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Mark A. Espeland PhD Jose A. Luchsinger MD MPH Rebecca H. Neiberg MS Owen Carmichael PhD Paul J. Laurienti PhD Xavier Pi‐Sunyer MD Rena R. Wing PhD Delilah Cook CCRP Edward Horton MD Ramon Casanova PhD Kirk Erickson PhD R. Nick Bryan MD the Action for Health in Diabetes Brain Magnetic Resonance Imaging Research Group 《Journal of the American Geriatrics Society》2018,66(1):120-126
Objectives
To determine whether long‐term behavioral intervention targeting weight loss through increased physical activity and reduced caloric intake would alter cerebral blood flow (CBF ) in individuals with type 2 diabetes mellitus.Design
Postrandomization assessment of CBF.Setting
Action for Health in Diabetes multicenter randomized controlled clinical trial.Participants
Individuals with type 2 diabetes mellitus who were overweight or obese and aged 45 to 76 (N = 310).Interventions
A multidomain intensive lifestyle intervention (ILI ) to induce weight loss and increase physical activity for 8 to 11 years or diabetes support and education (DSE ), a control condition.Measurements
Participants underwent cognitive assessment and standardized brain magnetic resonance imaging (MRI ) (3.0 Tesla) to assess CBF an average of 10.4 years after randomization.Results
Weight changes from baseline to time of MRI averaged ?6.2% for ILI and ?2.8% for DSE (P < .001), and increases in self‐reported moderate or intense physical activity averaged 444.3 kcal/wk for ILI and 114.8 kcal/wk for DSE (P = .03). Overall mean CBF was 6% greater for ILI than DSE (P = .04), with the largest mean differences between ILI and DSE in the limbic region (3.39 mL /100 g per minute, 95% confidence interval (CI ) = 0.07–6.70 mL /100 g per minute) and occipital lobes (3.52 mL /100 g per minute, 95% CI = 0.20–6.84 mL /100 g per minute). In ILI , greater CBF was associated with greater decreases in weight and greater increases in physical activity. The relationship between CBF and scores on a composite measure of cognitive function varied between intervention groups (P = .02).Conclusions
Long‐term weight loss intervention in overweight and obese adults with type 2 diabetes mellitus is associated with greater CBF .97.
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Transradial cardiac catheterization in patients with coronary bypass grafts: feasibility analysis and comparison with transfemoral approach. 总被引:2,自引:0,他引:2
Marcelo Sanmartin Diogenes Cuevas Joaquin Moxica Manuel Valdes Jose Esparza Jose Antonio Baz Ramon Mantilla Andres Iiguez 《Catheterization and cardiovascular interventions》2006,67(4):580-584
The objective of this study was to analyze the feasibility and safety of transradial catheterization in patients with remote surgical cardiac revascularization. Selective catheterization of coronary bypass grafts might be more difficult and time-consuming from the radial artery as compared to the femoral route. This special patient subset has been either excluded or underrepresented in previous studies. Retrospective review was made of 304 cardiac diagnostic procedures performed from January 2001 through December 2004 in patients with coronary artery bypass grafts in a single center. Patients had to be considered eligible for both transradial and transfemoral approach to be included. Cases with double internal mammary or gastroepiploic grafts were excluded. Selection of the arterial access was individualized according to operator preferences. Among diagnostic cases, transradial access was attempted as first choice in 151 cases (left radial in 133) and transfemoral in 154. Total procedural time (41 +/- 22 vs. 40 +/- 23 min), fluoroscopy time (15 +/- 10 vs. 18 +/- 13 min), and dye volume (180 +/- 64 vs. 192 +/- 73 ml) were similar. Crossover rates were 4.0% in the transradial group and 1.3% in transfemoral (P = 0.28). Only two patients in transradial group needed transfemoral access because of failure to catheterize a bypass graft. Transradial angiography of coronary bypass grafts can be performed with similar success rates as compared with transfemoral procedures and without a significant time delay. 相似文献
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Objectives The integral involvement of sinus and skull base surgeries in the field of otolaryngology makes the endonasal vasculature including the ethmoidal arteries important to consider. The anterior ethmoidal artery (AEA) and posterior ethmoidal artery (PEA) are well-known entities, yet the relatively recent notion of accessory or middle ethmoidal vessels complicates our understanding of this arterial system.
Study Design Radiographic study.
Methods Fifty computed tomographic angiographies were studied for the presence of accessory/middle ethmoidal arteries (MEAs). If contrasted arteries were not visualized reliably, foramina were accepted as evidence of arteries. The accessory arteries/foramina were then compared with the locations of the AEA and PEA.
Results A total of 19 of the 50 patient samples studied had evidence of a right, left, or bilateral middle ethmoidal vessels (38%). Overall, 26 arteries total were identified out of the 100 sides (26%). Unilateral middle arteries were more common than bilateral, and right sided were more common than left. There was no evidence of multiple MEAs on a given side.
Conclusion The endonasal surgeon must be cognizant of the possible presence of MEAs. These arteries should be considered when working in the medial orbit and anterior skull base region. 相似文献