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排序方式: 共有1482条查询结果,搜索用时 15 毫秒
941.
942.
943.
Fioravante Capone Francesco Ciro Tamburelli Fabio Pilato Paolo Profice Federico Ranieri Riccardo Di Iorio Francesco Iodice Gabriella Musumeci Vincenzo Di Lazzaro 《The spine journal》2013,13(9):1077-1079
Background contextCervical spondylotic myelopathy (CSM) is a common disorder, but its management and the role of surgery are still a matter of controversy. The assessment of surgical outcome is complicated by the lack of reliable and objective methods to assess the severity of the myelopathy and its evolution. Motor-evoked potentials (MEPs) are a useful and reliable tool to measure noninvasively the involvement of the corticospinal tract in patients with CSM. Recent evidence suggests that MEPs could also have a role in monitoring the effect of surgical therapy.PurposeThe aim of the present study is to use MEPs for the functional assessment of spinal cord before and after surgery and to correlate changes in MEPs with clinical findings.Study design/settingThis is a retrospective cohort study.Patient sampleThirty-eight patients affected by CSM who underwent surgical intervention.Outcome measuresWe used the 18-point modified Japanese Orthopedic Association (mJOA) score for clinical evaluation and the central motor conduction time (CMCT) for the study of MEPs.MethodsAll patients were evaluated both clinically and neurophysiologically before (7–15 days) and after (6–12 months) surgery. MEPs were recorded from the biceps, abductor digiti minimi, and tibialis anterior muscles bilaterally.ResultsAfter surgery, the 18-point mJOA score increased significantly from 10.1 to 15.1, and the value of CMCT for tibialis anterior muscles showed a slight but significant reduction, more evident in patients with mild to moderate symptoms.ConclusionsEarly surgical intervention for CSM could produce a beneficial effect on spinal cord functionality that can be detected by MEPs. 相似文献
944.
Ruggero Giuliani Cristina Cairone Lara Tavoschi Laura Ciaffi Teresa Sebastiani Raffaella Bartolotti Silvia Mancini Laura Cremonini Roberto Ranieri 《Euro surveillance : bulletin européen sur les maladies transmissibles = European communicable disease bulletin》2021,26(38)
Prisons are high-risk settings for COVID-19 and present specific challenges for prevention and control. We describe a COVID-19 outbreak in a large prison in Milan between 20 February and 30 April 2020. We performed a retrospective analysis of routine data collected during the COVID-19 emergency in prison. We analysed the spatial distribution of cases and calculated global and specific attack rates (AR). We assessed prevention and control measures. By 30 April 2020, 57 confirmed COVID-19 cases and 66 clinically probable cases were recorded among a population of 1,480. Global AR was 8.3%. The index case was a custodial officer. Two clusters were detected among custodial staff and healthcare workers. On 31 March, a confirmed case was identified among detained individuals. COVID-19 spread by physical proximity or among subgroups with cultural affinity, resulting in a cluster of 22 confirmed cases. Following index case identification, specific measures were taken including creation of a multidisciplinary task-force, increasing diagnostic capacity, contact tracing and dedicated isolation areas. Expanded use of personal protective equipment, environmental disinfection and health promotion activities were also implemented. Outbreaks of COVID-19 in prison require heightened attention and stringent comprehensive measures. 相似文献
945.
Antoni Riera-Mestre Luis Jara-Palomares Ramn Lecumberri Javier Trujillo-Santos Enric Grau Angeles Blanco-Molina Ana Piera Carbonell Sonia Jimnez Manuel Frías Vargas Mari Paz Fuset Sergi Bellmunt-Montoya Manuel Monreal David Jimnez 《Viruses》2021,13(11)
Patients with coronavirus disease 2019 (COVID-19) have a higher risk of venous thromboembolic disease (VTE) than patients with other infectious or inflammatory diseases, both as macrothrombosis (pulmonar embolism and deep vein thrombosis) or microthrombosis. However, the use of anticoagulation in this scenario remains controversial. This is a project that used DELPHI methodology to answer PICO questions related to anticoagulation in patients with COVID-19. The objective was to reach a consensus among multidisciplinary VTE experts providing answers to those PICO questions. Seven PICO questions regarding patients with COVID-19 responded with a broad consensus: 1. It is recommended to avoid pharmacological thromboprophylaxis in most COVID-19 patients not requiring hospital admission; 2. In most hospitalized patients for COVID-19 who are receiving oral anticoagulants before admission, it is recommended to replace them by low molecular weight heparin (LMWH) at therapeutic doses; 3. Thromboprophylaxis with LMWH at standard doses is suggested for COVID-19 patients admitted to a conventional hospital ward; 4. Standard-doses thromboprophylaxis with LMWH is recommended for COVID-19 patients requiring admission to Intensive Care Unit; 5. It is recommended not to determine D-Dimer levels routinely in COVID-19 hospitalized patients to select those in whom VTE should be suspected, or as a part of the diagnostic algorithm to rule out or confirm a VTE event; 6. It is recommended to discontinue pharmacological thromboprophylaxis at discharge in most patients hospitalized for COVID-19; 7. It is recommended to withdraw anticoagulant treatment after 3 months in most patients with a VTE event associated with COVID-19. The combination of PICO questions and DELPHI methodology provides a consensus on different recommendations for anticoagulation management in patients with COVID-19. 相似文献
946.
Francesca Maria Notarangelo Giuseppe Maglietta Paola Bevilacqua Marco Cereda Piera Angelica Merlini Giovanni Quinto Villani Paolo Moruzzi Giampiero Patrizi Guidantonio Malagoli Tagliazucchi Antonio Crocamo Angela Guidorossi Filippo Pigazzani Elisa Nicosia Giorgia Paoli Marco Bianchessi Mario Angelo Comelli Caterina Caminiti Diego Ardissino 《Journal of the American College of Cardiology》2018,71(17):1869-1877
Background
Although clopidogrel is still frequently used in patients with acute coronary syndromes (ACS), its efficacy is hampered by interpatient response variability caused by genetic polymorphisms associated with clopidogrel’s metabolism.Objectives
The goal of this study was to evaluate whether selecting antiplatelet therapy (clopidogrel, prasugrel, or ticagrelor) on the basis of a patient’s genetic and clinical characteristics leads to better clinical outcomes compared with the standard of care, which bases the selection on clinical characteristics alone.Methods
Patients hospitalized for ACS were randomly assigned to standard of care or the pharmacogenomic arm, which included the genotyping of ABCB1, CYP2C19*2, and CYP2C19*17 using an ST Q3 system that provides data within 70 min at each patient’s bedside. The patients were followed up for 12 ± 1 month for the primary composite endpoint of cardiovascular death and the first occurrence of nonfatal myocardial infarction, nonfatal stroke, and major bleeding defined according to Bleeding Academic Research Consortium type 3 to 5 criteria.Results
After enrolling 888 patients, the study was prematurely stopped. Clopidogrel was used more frequently in the standard-of-care arm (50.7% vs. 43.3%), ticagrelor in the pharmacogenomic arm (42.6% vs. 32.7%; p = 0.02), and prasugrel was equally used in both arms. The primary endpoint occurred in 71 patients (15.9%) in the pharmacogenomic arm and in 114 (25.9%) in the standard-of-care arm (hazard ratio: 0.58; 95% confidence interval: 0.43 to 0.78; p < 0.001).Conclusions
A personalized approach to selecting antiplatelet therapy for patients with ACS may reduce ischemic and bleeding events. (Pharmacogenetics of Clopidogrel in Patients With Acute Coronary Syndromes [PHARMCLO]; NCT03347435) 相似文献947.
High tidal volume and positive fluid balance are associated with worse outcome in acute lung injury 总被引:12,自引:0,他引:12
Sakr Y Vincent JL Reinhart K Groeneveld J Michalopoulos A Sprung CL Artigas A Ranieri VM;Sepsis Occurence in Acutely Ill Patients Investigators 《Chest》2005,128(5):3098-3108
STUDY OBJECTIVES: Recent data have suggested that ventilatory strategy could influence outcomes from acute lung injury (ALI) and ARDS. We tested the hypothesis that infection/sepsis and use of higher tidal volumes than those applied in the ARDS Network (ARDSnet) study (> 7.4 mL/kg of predicted body weight) would worsen outcome in patients with ALI/ARDS. DESIGN: International cohort, observational study. SETTING: One hundred ninety-eight European ICUs participating in the Sepsis Occurrence in Acutely Ill Patients study. PATIENTS OR PARTICIPANTS: All 3,147 adult patients admitted to one of the participating ICUs between May 1, 2002, and May 15, 2002. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: Patients were followed up until death, hospital discharge, or for 60 days. Of the 3,147 patients, 393 patients (12.5%) had ALI/ARDS. ICU and hospital mortality was higher in patients with ALI/ARDS than those without ALI/ARDS (38.9% vs 15.6% and 45.5% vs 21.0%, respectively; p < 0.001). A multivariable logistic regression analysis with ICU outcome as the dependent factor showed that the independent risks for mortality were as follows: presence of cancer, use of tidal volumes higher than those used by the ARDSnet study, degree of multiorgan dysfunction, and higher mean fluid balance. Sepsis, septic shock, and oxygenation at the onset of ALI/ARDS were not independently associated with higher mortality rates. CONCLUSIONS: In addition to comorbidities and organ dysfunction, high tidal volumes and positive fluid balance are associated with a worse outcome from ALI/ARDS. 相似文献
948.
Sophie Testa Walter Ageno Emilia Antonucci Rossella Morandini Jan Beyer-Westendorf Maurizio Paciaroni Marc Righini Piera Sivera Peter Verhamme Vittorio Pengo Daniela Poli Gualtiero Palareti 《Internal and emergency medicine》2018,13(7):1051-1058
The management of major bleeding in patients treated with direct oral anticoagulants (DOACs) is still not well established. START-Events, a branch of the START registry (Survey on anTicoagulated pAtients RegisTer) (NCT02219984), aims to describe the actual management of bleeding or recurrent thrombotic events in routine clinical practice. We here present the results of the management of bleeding patients. The START-Event registry is a prospective, observational, multicenter, international study. Baseline characteristics (demographic, clinical, risk factors) of patients, laboratory data at admission and during follow-up, site of bleeding, therapeutic strategies, and outcomes at the time of hospital discharge and after 6 months were recorded on a web-based case report form. Between January 2015 and December 2016, 117 patients with major bleeding events were enrolled. Non-valvular atrial fibrillation (NVAF) was the indication for treatment in 84% (62% males); 53 patients had intracranial bleeding (13 fatal), 42 had gastrointestinal bleeding (1 fatal), and 22 had bleeding in other sites. Therapeutic interventions for the management of bleeding were performed in 71% of patients. Therapeutic strategies with/without surgery or invasive procedures included: fluid replacement or red blood cells transfusion, prothrombin complex concentrates (3 or 4 factors), antifibrinolytic drugs, and the administration of idarucizumab. Creatinine, blood cell count, and PT/aPTT were the most frequent tests requested, while specific DOAC measurements were performed in 23% of patients. Mortality during hospitalization was 11.9%, at 6-month follow-up 15.5%. Our data confirm a high heterogeneity in the management of bleeding complications in patients treated with DOACs. 相似文献
949.
Francesca Ceccarelli Andrea Fuso Liana Civitelli Ersilia Ranieri Giuliana Caprio Paola Pagni Mario Rengo Sigfrido Scarpa 《Journal of cancer research and clinical oncology》2010,136(1):157-163
Purpose
Increased expression of urokinase (uPA), a member of the serine protease family, is an effector of metastatic cascade and has been reported in various malignancies, including breast cancer. uPA overexpression in cancer tissues was correlated with a more aggressive phenotype and it is considered a strong and independent unfavorable prognostic factor in breast cancer. 相似文献950.
Prevalence of hypothyroidism and Graves disease in sarcoidosis 总被引:1,自引:0,他引:1
BACKGROUND: The association of sarcoidosis (S) and thyroid autoimmunity has been reported by several studies in a wide range of variability. The aim of our study was to evaluate the prevalence of clinical and subclinical thyroid disorders in patients with S vs gender-matched and age-matched control subjects. METHODS: Thyroid hormones and antithyroid antibodies, thyroid ultrasonography and fine-needle aspiration were performed in 111 patients with S who had been consecutively referred to the Respiratory Pathophysiology Section of the University of Pisa, and the results were compared to 333 gender-matched and age-matched control subjects from the same geographic area. RESULTS: The odds ratio for subclinical hypothyroidism for female patients with S vs control subjects was 2.7 (95% confidence interval [CI], 1.3 to 5.9); for anti-thyroid peroxidase antibody titer (AbTPO) positivity, 2.2 (95% CI, 1.2 to 3.9); and for thyroid autoimmunity, 1.9 (95% CI, 1.1 to 3.2). The mean values of thyroid-stimulating hormone and AbTPO were higher in female S patients than in control subjects (p < 0.01). A significantly higher prevalence of clinical hypothyroidism (four patients) and Graves disease (three patients) was observed in female S patients than in control subjects (none; p = 0.005 and 0.0026, respectively). Two cases of papillary thyroid cancer were detected in S patients. No significant difference between S patients and control subjects was detected for free triiodothyronine and thyroxine, antithyroglobulin autoantibodies, thyroid volume and nodularity, and subclinical hyperthyroidism. CONCLUSIONS: Thyroid function, AbTPO antibodies, and ultrasonography should be tested as part of the clinical profile in female S patients. Subjects who are at high risk (female subjects, those with positive AbTPOs, and those with hypoechoic and small thyroid) should have thyroid function follow-up and appropriate treatment in due course. 相似文献