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Melissa Jehn Andreas Gebhardt Uta Liebers Bahar Kiran Dieter Scherer Wilfried Endlicher Christian Witt 《Lung》2014,192(4):619-624
Background
Summer heat waves with temperature extremes are becoming more frequent with growing numbers in morbidity and mortality in patients with respiratory diseases. The aim of this study was to evaluate the ramifications of heat stress (temperature >25 °C) on the health status of patients with pulmonary arterial hypertension (PAH).Methods
Fifteen patients with PAH (mean age = 66.7 ± 5.2 years) continuously wore an accelerometer from April 1 to September 30, 2011, and their daily step count was recorded. In addition, patients kept a diary to record data on seven standardized questions regarding their daily symptoms. Echocardiography, 6-minute walk test, NTproBNP, and Modified Medical Research Council Scale (MMRC) were assessed at baseline and at the end of the study after 6 months.Results
On heat-stress days, patients showed significantly more symptoms and lower total steps/day compared to thermal comfort days (3,995 ± 2,013 steps/day vs. 5,567 ± 2,434 steps/day, respectively; P < 0.001). There was a significant negative correlation between total steps/day and Tempmax (R = ?0.47; P < 0.001) and humidity (R = ?0.34; P < 0.001). A significant positive correlation was found between daily symptoms and Tempmax (R = +0.79; P < 0.001) and humidity (R = +0.23; P < 0.001).Conclusions
Heat stress is associated with a compromised clinical status in patients with PAH. Adaptation strategies must be implemented to prevent heart-related morbidity, including therapeutic adjustments and adequate room cooling in the patient’s home and at the hospital. 相似文献43.
Herwig Kloimstein MD MSc Rudolf Likar MD Prof Michael Kern MD Josef Neuhold MD Miroslav Cada MD Nadja Loinig MD Wilfried Ilias MD Prof Brigitta Freundl MD Heinrich Binder MD Andreas Wolf MD Christian Dorn MD Prof Eva Maria Mozes‐Balla MD Rolf Stein MD Ivo Lappe MD Sabine Sator‐Katzenschlager MD Prof 《Neuromodulation》2014,17(2):180-187
44.
Johann Kinzl Wilfried Biebl Manfred Herold 《The International journal of eating disorders》1993,13(1):117-124
The authors investigated the significance of vomiting for hyperamylasemia and sialadenosis in patients with bulimia nervosa. Hyperamylasemia was found in 61% of the bulimics and in 20% of the restrictor anorectics but in no patients with binge-eating syndrome. In more than three fourths of the bulimics there was a close positive correlation between the frequency of vomiting and total serum amylase levels. Both frequency and type of vomiting seem to be relevant to the extent of salivary gland enlargement. The significance of vomiting for the etiopathology of hyperamylasemia and for the diagnosis of eating disorders will be discussed. © 1993 by John Wiley & Sons, Inc. 相似文献
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Rationale and design of the AdaptResponse trial: a prospective randomized study of cardiac resynchronization therapy with preferential adaptive left ventricular‐only pacing 下载免费PDF全文
Gerasimos Filippatos David Birnie Michael R. Gold Bart Gerritse Ahmad Hersi Sandra Jacobs Kengo Kusano Christophe Leclercq Wilfried Mullens Bruce L. Wilkoff 《European journal of heart failure》2017,19(7):950-957
The AdaptResponse trial is designed to test the hypothesis that preferential adaptive left ventricular‐only pacing with the AdaptivCRT® algorithm reduces the incidence of the combined endpoint of all‐cause mortality and intervention for heart failure (HF) decompensation, compared with conventional cardiac resynchronization therapy (CRT), among patients with a CRT indication, left bundle branch block (LBBB) and normal atrioventricular (AV) conduction. The AdaptResponse study is a prospective, randomized, controlled, single‐blinded, multicentre, clinical trial ( ClinicalTrials.gov Identifier: NCT02205359), conducted at up to 200 centres worldwide. Following enrolment and baseline assessment, eligible subjects will be implanted with a CRT system containing the AdaptivCRT algorithm, and randomized in a 1:1 fashion to either a treatment (‘AdaptivCRT’) or control (‘Conventional CRT’) group. The study is designed to observe a primary endpoint in 1100 patients (‘event‐driven’) and approximately 3000 patients will be randomized. The primary endpoint is the composite of all‐cause mortality and intervention for HF decompensation; secondary endpoints include all‐cause mortality, intervention for HF decompensation, clinical composite score (CCS) at 6 months, atrial fibrillation, quality of life measured by the Kansas City Cardiomyopathy Questionnaire (KCCQ), health outcome measured by the EQ‐5D instrument, all‐cause readmission after a HF admission, and cost‐effectiveness. The AdaptResponse clinical trial is powered to assess clinical endpoints and is expected to provide definitive evidence on the incremental utility of AdaptivCRT‐enhanced CRT systems. 相似文献
47.
PD Dr. Dr. Martin Kunkel Thomas Morbach Wilfried Wagner 《Oral and maxillofacial surgery》2004,8(6):344-349
Background
In view of the conflicting guidelines issued by national and international scientific societies, debate about the indications for prophylactic extraction of wisdeom teeth is ongoing. This prospective study was therefore set up to explore the complications associated with wisdom teeth and requiring in-patient treatment.Patients and Methods
From January /2003 to December 2003, 21 subjects were admitted for treatment of complications associated with wisdom teeth. The medical history was recorded for each of these patients, as were the cause and type of the complications. The parameter used to quantify the severity of any infections was the CRP, and the overall clinical complexity level of each case was assessed by the length of stay in hospital (and the duration of intensive care if this had been necessary). The characteristics of patients in the group with postoperative complications were compared to those of patients with complications attributable to pericoronitis. Moreover, complications in patients who had undergone prophylactic extraction of wisdom teeth that had not been causing any symptoms were compared with those in patients whose wisdom teeth had been extracted because of morbidity.Results
Overall, 18 deep-space infections (15 abscesses, 2 inflammatory infiltrations, 1 case of phlegmonous cellulitis), 2 mandibular fractures and 1 lingual nerve injury were noted within 1 year. The complications resulted from surgical procedures in 15 of the 21 cases, while in 6 they had their origin in pericoronitis. Extensive surgery or intensive care was required only for patients with postoperative complications. The length of stay in hospital was significantly greater for patients with postoperative complications (p= 0.007, U-test). However, 9 of these 15 patients reported preoperative episodes of infection. Thus, more than two thirds of the complications could be traced back to wisdom teeth that were causing symptoms.Conclusion
In our clinic’s catchment area, infectious complications were more frequent and more severe and required more intensive and longer treatment in hospital than complications arising from pericoronitis. However, complications of prophylactic extraction of wisdom teeth were decidedly less frequent than direct or indirect complications of extraction of symptomatic teeth. Thus, our data tend to support the concept of elective extraction of wisdom teeth with the aim of preventing serious infections. 相似文献48.
Out R Jessup W Le Goff W Hoekstra M Gelissen IC Zhao Y Kritharides L Chimini G Kuiper J Chapman MJ Huby T Van Berkel TJ Van Eck M 《Circulation research》2008,102(1):113-120
The concept that macrophages can become foam cells as a result of a disturbed balance between the uptake of cholesterol from lipoproteins and cholesterol efflux is generally accepted. ABCA1 and ABCG1 are two cholesterol transporters that may act sequentially to remove cellular cholesterol, but currently their combined role in vivo is unknown. We report here that targeted disruption of both ABCA1 and ABCG1 in mice, despite severe plasma hypocholesterolemia, leads to massive lipid accumulation and foam cell formation of tissue macrophages. A complete ablation of cellular cholesterol efflux in vitro is observed, whereas in vivo macrophage-specific reverse cholesterol transport to the feces is markedly decreased. Despite the massive foam cell formation of tissue macrophages, no lipid accumulation was observed in the vascular wall, even in mice of 1 year old, indicating that the double knockout mice, possibly because of their hypocholesterolemia, lack the trigger to attract macrophages to the vessel wall. In conclusion, even under hypocholesterolemic conditions macrophages can be converted into foam cells, and ABCA1 and ABCG1 play an essential role in the prevention of foam cell formation. 相似文献
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