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1.
Maberley DA Yannuzzi LA Gitter K Singerman L Chew E Freund KB Noguiera F Sallas D Willson R Tillocco K 《Ophthalmology》1999,106(12):2248-52; discussion 2252-3
Objective
To examine the association between previous radiation exposure and idiopathic perifoveal telangiectasis (IPT).Design
A multicentered, individually matched, case-control study design was used.Participants/controls
Sixty-five case subjects were matched with 175 control subjects. Individuals with unequivocal evidence of angiographically confirmed IPT were included as cases. Control subjects were matched for center, age, and gender.Main outcome measure
The main exposures of interest were a history of therapeutic head or neck irradiation and environmental radiation exposure.Methods
A standardized questionnaire was administered to case and control subjects. Data were collected for the main exposures of interest as well as pertinent covariates. Conditional logistic regression was used to evaluate therapeutic and environmental radiation as risks for IPT.Results
On univariate analysis, head or neck irradiation was associated with IPT (odds ratios [OR] = 4.15, 95% confidence interval [CI] = 1.30–13.24). While controlling for diabetes and family history of diabetes, IPT was found to be associated with both head or neck irradiation (OR = 4.06, 95% CI = 1.20–13.76) and with environmental irradiation (OR = 6.73, 95% CI = 1.06–42.74).Conclusions
This study presents a previously unreported association between prior radiation exposure and IPT. 相似文献2.
Intravascular levels of low-density lipoprotein cholesterol (LDL-C) at approximately ≤ 0.6 mmol/L are likely to minimize, and perhaps eliminate, LDL-C-related vascular toxicity while having no effect on essential, intracellular cholesterol homeostatic pathways, according to accumulated knowledge from basic science. Randomized clinical trials, observational reports, and Mendelian randomization trials are also forcing a reconsideration of what “normal” LDL-C means. Recent trials of secondary prevention have substantiated that such levels are safe and associated with a decreased risk of cardiovascular events (CVEs) compared with patients with higher levels of LDL-C. Similarly, treatment to this low range is associated with regression and stabilization of established atherosclerosis. Primary prevention trials also show that low levels of LDL-C are safe and associated with decreased risk of CVEs through cholesterol-lowering in adults with LDL-C ≥ 3.5 mmol/L or when levels are < 3.5 mmol/L in association with other cardiovascular risks. Although there are no randomized clinical outcome trials of familial hypercholesterolemia patients, such patients have very high, lifetime risk of CVE, and registry studies show that LDL-C reduction has nearly normalized their CVE rates. The possibility of familial hypercholesterolemia should be considered if LDL-C is > 4.5 and > 4.0 mmol/L at ages 18-39 years and younger than 18 years, respectively. On the basis of these convergent and internally consistent lines of evidence, in this article we speculate on a translational paradigm aimed at eliminating LDL-C-related CVEs through aggressive primary prevention strategies that are already proven and well accepted in principle. 相似文献
3.
Brian Day 《Arthroscopy》2018,34(8):2511-2513
Personalized (based on a percentage of a patient's limb occlusion pressure) blood flow restriction is emerging as a potential advancement in orthopaedic surgery. Safe application of the technology requires the use of medical devices capable of customizing the pressures applied to individual patients. In those circumstances, it is a low risk and noninvasive technique. By limiting muscle atrophy and aiding in the recovery of strength and function, it has the potential to significantly reduce the morbidity from limb trauma and surgery, and aid in achieving a substantially earlier return to full activity. 相似文献
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5.
《Injury》2016,47(3):725-727
With the increasing prevalence of total hip arthroplasty and the increasing longevity of patients with implants in situ, periprosthetic fractures of the proximal femur are seen with greater frequency. They represent a challenging surgical problem, requiring combined arthroplasty and trauma skills in a potentially compromised surgical bed. We present data from the 82 consecutive patients with periprosthetic fractures around the hip presenting to two NHS Foundation Trusts in the period January 2009 to February 2014.Inpatient mortality across all sites was 11.0%. This increased to 17.1% at 1 year. There was no association between delay to surgery and either inpatient or 1 year mortality. Mean delay to surgery was 4.1 days in those without inpatient mortality, 5.2 days in those with (p = 0.3075). Mean delay to surgery was 4.5 days in those with 1 year mortality, 4.16 days in those without (p = 0.6203). The number of post-operative complications was not significantly positively correlated with increasing delay to surgery (Pearson correlation coefficient −0.04437).It would appear that a delay to order necessary equipment and obtain relevant surgical expertise for the treatment of these complex fractures is safe and not associated with increased mortality or post-operative complications. 相似文献
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7.
Daniele De Meo Benedetta Zucchi Valerio Castagna Edoardo M. Pieracci Massimiliano Mangone Alessandro Calistri 《Current medical research and opinion》2020,36(8):1375-1381
AbstractObjective: The Unified Classification System (UCS) presents itself as an evolution of the Vancouver Classification (VCS) for the evaluation of periprosthetic fractures of the proximal femur (PPF). The aim of our study was to highlight any loss of reproducibility or validity of the new classification system, compared to the previous one.Material and methods: We tested the interobserver and intraobserver agreement using 40 PPF clinical cases. Each classifying subtype of the UCS and VCS was present in at least two cases. Six experienced hip surgeons (Senior Surgeon, SS) and 5 surgeons in training (Junior Surgeon, JS) classified the clinical cases, using VCS and UCS. The validity of both classifications was then tested with intraoperative surveys.Results: The mean κ value for interobserver agreement for the VCS in the JS group was 0.65 and 0.81 for the SS group. The mean κ value for interobserver agreement for the UCS in the JS group was 0.63 and 0.65 for the SS group. The mean κ value for intraobserver agreement for the VCS in the JS group was 0.71 and 0.73 for the SS group. The mean κ value for intraobserver agreement for the UCS in the JS group was 0.72 and 0.7 for the SS group. Validity analysis showed a moderate agreement for the VCS and a good agreement for the UCS.Conclusion: The UCS completes the Vancouver classification, expanding it. It is reliable, despite the increase in classification categories and number of parameters to evaluate, with a slightly higher validity. 相似文献
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9.
Jason G. Andrade Marc W. Deyell Graham C. Wong Laurent Macle 《The Canadian journal of cardiology》2018,34(11):1426-1436
Atrial fibrillation (AF) is a progressive chronic disease characterized by exacerbations and periods of remission. It is estimated that up to 20% to 30% of those with AF also have coronary artery disease (CAD), and 5% to 15% will require percutaneous coronary intervention (PCI). In patients with concomitant AF and CAD, management remains challenging and requires a careful and balanced assessment of the risk of bleeding against the anticipated impact on ischemic outcomes (AF-related stroke and systemic embolism, as well as ischemic coronary events). Oral anticoagulation (OAC) is indicated for the prevention of AF-related stroke and systemic embolism, whereas antiplatelet therapy is indicated for the prevention of coronary events. Each offers a relative efficacy benefit (dual antiplatelet therapy [DAPT] is more effective than OAC alone in reducing cardiovascular death, myocardial infarction, stent thrombosis, and ischemic coronary events in a population with acute coronary syndromes [ACS]), but with a relative compromise (DAPT is significantly inferior to OAC for the prevention of stroke/systemic embolism in an AF population at increased risk of stroke). The purpose of this review is to explore the current evidence and rationale for antithrombotic treatment strategies in patients with both AF and CAD. Specifically, there is a focus on how to best tailor the therapeutic choices (OAC and antiplatelet therapy) to individual patients based on their underlying coronary presentation. 相似文献
10.
目的 在瘢痕疙瘩患者进行90Sr同位素敷贴治疗前,按照温哥华瘢痕量表进行评分,推断治疗效果,合理选择适应症.方法 选取2008年1月至2013年1月在本院皮肤科及外科门诊确诊的瘢痕疙瘩患者105例,按照温哥华瘢痕量表根据色泽、厚度、血管分布、柔软度进行评分,分为两组(A组0~8分,B组9~15分),采用90Sr同位素敷贴治疗,治疗后随访6 ~12个月,进行疗效评价.结果 在131例瘢痕疙瘩患者中,痊愈率48.09%;好转率51.91%;总有效率100%.其中A组剂量30.12±3.15Gy,痊愈率62.69%,不良反应发生率16.42%.B组剂量44.16±5.56Gy,痊愈率32.81%,不良反应发生率48.48%.经spssl6.0统计学软件处理,差异有统计学意义.结论 在瘢痕疙瘩患者进行90Sr同位素敷贴治疗前,按照温哥华瘢痕量表进行评分,根据量表评分来选择合适患者治疗,是一种简单、有效且较为准确的方法. 相似文献