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111.
Lucas Regatieri Barbieri Marcelo Luiz Peixoto Sobral Glaucio Mauren da Silva Ger?nimo Gilmar Geraldo dos Santos Evandro Sbaraíni Fabio Kirzner Dorfman Noedir Ant?nio Groppo Stolf 《Brazilian Journal Of Cardiovascular Surgery》2013,28(4):442-448
Introduction
Postoperative atrial fibrillation is the most common arrhythmia in cardiac surgery, its incidence range between 20% and 40%.Objective
Quantify the occurrence of stroke and acute renal insufficiency after myocardial revascularization surgery in patients who had atrial fibrillation postoperatively.Methods
Cohort longitudinal bidirectional study, performed at Portuguese Beneficent Hospital (SP), with medical chart survey of patients undergoing myocardial revascularization surgery between June 2009 to July 2010. From a total of 3010 patients were weaned 382 patients that presented atrial fibrillation preoperatively and/or associated surgeries. The study was conducted in accordance with national and international following resolutions: ICH Harmonized Tripartite Guidelines for Good Clinical Practice - 1996; CNS196/96 Resolution, and Declaration of Helsinki.Results
The 2628 patients included in this study were divided into two groups: Group I, who didn''t show postoperative atrial fibrillation, with 2302 (87.6%) patients; and group II, with 326 (12.4%) who developed postoperative atrial fibrillation. The incidence of stroke in patients was 1.1% without postoperative atrial fibrillation vs. 4% with postoperative atrial fibrillation (P<0.001). Postoperative acute renal failure was observed in 12% of patients with postoperative atrial fibrillation and 2.4% in the group without postoperative atrial fibrillation (P<0.001), that is a relation 5 times greater.Conclusion
In this study there was a high incidence of stroke and acute renal failure in patients with postoperative atrial fibrillation, with rates higher than those reported in the literature. 相似文献112.
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117.
Perin C Fagondes SC Casarotto FC Pinotti AF Menna Barreto SS Dalcin Pde T 《Sleep & breathing》2012,16(4):1041-1048
Purpose
Questions remain about the polysomnographic findings and the predictors for sleep desaturation in cystic fibrosis (CF) patients. Our study aimed to evaluate sleep parameters in a sample of adult CF patients comparing them with healthy controls and to determine the best predictors of sleep desaturation in CF patients with awake resting peripheral oxygen saturation (SpO2) ??90%.Methods
In a cross-sectional study, with data collected prospectively, 51 clinically stable adult CF patients (mean age 25.1?±?6.7?years) and 25 age-matched controls underwent an overnight polysomnography and answered sleep questionnaires. CF patients had their pulmonary function, 6-min walk test, and echocardiography assessed.Results
CF patients and control subjects had similar sleep architecture. However, CF patients had impaired subjective sleep quality and a higher arousal index than controls. The apnea?Chypopnea index was similar in both groups, and only two CF patients (3.9%) fulfilled the criteria for obstructive sleep apnea syndrome. Sleep desaturation was more common in CF patients (29.4% vs 0%; p?0.001). In a logistic regression model, we observed that awake resting SpO2 was the single best variable associated with sleep desaturation in CF population (p?0.001). The awake SpO2 <94% had a sensitivity, specificity, positive and negative predictive value for sleep desaturation of, respectively, 93.3%, 100%, 100%, and 97.3%.Conclusions
CF patients had a worse subjective sleep quality and small changes in sleep architecture. In nonhypoxic, adult CF patients, sleep desaturation is common, is not associated with obstructive sleep events, and can be accurately predicted by awake resting SpO2 <94%. 相似文献118.
Antó JM 《Current allergy and asthma reports》2012,12(3):192-200
The present review aims to identify and summarize epidemiologic investigations published during 2011 on the environmental
risk factors for asthma. Potentially eligible papers were identified by a MEDLINE search. In total, 1,130 items were retrieved.
Based on a broad definition of environment, the following topics were included: obesity, diet, vitamin D, air pollution, farming
environment, and social factors. Some of the more relevant contributions included evidence that 1) obesity precedes asthma,
2) fruit consumption is longitudinally associated with a lower risk of asthma and atopy, 3) a comprehensive statewide smoking
ban was followed by a reduction in hospital admissions for asthma, 4) asthma is one of the diseases showing the largest burdens
due to environmental tobacco smoke, 5) traffic-related urban air pollution is associated with bronchial inflammation as measured
by fractional exhaled nitric oxide and uncontrolled asthma, 6) aeroallergens and desert dust may contribute to the short-term
effects of air pollution and asthma, and 7) maternal exposure to air pollution before and during pregnancy may alter the immune
competence in offspring. 相似文献
119.
P. Garrido M. De Blas G. Ronzoni I. Cordero M. Antón E. Giné A. Santos A. Del Arco G. Segovia F. Mora 《Journal of neural transmission (Vienna, Austria : 1996)》2013,120(5):829-843
The present study was designed to investigate the modulation of the stress responses by the environmental conditions and its putative neurobiological mechanisms. For that an integrative study on the effects of environmental enrichment and isolation housing on (1) the corticosterone, dopamine and acetylcholine responses to acute restraint stress in the prefrontal cortex (PFC) of the awake rat; (2) the mRNA levels of glucocorticoid receptors (GRs) in the PFC, and (3) the behavioral responses to stress, related to the PFC (habituation to a novel environment, spatial-working memory and inhibitory avoidance response) was performed. Male Wistar rats were maintained from 3 to 6 months of age in two different conditions: enriched (EC) or impoverished (IC). Animals were stereotaxically implanted with bilateral guide cannulae in the PFC to perform microdialysis experiments to evaluate the concentrations of corticosterone, dopamine and acetylcholine. EC animals showed lower increases of corticosterone and dopamine but not of acetylcholine than IC animals in the PFC in response to acute restraint stress (20 min). In the PFC, GR mRNA levels showed a trend towards an enhancement in EC animals. EC reduced the days to learn the spatial working memory task (radial-water maze). Spatial working memory, however, was not different between groups in either basal or stress conditions. Inhibitory avoidance response was reduced in EC rats. The changes produced by EC in the neurochemical, neuroendocrine and behavioral parameters evaluated suggest that EC rats could show a better coping during an acute stress challenge. 相似文献
120.
Miguel M. Gonçalves António P. Ribeiro William B. Stiles Tatiana Conde Marlene Matos Carla Martins 《Psychotherapy research》2013,23(1):27-40
Abstract According to the author's narrative model of change, clients may maintain a problematic self-stability across therapy, leading to therapeutic failure, by a mutual in-feeding process, which involves a cyclical movement between two opposing parts of the self. During innovative moments (IMs) in the therapy dialogue, clients’ dominant self-narrative is interrupted by exceptions to that self-narrative, but subsequently the dominant self-narrative returns. The authors identified return-to-the-problem markers (RPMs), which are empirical indicators of the mutual in-feeding process, in passages containing IMs in 10 cases of narrative therapy (five good-outcome cases and five poor-outcome cases) with females who were victims of intimate violence. The poor-outcome group had a significantly higher percentage of IMs with RPMs than the good-outcome group. The results suggest that therapeutic failures may reflect a systematic return to a dominant self-narrative after the emergence of novelties (IMs). 相似文献