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31.
H Hultgren P Peduzzi W Shapiro D van Heeckeren 《Progress in cardiovascular diseases》1986,28(4):279-284
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34.
Ehab Farag Maged Argalious Samer Narouze Glenn E. DeBoer Julie Tome 《Journal canadien d'anesthésie》2002,49(9):958-962
PURPOSE: To present the anesthetic management for the correction of a ventricular septal defect (VSD) in a patient with multiple acyl CoA dehydrogenase deficiency (glutaric aciduria type II; GAII). A review of the literature about anesthetic management of patients with mitochondrial diseases undergoing cardiopulmonary bypass (CPB) is also included. Clinical features: An 11-yr-old girl with GAII manifested as severe hypoglycemia since she was a newborn and generalized muscle weakness. She underwent open-heart surgery for VSD correction with CPB. The anesthetic management avoided inhalational anesthetics, maintained the blood sugar within normal limits and continued normothermia during CPB in order to avoid the stress of hypothermia for her abnormal mitochondria. The patient tolerated the procedure well and experienced a good recovery. CONCLUSION: The anesthetic management of patients with any mitochondrial disease requires normoglycemia, normothermia and the avoidance of metabolic stress in order to preserve energy production by the diseased mitochondria. 相似文献
35.
Christopher G. Acker Richard Flick Ron Shapiro Velma P. Scantlebury Mark L. Jordan Carlos Vivas Arthur Greenberg John P. Johnson 《American journal of transplantation》2002,2(1):57-61
Delayed graft function (DGF) in cadaver kidney transplants is a common problem and is often due to acute tubular necrosis (ATN). DGF in transplants may have a deleterious effect on long-term graft survival. Since thyroid hormone has been shown to hasten recovery from ATN in experimental models, we designed a trial to determine if a defined course of triiodothyronine (T3) would improve the short- or long-term outcome of patients with DGF in cadaveric transplants. A prospective, randomized, placebo controlled, double blind trial of T3 was carried out in patients with DGF in cadaveric renal transplants. End-points were percentage requiring dialysis, percentage recovering function, time to recovery and length of hospital stay. Long-term outcomes were percentage grafts functioning at 1 year and mean serum creatinine at 1 year. Forty-four patients were randomized to receive either T3 or placebo. Three patients were dropped from each group when early biopsies disclosed that DGF was due to rejection. The groups were well matched by age, cold ischemia time of the graft, and percentage reactivity to a random panel of antigens. Baseline thyroid function studies, including T3, reverse T3 (rT3), and thyroid stimulating hormone (TSH) levels, were similar between the two groups and typical of 'euthyroid-sick syndrome'. T3 had no effect on percentage requiring dialysis, time to recovery, percentage recovering function, or length of stay. At 1 year follow-up, graft function was similar in both groups and significantly lower than that seen in patients with good initial function. Thyroid hormone, given early in the course of DGF in cadaver kidney recipients, had no effect on the course of DGF. Long-term graft function is impaired in patients who experience post-transplant DGF compared to those who have good initial function. 相似文献
36.
Efficacy of intensive multitherapy for patients with type 2 diabetes mellitus: a randomized controlled trial 总被引:1,自引:1,他引:0
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37.
Zoï Kapoula Maria Pia Bucci Frederic Jurion Julie Ayoun Farzaneh Afkhami Dominique Brémond-Gignac 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2006,245(7):931-936
Aim There is a controversy as to whether dyslexic children present visuo-motor disabilities such as vergence and accommodative
problems assessed with orthoptic tests. The purpose of this study is to re-examine this issue in a large population of children.
Methods Extensive orthoptic evaluation was made in 57 dyslexic and 46 non-dyslexic (“normal”) age-matched children. Convergence and
divergence capacities were evaluated at two distances (30 cm and 400 cm).
Results Binocular vision measured with stereo-acuity tests was normal in dyslexics. In contrast, the near point of convergence was
significantly more remote in dyslexics; most importantly, divergence at both far and near distance was significantly more
reduced in dyslexics (median value 4 pD and 10 pD, respectively, at far and near) than in “normals” (median value 6 pD and
12 pD, at far and near).
Conclusion The existence of the divergence deficit at far distance indicates the presence of deficit of divergence per se, independently
from convergence and accommodation relaxation. This result is novel and corroborated by physiological studies indicating distinct
control of convergence and divergence, both at the cortical and subcortical premotor level. We conclude that vergence deficits
are frequently present in dyslexics, and that dyslexics should be re-educated; training should address distinctively convergence
and divergence subsystems. 相似文献
38.
Rodica Pop-Busui Jiang Lu Neuza Lopes Teresa L. Z. Jones and the BARI D Investigators 《Journal of the peripheral nervous system : JPNS》2009,14(1):1-13
Abstract We evaluated the associations between glycemic therapies and prevalence of diabetic peripheral neuropathy (DPN) at baseline among participants in the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial on medical and revascularization therapies for coronary artery disease (CAD) and on insulin-sensitizing vs. insulin-providing treatments for diabetes. A total of 2,368 patients with type 2 diabetes and CAD was evaluated. DPN was defined as clinical examination score >2 using the Michigan Neuropathy Screening Instrument (MNSI). DPN odds ratios across different groups of glycemic therapy were evaluated by multiple logistic regression adjusted for multiple covariates including age, sex, hemoglobin A1c (HbA1c), and diabetes duration. Fifty-one percent of BARI 2D subjects with valid baseline characteristics and MNSI scores had DPN. After adjusting for all variables, use of insulin was significantly associated with DPN (OR = 1.57, 95% CI: 1.15–2.13). Patients on sulfonylurea (SU) or combination of SU/metformin (Met)/thiazolidinediones (TZD) had marginally higher rates of DPN than the Met/TZD group. This cross-sectional study in a cohort of patients with type 2 diabetes and CAD showed association of insulin use with higher DPN prevalence, independent of disease duration, glycemic control, and other characteristics. The causality between a glycemic control strategy and DPN cannot be evaluated in this cross-sectional study, but continued assessment of DPN and randomized therapies in BARI 2D trial may provide further explanations on the development of DPN. 相似文献
39.
Teresa Nunes José Paulo Monteiro José Carlos Ferreira Pedro Vilela 《European radiology》2009,19(10):2551-2554
L1 disease is the most common genetic cause of congenital hydrocephalus. Mutations in the L1CAM gene are associated with an overlapping clinical spectrum of four X-linked neurological conditions, characterized by hydrocephalus, mental retardation, lower limb spasticity and adducted thumbs. Brain anomalies are frequently present in L1 disease. We describe these anomalies by reporting a case of a male newborn presenting with congenital hydrocephalus along with corpus callosum agenesis and enlargement of the massa intermedia. These findings, in association with the presence of clasped thumbs, raised the suspicion of L1 disease, which was confirmed by the detection of a mutation in the L1CAM gene. In cases of congenital hydrocephalus, recognition of the brain anomalies associated with L1 disease may contribute to pursuing the genetic analysis needed for the diagnosis and genetic counseling. 相似文献
40.
Julie M Aultman 《Medical education》2009,43(11):1107-1107