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11.
NOWELL SOLISH MD FRCPC VINCE BERTUCCI MD FRCPC ALAIN DANSEREAU MD FRCPC H. CHIH-HO HONG MD FRCPC CHARLES LYNDE MD FRCPC MARK LUPIN MD FRCPC KEVIN C. SMITH MD FRCPC FACP GREG STORWICK MD FRCPC 《Dermatologic surgery》2007,33(8):908-923
BACKGROUND: Hyperhidrosis can have profound effects on a patient's quality of life. Current treatment guidelines ignore disease severity. OBJECTIVE: The objective was to establish clinical guidelines for the recognition, diagnosis, and treatment of primary focal hyperhidrosis. METHODS AND MATERIALS: A working group of eight nationally recognized experts was convened to develop the consensus statement using an evidence-based approach. RECOMMENDATIONS: An algorithm was designed to consider both disease severity and location. The Hyperhidrosis Disease Severity Scale (HDSS) provides a qualitative measure that allows tailoring of treatment. Mild axillary, palmar, and plantar hyperhidrosis (HDSS score of 2) should initially be treated with topical aluminum chloride (AC). If the patient fails to respond to AC therapy, botulinum toxin A (BTX-A; axillae, palms, soles) and iontophoresis (palms, soles) should be the second-line therapy. In severe cases of axillary, palmar, and plantar hyperhidrosis (HDSS score of 3 or 4), both BTX-A and topical AC are first-line therapy. Iontophoresis is also first-line therapy for palmar and plantar hyperhidrosis. Craniofacial hyperhidrosis should be treated with oral medications, BTX-A, or topical AC as first-line therapy. Local surgery (axillary) and endoscopic thoracic sympathectomy (palms and soles) should only be considered after failure of all other treatment options. CONCLUSIONS: These guidelines offer a rapid method to assess disease severity and to treat primary focal hyperhidrosis according to severity. 相似文献
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NICOLAS LELLOUCHE M.D. FREDERIC SACHER M.D. PIERRE JORROT M.D. ALAIN CARIOU M.D. CHRISTIAN SPAULDING M.D. AMANDINE AURORE M.D. XAVIER COMBES M.D. JEROME FICHET M.D. EMMANUEL TEIGER M.D. PIERRE JAIS M.D. JEAN‐LUC DUBOIS‐RANDÉ M.D. MICHEL HAISSAGUERRE M.D. 《Journal of cardiovascular electrophysiology》2011,22(2):131-136
Sudden Cardiac Arrest and ECG Repolarization. Introduction: Early repolarization (ERep) abnormalities on electrocardiogram (ECG) are common immediately following cardiac arrest. We characterized and correlated electrocardiographic repolarization abnormalities immediately after cardiac arrest with acute coronary angiography. Methods and Results: We studied 225 consecutive patients presenting with out‐of‐hospital cardiac arrest. All these patients had successful cardiopulmonary resuscitation and acute coronary angiography. The first ECG recorded after successful resuscitation was analyzed by two independent cardiologists. Patients were categorized according to their repolarization pattern.
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NEMATOLLAH JAAFARI M.D. MARIE‐SOPHIE BACHOLLET M.D. CELINE PAILLOT Ph.D. ALAIN AMIEL M.D. JEAN‐YVES ROTGE M.D. NICOLAS LAFAY M.D. SOLENE QUENTIN M.D. ISSA WASSOUF M.D. VINCENT CAMUS M.D. Ph.D. JEAN‐LOUIS SENON M.D. Ph.D. WISSAM EL HAGE M.D. Ph.D. 《Pacing and clinical electrophysiology : PACE》2009,32(3):399-402
Twiddler's or twist syndrome is the twisting of pulse generators around themselves. It may result from mechanical manipulation that can induce the malfunction of the device. In this case, twiddler's syndrome resulted from compulsive checking of the device. The implantable cardioverter‐defibrillator (ICD) triggered the development of an obsessive compulsive disorder (OCD). Two invasive procedures were required to replace the ICD. Psychiatric intervention prevented the recurrence of twiddler's syndrome in this patient for more than 2 years. We believe that preimplant psychiatric assessment should be the rule. 相似文献
14.
HÉLÉNE ELTCHANINOFF M.D. CARLOS GIRON M.D. RAPHAËLLE CARLOT M.D. CATHERINE BIZET M.D. STEPHAN CHASSAING M.D. ALAIN CRIBIER M.D. 《Journal of interventional cardiology》2000,13(4):295-299
Introduced more than 15 years ago, balloon aortic valvuloplasty (BAV) has clearly delineated indications and limitations. Although, aortic valve replacement is undoubtedly the treatment of choice for healthy patients with aortic stenosis, BAV has been demonstrated as a valuable and safe palliative procedure for patients considered too risky or old for current day surgery. Between January 1991 and December 1999, 858 patients (mean age 76 ± 11 years, 479 [57%] women) underwent BAV at our center. Indications for BAV were contraindication to surgery in 16.2% of the patients, high risk in 40.4%, refusal of surgery in 10.7%, personal decision in 18.5%, and other in 14.2%. The mean gradient decreased from 65 ± 23 to 27 ± 12 mmHg and the valve area increased from 0.56 ± 0.19 cm2 to 1.0 ± 0.38 cm2 . Eleven (1.1%) patients died during the procedure. The other severe complications were complete AV block in 18 (1.8%) patients, stroke in 8 (0.8%), tamponade in 6 (0.6%), and massive aortic insufficiency in 4 (0.4%). In conclusion, BAV does not replace valve replacement, even in the elderly. All those who can be operated on, should be. However, if surgical intervention is not considered reasonable, BAV offers good immediate results with an acceptable complication rate. Furthermore, previous published series have demonstrated that BAV is particularly indicated in specific subgroups, such as very old patients with high operative risk, end-stage heart failure, cardiogenic shock, or general anesthesia for noncardiac surgery. 相似文献
15.
FRANZ ESSER ALAIN CARPY HANS BRIEM HERBERT K
PPEN KARL-HEINZ POOK 《Chemical biology & drug design》1995,45(6):540-546
The diastereoselective synthesis is reported of a dipeptide template which is closely related to H-Gly-Trp-OH. Intramolecular bond formation between α-C of Gly and ring position 2 of the Trp unit has been achieved by a Pictet-Spengler-type electrophilic aromatic substitution. The absolute configuration of the N-Moc protected dipeptide template 9·2H2O was determined by single-crystal X-ray crystallography and found to be (2S,5S). The cis orientation of the amino and carboxy termini prompted us to investigate the potential of 9 as a β-turn mimic. MD calculations on the model pseudopeptide Ac-Ala-Gly-Trp-Ala-NHMe 11 suggest that an unusually tight turn should be favoured rather than a β-turn. The proper protective situation as a prerequisite for the incorporation of the template into a peptide has been established, and comments about its chemical properties are given. © Munksgaard 1995. 相似文献
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17.
Intracranial topography of event-related potentials (N400/P600) elicited during a continuous recognition memory task 总被引:8,自引:0,他引:8
FRANçOIS GUILLEM BERNARD N'KAOUA ALAIN ROUGIER BERNARD CLAVERIE 《Psychophysiology》1995,32(4):382-392
To isolate the anatomical locus of the neural activity most important for generating or modulating the scalp-recorded N400 and P600 components elicited during continuous recognition memory tasks, intracranial event-related potentials (ERPs) were recorded from medial and lateral aspects of the temporal, frontal, parietal, and occipital lobes in 25 patients undergoing stereoelectroencephalography for seizure localization. Large-amplitude and polarity-inverted ERPs were recorded from various temporal, frontal, and parietal structures, whereas the memory-related ERP modulation assessed by the ERP repetition effect was present only in those brain areas that play the most important role in memory processing. These data suggest that the scalp-recorded N400 and P600 components may represent the most readily observable aspect of synchronous activity occurring across widely distributed brain structures and neural systems underlying different cognitive mechanisms, which all contribute to some aspect of information processing during recognition memory. 相似文献
18.
DENISE J. ROE EDWARD F. VONESH RUSSELL D. WOLFINGER FLORENCE MESNIL ALAIN MALLET 《Statistics in medicine》1997,16(11):1241-1262
Statistical modeling methods have had increasing use in drug disposition studies, both to estimate pharmacokinetic parameters and to develop regression models that relate these parameter estimates to patient characteristics. These methods are particularly flexible as they allow non-linearity and sparse within-patient information. In the past few years, multiple analysis methods have become available, but there is a lack of systematic comparisons of their estimates on the same data sets. Two simulated data sets were therefore developed by the Population Modeling Workgroup of the Biopharmaceutical Section of the American Statistical Association. We analysed these data sets using seven population modeling programs, some of which contain multiple analysis methods. Although each data set represents a single replicate from a given model and data collection design, the results suggest that the behaviour of some methods differs from that of the others. © 1997 by John Wiley & Sons, Ltd. 相似文献
19.
FRANOIS HUGUET KATHY DRIEU ALAIN PIRIOU 《The Journal of pharmacy and pharmacology》1994,46(4):316-318
Abstract— Investigation of [3H]8-hydroxy-2(di-n-propylamino)tetralin binding to 5-HT1A receptors in cerebral cortex membranes of Wistar rats showed that the maximal number of binding sites (Bmax) was reduced significantly (22%) in aged (24-month-old) as compared with young (4-month-old) animals. Chronic treatment with Ginkgo biloba extract did not alter binding in young rats but increased binding density significantly (33%) in aged rats. These results confirm previously described age-related 5-hydroxytryptaminergic alterations. Together with data in the literature, they also suggest a restorative effect in aged rats, associated with decreased receptor density resulting from the protective action of Ginkgo biloba extract treatment on neuronal membrane. 相似文献
20.