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排序方式: 共有1598条查询结果,搜索用时 15 毫秒
51.
Gregor K Wenning Felix Geser Florian Krismer Klaus Seppi Susanne Duerr Sylvia Boesch Martin Köllensperger Georg Goebel Karl P Pfeiffer Paolo Barone Maria Teresa Pellecchia Niall P Quinn Vasiliki Koukouni Clare J Fowler Anette Schrag Christopher J Mathias Nir Giladi Tanya Gurevich Werner Poewe 《Lancet neurology》2013,12(3):264-274
52.
Victoria C. Wing Mera S. Barr Caroline E. Wass Nir Lipsman Andres M. Lozano Zafiris J. Daskalakis Tony P. George 《Brain stimulation》2013,6(3):221-230
BackgroundTobacco smoking is the leading cause of preventable deaths worldwide, but many smokers are simply unable to quit. Psychosocial and pharmaceutical treatments have shown modest results on smoking cessation rates, but there is an urgent need to develop treatments with greater efficacy. Brain stimulation methods are gaining increasing interest as possible addiction therapeutics.ObjectivesThe purpose of this paper is to review the studies that have evaluated brain stimulation techniques on tobacco addiction, and discuss future directions for research in this novel area of addiction interventions.MethodsElectronic and manual literature searches identified fifteen studies that administered repetitive transcranial magnetic stimulation (rTMS), cranial electrostimulation (CES), transcranial direct current stimulation (tDCS) or deep brain stimulation (DBS).ResultsrTMS was found to be the most well studied method with respect to tobacco addiction. Results indicate that rTMS and tDCS targeted to the dorsolateral prefrontal cortex (DLPFC) were the most efficacious in reducing tobacco cravings, an effect that may be mediated through the brain reward system involved in tobacco addiction. While rTMS was shown to reduce consumption of cigarettes, as yet no brain stimulation technique has been shown to significantly increase abstinence rates. It is possible that the therapeutic effects of rTMS and tDCS may be improved by optimization of stimulation parameters and increasing the duration of treatment.ConclusionAlthough further studies are needed to confirm the ability of brain stimulation methods to treat tobacco addiction, this review indicates that rTMS and tDCS both represent potentially novel treatment modalities. 相似文献
53.
Amson M Lamoureux E Hilzenrat N Tischkowitz M 《Journal canadien de gastroenterologie》2012,26(6):330-332
The authors describe two siblings, each with a different, rare genetic condition that affects liver function. The index case, the 18-year-old asymptomatic brother of a young man recently diagnosed with Wilson disease, presented for Wilson disease screening and was also found to have abnormal liver function suggestive of cholestasis. However, ceruloplasmin level, 24 h urine copper concentration and liver synthetic function were normal. Further hepatic investigations and genetic mutation analysis were performed, ultimately leading to a diagnosis of Alagille syndrome. He was treated with ursodiol, which resulted in normalization of his liver function tests. Subsequently, he was found to be a carrier for a mutation in the Wilson disease gene, ATP7B. In the present report, the potential implications of being a heterozygote for Wilson disease in the context of Alagille syndrome are discussed. Also stressed is that care must be exercised by the clinician when diagnosing family members who may present with two different disorders closely mimicking one another. 相似文献
54.
Colombo PC Ganda A Lin J Onat D Harxhi A Iyasere JE Uriel N Cotter G 《Heart failure reviews》2012,17(2):177-190
Although inflammation is a physiologic response designed to protect us from infection, when unchecked and ongoing it may cause
substantial harm. Both chronic heart failure (CHF) and chronic kidney disease (CKD) are known to cause elaboration of several
pro-inflammatory mediators that can be detected at high concentrations in the tissues and blood stream. The biologic sources
driving this chronic inflammatory state in CHF and CKD are not fully established. Traditional sources of inflammation include
the heart and the kidneys which produce a wide range of pro-inflammatory cytokines in response to neurohormones and sympathetic
activation. However, growing evidence suggests that non-traditional biomechanical mechanisms such as venous and tissue congestion
due to volume overload are also important as they stimulate endotoxin absorption from the bowel and peripheral synthesis and
release of pro-inflammatory mediators. Both during the chronic phase and, more rapidly, during acute exacerbations of CHF
and CKD, inflammation and congestion appear to amplify each other resulting in a downward spiral of worsening cardiac, vascular,
and renal functions that may negatively impact patients’ outcome. Anti-inflammatory treatment strategies aimed at attenuating
end organ damage and improving clinical prognosis in the cardiorenal syndrome have been disappointing to date. A new therapeutic
paradigm may be needed, which involves different anti-inflammatory strategies for individual etiologies and stages of CHF
and CKD. It may also include specific (short-term) anti-inflammatory treatments that counteract inflammation during the unsettled
phases of clinical decompensation. Finally, it will require greater focus on volume overload as an increasingly significant
source of systemic inflammation in the cardiorenal syndrome. 相似文献
55.
Background
Acne keloidalis nuchae (AKN) is a benign condition of keloid-like papules on the occipital scalp area. Treatment for AKN is divided into conservative and surgical. The use of tissue expander enables preservation of the hirsute area and thereby achieves a good cosmetic result. Osmotic tissue expander is a self-filling device, which absorbs tissue fluids in order to increase skin volume gradually. So far, the use of osmotic expander for reconstruction of AKN has not been described. We present our experience with five consecutive cases of tissue reconstruction using osmotic expanders in AKN.Methods
Five patients suffering from AKN, median age of 43 years (range 35–50), who were admitted to our department between April 2010 and December 2011 underwent reconstruction using an osmotic tissue expander. All patients had the lesions for a median of 12 years (range 7–15).Results
In three of the five patients, one expander was used per patient. In the remaining two, two expanders were used. In all the cases, the operative and postoperative management were uneventful with no major complications. A minor complication included partial extrusion of the expander (one patient), which caused an earlier conclusion of the reconstruction, nevertheless with a pleasing result. The average expansion period was 7 weeks (range 4–9). During that time, there was a median of one follow-up visit (range 1–2). Final aesthetic results were satisfactory in all the cases.Conclusions
Osmotic expander is a reliable tool for tissue expansion. The main advantages of this device make it especially suitable for AKN reconstruction. Its main disadvantages include the inability to control the filling rate and the need to remove it in case of tissue damage. Level of Evidence: Level V, therapeutic study. 相似文献56.
Nir Lubezky Yaacov Goykhman Richard Nakache Ada Kessler Roni Baruch Paulina Katz Itzhak Kori Joseph M. Klausner Menahem Ben-Haim 《World journal of surgery》2013,37(6):1430-1437
Background
Graft pseudoaneurysm (PSA) following pancreatic transplantation (PT) is a rarely reported complication that has significant morbidity and mortality. Few case reports and small series of this complication exist.Methods
Retrospective review of files of 106 patients who underwent PT at the Tel-Aviv Sourasky Medical center between 1995 and 2010. Accessible asymptomatic patients (n = 35) were referred for graft PSA screening using ultrasound-Doppler.Results
Eight patients developed graft PSA (8 %). All had early posttransplant sepsis. PSA incidence among patients who had perioperative sepsis is 13 %. Three patients developed early postoperative PSA, presenting as massive abdominal bleeding requiring urgent laparotomy and graft resection. Five patients were diagnosed with late-onset graft PSA between 3 months and 11 years posttransplant: clinical presentations were massive gastrointestinal bleeding (n = 2), acute renal failure (n = 1), and asymptomatic finding on screening ultrasound-Doppler (n = 2, 6 % of screened patients).Conclusions
PSA following PT occurs in 8 % of patients. Perioperative infection is a risk factor. Early PSAs present as massive intra-abdominal bleeding. PSA may develop years posttransplant, may be asymptomatic, but late rupture is possible and presents as gastrointestinal bleeding. We recommend screening of patients at risk with ultrasound Doppler for early detection and treatment of asymptomatic PSAs. 相似文献57.
Anat Mirelman PhD Talia Heman MsPT Kira Yasinovsky BS Avner Thaler MD Tanya Gurevich MD Karen Marder MD Susan Bressman MD Anat Bar‐Shira PhD Avi Orr‐Urtreger MD PhD Nir Giladi MD Jeffrey M. Hausdorff PhD 《Movement disorders》2013,28(12):1683-1690
Patients with Parkinson's disease (PD) who carry the G2019S mutation (a glycine to serine substitution at amino acid 2019) in the leucine‐rich repeat kinase 2 (LRRK2) gene are generally believed to be clinically indistinguishable from patients with sporadic PD. There are, however, conflicting reports on the relationship between the mutation and the motor phenotype. We quantitatively compared gait and mobility in patients with PD carriers of the G2019S mutation to non‐carrier patients with PD to better understand the genotype‐phenotype relationship. Fifty patients with PD carriers of the G2019S LRRK2 mutation and 50 age, disease duration, and disease severity matched PD non‐carriers were studied. An accelerometer quantified gait under three walking conditions: usual‐walking, dual‐tasking, and fast‐walking. The Unified Parkinson's Disease Rating Scale classified patients into PD sub‐types and the Timed Up and Go quantified mobility and fall risk. In all three walking conditions, gait variability was larger and the walking pattern was less consistent among the PD mutation carriers (P < 0.016). The PD carriers also took longer to complete the Timed Up and Go (P = 0.011) and were more likely to report having fallen in the previous year (P = 0.018). 64% of the PD carriers were classified as belonging to the postural‐instability‐gait‐difficulty (PIGD) sub‐type compared to only 17% of the PD non‐carriers (P < 0.0001). Among patients with PD, the G2019S mutation in the LRRK2 gene is apparently associated with increased gait variability, an increased fall risk, and the PIGD sub‐type. Therapeutic approach specifically designed to delay gait disturbances and falls may be justified in patients who carry the G2019S mutation. © 2013 International Parkinson and Movement Disorder Society 相似文献
58.
59.
Nurit Omer MD Nir Giladi MD Tanya Gurevich MD Anat Bar-Shira PhD Mali Gana-Weisz PhD Tal Glinka MSc Orly Goldstein PhD Meir Kestenbaum MD Jesse M. Cedarbaum MD Omar S. Mabrouk PhD Kyle B. Fraser PhD Julia C. Shirvan MD PhD Avi Orr-Urtreger MD PhD Anat Mirelman PhD Avner Thaler MD PhD 《Movement disorders》2022,37(1):190-195
60.