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51.
Daniele Borsetto Jonathan M. Fussey Diego Cazzador Joel Smith Andrea Ciorba Stefano Pelucchi Sara Don Paolo Boscolo‐Rizzo Michele Tomasoni Davide Lombardi Piero Nicolai Elisabetta Zanoletti Roberta Colangeli Enzo Emanuelli Max S. Osborne Syed F. Ahsan Margherita Tofanelli Giancarlo Tirelli Katherine McNamara Leonard Liew Katherine Harrison Ambrogio Fassina Samantha Sarcognato Neil Sharma Kanishka Rao Paul Pracy Paul Nankivell 《Head & neck》2020,42(3):522-529
52.
Franco Mazzalai Giacomo Piatto Antonio Toniato Renata Lorenzetti Claudio Baracchini Enzo Ballotta 《World journal of surgery》2014,38(5):1227-1232
Background
Controversy persists regarding the use of protamine sulfate (PS) during carotid endarterectomy (CEA), chiefly because of conflicting experiences reporting both less bleeding and a higher stroke risk. The goal of the present study was to test the hypothesis that reversing heparin with PS after CEA significantly reduces the incidence of bleeding complications without increasing the risk of postoperative stroke.Methods
From January 2010 to December 2012 all consecutive patients undergoing CEA under general anesthesia at our institution received 5,000 U of heparin prior to carotid clamping, which was partially (half-dose) reversed with PS 25 mg immediately after declamping (group I). Heparinization had never been reversed with PS in earlier CEAs performed from 1998 to 2009 at the same institution (group II). All patients were assessed preoperatively and postoperatively by a neurologist, and cerebral magnetic resonance imaging was performed in all group I patients to exclude any silent cerebral infarction. End points of the study were bleeding complications, perioperative (30-day) stroke, and death.Results
Overall, 219 CEAs (201 patients) were performed in group I, and 1,458 CEAs (1,294 patients) in group II. Demographics, risk factors, and preoperative antiplatelet medication were comparable in the two groups. The incidence of adverse events (group I vs group II) was as follows: stroke (0 vs 0.5 % [8/1,458], p = 0.27); death (0 vs 0 %); neck bleeding (0 vs 8.2 % [120/1,458], p < 0.001).Conclusions
The results of the present study demonstrate that (1) partially neutralizing heparin with PS after CEA can significantly reduce the risk of bleeding complications, and (2) there is no association between the administration of PS and the incidence of postoperative stroke. 相似文献53.
54.
Jae M. Sevelius Ph.D. Enzo Patouhas M.A. JoAnne G. Keatley M.S.W. Mallory O. Johnson Ph.D. 《Annals of behavioral medicine》2014,47(1):5-16
Background
Transgender women have 49 times the odds of human immunodeficiency virus (HIV) infection compared to other groups, yet they are disproportionately underserved by current treatment efforts.Purpose
This study aimed to examine culturally unique barriers and facilitators to engagement and retention in HIV care and strengthen efforts to mitigate health disparities, guided by the Models of Gender Affirmation and Health Care Empowerment.Methods
Through 20 interviews and five focus groups (n?=?38), transgender women living with HIV discussed their experiences and life contexts of engagement in and adherence to HIV care and treatment.Results
Our participants faced substantial challenges to adhering to HIV care and treatment, including avoidance of healthcare due to stigma and past negative experiences, prioritization of hormone therapy, and concerns about adverse interactions between antiretroviral treatment for HIV and hormone therapy. Receiving culturally competent, transgender-sensitive healthcare was a powerful facilitator of healthcare empowerment.Conclusions
Recommendations are offered to inform intervention research and guide providers, emphasizing gender affirming HIV care that integrates transition-related healthcare needs. 相似文献55.
56.
Symptoms and pathophysiological correlations in patients with constipation and functional dyspepsia 总被引:5,自引:0,他引:5
Sarnelli G Grasso R Ierardi E De Giorgi F Savarese MF Russo L Budillon G Cuomo R 《Digestion》2005,71(4):225-230
INTRODUCTION: Patients with constipation often report dyspeptic symptoms, but whether constipation is associated with specific dyspeptic symptoms and altered gastrointestinal (GI) motility, remains to be established. Our aim was to study symptoms association and GI motility parameters in patients with constipation and functional dyspepsia. PATIENTS AND METHOD: 42 patients with different symptoms and severity of constipation and dyspepsia were enrolled. Scintigraphic gastric emptying, colonic transit time and gallbladder contraction were studied in all subjects. RESULTS: No significant association was observed between individual symptoms of constipation and dyspepsia. Patients with more severe constipation did not have higher dyspepsia severity scores. Colonic transit time, gastric half emptying and gallbladder contraction were not significantly correlated. Although patients with severe nausea had faster colonic transit than those with absent/mild symptom (19 +/- 2 vs. 48 +/- 7 h; p < 0.05), the multivariate analysis only revealed a significant association between severe postprandial fullness, delayed t1/2 (OR 1.05, CI 1-1.1) and impaired gallbladder contraction (OR 0.94, CI 0.89-0.99). CONCLUSIONS: Constipation was not associated with severity, or any particular dyspeptic symptom. Although motor abnormalities of both colon and proximal GI tract regions existed in the subset of constipated dyspeptic patients, they did not seem associated with the genesis of different dyspeptic symptoms. 相似文献
57.
Tommaso Sanna Antonio Dello Russo Daniela Toniolo Michal Vytopil Gemma Pelargonio Giuseppe De Martino Enzo Ricci Gabriella Silvestri Vincenzo Giglio Loredana Messano Elisabetta Zachara Fulvio Bellocci 《European heart journal》2003,24(24):2227-2236
AIMS: Retrospective studies have identified a mutation in the lamin A/C (LMNA) gene in patients selected on the basis of a phenotype characterized by dilated cardiomyopathy, atrioventricular conduction disturbances and sudden death. However, the features of cardiac abnormalities in patients with an initial diagnosis of Emery-Dreifuss muscular dystrophy (EDMD) are poorly known. Aim of the present study was to investigate the spectrum of cardiac disease in patients with an initial diagnosis of EDMD caused by a mutation in the LMNA gene. METHODS AND RESULTS: Ten consecutive patients with EDMD and a LMNA gene mutation were evaluated with structured medical interview, physical examination, ECG, echocardiogram and 24-h Holter monitoring. Electrophysiological testing and cardiac catheterization were performed if a class 1 or 2 American Heart Association guidelines indication was present. Cardiac disease was found in eight of 10 patients and consisted in the variable combination of supraventricular arrhythmias, disorders of atrioventricular conduction, ventricular arrhythmias, dilated cardiomyopathy, non-dilated cardiomyopathy, restrictive cardiomyopathy and sudden death despite pacemaker implant. CONCLUSIONS: Cardiac disease is common in patients with an initial diagnosis of EDMD caused by a mutation in the LMNA gene and consists of arrhythmias, disorders of atrioventricular conduction, cardiomyopathies and sudden death despite pacemaker implant. 相似文献
58.
59.
60.
Enzo Tagliazucchi Robin Carhart‐Harris Robert Leech David Nutt Dante R. Chialvo 《Human brain mapping》2014,35(11):5442-5456
The study of rapid changes in brain dynamics and functional connectivity (FC) is of increasing interest in neuroimaging. Brain states departing from normal waking consciousness are expected to be accompanied by alterations in the aforementioned dynamics. In particular, the psychedelic experience produced by psilocybin (a substance found in “magic mushrooms”) is characterized by unconstrained cognition and profound alterations in the perception of time, space and selfhood. Considering the spontaneous and subjective manifestation of these effects, we hypothesize that neural correlates of the psychedelic experience can be found in the dynamics and variability of spontaneous brain activity fluctuations and connectivity, measurable with functional Magnetic Resonance Imaging (fMRI). Fifteen healthy subjects were scanned before, during and after intravenous infusion of psilocybin and an inert placebo. Blood‐Oxygen Level Dependent (BOLD) temporal variability was assessed computing the variance and total spectral power, resulting in increased signal variability bilaterally in the hippocampi and anterior cingulate cortex. Changes in BOLD signal spectral behavior (including spectral scaling exponents) affected exclusively higher brain systems such as the default mode, executive control, and dorsal attention networks. A novel framework enabled us to track different connectivity states explored by the brain during rest. This approach revealed a wider repertoire of connectivity states post‐psilocybin than during control conditions. Together, the present results provide a comprehensive account of the effects of psilocybin on dynamical behavior in the human brain at a macroscopic level and may have implications for our understanding of the unconstrained, hyper‐associative quality of consciousness in the psychedelic state. Hum Brain Mapp 35:5442–5456, 2014. © 2014 Wiley Periodicals, Inc . 相似文献