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1.
Quality of life in stroke survivor–caregiver dyads: a new conceptual framework and longitudinal study protocol
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2.
Leonardo Jönck Staub Roberta Rodolfo Mazzali Biscaro Erikson Kaszubowski Rosemeri Maurici 《The Journal of emergency medicine》2019,56(1):53-69
Background
Lung ultrasound can accelerate the diagnosis of life-threatening diseases in adults with respiratory symptoms.Objective
Systematically review the accuracy of lung ultrasonography (LUS) for emergency diagnosis of pneumonia, acute heart failure, and exacerbation of chronic obstructive pulmonary disease (COPD)/asthma in adults.Methods
PubMed, Embase, Scopus, Web of Science, and LILACS (Literatura Latino Americana e do Caribe em Ciências da Saúde; until 2016) were searched for prospective diagnostic accuracy studies. Rutter-Gatsonis hierarchical summary receiver operating characteristic method was used to measure the overall accuracy of LUS and Reitsma bivariate model to measure the accuracy of the different sonographic signs. This review was previously registered in PROSPERO (Centre for Reviews and Dissemination, University of York, York, UK; CRD42016048085).Results
Twenty-five studies were included: 14 assessing pneumonia, 14 assessing acute heart failure, and four assessing exacerbations of COPD/asthma. The area under the summary receiver operating characteristic curve of LUS was 0.948 for pneumonia, 0.914 for acute heart failure, and 0.906 for exacerbations of COPD/asthma. In patients suspected to have pneumonia, consolidation had sensitivity of 0.82 (95% confidence interval [CI] 0.74–0.88) and specificity of 0.94 (95% CI 0.85–0.98) for this disease. In acutely dyspneic patients, modified diffuse interstitial syndrome had sensitivity of 0.90 (95% CI 0.87–0.93) and specificity of 0.93 (95% CI 0.91–0.95) for acute heart failure, whereas B-profile had sensitivity of 0.93 (95% CI 0.72–0.98) and specificity of 0.92 (95% CI 0.79–0.97) for this disease in patients with respiratory failure. In patients with acute dyspnea or respiratory failure, the A-profile without PLAPS (posterior-lateral alveolar pleural syndrome) had sensitivity of 0.78 (95% CI 0.67–0.86) and specificity of 0.94 (95% CI 0.89–0.97) for exacerbations of COPD/asthma.Conclusion
Lung ultrasound is an accurate tool for the emergency diagnosis of pneumonia, acute heart failure, and exacerbations of COPD/asthma. 相似文献3.
4.
Khalil Fattouch Giuseppe Bianco Giuseppe Speziale Roberta Sampognaro Carlo Lavalle Francesco Guccione Pietro Dioguardi Giovanni Ruvolo 《European journal of cardio-thoracic surgery》2007,32(2):326-332
BACKGROUND: The inflammatory cascade has been hypothesized to be an important mechanism of post-ischaemic myocardial reperfusion injury and several studies demonstrated that C1 esterase inhibitor (C1-INH) is effective in post-ischaemia myocardial protection. Therefore, we aimed to investigate prospectively in a randomised double-blind study the cardioprotective effects of C1-INH in ST segment elevation myocardial infarction (STEMI) in patients who underwent emergent reperfusion with coronary artery bypass grafting (CABG). METHODS: In this study, we enrolled 80 patients affected with STEMI who underwent emergent CABG. Patients were assigned in two groups (C1-INH group: receive 1000 UI of C1-INH; and placebo group: receive a saline solution). The effects of C1-INH on complement inhibition, myocardial cell injury extension and clinical outcome were studied. Haemodynamic data and myocardial function were monitored. C1-INH, C3a, C4a complement activation fragments and cardiac troponin I (cTnI) serum levels were measured before, during and after surgery. RESULTS: Patient characteristics were not different between the two groups. The overall in-hospital mortality rate was 6.2%. No statistical significant difference was observed between the two groups with regard to early mortality (p=0.36). Statistical significant difference between the two groups was showed for cardiopulmonary bypass support (p=0.04), administration of high dose of inotropes drugs (p=0.001), time of intubation (p=0.03), intensive care unit (ICU) stay (p=0.04) and in-hospital stay (p=0.03). A significant improvement in mean arterial pressure (p=0.03), cardiac index (p=0.02) and stroke volume (p=0.03) was showed in C1-INH group versus placebo group. The serum cTnI levels were significantly low in the C1-INH group versus placebo group after reperfusion, during the observation period. Plasma levels of C3a and C4a complement fragments were reduced significantly in C1-INH group. No drugs-related adverse effects were observed. CONCLUSIONS: The inhibition of the classic complement pathway by C1-INH appears to be an effective mean of preserving ischaemic myocardium from reperfusion injury as demonstrated by low serum cTnI levels in C1-INH group. Therefore, the use of C1-INH during CABG as a rescue therapy in STEMI patients is probably an effective treatment to inhibit complement activity and to improve cardiac function and haemodynamic performance without impacting early mortality. Large randomised study should be performed to support our results. 相似文献
5.
Novel heteroplasmic mtDNA mutation in a family with heterogeneous clinical presentations. 总被引:1,自引:0,他引:1
P Corona E Lamantea M Greco F Carrara A Agostino D Guidetti M T Dotti C Mariotti M Zeviani 《Annals of neurology》2002,51(1):118-122
The protean manifestations of a novel maternally inherited point mutation of the mitochondrial genome are reported. The proband showed isolated, spastic paraparesis. A brother, who had suffered from a multisystem progressive disorder, ultimately died of cardiomyopathy. Another brother is healthy. The proband's mother showed truncal ataxia, dysarthria, severe hearing loss, mental regression, ptosis, ophthalmoparesis, distal cyclones, and diabetes mellitus. A muscle biopsy performed in the proband failed to show the morphological abnormalities typical of mitochondrial disorders; the activities of respiratory chain complexes were normal. However, complex I and IV activities were low in the muscle homogenate of the affected mother and brother. Sequence analysis of mtDNA showed a heteroplasmic mutation of the tRNA(Ile) gene (G4284A). The mutation load was approximately 55%, 80%, and 90% in the muscle mtDNA of the proband, his mother, and his affected brother, respectively. Mutation was undetected in the healthy brother, as well as in 100 control samples. Several cybrid clones containing homoplasmic mutant mtDNA from the proband showed significant reductions of complex IV activity and maximum oxygen consumption rate, compared with homoplasmic wild-type clones derived from the same subject. 相似文献
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8.
Do weekly and fast-rotating shiftwork schedules differentially affect duration and quality of sleep?
F. M. Fischer Antonio Castro Bruni Adelaide Berwerth Claudia Roberta Castro Moreno Rosaneli Lima Fernandez Claudia Riviello 《International archives of occupational and environmental health》1997,69(5):354-360
Characteristics of shiftwork schedules can have distinct impacts on workers’ sleep. This report presents comparisons of the
effects of two different shiftwork schedules on duration and quality of the main sleep episodes in comparable worker populations
at two different petrochemical plants. No significant differences were found for sleep duration in comparing the two plants.
However, within each plant’s shift cycles, morning and night shifts showed shorter sleep durations than all other workdays
and days off. Quality of sleep was perceived as lowest for night shifts of both plant schedules, and of lesser quality for
weekly than for fast-rotating shifts. These results support recommendations for reducing the number of consecutive nights
of shiftwork. However, before recommending any optimal shift schedule, interactions of sleep duration and quality with shift
schedules need much further evaluation.
Received: 18 December 1995/Accepted: 18 July 1996 相似文献
9.
10.
A V Levy F Gomez-Mont N D Volkow J F Corona J D Brodie R Cancro 《Journal of nuclear medicine》1992,33(2):287-295
Using the two-dimensional Fourier transform and the brain's centroidal principal axis, a method is developed for the analysis of PET metabolic brain images without the use of predefined anatomic regions of interest. We applied the method to images from a group of 11 normal and 12 medicated schizophrenics tested under resting conditions and under a visual task. A cortical/subcortical spatial pattern was found to be significant in two directions; anterior/posterior and chiasmatic (left-anterior/right-posterior). The best individual clinical classification (Jackknife classification) occurred under visual task at two axial brain levels: at the basal ganglia with correct classification rates of 91% and 84%, while the cerebellum had rates of 82% and 92%. These high classification rates were obtained using only the four coefficients of the lowest spatial frequency. These results point to the generalized brain dysfunction of regional glucose metabolism in chronic medicated schizophrenics both at rest and at a visual image-tracking task. 相似文献