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91.
Cognitive disorders in patients with occlusive disease of the carotid artery: a systematic review of the literature 总被引:5,自引:0,他引:5
We present a systematic review of the literature on the prevalence, nature, severity, course, and causes of cognitive deficits
in patients with occlusive disease of the carotid artery prior to surgery (if surgery was under discussion). Searches were
carried out on Medline and Psychlit from 1980 to 1999 using neurovascular and psychological index terms, and papers and books
were checked for further references. Studies describing neuropsychological assessment of groups of patients with carotid obstruction
were included. Eighteen studies were found. We extracted from the papers data on study design, demographic characteristics
of patients, clinical diagnosis, carotid obstruction, cerebral imaging, time interval between ischemic episode and neuropsychological
assessment, neuropsychological asessment procedures, integration and interpretation of test performances, and conclusions
of authors. Fourteen studies concluded that there are cognitive deficits both in patients with symptomatic and in those with
asymptomatic carotid obstruction; four studies denied cognitive impairment. There were no differences in patient characteristics,
study design, or neuropsychological assessment procedures between the 14 studies that found deficits and the 4 that did not.
There are indications for a mild, diffuse, detrimental effect of carotid occlusive disease on cognitive functioning. However,
methodological problems prevent a definitive conclusion. Further research is needed to confirm these findings and to ascertain
the neurovascular risk factors for and the natural course of cognitive impairment in patients with carotid occlusive disease.
Received: 12 July 1999/Received in revised form: 10 November 1999/Accepted: 26 January 2000 相似文献
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R.W.H. Smits Ivo ten Hove E.A.C. Dronkers T.C. Bakker Schut H. Mast R.J. Baatenburg de Jong E.B. Wolvius G.J. Puppels S. Koljenović 《International journal of oral and maxillofacial surgery》2018,47(8):959-964
Resection margins are frequently studied in patients with oral squamous cell carcinoma and are accepted as a constant prognostic factor. While most evidence is based on soft tissue margins, reported data for bone resection margins are scarce. The aim of this retrospective study was to evaluate and determine the utility of surgical margins in bone resections for oral cavity squamous cell carcinoma (OCSCC). The status of bone resection margins and their impact on survival was investigated in patients who had undergone segmental mandibulectomy for OCSCC. Medical records were retrieved for the years 2000–2012; 127 patients were identified and included in the study. Tumour-positive bone resection margins were found in 21% of the patients. The 5-year overall survival was significantly lower in this group (P < 0.005). Therefore, there is a need for intraoperative feedback on the status of bone resection margins to enable immediate additional resection where necessary. Although the lack of intraoperative methods for the evaluation of bone tissue has been addressed by many authors, there is still no reliable method for widespread use. Future research should focus on an objective, accurate, and rapid method of intraoperative assessment for the entire bone resection margin to optimize patient outcomes. 相似文献
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Patient‐ and family‐centred care in the intensive care unit: a challenge in the daily practice of healthcare professionals
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96.
Ellen Strijbos Martijn R. Tannemaat Iris Alleman Robert H.P. de Meel Jaap A. Bakker Ruud van Beek Frank P. Kroon Guus F. Rimmelzwaan Jan J.G.M. Verschuuren 《Vaccine》2019,37(7):919-925
Objective
To investigate the efficacy and safety of an influenza vaccination in patients with myasthenia gravis with acetylcholine receptor antibodies (AChR MG).Methods
An influenza vaccination or placebo was administered to 47 AChR MG patients. Before and 4?weeks after administration blood samples and clinical outcome scores were obtained. Antibodies to the vaccine strains A/California/7/2009 (H1N1)pdm09, A/Hong Kong/4801/14 (H3N2) and B/Brisbane/060/08 were measured using the hemagglutination-inhibition (HI) assay and disease-specific AChR antibody titers were measured with a radio-immunoprecipitation assay. Forty-seven healthy controls (HC) were vaccinated with the same influenza vaccine to compare antibody titers.Results
A post-vaccination, seroprotective titer (HI?≥?1:40) was achieved in 89.4% of MG patients vs. 93.6% in healthy controls for the H3N2 strain, 95.7% vs 97.9% for the H1N1 strain and 46.8 vs 51% for the B-strain. A seroprotective titer for all three strains of the seasonal influenza vaccine was reached in 40.4% (19/47) of the MG group and in 51% (24/47) of the HC group. Immunosuppressive medication did not significantly influence post geomean titers (GMT). The titers of disease-specific AChR antibodies were unchanged 4?weeks after vaccination. The clinical outcome scores showed no exacerbation of MG symptoms.Conclusion
The antibody response to an influenza vaccination in patients with AChR MG was not different from that in healthy subjects, even in AChR MG patients using immunosuppressive medication. Influenza vaccination does not induce an immunological or clinical exacerbation of AChR MG.Clinical trial registry
The influenza trial is listed on clinicaltrialsregister.eu under 2016-003138-26. 相似文献97.
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J. Klein-Nulend R. F. M. van Oers A. D. Bakker R. G. Bacabac 《Osteoporosis international》2014,25(5):1427-1437
One of the most serious healthcare problems in the world is bone loss and fractures due to a lack of physical activity in elderly people as well as in bedridden patients or otherwise inactive youth. Crucial here are the osteocytes. Buried within our bones, these cells are believed to be the mechanosensors that stimulate bone formation in the presence of mechanical stimuli and bone resorption in the absence of such stimuli. Intercellular signaling is an important physiological phenomenon involved in maintaining homeostasis in all tissues. In bone, intercellular communication via chemical signals like NO plays a critical role in the dynamic process of bone remodeling. If bones are mechanically loaded, fluid flows through minute channels in the bone matrix, resulting in shear stress on the cell membrane that activates the osteocyte. Activated osteocytes produce signaling molecules like NO, which modulate the activity of the bone-forming osteoblasts and the bone-resorbing osteoclasts, thereby orchestrating bone adaptation to mechanical loading. In this review, we highlight current insights in the role of NO in the mechanical adaptation of bone mass and structure, with emphasis on its role in local bone gain and loss as well as in remodeling supervised by osteocytes. Since mechanical stimuli and NO production enhance bone strength and fracture resistance, these new insights may facilitate the development of novel osteoporosis treatments. 相似文献
100.