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161.
F Lima N Buchanan L Froes S Kerslake M A Khamashta G R Hughes 《Annals of the rheumatic diseases》1995,54(7):604-606
OBJECTIVE--To study the fetal and maternal outcome of pregnancy in patients with granulomatous vasculitis. METHODS--Four pregnancies in two patients with Wegener's granulomatosis (WG) and one patient with Churg-Strauss syndrome (CSS) were identified and followed in our specialised clinic for pregnancy and connective tissue diseases. RESULTS--Three pregnancies ended with live babies and one with intrauterine death at 25 weeks of gestation. One WG patient remained in remission throughout pregnancy and the other experienced severe activity at 12 weeks. The CSS patient was in remission during her first pregnancy, but the disease flared severely in the second. CONCLUSIONS--Pregnancy in patients with granulomatous vasculitis requires preconceptual planning, careful clinical management, and vigorous treatment of active disease. 相似文献
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João Antônio Chula de Castro Tiago Rodrigues de Lima Diego Augusto Santos Silva 《Journal of bodywork and movement therapies》2018,22(1):134-146
Background
Bioelectrical impedance analysis (BIA) has commonly been used to assess the body composition of children and adolescents. BIA validation studies have found distinct correlation values with reference methods.Objectives
To assess the reproducibility, correlation and mean differences in body composition estimated by BIA and reference methods, we systematically reviewed the literature in the pediatric population.Method
The search for articles was conducted in March 2016 and was limited to articles published from 2005 to 2015 in the PubMed, Embase, EBSCO, Web of Science, Scopus and SciELO databases. Two reviewers independently performed data selection and extraction of studies that investigated the BIA validity, responsiveness, reliability and/or measurement error (reproducibility) to estimate body composition in children and adolescents with an average age ≤ 18 years.Results
The search produced 48 articles. Almost perfect reproducibility was found in the body fat percentage estimated by BIA, and there was almost perfect correlation between the BIA ratings and reference methods for fat mass and fat-free mass. Regarding component estimates, BIA underestimated the fat mass in both sexes.Conclusions
The body fat percentage estimated by BIA exhibited almost perfect reproducibility. The fat mass and fat-free mass estimated by BIA correlated almost perfectly with the reference methods in both sexes. BIA underestimated the fat mass in both sexes. 相似文献164.
Ney Meziat-Filho Maicom Lima Jessica Fernandez Felipe J.J. Reis 《Journal of bodywork and movement therapies》2018,22(1):32-36
This case report presents the effect of Cognitive Functional Therapy (CFT) in a patient with chronic non-specific neck pain. The patient believed that pain signified tissue damage, and demonstrated pain catastrophizing, hypervigilance, stress sensitivity, and movement impairment of the neck, during extension and rotation. The CFT intervention integrated a cognitive approach with manual therapy and active exercises to encourage the patient to trust her neck again. One month after the first appointment, the patient had recovered confidence, and the pain and disability had disappeared almost entirely. 相似文献
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Vanessa Chaves Barreto Ferreira de Lima Ana Luiza Bierrenbach Gizelton Pereira Alencar Ana Lucia Andrade Luciano Cesar Pontes Azevedo 《Intensive care medicine》2018,44(7):1090-1096
Purpose
To describe long-term mortality and hospital readmissions of patients admitted to Brazilian intensive care units (ICU).Methods
Retrospective cohort study of adult patients admitted to Brazilian hospitals affiliated to the Public Healthcare System from 10 state capitals. ICU patients were paired to non-ICU patients by frequency matching (ratio 1:2), according to postal code and admission semester. Hospitalization records were linked through deterministic linkage to national mortality data. Primary outcome was mortality up to 1 year. Other outcomes were mortality and readmissions at 30 and 90 days and 3 years. Multiple Cox regressions were used adjusting for age, sex, cancer diagnosis, type of hospital, and surgical status.Results
We included 324,594 patients (108,302 ICU and 216,292 non-ICU). ICU patients had increased hospital length of stay [9 (5–17) vs. 3 (1–6) days, p?<?0.001] and mortality (18.5 vs. 3.6%, p?<?0.001) versus non-ICU patients. One year after discharge, ICU patients were more frequently readmitted to hospital (25.4 vs. 17.4%, p?<?0.001) and to ICU (31.4 vs. 7.3%, p?<?0.001) than controls. Mortality up to 1 year was also higher for ICU patients (14.3 vs. 3.9%, p?<?0.001). A significant interaction between surgical status and mortality was found, with adjusted hazard ratios (HRs) up to 1 year of 2.7 [95% confidence interval (CI) 2.5–2.9] for surgical patients, and 3.4 (95%CI 3.3–3.5) for medical patients. The risk for death and readmission diminished over time up to 3 years.Conclusions
In a public healthcare system of a developing country, ICU patients have excessive long-term mortality and frequent readmissions. The ICU burden tended to reduce over time after hospital discharge.169.
Fernando G. Zampieri Theodore J. Iwashyna Elizabeth M. Viglianti Leandro U. Taniguchi William N. Viana Roberto Costa Thiago D. Corrêa Carlos Eduardo N. Moreira Marcelo O. Maia Giulliana M. Moralez Thiago Lisboa Marcus A. Ferez Carlos Eduardo F. Freitas Clayton B. de Carvalho Bruno F. Mazza Mariza F. A. Lima Grazielle V. Ramos Aline R. Silva Fernando A. Bozza Jorge. I. F. Salluh Marcio Soares for the ORCHESTRA Study Investigators 《Intensive care medicine》2018,44(9):1512-1520
Purpose
Frail patients are known to experience poor outcomes. Nevertheless, we know less about how frailty manifests itself in patients’ physiology during critical illness and how it affects resource use in intensive care units (ICU). We aimed to assess the association of frailty with short-term outcomes and organ support used by critically ill patients.Methods
Retrospective analysis of prospective collected data from 93 ICUs in Brazil from 2014 to 2015. We assessed frailty using the modified frailty index (MFI). The primary outcome was in-hospital mortality. Secondary outcomes were discharge home without need for nursing care, ICU and hospital length of stay (LOS), and utilization of ICU organ support and transfusion. We used mixed logistic regression and competing risk models accounting for relevant confounders in outcome analyses.Results
The analysis consisted of 129,680 eligible patients. There were 40,779 (31.4%) non-frail (MFI?=?0), 64,407 (49.7%) pre-frail (MFI?=?1–2) and 24,494 (18.9%) frail (MFI?≥?3) patients. After adjusted analysis, frailty was associated with higher in-hospital mortality (OR 2.42, 95% CI 1.89–3.08), particularly in patients admitted with lower SOFA scores. Frail patients were less likely to be discharged home (OR 0.36, 95% CI 0.54–0.79) and had higher hospital and ICU LOS than non-frail patients. Use of all forms of organ support (mechanical ventilation, non-invasive ventilation, vasopressors, dialysis and transfusions) were more common in frail patients and increased as MFI increased.Conclusions
Frailty, as assessed by MFI, was associated with several patient-centered endpoints including not only survival, but also ICU LOS and organ support.170.
Ana Paula de Oliveira Carnevalli Débora Bevilaqua-Grossi Ana Izabela Sobral Oliveira Gabriela Ferreira Carvalho César Fernández-De-Las-Peñas Lidiane Lima Florencio 《Journal of manipulative and physiological therapeutics》2018,41(7):621-627