone gastroduodenoscopy was characterized by PCR with the primers corresponding to the nucleotide sequence of S1a, S1b, S2 and m1, m2. The results showed that all three alleles of the vacA signal sequence could be detected and typed in most isolate as either S1a, S1b or S2. In 114 H.pylori strains investigated, 相似文献
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JIKEI HEART Study—A Morbi-Mortality and Remodeling Study with Valsartan in Japanese Patients with Hypertension and Cardiovascular Disease 总被引:1,自引:0,他引:1
Mochizuki S Shimizu M Taniguchi I Kanae K Yoshida S Tajima N Dahlöf B;JIKEI HEART Study Group 《Cardiovascular drugs and therapy / sponsored by the International Society of Cardiovascular Pharmacotherapy》2004,18(4):305-309
BACKGROUND: Several recent clinical trials have demonstrated that angiotensin II receptor blockers (ARBs) have cardiovascular as well as renal protective effects. Asian patients including Japanese were under-represented in these trials, however, and no large-scale clinical trials of ARBs have yet been performed in Japan. It is therefore important to verify that the results of these studies are also valid for Japanese patients. The JIKEI HEART Study has been designed to investigate whether concomitant treatment with valsartan, an angiotensin II receptor blocker, in addition to conventional treatment, will improve the prognosis of Japanese patients with cardiovascular diseases (hypertension, ischemic heart disease, congestive heart failure). METHOD AND EVALUATION OF RESULTS: Around 3,000 patients with hypertension, ischemic heart disease and/or congestive heart failure will be randomized to receive either additional treatment with valsartan (80 mg/day) or conventional therapy. The follow-up period will be three years. The primary endpoint will be the onset of any cardiovascular event. Secondary endpoints will include death from any cause, changes in left ventricular size and function, renal function, changes in neuro-hormonal levels and quality-of-life assessments. Sub-studies will explore the effect in patients with diabetes mellitus, hyperlipidemia and the effects of combination of drugs. CONCLUSION: Improved prognosis would confirm the role of angiotensin II receptor blockers in the treatment of the cardiovascular disease in Japanese patients. 相似文献
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Mabo P Defaye P Mouton E Cebron JP Davy JM Tassin A Babuty D Mondoly P Paziaud O Anselme F Daubert JC 《Journal of cardiovascular electrophysiology》2012,23(8):853-860
Impact of Recalls on ICD Utilization . Introduction: The study was designed to evaluate the feasibility and performance of right ventricular (RV) mid‐septal versus apical implantable defibrillator (ICD) lead placement. Methods and Results: SEPTAL is a randomized, noninferiority trial, which randomly assigned patients to implantation of ICD leads in the RV mid‐septum versus apex, with a primary objective of comparing the implant success rate of implant at each site, based on strict electrical predefined criteria. We also compared the (1) pacing lead characteristics, (2) rates of appropriate and inappropriate ICD therapies, and (3) all‐cause mortality between the 2 sites at 1 year. The trial enrolled 215 patients (mean age = 59.7 ± 12.4 years, mean LVEF = 34.0 ± 14.2%, 84.2% men), of whom 148 (68.8%) presented with ischemic heart disease. The ICD indication was primary prevention in 117 patients (54.4%). The lead was successfully implanted in 96/107 patients (89.7%) assigned to the RV mid‐septum, and in 99/108 (91.7%) assigned to the apex (ns). The 1‐year rate of lead‐related adverse events was similar in both groups. A total of 8 first inappropriate ICD therapies (7.9%) were delivered in the RV mid‐septal group, versus 8 (7.8%) in the apical group (ns), while first appropriate therapies were delivered to 22 (21.4%) and 24 patients (23.8%), respectively (ns). All‐cause mortality was 7.9% in the RV mid‐septal versus 2.9% in the RV apical group (ns). Conclusion: This study confirmed the technical feasibility and noninferior performance of ICD leads implanted in the RV mid‐septum versus the apex. (J Cardiovasc Electrophysiol, Vol. 23, pp. 853‐860, August 2012) 相似文献
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Ramachandran S. Vasan Vanessa Xanthakis Asya Lyass Charlotte Andersson Connie Tsao Susan Cheng Jayashri Aragam Emelia J. Benjamin Martin G. Larson 《JACC: Cardiovascular Imaging》2018,11(1):1-11
Objectives
The purpose of this study was to describe the temporal trends in prevalence of left ventricular systolic dysfunction (LVSD) in individuals without and with heart failure (HF) in the community over a 3-decade period of observation.Background
Temporal trends in the prevalence and management of major risk factors may affect the epidemiology of HF.Methods
We compared the frequency, correlates, and prognosis of LVSD (left ventricular ejection fraction [LVEF] <50%) among Framingham Study participants without and with clinical HF in 3 decades (1985 to 1994, 1995 to 2004, and 2005 to 2014).Results
Among participants without HF (12,857 person-observations, mean age 53 years, 56% women), the prevalence of LVSD on echocardiography decreased (3.38% in 1985 to 1994 vs. 2.2% in 2005 to 2014; p < 0.0001), whereas mean LVEF increased (65% vs. 68%; p < 0.001). The elevated risk associated with LVSD (~2- to 4-fold risk of HF or death) remained unchanged over time. Among participants with new-onset HF (n = 894, mean age 75 years, 52% women), the frequency of heart failure with preserved ejection fraction (HFpEF) increased (preserved LVEF ≥50%: 41.0% in 1985 to 1994 vs. 56.17% in 2005 to 2014; p < 0.001) and heart failure with reduced ejection fraction (HFrEF) decreased (reduced LVEF <40%: 44.10% vs. 31.06%; p = 0.002), whereas heart failure with midrange LVEF remained unchanged (LVEF 40% to <50%: 14.90% vs. 12.77%; p = 0.66). Cardiovascular mortality associated with HFrEF declined across decades (hazard ratio: 0.61; 95% confidence interval: 0.39 to 0.97), but remained unchanged for heart failure with midrange LVEF and HFpEF. Approximately 47% of the observed increase in LVEF among those without HF and 75% of the rising proportion of HFpEF across decades was attributable to trends in risk factors, especially a decline in the prevalence of coronary heart disease among those with HF.Conclusions
The profile of HF in the community has changed in recent decades, with a lower prevalence of LVSD and an increased frequency of HFpEF, presumably due to concomitant risk factor trends. 相似文献12.
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Objectives To analyze the results of coronary angiographies (CAG) in patients with single aortic valvular heart disease; To study the relationship between aortic valve diseases and coronary artery disease (CAD). Methods 105 patients with single aortic valvular heart disease before surgery underwent angiography. The data of clinical characteristics and angiographies were analyzed. Results 51 patients had symptoms of angina pectoris among 105 patients with single aortic valvular heart disease. Seven of them were confirmed coronary artery disease by angiographies. Although the incidence of angina in aortic valve stenosis group was significantly higher than that in aortic valve regurgitation, the probability of combination of CAD in aortic valve stenosis group was similar to the later. However, the probability of combination of CAD in degenerative aortic valve group was significantly higher than the groups of rheumatic, congenitally bicuspid aortic valves, and other causes (p < 0.01 ). Conclusions Angina pe 相似文献
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Objectives To evaluate the therapeutic effect of transcatheter Amplatzer device on the closure of ventricular septal defect (VSD). Methods Among 143 patients with VSD, 135 patients with perimembrane VSD and 2 with muscular VSD aged 2.5 -28 years old, were successfully closed with Amplatzer oeeluder device by the pereutaneous guidwire through femoral artery-VSD-femoral vein route under the guidance of fluoroscopy, ventrieulography and transthoracic echocardiography (TIE). The diameters of the VSDs were 2.3-15.7 (6.90±2.76)mm by left ventriculography. Results The success rate of transcatheter closure of VSD with Amplatzer devices was 96%(137/143). Minimal residual amount of shunts were found in one patient, although the shunts was decreased one month after the procedure. There were one patient who had respiratory arrest during the procedure, 7 patients(5%)had conduction disturbance, 3 patients had complete left bundle branch block, 2 patients had complete right bundle branch block, 1 patient had Ⅰ degree atrial-ventricular block and 1 patient had Ⅲ degree atr/al-ventricular block during hospitalization. The diameters of the occluder ranged from 4 to 23 (9.13±3.31)mm and were symmetrical in 122 patients and asymmetrical in 15 patients. Conclusions Transcatheter closure of the perimembranous ventrieular septal defect using Amplatzer VSD occluder device is an efficient method for patients with the perimembranous VSD. The operation is simple with a high success rate and a good effect. 相似文献
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Hanley WB Azen C Koch R Michals-Matalon K Matalon R Rouse B Trefz F Waisbren S de la Cruz F 《Journal of inherited metabolic disease》2004,27(6):711-723
Analysis of outcome data from 305 of the 414 offspring from the Maternal Phenylketonuria Collaborative Study (MPKUCS), plus 70 control offspring, revealed significant deficits in the IQ (intelligence quotient), as measured by the Wechsler Intelligence Scale for Children--Revised (WISC-R), when maternal metabolic control during pregnancy was delayed and/or inadequate. There were, however, 23 'outliers' (7.5% of the 305) in which the offspring's intellectual IQ was worse (n =10) or better (n =13) than expected. The aim of this study was to determine whether collection parameters were incomplete or whether these subjects were true biological variants influenced by other undetected factors or, perhaps, by modifier genes. Among the 10 offspring whose intellectual functioning was worse than expected, additional complications were uncovered that could explain the poor outcome. Four of the 13 offspring with higher than expected IQ had mothers with mild variants of PKU in which the insult to the fetus would not be expected to be as profound. For the other nine offspring whose intellectual performance was better than expected, there was no explanation, based on the parameters studied. We hypothesize that modifier genes will, at times, protect the fetus despite high maternal concentrations of phenylalanine. Not all offspring from the same (untreated) PKU mother may be similarly affected. Finding the source of these modifiers might effect the treatment of MPKU. 相似文献
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HUANG Zhi Gang ZHAI Wei Rong ZHANG Yue E ZHANG Xiu Rong 《World journal of gastroenterology : WJG》1998,(3)
StudyofheteroseruminducedratliverfibrosismodelanditsmechanismHUANGZhiGang,ZHAIWeiRong,ZHANGYueEandZHANGXiuRongSubjecthea... 相似文献
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Increased inducible nitric oxide synthase (iNOS) activity and expression has been associated with hypertension, but less is known whether the 2 known functional polymorphic sites in the iNOS gene (g.–1026 C/A (rs2779249), g.2087 G/A (rs2297518)) affect susceptibility to hypertension. The objective of this study was to investigate the association between the genetic variants of iNOS and diagnosed hypertension in a Finnish cohort.This study included 320 hypertensive cases and 439 healthy controls. All participants were 50-year-old men and women and the data were collected from the Tampere adult population cardiovascular risk study (TAMRISK). DNA was extracted from buccal swabs and iNOS single nucleotide polymorphisms (SNPs) were analyzed using KASP genotyping PCR. Data analysis was done by logistic regression.At the age of 50 years, the SNP rs2779249 (C/A) associated significantly with hypertension (P = 0.009); specifically, subjects carrying the A-allele had higher risk of hypertension compared to those carrying the CC genotype (OR = 1.47; CI = 1.08–2.01; P = 0.015). In addition, a 15-year follow-up period (35, 40, and 45 years) of the same individuals showed that carriers of the A-allele had more often hypertension in all of the studied age-groups. The highest risk for developing hypertension was obtained among 35-year-old subjects (odds ratio [OR] 3.83; confidence interval [CI] = 1.20–12.27; P = 0.024). Those carrying variant A had also significantly higher readings of both systolic (P = 0.047) and diastolic (P = 0.048) blood pressure during the follow-up. No significant associations between rs2297518 (G/A) variants alone and hypertension were found. However, haplotype analysis of rs2779249 and rs2297518 revealed that individuals having haplotype H3 which combines both A alleles (CA–GA, 19.7% of individuals) was more commonly found in the hypertensive group than in the normotensive group (OR = 2.01; CI = 1.29–3.12; P = 0.002).In conclusion, there was a significant association between iNOS genetic variant (rs2779249) and hypertension in the genetically homogenous Finnish population. Those who carried the rare A-allele of the gene had higher risk for hypertension already at the age of 35 years. 相似文献
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Anastomotic Leaks: What is the Best Diagnostic Imaging Study? 总被引:4,自引:0,他引:4
Nicksa GA Dring RV Johnson KH Sardella WV Vignati PV Cohen JL 《Diseases of the colon and rectum》2007,50(2):197-203
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Limited epidemiologic information is available on achalasia in Northern European countries and worldwide. Achalasia has never
been studied in Iceland. This study aimed to evaluate the epidemiology of achalasia in Iceland and compare the findings to
other studies. All patients diagnosed with achalasia in Iceland from 1952 to 2002 were identified and patients demographic
and clinical history was reviewed. The incidence and prevalence of achalasia were obtained. Sixty-two achalasia patients were
diagnosed during the 51-year study period, 33 males and 29 females. The mean age at diagnosis was 45.2 years (range, 13.2–85.4
years). The median duration of symptoms before diagnosis was 2.0 years. The mean prevalence was 8.7 cases/100,000 and the
overall incidence was 0.55 case/100,000/year. This is the first national epidemiological study of achalasia in a genetically
homogeneous population, spanning over half a century. The epidemiology of achalasia in Iceland is similar to that in most
other reported studies. 相似文献