排序方式: 共有42条查询结果,搜索用时 15 毫秒
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Frederick H Koh Jason MW Chua Joselyn LJ Tan Fung-Joon Foo Winson J Tan Sharmini S Sivarajah Leonard Ming Li Ho Bin-Tean Teh Min-Hoe Chew 《World journal of gastrointestinal surgery》2021,13(8):734-755
A growing body of evidence has demonstrated the prognostic significance of sarcopenia in surgical patients as an independent predictor of postoperative complications and outcomes. These included an increased risk of total complications, major complications, re-admissions, infections, severe infections, 30 d mortality, longer hospital stay and increased hospitalization expenditures. A program to enhance recovery after surgery was meant to address these complications; however, compliance to the program since its introduction has been less than ideal. Over the last decade, the concept of prehabilitation, or “pre-surgery rehabilitation”, has been discussed. The presurgical period represents a window of opportunity to boost and optimize the health of an individual, providing a compensatory “buffer” for the imminent reduction in physiological reserve post-surgery. Initial results have been promising. We review the literature to critically review the utility of prehabilitation, not just in the clinical realm, but also in the scientific realm, with a resource management point-of-view. 相似文献
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Wen Yea Hwong Swee Hung Ang Michiel L. Bots Sheamini Sivasampu Sharmini Selvarajah Wan Chung Law Lydia Abdul Latif Ilonca Vaartjes 《Global Heart》2021,16(1)
Background:Data on nationwide trends for stroke metrics are crucial to understand the extent of the disease burden to a country’s health system. Yet, this information remains scarce in low- and middle-income countries.Objectives:This study investigated trends of stroke incidence and 28-day all-cause mortality after a stroke from 2008 to 2016 in Malaysia, through linkage across national data sources.Methods:Hospital admissions with a principal diagnosis of stroke or transient ischemic attack were included. Cases with first stroke were identified through linkage of hospital admission registers where age and sex-standardized trends of stroke incidence and its subtypes were calculated. By linking hospital registers to the National Death Register, the 28-day all-cause mortality rates after a stroke were estimated. Mann-Kendall’s test was used for trend evaluation.Results:From 243,765 records, the trend of stroke incidence showed an increase of 4.9% in men and a drop of 3.8% among women. Incidences were higher in men, at 99.1 per 100,000 population in 2008 and 103.9 per 100,000 in 2016 than women (80.3 per 100,000 in 2008 and 77.2 per 100,000 in 2016). There was a substantial increase in stroke incidence among those below 65 years old, with the largest increase of 53.3% in men aged between 35–39 years and 50.4% in women of similar age group. The trend for 28-day all-cause mortality showed a decline for men at –13.1% and women, –10.6%. Women had higher mortality from stroke (22.0% in 2008 and 19.7% in 2016) than men (19.4% in 2008 to 17.2% in 2016).Conclusion:This first empirical study on stroke trends in Malaysia revealed a worrying increase in stroke incidence among the younger population. Despite a declining trend, mortality rates remained moderately high especially in women. Comprehensive strategies to strengthen the prevention and management of stroke care are warranted. 相似文献
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Sharmini Selvarajah Gurpreet Kaur Jamaiyah Haniff Kee Chee Cheong Tee Guat Hiong Yolanda van der Graaf Michiel L. Bots 《International journal of cardiology》2014
Background
Cardiovascular risk-prediction models are used in clinical practice to identify and treat high-risk populations, and to communicate risk effectively. We assessed the validity and utility of four cardiovascular risk-prediction models in an Asian population of a middle-income country.Methods
Data from a national population-based survey of 14,863 participants aged 40 to 65 years, with a follow-up duration of 73,277 person-years was used. The Framingham Risk Score (FRS), SCORE (Systematic COronary Risk Evaluation)-high and -low cardiovascular-risk regions and the World Health Organization/International Society of Hypertension (WHO/ISH) models were assessed. The outcome of interest was 5-year cardiovascular mortality. Discrimination was assessed for all models and calibration for the SCORE models.Results
Cardiovascular risk factors were highly prevalent; smoking 20%, obesity 32%, hypertension 55%, diabetes mellitus 18% and hypercholesterolemia 34%. The FRS and SCORE models showed good agreement in risk stratification. The FRS, SCORE-high and -low models showed good discrimination for cardiovascular mortality, areas under the ROC curve (AUC) were 0.768, 0.774 and 0.775 respectively. The WHO/ISH model showed poor discrimination, AUC = 0.613. Calibration of the SCORE-high model was graphically and statistically acceptable for men (χ2 goodness-of-fit, p = 0.097). The SCORE-low model was statistically acceptable for men (χ2 goodness-of-fit, p = 0.067). Both SCORE-models underestimated risk in women (p < 0.001).Conclusions
The FRS and SCORE-high models, but not the WHO/ISH model can be used to identify high cardiovascular risk in the Malaysian population. The SCORE-high model predicts risk accurately in men but underestimated it in women. 相似文献6.
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Kang KB Rajanayagam MA van der Zypp A Majewski H 《Naunyn-Schmiedeberg's archives of pharmacology》2007,375(4):273-281
β-Adrenoceptor-mediated vasorelaxation decreases with age in various vascular beds. The present study investigated the roles
of cyclooxygenase (COX) on β-adrenoceptor vasorelaxation by isoprenaline in 8- and 54-week-old rat aortas. The vasorelaxation
responses by isoprenaline (0.03–3 μM) were significantly reduced in 54-week-old aortas compared to 8-week. Addition of the
non-selective COX inhibitors indomethacin (10 μM) or aspirin (10 μM) restored isoprenaline vasorelaxation of 54-week-old aortas
to levels found in 8-week-old aortas. This suggests the involvement of COX prostanoids in the age-related reduction of β-adrenoceptor
vasorelaxation. Immunohistochemistry revealed greater levels of COX-1 and COX-2 staining in 54-week-old aortas compared to
8-week with expression located mainly in medial smooth muscle. An age-linked increase in COX-1 and COX-2 protein was found
in cremaster arterioles of 54-week-old rats (compared to 8-week) mainly in the endothelial layer. The age-related increase
in COX-1 and COX-2 protein led to elevation of prostacyclin (measured as 6-keto prostaglandin ) and thromboxane A2 (measured as thromboxane B2) in 54-week compared to 8-week-old aortas. Endothelium removal in 54-week aortas markedly reduced the 6-keto prostaglandin
level, thus suggesting an endothelial source for elevated prostacyclin. These findings in combination with the effects of
COX inhibitors suggest that the age-related decrease in β-adrenoceptor vasorelaxation by isoprenaline is due to an age-linked
increase in COX expression, which elevates production of COX-derived vasoactive prostanoids. 相似文献
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Ali Hassan Alashwal Azhany Yaakub Raja Azmi Mohd Noor Liza Sharmini Ahmad Tajudin 《美中国际眼科杂志》2009,(5):831-832
患者,男,63岁,以“左眼突发视力下降,眼部不适,眼红,流泪”主诉就诊。1wk前因继发性青光眼行青光眼阀植入术。同一眼1a前曾行扩大的小梁切除术,手术失效。眼科检查结果:最佳矫正视力为6/18,有滤过泡漏,前房浅,眼压6mmHg。应用纤维蛋白胶成功封闭滤过泡漏,前房加深,眼压升至13mmHg。此病例说明纤维蛋白胶是治疗早期滤过泡漏的有效方法。 相似文献