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81.
Niva Yacov Boris Feldman Alexander Volkov Eti Ishai Eyal Breitbart Itzhak Mendel 《Basic & clinical pharmacology & toxicology》2019,124(2):131-143
Focal segmental glomerulosclerosis (FSGS) is a scarring process associated with chronic low‐grade inflammation ascribed to toll‐like receptor (TLR) activation and monocyte migration. We developed synthetic, small‐molecule lecinoxoids, VB‐201 and VB‐703, that differentially inhibit TLR‐2‐ and TLR‐4‐mediated activation and monocyte migration. The efficacy of anti‐inflammatory lecinoxoid treatment on FSGS development was explored using a 5/6 nephrectomy rat model. Five‐sixths of nephrectomized rats were treated with lecinoxoids VB‐201, VB‐703 or PBS, for 7 weeks. Upon sacrifice, albumin/creatinine ratio, glomerulosclerosis, fibrosis‐related gene expression and the number of glomerular and interstitial monocyte were evaluated. Treatment of nephrectomized rats with lecinoxoids ameliorated glomerulosclerosis. The percentage of damaged glomeruli, glomerular sclerosis and glomeruli fibrotic score was significantly reduced following VB‐201 and VB‐703 treatment. VB‐703 attenuated the expression of fibrosis hallmark genes collagen, fibronectin (FN) and transforming growth factor β (TGF‐β) in kidneys and improved albumin/creatinine ratio with higher efficacy than did VB‐201, but only VB‐201 significantly reduced the number of glomerular and interstitial monocytes. These results indicate that treatment with TLR‐2, and more prominently, TLR‐4 antagonizing lecinoxioids, is sufficient to significantly inhibit FSGS. Moreover, inhibiting monocyte migration can also contribute to treatment of FSGS. Our data demonstrate that targeting TLR‐2‐TLR‐4 and/or monocyte migration directly affects the priming phase of fibrosis and may consequently perturb disease parthogenesis. 相似文献
82.
Mario Martínez-Galdmez Miguel Schüller-Arteaga Jorge Galvn-Fernndez Vladimir Kalousek Ezequiel Petra Boris Pabn Santiago Ortega-Gutirrez Paloma Jimnez-Arribas Carlos Rodríguez-Arias 《Interventional neuroradiology》2021,27(2):230
Flow diverter devices have become a routine first-line option for treatment of an increasing population of intracranial aneurysms at many neurovascular centers. Despite the promising results of flow diverter stents on anterior circulation, incomplete occlusion on the presence of fetal posterior circulation has been described on several reports. Here we describe a novel technical alternative to conventional flow diversion approach for this specific subgroup of aneurysms using the low-profile flow diverter, Silk Vista Baby. The device was selectively placed into the fetal type posterior cerebral artery in half-T configuration for the treatment of a posterior communicating aneurysm using a transcirculation approach through the anterior communicating artery. This represents a useful and effective technique and should be considered when encountering the above-described situation. 相似文献
83.
84.
Guy Sheahan Richard Reznick Don Klinger Leslie Flynn Boris Zevin 《American journal of surgery》2019,217(2):214-221
Purpose
Video feedback and faculty feedback has been shown to improve surgical performance; however, consistent access to faculty is challenging. We studied the utility of structured peer-feedback (PF) compared to faculty-feedback (FF) during acquisition of basic and intermediate surgical skills.Methodology
Two randomized non-inferiority trials were conducted with 1st (n?=?30) and 2nd year (n?=?29) medical students learning skin-lesion excision and closure (S), and single-layer hand-sewn bowel anastomosis (B), respectively. Five attempts were performed. PF participants used an Objective Structured Assessment of Technical Skills tool to guide feedback. Blinded raters assessed video-recorded performance, time and Integrity of the completed task were also assessed.Results
For both tasks performance by PF was comparable to FF (P?=?0.111). Both groups improved significantly: performance (B:P?<?0.0001, S:P?=?0.035), time (B:P?=?0.043, S:P?<?0.0001) and integrity (B:P?<?0.0001, S:P?<?0.032).Conclusion
Structured peer-feedback is equivalent to faculty-feedback in the acquisition of basic and intermediate surgical skills, giving students freedom to practice independently. 相似文献85.
Malte Lenders J?rg Stypmann Thomas Duning Boris Schmitz Stefan-Martin Brand Eva Brand 《Journal of the American Society of Nephrology : JASN》2016,27(1):256-264
Fabry disease (FD) is a progressive multisystemic disorder, treatable with recombinant enzyme replacement therapy (agalsidase). However, recent studies suggest an endogenous inhibition of agalsidase in patients with FD, as reported for other lysosomal storage diseases. To assess the clinical consequences of serum-mediated agalsidase inhibition in affected patients, we determined the agalsidase inhibition status of 168 patients (68 male) with FD and compared outcomes of inhibition-positive patients with those of inhibition-negative patients. The assessment included clinical events during time on agalsidase, determination of renal and cardiac function, and evaluation of FD-related symptoms. The frequency of serum-mediated agalsidase inhibition was 40% in agalsidase-treated males. Inhibition did not depend on the compound initially used (agalsidase-α or -β). Agalsidase inhibition was associated with higher lyso-globotriaosylceramide levels and worse disease severity scores in patients. Compared with agalsidase inhibition-negative men, agalsidase inhibition-positive men showed greater left ventricular mass (P=0.02) and substantially lower renal function (difference in eGFR of about –30 ml/min per 1.73 m2; P=0.04), which was confirmed by a longitudinal 5-year retrospective analysis. Additionally, affected patients presented more often with FD-typical symptoms, such as diarrhea, fatigue, and neuropathic pain, among others. Therefore, patients with poor clinical outcome on agalsidase should be tested for agalsidase inhibition. Future studies are warranted to determine if affected patients with FD benefit from acute reduction of anti-agalsidase antibodies or long-term immune modulation therapies to suppress agalsidase inhibition and to identify mechanisms that minimize antibody generation against agalsidase. 相似文献
86.
87.
Boris Yanovski Marina Gat Luis Gaitini Bruce Ben-David 《Journal of clinical anesthesia》2013,25(3):214-216
A case of a 10 year old boy who underwent a T10 continuous thoracic paravertebral block (TPVB) using a standard technique for postoperative pain management is reported. In the postoperative recovery area, 10 mL of Omnipaque contrast dye was injected through the catheter and an anteroposterior chest radiograph was performed. The radiograph showed longitudinal spread of contrast parallel to the spine from the T4-T5 intervertebral disc to the T10-T11 intervertebral disc with clear lateral extension of contrast along the fifth through the tenth intercostal nerves. 相似文献
88.
Assessment of myocardial partition coefficient of gadolinium (λ) in dilated cardiomyopathy and its impact on segmental and global systolic function 下载免费PDF全文
Alexis Jacquier MD PhD Alexandros Kallifatidis MD Nicolas Guibert MD Roch Giorgi MD PhD Claire Falque MD Franck Thuny MD PhD Pierre Croisille MD PhD Patrick Clarysse PhD Boris Maurel MD Antonin Flavian MD Jean‐Yves Gaubert MD Guy Moulin MD Gilbert Habib MD 《Journal of magnetic resonance imaging : JMRI》2014,40(6):1336-1341
89.
Posttraumatic or acute instability of the elbow can develop after complete or incomplete dislocation of the elbow. Isolated medial collateral ligament ruptures can be a result of valgus trauma and lateral collateral ligament ruptures of pivot shift or varus trauma. Chronic instability of the elbow may occur after conservative or operative treatment of a traumatic ligament rupture without stable healing. Repetitive overuse in sports or professions may also cause chronic instability. This article provides the reader an overview about current concepts in elbow instability. 相似文献
90.
Breton M Farret A Bruttomesso D Anderson S Magni L Patek S Dalla Man C Place J Demartini S Del Favero S Toffanin C Hughes-Karvetski C Dassau E Zisser H Doyle FJ De Nicolao G Avogaro A Cobelli C Renard E Kovatchev B;on behalf of The International Artificial Pancreas 《Diabetes》2012,61(9):2230-2237
Integrated closed-loop control (CLC), combining continuous glucose monitoring (CGM) with insulin pump (continuous subcutaneous insulin infusion [CSII]), known as artificial pancreas, can help optimize glycemic control in diabetes. We present a fundamental modular concept for CLC design, illustrated by clinical studies involving 11 adolescents and 27 adults at the Universities of Virginia, Padova, and Montpellier. We tested two modular CLC constructs: standard control to range (sCTR), designed to augment pump plus CGM by preventing extreme glucose excursions; and enhanced control to range (eCTR), designed to truly optimize control within near normoglycemia of 3.9-10 mmol/L. The CLC system was fully integrated using automated data transfer CGM→algorithm→CSII. All studies used randomized crossover design comparing CSII versus CLC during identical 22-h hospitalizations including meals, overnight rest, and 30-min exercise. sCTR increased significantly the time in near normoglycemia from 61 to 74%, simultaneously reducing hypoglycemia 2.7-fold. eCTR improved mean blood glucose from 7.73 to 6.68 mmol/L without increasing hypoglycemia, achieved 97% in near normoglycemia and 77% in tight glycemic control, and reduced variability overnight. In conclusion, sCTR and eCTR represent sequential steps toward automated CLC, preventing extremes (sCTR) and further optimizing control (eCTR). This approach inspires compelling new concepts: modular assembly, sequential deployment, testing, and clinical acceptance of custom-built CLC systems tailored to individual patient needs. 相似文献