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排序方式: 共有1216条查询结果,搜索用时 15 毫秒
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Oscar Bernal‐Pacheco MD Genko Oyama MD PhD Kelly D. Foote MD Yunfeng E. Dai MS Samuel S. Wu PhD Charles E. Jacobson IV BS Natlada Limotai MD Pamela R. Zeilman ARNP Janet Romrell PA Nelson Hwynn DO Ramon L. Rodriguez MD Irene A. Malaty MD Michael S. Okun MD 《Neuromodulation》2013,16(1):35-40
Objectives: To screen for potentially underreported behavioral changes in patients with idiopathic Parkinson's disease (PD) pre‐ and post‐deep brain stimulation (DBS), a retrospective data base review was performed. Methods: In total, 113 patients who underwent unilateral or bilateral DBS at the University of Florida in either subthalamic nucleus or globus pallidus internus for PD were screened for behavioral issues by asking about the presence or absence of seven neuropsychiatric symptoms (panic, fear, paranoia, anger, suicidal flashes, crying, and laughing). Results: There was a high prevalence of fear (16.3%), panic (14.0%), and anger (11.6%) at baseline in this cohort. In the first six months following DBS implantation, anger (32.6%), fear (26.7%), and uncontrollable crying (26.7%) were the most frequent symptoms reported. Those symptoms also were present following six months of DBS surgery (30.2%, 29.1%, and 19.8%, respectively). New uncontrollable crying occurred more in the acute postoperative stage (less than or equal to six months) (p= 0.033), while new anger occurred more in the chronic postoperative stage (greater than six months) (p= 0.017). The frequency of uncontrollable laughing significantly increased with bilateral DBS (p= 0.033). Conclusions: Many of the neuropsychiatric issues were identified at preoperative baseline and their overall occurrence was more than expected. There was a potential for worsening of these issues post‐DBS. There were subtle differences in time course, and in unilateral vs. bilateral implantations. Clinicians should be aware of these potential behavioral issues that may emerge following DBS therapy, and should consider including screening questions in preoperative and postoperative interviews. Standardized scales may miss the presence or absence of these clinically relevant issues. 相似文献
74.
Marie-Annick Clavel Philippe Pibarot David Messika-Zeitoun Romain Capoulade Joseph Malouf Shivani Aggarval Phillip A. Araoz Hector I. Michelena Caroline Cueff Eric Larose Jordan D. Miller Alec Vahanian Maurice Enriquez-Sarano 《Journal of the American College of Cardiology》2014
Background
Aortic valve calcification (AVC) load measures lesion severity in aortic stenosis (AS) and is useful for diagnostic purposes. Whether AVC predicts survival after diagnosis, independent of clinical and Doppler echocardiographic AS characteristics, has not been studied.Objectives
This study evaluated the impact of AVC load, absolute and relative to aortic annulus size (AVCdensity), on overall mortality in patients with AS under conservative treatment and without regard to treatment.Methods
In 3 academic centers, we enrolled 794 patients (mean age, 73 ± 12 years; 274 women) diagnosed with AS by Doppler echocardiography who underwent multidetector computed tomography (MDCT) within the same episode of care. Absolute AVC load and AVCdensity (ratio of absolute AVC to cross-sectional area of aortic annulus) were measured, and severe AVC was separately defined in men and women.Results
During follow-up, there were 440 aortic valve implantations (AVIs) and 194 deaths (115 under medical treatment). Univariate analysis showed strong association of absolute AVC and AVCdensity with survival (both, p < 0.0001) with a spline curve analysis pattern of threshold and plateau of risk. After adjustment for age, sex, coronary artery disease, diabetes, symptoms, AS severity on hemodynamic assessment, and LV ejection fraction, severe absolute AVC (adjusted hazard ratio [HR]: 1.75; 95% confidence interval [CI]: 1.04 to 2.92; p = 0.03) or severe AVCdensity (adjusted HR: 2.44; 95% CI: 1.37 to 4.37; p = 0.002) independently predicted mortality under medical treatment, with additive model predictive value (all, p ≤ 0.04) and a net reclassification index of 12.5% (p = 0.04). Severe absolute AVC (adjusted HR: 1.71; 95% CI: 1.12 to 2.62; p = 0.01) and severe AVCdensity (adjusted HR: 2.22; 95% CI: 1.40 to 3.52; p = 0.001) also independently predicted overall mortality, even with adjustment for time-dependent AVI.Conclusions
This large-scale, multicenter outcomes study of quantitative Doppler echocardiographic and MDCT assessment of AS shows that measuring AVC load provides incremental prognostic value for survival beyond clinical and Doppler echocardiographic assessment. Severe AVC independently predicts excess mortality after AS diagnosis, which is greatly alleviated by AVI. Thus, measurement of AVC by MDCT should be considered for not only diagnostic but also risk-stratification purposes in patients with AS. 相似文献75.
Chronic heart failure: global left ventricular perfusion and coronary flow reserve with velocity-encoded cine MR imaging: initial results 总被引:3,自引:0,他引:3
Lund GK Watzinger N Saeed M Reddy GP Yang M Araoz PA Curatola D Bedigian M Higgins CB 《Radiology》2003,227(1):209-215
PURPOSE: To quantify and compare global left ventricular (LV) perfusion and coronary flow reserve (CFR) in patients with chronic heart failure and in healthy volunteers by measuring coronary sinus flow with velocity-encoded cine (VEC) magnetic resonance (MR) imaging. MATERIALS AND METHODS: MR measurements were performed in 10 consecutive patients with chronic heart failure due to coronary artery disease and in 10 volunteers. Global LV perfusion was quantified by measuring coronary sinus flow in an oblique imaging plane perpendicular to the coronary sinus with non-breath-hold VEC MR imaging. LV mass was measured by means of cine imaging that encompassed the heart. LV perfusion was calculated from coronary sinus flow and mass. CFR was measured from LV perfusion at rest and that after infusion of dipyridamole. Analysis of covariance was used to determine differences between groups. Differences within groups were analyzed by means of the Student t test for paired data. Regression analysis was used to determine correlation between CFR and LV ejection fraction. RESULTS: At rest, LV perfusion was not significantly different in patients with chronic heart failure (0.46 mL/min/g +/- 0.19) and volunteers (0.52 mL/min/g +/- 0.21, P =.54). After administration of dipyridamole, LV perfusion was less than half in patients with chronic heart failure compared with that in volunteers (1.07 mL/min/g +/- 0.64 vs 2.19 mL/min/g +/- 0.98) (P =.03). CFR was severely reduced in patients with chronic heart failure compared with that in volunteers (2.3 +/- 0.9 vs 4.2 +/- 1.5, P =.01). A moderate but significant correlation was found between CFR and LV ejection fraction (r = 0.54, P =.02) CONCLUSION: Combined cine and VEC MR imaging revealed that patients with chronic heart failure have normal LV perfusion at rest but severely depressed LV perfusion after vasodilation. Impaired CFR may contribute to progressive decline in LV function in patients with chronic heart failure. 相似文献
76.
Cognitive function and patient‐reported memory problems after radiotherapy for cancers at the skull base: A cross‐sectional survivorship study using the Telephone Interview for Cognitive Status and the MD Anderson Symptom Inventory‐Head and Neck Module
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Chase C. Hansen MD Joshua B. Smith BS Abdallah S. R. Mohamed MD MSc Collin F. Mulcahy MD Jeffrey S. Wefel PhD Katherine A. Hutcheson PhD Kelsey Chrane PA Jack Phan MD PhD Steven J. Frank MD Adam S. Garden MD Blaine D. Smith BS Hillary Eichelberger BA Carthal Anderson BS Colton McCoy BS Marina Horiates BS Conner Patrick BS Sarah Floris BS Chloe French BS Beth M. Beadle MD PhD William H. Morrison MD Shirley Y. Su MD Carol M. Lewis MD Michael E. Kupferman MD Jason M. Johnson MD Heath D. Skinner MD PhD Stephen Y. Lai MD PhD Ehab Y. Hanna MD David I. Rosenthal MD Clifton D. Fuller MD PhD G. Brandon Gunn MD The MD Anderson Head Neck Cancer Symptom Working Group 《Head & neck》2017,39(10):2048-2056
77.
Rajeev Gupta MD Manuel Villa MD Emanuel Agaba MD Garry Ritter PA MHA Cristina Sison Corrado P. Marini MD Rafael Barrera MD 《JPEN. Journal of parenteral and enteral nutrition》2013,37(3):368-374
Background: The incidence of obesity is rising, and an increasing number of obese patients are admitted to surgical intensive care units (SICUs). However, it is not clear whether obesity is an independent risk factor for increased morbidity and mortality in SICU patients. We examined the effect of obesity on morbidity and mortality in patients admitted to the SICU in this study. Method: We reviewed prospectively acquired SICU data in normal and obese patients with an SICU length of stay >24 hours. Comparability of the groups was assessed using a χ2 test or Fisher exact test, as appropriate, for categorical variables and analysis of variance (ANOVA) or the Kruskal‐Wallis test, as appropriate, for continuous variables. Results: Of the 1792 consecutive patients evaluated, 711 had a normal body mass index (BMI), and 993 were either preobese or obese. There was no statistically significant difference across the 5 BMI groups with respect to any of the 3 comorbidity indices (Acute Physiology and Chronic Health Evaluation III [APACHE III], Simplified Acute Physiology Score, or Multiple Organ Dysfunction Score). There was no statistically significant difference in the intensive care unit (ICU) length of stay and hospital length of stay or time‐to‐ICU mortality (log‐rank test P = .054) among the 5 BMI groups. A Cox regression analysis and backward elimination algorithm selected APACHE III to be the most important explanatory variable for survival time. Conclusion: Obesity does not affect the mortality of patients admitted to the SICU. We conclude that obesity cannot be used as an independent predictive mortality outcome variable in patients admitted to the SICU. 相似文献
78.
ObjectiveTo investigate the potentials of the root bark of Annona (A.) senegalensis in the control of seizure and related hypnotic and motor incoordination effects in mice using experimental models.MethodsThe methanol extract (ME) of the root bark of A. senegalensis was studied in mice using pentylenetetrazole (PTZ) induced convulsions, phenobarbitone induced sleeping time and motor coordination test on rota-rod performance. Acute toxicity and lethality (LD50) test as well as phytochemical analysis were also carried out.ResultsThe extract (200, 400, 800 mg/kg) exhibited a non-dose dependent significant (P <0.05) delay in the onset of both tonic and clonic phases of seizure induced by PTZ (60 mg/kg, s.c.) as well as offered a 100% protection (200 mg/kg) in mice from PTZ induced seizures. The extract significantly (P <0.05) decreased the latency and increased the duration of phenobarbitone induced sleeping time. At 200 mg/kg, the extract exhibited a significant (P <0.05) motor incoordination. The acute toxicity test revealed an oral LD50 of 1 296 mg/kg, while the phytochemical studies showed the presence of alkaloids, resins, glycosides, carbohydrate, reducing sugar, flavonoids, terpenoids, saponins and tannins.ConclusionThe extract of A. senegalensis possessed anticonvulsant activity with pronounced hypnotic and muscle relaxant effects. 相似文献
79.
We have read the recent comprehensive review by Cruz et al.[1] regarding the targeting of receptor tyrosine kinases andtheir therapeutic perspectives in head and neck squamous cellcarcinomas (HNSCC). The major focus of this report was epidermalgrowth factor receptor (EGFR) biology and targeting. However,we feel 相似文献
80.
FJ Weir A Smith P Littleton N Carter PA Hamilton 《Acta paediatrica (Oslo, Norway : 1992)》1992,81(9):672-675
The aim of this study was to measure plasma atrial natriuretic peptide in preterm infants with a patent ductus arteriosus before and after closure with indomethacin. Atrial natriuretic peptide was measured in 28 preterm infants with clinical and echocardiographic evidence of a patent ductus arteriosus and in eight preterm infants who did not develop clinical evidence of a patent ductus arteriosus. Plasma concentration of atrial natriuretic peptide was measured by radioimmunoassay. In 18 infants the patent ductus arteriosus closed after one course of indomethacin; atrial natriuretic peptide levels decreased from median 1240 pg/ml (range 201-5483 pg/ml) to 266 pg/ml (range 62-1108 pg/ml). In four infants the patent ductus arteriosus closed after two courses of indomethacin and two infants had surgical ligation after indomethacin treatment failed. The patent ductus arteriosus closed spontaneously in four infants (atrial natriuretic peptide median level 152 pg/ml, range 61-495 pg/ml). In the eight infants without patent ductus arteriosus, atrial natriuretic peptide level was median 224 pg/ml (range 38-876 pg/ml). Measurement of plasma atrial natriuretic peptide concentration has a role in predicting when indomethacin treatment is indicated. 相似文献