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排序方式: 共有1478条查询结果,搜索用时 15 毫秒
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Rosario Fernández-Plata Rogelio Pérez-Padilla Rodrigo Del Río-Hidalgo Cecilia García-Sancho Laura Gochicoa-Rangel Christian Rodríguez-Hernández Luis Torre-Bouscoulet David Martínez-Briseño 《Archivos de bronconeumología》2019,55(10):513-518
IntroductionPeople with Down syndrome (DS) have high respiratory morbidity, evaluating their respiratory health with standardized, objective tests is desirable. Thus, the objective of this study was to evaluate the technical quality of Pulmonary Function Tests (PFTs) to determine which ones are most suitable for this population.MethodsParticipants included children, teenagers and adults with DS, 5 years of age or older (n = 302). The technical quality of the impulse oscillometry system (IOS), forced spirometry, lung-diffusing capacity for carbon monoxide (DLCO), and 6-min walk test (6MWT) were analyzed by age group. Capnography and pulse oximetry were included in the study. Technical quality was determined on the basis of current international PFTs standards.ResultsFifty-one percent of participants were males. A total of 184 participants (71%) who completed the IOS fulfilled the quality criteria, while 210 (70%) completed the 6MWT. Performance on forced spirometry and DLCO was poor. All pulse oximetries and 96% percent heart rates obtained had good quality, but exhaled carbon dioxide (PetCO2) and respiratory rate (RR) showed deficient repeatability.ConclusionsIOS appears to be the most reliable instrument for evaluating lung mechanics in individuals with DS. 相似文献
3.
J. E. P. Rockell C. M. Skeaff S. M. Williams T. J. Green 《Osteoporosis international》2006,17(9):1382-1389
Introduction Vitamin D plays an important role in bone health. Our purpose was to measure serum 25-hydroxyvitamin D concentrations and their determinants in a national sample (n=2,946) of New Zealanders aged 15 years and over.Findings Mean (99% CI) serum 25-hydroxyvitamin D concentrations were 47 (45–50) nmol/l in women and 52 (49–55) nmol/l in men. Mean concentrations in New Zealand European and Others (NZEO, n=2,440), Mori (n=370), and Pacific (n=136) were 51 (49–53), 42 (38–46) and 37 (33–42) nmol/l, respectively. Three percent of New Zealanders had serum 25-hydroxyvitamin D concentrations indicative of deficiency (≤17.5 nmol/l); 48% and 84% were insufficient based on cutoffs of ≤50 and ≤80 nmol/l. Determinants of serum 25-hydroxyvitamin D concentrations in women were age, ethnicity, obesity, latitude and season; determinants in men were ethnicity and season. Serum 25-hydroxyvitamin D in women declined with age; mean concentration was 13 (8–18) nmol/l lower in women 65 years or older and 9 (5–13) nmol/l lower in women 45–64 years compared with women 15–18 years. Spring to summer differences in serum 25-hydroxyvitamin D were 31 (28–34) and 28 (25–31) nmol/l in women and men, respectively. Obese women had lower vitamin status than normal-weight women by 6 (3–10). Women living in the South Island had a mean serum 25-hydroxyvitamin D that was 6 (3–9) nmol/l lower than women living in the North Island. Ethnicity and season are the major determinants of serum 25-hydroxyvitamin D in New Zealanders.Conclusion The high prevalence of vitamin D insufficiency in New Zealanders, particularly in older women, may warrant strategies to improve vitamin D status. 相似文献
4.
Generalized Convulsive Status Epilepticus in the Adult 总被引:10,自引:7,他引:3
David M. Treiman 《Epilepsia》1993,34(S1):S2-S11
Summary: Status epilepticus (SE) is denned as recurrent epileptic seizures without full recovery of consciousness before the next seizure begins, or more-or-less continuous clinical and/or electrical seizure activity lasting for more than 30 min whether or not consciousness is impaired. Three presentations of SE are now recognized: recurrent generalized tonic and/or clonic seizures without full recovery of consciousness between attacks, nonconvulsive status where the patient appears to be in a prolonged "epileptic twilight state," and continuous/repetitive focal seizure activity without alteration of consciousness. Generalized convulsive status epilepticus (GCSE) encompasses a broad spectrum of clinical presentations from repeated overt generalized tonic-clonic seizures to subtle convulsive movements in a profoundly comatose patient. Thus, GCSE is a dynamic state that is characterized by paroxysmal or continuous tonic and/or clonic motor activity, which may be symmetrical or asymmetrical and overt or subtle but which is associated with a marked impairment of consciousness and with bilateral (although frequently asymmetrical) ictal discharges on the EEG. Just as there is a progression from overt to increasingly subtle clinical manifestations of GCSE, there is also a predictable sequence of progressive EEG changes during untreated GCSE. A sequence of five patterns of ictal discharges has been observed: discrete electrographic seizures, waxing and waning, continuous, continuous with flat periods, and periodic epileptiform discharges on a relatively flat background. A patient actively having seizures or comatose who exhibits any of these patterns on EEG should be considered to be in GCSE and should be treated aggressively to stop all clinical and electrical seizure activity to prevent further neurological morbidity and mortality. 相似文献
5.
6.
目的:探讨成人急腹症超声诊断价值。方法:回顾分析ll0例经临床及手术证实的成人急腹症的超声诊断。结果:临床诊断准确率为97.3%,在成人腹腔脓肿,肝破裂,急性胰腺炎,胰腺外伤等病的诊断准确率分别为91.3%,93.5%,92.7%。结论:超声诊断在成人急腹症具有重要的诊断价值。在大部分病例是首选的诊断手段。 相似文献
7.
Tracy A. Glauser 《Epilepsia》2004,45(S5):23-26
Summary: As patients with catastrophic epilepsies move from childhood to adulthood, evolving and innovative therapeutic regimens are often required. However, the goal of providing the best quality of life while minimizing both seizures and side effects remains the same. Clinicians can develop appropriate care plans by being aware of patients' changing needs. Clinical symptoms of the catastrophic epilepsies may change over time; by understanding the natural history of a patient's condition, clinicians can help ease the transition from childhood to adulthood. Additionally, as children with catastrophic epilepsies become adults, medical issues (e.g., medication side effects, tolerance, and dependence) and nonmedical issues (e.g., guardian/caretaker issue, group home applications, and respite care options) must be considered when developing strategies for patient care. Regular assessment of patients, the development of emergency plans, and maintenance of consistency in the delivery of care are also important issues to consider. Finally, a multidisciplinary care plan that incorporates resources from health-care practitioners, social service professionals, and community agencies can be valuable in optimizing treatment for patients with catastrophic epilepsies. 相似文献
8.
P. Klein R. Anetsberger R. Stangl H. P. Hümmer 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》1994,379(1):54-57
Zusammenfassung Eine hochgradige Duodenalstenose im Erwachsenenalter kann in seltenen Fällen angeboren sein und findet ihre Ursache in einer intraduodenal gelegenen Membran. Die Anamnese zeigt Wachstumsstörungen mit Erbrechen und Meteorismus und abdominelle Beschwerden. Eine Perforationsöffnung in dieser Membran ist die Ursache fur ein Überleben bis ins Erwachsenenalter. Die Röntgendarstellung und die tiefe Duodenoskopie lassen auf einfache Weise die Diagnose stellen. Differentialdiagnostisch müssen der Volvulus bei Malrotation, Ladd-Bänder und das Pancreas anulare, sowie die Kompression des Duodenums durch Mesenterialgefäße erwogen werden. Das operative Verfahren der Wahl ist die Resektion der intraduodenalen Membran. Dabei ist v. a. die Papilla Vateri darzustellen, da diese nicht selten im Bereich des Septums mündet. Das längs eröffnete Duodenum wird quer verschlossen. Bei der Wind-Sock-Web-Anomalie sollte das Duodenum an der Ansatzstelle des Diaphragmas eröffnet werden. Die Anlage einer Gastrojejunostomie ist inadäquat und zu vermeiden.
Congenital duodenal stenosis in adulthood
A high-grade duodenal stenosis in adults can, in rare cases, be congenital, and its cause is found in an intraduodenally sited membrane. The anamnesis reveals growth disorders with vomiting and meteorism and abdominal complaints. A perforation opening in this membrane is the reason for survival into adulthood. The X-ray appearance and deep duodenoscopy make the diagnosis easy. Volvulus in cases of malrotation, Ladd's ligaments, anular pancreas, and compression of the duodenum by mesenteric vessels must be considered in the differential diagnosis. When the intraduodenal membrane is resected it is most important to expose the papilla Vateri, since this not uncommonly ends in the area of the septum. If necessary, a duodenoduodenostomy is performed. If the windsock web abnormality is present the duodenum should be opened at the point of attachment of the diaphragm. The construction of a gastrojejunostomy should be avoided.相似文献
9.
A consecutive series of six adult patients ranging in age from 29 to 53 years is presented. The clinical and radiological features in each patient are described. Attention is drawn to the features demonstrated on computed axial tomography. In only one patient, the first encountered, was surgical excision undertaken and histological verification obtained. One patient died before any form of treatment could be instituted. The remaining four patients were treated with antituberculous chemotherapy alone and their progress monitored by sequential computed tomography. The excellent response and good outcome in this conservatively treated group are documented. 相似文献
10.
A. Gratas-Delamarche J. Mercier M. Ramonatxo J. Dassonville C. Préfaut 《European journal of applied physiology》1993,66(1):25-30
Summary The aim of this study was to determine whether the greater ventilation in children at rest and during exercise is related to a greater CO2 ventilatory response. The CO2 ventilatory response was measured in nine prepubertal boys [10.3 years (SD 0.1)] and in 10 adults [24.9 years (SD 0.8)] at rest and during moderate exercise (
CO2 = 20 ml·kg–1·min–1) using the CO2-rebreathing method. Three criteria were measured in all subjects to assess the ventilatory response to CO2: the CO2 sensitivity threshold (Th), which was defined as the value of end titalPCO2 (P
ETCO2) where the ventilation increased above its steady-state level; the reactivity slope expressed per unit of body mass (SBM), which was the slope of the linear relation between minute ventilation (
E) andP
ETCO2 above Th; and the slope of the relationship between the quotient of tidal volume (V
T) and inspiration time (t
I) andP
ETCO2 (V
T ·t
I
–1 ·P
ETCO2
–1) values above Th. The
E,V
T, breathing frequency (f
R), oxygen uptake (
O2), and CO2 production (
CO2) were also measured before the CO2-rebreathing test. The following results were obtained. First, children had greater ventilation per unit body weight than adults at rest (P<0.001) and during exercise (P<0.01). Second, at rest, onlyV
T ·t
I
–1 ·P
ETCO2
–1 was greater in children than in adults (P<0.001). Third, during exercise, children had a higher SBM (P < 0.02) andV
T ·t
I
–1 ·P
ETCO2
–1 (P<0.001) while Th was lower (P<0.02). Finally, no correlation was found between
E/
CO2 and Th while a significant correlation existed between
E/
CO2 and SBM (adults,r=0.79,P<0.01; children,r=0.73,P<0.05). We conclude that children have, mainly during exercise, a greater sensitivity of the respiratory centres than adult. This greater CO2 sensitivity could partly explain their higher ventilation during exercise, though greater CO2 production probably plays a role at rest. 相似文献