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991.
应用高效液相色谱检测慢性肾炎肾功能不全患者尿纤维蛋白肽A及其临床意义 总被引:1,自引:0,他引:1
应用高效液相色谱法(HPLC)检测42例正常人,24例肾功能正常之慢性肾炎,12例慢性肾炎肾功能不全氮质血症期患者及21例尿毒症期患者尿FPA水平,其均值分别为:25.40±10.30ng/mgCr、26.99±5.77ng/mgCr、38.81±6.28ng/mgCr、79.74±18.76ng/mgCr。结果显示:氮质血症期组尿FPA水平明高于正常对照及肾功能正常之慢性肾炎组(P<0.01),尿毒症期组尿FPA显著高于氮质血症期组(P<0.01)。监测尿FPA水平与血浆肌酐浓度显示二者呈正相关性(r=0.9120,P<0.01)。揭示,慢性肾炎肾功能不全患者循环血液处于异常高凝状态,其严重程度与疾病的发生、发展密切相关,监测其尿FPA水平能较敏感地反映肾功能状态。 相似文献
992.
Koichiro Takahashi Hironori Sadamatsu Kumiko Suzuki Hiroki Tashiro Shinya Kimura Yuichiro Kuratomi Naoko Sueoka-Aragane 《Respiratory investigation》2021,59(1):126-134
BackgroundEosinophilic chronic rhinosinusitis (ECRS) is often complicated by asthma and can be difficult to diagnose. This study aimed to clarify the usefulness of the self-administered odor questionnaire (SAOQ) and visual analog scale (VAS) to identify olfactory disorders in patients with asthma.MethodsThis retrospective study was conducted on patients with asthma who were referred to the Otolaryngology clinic between May and September 2018. The treatment step of asthma, asthma control test (ACT), pulmonary function test, peripheral blood eosinophils, and fractional exhaled nitric oxide (FeNO) were analyzed. ECRS was diagnosed based on the Japanese Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis Study score. Olfactory dysfunction was evaluated using the SAOQ and VAS for olfactory disorders.ResultsThe study included 56 patients (18 males and 38 females), who were divided into two groups; those with ECRS (n = 18) and those without ECRS (n = 38). Age, sex, treatment step, ACT score, and pulmonary function were not significantly different between the groups. The ECRS group had a significantly higher FeNO value (89.1 ppb vs. 39.1 ppb) and a significantly lower SAOQ score (40.1% vs. 96.1%). The area under the receiver operating characteristic curve for the efficacy of ECRS diagnosis was 0.88, 0.889, 0.799, and 0.757 for SAOQ, VAS, blood eosinophil count, and FeNO, respectively.ConclusionThe SAOQ and VAS scores were useful tools that presented similar results to the blood eosinophil count and FeNO, and may help to improve the diagnosis of ECRS in patients with asthma. 相似文献
993.
Myocardial Fibrosis and Inflammation by CMR Predict Cardiovascular Outcome in People Living With HIV
《JACC: Cardiovascular Imaging》2021,14(8):1548-1557
ObjectivesThe goal of this study was to examine prognostic relationships between cardiac imaging measures and cardiovascular outcome in people living with human immunodeficiency virus (HIV) (PLWH) on highly active antiretroviral therapy (HAART).BackgroundPLWH have a higher prevalence of cardiovascular disease and heart failure (HF) compared with the noninfected population. The pathophysiological drivers of myocardial dysfunction and worse cardiovascular outcome in HIV remain poorly understood.MethodsThis prospective observational longitudinal study included consecutive PLWH on long-term HAART undergoing cardiac magnetic resonance (CMR) examination for assessment of myocardial volumes and function, T1 and T2 mapping, perfusion, and scar. Time-to-event analysis was performed from the index CMR examination to the first single event per patient. The primary endpoint was an adjudicated adverse cardiovascular event (cardiovascular mortality, nonfatal acute coronary syndrome, an appropriate device discharge, or a documented HF hospitalization).ResultsA total of 156 participants (62% male; age [median, interquartile range]: 50 years [42 to 57 years]) were included. During a median follow-up of 13 months (9 to 19 months), 24 events were observed (4 HF deaths, 1 sudden cardiac death, 2 nonfatal acute myocardial infarction, 1 appropriate device discharge, and 16 HF hospitalizations). Patients with events had higher native T1 (median [interquartile range]: 1,149 ms [1,115 to 1,163 ms] vs. 1,110 ms [1,075 to 1,138 ms]); native T2 (40 ms [38 to 41 ms] vs. 37 ms [36 to 39 ms]); left ventricular (LV) mass index (65 g/m2 [49 to 77 g/m2] vs. 57 g/m2 [49 to 64 g/m2]), and N-terminal pro–B-type natriuretic peptide (109 pg/l [25 to 337 pg/l] vs. 48 pg/l [23 to 82 pg/l]) (all p < 0.05). In multivariable analyses, native T1 was independently predictive of adverse events (chi-square test, 15.9; p < 0.001; native T1 [10 ms] hazard ratio [95% confidence interval]: 1.20 [1.08 to 1.33]; p = 0.001), followed by a model that also included LV mass (chi-square test, 17.1; p < 0.001). Traditional cardiovascular risk scores were not predictive of the adverse events.ConclusionsOur findings reveal important prognostic associations of diffuse myocardial fibrosis and LV remodeling in PLWH. These results may support development of personalized approaches to screening and early intervention to reduce the burden of HF in PLWH (International T1 Multicenter Outcome Study; NCT03749343). 相似文献
994.
Hsiao HH Hung YH Hsiao HP Tseng SB Tsai HJ Liu YC Liu TC Chao MC Chang Y Lin SF 《International journal of hematology》2004,80(4):351-353
Chronic lymphocytic leukemia is one of the most common leukemias in the western world and consists of many chromosome aberrations. We report the case of a 74-year-old male patient with chronic lymphocytic leukemia with complex variant translocations t(8;22)(q24;q11) and der(8)t(6;8)(p21;p21) identified by chromosome banding analysis and confirmed by fluorescence in situ hybridization analysis of interphase cells. Because of the rarity of these changes, possible molecular mechanisms associated with this karyotype are discussed. 相似文献
995.
Thinzar Min Gareth I. Davies Sam Rice James Chess Jeffrey W. Stephens 《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2018,12(2):123-127
Aims
Chronic kidney disease (CKD) is common in type 2 diabetes and limits the treatment choices for glycaemic control. Our aim was to examine real-world prescribing for managing hyperglycaemia in the presence of CKD.Methods
The SAIL (Secure Anonymised Information Linkage) databank was used to examine prescribing during the period from the 1st of January to 30th December 2014. CKD was defined as:- none or mild CKD, eGFR ≥60 mL/min/1.73m2; moderate CKD eGFR <60 mL/min/1.73m2; and severe CKD eGFR <30 mL/min/1.73m2 or requiring dialysis.Results
We identified 9585 subjects who received any form of glucose lowering therapy (8363 had no/mild CKD; 1137 moderate CKD; 85 severe CKD). There was a linear association between insulin use and CKD severity with approximately 54% of those with severe CKD receiving insulin. Sulphonylureas use did not differ among the CKD groups and was approximately 40%. Metformin showed a linear decrease across the groups, however approximately 21% in the severe CKD group received metformin. The use of dipeptidyl peptidase 4 inhibitors (DPP-4i) was approximately 20% and did not differ among groups. The DPP-4 inhibitor choice was:- 1% vildagliptin, 9% saxagliptin, 58% sitagliptin, and 32% linaglitpin. With respect to sitagliptin and saxagliptin, 72% and 62% received an inappropriately high dose in the setting of CKD.Conclusions
We observed that a considerable proportion of patients with type 2 diabetes and CKD were receiving metformin and non dose-adjusted DPP-4 inhibitors. Careful consideration of medication use and dosaging is required in the setting of CKD and type 2 diabetes. 相似文献996.
Sergio Leonardi Felice Gragnano Greta Carrara Giuseppe Gargiulo Enrico Frigoli Pascal Vranckx Dario Di Maio Vanessa Spedicato Emanuele Monda Luigi Fimiani Vincenzo Fioretti Fabrizio Esposito Marisa Avvedimento Fabio Magliulo Attilio Leone Salvatore Chianese Michele Franzese Martina Scalise Marco Valgimigli 《Journal of the American College of Cardiology》2021,77(4):375-388
BackgroundContemporary definitions of bleeding endpoints are restricted mostly to clinically overt events. Whether hemoglobin drop per se, with or without overt bleeding, adversely affects the prognosis of patients with acute coronary syndrome (ACS) remains unclear.ObjectivesThe aim of this study was to examine in the MATRIX (Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of Angiox) trial the incidence, predictors, and prognostic implications of in-hospital hemoglobin drop in patients with ACS managed invasively stratified by the presence of in-hospital bleeding.MethodsPatients were categorized by the presence and amount of in-hospital hemoglobin drop on the basis of baseline and nadir hemoglobin values and further stratified by the occurrence of adjudicated in-hospital bleeding. Hemoglobin drop was defined as minimal (<3 g/dl), minor (≥3 and <5 g/dl), or major (≥5 g/dl). Using multivariate Cox regression, we modeled the association between hemoglobin drop and mortality in patients with and without overt bleeding.ResultsAmong 7,781 patients alive 24 h after randomization with available hemoglobin data, 6,504 patients (83.6%) had hemoglobin drop, of whom 5,756 (88.5%) did not have overt bleeding and 748 (11.5%) had overt bleeding. Among patients without overt bleeding, minor (hazard ratio [HR]: 2.37; 95% confidence interval [CI]: 1.32 to 4.24; p = 0.004) and major (HR: 2.58; 95% CI: 0.98 to 6.78; p = 0.054) hemoglobin drop were independently associated with higher 1-year mortality. Among patients with overt bleeding, the association of minor and major hemoglobin drop with 1-year mortality was directionally similar but had wider CIs (minor: HR: 3.53 [95% CI: 1.06 to 11.79]; major: HR: 13.32 [95% CI: 3.01 to 58.98]).ConclusionsAmong patients with ACS managed invasively, in-hospital hemoglobin drop ≥3 g/dl, even in the absence of overt bleeding, is common and is independently associated with increased risk for 1-year mortality. (Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of Angiox; NCT01433627) 相似文献
997.
A Pilot Exploratory Study of Oral Electrical Stimulation on Swallow Function following Stroke: An Innovative Technique 总被引:3,自引:0,他引:3
This pilot study investigated the effect of oral electrical stimulation on swallow function in stroke patients with chronic
dysphagia. The purpose was to determine whether an innovative technique could make an improvement in swallow function that
might be developed as a potential treatment for patients with persistent dysphagia. Four stroke patients with chronic dysphagia
were recruited on the basis of videofluoroscopic findings of a delayed swallow reflex. A single case design was used. Oral
electrical stimulation of swallowing was carried out using a palatal prosthesis starting at an output pulse of 0.5 mA, with
a fixed duration of 200 μsec, repeated at 1-sec intervals. Barium paste (1 × 5 ml) was introduced at the level of the patient's
maximum tolerance of stimulation and any effect on swallow function was recorded by videofluoroscopy. The findings from the
pilot study indicated that oral electrical stimulation resulted in an improvement in swallow function in 2 of the 4 patients.
The stimulation was well tolerated in all cases with no serious adverse effects. These early results are promising, but further
research is needed. 相似文献
998.
Torben H?iland Hansen Mette Laursen Erik Christensen Helge Worning 《Journal of gastrointestinal cancer》1995,18(3):235-239
Summary The relationship between chronic pancreatitis (CP) and extrapancreatic cancer has been debated in the recent years. In prospective
studies, it has been found that pancreatic cancer develops in 0–5% of patients with chronic pancreatitis. Many papers describe
an increased relative risk for developing extrapancreatic cancer in patients suffering from chronic pancreatitis. In this
study including 181 patients with CP, we found 14 patients with extrapancreatic cancer (three of these had two different types
of cancer). No patient had pancreatic cancer. It was found that the respiratory airways and upper gastrointestinal tract were
the dominating locations (five and four cases, respectively), but also genital and hemolymphopoietic cancers were represented
(four and two cases, respectively). Two patients had metastatic cancer with unknown primary tumor. The patients with cancer
tended to be older than those without cancer. The patients with CP had a 2.43 times greater risk of developing cancer than
the general Danish population (age and sex standardized comparison). The relatively large number of cancers in the upper gastrointestinal
tract and respiratory airways suggest that tobacco and alcohol may be responsible, as these organs have the highest exposure
to these compounds, which are well known carcinogens. 相似文献
999.
1000.
目的探讨慢性阻塞性肺疾病并发呼吸衰竭患者无创通气撤机方式是否改善预后。方法选择COPD并发急性高碳酸血症呼吸衰竭插管上机患者51例,在插管机械通气24~48 h后,尝试T型管自主呼吸试验,若失败则对比两种撤机方式:①拔管后通过口鼻面罩接无创通气(治疗组n=26例);②不拔管,经气管插管给予PSV方式通气(对照组n=25例)。观察并比较两组患者动脉血气、机械通气时间、住ICU时间、呼吸机相关性肺炎及60 d生存率。结果住院时所有患者均有严重高碳酸血症呼吸衰竭,治疗组n=26:pH 7.21±0.06;PaCO2(95.4±18.9)mm Hg;对照组n=25:pH 7.21±0.07,PaCO2(93.7±17.7)mm Hg(P均>0.1),两组患者临床特征类似。治疗组平均机械通气时间(10.8±3.87)d,而对照组为(9±3.4)d(P>0.05);治疗组住ICU时间比对照组短(P<0.05),住院费用明显低于对照组(P<0.001),呼吸机相关性肺炎(VAP)发生率低于对照组(P<0.05),但60 d生存率两组无差异。结论无创通气可缩短住ICU时间,减少住院花费,降低VAP发生率。但对60 d生存率无影响。 相似文献