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1.
Marie Warrer Petersen Tine Sylvest Meyhoff Marie Helleberg Maj-Brit Nørregaard Kjær Anders Granholm Carl Johan Steensen Hjortsø Thomas Steen Jensen Morten Hylander Møller Peter Buhl Hjortrup Mik Wetterslev Gitte Kingo Vesterlund Lene Russell Vibeke Lind Jørgensen Klaus Tjelle Thomas Benfield Charlotte Suppli Ulrik Anne Sofie Andreasen Thomas Mohr Morten H. Bestle Lone Musaeus Poulsen Mette Friberg Hitz Thomas Hildebrandt Lene Surland Knudsen Anders Møller Christoffer Grant Sølling Anne Craveiro Brøchner Bodil Steen Rasmussen Henrik Nielsen Steffen Christensen Thomas Strøm Maria Cronhjort Rebecka Rubenson Wahlin Stephan Jakob Luca Cioccari Balasubramanian Venkatesh Naomi Hammond Vivekanand Jha Sheila Nainan Myatra Christian Gluud Theis Lange Anders Perner 《Acta anaesthesiologica Scandinavica》2020,64(9):1365-1375
Introduction
Severe acute respiratory syndrome coronavirus-2 has caused a pandemic of coronavirus disease (COVID-19) with many patients developing hypoxic respiratory failure. Corticosteroids reduce the time on mechanical ventilation, length of stay in the intensive care unit and potentially also mortality in similar patient populations. However, corticosteroids have undesirable effects, including longer time to viral clearance. Clinical equipoise on the use of corticosteroids for COVID-19 exists.Methods
The COVID STEROID trial is an international, randomised, stratified, blinded clinical trial. We will allocate 1000 adult patients with COVID-19 receiving ≥10 L/min of oxygen or on mechanical ventilation to intravenous hydrocortisone 200 mg daily vs placebo (0.9% saline) for 7 days. The primary outcome is days alive without life support (ie mechanical ventilation, circulatory support, and renal replacement therapy) at day 28. Secondary outcomes are serious adverse reactions at day 14; days alive without life support at day 90; days alive and out of hospital at day 90; all-cause mortality at day 28, day 90, and 1 year; and health-related quality of life at 1 year. We will conduct the statistical analyses according to this protocol, including interim analyses for every 250 patients followed for 28 days. The primary outcome will be compared using the Kryger Jensen and Lange test in the intention to treat population and reported as differences in means and medians with 95% confidence intervals.Discussion
The COVID STEROID trial will provide important evidence to guide the use of corticosteroids in COVID-19 and severe hypoxia.2.
Ashutosh Singh M.Ch. Vidyut Kumar Sinha M.Ch. Jayant Khandekar M.Ch. Nandkishor Agrawal M.Ch. Anil Patwardhan M.Ch. Dr. Jagdish Kharideparkar M.Ch. 《Indian Journal of Thoracic and Cardiovascular Surgery》2006,22(2):121-125
Objective The degree of Left Ventricular Mass Index (LVMI) regression following aortic valve replacement correlates with long-term survival.
This study aims to assess the extent of LVMI regression at 3 months following aortic valve replacement (AVR) with different
types and sizes of mechanical valves in rheumatic aortic valve disease.
Methods The LVMI regression was studied in 34 consecutive patients, undergoing elective AVR for rheumatic aortic stenosis and/or regurgitation.
They were grouped in A and B, matched in age, body surface area and pre-operative LVMI, receiving respectively a tilting disc
and a bileaflet mechanical valve. The LVMI was calculated by M-mode echocardiography using the Devereux' formula pre-operatively
and three months post-operatively. The trend of LVMI reduction was compared between the two groups and amongst the patients
with stenotic, regurgitant and mixed aortic valve, pathologies; and receiving different sizes of valves.
Results The mean preoperative LVMI was 199g±79.5 g/m2. At three months post aortic valve replacement, the mean LVMI was 130g±49.0 g/m2. There was a significant reduction of LVMI post-operatively (p=0.001) at three months follow-up. The extent of LVMI regression
following surgery amongst the groups A and B did not vary significantly (p=0.92). The extent of LVMI regression did not vary
significantly in patients with different aortic valve pathology nor with different sizes of the valves implanted.
Conclusions There is a significant early LVMI regression following aortic valve replacement in rheumatic aortic valve disease. The type
and the size of the mechanical prosthesis or the rheumatic pathology do not appear to influence this regression. 相似文献
3.
Z. S. Meharwal N. Trehan V. M. Kohli V. K. Sharma R. R. Kasliwal A. Mishra V. Kohli A. Jayant 《Indian Journal of Thoracic and Cardiovascular Surgery》1992,8(2):88-91
Between November 1988 and February 1992, 416 patients required coronary endarterectomy for diffuse coronary artery disease.
This constitutes 16.19 per cent of all patients who underwent coronary artery bypass grafting during the same period. A total
of 528 endarterectomies were performed. Four-hundred and twenty-two endarterectomies were performed on right coronary system
and 106 endarterectomies were performed on left coronary system. One-hundred and twelve (26.92%) patients required more than
one endarterectomies.
The hospital mortality was 2.16 percent. 3.37 per cent of patients had perioperative infarction. Intraaortic balloon pump
was required in 1.92 per cent of patients. 5.77 per cent of the patients had significant arrhythmias. The patients have been
followed up for a mean period of 27 months. One-hundred and forty patients were evaluated by exercise multigated radionuclide
angiogram. One-hundred and thirty-four (95.71%) patients showed increase in ejection fraction as compared to preoperative
value. Six (4.29%) patients did not show any significant change while eight (5.71%) patients had fall in ejection fraction.
Postoperative coronary angiogram was done in 44 patients at a mean of 10 months. 89.59 per cent of grafts to the endarterectomised
vessels and 91.67% of grafts to nonendarterectomised vessel were patent. The difference between the two groups was not statistically
significant. 相似文献
4.
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6.
Seeds of legume species Argyrolobium flaccidum, Desmodium elegans, D. tortuosum, Indigofera gangetica, Lespedeza stenocarpa and Sesbania sesban have been evaluated for the toxicity to rhizobia for the first time. Legume species differ in quantity and quality of released seed toxins to which the symbiotic bacteria respond differentially. Therefore, seed toxicity may be used as a selectable taxonomic marker for the strainal identification of rhizobia. Seed toxins are located in seed coat and are thermolabile to some extent. The seed genotypes, within the species, differ in toxicity and such polymorphism can be used in the selection of toxin-free seeds. Seed surface-disinfection procedures involving subsequent soaking and washing with water are the most useful methods for reducing the seed toxins. The seed toxins from I. gangetica inhibited the growth of its homologous strain but did not affect nodulation and symbiotic parameters. Various seed-toxin-producing legume species did not affect nodulation and symbiotic efficiency and effectiveness. 相似文献
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8.
9.
An episomal DNA vector (YpJA18), encoding two selectable recombinant yeast genes (TRP1, URA3), was constructed to assess the fidelity of DNA repair in haploid repair-competent (RAD) wild-type yeast and several radiation-sensitive mutants. Either a DNA double-strand break (DSB) or a double-strand gap of 169 bp (DSG) was introduced by restriction enzymes in-vitro within the coding sequence of the URA3 gene of this vector. To eliminate transfer artefacts, selection was first applied for the undamaged TRP1 gene followed by counter selection for URA3 gene activity, which indicated correct repair of the DSB and DSG. Correct repair of the damaged URA3 gene was found to be about 90% in RAD cells (normalized for the expression of undamaged URA3 in TRP
+ transformants). Plasmids isolated from the transformants (URA
+
TRP
+) carry both unique sites (ApaI and NcoI) within the URA3 gene indicating the precise restitution of the 169-bp gap. An excision-repair-defective rad4-4 mutant repaired these lesions as correctly as RAD cells, whereas the mutants rad50-1, rad51-1 and rad54-1, proven to be defective in DSB repair and mitotic recombination, showed less than 5% correct repair of such lesions. In contrast, a representative of the RAD6 epistasis group of genes, the rev2-1 mutant which is sensitive towards UV and ionizing radiation, had a significantly reduced ability (about 20%) for the correct repair of both DSBs and DSGs. 相似文献
10.
The amygdala (AMY) plays an important role in initiating appropriate neurobehavioral responses to emotionally arousing events. Its major efferents from the central nucleus (Ace) to the basal forebrain, hypothalamus and brainstem permit it to influence sleep mechanisms. To characterize further the neuronal activity of AMY during sleep and wakefulness, we recorded single neuronal activity in Ace across behavioral states in freely moving, normally behaving rats. Of the 49 neurons recorded from Ace, 24 neurons had firing patterns related to sleep-wakefulness (S-W). Of these, 50% (n = 12) had a high firing frequency during wakefulness (W) or both W and REM sleep (REM), 12% (n = 3) were non-REM (NREM)-related, 17% (n = 4) had a high firing rate in REM (REM-ON), and 20% (n = 5) fired at a low rate during REM. Because serotonin introduced into AMY during REM induces short-latency changes of state, we also studied the effects of low frequency (1 Hz) electrical stimulation of the dorsal raphe nucleus (DRN) on Ace neurons. All REM-ON neurons recorded from Ace were inhibited by DRN stimulation, and other cell types were unaffected. Thus, we found that the majority of cells in Ace related to S-W fired slowly during NREM and increased their discharge during W and/or REM, and that the DRN has the potential for modulating the spontaneous activity of REM-ON cells in rats. 相似文献