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81.
Stella CL O'Brien JM Forrester KJ Barton JR Istwan N Rhea D Sibai BM 《American journal of perinatology》2008,25(6):325-329
Gestational hypertension (GHTN) and gestational diabetes mellitus (GDM) are both insulin resistance states. Perinatal outcome of GHTN or GDM alone are well established, but their combined effect on pregnancy outcome is underinvestigated. Our objective was to determine if pregnancies complicated by GHTN/GDM have higher rates of morbidity. We identified nulliparous women with singleton pregnancies delivering at 37 to 40 weeks of gestation from 1995 to 2004 from a database. Outcomes of pregnancies complicated by GHTN only, GDM only, or combined GHTN/GDM were compared with controls. Data analysis included the Mann-Whitney U test, the Kruskal-Wallis H test, and analysis of variance. Multivariate analysis was used to adjust for confounders. Of 14,880 patients, there were 11,349 controls, 2604 GHTN, 728 GDM, and 199 GHTN/GDM. After controlling for covariates, GHTN significantly increased cesarean section (C/S) rate (odd ratio [OR], 1.62; confidence interval [CI], 1.47 to 1.78), rates of admittance to the neonatal intensive care unit (NICU), and birth of large for gestational age (LGA) infants. GDM significantly increased C/S (OR, 1.42; CI 1.21 to 1.66), rates of NICU admission (OR, 1.32; CI, 1 to 1.75), birth of LGA (OR, 1.51; CI 1.14 to 1.98), and macrosomic infants (OR, 1.53; CI, 1.12 to 2.08). Rates of LGA infants (OR, 1.85; CI, 1.19 to 2.86) and C/S (OR, 2.03; CI, 1.52 to 2.71) were significantly increased with GHTN/GDM. We concluded that GHTN or GDM is associated with increased rates of adverse outcomes. Their coexistence further increases adverse perinatal outcomes. 相似文献
82.
Uganda has been hailed as a success story in the fight against HIV that has seen a reversal in prevalence from a peak of 15% in 1991 to about 6.5% currently Since 1992, the largest and most consistent declines in HIV have occurred among the 15-19-year-olds. While many studies have examined how key behavior changes (Abstinence, Be faithful and Condom use) have contributed to the decline in HIV prevalence, few have studied the relationship between sexual behaviors and risk perception. Using data from the 2004 National Survey of Adolescents, multivariate logistic regression models were fitted to examine the strength of the association between risky sexual behavior and perceived risk among 12-19-year-old adolescents in Uganda. After controlling for other correlates of sexual behavior such as age, education, residence, region and marital status, the findings indicate highly significant positive association between perceived risk and risky sexual behavior among males but not females. The findings reveal that, regardless of their current sexual behavior, most female adolescents in Uganda feel at great risk of HIV infection. The findings also show that adolescents with broken marriages are much more vulnerable to high risk sexual behaviors than other categories of adolescents. These results further emphasize the need for a holistic approach in addressing the social, economic and contextual factors that continue to put many adolescents at risk of HIV infection. 相似文献
83.
84.
Does empirical research make bioethics more relevant? “The embedded researcher” as a methodological approach 总被引:1,自引:2,他引:1
Reiter-Theil S 《Medicine, health care, and philosophy》2004,7(1):17-29
Medicine, Health Care and Philosophy - What is the status of empirical contributions to bioethics, especially to clinical bioethics? Where is the empirical approach discussed in bioethics related... 相似文献
85.
E. Faglia L. Dalla Paola G. Clerici J. Clerissi L. Graziani M. Fusaro L. Gabrielli S. Losa A. Stella M. Gargiulo M. Mantero M. Caminiti S. Ninkovic V. Curci A. Morabito 《European journal of vascular and endovascular surgery》2005,29(6):620-627
OBJECTIVE: To evaluate the effectiveness of peripheral angioplasty (PTA) as the first-choice revascularisation procedure in diabetic patients with critical limb ischemia (CLI). DESIGN: Prospective study. METHODS: PTA was employed as first choice revascularisation in a consecutive series of diabetic patients hospitalized for CLI between January 1999 and December 2003. RESULTS: PTA was successful performed in 993 patients. Seventeen (1.7%) major amputations were carried out. One death and 33 non-fatal complications were observed. Mean follow-up was 26+/-15 months. Clinical restenosis was observed in 87 patients. The 5 years primary patency was 88%, 95% CI 86-91%. During follow-up 119 (12.0%) patients died at a rate of 6.7% per year. CONCLUSIONS: PTA as the first choice revascularisation procedure is feasible, safe and effective for limb salvage in a high percentage of diabetic patients. Clinical restenosis was an infrequent event and PTA could successfully be repeated in most cases. 相似文献
86.
87.
Echocardiographic features of post−transcatheter aortic valve implantation thrombosis and endocarditis 下载免费PDF全文
Marco Spartera MD Francesco Ancona MD Marta Barletta MD Isabella Rosa MD Stefano Stella MD Claudia Marini MD Leonardo Italia MD Matteo Montorfano MD Azeem Latib MD Ottavio Alfieri MD Alberto Margonato MD Antonio Colombo MD Eustachio Agricola MD 《Echocardiography (Mount Kisco, N.Y.)》2018,35(3):337-345
88.
Wanda Kwan Ulrike Tr?ger Dimitrios Davalos Austin Chou Jill Bouchard Ralph Andre Aaron Miller Andreas Weiss Flaviano Giorgini Christine Cheah Thomas M?ller Nephi Stella Katerina Akassoglou Sarah J. Tabrizi Paul J. Muchowski 《The Journal of clinical investigation》2012,122(12):4737-4747
In Huntington disease (HD), immune cells are activated before symptoms arise; however, it is unclear how the expression of mutant huntingtin (htt) compromises the normal functions of immune cells. Here we report that primary microglia from early postnatal HD mice were profoundly impaired in their migration to chemotactic stimuli, and expression of a mutant htt fragment in microglial cell lines was sufficient to reproduce these deficits. Microglia expressing mutant htt had a retarded response to a laser-induced brain injury in vivo. Leukocyte recruitment was defective upon induction of peritonitis in HD mice at early disease stages and was normalized upon genetic deletion of mutant htt in immune cells. Migration was also strongly impaired in peripheral immune cells from pre-manifest human HD patients. Defective actin remodeling in immune cells expressing mutant htt likely contributed to their migration deficit. Our results suggest that these functional changes may contribute to immune dysfunction and neurodegeneration in HD, and may have implications for other polyglutamine expansion diseases in which mutant proteins are ubiquitously expressed. 相似文献
89.
Anyfanti Panagiota Gavriilaki Eleni Pyrpasopoulou Athina Triantafyllou George Triantafyllou Areti Chatzimichailidou Sofia Gkaliagkousi Eugenia Aslanidis Spyros Douma Stella 《Clinical rheumatology》2016,35(5):1411-1411
Clinical Rheumatology - 相似文献
90.
Daniel R. Feikin M. Kariuki Njenga Godfrey Bigogo Barrack Aura Stella Gikunju Amanda Balish Mark A. Katz Dean Erdman Robert F. Breiman 《Clinical and Vaccine Immunology : CVI》2013,20(1):113-114
The role of serology in the setting of PCR-based diagnosis of acute respiratory infections (ARIs) is unclear. We found that acute- and convalescent-phase paired-sample serologic testing increased the diagnostic yield of naso/oropharyngeal swabs for influenza virus, respiratory syncytial virus (RSV), human metapneumovirus, adenovirus, and parainfluenza viruses beyond PCR by 0.4% to 10.7%. Although still limited for clinical use, serology, along with PCR, can maximize etiologic diagnosis in epidemiologic studies. 相似文献