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951.
James K. Min Troy M. Labounty Millie J. Gomez Stephan Achenbach Mouaz Al-Mallah Matthew J. Budoff Filippo Cademartiri Tracy Q. Callister Hyuk-Jae Chang Victor Cheng Kavitha M. Chinnaiyan Benjamin Chow Ricardo Cury Augustin Delago Allison Dunning Gudrun Feuchtner Martin Hadamitzky Jorg Hausleiter Philipp Kaufmann Yong-Jin Kim Jonathon Leipsic Fay Y. Lin Erica Maffei Gilbert Raff Leslee J. Shaw Todd C. Villines Daniel S. Berman 《Atherosclerosis》2014
Background
Coronary artery disease (CAD) diagnosis by coronary computed tomographic angiography (CCTA) is useful for identification of symptomatic diabetic individuals at heightened risk for death. Whether CCTA-detected CAD enables improved risk assessment of asymptomatic diabetic individuals beyond clinical risk factors and coronary artery calcium scoring (CACS) remains unexplored.Methods
From a prospective 12-center international registry of 27,125 individuals undergoing CCTA, we identified 400 asymptomatic diabetic individuals without known CAD. Coronary stenosis by CCTA was graded as 0%, 1–49%, 50–69%, and ≥70%. CAD was judged on a per-patient, per-vessel and per-segment basis as maximal stenosis severity, number of vessels with ≥50% stenosis, and coronary segments weighted for stenosis severity (segment stenosis score), respectively. We assessed major adverse cardiovascular events (MACE) – inclusive of mortality, nonfatal myocardial infarction (MI), and late target vessel revascularization ≥90 days (REV) – and evaluated the incremental utility of CCTA for risk prediction, discrimination and reclassification.Results
Mean age was 60.4 ± 9.9 years; 65.0% were male. At a mean follow-up 2.4 ± 1.1 years, 33 MACE occurred (13 deaths, 8 MI, 12 REV) [8.25%; annualized rate 3.4%]. By univariate analysis, per-patient maximal stenosis [hazards ratio (HR) 2.24 per stenosis grade, 95% confidence interval (CI) 1.61–3.10, p < 0.001], increasing numbers of obstructive vessels (HR 2.30 per vessel, 95% CI 1.75–3.03, p < 0.001) and segment stenosis score (HR 1.14 per segment, 95% CI 1.09–1.19, p < 0.001) were associated with increased MACE. After adjustment for CAD risk factors and CACS, maximal stenosis (HR 1.80 per grade, 95% CI 1.18–2.75, p = 0.006), number of obstructive vessels (HR 1.85 per vessel, 95% CI 1.29–2.65, p < 0.001) and segment stenosis score (HR 1.11 per segment, 95% CI 1.05–1.18, p < 0.001) were associated with increased risk of MACE. Beyond age, gender and CACS (C-index 0.64), CCTA improved discrimination by maximal stenosis, number of obstructive vessels and segment stenosis score (C-index 0.77, 0.77 and 0.78, respectively). Similarly, CCTA findings improved risk reclassification by per-patient maximal stenosis [integrated discrimination improvement (IDI) index 0.03, p = 0.03] and number of obstructive vessels (IDI index 0.06, p = 0.002), and by trend for segment stenosis score (IDI 0.03, p = 0.06).Conclusion
For asymptomatic diabetic individuals, CCTA measures of CAD severity confer incremental risk prediction, discrimination and reclassification on a per-patient, per-vessel and per-segment basis. 相似文献952.
953.
Kerollos N. Wanis Michael Linecker Arin L. Madenci Philip C. Müller Natascha Nüssler Roberto Brusadin Ricardo Robles-Campos Oszkar Hahn Matteo Serenari Elio Jovine Nadja Lehwald Wolfram T. Knoefel Tim Reese Karl Oldhafer Martin de Santibañes Victoria Ardiles Georg Lurje Rafaela Capelli Roberto Hernandez-Alejandro 《HPB : the official journal of the International Hepato Pancreato Biliary Association》2021,23(1):46-55
BackgroundVarious, often conflicting, estimates for post-operative morbidity and mortality following ALPPS have been reported in the literature, suggesting that considerable center-level variation exists. Some of this variation may be related to center volume and experience.MethodsUsing data from seventeen centers who were early adopters of the ALPPS technique, we estimated the variation, by center, in standardized 90-day mortality and comprehensive complication index (CCI) for patients treated between 2012 and 2018.ResultsWe estimated that center-specific 90-day mortality following treatment with ALPPS varied from 4.2% (95% CI: 0.8, 9.9) to 29.1% (95% CI: 13.9, 50.9), and that center-specific CCI following treatment with ALPPS varied from 17.0 (95% CI: 7.5, 26.5) to 49.8 (95% CI: 38.1, 61.8). Declines in estimated 90-day mortality and CCI were observed over time, and almost all individual centers followed this trend. Patients treated at centers with a higher number of ALPPS cases performed over the prior year had a lower risk of post-operative mortality.ConclusionDespite considerable center-level variation in ALPPS outcomes, perioperative outcomes following ALPPS have improved over time and treatment at higher volume centers results in a lower risk of 90-day mortality. Morbidity and mortality remain concerningly high at some centers. 相似文献
954.
de Paula Reis Michelle de Lima Daniely Alves Pauli Karoline Bach Andreotti Carlos Eduardo Linhares de Moraes André Luiz Soares Gonçalves Daniela Dib Navarro Italmar Teodorico Bueno Paulo Sérgio Alves Seixas Flavio Augusto Vicente Gasparotto Junior Arquimedes Lourenço Emerson Luiz Botelho 《Parasitology research》2018,117(5):1465-1471
Parasitology Research - Toxoplasmosis is a zoonosis of worldwide distribution. Currently, two drugs, pyrimethamine and sulfadiazine, are used as a reference in the treatment of toxoplasmosis, but... 相似文献
955.
Pérez-Sánchez R Valero ML Ramajo-Hernández A Siles-Lucas M Ramajo-Martín V Oleaga A 《Molecular and biochemical parasitology》2008,161(2):112-123
Schistosoma bovis, a parasite of ruminants, can live for years in the bloodstream in spite of the immune response of its host. The parasite tegument covers the entire surface of the worm and plays a key role in the host-parasite relationship. The parasite molecules involved in host immune response evasion mechanisms must be expressed on the tegument surface and are potential targets for immune or drug intervention. The purpose of the present work was to identify the tegumental proteomes of male and female S. bovis worms, in particular the proteins expressed on the outermost layers of the tegument structure. Adult worms of each sex were treated separately with trypsin in order to digest their tegumental proteins, after which the peptides released were analysed by LC-MS/MS for identification. This experimental approach afforded valuable information about the protein composition of the tegument of adult S. bovis worms. A range of tegumental proteins was identified, most of which had not been identified previously in this species. Although an absolute purification of the proteins expressed on the outermost layers of the tegument structure was not achieved, it is likely that present among the proteins identified are some of the molecules most closely associated with the tegument surface. Our study also suggests that there may be differences in the protein composition of the tegument of male and female schistosomes. Finally, the presence of actin and GAPDH on the surface of male and female worms and the presence of enolase exclusively on the surface of male worms were verified by confocal microscopy. 相似文献
956.
957.
An investigation on the relationship between the occurrence of CMV DNAemia and the development of invasive aspergillosis in the allogeneic stem cell transplantation setting 下载免费PDF全文
958.
959.
Marco Antonio Alarcón Ignacio Sanz-Sánchez Jamil Awad Shibli Alejandro Treviño Santos Santiago Caram Alejandro Lanis Paola Jiménez Ricardo Dueñas Ronald Torres Jacinto Alvarado Adrián Avendaño Roberto Galindo Vilma Umanzor Mónica Shedden Carlos Invernizzi Caroll Yibrin James Collins Roberto León Luis Contreras Luis Bueno Andrea López-Pacheco Lilian Málaga-Figueroa Mariano Sanz 《Clinical oral implants research》2021,32(4):521-537
960.