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21.
Kilger E Strom C Frey L Felbinger TW Pichler B Tichy M Rank N Wheeldon D Kesel K Schmitz C Reichenspurner H Polasek J Weis F Goetz AE 《Acta anaesthesiologica Scandinavica》2000,44(1):125-127
We report a 56-year-old male patient developing hypoxemia after surgical replacement of infected valves of a left ventricular assist device (LVAD, Novacor) which had supported him during the previous 15 months. Contrast transesophageal echocardiography (TEE) revealed an atrial septal defect with intermittent right-to-left shunt across a patent foramen ovale. We postulate that the shunt detected in this patient occurred as a consequence of reduced pulmonary vascular compliance due to positive end-expiratory pressure (PEEP) and an increase of mean intrathoracic pressure. Furthermore, we hypothesize that synchronized LVAD operation exacerbates any potential right-to-left shunt due to the profound left ventricular unloading which occurs during LVAD support. In this first report of a right-to-left shunt from a previously unrecognized patent foramen ovale in a Novacor patient, the subsequent transient hypoxemia could be managed by avoiding PEEP of more than 3 mmHg, and mean airway pressure of more than 11 mmHg and by careful volume replacement in order to prevent the pump from completely emptying the left ventricle (LV) and the left atrium (LA). Thus, prior to every LVAD implantation a transesophageal contrast echocardiography with Valsalva maneuver should be performed to identify intracardiac right-to-left shunt. 相似文献
22.
Arianne C Lim Kitty WM Bloemenkamp Kees Boer Johannes J Duvekot Jan Jaap HM Erwich Tom HM Hasaart Pieter Hummel Ben WJ Mol Jos PM Offermans Charlotte M van Oirschot Job G Santema Hubertina CJ Scheepers Willem A Schöls Frank PHA Vandenbussche Maurice GAJ Wouters Hein W Bruinse 《BMC pregnancy and childbirth》2007,7(1):1-6
Background
Adequate vitamin D concentrations during pregnancy are necessary to neonatal calcium homeostasis, bone maturation and mineralization. The aim of study is to evaluate serum vitamin D concentrations in mothers and their newborns and effect of vitamin D deficiency on pregnancy outcomes.Methods
552 pregnant women were recruited from Tehran University educating hospitals in the winter of 2002. Maternal and cord blood samples were taken at delivery. The serum was assayed for 25-hydroxyvitamin D3, calcium, phosphorus and parathyroid hormone.Results
The prevalence of vitamin D deficiency in maternal and cord blood samples were 66.8% and 93.3%, respectively (<35 nmol/l). There was significant correlation between maternal and cord blood serum concentrations of vitamin D. In mothers with vitamin D deficiency, cord blood vitamin D concentrations was lower than those from normal mothers (P = .001). Also, a significant direct correlation was seen between maternal vitamin D intake and weight gain during pregnancy.Conclusion
Consideration to adequate calcium and vitamin D intake during pregnancy is essential. Furthermore, we think it is necessary to reconsider the recommendation for vitamin D supplementation for women during pregnancy. 相似文献23.
Volk Strakosch T. Antoine v. Knorre Vidaković Hanse Hirsch-Hoffmann Rosenkranz W. Breipohl v. Pallos Sepp Pichler K. de Snod Strakosch Hans Heidler 《Journal of cancer research and clinical oncology》1942,53(3-4):256-261
Ohne Zusammenfassung 相似文献
24.
Ohne Zusammenfassung 相似文献
25.
Clinical features and serum antinuclear antibodies in 230 Danish patients with systemic sclerosis 总被引:5,自引:2,他引:5
Jacobsen S; Halberg P; Ullman S; Van Venrooij WJ; Hoier-Madsen M; Wiik A; Petersen J 《Rheumatology (Oxford, England)》1998,37(1):39-45
The objective was to investigate the relationship between the presence of
different types of antinuclear antibodies (ANA) in patients with systemic
sclerosis (SSc) and the presence of clinical features. Sera from 230
patients with SSc were tested for the presence of ANA, including
anticentromere antibodies (ab), antitopoisomerase I ab, anti- U1 RNP ab and
antinucleolar ab, including anti-Th RNP, anti-U3 RNP and anti-U17 RNP.
Clinical features were registered prospectively in a clinical database.
Eighty-two per cent of the patients were women. The median age was 58 yr
(45-67, quartiles) and median age at disease onset was 44 (30-55) yr. ANA
were found in 86% of the patients (anticentromere: 34%; antitopoisomerase
I: 14%; anti-U1 RNP: 6.5%; antinucleolar total: 16%; anti-Th RNP: 2.2%;
anti-U3 RNP: 3.5%; anti- U17 RNP: 0%). Anticentromere ab were found to be
related to a high prevalence of calcinosis, telangiectasia, digital ulcers,
acrosclerosis, primary biliary cirrhosis, isolated reduction of pulmonary
diffusing capacity, and a low prevalence of radiological evidence of
pulmonary fibrosis. Antitopoisomerase I ab were associated with a high
prevalence of digital joint deformity, distal osteolysis, radiological
signs of pulmonary fibrosis, a low prevalence of calcinosis and late onset
of disease. Anti-U1 RNP ab were related to a high prevalence of arthritis
and myositis, a low prevalence of calcinosis, and early disease onset. The
presence of antinucleolar ab, including anti-U3 RNP and anti-Th RNP, was
not significantly related to any particular clinical features in this
study; possibly due to the small number of patients with these ab. The
presence of anticentromere, antitopoisomerase I and anti-U1 RNP ab in the
serum was also found to have previously described clinical correlations in
a group of Danish SSc patients.
相似文献
26.
27.
Jacqueline AM Smith DL Patil OT Daniels Y-S Ding J-D Gallezot S Henry KHS Kim S Kshirsagar WJ Martin GP Obedencio E Stangeland PR Tsuruda W Williams RE Carson ST Patil 《The international journal of neuropsychopharmacology / official scientific journal of the Collegium Internationale Neuropsychopharmacologicum (CINP)》2015,18(2)
Background:
Monoamine reuptake inhibitors exhibit unique clinical profiles that reflect distinct engagement of the central nervous system (CNS) transporters.Methods:
We used a translational strategy, including rodent pharmacokinetic/pharmacodynamic modeling and positron emission tomography (PET) imaging in humans, to establish the transporter profile of TD-9855, a novel norepinephrine and serotonin reuptake inhibitor.Results:
TD-9855 was a potent inhibitor of norepinephrine (NE) and serotonin 5-HT uptake in vitro with an inhibitory selectivity of 4- to 10-fold for NE at human and rat transporters. TD-9855 engaged norepinephrine transporters (NET) and serotonin transporters (SERT) in rat spinal cord, with a plasma EC50 of 11.7ng/mL and 50.8ng/mL, respectively, consistent with modest selectivity for NET in vivo.Accounting for species differences in protein binding, the projected human NET and SERT plasma EC50 values were 5.5ng/mL and 23.9ng/mL, respectively. A single-dose, open-label PET study (4–20mg TD-9855, oral) was conducted in eight healthy males using the radiotracers [11C]-3-amino-4- [2-[(di(methyl)amino)methyl]phenyl]sulfanylbenzonitrile for SERT and [11C]-(S,S)-methylreboxetine for NET. The long pharmacokinetic half-life (30–40h) of TD-9855 allowed for sequential assessment of SERT and NET occupancy in the same subject. The plasma EC50 for NET was estimated to be 1.21ng/mL, and at doses of greater than 4mg the projected steady-state NET occupancy is high (>75%). After a single oral dose of 20mg, SERT occupancy was 25 (±8)% at a plasma level of 6.35ng/mL.Conclusions:
These data establish the CNS penetration and transporter profile of TD-9855 and inform the selection of potential doses for future clinical evaluation. 相似文献28.
29.
Dal Canto Elisa Remmelzwaal Sharon van Ballegooijen Adriana Johanne Handoko M. Louis Heymans Stephane van Empel Vanessa Paulus Walter J. Nijpels Giel Elders Petra Beulens Joline WJ 《Heart failure reviews》2022,27(1):207-218
Heart Failure Reviews - This study aimed to evaluate the diagnostic performance of echocardiographic markers of heart failure with preserved ejection fraction (HFpEF) and left ventricular diastolic... 相似文献
30.
Connor WJ Bevington Ju-Chieh Cheng Ivan S Klyuzhin Mariya V Cherkasova Catharine A Winstanley Vesna Sossi 《Journal of cerebral blood flow and metabolism》2021,41(1):116
Current methods using a single PET scan to detect voxel-level transient dopamine release—using F-test (significance) and cluster size thresholding—have limited detection sensitivity for clusters of release small in size and/or having low release levels. Specifically, simulations show that voxels with release near the peripheries of such clusters are often rejected—becoming false negatives and ultimately distorting the F-distribution of rejected voxels. We suggest a Monte Carlo method that incorporates these two observations into a cost function, allowing erroneously rejected voxels to be accepted under specified criteria. In simulations, the proposed method improves detection sensitivity by up to 50% while preserving the cluster size threshold, or up to 180% when optimizing for sensitivity. A further parametric-based voxelwise thresholding is then suggested to better estimate the release dynamics in detected clusters. We apply the Monte Carlo method to a pilot scan from a human gambling study, where additional parametrically unique clusters are detected as compared to the current best methods—results consistent with our simulations. 相似文献