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71.
72.
1q gain is a frequent finding in preoperatively treated Wilms tumors,but of limited prognostic value for risk stratification in the SIOP2001/GPOH trial 下载免费PDF全文
73.
Maria Torner Adjmal Mangal Hubert Scharnagl Christian Jansen Michael Praktiknjo Alexander Queck Wenyi Gu Robert Schierwagen Jennifer Lehmann Frank E. Uschner Christiana Graf Christian P. Strassburg Javier Fernandez Tatjana Stojakovic Rainer Woitas Jonel Trebicka 《Liver international》2020,40(1):186-193
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Frequent ventricular premature complexes (VPCs), particularly those without troublesome palpitations, are often regarded as a benign arrhythmia and are not treated other than with reassurance. However, VPCs can contribute to left ventricular (LV) dysfunction in the absence of symptoms. The present study was designed to investigate whether catheter ablation of VPCs can improve LV dysfunction in patients with and without troublesome palpitations. Of 80 consecutive patients who underwent catheter ablation of frequent VPCs, 24 (aged 60 ± 15 years) were found to have a reduced LV ejection fraction at baseline (<48%) and included in the present study. No important procedure-related complications occurred in these patients. During a median follow-up of 8 months, the VPC burden after ablation had decreased from 15 ± 6% to 1 ± 1% (p <0.001), and the left ventricular ejection fraction had increased from 32 ± 15% to 43 ± 14% (p <0.001). Ten patients (42%) had no palpitations before ablation. In the other 14 patients, the palpitations were improved or entirely resolved after ablation. No significant difference was found in the extent of LV ejection fraction improvement after ablation between patients with and without palpitations (+11 ± 12% vs +11 ± 11%, p = 0.941) or between patients with different locations of VPC origin. In conclusion, VPCs might not necessarily be associated with palpitations in many patients with LV dysfunction. Successful ablation of frequent VPCs in these "asymptomatic" patients is associated with an improvement in LV function similar to that observed in "symptomatic" patients. 相似文献
77.
Drabik A Büscher G Sawicki PT Thomas K Graf C Müller D Stock S 《Diabetes research and clinical practice》2012,95(2):194-200
Aim
Our objective was to examine the cost-effectiveness of disease management programs (DMPs) for type 2 diabetes mellitus (T2DM) taking into account their life prolonging effect.Methods
We compared real life costs in 19,888 propensity score matched pairs of T2DM DMP participants and T2DM patients in routine care (RC) according to sickness funds data. We estimated mean annual costs for survivors, last year of life costs for decedents, the influence of ageing on costs, incremental cost-effectiveness ratio and effects on hospitalization.Results
Annual costs for survivors were 3,318€ (DMP) and 3,570€ (RC). The mean costs in the last year of life were 16,911€ (DMP) and 15,763€ (RC). Ageing had a cost triggering effect for survivors (30€/36€ per year in DMP-/RC-group; p < 0.001) and a cost decreasing effect in the last year of life (546€/483€ per year in DMP-/RC-group; p < 0.001). The incremental cost-effectiveness ratio of the DMP vs. RC was −1396€ per life-year gained. Hospitalizations increased with age in case of survival and decreased with age in case of death but were always lower in the DMP-group.Conclusion
Despite increase in costs due to longer life DMPs are cost-effective. 相似文献78.
Stross L Günther J Gasteiger G Asen T Graf S Aichler M Esposito I Busch DH Knolle P Sparwasser T Protzer U 《Hepatology (Baltimore, Md.)》2012,56(3):873-883
The strength of antiviral T cell responses correlates with clearance of hepatitis B virus (HBV) infection, but the immunological mechanisms mitigating or suppressing HBV-specific T cells are still poorly understood. In this study, we examined the role of CD4(+) Foxp3(+) regulatory T cells (Tregs) in a mouse model of acute HBV infection. We initiated HBV infection via an adenoviral vector transferring a 1.3-fold overlength HBV genome (AdHBV) into transgenic DEREG mice, where Tregs can be transiently but selectively depleted by injection of diphtheria toxin. The effect of Treg depletion on the outcome of HBV infection was characterized by detailed virological, immunological, and histopathological analysis. Numbers of Tregs increase in the liver rapidly after initiation of HBV replication. Initial depletion of Tregs revealed their complex regulatory function during acute infection. Tregs mitigated immunomediated liver damage by down-regulating the antiviral activity of effector T cells by limiting cytokine production and cytotoxicity, but did not influence development of HBV-specific CD8 T cells or development of memory T cells. Furthermore, Tregs controlled the recruitment of innate immune cells such as macrophages and dendritic cells to the infected liver. As a consequence, Tregs significantly delayed clearance of HBV from blood and infected hepatocytes. Conclusion: Tregs limit immunomediated liver damage early after an acute infection of the liver, thereby contributing to conservation of tissue integrity and organ function at the cost of prolonging virus clearance. (HEPATOLOGY 2012;56:873-883). 相似文献
79.
Maximilian Schindler Axel Gamulin Wilson Belaieff Maruschka Francescato Alexis Bonvin Véronique Graf Pierre Hoffmeyer Blaise Wyssa Ilker Uçkay 《International orthopaedics》2013,37(10):2025-2030
Purpose
Empirical broad-spectrum antibiotic treatment for orthopaedic implant infections after surgical lavage is common practice while awaiting microbiological results, but lacks evidence.Methods
This was a single-centre cohort study from 1996 to 2010 with a follow-up of two years.Results
We retrieved 342 implant infections and followed them up for a median of 3.5 years (61 recurred, 18 %). Infected implants were arthroplasties (n = 186), different plates, nails or other osteosyntheses. The main pathogens were S. aureus (163, 49 methicillin-resistant) and coagulase-negative staphylococci (60, 45 methicillin-resistant). Median duration of empirical antibiotic coverage after surgical drainage was three days before switching to targeted therapy. Vancomycin was the most frequent initial empirical agent (147), followed by intravenous co-amoxiclav (44). Most empirical antibiotic regimens (269, 79 %) proved sensitive to the causative pathogen, but were too broad in 111 episodes (32 %). Cephalosporins and penicillins were used only in 44 and ten cases, respectively, although they would have covered 59 % of causative pathogens identified later. Multivariate Cox regression analysis showed that neither susceptible antibiotic coverage (compared to non-susceptible; hazard ratio 0.7, 95 % confidence interval 0.4–1.2) nor broad-spectrum use (hazard ratio 1.1, 0.8–1.5) changed remission rates.Conclusions
Provided that surgical drainage is performed, broad-spectrum antibiotic coverage does not enhance remission of orthopaedic implant infections during the first three days. If empirical agents are prescribed from the first day of infection, narrow-spectrum penicillins or cephalosporins can be considered to avoid unnecessary broad-spectrum antibiotic use. 相似文献80.
J. Farthmann D. Watermann A. Niesel C. Fünfgeld A. Kraus F. Lenz H. J. Augenstein E. Graf B. Gabriel 《International urogynecology journal》2013,24(5):749-758