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41.
Longitudinal Association Between Physical Activity and Frailty Among Community-Dwelling Older Adults
Xuxi Zhang MPH Siok Swan Tan PhD Carmen Betsy Franse PhD Lovorka Bilajac PhD Tamara Alhambra-Borrás PhD Jorge Garcés-Ferrer PhD Arpana Verma MD PhD Greg Williams MSc Gary Clough PGCert Elin Koppelaar PhD Tasos Rentoumis MSc Rob van Staveren MSc Antonius J. J. Voorham PhD Francesco Mattace-Raso MD PhD Amy van Grieken PhD Hein Raat MD PhD 《Journal of the American Geriatrics Society》2020,68(7):1484-1493
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EG Burden RW Walker DJ Ferguson AMF Goubran JR Howell JB John F Khan JS McGrath JP Evans 《Annals of the Royal College of Surgeons of England》2021,103(3):173
IntroductionWith the emergence of the COVID-19 pandemic, all elective surgery was temporarily suspended in the UK, allowing for diversion of resource to manage the anticipated surge of critically unwell patients. Continuing to deliver time-critical surgical care is important to avoid excess morbidity and mortality from pathologies unrelated to COVID-19. We describe the implementation and short-term surgical outcomes from a system to deliver time-critical elective surgical care to patients during the COVID-19 pandemic.Materials and methodsA protocol for the prioritisation and safe delivery of time-critical surgery at a COVID-19 ‘clean’ site was implemented at the Nuffield Health Exeter Hospital, an independent sector hospital in the southwest of England. Outcomes to 30 days postoperatively were recorded, including unplanned admissions after daycase surgery, readmissions and complications, as well as the incidence of perioperative COVID-19 infection in patients and staff.ResultsA total of 128 surgical procedures were performed during a 31-day period by a range of specialties including breast, plastics, urology, gynaecology, vascular and cardiology. There was one unplanned admission and and two readmissions. Six complications were identified, and all were Clavien-Dindo grade 1 or 2. All 128 patients had preoperative COVID-19 swabs, one of which was positive and the patient had their surgery delayed. Ten patients were tested for COVID-19 postoperatively, with none testing positive.ConclusionThis study has demonstrated the implementation of a safe system for delivery of time-critical elective surgical care at a COVID-19 clean site. Other healthcare providers may benefit from implementation of similar methodology as hospitals plan to restart elective surgery. 相似文献
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We have evaluated the blood-brain barrier (BBB) in 8 Parkinsonian patients before and after stereotactic implantation of foetal mesencephalon (STIM) and one patient with an adrenal medullary implant. Parenteral administration of dopamine did not reverse Parkinsonism pre-operatively or at 5 days, 1, 2, 3, 4 months and 1 year post-operatively. Apomorphine and domperidone reversed Parkinsonism and produced dyskinesia in all patients pre- and post-operatively. We conclude that the BBB remains intact to dopamine following implantation. 相似文献
46.
Hu CK McCall S Madden J Huang H Clough R Jirtle RL Anscher MS 《Prostate cancer and prostatic diseases》2006,9(1):62-67
BACKGROUND: The genetic events leading to initiation and/or progression of prostate cancer are not well characterized. The gene coding for the mannose 6-phosphate/insulin-like growth factor 2 receptor (M6P/IGF2R) has recently been identified as a tumor suppressor in several types of cancer. The purpose of the present study is to determine whether the M6P/IGF2R gene is inactivated in human prostate cancer, and if so, whether this is an early or late transformational event. METHODS: In total, 43 patients with prostate cancer treated by radical prostatectomy, with archival material available for analysis, were assessed for loss of heterozygosity (LOH) in the M6P/IGF2R gene using six different gene-specific nucleotide polymorphisms. Regions of tumor, normal prostate and premalignant high-grade prostate intraepithelial neoplasia (PIN) were identified and cells were excised by laser capture microdissection (LCM). DNA segments were amplified using polymerase chain reaction (PCR). RESULTS: The M6P/IGF2R gene was polymorphic in 83.7% (36/43) of patients, and 41.7% (15/36) of these informative patients had LOH in the tumor tissue. In 11/15 patients with LOH in malignant tissue, high-grade PIN could be identified, and 63.6% (7/11) also had LOH in this premalignant tissue. CONCLUSIONS: This study is the first to find that the M6P/IGF2R gene is inactivated in prostate cancer. LOH in premalignant tissue as well suggests that mutation in the M6P/IGF2R gene is an early event in the development of prostate cancer, supporting the conclusion that it functions as a tumor suppressor gene in this disease. 相似文献
47.
Leah C. Stevenson India Bohanna Jan A. Robertson Alan R. Clough 《Drug and alcohol review》2013,32(6):627-630
48.
Y-H Cha H Lee LS Santell & RW Baloh 《Cephalalgia : an international journal of headache》2009,29(5):550-555
The aim of this study was to determine the association of benign recurrent vertigo (BRV) and migraine, using standardized questionnaire-based interview of 208 patients with BRV recruited through a University Neurotology clinic. Of 208 patients with BRV, 180 (87%) met the International Classification of Headache Disorders 2004 criteria for migraine: 112 migraine with aura (62%) and 68 without aura (38%). Twenty-eight (13%) did not meet criteria for migraine. Among patients with migraine, 70% experienced headache, one or more auras, photophobia, or auditory symptoms with some or all of their vertigo attacks, meeting the criteria for definite migrainous vertigo. Thirty per cent never experienced migraine symptoms concurrent with vertigo attacks. These met criteria for probable migrainous vertigo. Among patients without migraine, 21% experienced either photophobia or auditory symptoms with some or all of their vertigo attacks; 79% experienced only isolated vertigo. The age of onset and duration of vertigo attacks did not differ significantly between patients with (34 ± 1.2 years) and patients without migraine (31 ± 3.0 years). In patients with migraine, the age of onset of migraine headache preceded the onset of vertigo attacks by an average of 14 years and aura preceded vertigo by 8 years. The most frequent duration of vertigo attacks was between 1 h and 1 day. Benign recurrent vertigo is highly associated with migraine, but a high proportion of patients with BRV and migraine never have migraine symptoms during their vertigo attacks. Other features such as age of onset and duration of vertigo are similar between patients with or without migraine. 相似文献
49.
Gopal Varma Rachel E. Clough Peter Acher Julien Sénégas Hannes Dahnke Stephen F. Keevil Tobias Schaeffter 《Magnetic resonance in medicine》2011,65(5):1483-1490
In magnetic resonance imaging, implantable devices are usually visualized with a negative contrast. Recently, positive contrast techniques have been proposed, such as susceptibility gradient mapping (SGM). However, SGM reduces the spatial resolution making positive visualization of small structures difficult. Here, a development of SGM using the original resolution (SUMO) is presented. For this, a filter is applied in k‐space and the signal amplitude is analyzed in the image domain to determine quantitatively the susceptibility gradient for each pixel. It is shown in simulations and experiments that SUMO results in a better visualization of small structures in comparison to SGM. SUMO is applied to patient datasets for visualization of stent and prostate brachytherapy seeds. In addition, SUMO also provides quantitative information about the number of prostate brachytherapy seeds. The method might be extended to application for visualization of other interventional devices, and, like SGM, it might also be used to visualize magnetically labelled cells. Magn Reson Med, 2011. © 2010 Wiley‐Liss, Inc. 相似文献
50.
M. Turzyniecka S. H. Wild A. J. Krentz A. J. Chipperfield J. Gamble G. F. Clough C. D. Byrne 《Diabetic medicine》2009,26(11):1112-1119
Aims Poor glycaemic control is associated with increased risk of microvascular disease in various organs including the eye and kidney, but the relationship between glycated haemoglobin (HbA1c) and microvascular function in skeletal muscle has not been described. We tested the association between HbA1c and a measure of microvascular exchange capacity (Kf) in skeletal muscle in people with central obesity at risk of developing Type 2 diabetes. Methods Microvascular function was measured in 28 women and 19 men [mean (± sd ) age 51 ± 9 years] with central obesity who did not have diabetes. We estimated insulin sensitivity by hyperinsulinaemic–euglycaemic clamp, visceral and total fatness by magnetic resonance imaging, fitness (VO2 max by treadmill testing), physical activity energy expenditure [metabolic equivalents of tasks (METS) by use of the SenseWear Pro armband] and skeletal muscle microvascular exchange capacity (Kf) by venous occlusion plethysmography. Results In regression modelling, age, sex and fasting plasma glucose accounted for 30.5% of the variance in HbA1c (r2 = 0.31, P = 0.001). Adding Kf to this model explained an additional 26.5% of the variance in HbA1c (r2 = 0.57, P = 0.0001 and Kf was strongly and independently associated with HbA1c (standardized B coefficient ?0.45 (95% confidence interval ?0.19, ?0.06), P = 0.001). Conclusions We found a strong negative independent association between a measure of skeletal muscle microvascular exchange capacity (Kf) and HbA1c. Kf was associated with almost as much of the variance in HbA1c as fasting plasma glucose. 相似文献