检索结果-南通市图书馆

Remote ischaemic conditioning for stroke: unanswered questions and future directions

stroke & Vascular Neurology 2021年第2期6卷 298-309页

作者： Sheharyar Baig Bethany Moyle Krishnan Padmakumari Sivaraman Nair Jessica Redgrave Arshad Majid Ali Ali Cerebrovascular medicine The University of Sheffield Institute for Translational NeuroscienceSheffieldUK Neurosciences Sheffield Teaching Hospitals NHS Foundation TrustSheffieldUK Faculty of medicine and Dentistry University of SheffieldSheffieldUK Geriatrics and Stroke Medicine Sheffield Teaching Hospitals NHS Foundation TrustSheffieldUK Sheffield NIHR Biomedical Research Centre The University of SheffieldSheffieldUK

Remote ischaemic conditioning(RIC)refers to a process whereby periods of intermittent ischaemia,typically via the cyclical application of a blood pressure cuff to a limb at above systolic pressure,confers systemic protection against ischaemia in spatially distinct vascular territories.The mechanisms underlying this have not been characterised fully but have been shown to involve neural,hormonal and systemic inflammatory signalling cascades.Preclinical and early clinical studies have been promising and suggest beneficial effects of RIC in acute ischaemic stroke,symptomatic intracranial stenosis and vascular cognitive impairment.Through systematic searches of several clinical trials databases we identified 48 active clinical trials of RIC in ischaemic stroke,intracerebral haemorrhage and subarachnoid haemorrhage.We summarise the different RIC protocols and outcome measures studied in ongoing clinical trials and highlight which studies are most likely to elucidate the underlying biological mechanisms of RIC and characterise its efficacy in the near future.We discuss the uncertainties of RIC including the optimal frequency and duration of therapy,target patient groups,cost-effectiveness,the confounding impact of medications and the absence of a clinically meaningful biomarker of the conditioning response.With several large clinical trials of RIC expected to report their outcomes within the next 2 years,this review aims to highlight the most important studies and unanswered questions that will need to be addressed before this potentially widely accessible and low-cost intervention can be used in clinical practice.

关键词： Remote directions founding

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Value of a comprehensive geriatric assessment for predicting one-year outcomes in patients undergoing transcatheter aortic valve implantation: results from the CGA-TAVI multicentre registry

引用

Journal of Geriatric Cardiology 2019年第6期16卷 468-477页

作者： Martijn S.van Mourik Nathalie van der Velde Giulio Mannarino Marie-Pierre Thibodeau Jean-Bernard Masson Gennaro Santoro Jan Baan Sofie Jansen Jana Kurucova Martin Thoenes Cornelia Deutsch ANDreas W.Schoenenberger ANDrea Ungar Peter Bramlage M Marije Vis Department of Cardiology Amsterdam UMC University of Amsterdam Department of Internal medicine Section of Geriatric Medicine Amsterdam UMC University of Amsterdam Geriatric Intensive Care Unit Department of Geriatrics and Medicine Careggi Hospital and University of Florence Centre Hospitalier de l’Université de Montréal Edwards Lifesciences Institute for Pharmacology und Preventive medicine Department of geriatrics Inselspital Bern University Hospital University of Bern

Background In a three-month report from the CGA-TAVI registry, we found the Multidimensional Prognostic Index (MPI) and Short Physical Performance Battery (SPPB) to be of value for predicting short-term outcomes in elderly patients undergoing transcatheter aortic valve implantation (TAVI). In the present analysis, we examined the association of these tools with outcomes up to one year post-TAVI. Methods CGA-TAVI is an international, observational registry of geriatric patients undergoing TAVI. Patients were assessed using the MPI and SPPB. Efficacy of baseline values and any postoperative change for predicting outcome were established using logistic regression. Kaplan- Meier analysis was carried out for each comprehensive geriatric assessment tool, with survival stratified by risk category. Results One year after TAVI, 14.1% of patients deceased, while 17.4% met the combined endpoint of death and/or non-fatal stroke, and 37.7% the combined endpoint of death and/or hospitalisation and/or non-fatal stroke. A high-risk MPI score was associated with an increased risk of all-cause mortality (aOR = 36.13, 95% CI: 2.77–470.78, P = 0.006) and death and/or non-fatal stroke (aOR = 10.10, 95% CI: 1.48–68.75, P = 0.018). No significant associations were found between a high-risk SPPB score and mortality or two main combined endpoints. In contrast to a worsening SPPB, an aggravating MPI score at three months post-TAVI was associated with an increased risk of death and/or non-fatal stoke at one year (aOR = 95.16, 95% CI: 3.41–2657.01). Conclusions The MPI showed value for predicting the likelihood of death and a combination of death and/or non-fatal stroke by one year after TAVI in elderly patients.

关键词： Comprehensive geriatric assessment Multidimensional prognostic index Short physical performance battery Silver code Transcatheter aortic valve implantation

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Concurrent stenoses: A common etiology of stroke in Asians

引用

World Journal of Clinical Cases 2014年第6期2卷 201-205页

作者： Bik Ling Man Yat Pang Fu Department of medicine and geriatrics Tuen Mun Hospital

Atherosclerosis of cerebral vessels is a common cause of stroke. Racial differences in the distribution of cerebrovascular occlusive disease are well documented.Extracranial stenosis is more common in Caucasians,while intracranial stenosis is more common in Asians,Hispanics and African-Americans. Concurrent atherosclerosis of extracranial and intracranial vessels is common in Asians. The incidence of concurrent stenoses ranges from 10% to 48% in patients with symptomatic cerebrovascular disease. The long-term prognosis of these patients is poor and they are at high risk of further vascular events or death. The purpose of this review is to examine the epidemiology, risk factors,stroke mechanism and genetics of concurrent stenoses and to discuss strategies for treatment.

关键词： Atherosclerosis Concurrent stenosis stroke Asians

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

A rare cause of pulmonary hypertension in an elderly woman

引用

Journal of Geriatric Cardiology 2023年第4期20卷 314-316页

作者： Shing Ching Chiu Sun Yue Division of Cardiology Department of Medicine and GeriatricsUnited Christian HospitalHong KongChina

Diastolic dysfunction is a common substrate of pulmonary hypertension(PH) in the elderly.A minority of them,however,has another etiology of PH with diastolic dysfunction as a confounder,the alarming echocardiographic features of which are important to recognize.For example,dilated coronary sinus is unusual,as is significantly dilated right atrium.

关键词： hypertension dilated coronary

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Ventricular tachycardia induced by functional ventricular undersensing and AutoCapture®

引用

Journal of Geriatric Cardiology 2022年第5期19卷 393-397页

作者： Shing Ching Chiu Sun Yue Division of Cardiology Department of Medicine and GeriatricsUnited Christian HospitalHong KongChina

The implantable cardioverter-defibrillator(ICD)is a key component in the primary pre-vention of sudden cardiac death in patients with ischemic cardiomyopathy.Appropriate device programming is pivotal in maximizing the benefit as well as minimizing any proarrhythmic effect of dev-ice therapy.It is even more so for patients who require pacing for bradycardia,in which interaction of the de-vice with intrinsic rhythm may generate unexpected consequences.We report a case of pacing induced ven-tricular tachycardia as a result of complex interplay of competitive atrial pacing,atrial and ventricular func-tional undersensing,ventricular functional loss of capture,and the AutoCapture®algorithm specific to Abbott devices.

关键词： ventricular tachycardia functional

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

3D vena contracta area in degenerative mitral regurgitation:cross-platform comparison in a single patient

引用

Journal of Geriatric Cardiology 2022年第4期19卷 322-324页

作者： Shing Ching Chiu Sun Yue Division of Cardiology Department of Medicine and GeriatricsUnited Christian HospitalHong KongChina

Quantification of degenerative mitral reg-urgitation(MR)by two-dimensional(2D)transthoracic echocardiography(TTE)and transesophageal echocardiography(TEE)is challen-ging.Eccentric,obliquely oriented regurgitant jets limit inter-observer and intra-observer consistency.In recent years,with increasingly sophisticated three-dimensional(3D)TTE and TEE systems that enable single-beat 3D color acquisition,3D vena contracta area(VCA)has emerged as an attractive indicator of MR severity.It overcomes geometric assumptions in 2D techniques and can be acquired in a single car-diac cycle,which is a major benefit in atrial fibrilla-tion.However,most studies of 3D VCA were perfo-rmed on the Philips TEE platform.[1-3]The perform-ance of the technique on GE systems and on 3D TTE is unexplored.We report 3D VCA measurements in a case of severe degenerative MR on 3D TTE(4V-D transducer,Vivid E95,GE Vingmed Ultrasound,Horten,Norway),and 3D TEE performed on GE(6VT-D transducer,Vivid E95,GE Vingmed Ultraso-und,Horten,Norway)and Philips(X7-2t transdu-cer,EPIC 7C,Philips Medical Systems,Andover,MA,USA).

关键词： degenerative overcome attractive

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Xueshuantong improves cerebral blood perfusion in elderly patients with lacunar infarction

引用

Neural Regeneration Research 2013年第9期8卷 792-801页

作者： Qifeng Gui Yunmei Yang Shihong Ying Minming Zhang Department of geriatrics First Affiliated HospitalSchool of MedicineZhejiang University Department of Radiology First Affiliated HospitalSchool of MedicineZhejiang University Department of Radiology Second Affiliated HospitalSchool of MedicineZhejiang University

A total of 64 patients with acute lacunar infarction were enrolled within 24 hours of onset. The patients received conventional therapy （antiplatelet drugs and hypolipidemic drugs） alone or conventional therapy plus 450 mg Xueshuantong once a day. The main ingredient of the Xueshuantong lyophilized powder used for injection was Panax notoginseng saponins. Assessments were made at admission and at discharge using the National Institutes of Health stroke Scale, the Activity of Daily Living and the Mini-Mental State Examination. Additionally, the relative cerebral blood flow, relative cerebral blood volume and relative mean transit time in the region of interest were calculated within 24 hours after the onset of lacunar infarction, using dynamic susceptibility contrast magnetic resonance perfusion imaging technology. Patients underwent a follow-up MRI scan after 4 weeks of treatment. There was an improvement in the Activity of Daily Living scores and a greater reduction in the scores on the National Institutes of Health stroke Scale in the treatment group than in the control group. However, the Mini-Mental State Examination scores showed no significant differences after 4 weeks of treatment. Compared with the control group, the relative cerebral blood flow at discharge had increased and showed a greater improvement in the treatment group. Furthermore, there was a reduction in the relative mean transit time at discharge and the value was lower in the treatment group than in the control group. The experimental findings indicate that Xueshuantong treatment improves neurological deficits in elderly patients with lacunar infarction, and the mechanism may be related to increased cerebral perfusion.

关键词： neural regeneration traditional Chinese medicine Xueshuantong cerebral perfusion lacunarinfarction Panax notoginseng saponins cerebrovascular disease neuroprotection grants-supported paper photographs-containing paper neuroregeneration

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Persistent dysexecutive syndrome after pneumococcal meningitis complicated by recurrent ischemic strokes:A case report

引用

World Journal of Clinical Cases 2023年第22期11卷 5344-5350页

作者： Laura Abbruzzese Giulia Martinelli Giulia Salti Benedetta Basagni Alessio Damora Cristiano Scarselli Giulia Peppoloni Aleksandra Podgorska Giuliana Rosso Marco Bacci Alba Rosa Alfano MAURO MANCUSO CRT Tuscany Rehabilitation ClinicMontevarchiArezzo 52025Italy Physical and Rehabilitative medicine Unit NHS ASL-Tuscany South EstGrosseto 58100Italy Department of Internal medicine and Medical Specialties UOC GeriatricsSapienza University of RomeRome 00185Italy

Meningitis is a possible complication of pneumococcal infection concerning acute otitis media and sinusitis.It might compromise cognitive function,both for the infection itself and the vascular events that sometimes follow the acute phase.CASE SUMMARY Here we describe the case of a 32-year-old female patient admitted to the emergency room due to extensive pneumococcal meningitis as a consequence of sinus outbreak.She presented with extensive laminar ischemic damage in the acute phase,resulting in severe cognitive and behavioural impairment.Four years of follow-up,through neuropsychological assessments and neuroradiological investigations,demonstrated the presence of subsequent vascular events,3 months and 2 years after onset.CONCLUSION The case is discussed in light of scientific knowledge of the long-term outcomes of this pathology in order to potentially improve diagnosis and promote better outcomes.

关键词： Pneumococcal meningitis stroke,Cognitive and behavioural functioning Long-term outcome Case report

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Multidisciplinary treatment of a patient with necrotizing fasciitis caused by Staphylococcus aureus: A case report

引用

World Journal of Clinical Cases 2019年第21期7卷 3595-3602页

作者： Li-Qian Xu Xin-Xiu Zhao Pei-Xia Wang Ji Yang Yun-Mei Yang Department of geriatrics The First Affiliated Hospital College of Medicine Zhejiang University

BACKGROUND Necrotizing fasciitis is a severe bacterial skin infection that spreads quickly and is characterized by extensive necrosis of the deep and superficial fascia resulting in the devascularization and necrosis of associated tissues.Because of high morbidity and mortality,accurate diagnosis and early treatment with adequate antibiotics and surgical intervention are vital.And timely identification and treatment of complications are necessary to improve survival of patient.CASE SUMMARY We report a case of necrotizing fasciitis caused by Staphylococcus aureus in a patient using high doses of glucocorticoid and suffering from secondary diabetes mellitus.He was admitted to our hospital due to redness and oedema of the lower limbs.After admission,necrotizing fasciitis caused by Staphylococcus aureus was considered,and he was discharged after B-ultrasound drainage and multiple surgical operations.In the process of treatment,multiple organ functions were damaged,but with the help of multi-disciplinary treatment,the patient got better finally.CONCLUSION The key to successful management of necrotizing fasciitis is an early and accurate diagnosis.The method of using vacuum sealing drainage in postoperative patients can keep the wound dry and clean,reduce infection rate,and promote wound healing.Interdisciplinary collaboration is a vital prerequisite for successful treatment.

关键词： Necrotizing fasciitis Surgical debridement Vacuum sealing drainage Multidisciplinary treatment Case report

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Moxibustion enables protective effects on rheumatoid arthritis-induced myocardial injury via transforming growth factor beta1 signaling and metabolic reprogramming

引用

Journal of Traditional Chinese medicine 2023年第6期43卷 1190-1199页

作者： WANG Miao ZHU Yan ZHAO Hui ZHAO Hongfang the geriatrics Anhui University of Traditional Chinese MedicineHefei 230031China the geriatrics the Second Hospital Affiliated of Anhui University of Traditional Chinese MedicineHefei 230061China

OBJECTIVE:To examine the effects of moxibustion on myocardial injury and myocardial metabolomics in rats with rheumatoid arthritis(RA)based on the transforming growth factor beta1(TGF-β1)/Smads signaling pathway.METHODS:One hundred rats were treated with saline[normal control(NC)group]or complete Freund’s adjuvant(CFA)by right plantar injection for the RA model group,and the latter were randomly divided into 4 groups.Tripterygium wilfordii polyglycoside tablets(雷公藤多苷片,TPT)have anti-inflammatory and are widely used in the clinical treatment of RA,therefore serving as a positive control group.Three days post injection rats were given TPT tablet(TPT group),acupuncture therapy(APT group),and moxibustion treatment(MOX group)for 15 consecutive days,while NC group and model group were equally grasped and fixed and received normal saline.Rat joint swelling scores and arthritis index(AI)were evaluated in each group before the CFA challenge,therapy and after receiving therapy.Myocardial ultrastructure was observed by electron microscope.Enzyme-linked immunosorbent assay was used to detect cardiac troponin I(cTnI)levels in rat myocardial tissue.Quantitative reverse transcription polymerase chain reaction and Western blotting analysis were used to measure the mRNA and protein levels of TGF-βsignaling molecules including TGF-β1,Smad2,Smad3,Smad4,and Smad7.Myocardial metabolomics was analyzed using gas chromatography-mass spectrometer.RESULTS:Compared with model group,RA model rats receiving TPT,acupuncture,or moxibustion therapy all showed reduced joint swelling scores and AI(all P<0.01)and improved myocardial damage,whereas rats treated with moxibustion were found to be more marked.Consistently,the expressions of cTnI,TGF-β1,Smad2,Smad3,and Smad4 were found to be elevated in model rat group in contrast to NC rats and were significantly downregulated in TPT,APT and MOX group when compared with model group,while the levels of Smad7 showed the opposite result(all P<0.01).Moreover,the dissection of metabolomics suggested a novel

关键词： moxibustion arthritis rheumatoid transforming growth factor beta1 smad proteins signal transduction myocardial injury metabolomics

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：