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61.
Gloria Maccabelli MD Anna Pichiecchio MD Andrea Guala MD Michela Ponzio PhD Fulvia Palesi PhD Diego Maranzana RT Guy Umberto Poloni PhD Stefano Bastianello MD PhD Cesare Danesino MD PhD 《Movement disorders》2010,25(15):2670-2674
No brain abnormalities are usually detected on conventional magnetic resonance imaging (MRI) in benign hereditary chorea (BHC); there are currently no studies with advanced techniques in literature. We investigated whether conventional and advanced MRI techniques could depict regional brain abnormalities in two familial BHC patients and 24 healthy controls. No brain abnormalities on conventional scans were detectable; also, no significant differences in fractional anisotropy of the basal nuclei were observed. Volumetric analysis showed a decreased volume of the striatum bilaterally compared with controls, whereas spectroscopy demonstrated a significant increased myoinositol/creatine ratio bilaterally, a reduction of choline/creatine ratio bilaterally, and of N‐acetyl‐aspartate/creatine in the right putamen. With the limits of the small sample size in the patient group, these data show that, despite the absence of macroscopic changes on conventional MRI, volumetric and metabolic abnormalities are present in the basal nuclei of BHC patients. © 2010 Movement Disorder Society. 相似文献
62.
Giacomo Pavesi MD Oriela Rustemi MD Silvia Berlucchi MD Anna Chiara Frigo MD Valerio Gerunda RT Renato Scienza MD 《Surgical neurology》2009,72(6):662-667
Background
Early surgical removal of cerebral AVMs is a relatively infrequent therapeutic option when dealing with a cerebral hemorrhage caused by AVM rupture: even in the case of low-grade AVMs, delayed treatment is, if possible, preferred because it is considered safer for patients and more comfortable for surgeons. To assess whether acute surgery may be a safe and effective management, we conducted a retrospective analysis of our early surgery strategy for ruptured low-grade AVMs.Methods
We reviewed 27 patients with SM grade I-II AVM treated during 2004 to 2008 in the acute stage of bleeding (within the first 6 days after bleed). All patients showed a cerebral AVM on DSA at admission, and surgical removal was controlled by postoperative angiography. Neurological outcomes were assessed with GOS. The average length of follow-up was 22 months (48-3 months).Results
Before surgery, 16 (59%) patients showed a GCS of 8 or less, 2 of them presenting an acute rebleeding after first hemorrhage. All patients underwent radical AVM surgical removal and hematoma evacuation in a single-stage procedure. Most patients (78%) were operated within the first day of hemorrhage. A favorable functional outcome (GOS: good recovery or moderate disability) was observed in 23 patients (85%). Mortality was 7.4%. Outcome was not significantly correlated with GCS at presentation and with presence of preoperative anisocoria.Conclusions
Early surgery for grade I-II AVMs is a safe and definitive treatment, achieving both immediate cerebral decompression and patient protection against rebleeding, reducing time of hospital stay and allowing a more rapid rehabilitative course whenever necessary. 相似文献63.
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65.
Frederik T. W. Groenland MD Annemieke C. Ziedses des Plantes BSc Tara Neleman BSc Alessandra Scoccia MD Jurgen M. R. Ligthart RT Karen T. Witberg RN Karim D. Mahmoud MD PhD Rutger-Jan Nuis MD PhD Wijnand K. den Dekker MD PhD Jeroen M. Wilschut MD Roberto Diletti MD PhD Felix Zijlstra MD PhD Nicolas M. Van Mieghem MD PhD Joost Daemen MD PhD 《Catheterization and cardiovascular interventions》2023,102(2):191-199
Background
Dedicated prospective studies investigating high-definition intravascular ultrasound (HD-IVUS)-guided primary percutaneous coronary intervention (PCI) are lacking. The aim of this study was to qualify and quantify culprit lesion plaque characteristics and thrombus using HD-IVUS in patients presenting with ST-segment elevation myocardial infarction (STEMI).Methods
The SPECTRUM study is a prospective, single-center, observational cohort study investigating the impact of HD-IVUS-guided primary PCI in 200 STEMI patients (NCT05007535). The first 100 study patients with a de novo culprit lesion and a per-protocol mandated preintervention pullback directly after vessel wiring were subject to a predefined imaging analysis. Culprit lesion plaque characteristics and different thrombus types were assessed. An IVUS-derived thrombus score, including a 1-point adjudication for a long total thrombus length, long occlusive thrombus length, and large maximum thrombus angle, was developed to differentiate between low (0–1 points) and high (2–3 points) thrombus burden. Optimal cut-off values were obtained using receiver operating characteristic curves.Results
The mean age was 63.5 (±12.1) years and 69 (69.0%) patients were male. The median culprit lesion length was 33.5 (22.8–38.9) mm. Plaque rupture and convex calcium were appreciated in 48 (48.0%) and 10 (10.0%) patients, respectively. Thrombus was observed in 91 (91.0%) patients (acute thrombus 3.3%; subacute thrombus 100.0%; organized thrombus 22.0%). High IVUS-derived thrombus burden was present in 37/91 (40.7%) patients and was associated with higher rates of impaired final thrombolysis in myocardial infarction flow (grade 0–2) (27.0% vs. 1.9%, p < 0.001).Conclusions
HD-IVUS in patients presenting with STEMI allows detailed culprit lesion plaque characterization and thrombus grading that may guide tailored PCI. 相似文献66.
Jennifer Hamilton RN Amanda Cole RN RT PhD Richard Bostwick RN PhD Irene Ngune RN PhD 《International journal of mental health nursing》2023,32(3):801-818
The Safewards model is used across various mental health settings to reduce incidents of conflict and containment and its efficacy in reducing the use of seclusion and restraint, improving patients' experiences of care, and enhancing safety within clinical settings is well documented (Bowers, Journal of Psychiatric & Mental Health Nursing, 21, 2014, 499). However, there are barriers to successful implementation, including level of staff buy-in (Baumgardt et al., Frontiers in Psychiatry, 10, 2019, 340; Price et al., Mental Health Practice, 19, 2016, 14). This mixed-method study assessed the impact of adopting a Safewards model within a clinical supervision framework in an approach, named Group Reflective integrated Practice with Safewards (GRiP-S), which integrates Safewards theory within the clinical supervision framework. Both quantitative and qualitative data were collected using the questions derived from the Manchester Clinical Supervision Scale −26© (Winstanley & White, The Wiley International Handbook of Clinical Supervision. John Wiley & Sons Ltd, 2014). A total of 67 surveys and eight interviews were completed by nursing staff. Overall, the results showed that the GRiP-S approach improves the implementation of Safewards and nurses' clinical practice. Nursing staff satisfaction with clinical supervision and Safewards improved post GRiP-S pre-GRIP-S- 69.54 (SD 16.059); post-GRIP-S 71.47 (SD 13.978). The survey also identified nursing staff's perception of GRiP-S in the restorative and formative domains of clinical supervision improved. The restorative mean score pre-GRiP-S was 28.43 (SD 5.988) and post-GRiP-S 29.29 (SD 3.951). The formative mean score pre-GRiP-S was 20.10 (SD 5.617) and post-GRiP-S 20.63 (SD 13.978). The qualitative results further explained the satisfaction levels and the changes seen in perception domains. The GRiP-S approach reported (i) improved therapeutic relationships and patient centred care, (ii) improved staff communication and teamwork, (iii) barriers to GRiP-S engagement, and (iv) assistance with the change process. The results indicate that the GRiP-S approach had a positive impact on Safewards delivery and supports ongoing change of practice. 相似文献
67.
Kai Tonda MD Yu Iwabuchi MD Tohru Shiga MD Yoshiki Owaki RT Arashi Fujita RT Takehiro Nakahara MD Ryosuke Sakurai MD Atsushi Shimizu MD Yoshitake Yamada MD Masahiro Okada MD Masahiro Jinzaki MD 《Diabetes, obesity & metabolism》2023,25(12):3521-3528
Aims
To assess the impact of various patient characteristics on the dynamics of liver glucose metabolism using automated multiparametric imaging with whole-body dynamic 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET).Materials and Methods
We retrospectively enrolled 540 patients who underwent whole-body dynamic FDG-PET. Three quantitative indices representing hepatic glucose metabolism [mean standardized uptake value normalized by lean body mass (SULmean), metabolic glucose rate (kinetic index) and distribution volume (DV)] were measured from multiparametric PET images produced automatically based on the Patlak plot model. Patient characteristics including age, sex, body mass index, fasting time, blood glucose level, and the presence of diabetes mellitus (DM) or hepatic steatosis (HS) were collected. We examined the correlations between the characteristic factors and three quantitative indices using multiple regression analysis.Results
The success rate of kinetic analysis using multiparametric PET imaging was 93.3% (504/540). Hepatic SULmean was significantly correlated with age (p < .001), sex (p < .001) and blood glucose level (p = .002). DV was significantly correlated with age (p = .033), sex (p < .001), body mass index (p = .002), fasting time (p = .043) and the presence of HS (p = .002). The kinetic index was significantly correlated with age (p < .001) and sex (p = .004). In the comparison of the healthy, DM and HS groups, patients with DM had a significantly increased SULmean, whereas patients with HS had a significantly decreased DV.Conclusions
Our results showed that liver glucose metabolism was influenced by various patient characteristic factors. Multiparametric FDG-PET imaging can be used to analyse the kinetics of liver glucose metabolism in routine clinical practice. 相似文献68.
Giulia Ghizzoni MD Marco B. Ancona MD Vittorio Romano RT Barbara Bellini MD Luca Ferri MD Filippo Russo MD Ciro Vella MD Domitilla Gentile MD Giulia Chionchio MD Veronica Macelletti MD Francesco Ancona MD Eustachio Agricola MD Anna Palmisano MD Antonio Esposito MD Matteo Montorfano MD 《Catheterization and cardiovascular interventions》2023,102(3):538-541
69.
70.
Toshihiro Nakamura MD Kunihiko Kiuchi MD FHRS Koji Fukuzawa MD Mitsuru Takami MD Yoshiaki Watanabe MD Yu Izawa MD Hideya Suehiro MD Tomomi Akita MD Makoto Takemoto MD Jun Sakai MD Atsusuke Yatomi MD Yusuke Sonoda MD Hiroyuki Takahara MD Kazutaka Nakasone MD Kyoko Yamamoto MD Noriyuki Negi RT Atsushi Kono MD Takashi Ashihara MD PhD Ken-ichi Hirata MD PhD 《Journal of cardiovascular electrophysiology》2021,32(4):1005-1013