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排序方式: 共有1254条查询结果,搜索用时 15 毫秒
1.
Yosuke Homma Takashi Shiga Hiraku Funakoshi Dai Miyazaki Atsushi Sakurai Yoshio Tahara Ken Nagao Naohiro Yonemoto Arino Yaguchi Naoto Morimura 《The American journal of emergency medicine》2019,37(2):241-248
Objective
This study assessed the association between the timing of first epinephrine administration (EA) and the neurological outcomes following out-of-hospital cardiac arrests (OHCAs) with both initial shockable and non-shockable rhythms.Methods
This was a post-hoc analysis of a multicenter prospective cohort study (SOS-KANTO 2012), which registered OHCA patients in the Kanto region of Japan from January 2012 to March 2013. We included consecutive adult OHCA patients who received epinephrine. The primary result included 1-month favorable neurological outcomes defined as cerebral performance category (CPC) 1 or 2. Secondary results included 1-month survival and return of spontaneous circulation (ROSC) after arrival at the hospital. Multivariable logistic regression analysis determined the association between delay per minute of the time from call to first EA in both pre- or in-hospital settings and outcomes.Results
Of the 16,452 patients, 9344 were eligible for our analyses. In univariable analysis, the delay in EA was associated with decreased favorable neurological outcomes only when the initial rhythm was a non-shockable rhythm. In multivariable analyses, delay in EA was associated with decreased ROSC (adjusted odds ratio [OR] for one minute delay, 0.97; 95% confidence interval [CI], 0.96–0.98) and 1-month survival (adjusted OR, 0.95; 95% CI, 0.92–0.97) when the initial rhythm was a non-shockable rhythm, whereas during a shockable rhythm, delay in EA was not associated with decreased ROSC and 1-month survival.Conclusions
While assessing the effectiveness of epinephrine for OHCA, we should consider the time-limited effects of epinephrine. Additionally, consideration of early EA based on the pathophysiology is needed. 相似文献2.
The authors studied the clinical features and outcome at 6 months in 191 patients with subarachnoid hemorrhage (SAH) from ruptured aneurysms. Aneurysm repair (AR) was undertaken in 123 cases (64.4%). In the non-AR group (n = 68), 48.5% of the patients were 70 years of age or older, compared with 12.2% in the AR group. The duration from onset to admission was less than 3 hours in 48 non-AR cases (70.6%) and in 42 AR cases (34.1%). Among non-AR patients, 63.2% were Hunt and Hess grade IV or V, whereas the figure for AR patients was only 14.7%. By 6 months after SAH, 94.1% of non-AR patients had died, and the remainder were vegetative or severely disabled. In contrast, only 15.4% in the AR group died, and over 50% showed good recovery. The large majority of non-AR patients were treated conservatively because they were judged to be poor surgical risks and, among these patients, nearly one half were elderly. In the 10 elderly patients considered good surgical candidates, vasospasm was the most common reason (70%) for not performing AR. 相似文献
3.
Chikako Nishigori Miran Tanaka Shin-ichi Moriwaki Sadao Imamura Hiraku Takebe 《Cancer science》1992,83(11):1172-1178
Skin tumors were produced on the back of hairless mice, HOS (HR/De), by exposure to ultraviolet B light (UVB, 290–320 nm) with 4 different protocols. The first tumors appeared earlier (in 10 weeks in group I and 7 weeks in group III) when initial intense exposure was given, followed by repeated lower-level exposures, than when the mice were exposed to the repeated UV only (in 16 weeks both in group II and group IV). All mice developed skin tumors earlier in the groups given the repeated UV exposures three times a week than in the groups given the exposures twice a week. Most of the skin tumors produced by the UVB exposure were histologically malignant, being transplantable to nude mice, and the cultured cells grown from the tumors were capable of producing tumors when injected into nude mice. The accelerated development of skin tumors by initial intense exposure and short intervals of repeated exposure observed in this study may have implications for humans who expose themselves to intense sunbathing and UV tanning (burning) by fluorescent sun lamps. 相似文献
4.
Amiloride inhibition of responses of rat single chorda tympani fibers to chemical and electrical tongue stimulations 总被引:6,自引:0,他引:6
Amiloride inhibition of single fiber responses of the rat chorda tympani to ionic chemical and electrical tongue stimulations was studied. Amiloride reduced responses to both chemical and electrical stimulations with NaCl or LiCl in most of the single fibers. However, the magnitude of reduction of the response by amiloride varied among the fibers and was greater for chemical than electrical stimulation with NaCl in each fiber. Thirty-two single fibers were divided into two groups, such as 18 high (HAS) and 14 low amiloride-sensitive (LAS) fibers. Percent responses (control, 100%) of the former group to chemical stimulus with NaCl after amiloride ranged from 1.1 to 42.5%, while those of the latter from 72.8 to 108.0%. In HAS fibers, amiloride also reduced responses to KCl and CaCl2, but to a smaller degree than those to NaCl and LiCl. Fifteen out of 18 HAS fibers more strongly responded to a chemical stimulus with 0.1 M NaCl than 0.01 M HCl, while the opposite was true for 13 out of 14 LAS fibers, although the threshold concentration for NaCl was rather lower in LAS fibers than in HAS fibers. These results suggest that there exist at least two different receptor mechanisms for NaCl or LiCl which are amiloride-sensitive and -insensitive, and the observed differences in relative specificities to ionic taste stimuli and sensitivities to amiloride among rat chorda tympani fibers are possibly due to a disproportional distribution of these two receptors. 相似文献
5.
6.
Satoko Kobori Fumihito Yoshii Hirohide Takahashi Shigeharu Takagi Kei Funakoshi 《Clinical neurology》2007,47(1):53-55
We report a patient who developed overlapping symptoms of ophthalmoplegia and oropharyngeal palsy after Campylobacter jejuni infection. A 15-year-old man had diarrhea and fever, and developed dysarthria, diplopia and ptosis two weeks later. He did not show ataxia, weakness or abnormal tendon reflexes in the extremities during the clinical course. In the acute phase of the disease, we found significant elevation of anti-GQlb and anti-GTla IgG antibodies in the serum, and high-dose intravenous immunoglobulin therapy remarkably ameliorated the symptoms. Our patient was atypical of Fisher syndrome or pharyngeal-cervical-brachial (PCB) weakness, and this is the first case of multiple cranial neuropathy associated with C. jejuni infection. 相似文献
7.
Despite the high prevalence of diabetes mellitus in patients with chronic pancreatitis, few studies of pancreatic diabetes
have been reported. We investigated 154 patients with chronic pancreatitis, of whom 50% were diabetics, with special reference
to the features and clinical course of pancreatic diabetes. We arrived to clarify the features of pancreatic diabetes by comparing
pancreatic exocrine function in 112 patients with primary diabetes with findings in a separate group of 80 patients with chronic
pancreatitis. Pancreatic diabetes is proposed as a type of diabetes in which exocrine pancreatic function is markedly decreased.
Progressive and fatal angiopathies were found in patients with pancreatic diabetes after a long duration of diabetes. The
present investigation suggests that treatment of malnutrition is necessary in patients with pancreatic diabetes and that control
of blood glucose is often difficult in these patients because of the high incidence of insulin-induced hypoglycemic episodes.
(Received Feb. 6, 1997; accepted July 25, 1997) 相似文献
8.
Shimazoe T Nakamura S Kobayashi K Watanabe S Miyasaka K Kono A Funakoshi A 《Neuroscience》2004,123(1):201-205
The role of 5-HT1A and 5-HT1B receptors in entrainment function was studied in Otsuka Long Evans Tokushima fatty (OLETF) rats and control Long Evans Tokushima Otsuka (LETO) rats. Light-induced (100 lux, 30 min) Fos expression in the suprachiasmatic nucleus was studied. Light-induced Fos expression was significantly decreased in OLETF rats compared to that in LETO rats. The decrease of light-induced Fos expression in OLETF rats was significantly reversed by pretreatment with the 5-HT1B receptor antagonist, isamoltan (3 mg/kg, i.p.). Simultaneous administration of CGS12066B (5 mg/kg, i.p.), a 5-HT1B agonist, blocked the reversal effect of isamoltan on Fos expression. Fos expression was not changed in LETO rats by pretreatment with isamoltan (3 mg/kg, i.p.). The Fos expression in LETO and OLETF rats was significantly decreased by pretreatment with the 5-HT1A antagonist, WAY-100,635. Phase shifts in locomotor activity paralleled the Fos expression. Light-induced phase shifts of locomotor activity in OLETF rats were significantly smaller than those in LETO rats. The phase shifts were significantly increased by isamoltan (3 mg/kg, i.p.) in OLETF rats. These results suggest that 5-HT1B receptors are involved in the reduced entrainment function of OLETF rats. 相似文献
9.
Serotonin-immunoreactive axonal components were observed in the central autonomic nucleus (CAN), a cell column of sympathetic preganglionic neurons in the rostral spinal cord of the filefish Stephanolepis cirrhifer. Serotonin-positive axonal varicosities were seen around neuronal perikarya through the whole rostrocaudal extent of the CAN, although their distribution pattern in the rostral CAN was different from that in the caudal CAN. Electron microscopically, serotonin-positive axonal varicosities were found to make axodendritic and axosomatic synapses on CAN neurons. Many serotonin-positive neuronal cell bodies were seen in the raphe nuclei in the lower brainstem, whereas only a few were found in the spinal cord. Thus most of serotoninergic axons within the CAN were considered to originate from the raphe nuclei in the lower brainstem. 相似文献
10.
The purpose of the present study was to investigate the effects of informational and motivational level of feedback stimuli on the stimulus-preceding negativity (SPN). In the time estimation task, in which a visual stimulus was presented 3 s after a voluntary movement, (a) the information level (high information and low information) and (b) the motivation level (reward and no-reward) for feedback stimuli were manipulated. Under the high-information condition, subjects received feedback information about (1) correctness (correct or incorrect), (2) direction of error (under- or overestimate), and (3) degree of accuracy (accurate or less accurate) of their time estimation. In the low-information condition, however, they received information about the correctness only. In the reward condition, they received a monetary reward for accurate time estimations but received nothing in the no-reward condition. The results demonstrated a significant interaction of information by motivation level, showing that the SPN amplitude under the reward/high-information was larger than that in the no-reward/high-information condition. The results are discussed in terms of emotional anticipation, taking into consideration the result of self-report that subjects felt to be more motivated when they received precise information. 相似文献