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991.
Benjamin CL Puleo CM Settipani CA Brodman DM Edmunds JM Cummings CM Kendall PC 《Child and adolescent psychiatric clinics of North America》2011,20(2):179-189
The numerous intervention strategies that comprise cognitive-behavioral therapy (CBT) reflect its complex and integrative nature and include such topics as extinction, habituation, modeling, cognitive restructuring, problem solving, and the development of coping strategies, mastery, and a sense of self-control. CBT targets multiple areas of potential vulnerability (eg, cognitive, behavioral, affective) with developmentally guided strategies and traverses multiple intervention pathways. Although CBT is often considered the "first-line treatment" for many psychological disorders in youth, additional work is necessary to address nonresponders to treatment and to facilitate the dissemination of efficacious CBT approaches. 相似文献
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We report a case of a patient with idiopathic left ventricular tachycardia (VT) successfully ablated from the epicardial aspect of the left ventricle, after a previous failed endocardial ablation. The VT appeared to be catecholamine sensitive. An excellent epicardial pacemap was found in the midlateral region of the left ventricle, remote from vascular structures. Following ablation, the patient discontinued antiarrhythmic drug use and has not experienced any recurrence of VT for more than 2 1/2 years. 相似文献
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Jain M Lam A Gottardi CJ 《American journal of respiratory and critical care medicine》2011,184(8):983; author reply 983-983; author reply 984
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Zehra Jaffery MD Lior Shamai DO MPH Christopher J. White MD 《Catheterization and cardiovascular interventions》2011,78(4):599-603
Background : Serum hemoglobin (H) level is a well‐known predictor of all‐cause mortality in patients undergoing percutaneous coronary interventions but has not been studied in patients undergoing peripheral vascular interventions (PVI). We sought to determine the prognostic significance of serum H in patients undergoing PVI. Methods : We identified 346 consecutive patients undergoing PVI who had a documented a baseline and a postprocedural serum H level over a 33‐month period. A multivariate analysis of predictors of 9‐month mortality was performed. Results : Of 346 patients identified, there were 28 deaths (8.1%) over a 9‐month follow‐up period. Periprocedural H change was not associated with death [OR: 1.12 (95% CI: 0.71–1.79), P = NS]. In a multivariate model independent predictors of all‐cause mortality were clinical bleeding [OR: 10.7 (95% CI: 0.012–0.769), P = 0.026], emergency intervention [OR: 4.5 (95% CI: 0.07–0.71), P = 0.011], ejection fraction [OR: 1.02 (95% CI: 1.01–1.05), P = 0.020], and preprocedural H [OR: 1.56 (95% CI: 1.19–2.04) P = 0.001]. Conclusion : In patients undergoing PVI, preprocedural H was a significant predictor of 9‐month all‐cause mortality. The highest mortality rate was seen in patients with a preprocedural H level ≤ 10 g/dl. Preprocedural H level can be used in clinical practice to risk stratify patients being considered for PVI. Further investigation is needed to assess if optimization of H level preprocedure improves midterm mortality. © 2011 Wiley‐Liss, Inc. 相似文献
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Edward Bergen DO Steven R. Bailey MD FSCAI 《Catheterization and cardiovascular interventions》2011,77(5):746-749
Endovascular intervention to exclude popliteal artery aneurysms (PAA) achieves results comparable to surgical intervention with less associated morbidity and mortality. However, the biomechanical forces inherent to this region pose unique impediments that can limit successful endovascular exclusion. Herein, we present a case of recurrent thrombotic occlusion of a PAA endoprosthesis secondary to dynamic extrinsic compression from the excluded PAA in the absence of an endoleak. Multimodality imaging proved vital in elucidating this novel etiology and enabled an appropriate definitive intervention. © 2010 Wiley‐Liss, Inc. 相似文献
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Eric L. Logigian MD Paul Twydell DO Nuran Dilek MS William B. Martens BA Chris Quinn MS Allen W. Wiegner PhD Chad R. Heatwole MD Charles A. Thornton MD Richard T. Moxley III MD 《Muscle & nerve》2010,41(2):191-196
It is unknown how evoked myotonia varies with stimulus frequency or train length, or how it compares to voluntary myotonia in myotonic dystrophy type 1 (DM1). First dorsal interosseous (FDI) tetanic contractions evoked by trains of 10–20 ulnar nerve stimuli at 10–50 HZ were recorded in 10 DM1 patients and 10 normals. For comparison, maximum voluntary handgrip contractions were also recorded. An automated computer program placed cursors along the declining (relaxation) phase of the force recordings at 90% and 5% of peak force (PF) and calculated relaxation times (RTs) between these points. For all stimulus frequencies and train lengths, evoked RTs were much shorter, and evoked PFs were much greater in normals than in DM1. In normals, evoked RT was independent of stimulus frequency and train length, while in DM1 RT was longer for train lengths of 20 stimuli (mean: 9 s in DM1; 0.20 in normals) than for 10 stimuli (mean: 3 s in DM1, 0.19 in normals), but it did not change with stimulus frequency. In both groups PF increased greatly as stimulus frequency rose from 10–50 HZ but only slightly as train length rose from 10–20 stimuli. Voluntary handgrip RT (mean: 1.9 s) was less than evoked FDI RT (mean: 9 s). In DM1, evoked RT can be “dialed up” by increasing stimulus train length. Evoked myotonia testing utilizing a stimulus paradigm of at least 20 stimuli at 30–50 HZ may be useful in antimyotonic drug trials, particularly when grip RT is normal or equivocal. Muscle Nerve, 2010 相似文献