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排序方式: 共有628条查询结果,搜索用时 31 毫秒
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Lia Assumpcao John L. Cameron Christopher L. Wolfgang Barish Edil Michael A. Choti Joseph M. Herman Jean-Francois Geschwind Kelvin Hong Christos Georgiades Richard D. Schulick Timothy M. Pawlik 《Journal of gastrointestinal surgery》2008,12(11):1915-1923
Background
No data on incidence, management, or natural history of chyle leaks following pancreatic resection have been published. We
sought to identify possible risk factors associated with chyle leaks following pancreatic resection, as well as determine
the natural history of this rare complication.
Methods
Between 1993 and 2008, 3,532 patients underwent pancreatic resection at a single institution. Data on demographics, operative
details, primary tumor status, and chyle leak were collected. To identify risk factors associated with chyle leak, a matched
3:1 paired analysis was performed.
Results
Of 3,532 patients undergoing pancreatic resection, 47 (1.3%) developed a chyle leak (n = 34, contained chyle leak versus n = 13, diffuse chylous ascites). Chyle leak was identified at median 5 days following surgery. Median drain triglyceride levels
were 592 ng/dl. After matching on tumor size, disease etiology, and resection type, the number of lymph nodes harvested and
history of concomitant vascular resection predicted higher risk of chyle leak (both P < 0.05). Total parenteral nutrition (TPN) was required in more patients with chylous ascites (92.3%) than those with chyle
leaks (44.1%) (P = 0.003). The median time to resolution was shorter for contained chyle leaks (13 days) versus chylous ascites (36 days)
(P < 0.001). Patients with chylous ascites tended to have shorter overall survival (3-year, 18.8%) versus patients with no chyle
leak (3-year, 46.9%) (P = 0.12). In contrast, patients with a contained chyle leak had a similar survival as patients with no chyle leak (3-year,
53.4% versus 46.9%, respectively) (P = 0.32).
Conclusion
Chyle leak was a rare (1.3%) complication following pancreatic resection that was associated with number of lymph nodes harvested
and concomitant vascular resection. In general, chyle leaks were successfully managed with TPN with no adverse impact on outcome.
Patients with chylous ascites, however, had a more protracted clinical course and tended to have a worse long-term survival.
Presented at the Society for Surgery of the Alimentary Tract, 49th Annual Meeting, San Diego, CA, May 18th, 2008
Support: Dr. Pawlik is supported by Grant Number 1KL2RR025006-01 from the National Center for Research Resources (NCRR), a
component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. The contents of this publication
are solely the responsibility of the authors and do not necessarily represent the official view of NCRR or NIH. 相似文献
3.
Rau R Georgiades A Fredrikson M Lemne C de Faire U 《Journal of occupational health psychology》2001,6(3):171-181
This study examined the effects of psychosocial work characteristics on cardiovascular rewind at night. Ambulatory 24-hr recordings of blood pressure (BP) and heart rate (HR) of 75 borderline hypertensive and 74 normotensive men were related to diary ratings of perceived control (PC) and to scores of psychological demand (P), control (C), and social support (S) at work determined by an occupational classification system. Multiplicative interaction terms for job strain (P x C), isostrain (P x C x S), and Job Strain x Perceived Control (P x C x PC) were calculated. The P x C x PC interaction predicted diastolic BP at night but not at work. A delayed latency to attain the lowest systolic BP during the night was found for jobs with high job strain and isostrain. Low perceived control and social support were associated with higher HR at work and at night. A logistic regression analysis indicated that the interaction between P x C x PC and the body mass index was independently associated with borderline hypertension. 相似文献
4.
E Georgiades J J Reilly E Stathopoulou A M Livingston Y P Pitsiladis 《Archives of disease in childhood》2003,88(11):978-979
Body mass index (BMI) distribution changes were assessed in 2547 relatively affluent English girls, aged 12-16 years, during the UK childhood obesity epidemic (1986-96). An increase in BMI variability was observed only in 12-14 year olds, suggesting that BMI changes for population subgroups were complex, and inconsistent with a generalised increase in BMI. 相似文献
5.
Polyxeni Ntontsi Aggeliki Detta Petros Bakakos Stelios Loukides 《Expert opinion on investigational drugs》2019,28(3):261-266
Introduction: Severe, inadequately-controlled asthma remains a clinical challenge. For this reason, clinical trials and preclinical experimental studies on novel agents as an add-on therapies continue emerge. Phosphodiesterases (PDEs) are enzymes that regulate the function of immune cells by hydrolyzing cyclic guanosine monophosphate/cGMP and cyclic adenosine monophosphate/cAMP. PDEs are divided into subfamilies [PDE3, PDE4, PDE5 and PDE7] which are mainly found in the respiratory tract. Inhibitors of PDEs have already been approved for COPD and pulmonary hypertension.
Areas covered: The role of PDE inhibitors in asthma treatment and the possible mechanism of action via their anti-inflammatory and/or bronchodilating effect are discussed.
Expert opinion: Novel PDE inhibitors exhibiting fewer adverse events may have a role as add-on therapies in asthma treatment in the future. More clinical trials are necessary to prove their efficacy and evaluate their safety profile before approval by regulatory bodies is granted. 相似文献
6.
Malcolm Brock Tae Hwan Chung Sathvika Reddy Gaddam Anjaneya Singh Kathait Cecily Ober Christos Georgiades 《Cardiovascular and interventional radiology》2016,39(12):1785-1788
Postural orthostatic tachycardia syndrome is characterized by orthostatic intolerance. Orthostasis (or other mild physical stress) triggers a cascade of inappropriate tachycardia, lightheadedness, palpitations, and often fainting. The underlying defect is sympathetic dysregulation of the heart, which receives its sympathetic tone from the cervical and upper thoracic sympathetic ganglia. Primary hyperhidrosis is also thought to be the result of sympathetic dysregulation. We present the case of a patient treated with CT-guided, percutaneous T2 EtOH sympatholysis for craniofacial hyperhidrosis. The patient also suffered from postural orthostatic tachycardia syndrome for many years and was unresponsive to treatment. Immediately after sympatholysis, the patient experienced resolution of both craniofacial hyperhidrosis and postural orthostatic tachycardia syndrome. 相似文献
7.
8.
Electrophysiological markers predicting impeding AV‐block during ablation of atrioventricular nodal reentry tachycardia 下载免费PDF全文
Nikolaos Fragakis MD PhD Lydia Krexi MD Panagiota Kyriakou MD PhD Melani Sotiriadou MD Charalambos Lazaridis MD Athanasios Karamanolis MD Panagiotis Dalampyras MD Stelios Tsakiroglou Vassilios Skeberis MD PhD Dimitrios Tsalikakis PhD Vassilios Vassilikos MD PhD 《Pacing and clinical electrophysiology : PACE》2018,41(1):7-13
1 Background
Radiofrequency (RF) ablation of the slow pathway (SP) in atrioventricular nodal reentry tachycardia (AVNRT) is occasionally complicated with atrioventricular block (AVB) often predicted by junctional beats (JB) with loss of ventriculo‐atrial (VA) conduction.2 Methods
We analyzed retrospectively 153 patients undergoing ablation of SP for typical AVNRT. Patients were divided into two age groups: 127 ≤ 70 years and 26 > 70 years. We analyzed the interval between the atrial electrogram in the His‐bundle position and the distal ablation catheter [A(H)‐A(RFd)] and between the distal ablation catheter and the proximal coronary sinus catheter [A(RFd)‐A(CS)] before RF applications with and without JB. We evaluated if these intervals can be used as predictors of JB incidence and also of JB with loss of VA conduction. We also assessed if age influences the risk of loss of VA conduction.3 Results
The A(H)‐A(RFd) and A(RFd)‐A(CS) intervals were significantly shorter in RF applications causing JB than those without JB (33 ± 11 ms vs 39 ± 9 ms, P < 0.001, 14 ± 9 ms vs 20 ± 7 ms, P < 0.001, respectively). The A(H)‐A(RFd) and A(RFd)‐A(CS) intervals were also significantly shorter in RFs causing JB with VA block than those with VA conduction (29 ± 11 ms vs 35 ± 11 ms, P < 0.001, 8 ± 8 ms vs 17 ± 8 ms, P < 0.001, respectively). Patients > 70 years had shorter intervals (36 ± 11 ms vs 29 ± 8 ms, P = 0.012, 17 ± 8 ms vs 13 ± 7 ms, P = 0.027, respectively), while VA block was more common in this age group.4 Conclusions
The A(H)‐A(RFd) and A(RFd)‐A(CS) intervals can be used as markers for predicting JB occurrence as well as impending AVB. JB with loss of VA conduction occur more often in older patients possibly due to a higher position of SP. 相似文献9.
10.
Katsantonis JC Protopsaltis J Kokkoris S Brestas P Aroni K Tournis S Giannoulis G 《Rheumatology international》2008,28(11):1165-1168
Systemic sclerosis (SSc) is a progressively evolving multisystemic disorder of unknown etiology. Beyond skin, several other organs can also be affected with a severity of involvement that is often heterogeneous. We describe a 53-year-old female patient who was admitted urgently to the hospital almost collapsed, because of numerous bleeding deep skin ulcers, located all over the body. Clinical findings and autoantibody screening were typical of SSc. Moreover, both histopathology and immunofluorescence findings were compatible with scleroderma and vasculitis as well. In addition, pituitary hormone investigation revealed severely damaged function of the gland. We assume that severe skin ulceration and serious hypopituitarism were both implications of underlying SSc-associated vasculitis. To the best of our knowledge, these peculiar clinical manifestations have not been described in the international literature to date. 相似文献