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991.
Adriana DM Villa Eva Sammut Arjun Nair Ronak Rajani Rodolfo Bonamini Amedeo Chiribiri 《World journal of radiology》2016,8(6):537-555
The aim of this review is to give a comprehensive and concise overview of coronary embryology and normal coronary anatomy, describe common variants of normal and summarize typical patterns of anomalous coronary artery anatomy. Extensive iconography supports the text, with particular attention to images obtained in vivo using non-invasive imaging. We have divided this article into three groups, according to their frequency in the general population: Normal, normal variant and anomaly. Although congenital coronary artery anomalies are relatively uncommon, they are the second most common cause of sudden cardiac death among young athletes and therefore warrant detailed review. Based on the functional relevance of each abnormality, coronary artery anomalies can be classified as anomalies with obligatory ischemia, without ischemia or with exceptional ischemia. The clinical symptoms may include chest pain, dyspnea, palpitations, syncope, cardiomyopathy, arrhythmia, myocardial infarction and sudden cardiac death. Moreover, it is important to also identify variants and anomalies without clinical relevance in their own right as complications during surgery or angioplasty can occur. 相似文献
992.
Sahajal Dhooria MD DM Karan Madan MD DM Vallandramam Pattabhiraman MD Inderpaul Singh Sehgal MD DM Ravindra Mehta MD Gella Vishwanath MD DM Arjun Srinivasan MD DM Mahadevan Sivaramakrishnan MD Anant Mohan MD Joseph L. Mathew MD Sushil K. Kabra MD Randeep Guleria MD DM Digambar Behera MD Ritesh Agarwal MD DM 《Pediatric pulmonology》2016,51(10):1031-1039
993.
994.
Everard ML 《Current allergy and asthma reports》2006,6(2):97-102
The majority of infants admitted to hospital in infancy with lower respiratory tract infections (LRTIs) have been infected
with the respiratory syncytial virus (RSV). Infants and young children experiencing RSV LRTIs experience increased respiratory
morbidity in subsequent years, although the prevalence falls rapidly in early childhood. Recent data support the suggestion
that in most subjects, this recurrent morbidity is not attributable to atopic asthma and that in most respects, the acute
and longterm outcomes with RSV infections are similar in nature to those attributable to other viruses. The phenotype of the
acute illness probably provides better prognostic information than the type of virus. 相似文献
995.
What is the best treatment for a child with an acute tear of the anterior cruciate ligament? 下载免费PDF全文
Innes DM Smith Ahmer Irfan James S Huntley Simon J Spencer 《Journal of paediatrics and child health》2018,54(9):1037-1041
With the heightened popularity of childhood sporting activity, the number of paediatric anterior cruciate ligament (ACL) ruptures has increased. Management of these injuries presents a particular challenge due to the open femoral and tibial growth plates. Physeal damage has the potential to cause angular deformity or length discrepancy. This review was conducted to determine the best way to treat this injury. A primary search of Ovid MEDLINE (1 October 2017) used the terms: (ACL or anterior cruciate ligament) and (young or child or children or pediatric or immature or pre‐pubescent). Titles/Abstracts of 369 articles were screened for relevance. A total of 217 were excluded, leaving 152 articles for full‐paper retrieval. Of these, 9 articles remained with one further article identified during cross‐referencing; 10 papers (1 level 2 and 9 level 3) were included for analysis. Comparative studies investigating surgical (140 knees) versus conservative (110 knees) treatment provide evidence in favour of the former, in reducing instability and meniscal tears and improving return to previous activity. Of the papers analysed (163 reconstructions), there was only one case of growth arrest (0.6%) and no cases of length discrepancy. In those studies investigating early (218 patients) versus delayed (140 patients) reconstruction, medial meniscal tears and chondral injuries occurred more frequently in the delayed group. To conclude, for children, there is level 2/3 evidence that early operative ACL reconstruction offers the best chance of a return to pre‐injury sporting activity and minimises the risks of further structural damage. Iatrogenic growth disturbance remains a rare but worrying complication. 相似文献
996.
997.
Clinical correlates of hypoglycaemia over 4 years in people with type 2 diabetes starting insulin: An analysis from the CREDIT study 下载免费PDF全文
Philip Home DPhil DM Francoise Calvi‐Gries MSc Lawrence Blonde MD Valerie Pilorget MD Joseph Berlingieri MD Nick Freemantle PhD 《Diabetes, obesity & metabolism》2018,20(4):921-929
Aim
To identify factors associated with documented symptomatic and severe hypoglycaemia over 4 years in people with type 2 diabetes starting insulin therapy.Materials and methods
CREDIT, a prospective international observational study, collected data over 4 years on people starting any insulin in 314 centres; 2729 and 2271 people had hypoglycaemia data during the last 6 months of years 1 and 4, respectively. Multivariable logistic regression was used to select the characteristics associated with documented symptomatic hypoglycaemia, and the model was tested against severe hypoglycaemia.Results
The proportions of participants reporting ≥1 non‐severe event were 18.5% and 16.6% in years 1 and 4; the corresponding proportions of those achieving a glycated haemoglobin (HbA1c) concentration <7.0% (<53 mmol/mol) were 24.6% and 18.3%, and 16.5% and 16.2% of those who did not. For severe hypoglycaemia, the proportions were 3.0% and 4.6% of people reaching target vs 1.5% and 1.1% of those not reaching target. Multivariable analysis showed that, for documented symptomatic hypoglycaemia at both years 1 and 4, baseline lower body mass index and more physical activity were predictors, and lower HbA1c was an explanatory variable in the respective year. Models for documented symptomatic hypoglycaemia predicted severe hypoglycaemia. Insulin regimen was a univariate explanatory variable, and was not retained in the multivariable analysis.Conclusions
Hypoglycaemia occurred at significant rates, but was stable over 4 years despite increased insulin doses. The association with insulin regimen and with oral agent use declined over that time. Associated predictors and explanatory variables for documented symptomatic hypoglycaemia conformed to clinical impressions and could be extended to severe hypoglycaemia. Better achieved HbA1c was associated with a higher risk of hypoglycaemia. 相似文献998.
999.
1000.
Harihar V. Hegde MD G. D. Puri MD Bhupesh Kumar MD DM Arunanshu Behera MS 《Journal of clinical monitoring and computing》2009,23(4):189-196
Objectives. Anaesthetic management of pheochromocytoma is far from satisfactory even though various techniques are available. Feasibility
as well as safety of Bi-spectral Index (BIS™)-guided closed-loop control of anaesthesia has been shown in various clinical
settings. We evaluated the performance of BIS-guided closed-loop-anaesthesia-delivery system (CLADS) in patients undergoing
resection of pheochromocytoma. Methods. Thirteen patients (7 males and 6 females, 15–65 years) who underwent adrenalectomy for pheochromocytoma in the past 4 years
operated by a single surgeon were included in the study. Closed-loop-control of propofol-anaesthesia was induced and maintained
with target BIS value =50. Results. Median performance error and median absolute performance error of target BIS control were 2 (2–7) [median (IQR)] and 10 (8–10),
respectively. BIS was maintained within 50 ± 10 for 87 ± 8.6% (mean ± SD) of the valid CLAD time. Heart rate (HR) and mean
arterial pressure (MAP) were maintained within ±25% of the baseline value for 90.3 ± 12.1% and 76.3 ± 13.2% of the time duration,
respectively. BIS increased significantly following intubation, incision and tumor handling (P = 0.001, 0.001 and 0.03 respectively). There was a significant fall in both HR and MAP following induction of anaesthesia
(P = 0.001), and MAP following tumor excision (P = 0.045) as compared to the baseline. Though maximum HR within 5 min post-intubation, post-incision and during tumor handling
were significantly higher (P = 0.001, 0.014 and 0.037) compared to just before the respective event, they were not statistically different from the baseline.
Though maximum MAP within 5 min post-intubation, post-incision and during tumor handling were significantly higher compared
to MAP just before the respective event (P = 0.001, 0.021 and 0.001), they were not significantly different compared to the baseline value except maximum MAP during
tumor handling (P = 0.001). Conclusion. CLADS performed well in patients undergoing pheochromocytoma surgeries which represent one of the few clinically extreme
situations.
Hegde HV, Puri GD, Kumar B, Behera A. Bi-spectral index guided closed-loop anaesthesia delivery system (CLADS™) in pheochromocytoma. 相似文献