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101.
Park KL Budaj A Goldberg RJ Anderson FA Agnelli G Kennelly BM Gurfinkel EP Fitzgerald G Gore JM;Grace Investigators 《The American journal of cardiology》2012,110(5):628-635
The risk of stroke in patients hospitalized with an acute coronary syndrome (ACS) ranges from <1% to ≥2.5%. The aim of this study was to develop a simple predictive tool for bedside risk estimation of in-hospital ischemic stroke in patients with ACS to help guide clinicians in the acute management of these high-risk patients. Data were obtained from 63,118 patients enrolled from April 1999 to December 2007 in the Global Registry of Acute Coronary Events (GRACE), a multinational registry involving 126 hospitals in 14 countries. A regression model was developed to predict the occurrence of in-hospital ischemic stroke in patients hospitalized with an ACS. The main study outcome was the development of ischemic stroke during the index hospitalization for an ACS. Eight risk factors for stroke were identified: older age, atrial fibrillation on index electrocardiogram, positive initial cardiac biomarkers, presenting systolic blood pressure ≥160 mm Hg, ST-segment change on index electrocardiogram, no history of smoking, higher Killip class, and lower body weight (c-statistic 0.7). The addition of coronary artery bypass graft surgery and percutaneous coronary intervention into the model increased the prediction of stroke risk. In conclusion, the GRACE stroke risk score is a simple tool for predicting in-hospital ischemic stroke risk in patients admitted for the entire spectrum of ACS, which is widely applicable to patients in various hospital settings and will assist in the management of high-risk patients with ACS. 相似文献
102.
ABSTRACTNeuroimaging and genomic analysis greatly aid in the identification of young-onset dementia antemortem. We present the case of a 33-year-old female with a 2-year rapid decline to dementia and immobility marked by personality change, executive deficits including compulsions, attention deficit, apraxia, Parkinsonism, and pyramidal signs. She had unique and dramatic calcifications and confluent white matter changes on imaging and was found to have a novel mutation in the colony stimulating factor 1 receptor gene causing adult-onset leukoencephalopathy with axonal spheroids and pigmented glia (ALSP). Here, we review ALSP and briefly discuss differential diagnoses. 相似文献
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Spencer FA Kroll A Lessard D Emery C Glushchenko AV Pacifico L Reed G Gore JM Goldberg RJ 《Journal of thrombosis and thrombolysis》2012,33(3):211-217
The prevalence of isolated calf deep vein thrombosis (DVT) in the community setting is relatively unexplored. Confusion remains
with regards to its management and contemporary natural history. The purpose of this investigation was to describe the number
of cases of calf DVT in the community, use of early management strategies, and rates of venous thromboembolism (VTE) recurrence
and major bleeding. The medical records of residents of the Worcester (MA) metropolitan area with ICD-9 codes consistent with
potential VTE during 4 study years (1999/2001/2003/2005) were validated by trained nurses. Patient demographic/clinical characteristics,
treatment practices, and outcomes were evaluated. Isolated calf DVT was diagnosed in 166 (11.1%) of 1,495 patients with lower
extremity DVT. Patients with calf DVT were less likely to be discharged on anticoagulants or with an IVC filter than patients
with proximal DVT (84.1 vs. 92.3%). The rates of VTE recurrence and pulmonary embolism did not differ significantly between
patients with calf DVT and proximal DVT at 6 months (11.0 vs. 8.7%, 2.6 vs. 1.8%, respectively). Patients with calf DVT had
higher adjusted risk of early (14-day) VTE recurrence/extension (OR 2.34, 95% CI 1.01–5.44). Patients with calf DVT had lower
rates of major bleeding at 6 months compared to patients with proximal DVT (5.2 vs. 9.3%, P = 0.04). Rates of recurrent VTE and major bleeding following calf DVT in the community are much higher than in randomized
clinical trials of patients with proximal or calf DVT. Further study of management strategies for isolated calf DVT is needed. 相似文献
106.
Prospective study of sentinel node biopsy for high‐risk cutaneous squamous cell carcinoma of the head and neck 下载免费PDF全文
107.
An improved finite difference (FD) method has been developed in order to calculate the behaviour of the nuclear magnetic resonance signal variations caused by water diffusion in biological tissues more accurately and efficiently. The algorithm converts the conventional image-based finite difference method into a convenient matrix-based approach and includes a revised periodic boundary condition which eliminates the edge effects caused by artificial boundaries in conventional FD methods. Simulated results for some modelled tissues are consistent with analytical solutions for commonly used diffusion-weighted pulse sequences, whereas the improved FD method shows improved efficiency and accuracy. A tightly coupled parallel computing approach was also developed to implement the FD methods to enable large-scale simulations of realistic biological tissues. The potential applications of the improved FD method for understanding diffusion in tissues are also discussed. 相似文献
108.
Sorafenib in advanced clear-cell renal-cell carcinoma 总被引:1,自引:0,他引:1
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