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排序方式: 共有299条查询结果,搜索用时 15 毫秒
1.
HIPDM single photon emission computed tomography brain imaging in partial onset secondarily generalized tonic-clonic seizures 总被引:3,自引:3,他引:0
HIPDM-Single photon emission computed tomography brain imaging was performed during interictal and ictal stages in three patients with complex partial seizures and secondarily generalized tonic-clonic seizures. In all three patients, interictal studies demonstrated decreased regional cerebral perfusion (rCP) and ictal studies showed increased rCP in the epileptogenic region. The demonstration of focal hyperperfusion by SPECT performed during secondarily generalized tonic-clonic seizures suggests that rCP in the epileptic focus remains higher than in other cerebral regions during immediate postictal stages, even in secondarily generalized seizures. 相似文献
2.
Ictal brain imaging in presurgical evaluation of patients with medically intractable complex partial seizures 总被引:1,自引:0,他引:1
O. N. Markand V. Salanova R. M. Worth H.-M. Park H. H. Wellman Omkar N. Markand M.D 《Acta neurologica Scandinavica》1994,89(S152):137-144
At the Indiana University Medical Center, 99 patients with medically intractable complex partial seizures (MI-CPS) had presurgical evaluation with subsequent anterior temporal lobectomy. The majority of the patients had single photon emission tomography (SPECT) performed interictally as well as during an actual epileptic seizure (ictal scan). Decreased regional cerebral perfusion (rCP) was seen in 54/94 (57%) of the interictal scans corresponding to the eventual site of the surgery. However, ictal scans provided a higher yield; increased rCP in the temporal lobe during an actual seizure was observed in 60/82 (73%) concordant to the side of surgery. SPECT is a useful, noninvasive method of localizing the epilepti-form focus in patients with MI-CPS considered for resective surgery. Both interictal and ictal SPECT need to be performed; combined interictal hypo-perfusion and ictal hyperperfusion in the same focal area are unique to epileptogenic lesions. Ictal SPECT studies can be performed in the majority of patients during the period of continuous video/EEG monitoring with only a little additional effort. Combining the results of functional brain imaging (interictal and ictal SPECT, PET) with clinical semiology of seizures, surface and sphenoidal EEG, magnetic resonance imaging and other non-invasive tests, anterior temporal lobectomy can be recommended in approximately two-thirds of the patients without resorting to potentially dangerous intracranial EEG monitoring. 相似文献
3.
4.
WEINBERG JULIUS; GRIMAUD OLIVIER; NEWTON LISA; ON BEHALF OF THE CHARTER GROUP 《European journal of public health》1999,9(3):236-240
Background: Several collaborations in communicable disease surveillancehave developed between European Union member states. Involvementin these activities takes time and money. It is vital that collaborationsare established in areas most likely to be beneficial. An exercisewas undertaken to inform national surveillance centres and theEuropean Commission as to priority areas for the developmentof collaborations. Methods: A modified Delphi exercise was undertakenamongst the heads of centres with responsibilities for surveillanceat national level in the member states of the EU. Participantsdeveloped, agreed and ranked criteria for developing collaborations.A list of communicable diseases and syndromes was then rankedusing a Likert-type scale. Three rounds were undertaken. Betweenrounds, scores and a ranking were fed back showing where participantshad ranked items, compared to the overall mean and rank distribution.For the third round participants were asked to use a categoricalscale, nominating six or ten high priority disease areas. Results:Response rates were 87.5% for round 1, 44% round 2 and 87% round3. The low round 2 response rate appeared to be because respondentsdid not wish to alter their rankings. The six high priorityareas were outbreaks of gastroenteritis/food poisoning, CID/otherslow virus infections, serious imported diseases, legionellosis,antimicrobial resistance and tuberculosis. When participantsgave ten high priority areas meningococcal disease, travel advice,vaccination/immunization and influenza were also included. Thefinal lists were accepted at the meeting of participants. Conclusions:The process was successful in developing both a priority listand consensus. 相似文献
5.
Slow spike-wave activity in EEG and associated clinical features: often called 'Lennox' or "Lennox-Gastaut' syndrome. 总被引:11,自引:0,他引:11
O N Markand 《Neurology》1977,27(8):746-757
Clinical features were studied in 83 patients with slow spike-wave activity in the EEG. Epileptic seizures, usually intractable, occurred in 82 patients. The majority had the onset of seizures during the first 2 years of life. Minor motor seizures alone or in combination with other types of seizures occurred in 80 percent, and most had more than one type of seizure. The combination of tonic-clonic, minor motor, and absence seizures was the commonest, occurring in 37 percent. Sixty-six patients were definitely retarded and 49 showed definite motor impairment. Etiologic factors responsible for cerebral insult were identified in 53 patients. Serial EEG studies showed a close relationship between the EEG patterns of hypsarrhythmia, independent multifocal spike discharges, and slow spike-wave activity. The eponym "Lennox-Gastaut" syndrome is appropriate for a patient who has slow spike-wave activity in the EEG, exhibits mental retardation, and has intractable seizures of various types. However, the syndrome does not imply a pathologic entity because many diverse processes, both static and progressive, can produce this syndrome. 相似文献
6.
FOX K.; POOL J.; VOS J.; LUBSEN J.; ON BEHALF OF THE ROCKET-STUDY GROUP 《European heart journal》1991,12(9):1283-1287
This study was designed to examine the effects of nisoldipine(relative to placebo), a new dihydropyridine calcium entry blockingagent, in the treatment of silent ischaemia in conventionaldoses. A total of 409 patients with proven coronary artery diseasewere screened and of this 64 had at least six episodes or atotal duration of 30 mm of ST segment depression (1 mm lastingat least 1 min) over 48 h. Fifty-two patients ultimately completeda randomized double-blind cross-over study comparing nisoldipine5 mg twice a day, nisoldipine 10 mg daily and placebo. There was a reduction in the ST segment integral and numberof episodes of ST segment depression when compared to placeboon treatment with nisoldipine 5 mg twice a day and nisoldipine10 mg daily. However, the confidence limits were wide and crossedthe no-treatment effect line. In addition, the nisoldipine dosesneither affected the circadian distribution of ischaemic episodesnor caused an alteration of the workload achieved either atpeak exercise or at 1 mm ST segment depression measured 24 hafter nidoldipine 10 mg or 12 h after nisoldipine 5 mg. We conclude that frequent silent ischaemia in patients withproven coronary artery disease is relatively uncommon, it accountsfor approximately 16% of patients with positive exercise. Inthese patients nisoldipine, given as 5mg twice a day and 10mg daily, showed no significant therapeutic effects, eitheron the frequency or severity of silent ischaemia. New formulationsof slow release nisoldipine are consequently being developedso that a fuller 24 h therapeutic profile may be obtained. 相似文献
7.
8.
FOX K.; POOL J.; VOS $$$; LUBSEN J.; ON BEHALF OF THE ROCKET-STUDY GROUP 《European heart journal》1991,12(8):1283-1287
This study was designed to examine the effects of nisoldipine(relative to placebo), a new dihydropyridine calcium entry blockingagent, in the treatment of silent ischaemia in conventionaldoses. A total of 409 patients with proven coronary artery diseasewere screened and of this 64 had at least six episodes or atotal duration of 30 mm of ST segment depression (1 mm lastingat least 1 min) over 48 h. Fifty-two patients ultimately completeda randomized double-blind cross-over study comparing nisoldipine5 mg twice a day, nisoldipine 10 mg daily and placebo. There was a reduction in the ST segment integral and numberof episodes of ST segment depression when compared to placeboon treatment with nisoldipine 5 mg twice a day and nisoldipine10 mg daily. However, the confidence limits were wide and crossedthe no-treatment effect line. In addition, the nisoldipine dosesneither affected the circadian distribution of ischaemic episodesnor caused an alteration of the workload achieved either atpeak exercise or at 1 mm ST segment depression measured 24 hafter nidoldipine 10 mg or 12 h after nisoldipine 5 mg. We conclude that frequent silent ischaemia in patients withproven coronary artery disease is relatively uncommon, it accountsfor approximately 16% of patients with positive exercise. Inthese patients nisoldipine, given as 5mg twice a day and 10mg daily, showed no significant therapeutic effects, eitheron the frequency or severity of silent ischaemia. New formulationsof slow release nisoldipine are consequently being developedso that a fuller 24 h therapeutic profile may be obtained. 相似文献
9.
BADANO L.; BERTOLI D.; ASTENGO D.; CARRATINO L.; DEGAETANO G.; PASSERONE G. C.; CAMERIERI A.; GRAMENZI S.; MAGAJA O.; FAZZINI L.; PAPAGNA D.; BIANCHI F.; BARBERIS L.; LUCATTI A.; ON BEHALF OF THE VALVE PROSTHESES LIGURIAN COOPERATIVE DOPPLER STUDY 《European heart journal》1993,14(12):1602-1609
Doppler echocardiographic characteristics of normally functioningAllcarbon prostheses were studied in 149 consecutive patientswith 157 valves in the mitral (n=73) and aortic (n=84) positionswhose function was considered normal by clinical and echocardiographicevaluation. In the mitral position, the mean gradient and theeffective mitral orifice area were not significantly differentin either the 25-mm or the 31-mm size valves (from 5±1to 4±1 mmHg and from 2.2±0.6 to 2.8±0.9cm2, respectively; P=ns for both). Conversely, peak gradientwas significantly and inversely correlated to actual orificearea (r=0.70; P<0.0006), decreasing from 15±3mmHg in the 25-mm size valve to 9±1 mmHg in the 31-mmsize. In the aortic position, the mean gradient was 29±8 mmHgin the 19-mm size valve; it decreased to 8±2 mmHg inthe 29-mm size. Effective prosthetic aortic valve area, calculatedusing the continuity equation, ranged between 0.9±0.1cm2 for the 19-mm size valve to 4.1±0.7 cm2 for the 29-mmsize. By analysis of variance, effective prosthetic aortic valvearea differentiated various valve sizes (F=25.3; P<0.0001)better than peak (F=5.34; P=0.012) or mean (F=4.34; P=0.0052)gradients alone, and it correlated better with actual orificearea (r=0.89, r=0.70 and r=0.65, respectively).This study provides the normal range for Doppler haemodynamiccharacteristics of the various sizes of the Allcarbon valvein the mitral and aortic positions so that prosthetic malfunctioncan be identified. 相似文献
10.
Aznar JA Marco A Jiménez-Yuste V Fernández-Fontecha E Pérez R Soto I Parra R Moreno M Mingot ME Moret A;ON BEHALF OF THE SPANISH HAEMOPHILIA EPIDEMIOLOGICAL STUDY WORKING GROUP 《Haemophilia》2012,18(5):738-742
Summary. On‐demand therapy enables stopping haemorrhages rapidly, reducing joint pain and restoring joint mobility, but does not prevent the beginning and subsequent development of haemophilic arthropathy. The main objective of this study was to identify the clinical and orthopaedic status of severe haemophilic patients with bleeding phenotype receiving on‐demand treatment in Spain. We conducted an epidemiological, observational, retrospective study, recruiting 167 patients from 36 centres (92% of them with haemophilia A), median age at enrolment of 35 years. Forty per cent of the patients received a combination of on‐demand and short‐term prophylaxis regimen; the rest was under on‐demand treatment. One hundred and forty‐five patients (87%) reported at least one bleeding episode and 22 (13%) of the biologically severe patients had no bleeding phenotype. Seventy‐one per cent of the studied population presented established haemophilic arthropathy, reaching 80% if we exclude patients without bleeding phenotype. Forty‐three per cent of these patients had one or two joints affected, 28% of them had three or four affected joints, 20% reported five or six affected joints and 9% more than six injured joints. An increase in established haemophilic arthropathy with age was observed. Forty‐six patients underwent orthopaedic surgery at least once. These data show that on‐demand therapy is not effective in preventing the development of haemophilic arthropathy in severe haemophilic population with bleeding phenotype. Therefore, we suggest that the optimal treatment in these patients should be based on prophylaxis. We recommend analysing the reasons for ending prophylaxis, in case its reinstatement should be necessary. 相似文献