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1.
Conall T. Morgan Brigitte Mueller Varsha Thakur Vitor Guerra Callaghan Jull Luc Mertens Mark Friedberg Fraser Golding Mike Seed Steven E.S. Miner Edgar T. Jaeggi Cedric Manlhiot Lynne E. Nield 《The Canadian journal of cardiology》2019,35(4):453-461
Background
The purpose of the study was to evaluate the association between fetal echocardiographic measurements and the need for intervention (primary coarctation repair, staged coarctation repair, or catheter intervention) in prenatally diagnosed coarctation of the aorta.Methods
A single-centre retrospective cohort study (2005-2015) of 107 fetuses diagnosed with suspected coarctation of the aorta in the setting of an apex-forming left ventricle and antegrade flow across the mitral and aortic valves.Results
Median gestational age at diagnosis was 32 weeks (interquartile range, 23-35 weeks). Fifty-six (52%) did not require any neonatal intervention, 51 patients (48%) underwent a biventricular repair. In univariable analysis, an increase in ascending aorta (AAo) peak Doppler flow velocity (odds ratio [OR], 1.40 [95% confidence interval [CI], 1.05-1.91] per 20 cm/s; P = 0.03) was associated with intervention. No intervention was associated with larger isthmus size (OR, 0.23; P < 0.001), transverse arch diameter (OR, 0.23; P < 0.001), and aortic (OR, 0.72; P = 0.02), mitral (OR, 0.58; P = 0.001), and AAo (OR, 0.53; P < 0.001) z-scores. In multivariable analysis, higher peak AAo Doppler (OR, 2.51 [95% CI, 1.54-4.58] per 20 cm/s; P = 0.001) and younger gestational age at diagnosis (OR, 0.81 [95% CI, 0.70-0.93] per week; P = 0.005) were associated with intervention, whereas a higher AAo z-score (OR, 0.65 [95% CI, 0.43-0.94] per z; P = 0.029) and transverse arch dimension (OR, 0.44 [95% CI, 0.18-0.97]; P = 0.05) decreased the risk of intervention.Conclusions
In prenatally suspected coarctation, the variables associated with intervention comprised smaller AAo and transverse arch size, earlier gestational age at diagnosis, and the additional finding of a higher peak AAo Doppler. 相似文献2.
3.
Duct-associated lymphoid tissue (DALT) of minor salivary glands and mucosal immunity. 总被引:3,自引:0,他引:3
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Minor salivary glands (MSG) play a substantial role in the secretory immunoglobulin A (sIgA)-mediated immunity of the oral cavity. There are two possibilities for the induction of this immunity: (i) an explicitly local antigenic stimulus, or (ii) a remote stimulus as part of the so-called 'common mucosal immune system'. This communication is an attempt to consolidate available evidence in support of both possibilities and to address the former in detail. Although there is strong circumstantial evidence supporting the feasibility of MSG functioning as a part of the common mucosal immune system, direct experimental evidence is yet to emerge. On the other hand, there is increasing structural and physiological evidence in support of MSG serving as a local immunological organ. The purely local response is attributed to the presence of MSG duct-associated lymphoid tissue (DALT), which is comparable to gut- or bronchial-associated lymphoid tissue (GALT or BALT) in origin, tissue organization and function. DALT is accessible to oral antigens by retrograde passage through MSG ducts. Repeated topical antigenic challenging via the oral mucosa may result in the appearance of interacinar plasma cells carrying specific homologous antibodies in MSG. Gut or enteric priming of the same antigen, by passing the oral mucosa by gastric intubation, need not evoke a remote immune response in MSG. Since DALT is more likely to occur in healthy, young growing individuals, who are less likely to undergo bioptic examination of MSG, it has not yet been documented in humans. The physiologically induced DALT is apt to be confused with focal accumulations of lymphoid tissue in pathologically altered MSG, as a consequence of local and some systemic autoimmune diseases. An attempt is made to demarcaate healthy and pathological MSG on the basis of currently available clinical, serological, immunological and genetic evidence. 相似文献
4.
Prof. Dr. W. Schroeder 《Basic research in cardiology》1949,15(1-6):24-32
Zusammenfassung Es wird ein für die fortlaufende Blutdruckschreibung an der Karotisschlinge des Hundes entwickeltes Gerät hoher Empfindlichkeit beschrieben, welches bei entlasteter Gefäßwand die Blutdruckänderungen mit automatisch richtiger Wiedergabe der Amplitude durch ein optisches Glasplattenmanometer zur Aufschrift bringt. Die Steuerung des Manometers erfolgt durch eine sich selbsttätig entlastende Membran.Mit 7 Abbildungen 相似文献
5.
Brigitte Belmont Eric Plaisance Aliette Vérillon 《ALTER. European Journal of Disability research, Journal europeen de recherche sur le handicap》2009,3(4):320-339
Coinciding with the present period of unemployment, a corps of school assistants – assistants de vie scolaire (AVS) – has been created in order to meet the demand for in-school assistance raised by the development of schooling for children with special needs. This paper reports on a questionnaire-based survey carried out among 151 AVS working in the Seine Saint-Denis department. It aims at describing their working conditions considering the precariousness of their status (temporary jobs, poor pay) and the nature of their assignment. The main question bears on whether these conditions enable the assistants to develop the capabilities necessary for dealing with their tasks. Results could contribute to the present issue of reorienting government action in order to improve these jobs in terms of professional development. Notably, they reveal that AVS's training is usually brief and that their opportunities for developing workplace professional relationships are scant even though these are needed for them to collaborate with the other workers concerned by schooling children with special needs. 相似文献
6.
Burkhard H. A. von Rahden Brigitte Stigler Wolfgang Weiß Hubert J. Stein 《Journal of gastrointestinal surgery》2007,11(7):945-947
Management of upper gastrointestinal bleeding because of erosion of vessels by esophageal cancer may be challenging. We present
herein the angiographic images of a 49-year-old patient who was admitted with massive bleeding from a tumor-eroded inferior
thyroid artery. Attempts to control the bleeding by means of flexible endoscopy and insertion of a Sengstaken–Blakemore tube
had failed. The diagnosis was impressively demonstrated by multislice computed tomography with intravenous contrast in the
arterial phase and multiplanar reconstructions (computed tomography angiography) and by digital subtraction angiography. The
bleeding was successfully treated with superselective catheterization and coiling of the eroded vessel. 相似文献
7.
Variations in length of stay and outcomes for six medical and surgical conditions in Massachusetts and California 总被引:15,自引:1,他引:14
P D Cleary S Greenfield A G Mulley S G Pauker S A Schroeder L Wexler B J McNeil 《JAMA》1991,266(1):73-79
OBJECTIVES.--To determine the extent to which interinstitutional variations in length of stay are explained by differences in patient characteristics and to determine whether patients in hospitals with shorter lengths of stay had worse outcomes. DESIGN.--We reviewed patients' medical records and surveyed patients between 3 and 12 months after hospital discharge using a questionnaire. SETTING.--Six teaching hospitals in California and Massachusetts. PATIENTS.--A cohort of 2484 selected patients who had been hospitalized for acute myocardial infarction or to rule out acute myocardial infarction, coronary artery bypass graft surgery, total hip replacement, cholecystectomy, or transurethral prostatectomy. Between 73% and 84% of the patients with each condition completed a follow-up questionnaire. OUTCOME MEASURES.--In-hospital complications, deaths, length of stay, functional status after hospital discharge, readmission, and patient satisfaction with hospital care were analyzed. RESULTS.--Significant interinstitutional differences in length of stay were noted for all conditions except rule-out acute myocardial infarction. Statistical adjustment for case-mix differences accounted for most of the interinstitutional differences in length of stay for total hip replacement but explained little of the differences in the other conditions. When we controlled statistically for other predictors, length of stay did not have a significant impact on deaths, functional status after hospital discharge, the probability of readmission, or patient satisfaction with hospital care. CONCLUSION.--More research is needed to determine the medical practices that are related to variations in lengths of stay. Routinely available outcome data may help preserve quality in the face of efforts to decrease costs by effecting more standardized practices of care. 相似文献
8.
9.
Chretien Marie Francoise; Lebouvier Brigitte; Denis Alain; Chappard Daniel 《Human reproduction (Oxford, England)》1998,13(10):2767-2771
A cytomorphometric analysis of superficial vaginal cells inwomen in three groups of different types of hormonal concentrationwas made. There were 15 women in each group. Group I was studiedduring a natural cycle, group II under oral contraceptive therapyand group III during an in-vitro fertilization (IVF) stimulationprotocol. Morphometric parameters were measured on an imageanalyser. The area, perimeter and several form factors weremeasured separately for nuclei and cytoplasm. The nucleus:cytoplasmicratio was also determined. The cytoplasmic area was significantlyreduced in group II and was associated with a statisticallysignificant reduction of the nuclear area. The nucleus:cytoplasmicratio appeared significantly increased in group II and reducedin group III. Low oestradiol impregnation obtained with an oralminidosed contraceptive interfered with vaginal cell maturation.High oestradiol concentrations obtained during IVF protocolsinduced marked nuclear pycnosis but did not induce supra-physiologicalcell enlargement. Maximal cell size is genetically regulatedaccording to Driesch's law of volume invariance and hormonalover-stimulation has no effect on cell size. The nucleus:cytoplasmicratio appears to be a powerful parameter reflecting the oppositeeffects of hormones on cell compartments. 相似文献
10.
Pamela H. Orr Victor Dong Marlis L. Schroeder Malcolm R. Ogborn 《Pediatric nephrology (Berlin, Germany)》1995,9(5):612-613
P1 blood group positivity has been postulated as a host factor which may provide protection against the development of post-enteropathic hemolytic uremic syndrome (HUS). In this study, blood group status in 20 Inuit survivors ofEscherichia coli 0157: H7-associated HUS was compared with age-and sex-matched controls from the same community who had experienced uncomplicated diarrheal illness due to the same pathogen. Of 20 HUS survivors, 6 were P1 antigen positive compared with 8 of the 20 controls (P=0.7). We conclude that P1 antigen positivity was not protective against HUS in this population. Further studies of this condition to clarify the role of host factors in verotoxin-induced endothelial damage are indicated. 相似文献