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61.
Artur Vetkas Tanel Lepik Tõnis Eilat Tõnu Rätsep Toomas Asser 《Acta neurochirurgica》2013,155(6):1107-1114
Background
Emotional disorders and decrease in health-related quality of life (HRQoL) are well-documented sequelae of aneurysmal subarachnoid hemorrhage (SAH). The aim of this study was to analyze the impact of emotional disorders on HRQoL in survivors of SAH.Methods
This was a retrospective study enrolling 114 SAH-survivors at 1–10 years (mean 4,5 years) after the disease. Emotional State Questionnaire (EST-Q) was used to measure emotional health and the Short Form Health Survey (SF-36) was used to assess HRQoL of the patients.Results
Most of the patients reported good recovery, but EST-Q results revealed high prevalence of emotional disorders after SAH. Almost half of the patients had higher than cut-off values indicating fatigue (47 %) and insomnia (46 %). About one third of SAH-patients had higher than cut-off scores demonstrating depression (30 %) and anxiety (31 %). The patients scored significantly lower in all scales of SF-36 as compared to age-matched general population. All EST-Q subscale results were significantly and negatively correlated with SF-36 scores. Fatigue was independently related to all SF-36 subscales and depression to most of the mental health component scores. Emotional symptoms alone were demonstrated to explain 23–47 % of the SF-36 subscale values, and more than half of the variance of mental health component score values were found to be explained by emotional disorders (53 %).Conclusions
Emotional disorders are frequent after SAH and significantly associated with impairment of HRQOL. Proper and timely screening tests are important to reveal development of emotional problems and improve QoL for the SAH-patients. 相似文献62.
Leslie KnodEileen C. Donovan BS Artur ChernoguzKelly M. Crawford BS Mary R. DusingJason S. Frischer MD 《The Journal of surgical research》2013
Background
In the setting of inflammatory bowel disease, inflammation is associated with a simultaneous increase in angiogenesis; moreover, elevated vascular endothelial growth factor (VEGF) levels implicate angiogenesis as a pathologic contributor to disease severity. We hypothesize that selectively inhibiting vascular endothelial growth factor receptor-2 (VEGFR2) in a model of murine colitis will reduce angiogenesis, resulting in decreased inflammation and disease severity, providing mechanistic insight into the role of pathologic angiogenesis in IBD.Materials and methods
In a dextran sodium sulfate model of murine colitis, anti-VEGFR2 monoclonal antibody (DC101) or placebo was administered. Clinical assessments followed by histologic and molecular tissue analysis were performed to quantify inflammation, microvessel density (MVD), VEGF and VEGFR2 gene expression, and phosphorylated mitogen-activated protein kinase protein expression.Results
Weight loss began after d 6 with the treatment group demonstrating a more favorable percent weight change. Inflammation and MVD were similar between cohorts, both increasing in parallel toward a plateau. VEGF and VEGFR2 messenger RNA expression were not significantly different, but phosphorylated mitogen-activated protein kinase was elevated in the DC101 cohort (P = 0.03).Conclusions
Despite a more favorable weight change profile in the treated group, no difference was observed between cohorts regarding clinical disease severity. However, a parallel rise in inflammation and MVD was observed coinciding with weight loss, suggesting their relationship in IBD. VEGFR2 downstream signaling was significantly elevated in the treated cohort, possibly by VEGF-independent signal transduction. Early and effective inhibition of angiogenesis by limiting downstream VEGF signaling or targeting multiple angiogenic pathways may block angiogenesis, thereby reducing disease severity and provide evidence toward the mechanism and clinical benefit of antiangiogenics in the setting of IBD. 相似文献63.
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All deleterious changes in platelet morphology, structure and function that occur in platelet concentrates (PC) during storage are titled as the 'platelet storage lesion'. No single in?vitro test currently available is sufficient in assessing these changes of platelet quality. The release of soluble CD40 Ligand (sCD40L), the formation of thromboxane (TXB2) and the thrombopoietin (TPO) clearance reflect different aspects of platelet metabolism and activitiy, and were used to examine platelet quality in apheresis platelet products. At days 1, 3 and 5, in single-donor apheresis platelet products (n?=?10) under routine storage conditions, sCD40L (measured by ELISA) and TXB2 (measured by RIA) were determined after platelet stimulation (recalcification and clot formation). TPO (measured by ELISA) was determined after an incubation time of 5?h at 37°C with platelet-rich plasma (adjusted initial TPO concentration of about 500?pg/mL). Results were related to a therapeutic unit (TU?=?2?×?10(11)?platelets). Immediately after platelet preparation, sCD40L release was 41?±?7.6?ng/TU, TXB2 formation 1688?±?374?ng/TU and TPO clearance 1.22?±?0.32?ng/h/TU. At days 1, 3 and 5, sCD40L was reduced to 89?±?7%, 71?±?12% and 57?±?9%, TXB2 release to 91?±?6%, 74?±?12% and 58?±?9% and TPO clearance to 90?±?15%, 84?±?5% and 79?±?10% of the respective control values. In conclusion, in single-donor apheresis PC, sCD40L release and TXB2 formation as well as TPO clearance by the platelets were dependent on storage duration and reduced to about 60% to 80% of the respective control values after a storage period for 5 days. These findings are in line with literature data, indicating that a loss of platelet functionality of about 30% will occur after 5 days of storage. 相似文献
66.
Mandl P Naredo E Conaghan PG D'Agostino MA Wakefield RJ Bachta A Backhaus M Hammer HB Bruyn GA Damjanov N Filippucci E Grassi W Iagnocco A Jousse-Joulin S Kane D Koski JM Möller I De Miguel E Schmidt WA Swen WA Szkudlarek M Terslev L Ziswiler HR Ostergaard M Balint PV 《Rheumatology (Oxford, England)》2012,51(1):184-190
67.
Rita Nely Vilar Furtado Daniele Freitas Pereira Karine Rodrigues da Luz Marla Francisca dos Santos Monique Sayuri Konai Sonia de Aguiar Vilela Mitraud Andre Rosenfeld Artur da Rocha Correa Fernandes Jamil Natour 《REV BRAS REUMATOL》2013,53(6):476-482
ObjectiveCompare the effectiveness of ultrasound and fluoroscopy to guide intra-articular injections (IAI) in selected cases.Material and methodsA prospective study in our outpatient clinics at the Rheumatology Division at Universidade Federal de São Paulo (UNIFESP), Brazil, was conducted to compare the short-term (4 weeks) effectiveness of ultrasound and fluoroscopy-guided IAI in patients with rheumatic diseases. Inclusion criteria were: adults with refractory synovitis undergo- ing IAI with glucocorticoid. All patients had IAI performed with triamcinolone hexaceton- ide (20 mg/ml) with varying doses according to the joint injected.ResultsA total of 71 rheumatic patients were evaluated (52 women, 44 whites). Mean age was 51.9 ± 13 years and 47 of them (66.2%) were on regular DMARD use. Analysis of the whole sample (71 patients) and hip sub-analysis (23 patients) showed that significant im- provement was observed for both groups in terms of pain (P < 0.001). Global analysis also demonstrated better outcomes for patients in the FCG in terms of joint flexion (P < 0.001) and percentage change in joint flexion as compared to the USG. Likert scale score analyses demonstrated better results for the patients in the USG as compared to the FCG at the end of the study (P < 0.05). No statistically significant difference between groups was observed for any other study variable.Discussion and conclusionImaging-guided IAI improves regional pain in patients with vari- ous types of synovitis in the short term. For the vast majority of variables, no significant difference in terms of effectiveness was observed between fluoroscopy and ultrasound- guided IAI. 相似文献
68.
Artur Dziadkiewicz Monika Białecka Piotr Janik Jarosław Sławek 《Neurologia i neurochirurgia polska》2013,47(4):387-392
Hemiparkinsonism-hemiatrophy (HPHA) is a rare neurological syndrome. The main clinical features of HPHA consist of atrophy of one side of the body (face, trunk, limbs), ipsilateral hemiparkinsonism (bradykinesia, rigidity, tremor) and in many cases dystonia. There are no data on prevalence of HPHA as the condition is rare. The mean age of parkinsonism onset is earlier than in idiopathic Parkinson disease (43.7 years, range: 15–63). Changes in magnetic resonance imaging (MRI) (cortical, basal ganglia atrophy contralaterally to the side of clinical presentation) are described in 30% of patients. The pathogenesis of HPHA is unknown, but in many cases a history of prenatal injuries was reported.We present two male patients with HPHA – 45 and 55 years old, with left-sided parkinsonism, dystonia and hemiatrophy (to our knowledge, the first Polish cases). Both patients had no atrophic changes in MRI and levodopa treatment was ineffective. In the discussion the authors review current literature on HPHA. 相似文献
69.
The effect of brain death protocol duration on potential donor losses due to cardiac arrest
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