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61.
Brown AS Calachanis M Evdoridis C Hancock J Wild S Prasan A Nihoyannopoulos P Monaghan MJ 《Irish journal of medical science》2004,173(1):13-17
Background Stress echocardiography is useful for assessing patients with coronary artery disease unable to undergo formal exercise testing.
Considerable skill is required to avoid large intra- and inter-observer variability due to poor endocardial definition. Intravenous
ultrasound contrast agents are now available which may improve this variability.
Aim To study intravenous Sonovue in assessing wall motion score and ejection fraction (EF) during stress echocardiography.
Methods Thirty-eight patients undergoing arbutamine stress echocardiography for known or suspected coronary artery disease were studied.
Echocardiographic analysis of wall motion score index, endocardial border detection (EBD) and EF was performed at rest and
at peak stress before and after intravenous injection of Sonovue, by experienced and inexperienced observers.
Results All three observers noted an improvement in endocardial border definition following Sonovue (p=<0.001). At baseline, there
was a significant difference in wall motion score index between experienced and inexperienced observers at rest (p=0.01) and
at peak stress (p=0.001). Following Sonovue administration this was no longer significant (p=0.07, p=0.114). Intra-observer
variability of end diastolic, end systolic volumes (ESV) and EF improved following contrast (p<0.05) at rest and during stress.
Conclusion Sonovue significantly improved EBD and reduced intra-observer variability of EF at rest and during peak arbutamine infusion. 相似文献
62.
There have been significant changes in the doctor patient relationship with the impact of technology in day-to-day practice. More and more patients are aware of their rights and are keen to make free choice and decision on their treatment. This helps them to choose the treatment of their choice from the options available and to select a physician of their choice. Doctor's decisions are being questioned regarding their correctness and there is a need to educate the patient, on what one offers by way of treatment. In some procedures and types of treatment, patient needs to be educated and informed of the merits and demerits of the treatment available. This will help the patient to make appropriate choice and also to accept some adverse outcome of treatment. Towards this end, all countries are looking afresh at the necessity of Informed Consent. Methods adopted by some countries are highlighted to help our physicians practice them in an appropriate way. A lot of remedial work needs to be done to minimize future litigation, as many doctors misunderstand their legal obligations and haven't caught up with the change in judge's thinking. 相似文献
63.
The significance of a subcentimetre 18F-FDG PET/CT pulmonary abnormality in a patient with known extrapulmonary primary malignancy can have a major impact on the clinical management of the patient. The clinician’s reliance on the semi-quantitative and qualitative PET/CT analysis of the abnormality has, at times, led to untoward diagnostic problems, given the limited spatial resolution of PET for a small volume lesion performed as part of the standard PET/CT study. This paper highlights a case each of an FDG-positive and an FDG-negative focal pulmonary abnormality in a combined PET/CT study of patients with known extrapulmonary malignancy. © 2010 Biomedical Imaging and Intervention Journal. All rights reserved. 相似文献
64.
DJ Crofts VJ-M Michel AS Rigby MS Tanner DMB Hall JR Bonham 《Acta paediatrica (Oslo, Norway : 1992)》1999,88(9):969-974
Jaundice persisting beyond the first 2 wk of life is often regarded as an indication for investigation to exclude cholestatic liver disease. Most babies with prolonged jaundice have breast milk-related jaundice, which is a benign condition. Cholestatic liver disease is usually accompanied by pale stools and yellow or orange urine. A community programme was established to ascertain the incidence of prolonged jaundice and determine whether abnormal stool and urine colour could be used to assist primary care staff in referral decisions. Data were collected on normal stool and urine colour and used to devise a colour chart and information sheet for parents. Babies with prolonged jaundice were identified and referred for investigation. In all, 3661 babies were recruited into the study, of which 127 were jaundiced at 28 d of age. Of these, 125 were breastfed. The incidence of jaundice in breastfed babies at 28 d was 9.2% (95% CI 7.8%-11.0%) Abnormal liver function tests (LFTs) were common, but no baby had abnormal stool or urine colour and none was found to have liver disease. Jaundiced breastfed babies who are well are unlikely to have serious disease. Elevated LFTs are compatible with a diagnosis of breast milk-related jaundice. Prolonged jaundice in bottle-fed babies, and persistent pallor of stools or yellow/orange urine, are rare and merit immediate referral. Parents and professionals can be advised to report pale stools without generating a large number of unnecessary referrals. Further work is needed to determine whether a colour chart reduces the mean age of referral and treatment of infants with cholestatic liver disease. 相似文献
65.
AS Winkler B Stelzhammer K Kerschbaumsteiner M Meindl W Dent J Kaaya W Matuja & E Schmutzhard 《Cephalalgia : an international journal of headache》2009,29(12):1317-1325
The aim of the study was to assess the prevalence of headache with special attention to tension-type headache (TTH) in a rural area in northern Tanzania. A door-to-door study was performed using a standardized and validated questionnaire. A total of 7412 participants were screened. The total headache prevalence during the past year was 12.1%; the overall 1-year prevalence of TTH was 7%; 5% reported episodic TTH and 0.4% chronic TTH. Borderline cases (International Headache Society code 2.3) were described in 1.6%. The prevalence of headache was highest in the 41–50-year-old group in women and in the 61+ age group in men. This is the first account of the prevalence of TTH in a rural Tanzanian population, and shows that headache in general and, more specifically, TTH are prevalent disorders that deserve attention. However, the prevalence of primary headache seems to be lower than in Western countries. 相似文献
66.
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68.
Erosions of the ossicular chain that occurred as a complication of noncholesteatomatous chronic otitis media were studied with computed tomography (CT) in 55 patients. The incus (particularly the long and lenticular processes) was the ossicle most commonly involved (50 cases). Coronal and axial CT sections were complementary in the diagnosis of these erosions. Fibrous replacement of the incudostapedial articulation was diagnosed in four cases on axial CT scans when an unusually wide joint was present. 相似文献
69.
Alexandra Sverac Cauquil Stphanie Delaux Renaud Lestringant Margot J. Taylor Yves Trotter 《Neuropsychologia》2009,47(12):2677-2681
Chromostereopsis is an illusion of depth arising from colour contrast: ocular chromatic aberrations usually make red appear closer to the viewer than blue. Whereas this phenomenon is widely documented from the optical and psychophysical point of view, its neural correlates have not been investigated. To determine the cortical processing of this colour-based depth effect, visual evoked potentials (VEPs) to contrasts of colour were recorded in 25 subjects. Chromostereopsis was found with the stimuli combining spectra extremes. VEP amplitude but not latency effects were observed to colour depth cues, suggesting an underlying, depth-specific slow negative wave, located using source modelling first in occipito-parietal, parietal, then temporal areas. The component was larger over the right hemisphere consistent with RH dominance in depth processing, likely due to context-dependent top-down modulation. These results demonstrate that the depth illusion obtained from contrast of colour implicates similar cortical areas as classic binocular depth perception. 相似文献
70.
Congenital abnormalities of the aortic arch: MR imaging 总被引:1,自引:0,他引:1
Thirty-four patients, 1 month to 63 years old, with known or suspected congenital abnormalities of the aortic arch underwent magnetic resonance (MR) imaging. Sixteen patients were studied retrospectively, 18 prospectively. In all retrospective studies, the aortic arch abnormality was seen with MR imaging. In the prospective studies, MR imaging enabled diagnosis in 15 of 18 (83%) patients. Twenty-nine of 34 patients underwent two-dimensional echocardiography; nine were studied retrospectively, 20 prospectively. In the prospective studies, echocardiography enabled diagnosis in 13 of 20 (65%) patients. Although two-dimensional echocardiography has a high sensitivity in the detection of aortic arch abnormalities in the neonate, arch abnormalities in the neonate, its sensitivity is lower in older children, adults, and postoperative patients. The authors' experience shows that MR imaging is an important, noninvasive modality in the evaluation of older children, adults, and postoperative patients with congenital aortic arch abnormalities. 相似文献