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State-of-the-Art management of knee osteoarthritis

World Journal of Clinical Cases 2015年第2期3卷 89-101页

作者： kenton h fibel howard J hillstrom Brian C halpern Department of Medicine Primary Care Sports MedicineHospital for Special Surgery Leon Root Motion Analysis Laboratory Department of RehabilitationHospital for Special Surgery

Osteoarthritis(OA) is the most common type of arthritis found in the United States' population and is also the most common disease of joints in adults throughout the world with the knee being the most frequently affected of all joints. As the United States' population ages along with the increasing trends in obesity prevalence in other parts of the world, it is expected that the burden of OA on the population, healthcare system, and overall economy will continue to increase in the future without making major improvements in managing knee OA. Numerous therapies aim to reduce symptoms of knee OA and continued research has helped to further understand the complex pathophysiology of its disease mechanism attempting to uncover new potential targets for the treatment of OA. This review article seeks to evaluate the current practices for managing knee OA and discusses emerging therapies on the horizon. These practices include non-pharmacological treatments such as providing patient education and self-management strategies, advising weight loss, strengthening programs, and addressing biomechanical issues with bracing or foot orthoses. Oral analgesics and anti-inflammatories are pharmacologicals that are commonly used and the literature overall supports that some of these medications can be helpful for managing knee OA in the short-term but are less effective for long-term management. Additionally, more prolonged use significantly increases the risk of serious associated side effects that are not too uncommon. Diseasemodifying osteoarthritis drugs are being researched as a treatment modality to potentially halt or slow disease progression but data at this time is limited and continued studies are being conducted to further investigate their effectiveness. Intra-articular injectables are also implemented to manage knee OA ranging from corticosteroids to hyaluronans to more recently plateletrich plasma and even stem cells while several other injection therapies are presently b

关键词： Disease-modifying osteoarthritis drugs Knee osteoarthritis Disease-modifying osteoarthritis drugs Osteoarthritis management Non-steroidal antiinflammatory drugs hyaluronic acid Arthroscopy Platelet-rich plasma Corticosteroids Stem cells

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A cadaveric model for transesophageal echocardiography transducer placement training: A pilot study

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World Journal of Emergency Medicine 2022年第1期13卷 18-22页

作者： Ryan W.horton Kian R.Niknam Viveta Lobo Kathryn h.Pade Drew Jones kenton L.Anderson Department of Emergency Medicine Stanford University School of MedicinePalo Alto 94304USA Emergency Medicine Residency Program University of Texas at Austin Dell Medical SchoolAustin 78756USA University of California San Francisco School of Medicine San Francisco 94143USA Department of Emergency Medicine Rady Children’s HospitalSan Diego 92123USA Department of Emergency Medicine University of Central Florida/HCA Ocala RegionalOcala 34471USA

BACKGROUND: Transesophageal echocardiography(TEE) is used in the emergency department to guide resuscitation during cardiac arrest. Insertion of a TEE transducer requires manual skill and experience, yet in some residency programs cardiac arrest is uncommon, so some physicians may lack the means to acquire the manual skills to perform TEE in clinical practice. For other infrequently performed procedural skills, simulation models are used. however, there is currently no model that adequately simulates TEE transducer insertion. The aim of this study is to evaluate the feasibility and efficacy of using a cadaveric model to teach TEE transducer placement among novice ***: A convenience sample of emergency medicine residents was enrolled during a procedure education session using cadavers as tissue models. A pre-session assessment was used to determine prior knowledge and confidence regarding TEE manipulation. Participants subsequently attended a didactic and hands-on education session on TEE placement. All participants practised placing the TEE transducer until they were able to pass a standardized assessment of technical skill(SATS). After the educational session, participants completed a post-session assessment. RESULTS: Twenty-five residents participated in the training session. Mean assessment of knowledge improved from 6.2/10 to 8.7/10(95% confidence interval [CI] of knowledge difference 1.6–3.2, Phere was no relationship between training level and the delta in knowledge or ***: In this pilot study, the use of a cadaveric model to teach TEE transducer placement methods among novice users is feasible and improves both TEE manipulation knowledge and confidence levels.

关键词： Cardiopulmonary resuscitation Echocardiography Education Simulation

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Direct detection and measurement of wall shear stress using a filamentous bio-nanoparticle

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Nano Research 2015年第10期8卷 3307-3315页

作者： Daniela P. Lobo Alan M. Wemyss David J. Smith Anne Straube Kai B. Betteridge Andrew h. J. Salmon Rebecca R. Foster hesham E. Elhegni Simon C. Satchell haydn A. Little Raul Pacheco-Gomez Mark J. Simmons Matthew R. hicks David O. Bates Alison Rodger Timothy R. Dafforn kenton P. Arkill DepartmentofChemistryandWarwickAnalyticalScienceCentre UniversityofWarwickCoventryCV47ALUK MOACDoctoralTrainingCentre UniversityofWarwickCoventryCV47ALUK Mathematics UniversityofBirminghamEdgbastonBirminghamWestMidlandsB152TTUK CentreforMechanochemicalCellBiology WarwickMedicalSchoolUniversityofWarwickCoventryCV47ALUK PhysiologyandPharmacology UniversityofBristolUniversityWalkBristolBS81TDUK ClinicalSciences WhitsonStreetUniversityofBristolBristolBS13NYUK SchoolofChemistry UniversityofBirminghamEdgbastonBirminghamWestMidlandsB152TTUK Biosciences UniversityofBirminghamEdgbastonBirminghamWestMidlandsB152TTUK ChemicalEngineering UniversityofBirminghamEdgbastonBirminghamWestMidlandsB152TTUK SchoolofMedicine UniversityofNottinghamQueen'sMedicalCentreNottinghamNG27UHUK Biochemistry UniversityofBristolUniversityWalkBristolBS81TDUK

The wall shear stress （WSS） that a moving fluid exerts on a surface affects many processes including those relating to vascular function. WSS plays an important role in normal physiology （e.g. angiogenesis） and affects the microvasculature＇s primary function of molecular transport. Points of fluctuating WSS show abnormalities in a number of diseases; however, there is no established technique for measuring WSS directly in physiological systems. All current methods rely on estimates obtained from measured velocity gradients in bulk flow data. In this work, we report a nanosensor that can directly measure WSS in microfluidic chambers with sub-micron spatial resolution by using a specific type of virus, the bacteriophage M13, which has been fluorescently labeled and anchored to a surface. It is demonstrated that the nanosensor can be calibrated and adapted for biological tissue, revealing WSS in micro-domains of cells that cannot be calculated accurately from bulk flow measurements. This method lends itself to a platform applicable to many applications in biology and microfluidics.

关键词： microfluidics nanoparticle M13 bacteriophage wall shear stress fluorescent microscopy

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谷蛋白敏感与视神经脊髓炎:2例报道

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世界核心医学期刊文摘（神经病学分册） 2005年第10期1卷 35-35页

作者： Jacob S. Zarei M. kenton A. Allroggen h. 方伯言 Department of Neurology Walsgrave Hospital University Hospitals of Coventry and Warwickshire NHS Trust Coventry CV2 2DX United Kingdom Dr.

Neuromyelitis optica is a clinical syndrome characterised by acute transverse myelitis plus an acute or subacute optic neuritis with or without recovery. Alt hough once believed to be a variant of multiple sclerosis, diagnostic criteria h ave recently been proposed for neuromyelitis optica, making it a clinically dist inct syndrome. The term gluten sensitivity refers to a state of heightened immun ological responsiveness to ingested gluten in genetically susceptible individual s, as indicated by circulating antibodies to gliadin. Several neurological compl ications have been described associated with gluten sensitivity ranging from per ipheral neuropathy and cerebellar ataxia to an increased risk of epilepsy. Altho ugh myelopathy has been described in some case reports of coeliac disease, neuro myelitis optica has never been described in association with gluten sensitivity. We describe two cases of gluten sensitivity presenting as neuromyelitis optica with no previous history of significant gastrointestinal symptoms. Gluten sensit ivity was confirmed by immunological and histological studies.

关键词：视神经脊髓炎谷蛋白小脑共济失调脊髓病多发性硬化症肠道症状抗麦胶蛋白抗体视神经炎免疫组化研究腹部疾病

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AhA／ASA关于卒中和短暂性脑缺血发作患者卒中预防推荐的更新

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国际脑血管病杂志 2008年第4期16卷 266-269页

作者： Robert J. Adams Greg Albers Mark J. Alberts Oscar Benavente Karen Furie Larry B. Goldstein Philip Gorelick Jonathan halperin Robert harbaugh S. Claiborne Johnston Irene Katzan Margaret Kelly-hayes Edgar J. kenton Michael Marks Ralph L. Sacco Lee h. Schwamm 赵洪芹李海峰 (译) 不详青岛大学医学院附属医院神经内科 266003

在卒中和短暂性脑缺血发作（transient ischemic attack,TIA）患者卒中预防推荐发表以后，美国心脏协会和美国卒中协会（American heart Association／American Stroke Association,AhA／ASA）著述委员会对最近的一些试验结果进行了回... 详细信息

在卒中和短暂性脑缺血发作（transient ischemic attack,TIA）患者卒中预防推荐发表以后，美国心脏协会和美国卒中协会（American heart Association／American Stroke Association,AhA／ASA）著述委员会对最近的一些试验结果进行了回顾。本文的目的是对这些新资料做简要回顾、更新某些推荐意见并说明进行这些修改的理由。在2个领域已发表了一些新的重要临床试验结果：（1）在非心源性栓塞所致缺血性卒中或TIA患者卒中二级预防中具体抗血小板药的应用；（2）他汀类药物在预防卒中复发中的应用。

关键词：短暂性脑缺血发作卒中协会二级预防 AhA ASA 美国心脏协会临床试验抗血小板药

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缺血性卒中或短暂性脑缺血发作患者的卒中预防指南

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中华脑血管病论坛 2006年第1期4卷 21-66页

作者： Ralph L.Sacco Robert Adams Grge Albers Mark J.ALBERTS Oscar Benavente Karen Furie Larry B.Goldstein Philip Gorelick Jonathan halperin Robert harbaugh S.Claiborne Johnston Irene Katzan Margaret Kelly-hayes Edgar J.kenton Michael Marks Lee h.Schwamm Thomas Tomsick 曹勇军（译）陈孝东（译）毛成洁（译）刘春风（译）

这份新声明旨在为缺血性卒中或短暂性脑缺血发作存活者的缺血性卒中预防提供全面和及时的循证推荐，循证推荐包括对危险因素的控制，动脉粥样硬化性疾病的干预措施，心源性栓塞的抗栓治疗以及非心源性卒中抗血小板药的应用。另外，还为... 详细信息

这份新声明旨在为缺血性卒中或短暂性脑缺血发作存活者的缺血性卒中预防提供全面和及时的循证推荐，循证推荐包括对危险因素的控制，动脉粥样硬化性疾病的干预措施，心源性栓塞的抗栓治疗以及非心源性卒中抗血小板药的应用。另外，还为其他多种特殊情况下复发性卒中的预防提供了推荐、包括动脉夹层分离、卵圆孔未闭、高同型半胱氨酸血症、高凝状态、镰状细胞病、脑静脉窦血栓形成、女性卒中（特别是与妊娠和绝经后激素替代治疗相关卒中），脑出血后肮凝药的应用，以及该指南在高危人群中执行和应用的特殊措施。

关键词：美国心脏协会科学声明缺血短暂性脑缺血发作卒中

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AhA/ASA关于卒中和短暂性脑缺血发作患者卒中预防推荐的更新

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中华脑血管病杂志（电子版） 2008年第6期2卷 378-381页

作者： Robert J.Adams Greg Albers Mark J.Alberts Oscar Benavente Karen Furie Larry B.Goldstein Philip Gorelick Jonathan halperin Robert harbaugh S.Claiborne Johnston Irene Katzan Margaret Kelly-hayes Edgar J.kenton Michael Marks Ralph L.Sacco Lee h.Schwamm 赵洪芹李海峰青岛大学医学院附属医院神经内科 266003

在卒中和短暂性脑缺血发作（transient ischemicattack,TIA）患者卒中预防推荐发表以后，美国心脏协会和美国卒中协会（American heart Association／American Stroke Association，AhA／ASA）著述委员会对最近的一些试验结果进行了回... 详细信息

在卒中和短暂性脑缺血发作（transient ischemicattack,TIA）患者卒中预防推荐发表以后，美国心脏协会和美国卒中协会（American heart Association／American Stroke Association，AhA／ASA）著述委员会对最近的一些试验结果进行了回顾。本文的目的是对这些新资料做简要回顾、

关键词：短暂性脑缺血发作卒中协会 AhA 预防 ASA 美国心脏协会委员会新资料

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