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211.
Thomas Grunwald Manila Vannucci Nico Pezer Martin Kurthen Johannes Schramm Christian E Elger 《Clinical EEG and neuroscience》2007,38(3):143-147
Eye contact is a powerful social stimulus for human and non-human primates. However, it is unclear whether brain mechanisms that interpret eye contact are sensitive to gender. Here we show that human brain responses to eye contact are indeed gender specific. Recording event-related potentials directly from the medial temporal lobes, we found that eye contact elicited specific responses in men only when they saw female faces. Conversely, women responded specifically to eye contact only when they saw pictures of men. Thus, the human medial temporal lobes subserve specifically the processing of eye contact with persons of the opposite gender. 相似文献
212.
Boerhaave’s syndrome: Primary repair vs. esophageal resection—Case reports and meta-analysis of the literature 总被引:3,自引:0,他引:3
Otto Kollmar M.D. Werner Lindemann M.D. Sven Richter M.D. Ingo Steffen M.D. Georg Pistorius M.D. Martin K. Schilling M.D. 《Journal of gastrointestinal surgery》2003,7(6):726-734
Boerhaave’s syndrome is a life-threatening disease with a high mortality. With regard to the heterogeneity of treatment strategies,
no comparative studies exist and recommendations remain controversial. Seventeen cases of Boerhaave’s syndrome operated on
between 1989 and 2000 at our hospital were reviewed retrospectively to compare the time period between perforation and diagnosis,
and the morbidity and mortality among the different treatment options. In addition, we conducted a meta-analysis of the literature
including all series containing five or more patients and compared the findings with our own data. Our patients with a perforation
history of less than 12 hours showed significantly fewer signs of sepsis compared to patients with a history of more than
12 hours. In a comparison of patients with primary repair vs. patients treated with esophageal resection or an exclusion operation,
no differences were found. In the literature, patients with a long period of perforation (more than 24 hours) were treated
more often with an esophageal resection than patients with primary repair. In cases of Boerhaave’s syndrome, primary suturing
of the esophageal perforation should be reserved only for those patients presenting within 12 hours after perforation. In
all other cases, depending on the extent of the tissue damage, a two-stage esophageal resection with cervical esophagostomy
and gastrostomy is recommended as the safest treatment. 相似文献
213.
214.
Patrizio Pascale Martin Fromer 《Journal of the American College of Cardiology》2007,49(1):124-5; author reply 125
215.
Measuring the efficacy of antiepileptic drugs. 总被引:4,自引:0,他引:4
Clinical trials of new antiepileptic drugs (AEDs) include regulatory studies aimed at demonstrating efficacy and reasonable safety, post-marketing open-open label studies and longer term outcome studies. Regulatory trials involve a carefully selected population of patients and are conducted under rigorously standardised conditions. Data from such studies cannot often be translated into clinical practice. Pragmatic post-marketing studies using flexible dosing schedules allow clinicians to better judge the utility of the new drug in a wider population of patients with epilepsy and decide the most appropriate dosing schedules. This paper discusses some of the issues surrounding the measurement of efficacy of new AEDs in both pre- and post-marketing phases of their development. All of the newer AEDs are initially used in patients with refractory partial seizures as adjunctive treatment. These trials are generally parallel-group studies although cross-over designs have been employed. The use of placebo-control is uncontroversial in this type of study. Efficacy endpoints are generally manipulations of seizure frequency on study drug compared to control. Global outcome measures and health related quality of life scores can also be used to measure efficacy. As the standard AEDs are associated with a high rate of seizure remission in patients who receive them as monotherapy, demonstration of superior efficacy of a new agent in a comparative trial will require large numbers of patients in a design that takes into account the natural history of treated epilepsy. Comparing investigational agents to a standard AED in an 'active-control' study with demonstration of equivalent efficacy would seem to be an acceptable way of assessing efficacy of new AEDs in this population. Some regulators, however, do not accept equivalence as proof of efficacy and insist on demonstration of superiority compared to a control. The use of placebo alone in the control group is ethically dubious. Several innovative study designs have, therefore, been used to satisfy regulatory requirements, while maintaining patient safety including withdrawal to monotherapy using high versus low dose comparators. Observational outcome studies provide the best opportunity of exploring the long-term utility of individual AEDs. Such studies largely follow standard clinical practice and need considerable time and resources. They can, however, yield valuable information about the effectiveness of AEDs in everyday clinical practice. Data from regulatory trials should be complemented by postmarketing studies and longer term studies of outcome to help clinicians decide the best way of utilising new AEDs and establishing their role in the therapeutic armamentarium. 相似文献
216.
Catarina Gonzalez da Silva Karl Magnus Petersson Luís Faísca Martin Ingvar Alexandra Reis 《Journal of clinical and experimental neuropsychology》2004,26(2):266-277
Semantic verbal fluency tasks are commonly used in neuropsychological assessment. Investigations of the influence of level of literacy have not yielded consistent results in the literature. This prompted us to investigate the ecological relevance of task specifics, in particular, the choice of semantic criteria used. Two groups of literate and illiterate subjects were compared on two verbal fluency tasks using different semantic criteria. The performance on a food criterion (supermarket fluency task), considered more ecologically relevant for the two literacy groups, and an animal criterion (animal fluency task) were compared. The data were analysed using both quantitative and qualitative measures. The quantitative analysis indicated that the two literacy groups performed equally well on the supermarket fluency task. In contrast, results differed significantly during the animal fluency task. The qualitative analyses indicated differences between groups related to the strategies used, especially with respect to the animal fluency task. The overall results suggest that there is not a substantial difference between literate and illiterate subjects related to the fundamental workings of semantic memory. However, there is indication that the content of semantic memory reflects differences in shared cultural background--in other words, formal education--, as indicated by the significant interaction between level of literacy and semantic criterion. 相似文献
217.
218.
Regina P Walker Howard L Levine Martin L Hopp David Greene Kenny Pang 《Otolaryngology--head and neck surgery》2006,135(4):549-554
OBJECTIVE: To evaluate the short-term safety and efficacy of palatal implants in patients with mild and moderate obstructive sleep apnea (OSA). STUDY DESIGN AND SETTING: A prospective, non-randomized study conducted at 5 clinical sites. Three polyester implants were placed in the soft palate under local anesthesia during a single-stage office procedure. Polysomnography was conducted at baseline and 90 days post-procedure. Subjective quality of life data were collected. RESULTS: Fifty-three patients were evaluated; the apnea hypopnea index (AHI) decreased from 25.0 +/- 13.9 to 22.0 +/- 14.8 events/hour (P = 0.05). The Epworth Sleepiness Scale (ESS) decreased from 11.0 +/- 5.1 to 6.9 +/- 4.5 (P < 0.001), and the snore score decreased from 7.9 +/- 2.1 to 4.0 +/- 3.0 (P < 0.001). No serious complications occurred during the study. CONCLUSION: Palatal implants can be an effective initial low morbidity treatment option for patients diagnosed with mild to moderate OSA. 相似文献
219.
220.
Identification and functional significance of troponin I isoforms in neonatal rat heart myofibrils 总被引:6,自引:0,他引:6
We investigated the mechanism(s) responsible for differences in the effects of acidic pH on Ca2+ activation of the activity of adult and neonatal rat heart myofilaments. Studies on preparations of myofilaments reconstituted with adult troponin-tropomyosin (Tn-Tm) and either adult or neonatal thick filaments indicated that the difference in effect of acidic pH is related to differences in Tn-Tm and not other myofilament proteins. Immunoblotting analysis showed that development of the rat heart myofibrils is associated with isoform switching from slow skeletal TnI to cardiac TnI and from a slow mobility isoform of TnT (TnT1) to a faster Mr isoform (TnT2. Expression of slow skeletal TnI was associated with a relative insensitivity of myofilament Ca2+ activation to deactivation by acidic pH. Moreover, the effect of acidic pH on Ca2+ activation of ATPase activity of soleus myofibrils, which contain cardiac TnC and slow skeletal TnI, was essentially the same as the effect of acidic pH on rat cardiac myofibrils in the early neonatal period. Neonatal myofilaments also contained a relative abundance of a set of polypeptides copurifying with the thin filaments. We have identified these proteins as histones. The relative amount of histones among a variety of preparations from different species was not correlated with the pH sensitivity of myofibrillar Ca2+ activation. Shifts in TnT isoforms among these species were also not correlated with an altered response to acidic pH. Our data provide evidence in support of the hypothesis that the relative insensitivity of neonatal myofilament activity to acidic pH is due to the presence of slow skeletal TnI in the thin-filament regulatory complex. 相似文献