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Prediction of delayed graft function using different scoring algorithms: A single-center experience

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World Journal of Transplantation 2017年第5期7卷 260-268页

作者： magda michalak Kristien Wouters Erik Fransen Rachel Hellemans Amaryllis H Van Craenenbroeck marie m Couttenye Bart Bracke Dirk K Ysebaert Vera Hartman kathleen De Greef Thiery Chapelle Geert Roeyen Gerda Van Beeumen marie-Paule Emonds Daniel Abramowicz Jean-Louis Bosmans Department of Nephrology-Hypertension Antwerp University Hospital Department of medical Statistics Antwerp University Hospital StatUa Center for Statistics University of Antwerp Department of Hepatobiliary Endocrine and Transplantation SurgeryAntwerp University Hospital Histocompatibility and Immunogenetic Laboratory

AIm To compare the performance of 3 published delayed graftfunction(DGF) calculators that compute the theoretical risk of DGF for each *** This single-center,retrospective study included 247 consecutive kidney transplants from a deceased *** kidney transplantations were performed at our institution between January 2003 and December *** compared the occurrence of observed DGF in our cohort with the predicted DGF according to three different published calculators. The accuracy of the calculators was evaluated by means of the c-index(receiver operating characteristic curve).RESULTS DGF occurred in 15.3% of the transplants under *** c index of the Irish calculator provided an area under the curve(AUC) of 0.69 indicating an acceptable level of prediction,in contrast to the poor performance of the Jeldres nomogram(AUC = 0.54) and the Chapal nomogram(AUC = 0.51). With the Irish algorithm the predicted DGF risk and the observed DGF probabilities were close. The mean calculated DGF risk was significantly different between DGF-positive and DGF-negative subjects(P m 10% to 51% for recipients with DGF and from 4% to 56% for those without *** sensitivity,specificity and positive predictive value of a calculated DGF risk ≥ 30% with the Irish nomogram were 32%,91% and 38%. CONCLUSION Predictive models for DGF after kidney transplantation are performant in the population in which they were derived,but less so in external validations.

关键词： Delayed graft function Kidney transplantation Nomogram Receiver operating characteristic curve Risk calculation

吉兰-巴雷综合征诊治的10个步骤(Diagnosis and management of Guillain-Barrésyndrome in ten steps全译)

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中华诊断学电子杂志 2023年第3期11卷 198-211页

作者： Sonja E Leonhard melissa R mandarakas Francisco AA Gondim kathleen Bateman maria LB Ferreira David R Cornblath Pieter A van Doorn mario E Dourado Richard AC Hughes Badrul Islam Susumu Kusunoki Carlos A Pardo Ricardo Reisin James J Sejvar Nortina Shahrizaila Cristiane Soares Thirugnanam Umapathi 王玉忠 Eppie m Yiu Hugh J Willison Bart C Jacobs 伊拉斯姆斯大学医疗中心神经内科鹿特丹市3015 CE 福塔莱萨联邦大学沃尔特·坎迪奥大学医院塞阿拉州60430-370 开普敦大学格鲁特·舒尔医院开普敦市7925 累西腓市康复医院神经内科伯南布哥州52171-011 约翰·霍普金斯大学医学院神经病学系马里兰州21218 北里奥格兰德州联邦大学奥诺弗雷卢佩斯医院综合医学部纳塔尔市59012-300 伦敦大学学院皇后广场神经病学研究所伦敦市WC1N 3BG 国际腹泻病研究中心达卡市1212 金代大学医学院大阪市589-8511 不列颠医院布宜诺斯艾利斯市C1280AEB 亚特兰大市疾病预防控制中心乔治亚州30329 马来亚大学神经病学系吉隆坡市50603 埃斯塔多联邦医院里约热内卢市20221-903 国家神经科学研究所新加坡308433 济宁医学院附属医院神经内科济宁272029 墨尔本皇家儿童医院神经内科维多利亚州3052 默多克儿童研究所神经科学研究组维多利亚州3052 墨尔本大学儿科学系维多利亚州3052 格拉斯哥大学医学、兽医学与生命科学学院格拉斯哥市G611QH 伊拉斯姆斯大学医疗中心免疫科鹿特丹市3015 GD

吉兰-巴雷综合征(GBS)是一种少见但可危及生命的、自身免疫介导的周围神经病。GBS通常由感染引发,发病率可在感染性疾病暴发期间增加,如2013年法属波利尼西亚和2015年拉丁美洲的寨卡病毒流行期间,该病的发病率明显上升。由于GBS的临床... 详细信息

吉兰-巴雷综合征(GBS)是一种少见但可危及生命的、自身免疫介导的周围神经病。GBS通常由感染引发,发病率可在感染性疾病暴发期间增加,如2013年法属波利尼西亚和2015年拉丁美洲的寨卡病毒流行期间,该病的发病率明显上升。由于GBS的临床表现和病程多种多样,其诊疗存在一定的复杂性,而目前尚无可用的国际性临床诊疗指南。本文作者撰写了一份适用于全球的GBS诊疗指南,特别是在疾病暴发期间,以期为临床医生提供指导。本指南根据当前文献和专家共识撰写而成,采用10步式结构,以便在临床实践中更好地应用。本文首先介绍了GBS的诊断标准、临床变异和鉴别诊断;其次,通过10个步骤介绍了GBS的早期识别和诊断、收治重症监护室的指征、治疗指征和选择、疾病进展的监测和处理、临床病程和结局的预测,以及并发症和后遗症的处理。

关键词：吉兰-巴雷综合征诊断治疗

interrelationships between ghrelin, insulin and glucose homeostasis: physiological relevance

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World Journal of Diabetes 2014年第3期5卷 328-341页

作者： FranCois Chabot Alexandre caron mathieu Laplante David H St-Pierre Département de Kinanthropologie Université du Québec à Montréal Department of Anatomy and Physiology Institut universitaire de cardiologie et de pneumologie de Québec

Ghrelin is a 28 amino acid peptide mainly derived from the oxyntic gland of the stomach. Both acylated(AG) and unacylated(UAG) forms of ghrelin are found in the circulation. Initially, AG was considered as the only bioactive form of ghrelin. However, recent advances indicate that both AG and UAG exert distinct and common effects in organisms. Soon after its discovery, ghrelin was shown to promote appetite and adiposity in animal and human models. In response to these anabolic effects, an impressive number of elements have suggested the influence of ghrelin on the regulation of metabolic functions and the development of obesityrelated disorders. However, due to the complexity ofits biochemical nature and the physiological processes it governs, some of the effects of ghrelin are still debated in the literature. Evidence suggests that ghrelin influences glucose homeostasis through the modulation of insulin secretion and insulin receptor signaling. On the other hand, insulin was also shown to influence circulating levels of ghrelin. Here, we review the relationship between ghrelin and insulin and we describe the impact of this interaction on the modulation of glucose homeostasis.

关键词： Acylated ghrelin Unacylated ghrelin Insulin secretion β-cell functions Insulin receptor signalling Glucose homeostasis

母乳哺育医疗学会临床程序1:哺喂母乳婴儿之血糖监测及低血糖处理指导方针

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母乳哺育医疗学会临床程序1:哺喂母乳婴儿之血糖监测及低血糖处理...

Diagnostic Performance and Inter-Observer Agreement of 4-Dimensional Computed Tomography Parathyroid Scans in Patients with Primary and Secondary Hyperparathyroidism

全国妇产科新技术、新理论进展研讨会

作者： NANCY WIGHT kathleen A.mARINELLI 柯婷蓉陳倩儀母乳哺育医疗学会临床程序制订委员会 m.D.Children’s Hospital and Health Center and Sharp mary Birch Hospital for Women San Diego CA m.D.University of Connecticut Hartford CT 台大医院小儿部新生儿科

2006六月修订一些常见的医疗问题常影响母哺乳哺育的成效,而母乳哺育医疗学会的主要目标就是发展出可以处理相关医疗问题的临床程序。这些临床程序只用来作为照顾哺乳母亲与婴儿的方针,而非绝对的治疗方式或是医疗照护的标准。根据个别...

2006六月修订一些常见的医疗问题常影响母哺乳哺育的成效,而母乳哺育医疗学会的主要目标就是发展出可以处理相关医疗问题的临床程序。这些临床程序只用来作为照顾哺乳母亲与婴儿的方针,而非绝对的治疗方式或是医疗照护的标准。根据个别病人的需求而有治疗上的差异可能是适当的。

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Open Journal of Radiology 2019年第1期9卷 82-91页

作者： Bundhit Tantiwongkosi Frank R. miller Viet D. Nguyen kathleen E. Hands Boyce B. Oliver Alfredo A. Santillan Wilson B. Altmeyer Achint K. Singh Fang Yu Radiology Department University of Texas Health San Antonio San Antonio TX USA Otolaryngology Head Neck Surgery Department University of Texas Health San Antonio San Antonio TX USA Thyroid and Endocrine Center of South Texas San Antonio TX USA Surgical Oncology Department University of Texas Health San Antonio San Antonio TX USA Surgical Oncology Department Texas Oncology San Antonio TX USA Radiology Department University of Texas Southwestern Dallas TX USA

Background: 4D-CT has been used to localize the parathyroid adenomas and hyperplasia since 2006 as a second line study after TC-99 m mIBI and ultrasonography. However, multiple studies have shown that 4D-CT is a robust imaging method with high diagnostic accuracy, becoming increasingly popular among surgeons and radiologists. Purpose: To assess the diagnostic performance of 4D-CT scans to identify the pathologic gland(s), using pathology and intraoperative findings as gold standards. methods: We analyzed patients with primary and secondary hyperparathyroidism who had intraoperative reports, pathology, parathyroid hormone levels, and preoperative 4D-CT. Histology, surgical findings, and decreased parathyroid hormone levels were used as gold standards. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy and 95% confidence interval were calculated. Fleiss’ kappa was used to assess the inter-observer agreement. Results: Sixty-seven patients were included. Sixty-two patients had a single adenoma, and five patients had a multiple gland disease (adenomas or hyperplasia). A total of 72 glands were proven to have parathyroid adenomas or hyperplasia. The sensitivity, specificity, PPV, NPV and accuracy are 85%, 97%, 96%, 87% and 91% for lateralization and 76%, 96%, 85%, 92% and 90% for quadrant localization, respectively in single-gland disease. The sensitivity, specificity, PPV, NPV and accuracy are 88%, 100%, 100%, 50% and 90% for lateralization and 71%, 100%, 100%, 60% and 80% for quadrant localization respectively in multiple-gland disease. Fleiss’ kappa value is 5.6 (moderate inter-observer agreement). Conclusion: 4D-CT is a robust method in the localization of hyperfunctioning parathyroid glands with high accuracy and at least moderate inter-observer agreement.

关键词： Computed Tomography Parathyroid 4-Dimensional Hyperparathyroidism

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与时间同速前进：参与永不停息的市场竞争

工业企业管理 2000年第12期 55-58页

作者：凯思林·艾森哈特（kathleen m.Eisenhardt）肖娜·布朗（Shona L.Brown）

与时间保持同速前进，是公司立于市场不败之地的法宝。英特尔公司创办人之一戈登·穆尔（Gordan moore）在1965年预言微机集成芯片的容量每过18个月就会增加1倍。他的这番话后来被人叫做“穆尔定律”，它听起来像是一条物理学定律，其...

与时间保持同速前进，是公司立于市场不败之地的法宝。英特尔公司创办人之一戈登·穆尔（Gordan moore）在1965年预言微机集成芯片的容量每过18个月就会增加1倍。他的这番话后来被人叫做“穆尔定律”，它听起来像是一条物理学定律，其实不是。它是英特尔公司的工程师们和经理们牢记心间的一个业务目标。这些年来，英特尔以艰苦的工作提供的新产品为它本行业确定了一种极快的步调。在从1987至1997年的10年间，英特尔创造了令人惊讶的、高达44%的年平均投资回报率。更加令人难忘的是，最近英特尔的年收入竟相当于10家最大的个人电脑公司的年收入之和。尽管很少公司能享有英特尔在市场上的那种地位，但经理们却可以从世界上这头号集成芯片制造商学到一条重要经验。英特尔肯定是“与时间同速前进”这一信条的最明显的——但不是唯一的——实践者。“与时间同速前进”是通过将不时出现的变化列入计划表，以参与快速变化，难以预测的市场，进行竞争的一种战略。英特尔不仅通过推出新产品来实现穆尔定律，而且在其他领域也同样奉行“与时间同速前进”的战略。例如，大约每隔9个月，英特尔就要增加一种新的设施。英特尔公司总裁安迪·格罗夫（Andy Grove）说：“在需要工厂的2年以前，在以工厂制造产品以前，在我们知道这个行业将有发展以前，我们就建造工厂。”以这种立足于未来的方式扩展生产力，英特尔就能防止对手进入某项业务。公司无论大小，技术无论高低，都可以从“与时间同速前进”的战略获益，特别是在永不静止的市场中更是如此。思科系统（CiscoSystems）、艾默生电气（Emerson Electric）、吉列（Gillette）、网景（Netscape）、SAP、索尼（Sony）、斯塔巴克斯（Starbucks）和3m都以这种或那种方式运用“与时间同速前进”的战略。在急速变化的行业中，这种战略能帮助经理们预见到变化，或者像英特尔那样，确定应对变化的步骤。即使在变化速度不快的行业中，“与时间同速前进”也可以制止一些经理在等待观望中丧失冲劲的自然倾向。我们对“与时间同速前进”的认识来自对一些发展迅速、竞争激烈的行业中的若干成功者将近10年的研究。这项研究工作的一个方面使我们进入了电脑行业不同部门中的12家成功的公司——对目前这个新型的、竞争性的现状来说，电脑行业起到了原型的作用。我们还在其他一些行业中通过有目标的个案研究和与高层管理人员的研讨检验了这些想法的实用性。我们发现，不论经理们是在哪里应对多变的业务环境，“与时间同速前进”对他们的成功都是十分重要的，它帮助他们解决了该隔多久进行一次变革的根本性难题。

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连续腰穿和出血后脑积水与脑膜炎的关系

空军航空医学 1988年第2期 64-64页

作者： kathleen m.smith ,徐华

有人提出早产婴脑室内出血可通过腰穿减低颅内压并限制脑积水的进展。在两年中,我们对监护中心的婴儿进行了连续腰穿,试图治疗出血后脑积水,发现治疗后脑膜炎发生率高的惊人。为了判定引起脑膜炎的原因,我们对出血后脑积水采用腰穿治疗... 详细信息

有人提出早产婴脑室内出血可通过腰穿减低颅内压并限制脑积水的进展。在两年中,我们对监护中心的婴儿进行了连续腰穿,试图治疗出血后脑积水,发现治疗后脑膜炎发生率高的惊人。为了判定引起脑膜炎的原因,我们对出血后脑积水采用腰穿治疗并发与未并发脑膜炎的婴儿进行了比较。方法通过neurosongrams检查,筛查出全部早产婴的脑室内出血。根据PapiLe等对脑室内出血的严重性进行分类。一旦证明有进行性脑积水,开始每天连续腰穿治疗,其目的是使脑室大小恢复正常或保持2周无变化。我们希望每天做腰穿,但如果脑室进行性增大或连续3天腰穿不成功,就停止腰穿。

关键词：出血后脑积水发生率脑膜炎脑刺痛连续腰穿

Analysis of Freely Swimming C. elegans Using Laser Diffraction

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Acute renal artery occlusion following infliximab infusion

Open Journal of Biophysics 2012年第3期

作者： Jenny magnes kathleen m. Raley-Susman Noureddine melikechi Alicia Sampson Rebecca Eells Alexandra Bello michael Lueckheide

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World Journal of Nephrology 2013年第3期2卷 90-93页

作者： Caroline Lemaitre Isabelle Iwanicki-caron Clément De Vecchi Nathalie Bertiaux-Vandaёle Guillaume Savoye Department of Gastroenterology Rouen University Hospital76031 RouenFrance Department of Radiology Rouen University Hospital76031 RouenFrance Institut National de la santé et de la recherche médicale (INSERm) U1073 Rouen University Hospital76031 RouenFrance

We report the case of a 44-year-old male patient who presented with acute renal artery occlusion, 3 d after first injection of infliximab for steroid refractory attack of ulcerative colitis. Extensive work-up provided no evidence of predisposing factors for arterial thrombosis. Infliximab was thus suspected in the genesis of thrombosis, based on both intrinsic and extrinsic criteria. At month 3 after thrombosis with ongoing anticoagulation, angio-tomodensitometry showed complete revascularization of the left renal artery with renal atrophy. Renal function remained normal and the patient was still in steroid free remission on mercaptopurin monotherapy at maximal follow-up. Few thromboembolic events have been described with anti- tumor necrosis factor(TNF) agents, but it is the first case reported of renal artery thrombosis after infliximab infusion. In addition, we review thrombosis associated with anti-TNF agents.

关键词：急性肾动脉闭塞治疗方法临床分析肾萎缩