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21.
In a cohort of 3383 men aged 53 to 74 in the Copenhagen Male Study we investigated the association between ischaemic heart disease (IHD) and the Lewis blood group, assigned to chromosome 19. Among men with the Le(a-b-) phenotype, 8% had a history of non-fatal myocardial infarction, among others the frequency was 4%. The corresponding odds ratio was (95% confidence interval: CI) 1.9 (1.2-3.0) P < 0.01, men with Le(a-b-) had a risk-factor profile and pattern of disease resembling that of Reaven's syndrome X. In a subsequent prospective study 343 men with arteriosclerotic stigmas were excluded. The men had their morbidity and mortality recorded over the next 4 years. One-hundred-and-one men suffered IHD; 26 dying from IHD. In total 162 men died. Men with Le(a-b-) had an increased risk of death from IHD compared with others. Adjusted for age, relative risk (RR) (95% CI) was: 4.4 (1.9-10.3), P < 0.001, and for all causes of mortality: RR = 1.6 (1.0-2.6), P < 0.05. Men with the Le(a-b-) phenotype had an increased risk of an IHD event compared to men with other phenotypes (RR = 1.6 (0.9-2.8), P = 0.10) and a significantly higher IHD case fatality rate (RR = 2.8 (1.5-5.2), P = 0.01). The finding that the Le(a-b-) phenotype is a genetic marker of IHD risk may have implications in terms of prevention. The Le(a-b-) phenotype may also contribute to providing an explanation for the substantial ethnic differences found in the incidence of IHD. The similar risk-factor profile and pattern of disease found between Le(a-b-) men and individuals with Reaven's syndrome X is hypothesized to be due to a close genetic relationship on chromosome 19. 相似文献
22.
彩色多普勒在心脏起搏器综合征诊断中的应用价值 总被引:1,自引:1,他引:0
目的 :探讨运用彩色多普勒血流显像 (CDFI)并结合心电图 (ECG)诊断起搏器综合征 (PMS)的临床价值。方法 :对具有详实临床及ECG资料的心室按需 (VVI)起搏器安置患者 6 0例及对照组 4 8例进行CDEI检查 ,观察起搏组与对照组的三尖瓣返流 (TR)的发生率、返流程度 ,并分析二者之间的相关性。结果 :起搏组出现逆传P波 (即PMS阳性 )者 15例 ,CDFI检测出现TR者 2 0例 ,明显高于对照组 ,且PMS阳性者TR发生率明显高于PMS阴性者 ,表明安置VVI起搏器后出现逆传P波与TR的发生相关性良好。结论 :CDFI对PMS的诊断具有重要意义 ,尤其将ECG与CDFI结合应用有助于诊断率的提高。 相似文献
23.
Stefan Whrl Robert Loewe Winfried F. Pickl Georg Stingl Stephan N. Wagner 《Journal der Deutschen Dermatologischen Gesellschaft》2005,3(1):39-43
Background: Seizure prophylaxis with phenytoin is a common measure in oncologic patients with brain metastases. In these patients, generalized severe adverse drug reactions such as erythema multiforme (EEM) may occur. However, in a subgroup of patients with brain radiation therapy, EEM‐like lesions develop particularly in the radiation field. Most recently, the acronym EMPACT ( E rythema M ultiforme associated with P henytoin A nd C ranial radiation T herapy) was proposed to specifically describe this syndrome. Patient/Method: Here, we report on EMPACT syndrome in a 46‐year‐old woman. Therapeutic measures included seizure prophylaxis with phenytoin and total brain radiation therapy of brain metastases from bronchial carcinoma. Three weeks after introduction of phenytoin, the patient presented with EEM‐like skin lesions restricted to the original radiation field and facial mucocutaneous involvement. After a few days, the rash spread to the upper part of the body. She was also in poor general condition. Results: The immediate cessation of phenytoin therapy, combined with administration of systemic corticosteroids and high dose immunoglobulins along with intensive local treatment and pain medications, resulted in complete resolution of the skin eruption. Patch testing to phenytoin was positive after 72 hours. Conclusion: EMPACT should be classified as an specific entity among the EEM‐like drug reactions as it only appears after radiotherapy and seizure prophylaxis with the anticonvulsant phenytoin. We propose including specific type IV‐sensitization to phenytoin into the definition of EMPACT. 相似文献
24.
目的吸取误诊教训,提高对茎突综合征诊断水平。方法回顾性分析3例茎突综合征误诊的临床资料。结果找出误诊原因,并借助文献进行分析、讨论。结论要熟悉茎突综合征的病因,临床特点和并发症,提高警惕性,发现可茎突综合征病人,及时做医学影像检查和咽部触诊。 相似文献
25.
Kulbir S. Walia MD ; Daniel E. Muser MD ; Shariq S. Raza MD ; Tricia Griech MSPT ; Yasin N. Khan MD 《Pain practice》2004,4(4):303-306
Abstract: We present a case of a 13-year-old boy who developed signs and symptoms of neuropathic pain/early Complex Regional Pain Syndrome (CRPS) Type I, formerly known as Reflex Sympathetic Dystrophy (RSD), after spraining his ankle while wrestling. Aggressive pain control, using medications and sympatholytic blocks, with physical therapy and rehabilitation, led to the resolution of his painful condition. This prevented the disease from possibly progressing to a full-blown case of CRPS I (RSD) that is very challenging to treat. 相似文献
26.
Georges Charbonneau 《L'évolution Psychiatrique》2006,71(1):57
Dimension of contact is the very moment when meeting with someone. The limits can be precisely defined as an aesthetic moment, i.e. the very moment when someone appears. That is an experience of one's expressivity. One can usually go through this ephemeral moment to reach simple self-continuity. Pathologies of contact may be described at different levels: neurosis, pathological personalities and psychosis. 相似文献
27.
目的:探讨X线、超声联合导向下对布 加氏综合征的介入治疗方法和临床应用价值。方法:本组病人 30例,采用X线和超声联合导向。穿刺下腔静脉闭塞或狭窄部位,经球囊扩张后在X线、超声联合定位置入支架 成形。结果:28例成功,占93%。无严重并发症。术后患者症状明显缓解,下腔静脉压基本恢复正常(治疗前 2.8±0.51kPa,治疗后0.7±0.2kPa)。结论:采用X线、超声联合导向介入治疗布 加氏综合征是一种成功率高、 损伤小、效果可靠的治疗方法。 相似文献
28.
综合医院医务人员感染SARS情况对比分析 总被引:3,自引:1,他引:2
目的:分析在防治SARS工作初期、后期医务人员感染SARS的差异和采取的对策,为减少综合医院内医务人员SARS的感染提供参考。方甚:对本院自2003年3月24日至6月2日SARS诊断治疗任务中发生的医务人员的感染原因和采取的对策进行回顾性分析。结果:防治SARS工作初期,急诊科交叉感染和在SARS隔离病房等与SARS患者密切接触的工作岗位,共有17名医务人员感染,及时隔离治疗,均已痊愈,未造成医护人员的进一步交叉感染:经加强防护培训,改善工作条件,在防治SARS工作后期,仅发生2名护工感染,亦已痊愈,派出非典医疗队实现零感染。结论:综合医院内医务人员感染SARS的问题严峻,加强医院内的全员防护培训,按岗分区管理,改善医务人员的工作条件和病人的隔离观察环境,做好监督检查,积极应对,可以减少医务人员的SARS感染。 相似文献
29.
J. Dörr F. J. Dieste D. Klaasen van Husen F. Zipp H. P. Vogel 《Neurological sciences》2006,27(6):424-425
Abstract Miller Fisher syndrome (MFS) is a rare and usually monophasic polyradiculoneuropathy characterised by ophthalmoplegia, decreased
or absent tendon reflexes, and ataxia. The objective of this study was to report a case of recurrent MFS with a clinical presentation
virtually indistinguishable from botulism. The patient was a young man with two episodes of increasing external ophthalmoplegia,
ptosis, and ataxia with a long asymptomatic interval in between. The second episode occurred after consumption of rotten fish
and was accompanied by gastrointestinal symptoms and an anticholinergic syndrome. Very rarely, MFS can present with a recurrent
course. The importance of this case of recurrent MFS lies not only in its long asymptomatic period and identical clinical
presentation, but also in its instructiveness regarding the differential diagnosis of MFS, particularly life-threatening botulism. 相似文献
30.
目的 :研究肺表面活性物质 (PS)治疗新生儿呼吸窘迫综合征 (NRDS)前后血管内皮分泌功能变化及可能的治疗机理。方法 :用PS制剂固尔苏治疗 18例NRDS患儿 ,于治疗前 3 0min ,治疗后 1、 6、 12、 2 4h ,用硝酸还原酶法测定NO (一氧化氮 )、放射免疫法测定ET (内皮素 )、 6 K PGF1α (6 酮前列环素 )。结果 :固尔苏治疗后患儿NO、 6 K PGF1α明显升高 ,ET明显下降 ,与治疗前比较有显著性差异 (P <0 0 1)。治疗后 1、 6、 12、 2 4hNO、6 k PGF1α、ET各组间两两比较无明显差异 (P >0 0 5 )。结论 :PS治疗NRDS的机理可能是通过改善血管内皮功能发挥作用 ,为用外源性NO吸入和静注前列环素辅助治疗NRDS提供可能的实验依据。 相似文献