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351.
We describe our surgical technique to manage a small aortic annulus during aortic valve replacement. Starting with the posterior annular enlargement incision described by Manouguian, a stentless porcine aortic root, with excision of the left and right porcine coronary segments and conservation of the mural wall (Freestyle MS design, Medtronic, Minneapolis, MN ), was used. The Freestyle bioprosthesis enlarges the aortic annulus using a direct suture of the valve on the enlarged annulus, and the aorta is closed by a direct suture of the mural wall of the bioprosthesis. Therefore, the aortic annulus enlargement is made only using the aortic bioprosthesis, without other material. 相似文献
352.
The effect of topical application of SPP 635, a renin inhibitor, on intraocular pressure (IOP) was evaluated in the eyes of monkeys with laser induced unilateral glaucoma. A multiple-dose study was performed in 8 glaucomatous monkey eyes with 3 concentrations of SPP 635, 0.2%, 0.3% and 0.4%. IOP was measured hourly for 6?h on each day of the study beginning at 9:30 a.m. Following one baseline day (untreated) and one vehicle-treated day (50?μl drop of vehicle to the glaucomatous eye at 9:30 a.m.), a 50?μl drop (25?μl?×?2) of SPP 635, 0.2%, 0.3% or 0.4%, was topically applied to the glaucomatous eye at 9:30 a.m. and 3:30 p.m. for 5 consecutive days. Twice daily administration of each of the 3 concentrations of SPP 635 for 5 days significantly (p?0.05) reduced IOP. The maximum reduction in IOP occurred 3 or 4?h after morning dosing and was 4.3?±?0.8 (mean?±?SEM) mmHg (14%) for 0.2% SPP 635, 5.3?±?1.0?mmHg, (19%) for 0.3% SPP 635, and 8.0?±?1.3?mmHg (25%) for 0.4% SPP 635. The longest duration of IOP reduction was for 6?h with 0.2% or 0.3% SPP 635, and was for at least 18?h with 0.4% concentration. Compared to 0.2% or 0.3% concentrations, 0.4% SPP 635 produced a greater (p?0.05) and longer duration of IOP reduction (18 vs. 6?h). Mild conjunctival discharge appeared in 2 of 8 eyes, and hyperemia appeared in 2 eyes with the 0.3% and 0.4% concentrations on treatment days 3 and 5. Topically applied SPP 635, a new renin inhibitor, reduces IOP in glaucomatous monkeys in a dose-dependent manner. Renin inhibitors, are a novel class of compounds which may have potential for the treatment of glaucoma. 相似文献
353.
Pavel Filip Ovidiu V. Lungu Mario-Ubaldo Manto Martin Bareš 《Cerebellum (London, England)》2016,15(6):774-780
Essential tremor (ET), clinically characterized by postural and kinetic tremors, predominantly in the upper extremities, originates from pathological activity in the dynamic oscillatory network comprising the majority of nodes in the central motor network. Evidence indicates dysfunction in the thalamus, the olivocerebellar loops, and intermittent cortical engagement. Pathology of the cerebellum, a structure with architecture intrinsically predisposed to oscillatory activity, has also been implicated in ET as shown by clinical, neuroimaging, and pathological studies. Despite electrophysiological studies assessing cerebellar impairment in ET being scarce, their impact is tangible, as summarized in this review. The electromyography–magnetoencephalography combination provided the first direct evidence of pathological alteration in cortico-subcortical communication, with a significant emphasis on the cerebellum. Furthermore, complex electromyography studies showed disruptions in the timing of agonist and antagonist muscle activation, a process generally attributed to the cerebellum. Evidence pointing to cerebellar engagement in ET has also been found in electrooculography measurements, cerebellar repetitive transcranial magnetic stimulation studies, and, indirectly, in complex analyses of the activity of the ventral intermediate thalamic nucleus (an area primarily receiving inputs from the cerebellum), which is also used in the advanced treatment of ET. In summary, further progress in therapy will require comprehensive electrophysiological and physiological analyses to elucidate the precise mechanisms leading to disease symptoms. The cerebellum, as a major node of this dynamic oscillatory network, requires further study to aid this endeavor. 相似文献
354.
Marco Metra Daniela Tomasoni Marianna Adamo Antoni Bayes-Genis Gerasimos Filippatos Magdy Abdelhamid Stamatis Adamopoulos Stefan D. Anker Laura Antohi Michael Böhm Frieder Braunschweig Tuvia Ben Gal Javed Butler John G.F. Cleland Alain Cohen-Solal Kevin Damman Finn Gustafsson Loreena Hill Ewa A. Jankowska Mitja Lainscak Lars H. Lund Theresa McDonagh Alexandre Mebazaa Brenda Moura Wilfried Mullens Massimo Piepoli Piotr Ponikowski Amina Rakisheva Arsen Ristic Gianluigi Savarese Petar Seferovic Rajan Sharma Carlo Gabriele Tocchetti Mehmet Birhan Yilmaz Cristiana Vitale Maurizio Volterrani Stephan von Haehling Ovidiu Chioncel Andrew J.S. Coats Giuseppe Rosano 《European journal of heart failure》2023,25(6):776-791
Episodes of worsening symptoms and signs characterize the clinical course of patients with chronic heart failure (HF). These events are associated with poorer quality of life, increased risks of hospitalization and death and are a major burden on healthcare resources. They usually require diuretic therapy, either administered intravenously or by escalation of oral doses or with combinations of different diuretic classes. Additional treatments may also have a major role, including initiation of guideline-recommended medical therapy (GRMT). Hospital admission is often necessary but treatment in the emergency service or in outpatient clinics or by primary care physicians has become increasingly used. Prevention of first and recurring episodes of worsening HF is an essential component of HF treatment and this may be achieved through early and rapid administration of GRMT. The aim of the present clinical consensus statement by the Heart Failure Association of the European Society of Cardiology is to provide an update on the definition, clinical characteristics, management and prevention of worsening HF in clinical practice. 相似文献
355.
Bahira Shahim Angiza Shahim Marianna Adamo Ovidiu Chioncel Lina Benson Maria G. Crespo-Leiro Stefan D. Anker Andrew J.S. Coats Gerasimos Filippatos Mitja Lainscak Theresa McDonagh Alexandre Mebazaa Massimo F. Piepoli Giuseppe M.C. Rosano Frank Ruschitzka Gianluigi Savarese Petar Seferovic Maurizio Volterrani Marisa Crespo Leiro Javier Segovia Cubero Offer Amir Benjamin Palic Aldo P. Maggioni Marco Metra Lars H. Lund 《European journal of heart failure》2023,25(7):1049-1060
Aims
To assess the prevalence, clinical characteristics, and outcomes of patients with heart failure (HF) with or without moderate to severe aortic valve disease (AVD) (aortic stenosis [AS], aortic regurgitation [AR], mixed AVD [MAVD]).Methods and results
Data from the prospective ESC HFA EORP HF Long-Term Registry including both chronic and acute HF were analysed. Of 15 216 patients with HF (62.5% with reduced ejection fraction, HFrEF; 14.0% with mildly reduced ejection fraction, HFmrEF; 23.5% with preserved ejection fraction, HFpEF), 706 patients (4.6%) had AR, 648 (4.3%) AS and 234 (1.5%) MAVD. The prevalence of AS, AR and MAVD was 6%, 8%, and 3% in HFpEF, 6%, 3%, and 2% in HFmrEF and 4%, 3%, and 1% in HFrEF. The strongest associations were observed for age and HFpEF with AS, and for left ventricular end-diastolic diameter with AR. AS (adjusted hazard ratio [HR] 1.43, 95% confidence interval [CI] 1.23–1.67), and MAVD (adjusted HR 1.37, 95% CI 1.07–1.74) but not AR (adjusted HR 1.13, 95% CI 0.96–1.33) were independently associated with the 12-month composite outcome of cardiovascular death and HF hospitalization. The associations between AS and the composite outcome were observed regardless of ejection fraction category.Conclusions
In the ESC HFA EORP HF Long-Term Registry, one in 10 patients with HF had AVD, with AS and MAVD being especially common in HFpEF and AR being similarly distributed across all ejection fraction categories. AS and MAVD, but not AR, were independently associated with increased risk of in-hospital mortality and 12-month composite outcome, regardless of ejection fraction category. 相似文献356.
357.
Natan M. Bornstein Alla Guekht Johannes Vester Wolf-Dieter Heiss Eugene Gusev Volker Hömberg Volker W. Rahlfs Ovidiu Bajenaru Bogdan O. Popescu Dafin Muresanu 《Neurological sciences》2018,39(4):629-640
This meta-analysis combines the results of nine ischemic stroke trials, assessing efficacy of Cerebrolysin on global neurological improvement during early post-stroke period. Cerebrolysin is a parenterally administered neuropeptide preparation approved for treatment of stroke. All included studies had a prospective, randomized, double-blind, placebo-controlled design. The patients were treated with 30–50 ml Cerebrolysin once daily for 10–21 days, with treatment initiation within 72 h after onset of ischemic stroke. For five studies, original analysis data were available for meta-analysis (individual patient data analysis); for four studies, aggregate data were used. The combination by meta-analytic procedures was pre-planned and the methods of synthesis were pre-defined under blinded conditions. Search deadline for the present meta-analysis was December 31, 2016. The nonparametric Mann-Whitney (MW) effect size for National Institutes of Health Stroke Scale (NIHSS) on day 30 (or 21), combining the results of nine randomized, controlled trials by means of the robust Wei-Lachin pooling procedure (maximin-efficient robust test), indicated superiority of Cerebrolysin as compared with placebo (MW 0.60, P?<?0.0001, N?=?1879). The combined number needed to treat for clinically relevant changes in early NIHSS was 7.7 (95% CI 5.2 to 15.0). The additional full-scale ordinal analysis of modified Rankin Scale at day 90 in moderate to severe patients resulted in MW 0.61 with statistical significance in favor of Cerebrolysin (95% CI 0.52 to 0.69, P?=?0.0118, N?=?314). Safety aspects were comparable to placebo. Our meta-analysis confirms previous evidence that Cerebrolysin has a beneficial effect on early global neurological deficits in patients with acute ischemic stroke. 相似文献
358.
Willi Andrei Uriciuc Adina Bianca Boca Anida-Maria Bban Horaiu Vermean Cecilia Cristea Mihaela Terti Petru Pcu Gheorghe Borodi Maria Suciu Lucian Barbu-Tudoran Ctlin Ovidiu Popa Aranka Ilea 《Materials》2022,15(9)
This study presents the correct processing of Co–Cr alloys as a method of preserving the properties of the materials as-cast, and therefore they can be safely placed in contact with the oral cavity tissues as resistance frameworks. The basic materials analyzed in this study were five commercial Co–Cr dental alloys with different components obtained in three processing steps. The analysis of the electrochemical behavior at the surface of the Co–Cr alloys was performed by electrochemical measurements: impedance spectroscopy (EIS), open circuit electrical potential (OCP), and linear polarization (LP). In terms of validation, all five alloys had a tendency to generate a stable oxide layer at the surface. After the measurements and the graphical representation, the alloy that had a higher percentage of tungsten (W) and iron (Fe) in composition showed a higher tendency of anodizing. After the application of the heat treatment, the disappearance of the hexagonal phase was observed, with the appearance of new phases of type (A,B)2O3 corresponding to some oxide compounds, such as Fe2O3, Cr2O3, (Cr,Fe)2O3, and CoMnO3. In conclusion, the processing of Co–Cr alloys by melting and casting in refractory molds remains a viable method that can support innovation, in the context of technology advance in recent years towards digitalization of the manufacturing process, i.e., the construction of prosthetic frameworks conducted by additive methods using Co–Cr powder alloy. 相似文献
359.
Marianna Adamo Ovidiu Chioncel Lina Benson Bahira Shahim Maria G. Crespo-Leiro Stefan D. Anker Andrew J.S. Coats Gerasimos Filippatos Mitja Lainscak Theresa McDonagh Alexander Mebazaa Massimo F. Piepoli Giuseppe M.C. Rosano Frank Ruschitzka Gianluigi Savarese Petar Seferovic Angiza Shahim Bogdan A. Popescu Bernard Iung Maurizio Volterrani Aldo P. Maggioni Marco Metra Lars H. Lund 《European journal of heart failure》2023,25(7):1061-1071
360.
Agnieszka Kapłon-Cieślicka Lina Benson Ovidiu Chioncel Maria G. Crespo-Leiro Andrew J.S. Coats Stefan D. Anker Frank Ruschitzka Camilla Hage Jarosław Drożdż Petar Seferovic Giuseppe M.C. Rosano Massimo Piepoli Alexandre Mebazaa Theresa McDonagh Mitja Lainscak Gianluigi Savarese Roberto Ferrari Wilfried Mullens Antoni Bayes-Genis Aldo P. Maggioni Lars H. Lund on behalf of the Heart Failure Association of the European Society of Cardiology the ESC Heart Failure Long-Term Registry Investigators 《European journal of heart failure》2023,25(9):1571-1583