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91.
Teresa Trenkwalder Anna Lena Lahmann Magdalena Nowicka Costanza Pellegrini Tobias Rheude N. Patrick Mayr Stephanie Voss Sabine Bleiziffer Rüdiger Lange Michael Joner Albert M. Kasel Adnan Kastrati Heribert Schunkert Oliver Husser Martin Hadamitzky Christian Hengstenberg 《The international journal of cardiovascular imaging》2018,34(6):985-992
Multislice computed tomography (MSCT) has emerged as the mainstay in patients planned for transcatheter aortic valve implantation (TAVI). Incidental findings (IF) in MSCT are common. However, the exact incidence, clinical relevance and further consequences of IF are unclear and it is controversial whether IF adversely affect patients’ outcome. We analyzed MSCT data of 1050 patients screened for TAVI between January 2011 and December 2014. Median follow-up of patients was 20 months. In total, 3194 IF were identified, which were classified into clinically non-relevant IF (2872, 90%) and clinically relevant IF (322, 10%). In 25% of patients (258/1050) at least one clinically relevant IF was present. Age (80?±?7 vs. 80?±?7 years; p?=?0.198) and EuroSCORE II (3.6% [2.1–5.7] vs. 3.6% [2.1–5.9]; p?=?0.874) was similar between patients with and without a clinically relevant IF. TAVI was performed less frequently in patients with a clinically relevant IF (76% vs. 85%; p?<?0.001), with more patients receiving surgical aortic valve replacement in that group (14% vs. 11%; p?=?0.042), possibly due to the high rate of incidental aneurysms of the ascending aorta (n?=?48). If TAVI was performed mortality did not differ (30-days: 4% vs. 3%; p?=?0.339, 1-year: 11% vs. 14%; p?=?0.226) between patients with and without a clinically relevant IF. Our study is the largest study to analyze prevalence, clinical relevance and therapeutic consequences of IF during screening for TAVI. IF in pre-procedural MSCT are common and clinically relevant in one-quarter of patients. However, these findings had no impact on overall mortality. 相似文献
92.
Charles J. Weschler Gabriel Bek? Holger M. Koch Tunga Salthammer Tobias Schripp J?rn Toftum Geo Clausen 《Environmental health perspectives》2015,123(10):928-934
Background
Fundamental considerations indicate that, for certain phthalate esters, dermal absorption from air is an uptake pathway that is comparable to or greater than inhalation. Yet this pathway has not been experimentally evaluated and has been largely overlooked when assessing uptake of phthalate esters.Objectives
This study investigated transdermal uptake, directly from air, of diethyl phthalate (DEP) and di(n-butyl) phthalate (DnBP) in humans.Methods
In a series of experiments, six human participants were exposed for 6 hr in a chamber containing deliberately elevated air concentrations of DEP and DnBP. The participants either wore a hood and breathed air with phthalate concentrations substantially below those in the chamber or did not wear a hood and breathed chamber air. All urinations were collected from initiation of exposure until 54 hr later. Metabolites of DEP and DnBP were measured in these samples and extrapolated to parent phthalate intakes, corrected for background and hood air exposures.Results
For DEP, the median dermal uptake directly from air was 4.0 μg/(μg/m3 in air) compared with an inhalation intake of 3.8 μg/(μg/m3 in air). For DnBP, the median dermal uptake from air was 3.1 μg/(μg/m3 in air) compared with an inhalation intake of 3.9 μg/(μg/m3 in air).Conclusions
This study shows that dermal uptake directly from air can be a meaningful exposure pathway for DEP and DnBP. For other semivolatile organic compounds (SVOCs) whose molecular weight and lipid/air partition coefficient are in the appropriate range, direct absorption from air is also anticipated to be significant.Citation
Weschler CJ, Bekö G, Koch HM, Salthammer T, Schripp T, Toftum J, Clausen G. 2015. Transdermal uptake of diethyl phthalate and di(n-butyl) phthalate directly from air: experimental verification. Environ Health Perspect 123:928–934; http://dx.doi.org/10.1289/ehp.1409151 相似文献93.
Heather Olson Tiffany Rudloe Tobias Loddenkemper Marvin B. Harper Amir A. Kimia 《The American journal of emergency medicine》2018,36(8):1386-1390
Background and aims
Children with first complex febrile seizure (CFS) are often admitted for observation. The goals of this study were 1) to assess the risk of seizure recurrence during admission, 2) to determine whether early EEG affects acute management.Design/methods
We retrospectively reviewed a cohort of children 6–60 months of age admitted from a Pediatric Emergency Department for first CFS over a 15 year period. We excluded children admitted for supportive care of their febrile illness. Data extraction included age, gender, seizure features, laboratory and imaging studies, EEG, further seizures during admission, and antiepileptic drugs (AEDs) given.Results
One hundred eighty three children met inclusion criteria. Seven patients had seizures during the admission (7/183 or 3.8%) Since 38 children were loaded with anti-epileptic medication during their visit, the adjusted rate is 7/145 or 4.8.Increased risk of seizure recurrence during admission was observed in children presenting with multiple seizures (P = 0.005).EEG was performed in 104/183 children (57%) and led to change in management in one patient (1%, 95% C.I. 0.05–6%). Six of the 7 children with seizure had an EEG. The study was normal in 3 and findings in the other 2 did not suggest/predict further seizures during the admission.Conclusions
Children with first CFSs are at low risk for seizure recurrence during admission. Multiple seizures at presentation are associated with risk of early recurrence and may warrant an admission. EEG had limited effect on acute management and should not be an indication for admission. 相似文献94.
95.
Reduced memory skills and increased hair cortisol levels in recent Ecstasy/MDMA users: significant but independent neurocognitive and neurohormonal deficits 下载免费PDF全文
96.
Weidner Kathrin Behnes Michael Schupp Tobias Hoppner Jorge Ansari Uzair Mueller Julian Lindner Simon Borggrefe Martin Kim Seung-hyun Huseyinov Aydin Ellguth Dominik Akin Muharrem Meininghaus Dirk Große Bertsch Thomas Taton Gabriel Bollow Armin Reichelt Thomas Engelke Niko Reiser Linda Akin Ibrahim 《Journal of interventional cardiac electrophysiology》2022,63(1):13-20
Journal of Interventional Cardiac Electrophysiology - The study sought to assess the prognostic impact of chronic kidney disease (CKD) in patients with electrical storm (ES). ES represents a... 相似文献
97.
Anna Lam MD Thomas Küffer MSc Lukas Hunziker MD Nikolas Nozica MD Babken Asatryan MD PhD Florian Franzeck MD Antonio Madaffari MD Andreas Haeberlin MD PhD Aline Mühl MSc Helge Servatius MD Jens Seiler MD Fabian Noti MD Samuel H. Baldinger MD Hildegard Tanner MD Stephan Windecker MD Tobias Reichlin MD Laurent Roten MD 《Journal of cardiovascular electrophysiology》2021,32(6):1610-1619
98.
G M Spencer S M Thorpe I R Sargeant G M Blackman J Solano J S Tobias S G Bown 《Gut》1996,39(5):726-731
BACKGROUND: Palliation of malignant dysphagia is possible by a variety of methods although all have significant drawbacks. Laser therapy is an effective and safe treatment but has to be repeated at four to five weekly intervals to maintain palliation. A means of augmenting the benefits while reducing the need for repeat treatments would be highly beneficial to these patients. AIMS: To prospectively explore the safety and efficacy of intraluminal radiotherapy (brachytherapy) when used to augment laser recanalisation for malignant dysphagia. PATIENTS: Nineteen patients with dysphagia due to advanced adenocarcinoma of the oesophagus or cardia were recruited. METHODS: All patients received laser recanalisation until able to swallow a soft diet or better, before the application of a single dose of brachytherapy (10 Gy at 1 cm from the source). Patients were followed up and treated promptly by further endoscopic means in the event of their dysphagia worsening. RESULTS: Six patients (32%) required no further treatment until death at a median of 10 weeks (range 1-20 weeks). Further therapy was required at a median of 11 weeks (range 4-37 weeks) after brachytherapy for those 13 patients with recurrent dysphagia. Subsequent symptom control required endoscopic intervention at an average of once every nine weeks. There was no mortality associated with laser or brachytherapy. Median survival from initial treatment and including the one survivor was 36 weeks (range 5-132 weeks). CONCLUSIONS: Laser plus brachytherapy offers a safe and effective means of palliating malignant dysphagia due to adenocarcinoma, with a longer dysphagia free interval than historical controls treated with laser alone. 相似文献
99.
Diane Purper-Ouakil Hilario Blasco-Fontecilla Tomas Ros Eric Acquaviva Tobias Banaschewski Sarah Baumeister Elisa Bousquet Aurore Bussalb Marie Delhaye Richard Delorme Renate Drechsler Allison Goujon Alexander Häge Anna Kaiser Louis Mayaud Konstantin Mechler Caroline Menache Olivier Revol Friederike Tagwerker Susanne Walitza Anna Maria Werling Stephanie Bioulac Daniel Brandeis 《Journal of child psychology and psychiatry, and allied disciplines》2022,63(2):187-198
100.
Wienbergen H Schiele R Gitt AK Juenger C Heer T Meisenzahl C Landgraf H Bossaller C Senges J;MITRA PLUS Study Group 《The American journal of cardiology》2002,90(10):1045-1049
We examined the impact of treatment with ramipril versus other angiotensin-converting enzyme (ACE) inhibitors on clinical outcome in unselected patients of the prospective multicenter registry Maximal Individual Therapy of Acute Myocardial Infarction PLUS registry (MITRA PLUS). Of 14,608 consecutive patients with ST-elevation acute myocardial infarction, 4.7% received acute therapy with ramipril, 39.0% received other ACE inhibitor therapy, and 56.3% received no ACE inhibitor therapy. In a multivariate analysis, the treatment with ramipril compared with the treatment without ACE inhibitors was associated with a significantly lower hospital mortality and a lower rate of nonfatal major adverse coronary and cerebrovascular events. Compared with other generic ACE inhibitors, ramipril therapy was independently associated with a significantly lower hospital mortality (odds ratio [OR] 0.54, 95% confidence interval [CI] 0.32 to 0.90) and a lower rate of nonfatal major adverse coronary and cerebrovascular events (OR 0.65, 95% CI 0.46 to 0.93), but not with a lower rate of heart failure at discharge (OR 0.79, 95% CI 0.50 to 1.27). 相似文献