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1.
Pulmonary hypertension: Barrier or just a bump in the road in transplanting adults with congenital heart disease
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Jonathan N. Menachem MD Edo Y. Birati MD Payman Zamani MD Anjali T. Owens MD Pavan Atluri MD Christian A. Bermudez MD David Drajpuch NP Stephanie Fuller MD Yuli Y. Kim MD Christopher E. Mascio MD Vikram Palanivel MD J. Eduardo Rame MD Joyce Wald DO Michael A. Acker MD Jeremy A. Mazurek MD 《Congenital heart disease》2018,13(4):492-498
2.
Ladan Mohajeri Farnaz Salehi Payman Mehrvarzfar Hamide Arfaee Behnam Bohluli Reza Hamedy 《Anesthesia progress》2015,62(1):14-19
Achieving adequate pulpal anesthesia in mandibular teeth is always a challenge. Supplementary injections and using drugs in combination are some methods implemented to overcome this hurdle. In this randomized clinical trial, use of meperidine in conjunction with lidocaine in intraligamentary injection did not exhibit significant improvement in anesthesia.Key Words: Periodontal ligament, Meperidine, Irreversible pulpitis, Dental anesthesiaThe failure rate of the inferior alveolar nerve block (IANB) in some experimental studies has been reported up to 75%.1–4 This lack of success has even increased to a maximum of 81% in some recent studies.5–7 To overcome this shortcoming, dental clinicians have actively sought measures to improve the patients'' anesthesia during different dental procedures. Apart from the anatomical variations mentioned in the applied anatomy of injections,8 several authors have attempted to modify the anesthetic technique,9–12 and others have compared different anesthetic agents13 or their concentrations14 to improve their efficacy.Activating the opioid receptors peripherally in inflammatory conditions has become a new trend in research to manage postoperative pain.15 Synergy between local anesthetics and opioids has become an interesting field of research recently.16 Opioids are frequently added to local anesthetics in a variety of surgical procedures, eg, intrathecal application for minor surgery.17 Meperidine or its derivatives, eg, pethidine (meperidine chloride) or norpethidine (Pethidine Intermediate B) are agonists of μ-opioid receptors, which block the pathway of pain signals to the trigeminal nucleus. They also activate peripheral opioid receptors and block sodium channels.17–22 Despite controversy regarding the use of meperidine as an anesthetic,22 recent studies have demonstrated its benefits over prilocaine in arthroscopy with local anesthesia,16 nasal packing removal,23 etc.However, only a few studies have investigated the dental anesthetic efficacy of such combinations.24,25 The effect of the addition of meperidine to lidocaine in IANB for pain management in normal teeth24 and also in teeth with irreversible pulpitis25 has been studied. The aim of our study was to compare the efficacy of local anesthetics with and without meperidine for intraligamentary supplemental injection for teeth with irreversible pulpitis. Our null hypothesis stated that the addition of meperidine to standard lidocaine with epinephrine does not improve the efficacy of supplemental intraligamentary anesthesia in teeth with symptomatic irreversible pulpitis. The specific objectives were to randomly allocate volunteers with complete soft tissue anesthesia following an IANB, yet having positive pulp response, into 2 groups, and then compare the efficacy of lidocaine with epinephrine plus meperidine with that of lidocaine with epinephrine plus an equal volume of sterile water for supplemental periodontal ligament anesthesia. 相似文献
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To review long-term respiratory effects of mustard gas on Iranian veterans having undergone Iraq-Iran war. Electronic databases of Scopus, Medline, ISI, IranMedex, and Irandoc sites were searched. We accepted articles published in scientific journals as a quality criterion. The main pathogenic factors are free radical mediators. Prevalence of pulmonary involvement is approximately 42.5%. The most common complaints are cough and dyspnea. Major respiratory complications are chronic obstructive pulmonary disease, bronchiectasis, and asthma. Spirometry results can reveal restrictive and obstructive pulmonary disease. Plain chest X-ray does not help in about 50% of lung diseases. High-resolution CT of the lung is the best modality for diagnostic assessment of parenchymal lung and bronchi. There is no definite curative treatment for mustard lung. The effective treatment regimens consist of oxygen administration, use of vaporized moist air, respiratory physiotherapy, administration of mucolytic agents, bronchodilators, corticosteroids, and long-acting beta-2 agonists, antioxidants, surfactant, magnesium ions, therapeutic bronchoscopy, laser therapy, placement of respiratory stents, early tracheostomy in laryngospasm, and ultimately lung transplantation. High-resolution CT of the lung is the most accurate modality for the evaluation of the lung parenchyma and bronchi. The treatment efficacy of patients exposed to mustard gas depends on patient conditions (acute or chronic, upper or lower respiratory tract involvement). There are various treatment protocols, but unfortunately none of them is definitely curable. 相似文献
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Neda Behzadnia Katayoun Najafizadeh Babak Sharif-Kashani Davoud Oulad Dameshghi Payman Shahabi 《Heart and vessels》2010,25(4):313-318
We aimed to assess the acute cardiopulmonary effects of a 100-mg oral single dose of sildenafil in patients with idiopathic
pulmonary hypertension (IPAH) using a well-validated but less-used noninvasive echocardiographic method for the measurement
of both systolic and diastolic pulmonary artery pressure (PAP), by tricuspid regurgitation (TR) velocity curve analysis. We
studied 12 consecutive patients with IPAH (10 patients with New York Heart Association functional class III, and 2 patients
with functional class II). A 100-mg oral single dose of sildenafil was added to previous medications of all patients and its
immediate effects were evaluated 1, 5, and 12 h after treatment. Using paired analysis, administration of a 100-mg oral single
dose of sildenafil led to a significant reduction in mean PAP and a remarkable increase in pulmonary acceleration time (PAT)
1 h after treatment (P = 0.000; 95% confidence interval [CI] 18.99–26.00 and P = 0.005; 95% CI −12.89 to −2.95, respectively). In addition, although the right heart dimensions (right atrium and right
ventricle) showed a trend toward improvement, the differences were not statistically significant (P = 0.13 and P = 0.08, respectively). Our results demonstrated that Doppler examination of TR alone can be easily used for the estimate
of systolic and diastolic PAP in patients with IPAH. This study also shows that sildenafil is the only drug given orally that
can evaluate the vasodilatory capacity of the pulmonary vascular bed in patients with IPAH, with promising effects on mPAP
and PAT in these patients. 相似文献
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9.
Peter Henneman Femke van der Sman-de Beer Payman Hanifi Moghaddam Petra Huijts Anton FH Stalenhoef John JP Kastelein Cornelia M van Duijn Louis M Havekes Rune R Frants Ko Willems van Dijk Augustinus HM Smelt 《European journal of human genetics : EJHG》2009,17(5):620-628
Type III hyperlipoproteinemia (HLP) is mainly found in homozygous apolipoprotein (APO) E2 (R158C) carriers. Genetic factors contributing to the expression of type III HLP were investigated in 113 hyper- and 52 normolipidemic E2/2 subjects, by testing for polymorphisms in APOC3, APOA5, HL (hepatic lipase) and LPL (lipoprotein lipase) genes. In addition, 188 normolipidemic Dutch control panels (NDCP) and 141 hypertriglyceridemic (HTG) patients were genotyped as well. No associations were found for four HL gene polymorphisms and two LPL gene polymorphisms and type III HLP. The frequency of the rare allele of APOC3 3238 G>C and APOA5 −1131 T>C (in linkage disequilibrium) was significantly higher in type III HLP patients when compared with normolipidemic E2/2 subjects, 15.6 vs 6.9% and 15.1 vs 5.8%, respectively, (P<0.05). Furthermore, the frequencies of the APOA5 c.56 G>C polymorphism and LPL c.27 G>A mutation were higher in type III HLP patients, though not significant. Some 58% of the type III HLP patients carried either the APOA5 −1131 T>C, c.56 G>C and/or LPL c.27 G>A mutation as compared to 27% of the normolipidemic APOE2/2 subjects (odds ratio 3.7, 95% confidence interval=1.8–7.5, P<0.0001). The HTG patients showed similar allele frequencies of the APOA5, APOC3 and LPL polymorphisms, whereas the NDCP showed similar allele frequencies as the normolipidemic APOE2/2. Patients with the APOC3 3238 G>C/APOA5 −1131 T>C polymorphism showed a more severe hyperlipidemia than patients without this polymorphism. Polymorphisms in lipolysis genes associate with the expression and severity of type III HLP in APOE2/2. 相似文献
10.
Glowinski R Payman V Frencham K 《The Australian and New Zealand journal of psychiatry》2008,42(11):932-940
Confabulation can be of two types: provoked or spontaneous. The former is the more common and can occur on challenge to an amnesic patient's memory. Spontaneous confabulation involves an unprovoked outpouring of unbelievable autobiographical claims. The purpose of the present paper is to synthesize the current literature on confabulation for the use of treating clinicians. There is a focus on the spontaneous form, which is less common, but more memorable when encountered. In this paper the history, phenomenology, incidence, anatomical underpinnings and theoretical mechanisms of spontaneous confabulations will be reviewed, and then the paper will conclude by addressing prognostic and treatment issues. A systematic literature review of electronic databases was conducted to identify the key articles, reviews and books that have shaped the understanding of spontaneous confabulation. 相似文献