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D. E. FRANSEN VAN DE PUTTE K. FISCHER D. POSTHOUWER E. P. MAUSER‐BUNSCHOTEN 《Haemophilia》2011,17(5):791-799
Summary. Many patients with inherited bleeding disorders are infected with hepatitis C virus (HCV). Antiviral treatment, consisting of pegylated interferon and ribavirin, has many side‐effects. The aim of the study was to prospectively assess the occurrence and course of side‐effects and changes in health‐related quality of life (HRQoL) during antiviral treatment in patients with inherited bleeding disorders and chronic HCV. Forty‐seven patients were followed during antiviral treatment. Side‐effects of treatment were recorded, and the Beck Depression Inventory and the RAND‐36 HRQoL questionnaire were administered at regular intervals. Frequently reported side‐effects were fatigue (100%), headache (94%), pruritus and skin rash (94%), concentration problems (89%), decreased appetite (89%), fever, irritability and hair loss (all 85%). Many side‐effects disappeared soon after end of treatment, but 4 weeks after cessation fatigue, concentration problems and sleeping problems were still present in more than 30% of patients. Dose reduction was necessary in 21 patients (45%), mostly because of decreasing weight or haemoglobin levels. Two patients stopped treatment prematurely because of side‐effects. Depression was present in 28 patients (60%). HRQoL decreased significantly during treatment in all RAND‐36 domains, and increased again within 4 weeks after treatment. Major side‐effects were similar in patients with successful (n = 31, 66%) and unsuccessful antiviral treatment. In patients with inherited bleeding disorders and chronic HCV, antiviral treatment has many, but mostly transient side‐effects and a significant impact on quality of life. Careful follow‐up and management of side‐effects will ensure optimal compliance and treatment results. 相似文献
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UGARTE M.; ALONSO-PULPON L.; GONZALEZ-VILLA J.; DE ARTAZA M.; MARTIN-JUDEZ V. 《European heart journal》1982,3(6):577-582
A case of primary angiosarcoma of the heart diagnosed duringlife is presented. Selective coronary arteriography providedthe clue for the correct pre-operative identification of thetumor, showing angiomatous dilatations over the area suppliedby the right coronary artery. A small left-to-right shunt wasdetected by oximetry at the atrioventricular level, furtherconfirming the angiomatous nature of the tumor. 相似文献
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患者男性,73岁。因3周前无明显诱因出现眩晕于2005年7月5日入院。患者眩晕主要为体位变化和活动后发生,每次发作时间持续2~3min,休息后缓解,自发病以来,偶有打鼾,未发现睡眠呼吸暂停现象,无视物模糊,无黑嚎、意识障碍,无心悸、气促、呼吸困难,无恶心、呕吐,无肢体活动障碍。病人曾于2004年11月因头晕、胸闷,行动态心电图检查示:偶发房性早搏、偶发室性早搏、sT—T改变。冠状动脉造影示冠状动脉多支病变,行冠状动脉搭桥术。自冠状动脉塔桥术后服用:美托洛尔25mg,2次/日;地高辛0.125mg,1次/日。体格检查:心率76次/min,血压140/90mmHg(1mmHg=0.133kPa),各瓣膜区未闻及心脏杂音,双肺听诊呼吸音清。诊断:颈椎病,冠心病。行24h动态心电图检查,总心率:81244次;平均心率59次/min;最慢窦性心率24次/min(图1),最快窦性心率89次/min。〉2s的窦性停搏共799次,最长的全心停搏达14.45s(图2),发生于1:43:15睡眠时,此次停搏后恢复的第一个心搏为交界性逸搏,其后为交界性逸搏心律,窦性PP间距为24.59S;全程室性早搏30次,室上性早搏778次,短阵房性心动过速1次,ST—T水平型缺血改变,最明显时ST段压低0.20mV,长RR间距后ST—T压低无明显加重。动态心电图诊断:窦性心动过缓,窦性停搏、全心停搏,交界性逸搏心律,室性逸搏心律,频发房性早搏,短阵房性心动过速,偶发室性早搏,ST—T改变。 相似文献
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Low-dose aspirin in patients recovering from myocardial infarction. Evidence for a selective inhibition of thromboxane-related platelet function 总被引:1,自引:0,他引:1
DE CATERINA R.; GIANNESSI D.; BERNINI W.; GAZZETTI P.; MICHELASSI C.; L'ABBATE A.; DONATO L.; PATRIGNANl P.; FlLABOZZl P.; PATRONO C. 《European heart journal》1985,6(5):409-417
The adequacy, selectivity and long-term persistence of inhibitionin cyclooxygenase-dependent platelet function by a daily low-dose(0.45 mg kg1 day1) aspirin treatment have beenevaluated in 15 patients after a recent (less than 17 days)acute myocardial infarction. Serum thromboxane (TX) B2, an indexof platelet TXA2 production, was decreased by 9498% (P<0.001)by aspirin, while urinary excretion of 6-keto-prostaglandinFla, as an index of extraplatelet cyclooxygenase activity, remainedunchanged. Compared to placebo, aspirin induced a persistentincrease in bleeding time (% difference 45.6±21.4, mean± SD) and a decrease in platelet aggregation by ADP,epinephrine, collagen and arachidonic acid. No tendency towardsan attenuation of the effects was apparent for the period ofaspirin administration (4 weeks). Aspirin 0.45 mg kg1 day1 is adequate and selectivein the long-term inhibition of TX-related platelet functionin patients after acute myocardial infarction. The clinicaleffectiveness of such a regimen remains to be proven in clinicaltrials. 相似文献