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81.
Khedr Eman M. El Fetoh Noha Abo Gamal Rania M. Elzohri Mona H. Azoz Nashwa Mostafa A. Furst Daniel E. 《Clinical rheumatology》2020,39(5):1551-1559
Clinical Rheumatology - To investigate cognitive dysfunction in adult patients with systemic sclerosis (SSc) who had no known clinical neurological manifestations and to relate it with other... 相似文献
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Silvia Riva Anne-Linda Camerini Ahmed Allam Peter J Schulz 《Journal of medical Internet research》2014,16(8)
Background
Chronic back pain (CBP) represents a significant public health problem. As one of the most common causes of disability and sick leave, there is a need to develop cost-effective ways, such as Internet-based interventions, to help empower patients to manage their disease. Research has provided evidence for the effectiveness of Internet-based interventions in many fields, but it has paid little attention to the reasons why they are effective.Objective
This study aims to assess the impact of interactive sections of an Internet-based self-management intervention on patient empowerment, their management of the disease, and, ultimately, health outcomes.Methods
A total of 51 patients were recruited through their health care providers and randomly assigned to either an experimental group with full access to the Internet-based intervention or a control group that was denied access to the interactive sections and knew nothing thereof. The intervention took 8 weeks. A baseline, a mid-term after 4 weeks, and a final assessment after 8 weeks measured patient empowerment, physical exercise, medication misuse, and pain burden.Results
All patients completed the study. Overall, the intervention had a moderate effect (F 1.52=2.83, P=.03, η2=0.30, d=0.55). Compared to the control group, the availability of interactive sections significantly increased patient empowerment (midterm assessment: mean difference=+1.2, P=.03, d=0.63; final assessment: mean difference=+0.8, P=.09, d=0.44) and reduced medication misuse (midterm assessment: mean difference=−1.5, P=.04, d=0.28; final assessment: mean difference=−1.6, P=.03, d=−0.55) in the intervention group. Both the frequency of physical exercise and pain burden decreased, but to equal measures in both groups.Conclusions
Results suggest that interactive sections as part of Internet-based interventions can positively alter patients’ feelings of empowerment and help prevent medication misuse. Detrimental effects were not observed.Trial Registration
ClinicalTrials.gov: ; http://www.clinicaltrials.gov/ct2/show/ NCT02114788 (Archived by WebCite at http://www.webcitation.org/6ROXYVoPR). NCT02114788相似文献85.
Pradyumna Agasthi Hasan Ashraf Sai Harika Pujari Marlene Girardo Andrew Tseng Farouk Mookadam Nithin Venepally Matthew R Buras Bishoy Abraham Banveet K Khetarpal Mohamed Allam Siva K Mulpuru MD Mackram F Eleid Kevin L Greason Nirat Beohar John Sweeney David Fortuin David R Jr Holmes Reza Arsanjani 《World journal of cardiology》2023,15(3):95-105
BACKGROUND Atrioventricular block requiring permanent pacemaker(PPM) implantation is an important complication of transcatheter aortic valve replacement(TAVR).Application of machine learning could potentially be used to predict preprocedural risk for PPM.AIM To apply machine learning to be used to predict pre-procedural risk for PPM.METHODS A retrospective study of 1200 patients who underwent TAVR(January 2014-December 2017) was performed. 964 patients without prior PPM were included for a 30-d ... 相似文献
86.
Worsening heart failure in ‘real‐world’ clinical practice: predictors and prognostic impact
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87.
Hasan Ashraf Pradyumna Agasthi Anusha Shanbhag Ramila A. Mehta Pattara Rattanawong Mohamed Allam Sai Harika Pujari Farouk Mookadam William K. Freeman Komandoor Srivathsan Dan Sorajja Win-Kuang Shen Peter A. Noseworthy Eric H. Yang Hicham Z. El Masry Xiaoxi Yao Siva K. Mulpuru Nirat Beohar Reza Arsanjani 《The American journal of medicine》2021,134(6):788-796
BackgroundAlthough direct oral anticoagulants (DOACs) have been shown to be effective at reducing the risk of stroke in patients with atrial fibrillation/flutter (AF), they are sometimes underdosed off-label to mitigate their associated higher bleeding risk. We sought to evaluate frequency and clinical outcomes of inappropriate underdosing of DOACS in patients with AF.MethodsWe conducted a study of subjects with AF who had a clinical indication for stroke prophylaxis (with a congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke or transient ischemic attack, vascular disease, age 65 to 47 years, sex category [CHA2DS2-VASc] of 2 or greater) and were prescribed 1 of the 4 clinically approved DOACs (apixaban, rivaroxaban, dabigatran, or edoxaban). We compared all-cause mortality, composite of stroke and systemic embolism, composite of myocardial infarction (MI), acute coronary syndromes (ACS), and coronary revascularization, and major bleeding between patients appropriately dosed and inappropriately underdosed.ResultsA total of 8125 patients met inclusion criteria, with a mean follow up of 2.2 ± 2 years. Of those, 1724 patients (21.2%) were inappropriately dosed. After adjusting for baseline variables, there was no difference in all-cause mortality, risk of stroke or systemic embolism, International Society on Thrombosis and Haemostasis (ISTH) major bleeding, or composite of myocardial infarction, acute coronary syndromes, or coronary revascularization between patients appropriately dosed and inappropriately underdosed. In subgroup analysis, only apixaban demonstrated an increased incidence all-cause mortality (hazard ratio [HR] 1.24, 95% confidence interval [CI] 1.03-1.49) with inappropriate underdosing. There was no difference in the remaining clinical outcomes noted on subgroup analysis.ConclusionUnderdosing of DOACs did not minimize risk of bleeding, systemic embolization or all-cause mortality in patients with AF. Inappropriate underdosing with apixaban in particular was associated with increased all-cause mortality. 相似文献
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Background
ERCP remains the prevailing method of treating CBDS; however, its ideal timing in respect to laparoscopic cholecystectomy (LC) is not defined. LC combined with intraoperative endoscopic sphincterotomy (IOES) was compared with preoperative endoscopic sphincterotomy (PES) followed by LC for management of preoperatively known cholecystocholedocholithiasis. 相似文献90.
Percutaneous video choledochoscopic treatment of retained biliary stones via dilated T-tube tract 总被引:2,自引:1,他引:2
Gamal EM Szabó A Szüle E Vörös A Metzger P Kovács G Kovács J Oláh A Rózsa I Kiss J 《Surgical endoscopy》2001,15(5):473-476
Background: Retained biliary stones is a common clinical problem in patients after surgery for complicated gallstone disease.
When postoperative endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy are unsuccessful, several
percutaneous procedures for stone removal can be applied as alternatives to relaparotomy. These procedures are performed either
under fluoroscopic control or with the use of choledochoscopy, but it is also possible to combine these methods. Methods:
Since 1994, we have used the percutaneous video choledochoscopic technique for the removal of difficult retained biliary stones
via dilated T-tube tract in 17 patients, applying the technique of percutaneous stone extraction used in urology. While waiting
for the T-tube tract to mature and after the removal of the T-tube, the dilatation of its tract was 26--30 Fr. Stone removal
was carried out using a flexible video choledochoscope and a rigid renoscope under fluoroscopic control, with the aid of Dormia
baskets, rigid forceps, and high-pressure irrigation. Results: We performed 23 operative procedures, and the clearance of
the biliary ducts was successful in all cases. There were no major complications or deaths. Conclusion: Percutaneous video
choledochoscopic--assisted removal of large retained biliary stones via the T-tube tract is a highly effective and safe procedure.
Its advantages over other procedures include the ability to visualize the stones and noncalculous filling defects; it also
guarantees that the stones can be removed under visual video endoscopic control. It has no problems related to tract or stone
size.
apd: 21 December 2000 相似文献