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91.
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Clodfelter RC Albanese MJ Baker G Domoto K Gui AL Khantzian EJ 《The American journal on addictions / American Academy of Psychiatrists in Alcoholism and Addictions》2003,12(5):448-454
This report describes the MICA (Mentally Ill Chemically Abusing) Program at the Tewksbury Hospital campus in Tewksbury, Massachusetts. Several campus facilities collaborate in the MICA Program. Through Expert Case Conferences, principles of integrated psychosocial treatment with dual diagnosis patients are demonstrated. An expert clinician focuses on the interplay between psychological pain, characterological traits, defenses, and the patient's drug of choice. Patients who have participated in the program have reported positive experiences. The staff reported that the program has resulted in facility improvement in assessment and treatment of complex dual diagnosis patients. 相似文献
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Contrast-induced nephropathy after percutaneous coronary interventions in relation to chronic kidney disease and hemodynamic variables 总被引:9,自引:0,他引:9
Dangas G Iakovou I Nikolsky E Aymong ED Mintz GS Kipshidze NN Lansky AJ Moussa I Stone GW Moses JW Leon MB Mehran R 《The American journal of cardiology》2005,95(1):13-19
We previously found that contrast-induced nephropathy (CIN) complicating percutaneous coronary intervention adversely affects patients with chronic kidney disease (CKD). Therefore, we further investigated whether the predictors and outcome of CIN after percutaneous coronary intervention differ among patients with versus without CKD. Among 7,230 consecutive patients, CIN (>or=25% or >or=0.5 mg/dl increase in preprocedure serum creatinine 48 hours after the procedure) developed in 381 of 1,980 patients (19.2%) with baseline CKD (estimated glomerular filtration rate [eGFR] <60 ml/min/1.73 m(2)) and in 688 of 5,250 patients (13.1%) without CKD. Decreased eGFRs, periprocedural hypotension, higher contrast media volumes, lower baseline hematocrit, diabetes, pulmonary edema at presentation, intra-aortic balloon pump use, and ejection fraction <40% were the most significant predictors of CIN in patients with CKD. Apart from intra-aortic balloon pump use, predictors of CIN in patients without CKD were the same as mentioned, plus older age and type of contrast media. Regardless of baseline renal function, CIN correlated with longer in-hospital stay and higher rates of in-hospital complications and 1-year mortality compared with patients without CIN. By multivariate analysis, CIN was 1 of the most powerful predictors of 1-year mortality in patients with preexisting CKD (odds ratio 2.37, 95% confidence interval 1.63 to 3.44) or preserved eGFR (odds ratio 1.78; 95% confidence interval 1.22 to 2.60). Thus, regardless of the presence of CKD, baseline characteristics and periprocedural hemodynamic parameters predict CIN, and this complication is associated with worse in-hospital and 1-year outcomes. 相似文献
95.
Distinct roles for jasmonate synthesis and action in the systemic wound response of tomato 总被引:27,自引:0,他引:27
Li L Li C Lee GI Howe GA 《Proceedings of the National Academy of Sciences of the United States of America》2002,99(9):6416-6421
Plant defense responses to wounding and herbivore attack are regulated by signal transduction pathways that operate both at the site of wounding and in undamaged distal leaves. Genetic analysis in tomato indicates that systemin and its precursor protein, prosystemin, are upstream components of a wound-induced, intercellular signaling pathway that involves both the biosynthesis and action of jasmonic acid (JA). To examine the role of JA in systemic signaling, reciprocal grafting experiments were used to analyze wound-induced expression of the proteinase inhibitor II gene in a JA biosynthetic mutant (spr-2) and a JA response mutant (jai-1). The results showed that spr-2 plants are defective in the production, but not recognition, of a graft-transmissible wound signal. Conversely, jai-1 plants are compromised in the recognition of this signal but not its production. It was also determined that a graft-transmissible signal produced in response to ectopic expression of prosystemin in rootstocks was recognized by spr-2 but not by jai-1 scions. Taken together, the results show that activation of the jasmonate biosynthetic pathway in response to wounding or (pro)systemin is required for the production of a long-distance signal whose recognition in distal leaves depends on jasmonate signaling. These findings suggest that JA, or a related compound derived from the octadecanoid pathway, may act as a transmissible wound signal. 相似文献
96.
Maayan Konigstein Ori Ben-Yehuda Pieter C. Smits Michael P. Love Shmuel Banai Gidon Y. Perlman Mordechai Golomb Melek Ozgu Ozan Mengdan Liu Martin B. Leon Gregg W. Stone David E. Kandzari 《JACC: Cardiovascular Interventions》2018,11(24):2467-2476
Objectives
The authors sought to investigate the impact of diabetes mellitus (DM) on outcomes following contemporary drug-eluting stent (DES) implantation in the BIONICS (BioNIR Ridaforolimus Eluting Coronary Stent System in Coronary Stenosis) trial.Background
Patients with DM are at increased risk for adverse events following percutaneous coronary intervention (PCI).Methods
A prospective, multicenter, 1:1 randomized trial was conducted to evaluate in a noninferiority design the safety and efficacy of ridaforolimus-eluting stents versus zotarolimus-eluting stents among 1,919 patients undergoing PCI. Randomization was stratified to the presence of medically treated DM, and a pre-specified analysis compared outcomes according to the presence or absence of DM up to 2 years.Results
The overall prevalence of DM was 29.1% (559 of 1,919). DM patients had higher body mass index, greater prevalence of hyperlipidemia and hypertension, and smaller reference vessel diameter. One-year target lesion failure (cardiac death, target vessel myocardial infarction, or ischemia-driven target lesion revascularization) was significantly higher among diabetic patients (7.8% vs. 4.2%; p = 0.002), mainly due to higher target lesion revascularization (4.5% vs. 2.0%; p = 0.002). Rates of cardiac death, myocardial infarction, and stent thrombosis did not statistically vary. Among 158 patients undergoing 13-month angiographic follow-up, restenosis rates were 3 times higher in diabetic patients compared with nondiabetic patients (15.2% vs. 4.7%; p = 0.01). Clinical and angiographic outcomes were similar between ridaforolimus-eluting stent– and zotarolimus-eluting stent–treated patients.Conclusions
Despite advances in interventional therapies, and the implementation of new-generation DES, diabetic patients still have worse angiographic and clinical outcomes compared with nondiabetic patients undergoing PCI. 相似文献97.
Calcium channel blocker toxicity can be devastating. Initial therapy with fluid, calcium, and adrenoreceptor agonists should be prompt and novel therapies can be added if no response. Determining cardiogenic shock versus vasoplegia with echocardiogram or other hemodynamic monitoring may guide treatment options. 相似文献
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99.