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51.
Athyros VG Elisaf MS Alexandrides T Achimastos A Ganotakis E Bilianou E Karagiannis A Liberopoulos EN Tziomalos K Mikhailidis DP;Assessing the Treatment Effect in Metabolic Syndrome Without Perceptible Diabetes 《Angiology》2012,63(5):358-366
This post hoc analysis of the Assessing The Treatment Effect in Metabolic Syndrome Without Perceptible diabeTes (ATTEMPT) study assesses the 3? year incidence of new-onset diabetes (NOD) and related cardiovascular disease (CVD) events in patients with metabolic syndrome (MetS), after multifactorial (lifestyle and drug, including atorvastatin) intervention. Patients were randomized to group A (low-density lipoprotein cholesterol [LDL-C] target < 100 mg/dL) and group B (< 130 mg/dL). The incidence of NOD during the 42-month follow-up was very low, 0.83 to 1.00/100 patient-years in patients with MetS and MetS with impaired fasting glucose, respectively. Older age, increased waist circumference, and persistent MetS were determinants of NOD. One CVD nonfatal event occurred in the 28 patients with NOD. Our findings suggest that treating the characteristics of MetS is achievable and beneficial. New-onset diabetes incidence and CVD events were negligible and not different from what is expected in the general population. 相似文献
52.
Bielecka-Dabrowa A Mikhailidis DP Jones L Rysz J Aronow WS Banach M 《International journal of cardiology》2012,158(1):12-17
Maintenance of normal potassium (K(+)) homeostasis has become an increasingly important limiting factor in the therapy of heart failure (HF). With the application of loop diuretics and digoxin, hypokalemia has become a frequent and feared side effect of treatment. Low serum K(+) in HF may be also a marker of increased neurohormonal activity and disease progression. To gain the maximum benefit from treatment, we need to individualize drug use and carefully monitor electrolytes. Symptomatic HF patients (New York Heart Association class III-IV) should be prescribed the lowest dose of diuretic necessary to maintain euvolemia. Mild hypokalemia may be corrected by the use of aldosterone receptor antagonists such as spironolactone or eplerenone. However, a more severe hypokalemia should preferably be corrected using K(+) supplement. Serum K levels should be frequently checked and maintained between 4.0 and 5.5 mEq/l (mmol/l). 相似文献
53.
Dimitri D Eymard B 《La Revue de médecine interne / fondée ... par la Société nationale francaise de médecine interne》2012,33(3):134-142
The inflammatory myopathies are an important and treatable group of disorders. The diagnostic criteria and the classifications are complex and subject to debate. Furthermore, there is clinical and histopathological overlap between the features of inflammatory myopathies and those of adult-onset genetic myopathies. In this review, we will discuss the two more common pitfalls in inflammatory myopathies diagnosis: firstly, the misdiagnosis between different types of inflammatory myopathies and uncommon myopathies; secondly, the confusion between inflammatory myopathies and genetic myopathies. Among the group of limb-girdle dystrophies, dysferlinopathies are the more common confounding myopathies. An accurate diagnosis is essential for an optimal management in patients with myopathies. 相似文献
54.
55.
Vasilios G. Athyros Niki Katsiki Konstantinos Tziomalos Thomas D. Gossios Eleni Theocharidou Eygenia Gkaliagkousi Panagiotis Anagnostis Efstathios D. Pagourelias Asterios Karagiannis Dimitri P. Mikhailidis for the GREACE Study Collaborative Group 《Archives of Medical Science》2013,9(3):418-426
Introduction
The effect of cardiovascular disease (CVD) prevention measures aimed at elderly patients requires further evidence. We investigated the effect of statin treatment (targeted to achieve guideline goals) on CVD outcomes in different age groups to determine whether statins are more beneficial in the elderly.Material and methods
The primary endpoint of this post hoc analysis of the GREek Atorvastatin and Coronary-heart-disease Evaluation (GREACE) study (n = 1,600 patients with established coronary heart disease (CHD), mean follow-up 3 years) was the absolute and relative CVD event (a composite of death, myocardial infarction, revascularization, unstable angina, heart failure and stroke) risk reduction in age quartiles (each n = 200). Patients on “structured care” with atorvastatin (n = 800) followed up by the university clinic and treated to lipid goal were compared with the corresponding quartiles on “usual care” (n = 800) followed up by specialists or general practitioners of the patient''s choice outside the hospital.Results
In the elderly (mean age 69 ±4 and 70 ±3 years in the “structured” and “usual care”, respectively) the absolute CVD event reduction between “structured” and “usual care” was 16.5% (p < 0.0001), while in the younger patients (mean age 51 ±3 years and 52 ±3 years in the “structured” and “usual care”, respectively) this was 8.5% (p = 0.016); relative risk reduction (RRR) 60% (p < 0.0001) vs. 42% respectively (p = 0.001). The elderly had higher rates of chronic kidney disease and higher uric acid levels, plus an increased prevalence of diabetes, metabolic syndrome and non-alcoholic fatty liver disease. These factors might contribute to the increased CVD risk in older patients.Conclusions
All age groups benefited from statin treatment, but the elderly on “structured care” had a greater absolute and relative CVD risk reduction than the younger patients when compared with the corresponding patients assigned to “usual care”. These findings suggest that we should not deprive older patients of CVD prevention treatment and lipid target achievement. 相似文献56.
Results of titanium locking plate and stainless steel cerclage wire combination in femoral fractures
Bilal Farouk El-Zayat Steffen Ruchholtz Turgay Efe Jürgen Paletta Dimitri Kreslo Ralph Zettl 《Indian Journal of Orthopaedics》2013,47(5):454-458
Background:
Some in vitro studies warn combining different metals in orthopedic surgery. The aim of this study is to determine the impact of combining titanium and stainless steel on bone healing and the clinical course of patients undergoing internal fixation of femoral fractures.Materials and Methods:
69 patients with femoral fractures had polyaxial locking plate osteosynthesis. The locking plate was made of a titanium alloy. Two different cohorts were defined: (a) sole plating and (b) additional stainless steel cerclage wiring. Postoperative radiographs and clinical followup were performed at 6 weeks, 3 months and 12 months.Results:
Cohorts A and B had 36 and 33 patients, respectively. Patient demographics and comorbidities were similar in both groups. In two cases in cohort A, surgical revision was necessary. No complication could be attributed to the combination of titanium and stainless steel.Conclusion:
The combination of stainless steel cerclage wires and titanium plates does not compromise fracture healing or the postoperative clinical course. 相似文献57.
Anna L. McGuire Wilma M. Hopman Dimitri Petsikas Ken Reid 《Canadian journal of surgery》2013,56(6):E165-E170
Background
Sublobar resection for non–small cell lung cancer (NSCLC) remains controversial owing to concern about local recurrence and long-term survival outcomes. We sought to determine the efficacy of wedge resection as an oncological procedure.Methods
We analyzed the outcomes of all patients with NSCLC undergoing surgical resection at the Cancer Centre of Southeastern Ontario between 1998 and 2009. The standard of care for patients with adequate cardiopulmonary reserve was lobectomy. Wedge resection was performed for patients with inadequate reserve to tolerate lobectomy. Predictors of recurrence and survival were assessed. Appropriate statistical analyses involved the χ2 test, an independent samples t test and Kaplan–Meier estimates of survival. Outcomes were stratified for tumour size and American Joint Committee on Cancer seventh edition TNM stage for non–small cell lung cancer.Results
A total of 423 patients underwent surgical resection during our study period: wedge resection in 71 patients and lobectomy in 352. The mean age of patients was 64 years. Mean follow-up for cancer survivors was 39 months. There was no significant difference between wedge resection and lobectomy for rate of tumour recurrence, mortality or disease-free survival in patients with stage IA tumours less than 2 cm in diameter.Conclusion
Wedge resection with lymph node sampling is an adequate oncological procedure for non–small cell lung cancer in properly selected patients, specifically, those with stage IA tumours less than 2 cm in diameter. 相似文献58.
59.
Alexandra Masson-Lecomte Laurent Guy Philippe Pedron Franck Bruyere Morgan Rouprêt Bonaventure Nsabimbona Mickael Dahan Patrice Hoffman Laurent Salomon Dimitri Vordos Andras Hoznek Philippe Le Corvoisier Pierrick Morel Claude Abbou Alexandre de la Taille 《World journal of urology》2013,31(2):339-343
Purpose
At the time of castration resistance, it is recommended to realize hormonal manipulations before chemotherapy. We evaluated the impact of a switch from GnRH agonist to antagonist in patients with castration-resistant prostate cancer on PSA and testosterone levels at 3 months.Methods
Retrospectively, 17 patients from 5 different centers undergoing androgen deprivation therapy and presenting rising PSA confirmed on 3 blood samples 2 weeks apart and despite a castrate testosterone level (<0.5 ng/ml) were reviewed. Antiandrogen withdrawal syndrome had been tested before the switch. Degarelix was administered as followed: 240 mg for the first injection and then 80 mg every month, subcutaneously. We evaluated the PSA and testosterone level variation 3 months after the switch. Patients who experienced a variation in PSA of less than 10% compared to the baseline or who had a more than 10% PSA decrease were defined as responders.Results
Mean PSA level at the switch was 34.3 ± 50.3 ng/ml, with a mean testosterone level of 0.21 ± 0.13 ng/ml. Three months after the switch, mean PSA level was 59.9 ± 81.6 ng/ml (P = 0.061), with a mean testosterone level of 0.19 ± 0.08 ng/ml (P = 0.086). At 3 months, 4 patients (23%) responded to therapy. Thirteen patients (77%) experienced a rise in PSA of more than 10% compared to baseline; 41% of patients decreased their testosterone level. The limitations of this study are its retrospective nature and the limited number of patients.Conclusion
Switch from an agonist to an antagonist of GnRH has a limited impact on PSA at 3 months in castration-resistant prostate cancer patients. 相似文献60.
Dimitri Dorcaratto Fernando Burdío Dolors Fondevila Anna Andaluz Rita Quesada Ignasi Poves Marta Caceres Xavier Mayol Enrique Berjano Luis Grande 《Surgical endoscopy》2013,27(10):3710-3719