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51.
《Clinical and experimental hypertension (New York, N.Y. : 1993)》2013,35(3-4):363-370
Life expectancy has significantly increased in the last decades in many western populations, due to the fall of total and cardiovascular death rate. However, morbidity from cardiovascular diseases has decreased to a smaller extent. The overall population risk profile has improved, but it is still unsatisfactory. This is true for blood pressure control (with only 20% of hypertensive patients achieving normotension with antihypertensive drugs), hypercholesterolemia (with bordeline-high serum cholesterol levels in 50% of the population), and smoking habits. Other potential causes of the poor cardiovascular prevention are: 1) a limited knowledge of the optimal blood 相似文献
52.
《Amyloid》2013,20(4):235-239
AA (secondary) amyloidosis is one of the most severe and uncommon complications of several rheumatic disorders and chronic infections such as tuberculosis (TB). Successful treatment depends on the control of the underlying inflammatory process, what can lead to an improvement or a regression in organ dysfunction. If the disorder persists, it has been reported in some cases of AA amyloidosis secondary to rheumatic diseases, that the use of biologic therapy is so far the only opportunity to reduce the development of AA amyloidosis and to reverse established deposits. We report herein a case of a latent TB infection complicated by a life-threatening AA amyloidosis presented as nephrotic syndrome. After an adequate antituberculostatic treatment, AA amyloidosis remained active and Tocilizumab (TCZ) was started with a dramatic resolution of the proteinuria, stabilization of the amyloid deposits and improvement in general condition. 相似文献
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54.
目的探讨多层螺旋CT对结直肠癌肝脏钙化性转移瘤的诊断价值。方法 选取合肥市滨湖医院2015年1月至2018年12月确诊为结直肠癌伴钙化性肝转移病人21例,均行多层螺旋CT检查,分析肝内钙化性转移瘤的影像学特征。结果 21例均病理证实为非黏液腺癌,低分化2例(9.52%),中分化19例(90.48%);钙化灶形态的CT表现为细颗粒状或砂砾样钙化18例(85.71%),粗大团状钙化4例(19.05%),不规则斑片状钙化9例(42.86%);钙化分布在转移瘤的中心20例(95.24%),钙化分布在转移瘤的周边5例(23.81%)。13例增强扫描,11例出现花瓣样强化,发生率85%(11/13);2例出现环形强化,发生率15%(2/13)。右半结肠癌10例(47.62%),左半结肠癌11例(52.38%);共计检出266枚转移瘤,钙化92枚,转移瘤钙化率34.59%。右半结肠癌转移瘤共100枚,钙化58枚,钙化率58.00%(58/100);左半结肠癌转移瘤共166枚,钙化34枚,钙化率20.48%(34/166),左半结肠癌与右半结肠癌转移瘤钙化率差异有统计学意义(χ2=38.827,P<0.001)。肝右叶转移瘤共145枚,钙化62枚,钙化率42.76%;肝左叶转移瘤共121枚,钙化30枚,钙化率24.79%(30/121),肝右叶与肝左叶转移瘤钙化率差异有统计学意义(χ2=9.409,P=0.002)。结论 右半结肠癌转移瘤钙化率明显高于左半结肠癌;肝右叶转移瘤钙化率显著高于肝左叶转移瘤钙化率;结直肠癌肝转移瘤钙化CT表现主要以细颗粒状或砂砾样钙化为主,并且大多数分布在病灶中心。 相似文献
55.
《Hellenic Journal of Cardiology》2020,61(5):321-328
ObjectiveThe sex-specific effect of depressive symptomatology on 10-year first and recurrent cardiovascular disease (CVD) events was evaluated.MethodsThe Greek samples from ATTICA (2002-2012, n = 845 free-of-CVD subjects) and GREECS (2004-2014, n = 2,172 subjects with acute coronary syndrome (ACS)) prospective epidemiological studies with baseline psychological assessments were used for the first and the recurrent event, respectively. Depressive symptomatology was assessed at baseline, through Zung Self-Rating Depression Scale in the ATTICA study, and through the Center for Epidemiological Studies-Depression scale in the GREECS study.ResultsACS as well as free-of-CVD women scored significantly higher for depressive symptomatology. Men scored higher than women against first (19.7% vs. 11.7%) and subsequent CVD events (38.8% vs. 32.9%). In participants with depressive symptoms man-to-woman first and recurrent CVD event rate ratio was below 1, confirming that depressive women were more likely to have a CVD event than depressive men. Multiadjusted analysis revealed that depressive symptomatology had an independent aggravating effect on the first (hazard ratio (HR) = 2.72, 95% confidence interval (95% CI) 1.50, 9.12) and recurrent (HR = 1.31, 95% CI 1.01, 1.69) CVD events only in women. Mediation analysis in women revealed that 35% (23%, 44%) of excess first-CVD-event risk of depressive symptoms was attributed to conventional risk factors. The respective number for recurrent CVD events was 46% (23%, 53%); different patterns of ranking regarding the mediating effect corresponding to each adjustment factor were observed.ConclusionsThe present work augments prior evidence that psychological stressors possess important drivers of CVD onset and progression mainly in women, while it gives rise to research toward unidentified paths behind this claim. 相似文献
56.
Kutlay S Civriz S Ensari A Nergizoglu G Ates K Karatan O 《Rheumatology international》2004,24(1):37-39
Development of secondary amyloidosis is an infrequent complication in patients with Behçet's syndrome (BS). It has been reported that multiple systemic involvement, long disease duration, and male gender are major clinical factors accompanying the development of amyloidosis in BS. We report a case of secondary amyloidosis in a patient diagnosed as having BS with a positive pathergy test 9 years previously and who had isolated mucocutaneous involvement. Regular use of colchicine since the diagnosis and somewhat mild progress of the disease could not prevent the development of secondary amyloidosis in this patient. He is alive and receives hemodialysis regularly. 相似文献
57.
Objectives Hypovitaminosis D (HD) and secondary hyperparathyroidism (SHP) are common in elders, and many factors could contribute to
them. The objectives of this study were to estimate the prevalence of HD, SHP, and its associated factors, in individuals
living in nonprofit homes for elders in south Brazil. Design Cross-sectional study. Methods Serum 25-hydroxyvitamin D 25(OH)D, intact parathyroid hormone (PTH), total calcium, phosphorus, alkaline phosphatase, magnesium,
creatinine, and albumin levels were measured in late spring, November, 2005. The presence of factors potentially related with
HD and SHP—age, sex, weight, height, skin phototype, sun exposure, exercise, smoking, use of ≤5 medications or diuretics or
alcohol, and daily calcium ingestion. Results 102 subjects age 77.8 ± 9.0 were included in the study. HD was found in 85.7% and SHP in 53% of the subjects. The estimated
daily calcium ingestion was 720 mg. There was no association between serum 25(OH)D levels and any of the risk factors evaluated.
Serum 25(OH)D levels were correlated with serum PTH (r = −0.358, P = 0.000), calcium (r = 0.306, P = 0.002), and albumin (r = 0.253, P = 0.011) levels. In univariate analysis, SHP was positively associated with age (P = 0.006), and female sex (0.007); and negatively associated with sunlight exposure (P = 0.020), GFR (P = 0.000), Ln25(OH)D (P = 0.002), and total serum calcium (P = 0.024). After multivariate model adjustment, age [OR 1.09 (CI 1.01–1.18); P = 0.024], Ln25(OH)D [OR 0.92 (CI 0.08–0.74); P = 0.013], GFR [OR 0.96 (CI 0.92–0.99); P = 0.013], and hydrochlorothiazide treatment [OR 7.63 (CI 1.67–34.9); P = 0.008] were independently associated with SHP. Conclusions HD and SHP are highly prevalent in elders living in old-age homes. No associations were established between common risk factors
and low serum levels of 25(OH)D levels; however, SHP was independently related with age, 25(OH)D, GFR, and hydrochlorothiazide
use. 相似文献
58.
《Annales de cardiologie et d'angeiologie》2021,70(4):237-244
Cardiac non-Hodgkin lymphoma (CNHL) is a rare extranodal lymphoma with a poor prognosis. Secondary cardiac lymphoma is more frequent than primary cardiac lymphoma. CNHL often involves the right side of the heart. Diagnosis of CNHL can be suggested by echocardiography and magnetic resonance imaging. Cytological examination of pericardial fluid or histological of cardiac tissue is essential. The majority of cases are diffuse B-cell lymphoma. A prompt immediate diagnosis and early treatment are essential for better outcome. Management should be individualized and the most effective treatment is chemotherapy containing anthracycline variably combined with radiotherapy. A multidisciplinary approach is essential to the successful treatment of CNHL. 相似文献
59.
60.
We study gatekeeping physicians’ referrals of patients to specialty care. We derive theoretical results when competition in the physician market intensifies. First, due to competitive pressure, physicians refer patients to specialty care more often. Second, physicians earn more by treating patients themselves, so refer patients to specialty care less often. We assess empirically the overall effect of competition with data from a 2008–2009 Norwegian survey, National Health Insurance Administration, and Statistics Norway. From the data we construct three measures of competition: the number of open primary physician practices with and without population adjustment, and the Herfindahl–Hirschman index. The empirical results suggest that competition has negligible or small positive effects on referrals overall. Our results do not support the policy claim that increasing the number of primary care physicians reduces secondary care. 相似文献