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941.
Platelet function profiles in patients with type 2 diabetes and coronary artery disease on combined aspirin and clopidogrel treatment 总被引:8,自引:0,他引:8
Angiolillo DJ Fernandez-Ortiz A Bernardo E Ramírez C Sabaté M Jimenez-Quevedo P Hernández R Moreno R Escaned J Alfonso F Bañuelos C Costa MA Bass TA Macaya C 《Diabetes》2005,54(8):2430-2435
To assess platelet function profiles in diabetic and nondiabetic patients on aspirin and clopidogrel therapy, two patient populations were included to investigate the 1) acute effects of a 300-mg clopidogrel loading dose (group 1, n = 52) and 2) long-term effects of clopidogrel (group 2, n = 120) on platelet function in diabetic compared with nondiabetic patients already on aspirin treatment. Patients were stratified according to the presence of type 2 diabetes. Platelet aggregation was assessed using light transmittance aggregometry (groups 1 and 2). Platelet activation (P-selectin expression and PAC-1 binding) was determined using whole-blood flow cytometry (group 2). Clopidogrel response was also assessed. In group 1, platelet aggregation was significantly increased in diabetic (n = 16) compared with nondiabetic (n = 36) patients at baseline and up to 24 h following a 300-mg loading dose (P = 0.005). In group 2, platelet aggregation and activation were increased in diabetic (n = 60) compared with nondiabetic (n = 60) subjects (P < 0.05 for all platelet function assays). Diabetic subjects had a higher number of clopidogrel nonresponders (P = 0.04). Diabetic patients have increased platelet reactivity compared with nondiabetic subjects on combined aspirin and clopidogrel treatment. Reduced sensitivity to antiplatelet drugs may contribute to the increased atherothombotic risk in diabetic patients. 相似文献
942.
Paulo Gustavo Sampaio Lacativa Laura Maria Carvalho de Mendon?a Pedro José de Mattos Patrício Filho José Raimundo Pimentel Manoel Domingos da Cruz Gon?alves Maria Lucia Fleiuss de Farias 《Journal of clinical densitometry》2005,8(3):352-361
Hyperparathyroidism contributes significantly to decreased bone mineral density (BMD) in end-stage renal disease patients, but this negative influence is not homogeneous throughout the skeleton. We studied the BMD by dual-energy X-ray absorptiometry on total body and on different regions of the skeleton in 42 patients with severe hyperparathyroidism on hemodialysis. We also evaluated the relationship between different risk factors and BMD found on the regions examined in these patients. The legs and other sites where cortical bone predominate were mostly affected, whereas trabecular bone was relatively preserved. This is probably the result of the different effects of hyperparathyroidism on cortical and trabecular bone, but we cannot rule out the interference of ectopic calcifications and sclerotic lesions of vertebral end-plates falsely increasing lumbar spine BMD. The main determinants of low total-body BMD were, in order of importance, immobility, high intact parathyroid hormone levels, low body mass index, and low albumin. Eleven patients presented with pathologic fractures, mainly in the legs, and BMD was lower in this group than in patients without fractures. In conclusion, our study makes clear that hyperparathyroidism is a great threat to bone density in hemodialysis patients, mainly in the legs, the site mostly affected by fragility fractures in our patients. Physicians must worry not only with high parathyroid hormone levels, but also with the nutritional state of these patients. 相似文献
943.
Enríquez-Navascués JM Elósegui JL Apeztegui F Placer C Múgica JA Goena JI Aguirrezabaldegui L 《Cirugía espa?ola》2005,78(Z3):66-71
Genital prolapse, whether associated or not with urinary, anal or sexual dysfunction, should be evaluated globally to select the appropriate treatment. Rectocele and enterocele are defects of the posterior vaginal compartment, although they can be secondary to abnormalities of the central compartment, since lesions of the perineal raphe and rectovaginal septum can occur in isolation or accompanied by others that also affect the tissues involved in pelvic support. The various surgical approaches to rectocele alone or associated with other defects are reviewed. Likewise, the distinct pathogenic types of enterocele are discussed. Laparoscopic sacrocolpoperineopexy is a promising intervention for the simultaneous correction of defects of the posterior and central compartments. New and better designed studies are required to evaluate the distinct surgical approaches and interventions for genital prolapse. 相似文献
944.
Endoanal ultrasound is undoubtedly one of the major advances that has taken place in the evaluation of anorectal disease and pelvic floor disorders in the last decade. The main indications for endoanal ultrasound are evaluation of the morphology of the sphincteric apparatus in patients with fecal incontinence, the localization of perianal abscesses and fistulas, the staging of anal cancer and follow-up of squamous cell carcinoma after conservative treatment, and the study and morphological confirmation of lateral internal sphincterotomy in patients with fissure-in-ano, amongst others. In this article we review the main indications and use of endoanal ultrasound in the diagnosis of benign proctological disease. 相似文献
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947.
Corral Molina JM Luque Gálvez P Agud Piqué A Alcover García JB 《Archivos espa?oles de urología》2005,58(6):511-515
Living donation for kidney transplantation is being promoted due to the shortage of organs, the improved outcomes of living donor transplants and the evolution of immunosuppression regimens. The process of organ donation from a living donor affects not only medical-surgical features but also emotional, social and economic. Using kidneys from living donors involves a great responsibility in evaluation and selection. Candidates for donation undergo an extensive set of examinations in order to optimize selection and to plan surgery. Radiological evaluation is one of the most important features of the evaluation process and selection of the kidney; it shows precisely the renal vascular anatomy, which is decisive in the choice of the kidney and helps to optimize the process and diminish risks and complications during extraction and/or tronsplantation. The advantages on imaging tests allow to evaluate potential donors in a safely, fast and almost noninvasive matter. The aim of the process is to select the kidney with less likelihood of failure due to technical reasons, and always leave the best kidney for the donor. 相似文献
948.
949.
Javier Alegre-López José Cordero-Guevara José L. Alonso-Valdivielso Julia Fernández-Melón 《Osteoporosis international》2005,16(7):729-736
Hip fracture results in excess mortality and functional disability. This study sought to identify predictors of mortality and limited functional ability 1 year after hip fracture. We conducted a 1-year follow-up of a prospective population-based inception cohort of 218 hip fracture patients who had been consecutively admitted and discharged from hospital during the previous year. Mortality was observed to be independently associated with poor mental status (relative risk [RR]=6.96; 95% confidence interval [95% CI], 1.73–28.00), prefracture limited functional ability (RR=4.35; 95% CI, 1.32–14.36), institutionalized disposition at discharge (RR=2.92; 95% CI, 1.02–8.38), and male gender (RR=2.44; 95% CI, 1.01–5.93). Independent predictors of limited functional ability were prefracture functional disability (RR=34.14; 95% CI, 3.13–372.33), poor mental status (RR=9.71; 95% CI, 1.57–59.82), age >80 years (RR=4.03; 95% CI, 1.48–11.00), and female gender (RR=3.57; 95% CI, 0.08–0.98). On discharge, special attention and care should thus be given to all patients displaying any of the above predictive factors. 相似文献
950.