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71.
72.
Background
In order to create a well-functioning total hip arthroplasty (THA), it is important to restore femoral off-set and thus the abductor lever arm. The aim of this study was to investigate the clinical effect of increasing the abductor lever arm to and beyond the anatomical native lever arm in minimally invasive total hip arthroplasty performed through a direct anterior approach.Materials and methods
We compared the lever arm of the operated hip to the lever arm of the contralateral native hip on radiographs in 148 patients following THA. The patients were divided in two groups based on whether they kept their anatomical lever arm or had an increased lever arm. The clinical outcome was assessed using hip osteoarthritis outcome score (HOOS), Harris hip score and UCLA activity score.Results
Patients who kept their anatomical lever arm did not experience a significantly better clinical outcome than the patients with an increased abductor lever arm. We found no significant difference in clinical scores at any of the follow-ups during the first year after THA.Conclusion
The results of this study suggest that an increase in the abductor lever arm does not have major effects on the clinical outcome after THA. To avoid the potential negative effects of decreasing the lever arm, the surgeon should aim for an equal or slightly increased lever arm.Level of evidence Level 3, prospective cohort study. 相似文献73.
Aurigemma GP Devereux RB Wachtell K Palmieri V Boman K Gerdts E Nieminen MS Papademetriou V Dahlöf B 《American journal of hypertension》2003,16(3):180-186
BACKGROUND: Whether to include only those patients who have not had prior hypertension treatment in clinical trials of left ventricular (LV) mass reduction is controversial. Accordingly, our aim was to study the relationship between prior treatment and both baseline and 1-year echocardiographic LV mass in subjects enrolled in the Losartan Intervention For Endpoint reduction (LIFE) study. METHODS: We studied clinical and baseline echocardiographic data on 960 patients with electrocardiographically confirmed left ventricular hypertrophy enrolled in the electrocardiographic substudy of the LIFE study, 847 of whom had LV mass remeasured after 1 year of blinded treatment. The majority (75%) of these patients had prior medical treatment for hypertension. RESULTS: In multivariable regression analysis, controlling for age, sex, blood pressure (BP), body mass index, and indices of pump and myocardial function, prior antihypertensive treatment was not associated with either greater LV mass or relative wall thickness on the baseline study. Moreover, there was no significant difference between the 637 subjects who were previously treated and the 210 who were not treated with regard to the mean reduction in systolic or diastolic pressures (-25 +/- 17 v -24 +/- -16 and -13 +/- 9 mm Hg v -12 +/- 9 mm Hg), LV mass (-27 +/- 38 v -29 +/- 34 g), or LV mass/body surface area (-14 +/- 20 v -15 +/- 18 g/m(2)), all P >.05. CONCLUSIONS: Prior treatment is not associated with either greater LV mass or greater relative wall thickness when age, body mass index, sex, systolic BP, heart rate, or indices of LV volume load and systolic function are taken into account. In addition, prior treatment is not associated with lesser degrees of LV mass reduction. For design of future clinical trials, restriction of inclusion criteria to only previously untreated patients does not appear to be necessary when the selection criterion is electrocardiographically determined left ventricular hypertrophy. 相似文献
74.
Oriana Yu Laurent Azoulay Hui Yin Kristian B. Filion Samy Suissa 《The American journal of medicine》2018,131(3):317.e11-317.e22
Purpose
The magnitude of the risk of severe hypoglycemia associated with sulfonylureas as the initial treatment for type 2 diabetes in the real-world setting is unknown. We assessed the risk of severe hypoglycemia associated with initiating monotherapy with sulfonylurea compared with metformin for the treatment of type 2 diabetes.Methods
By using the UK Clinical Practice Research Datalink and Hospital Episode Statistics linked to the Office for National Statistics, we identified a cohort of patients with type 2 diabetes who initiated sulfonylureas or metformin monotherapy between April 1, 1998, and December 31, 2012, with follow-up until December 31, 2013. Sulfonylurea users were matched one-to-one to metformin users by high-dimensional propensity scores. Hazard ratios (HRs) and 95% confidence intervals (CIs) of severe hypoglycemia, defined as requiring hospitalization, were estimated using Cox proportional hazards models comparing sulfonylureas with metformin monotherapy.Results
The study cohort consisted of 14,012 initiators of sulfonylureas matched to 14,012 initiators of metformin. The mean treated follow-up time was 1.41 (standard deviation, 1.84) years. Use of sulfonylurea was associated with an elevated incidence of severe hypoglycemia compared with metformin as the initiating monotherapy for type 2 diabetes (incidence rate, 2.4/1000 person-years; 95% CI, 1.90-2.90; HR, 4.53; 95% CI, 2.76-7.45).Conclusions
Sulfonylureas, when prescribed as the initiating monotherapy for the treatment of type 2 diabetes, is associated with a 4.5-fold increase in the risk of severe hypoglycemia. Given the negative consequences of this outcome, clinicians should consider alternative hypoglycemic agents when metformin is not tolerated or contraindicated. 相似文献75.
Nørgaard BL Terkelsen CJ Riiskjaer M Holmvang L Grip L Heickendorff L Thygesen K 《Acute cardiac care》2008,10(3):159-166
There is limited information about the in-hospital plasma profile of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with non-ST-elevation acute coronary syndrome (NSTACS) and furthermore, the prognostic influence of the timing of NT-proBNP measurements in NSTACS is unsettled. These subject matters are elucidated in this study composed of 455 patients with NSTACS (symptoms <24 h). NT-proBNP was measured at 0, 6, 12, 24, 36, 48, 72 and 96 h following admission. Any death was registered at follow-up (median: 2.3 years). The study demonstrated a monophasic profile of the plasma NT-proBNP values, reaching a maximum at 6 hours, and it showed an independent prognostic significance of NT-proBNP irrespective of the sampling time. Risk prediction by NT-proBNP was improved by combining the baseline measurement and one value taken between 24 and 96 h (at 48 h, P<0.001). No additional prognostic information was provided by including more than one late in-hospital NT-proBNP value. Conclusions: The in-hospital NT-proBNP measurements exhibit a monophasic profile in patients with NSTACS and these values provide independent prognostic information as regards mortality irrespective of the sampling time. Moreover, risk prediction of NT-proBNP is strengthened by combining the admission measurement with an additional value during the hospitalization. 相似文献
76.
77.
Christian P Vink Charlotte W Ockeloen Sietske ten Kate David A Koolen Johannes Kristian Ploos van Amstel Anne-Marie Kuijpers-Jagtman Celeste C van Heumen Tjitske Kleefstra Carine E L Carels 《European journal of human genetics : EJHG》2014,22(9):1063-1070
This article describes the inter- and intra-familial phenotypic variability in four families with WNT10A mutations. Clinical characteristics of the patients range from mild to severe isolated tooth agenesis, over mild symptoms of ectodermal dysplasia, to more severe syndromic forms like odonto-onycho-dermal dysplasia (OODD) and Schöpf–Schulz–Passarge syndrome (SSPS). Recurrent WNT10A mutations were identified in all affected family members and the associated symptoms are presented with emphasis on the dentofacial phenotypes obtained with inter alia three-dimensional facial stereophotogrammetry. A comprehensive overview of the literature regarding WNT10A mutations, associated conditions and developmental defects is presented. We conclude that OODD and SSPS should be considered as variable expressions of the same WNT10A genotype. In all affected individuals, a dished-in facial appearance was observed which might be helpful in the clinical setting as a clue to the underlying genetic etiology. 相似文献
78.
Carolina Noble Annelies Cannaert Kristian Linnet Christophe P. Stove 《Drug testing and analysis》2019,11(3):501-511
Synthetic cannabinoids (SCs) are the most chemically diverse group of new psychoactive substances. This group has been associated with several intoxications, many with fatal outcomes. Although advancements have been achieved in pharmacology, metabolism, and detection of these compounds in recent years, these aspects are still unresolved for many SCs. The aim of this study was to investigate the in vitro potency of 14 indole‐ and indazole‐based SCs by applying a stable CB1 or CB2 receptor activation assay and correlating the activity with their structure. The half‐maximal effective concentration (EC50) of 5‐chloropentyl, 5‐bromopentyl, and 5‐iodopentyl JWH‐122 analogs varied from 74.1 to 283.7 nM for CB1 and 7.05 to 23.4 nM for CB2, where the addition of a chlorine atom enhanced the potency at CB1 compared with the bromo and iodo analogs. AM‐2201 was the most active at CB1 within this naphthoylindole family, with an EC50 of 23.5 nM but with the lowest efficacy (Emax 98.8%). Within the indole‐3‐carboxamide derivatives, 5F‐MDMB‐PICA was the most active compound, with a CB1/CB2 EC50 of 3.26/0.87 nM and an Emax around three times higher than JWH‐018. ADB‐FUBINACA was the most potent tested SC overall, with a CB1/CB2 EC50 of 0.69/0.59 nM, and an Emax around 3‐fold higher than that for JWH‐018 at CB1. The data obtained in this study confirm how small differences in the structure of SCs might lead to large differences in their activity, especially at CB1, which may be correlated with differences in their toxic effects in humans. 相似文献
79.
Kyoko Kawasaki Julia Freimuth Dominique S. Meyer Marie M. Lee Akiko Tochimoto-Okamoto Michael Benzinou Frederic F. Clermont Gloria Wu Ritu Roy Tom G. W. Letteboer Johannes Kristian Ploos van Amstel Sophie Giraud Sophie Dupuis-Girod Gaeten Lesca Cornelius J. J. Westermann Robert J. Coffey Jr. Rosemary J. Akhurst 《Proceedings of the National Academy of Sciences of the United States of America》2014,111(21):7723-7728
80.
Marion Munch MD Laurent Meyer MD Thierry Hannedouche MD Kristian Kunz MD Farideh Alenabi MD Patrice Winiszewski MD Philippe Baltzinger MD Agnès Smagala MD Alexandre Klein MD François Dorey MD Dominique Fleury MD Odile Verier-Mine MD Bruno Guerci MD Joëlle Cridlig MD Sophie Borot MD Didier Ducloux MD Nicolas Meyer MD Samy Hadjadj MD François Chantrel MD Laurence Kessler MD 《Diabetes, obesity & metabolism》2020,22(6):978-987