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101.
Anand V. Nene Alexandre Rainha Campos Klemen Grabljevec Arminda Lopes Bengt Skoog Anthony S. Burns 《Archives of physical medicine and rehabilitation》2018,99(9):1917-1926
A thorough assessment of the extent and severity of spasticity, and its effect on functioning, is central to the effective management of spasticity in persons with spinal cord damage (SCD). These individuals however do not always receive adequate assessment of their spasticity. Inadequate assessment compromises management when the effect of spasticity and/or need for intervention are not fully recognized. Assessment is also central to determining treatment efficacy. A barrier to spasticity assessment has been the lack of consensus on clinical and functional measures suitable for routine clinical practice. To extend on existing work, a working group of the Ability Network identified and consolidated information on possible measures, and then synthesized and formulated findings into practical recommendations for assessing spasticity and its effect on function in persons with SCD. Sixteen clinical and functional measures that have been used for this purpose were identified using a targeted literature review. These were mapped to the relevant domains of the International Classification of Functioning, Disability and Health to assess the breadth of their coverage; coverage of many domains was found to be lacking, suggesting a focus for future work. The advantages, disadvantages, and usefulness of the measures were assessed using a range of criteria, with a focus on usefulness and feasibility in routine clinical practice. Based on this evaluation, a selection of measures suitable for initial and follow-up assessments are recommended. The recommendations are intended to have broad applicability to a variety of health care settings where people with SCD are managed. 相似文献
102.
Etienne Gayat Alexa Hollinger Alain Cariou Nicolas Deye Antoine Vieillard-Baron Samir Jaber Benjamin G. Chousterman Qin Lu Pierre François Laterre Xavier Monnet Michael Darmon Marc Leone Bertrand Guidet Romain Sonneville Jean-Yves Lefrant Marie-Céline Fournier Matthieu Resche-Rigon Alexandre Mebazaa Matthieu Legrand On behalf of FROG-ICU investigators 《Intensive care medicine》2018,44(5):598-605
103.
104.
Romain Jouffroy Anastasia Saade Alexandre Muret Pascal Philippe Maud Michaloux Pierre Carli Benoit Vivien 《The American journal of emergency medicine》2018,36(10):1754-1758
Background
Septic shock is associated with hypovolemia resulting in organs failure and poor prognosis. The first step in hemodynamic resuscitation relies on early fluid expansion. In this study, we describe qualitative and quantitative fluid resuscitation of septic shock initially managed in a pre-hospital setting by a mobile intensive care unit.Methods
Patients with septic shock who received pre-hospital medical care were retrospectively analysed. Qualitative and quantitative fluid resuscitation performed in the pre-hospital setting were analysed. Applying the "grey zone" concept, we define 3 categories of fluid expansion indexed on ideal body weight (IBW): >20ml/kg, 10-20ml/kg and ?<?10ml/kg. The relationship between the pre-specified categories and mortality at day 28 were analyzed.Results
Ninety-five patients were included. The origin of sepsis was mainly pulmonary (68%). Mortality reached 34%. Pre-hospital fluid expansion was performed using serum saline (98%) with a mean of 1158±559ml. An inversed linear relationship between pre-specified categories and mortality was observed. Using logistic regression model, significant association with mortality remained for fluid expansion indexed on IBW: p=0.02, ORa [CI95] = 0.93 [0.89-0.98]. For fluid expansion indexed on IBW?<?10ml/kg, the OR [CI95] was 4.03 [1.78-9.41] (p=0.005) whereas for fluid expansion indexed on IBW?>?20ml/kg, the OR [CI95] was 0.30 [0.13-0.66] (p=0.01).Discussion
Pre-hospital fluid resuscitation in septic shock is mainly performed using crystalloids with quantitative fluid expansion lower than recommended. Low pre-hospital fluid expansion was associated with increased mortality. Further prospective studies are needed to evaluate the impact of optimized early fluid expansion on mortality in the prehospital management of septic shock. 相似文献105.
106.
107.
New insights on IgA vasculitis with underlying solid tumor: a nationwide French study of 30 patients
Hankard Antoine Michot Jean-Marie Terrier Benjamin Brihaye Benoît Chanal Johan Combe Christian Karras Alexandre Urbanski Geoffrey Amoura Zahir Darrigade Anne-Sophie Deroux Alban Guerville Florent Burel Le Sébastien Maigné Gwénola Mekinian Arsène Moulis Guillaume Riviere Etienne Vandamme-Giard Carole Maillot Francois De Boysson Hubert Aouba Achille Audemard-Verger Alexandra 《Clinical rheumatology》2021,40(5):1933-1940
Clinical Rheumatology - IgA vasculitis (IgAV) frequently occurs during or after a mucosal infection; it also rarely occurs in patients with cancer. We hypothesized that cancer could impact the... 相似文献
108.
Legallois Damien Hodzic Amir Alexandre Joachim Dolladille Charles Saloux Eric Manrique Alain Roule Vincent Labombarda Fabien Milliez Paul Beygui Farzin 《Heart failure reviews》2022,27(1):37-48
Heart Failure Reviews - An increase in left ventricular volumes between baseline and follow-up imaging is the main criteria for the quantification of left ventricular remodelling (LVR) after... 相似文献
109.
Guthmann JP Pittet A Lesage A Imwong M Lindegardh N Min Lwin M Zaw T Annerberg A de Radiguès X Nosten F 《Tropical medicine & international health : TM & IH》2008,13(1):91-98
Objective To assess the efficacy of chloroquine in the treatment of Plasmodium vivax malaria in in Dawei District, southern Myanmar.
Methods Enrolled patients at Sonsinphya clinic >6 months of age were assessed clinically and parasitologically every week for 28 days. To differentiate new infections from recrudescence, we genotyped pre- and post-treatment parasitaemia. Blood chloroquine was measured to confirm resistant strains.
Results Between December 2002 and April 2003, 2661 patients were screened, of whom 252 were included and 235 analysed. Thirty-four per cent (95% CI: 28.1–40.6) of patients had recurrent parasitaemia and were considered treatment failures. 59.4% of these recurrences were with a different parasite strain. Two (0.8%) patients with recurrences on day 14 had chloroquine concentrations above the threshold of 100 ng/ml and were considered infected with chloroquine resistant parasites. 21% of failures occurred during the first 3 weeks of follow-up: early recurrence and median levels of blood chloroquine comparable to those of controls suggested P. vivax resistance.
Conclusions Plasmodium vivax resistance to chloroquine seems to be emerging in Dawei, near the Thai-Burmese border. While chloroquine remains the first-line drug for P. vivax infections in this area of Myanmar, regular monitoring is needed to detect further development of parasite resistance. 相似文献
Methods Enrolled patients at Sonsinphya clinic >6 months of age were assessed clinically and parasitologically every week for 28 days. To differentiate new infections from recrudescence, we genotyped pre- and post-treatment parasitaemia. Blood chloroquine was measured to confirm resistant strains.
Results Between December 2002 and April 2003, 2661 patients were screened, of whom 252 were included and 235 analysed. Thirty-four per cent (95% CI: 28.1–40.6) of patients had recurrent parasitaemia and were considered treatment failures. 59.4% of these recurrences were with a different parasite strain. Two (0.8%) patients with recurrences on day 14 had chloroquine concentrations above the threshold of 100 ng/ml and were considered infected with chloroquine resistant parasites. 21% of failures occurred during the first 3 weeks of follow-up: early recurrence and median levels of blood chloroquine comparable to those of controls suggested P. vivax resistance.
Conclusions Plasmodium vivax resistance to chloroquine seems to be emerging in Dawei, near the Thai-Burmese border. While chloroquine remains the first-line drug for P. vivax infections in this area of Myanmar, regular monitoring is needed to detect further development of parasite resistance. 相似文献
110.
Martin RM Lin CJ Costa EM de Oliveira ML Carrilho A Villar H Longui CA Mendonca BB 《The Journal of clinical endocrinology and metabolism》2003,88(12):5739-5746
P450c17 deficiency is an autosomal recessive disorder and a rare cause of congenital adrenal hyperplasia characterized by hypertension, hypokalemia, and impaired production of sex hormones. We performed a clinical, hormonal, and molecular study of 11 patients from 6 Brazilian families with the combined 17alpha-hydroxylase/17,20-lyase deficiency phenotype. All patients had elevated basal serum levels of progesterone (1.8-38 ng/ml; 0.57-12 pmol/liter) and suppressed plasma renin activity. CYP17 genotyping identified 5 missense mutations. The compound heterozygous mutation R362C/W406R was found in 1 family, whereas the homozygous mutations R96W, Y329D, and P428L were seen in the other 5 families. The R96W mutation has been described as the cause of p450c17 deficiency in Caucasian patients. The other mutations were not found in 50 normal subjects screened by allele-specific oligonucleotide hybridization (Y329D, R362C, and W406R) or digestion with HphI (P428L) and were recently found in other Brazilian patients. Therefore, we elucidated the genotype of 11 individuals with p450c17 deficiency and concluded that basal progesterone measurement is a useful marker of p450c17 deficiency and that its use should reduce the misdiagnosis of this deficiency in patients presenting with male pseudohermaphroditism, primary or secondary amenorrhea, and mineralocorticoid excess syndrome. 相似文献