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排序方式: 共有4173条查询结果,搜索用时 15 毫秒
101.
102.
Mura M Porretta MA Bargagli E Sergiacomi G Zompatori M Sverzellati N Taglieri A Mezzasalma F Rottoli P Saltini C Rogliani P 《The European respiratory journal》2012,40(1):101-109
The natural history of idiopathic pulmonary fibrosis (IPF) is not well defined and its clinical course is variable. We sought to investigate the survival and incidence of acute exacerbations (AEs) and their significant predictors in newly diagnosed patients. 70 patients newly diagnosed with IPF were prospectively followed for at least 3 yrs. Baseline evaluation included Medical Research Council dyspnoea score (MRCDS), 6-min walk test, pulmonary function tests, all of which were repeated at 6 months, and high-resolution computed tomography. A retrospective cohort of 68 patients was used for confirmation. Mean survival from the time of diagnosis was 30 months, with a 3-yr mortality of 46%. A Risk stratificatiOn ScorE (ROSE) based on MRCDS > 3, 6-min walking distance ≤ 72% predicted and composite physiologic index > 41 predicted 3-yr mortality with high specificity. 6-month progression of ROSE predicted rapid progression. 3-yr incidence of AE was 18.6%, mostly occurring in the first 18 months; risk factors for AE were concomitant emphysema and low diffusing coefficient of the lung for carbon monoxide. Results were confirmed in an independent cohort of patients. In newly diagnosed IPF, advanced disease at presentation, rapid progression and AEs are the determinants of 3-yr survival. The purpose of the multifactorial ROSE is to risk-stratify patients in order to predict survival and detect rapid disease progression. 相似文献
103.
Lippi G Schena F Salvagno GL Tarperi C Aloe R Guidi GC 《Journal of thrombosis and thrombolysis》2012,33(4):338-342
Cardiac troponins are a mainstay in the diagnostic approach of patients with suspected acute coronary syndrome. Along with
other causes of cardiac injury, strenuous aerobic exercise is an important source of troponin leakage from myocardium. Due
to recent immunoassays development, there is no information on variation of highly-sensitive (HS) troponin I (TnI) in ultra-marathon
runners. We studied 15 healthy trained Caucasian athletes before and immediately after completion of a 60 km, ultra-marathon.
TnI was measured with both the conventional AccuTnI and the novel HS-AccuTnI immunoassays. At the end of the ultra-marathon
the concentration of HS-AccuTnI significantly increased from the baseline value (19.2 ± 4.2 vs. 5.2 ± 0.8 ng/l; P = 0.001). The number of athletes displaying HS-AccuTnI values exceeding the 99th percentile of the reference limit was 2
(13%) pre-exercise, increasing significantly to 12 (80%; P < 0.001) post-exercise. Measurable value of AccuTnI were found in 1 (7%) and 12 (80%; P < 0.001) athletes pre- and post exercise, respectively. All AccuTnI values were below the 99th percentile reference limit
pre-exercise, whereas this cut-off was overcome in 20% of athletes, post-exercise. These results suggest that the myocardium
release of TnI during strenuous aerobic exercise mirrors that of troponin T. Moreover, the improved sensitivity of the HS-AccuTnI
over the conventional assay makes it more suited for detecting even minor elevations of TnI in blood. 相似文献
104.
105.
Masked hypertension (MH) is an emerging clinical entity predisposing to subclinical organ damage and to increased cardiovascular risk. We sought to review the recent literature focusing on the association between MH and echocardiographic left ventricular hypertrophy (LVH). A MEDLINE search was performed in order to identify relevant papers using the key words such as 'masked hypertension', 'ambulatory hypertension', 'left ventricular hypertrophy', 'cardiac damage', 'target organ damage', 'left ventricular dysfunction'. Full articles published in English language in the last decade, namely from 1 December 1999 to 31 July 2011, reporting studies in adult or elderly individuals, were considered. Checks of the reference lists of selected papers complemented the electronic search. A total of 13 studies, including 966 patients with MH (sample size range 17-222 patients, mean age range 30-70 years; men 71%) and 2640 controls with sustained normotension, controlled hypertension, and white coat hypertension were considered. The prevalence of LVH, defined according to six criteria, ranged from 7 to 66% in MH and from 0.4 to 42% in non-MH counterparts (average 29 vs. 9%, P<0.01). In conclusion, available evidence linking a selective blood pressure elevation outside office to echocardiographic LVH in clinically normotensive individuals is supported by limited evidence. Further studies are needed to expand our knowledge in this area and to explore the beneficial effects of antihypertensive treatment on subclinical cardiac damage in patients with MH. 相似文献
106.
Martini R Andreozzi GM Tiengo C Azzena B Mazzoleni F 《Clinical hemorheology and microcirculation》2012,51(2):149-157
A 46 years old male with a post traumatic loss of tissue localized on the anterior surface of the right thigh and knee due to a road accident, was treated with different surgical reconstructive techniques. Combined use of autologous skin graft and acellular dermal substitute Integra? allowed the satisfactory recovery of the patient who was discharged after 82 days from the trauma. To analyse the characteristics and the quality of the healing tissues we performed a videocapillaroscopy study to assess the microcirculatory pattern of the autologous skin grafted on the dermal substitute in comparison with the autologous skin grafted on granulation tissue. The videocapillaroscopy was performed in the zone skin grafted directly on granulation tissue, Zone 1 (Z1); on the region of the lesion in the knee, treated with dermal substitute and autologous skin graft, Zone 2 (Z2), and on the undamaged controlateral knee skin. Zone 3 (Z3). The results showed that the capillary density was similar between Z2 and Z3, while in Z1, the zone skin grafted on the granulation tissue without Integra? the capillary density was significatively reduced. These preliminary observations within the clinical data may be an useful contribute to better understand the tissue healing process. 相似文献
107.
Despite several decades of research and clinical experience, the basic mechanisms of the failing heart remain largely a secret. While pharmacological therapy can induce limited reverse remodeling, left ventricular assist device (LVAD) therapy offers the opportunity to induce significant improvements to the structure and function of the heart, with major clinical implications. LVAD therapy also provides significant insight into which changes have an impact on function and which do not, and could therefore reveal some of the secrets of the failing heart. In addition, LVAD-induced mechanical unloading may unlock further myocardial properties hitherto unknown such as the proliferation of the stem cell compartment. It may also serve as an important platform for emerging therapies such as gene and cell therapies. In this review, we highlight the most recent novel discoveries related to LVAD therapy and bridge to recovery (BTR). Discovering the integrated network of events that underlies BTR could unravel the secrets of the failing heart. 相似文献
108.
109.
Phalangeal neck fractures occur almost exclusively in children. We present the case of a 49 years
old man with a dislocated fracture of the neck of the middle phalanx with the distal fragment rotated at 180°, due to a traumatic circular saw injury to the left index, which was solved by anatomical reduction and bone fixation with two 1.5 mm Synthes screws and a temporary transarticular Kwire at the distal interphalangeal joint. Zone Iflexor digitorum profundus repair was performed using a modification of the Kessler 4-strands core suture and a full-thickness skin graft from the hypothenar eminence was taken to cover the skin gap. At 6-month follow-up the patient was pain-free and
with a total active movement equivalent to 190°. No radiological signs of avascular necrosis of the head of the middle phalanx or nonunion of the distal fragment was detectable with recovery to the previous manual work. Owing to the position of the phalangeal head maintained in position by
the collateral ligaments an anatomic reduction from dorsal approach is difficult to be performed and a longitudinal traction can render the reduction harder too. The volar approach permits an easier reduction of the fracture through a derotation of the distal fragment facing palmar. 相似文献
110.
Francesco Sanguedolce Alberto Breda Felix Millan Marianne Brehmer Thomas Knoll Evangelos Liatsikos Palle Osther Olivier Traxer Cesare Scoffone 《World journal of urology》2013,31(6):1575-1580