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41.
Dieter Soyka Director Ziya Taneri Neurologist Psychiatrist Wolfgang Oestreich Director Rainer Schmidt Assistant Medical Development 《Headache》1989,29(1):21-27
The efficacy and tolerance of 20 mg flunarizine i.v. were tested in comparison with placebo in a multicentre randomised double-blind trial in the acute treatment of migraine attacks. Sixty case reports were included in the evaluation; 31 patients were treated with flunarizine and 29 with placebo. Flunarizine proved to be significantly superior in its effect on the intensity of pain and the typical concomitant symptoms of the attacks. Patients were classed as responders who displayed a reduction in pain intensity by at least 50% within 60 minutes after the administration of flunarizine. 23 patients (= 74.2%) were responders, including 11 patients being without pain after 60 minutes. In the placebo group the responder rate was 27.6% The fact that both groups were comparable in all respects should be emphasized. The tolerance of intravenously administered flunarizine was excellent and corresponded to that of placebo. Apart from a sedative effect reported by 9 patients there were no side-effects. The circulatory conditions remained largely stable. The result of this study seems to indicate that an intravenous injection of 20 mg flunarizine might represent a genuine alternative, and as regards tolerance even a superior one, to the parenteral administration of ergotamine in migraine attacks. 相似文献
42.
A. E. Oestreich 《Der Radiologe》2002,11(6):217-221
Der Radiologe sollte seltene gef?hrliche Krankheitsbilder wie z. B. eine Epiglottits oder einen membran?sen Krupp anhand eines Nativr?ntgens erkennen. Subglottische Stenosen wie beim Krupp sind durch den Verlust der Grenzfl?chen zwischen Trachea und Stimmb?ndern gekennzeichnet. Ein laterales R?ntgenbild ist insbesondere bei einem a.-p.-Bild diagnostizierten Fremdk?rpern wichtig. 相似文献
43.
Taryn E. Hassinger J. Hunter Mehaffey Lily E. Johnston Robert B. Hawkins Bruce D. Schirmer Peter T. Hallowell 《Surgery for obesity and related diseases》2018,14(8):1133-1138
Background
Numerous studies have established the effectiveness of Roux-en-Y gastric bypass (RYGB) for weight loss and co-morbidity amelioration. However, its safety and efficacy in elderly patients remains controversial.Objectives
To evaluate outcomes in patients aged ≥60 years who underwent RYGB compared with nonsurgical controls with the hypothesis that RYGB provides weight loss benefits without differences in survival.Setting
University-affiliated tertiary center.Methods
All patients who underwent RYGB from 1985 to 2015 were identified and divided into elderly (age ≥60) and nonelderly (age <60) groups. A nonsurgical elderly control population was identified using a clinical data repository of outpatient visits to propensity match elderly patients 4:1 on demographic characteristics, co-morbidities, and relevant preoperative substance/medication use. Unpaired appropriate univariate analyses compared each stratified group. Kaplan-Meier survival curves were fitted based on social security death data.Results
A total of 2306 patients underwent RYGB. The 107 elderly patients had lower median body mass index (47.0 versus 49.9; P?=?.007) and higher rates of co-morbidities. Rates of complications did not differ between elderly and nonelderly patients. Elderly surgical patients were propensity matched 4:1 (10,044 controls) yielding 428 well-matched nonsurgical controls. The elderly group demonstrated significant percent reduction in excess body mass index compared with the control group (81.8% versus 10.3%; P < .001). Kaplan-Meier survival analysis with log-rank test demonstrated no difference in midterm survival (P?=?.63).Conclusions
A significant weight reduction benefit was identified after RYGB in elderly patients without a difference in midterm survival compared with propensity-matched controls, suggesting RYGB is a safe and efficacious weight loss strategy in the elderly. 相似文献44.
Vasudha Shukla Victoria Barnhouse William E. AckermanIV Taryn L. Summerfield Heather M. Powell Jennifer L. Leight Douglas A. Kniss Samir N. Ghadiali 《Annals of biomedical engineering》2018,46(1):197-207
The leading cause of neonatal mortality, pre-term birth, is often caused by pre-mature ripening/opening of the uterine cervix. Although cervical fibroblasts play an important role in modulating the cervix’s extracellular matrix (ECM) and mechanical properties, it is not known how hormones, i.e., progesterone, and pro-inflammatory insults alter fibroblast mechanics, fibroblast-ECM interactions and the resulting changes in tissue mechanics. Here we investigate how progesterone and a pro-inflammatory cytokine, IL-1β, alter the biomechanical properties of human cervical fibroblasts and the fibroblast-ECM interactions that govern tissue-scale mechanics. Primary human fibroblasts were isolated from non-pregnant cervix and treated with estrogen/progesterone, IL-1β or both. The resulting changes in ECM gene expression, matrix remodeling, traction force generation, cell-ECM adhesion and tissue contractility were monitored. Results indicate that IL-1β induces a significant reduction in traction force and ECM adhesion independent of pre-treatment with progesterone. These cell level effects altered tissue-scale mechanics where IL-1β inhibited the contraction of a collagen gel over 6 days. Interestingly, progesterone treatment alone did not modulate traction forces or gel contraction but did result in a dramatic increase in cell-ECM adhesion. Therefore, the protective effect of progesterone may be due to altered adhesion dynamics as opposed to altered ECM remodeling. 相似文献
45.
Melissa G.Y. Lee Johnny Millar Elizabeth Rose Aleesha Jones Dora Wood Taryn L. Luitingh Diana Zannino Johann Brink Igor E. Konstantinov Christian P. Brizard Yves dUdekem 《The Journal of thoracic and cardiovascular surgery》2018,155(6):2579-2587
Objectives
To determine the incidence of vocal cord paresis (VCP) after neonatal aortic arch repair/Norwood-type procedure, and the effectiveness of noninvasive laryngeal ultrasound in detecting VCP compared with gold standard invasive nasoendoscopy.Methods
Fifty-two patients who underwent an arch repair (39 of 52; 75%) or Norwood-type procedure (13 of 52; 25%) via sternotomy between April 1, 2015, and April 30, 2017 underwent laryngeal ultrasound (50 of 52; 96%) and/or flexible fiber optic nasoendoscopy (39 of 52; 75%) at 48 to 72 hours after endotracheal extubation. Primary arch diagnoses were coarctation in 56% (29 of 52), hypoplastic left heart syndrome in 17% (9 of 52), isolated hypoplastic arch in 17% (9 of 52), and interrupted aortic arch in 10% (5 of 52). The median patient age at surgery was 5.5 days (interquartile range, 4.0-12.5 days). Fifteen patients (15 of 52; 29%) required preoperative intubation.Results
Left VCP was present in 59% (23 of 39) of patients on nasoendoscopy and in 59% (27 of 46) of patients on laryngeal ultrasound, and 4 additional patients had inconclusive ultrasound results. There was agreement between the results of nasoendoscopy and conclusive ultrasound in all cases. The overall sensitivity, specificity, positive and negative predictive values, and Cohen's kappa coefficient of laryngeal ultrasound compared with nasoendoscopy for the detection of left VCP were 95%, 88%, 91%, 93%, and 0.83, respectively. On multivariable analysis, preoperative intubation and arch repair techniques other than the Norwood procedure were associated with left VCP (odds ratio, 12.7; P = .03; and 14.1; P = .03, respectively).Conclusions
There is a high incidence of VCP after arch repair via sternotomy. Laryngeal ultrasound seems to be an effective and noninvasive method for detecting VCP in neonates and young children. 相似文献46.
Impact of cord blood banking technologies on clinical outcome: a Eurocord/Cord Blood Committee (CTIWP), European Society for Blood and Marrow Transplantation and NetCord retrospective analysis
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Riccardo Saccardi Luciana Tucunduva Annalisa Ruggeri Irina Ionescu Gesine Koegler Sergio Querol Giuliano Grazzini Lucilla Lecchi Alessandro Nanni Costa Cristina Navarrete Fabienne Pouthiers Jerome Larghero Donna Regan Taryn Freeman Henrique Bittencourt Chantal Kenzey Myriam Labopin Etienne Baudoux Vanderson Rocha Eliane Gluckman 《Transfusion》2016,56(8):2021-2029
47.
Taryn G. Moss MA Andrea H. Weinberger PhD Jennifer C. Vessicchio MSW LCSW Vincenza Mancuso MEd Sandra J. Cushing MSW RSW Michael Pett MSW RSW Kate Kitchen MSW RSW Peter Selby MD CCFP Tony P. George MD FRCPC 《The American journal on addictions / American Academy of Psychiatrists in Alcoholism and Addictions》2010,19(4):293-311
Tobacco dependence is the leading cause of death in persons with psychiatric and substance use disorders. This has lead to interest in the development of pharmacological and behavioral treatments for tobacco dependence in this subset of smokers. However, there has been little attention paid to the development of tobacco‐free environments in psychiatric institutions despite the creation of smoke‐free psychiatric hospitals mandated by the Joint Commission for Accreditation of Health Organizations (JCAHO) in 1992. This review article addresses the reasons why tobacco should be excluded from psychiatric and addictions treatment settings, and strategies that can be employed to initiate and maintain tobacco‐free psychiatric settings. Finally, questions for further research in this field are delineated. This Tobacco Reconceptualization in Psychiatry is long overdue, given the clear and compelling benefits of tobacco‐free environments in psychiatric institutions. (Am J Addict 2010;00:1–19) 相似文献
48.
Diana C. Kang Miranda J. Hardee Susan F. Fesperman Taryn L. Stoffs Philipp Dahm 《European urology》2010
Background
Robot-assisted laparoscopic prostatectomy (RALP) is displacing radical retropubic prostatectomy as the gold standard surgical approach for clinically localised prostate cancer in the United States and is also being increasingly used in Europe and other parts of the world. This trend has occurred despite the paucity of high-quality evidence to support its relative superiority to more established treatment modalities.Objective
We performed this study to critically assess the quality of published evidence on RALP to support this major shift in practice patterns.Design, setting, and participants
We conducted a systematic review of the published literature through Medline and Embase (1966 to December 2008). All original research publications on RALP were included. Editorials, letters to the editor, and review articles were excluded.Measurements
Two reviewers independently performed the data abstraction using a standardised form derived from the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) criteria.Results and limitations
Seventy-five original research publications met eligibility criteria. Fifty-five (73.3%) studies were published between 2005 and 2008, and 20 studies (26.7%) were published between 2001 and 2004. Approximately three-quarters of the studies were case series (74.7%), and only two (2.7%) randomised, controlled trials (RCT) were identified. Twelve authors cowrote 72% (54 of 75) of the published studies. Reporting of STROBE criteria ranged from 100.0% (scientific rationale/background explained) to 1.3% (consideration of sample size), with no improvement over time. The study was limited to published literature in the English language.Conclusions
The published RALP literature is limited to observational studies of mostly low methodologic quality. Our findings draw into question to what extent valid conclusions about the relative superiority or equivalence of RALP to other surgical approaches can be drawn and whether published outcomes can be generalised to the broader community. There is an urgent need to raise the methodologic standards for clinical research on new urologic procedures and devices. 相似文献49.
Benedetto Vitiello David A. Brent Laurence L. Greenhill Graham Emslie Karen Wells John T. Walkup Barbara Stanley Oscar Bukstein Betsy D. Kennard Scott Compton Barbara Coffey Mary F. Cwik Kelly Posner Ann Wagner John S. March Mark Riddle Tina Goldstein John Curry Lisa Capasso Taryn Mayes Jamie Zelazny 《Journal of the American Academy of Child and Adolescent Psychiatry》2009,48(10):997-1004
ObjectiveTo examine the course of depression during the treatment of adolescents with depression who had recently attempted suicide.MethodAdolescents (N = 124), ages 12 to 18 years, with a 90-day history of suicide attempt, a current diagnosis of depressive disorder (96.0% had major depressive disorder), and a Children's Depression Rating Scale-Revised (CDRS-R) score of 36 or higher, entered a 6-month treatment with antidepressant medication, cognitive-behavioral therapy focused on suicide prevention, or their combination (Comb), at five academic sites. Treatment assignment could be either random or chosen by study participants. Intent-to-treat, mixed effects regression models of depression and other relevant ratings were estimated. Improvement and remission rates were computed with the last observation carried forward.ResultsMost patients (n = 104 or 84%) chose treatment assignment, and overall, three fourths (n = 93) received Comb. In Comb, CDRS-R declined from a baseline adjusted mean of 49.6 (SD 12.3) to 38.3 (8.0) at week 12 and to 27.0 (10.1) at week 24 (p < .0001), with a Clinical Global Impression -defined improvement rate of 58.0% at week 12 and 72.2% at week 24 and a remission (CDRS-R ≤28) rate of 32.5% at week 12 and 50.0% at week 24. The CDRS-R and the Scale for Suicidal Ideation scores were correlated at baseline (r= 0.43, p < .0001) and declined in parallel.ConclusionsWhen vigorously treated with a combination of medication and psychotherapy, adolescents with depression who have recently attempted suicide show rates of improvement and remission of depression that seem comparable to those observed in nonsuicidal adolescents with depression. 相似文献
50.
The number of patients diagnosed with autism spectrum disorders (ASD) in the United States has increased significantly. The objectives of this study were to explore general and pediatric dentists' professional attitudes and behavior towards patients with ASD; these dentists' perceptions of their dental education about these issues; and the relationships among their educational experiences, attitudes, and behaviors concerning patients with ASD. Survey data were collected from 162 general dentists in Michigan and 212 pediatric dentists across the United States. The results showed that 89 percent of pediatric dentists and 32 percent of general dentists treat patients with ASD. The respondents disagreed with statements indicating that their predoctoral dental education had prepared them well to treat patients with ASD. However, the better they felt prepared, the more likely they were to provide care for these patients. The frequency with which pediatric dentists said they use appropriate behavior management strategies when treating patients with ASD correlated with the quality of their educational experiences. In conclusion, given the growing number of patients with ASD, it is important to revisit dental education efforts targeted towards preparing future dental care providers for the treatment of patients with ASD and special needs. 相似文献