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排序方式: 共有1168条查询结果,搜索用时 15 毫秒
911.
Monda L Shehata Susan Cheng Nael F Osman David A Bluemke João AC Lima 《Journal of cardiovascular magnetic resonance》2009,11(1):1-12
Aims
Patients with prior major cardiovascular or cerebrovascular events (MACE) are more likely to have future recurrent events independent of traditional cardiovascular disease risk factors. The purpose of this study was to determine if patients with traditional risk factors and prior MACE had increased cardiovascular magnetic resonance (CMR) plaque burden measures compared to patients with risk factors but no prior events.Methods and Results
Black blood carotid and thoracic aorta images were obtained from 195 patients using a rapid extended coverage turbo spin echo sequence. CMR measures of plaque burden were obtained by tracing lumen and outer vessel wall contours. Patients with prior MACE had significantly higher MR plaque burden (wall thickness, wall area and normalized wall index) in carotids and thoracic aorta compared to those without prior MACE (Wall thickness carotids: 1.03 ± 0.03 vs. 0.93± 0.03, p = 0.001; SD wall thickness carotids: 0.137 ± 0.0008 vs. 0.102 ± 0.0004, p < 0.001; wall thickness aorta: 1.63 ± 0.10 vs. 1.50 ± 0.04, p = 0.009; SD wall thickness aorta: 0.186 ± 0.035 vs. 0.139 ± 0.012, p = 0.009 respectively). Plaque burden (wall thickness) and plaque eccentricity (standard deviation of wall thickness) of carotid arteries were associated with prior MACE after adjustment for age, sex, and traditional risk factors. Area under ROC curve (AUC) for discriminating prior MACE improved by adding plaque eccentricity to models incorporating age, sex, and traditional CVD risk factors as model inputs (AUC = 0.79, p = 0.05).Conclusion
A greater plaque burden and plaque eccentricity is prevalent among patients with prior MACE. 相似文献912.
A HIV positive man with a CD4 count of 777×10(6)/l and suppressed viral load on antiretroviral medication had a delayed diagnosis of Kaposi's sarcoma (KS) affecting his left leg. He was diabetic and on a controlled diet and had a previous deep vein thrombosis affecting the same leg. Factors that have been studied in HIV-related KS as well as classical KS, such as diabetes mellitus, not smoking and previous deep vein thrombosis, may have increased our patient's risk for the development of this disease. Clinicians should consider KS as a possible diagnosis even in patients with well-controlled HIV. 相似文献
913.
914.
Willem F. Arts Ada T. Geerts Oebele F. Brouwer Cees A. van Donselaar Hans Stroink Boudewijn AC. Peters Els AJ. Peeters Peter Camfield Carol Camfield 《Epileptic Disord》2019,21(2):141-153
Aims. It is unknown whether treatment with antiepileptic drugs in children with epilepsy with a presumed good prognosis is always necessary. We aimed to study the course of newly diagnosed epilepsy in children with a presumed good prognosis who are managed without AED treatment. Methods. A total of 151 children (one month to 12 years of age) with two to five lifetime unprovoked seizures (excluding febrile convulsions), were followed for three years. Treatment was initially withheld. Children with symptomatic epilepsy, or absence or myoclonic epilepsy, were excluded. AED treatment was started after >10 lifetime seizures or an episode of status epilepticus during follow‐up, or if the parents or treating physician deemed it otherwise necessary. Results. During follow‐up, 113 children continued to meet our criteria for refraining from treatment with antiepileptic drugs, yet 30 started treatment at the request of the parents. Thirty‐eight children at some time met the criteria to start treatment, but the parents of 16 declined treatment. In all, 99 (66%) children maintained the no‐treatment regime. Ninety‐eight children (65% of 151) reached terminal remission for at least one year, including 83 who did not receive antiepileptic drug treatment (84% of the untreated 99). Mean terminal remission was significantly longer in the group with a total of <10 seizures compared to those with >10 seizures. Treatment did not increase the length of terminal remission. Adverse events, including traumatic injury, occurred equally in the treated and untreated children. Measures of quality of life suggested a better outcome in those without treatment. Conclusions. Children with newly diagnosed epilepsy with a presumed good prognosis may not need immediate AED treatment. Postponing treatment does not alter the chance of remission or the risk of accidents and adverse events and appears to be associated with a good quality of life. 相似文献
915.
Thijs R van Oudheusden Bart AC Aerts Ignace HJT de Hingh Misha DP Luyer 《World journal of gastroenterology : WJG》2013,19(43):7489-7493
Adhesive small bowel obstruction(ASBO)is the most frequently encountered surgical disorder of the small intestine.Up to 80%of ASBO cases resolve spontaneously and do not require invasive treatment.It is important to identify such patients that will benefit from conservative treatment in order to prevent unnecessarily exposing them to the risks associated with surgical intervention,such as morbidity and further adhesion formation.For the remaining ASBO patients,timely surgical intervention is necessary to prevent small bowel strangulation,which may cause intestinal ischemia and bowel necrosis.While early identification of these patients is key to decreasing ASBO-related morbidity and mortality,the non-specific signs and laboratory findings upon clinic presentation limit timely diagnosis and implementation of appropriate clinical management.Combining the clinical presentation findings with those from other diagnostic imaging modalities,such as abdominal X-ray,computed tomography-scan and water-soluble contrast studies,will improve diagnosis of ASBO and help clinicians to better evaluate the potential of conservative management as a safe strategy for a particular patient.Nonetheless,patients who present with moderate findings by all these approaches continue to represent a challenge.A new diagnostic strategy is urgently needed to further improve our ability to identify early signs of strangulated bowel,and this diagnostic modality should be able to indicate when surgical management is required.A number of potential serum markers have been proposed for this purpose,including intestinal fatty acid binding protein andα-glutathione S transferase.On-going research is attempting to clearly define their diagnostic utility and to optimize their potential role in determining which patients should be managed surgically. 相似文献
916.
Background
Breast cancer is the most common malignancy in Chinese women. Conventional cancer treatments can increase the survival but often cause cardiovascular complications that compromise quality of life. Findings from previous exploratory studies showed that Tai Chi Qigong (TCQ) might induce favourable cardiovascular changes in cancer survivors. We aimed to assess the efficacy of a TCQ programme in improving arterial haemodynamics and quality of life in breast cancer survivors.Methods
In this single-blinded, randomised controlled trial, 54 Chinese women who survived breast cancer and completed conventional medical care were recruited through a cancer self-help group and a medical clinic in Hong Kong. The participants were randomly allocated to either TCQ or no training (control) using computer-generated random numbers. Participants in the TCQ group attended two 1 h sessions per week for 3 months at the Nature Health Qigong Association (Hong Kong); during these sessions participants practiced the 18 forms of Tai Chi Internal Qigong. Both groups received usual medical care. The primary outcomes were maximum systolic and minimum diastolic arterial blood flow velocities as measured by a Doppler ultrasound machine. The secondary outcomes were oxygen saturation in blood at rest (as measured by an oximeter) and quality of life measured with the Functional Assessment of Cancer Therapy–Breast (FACT-B v4). Data were collected at baseline, post-test, and 3 months (follow-up). Two-way repeated-measures analysis of variance and intention-to-treat analysis were used in data analysis. Ethical approval was obtained from the Human Research Ethics Committee of Hong Kong University. The trial was registered with ClinicalTrials.gov (NCT02420249). Written informed consent was obtained from each participant.Findings
Baseline characteristics were comparable between participants in the TCQ (n=33; mean age 52·7 years, SD 7·5 years) and control group (n=21; mean age 51·5 years, SD 8·2 years). The TCQ and control groups showed similar changes in systolic velocity (group-by-time interaction F2,102=2·118, 95% CI 14·90–18·13; p=0·126; ηp2=0·040) and diastolic velocity (group-by-time interaction2,102=1·375, 95% CI 1·49–2·33; p=0·258; ηp2=0·026). Blood oxygen saturation increased by 0·5% from baseline to follow-up test in the TCQ group (p=0·002, 95% CI ?0·78 to ?0·19) while no change was noted in the control group (p=0·119, 95%CI ?1·03 to 0·13). The FACT-B total score decreased by 23·04 points (24·0%) between baseline and follow up in the control group only (p=0·033, 95% CI 2·12–43·97; TCQ group: p=0·427, 95%CI ?8·33 to 19·22). No adverse events were reported.Interpretation
The TCQ programme improved blood oxygenation and quality of life, but it did not improve blood flow velocities in Chinese women who had survived breast cancer. Further studies could examine the mechanisms or causes of the favourable changes.Funding
Seed Funding Programme for Basic Research (201410159001), the University of Hong Kong. 相似文献917.
Short‐term weight gain after antiretroviral therapy initiation and subsequent risk of cardiovascular disease and diabetes: the D:A:D study 下载免费PDF全文
918.
Descamps D Chaix ML Montes B Pakianather S Charpentier C Storto A Barin F Dos Santos G Krivine A Delaugerre C Izopet J Marcelin AG Maillard A Morand-Joubert L Pallier C Plantier JC Tamalet C Cottalorda J Desbois D Calvez V Brun-Vezinet F Masquelier B Costagliola D;ANRS AC Resistance Study Group 《The Journal of antimicrobial chemotherapy》2010,65(12):2620-2627
919.
Background
Bicycle use entails high safety and health risks especially for adolescents. Most safety education programs aimed at adolescents focus on accident statistics and risk perceptions. This paper proposes the investigation of the social-cognitive correlates of risky cycling behaviors of adolescents prior to developing safety education programs. 相似文献920.
Shi Sum Poon Caterina Alberti Marco Nardini Marcello Migliore 《Interactive Cardiovascular and Thoracic Surgery》2022,35(1)
Mediastinal malignant pleural mesothelioma with signs of tamponade is rare. Indication for reoperation for recurrent malignant pleural mesothelioma is a controversial but viable option in selected patients. We report a case of a 68-year-old man presenting with epithelioid malignant pleural mesothelioma who underwent a total of three debulking surgeries (pleurectomy/decortication) combined with hyperthermic intrathoracic chemotherapy. Five years after the first procedure, a third urgent operation was performed for recurrence of a large mediastinal mesothelioma causing acute symptoms of pericardial constriction and tamponade. The patient was alive for eight years since the first treatment and 36 months after the second reoperation. 相似文献