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1.
Cerebral microbleeds and cognitive decline in a hemodialysis patient: Case report and review of literature 下载免费PDF全文
Lin Li Mark Fisher Wei‐Ling Lau Hamid Moradi Alexander Cheung Gaby Thai Jason Handwerker Kamyar Kalantar‐Zadeh 《Hemodialysis international. International Symposium on Home Hemodialysis》2015,19(3):E1-E7
Cerebral microbleeds (CMBs) are small hemosiderin deposits indicative of prior cerebral microscopic hemorrhage and previously thought to be clinically silent. Recent population‐based cross‐sectional studies and prospective longitudinal cohort studies have revealed association between CMB and cognitive dysfunction. In the general population, CMBs are associated with age, hypertension, and cerebral amyloid angiopathy. In the chronic kidney disease (CKD) population, diminished estimated glomerular filtration rate has been found to be an independent risk factor for CMB, raising the possibility that a uremic milieu may predispose to microbleeds. In the end‐stage renal disease (ESRD) population on hemodialysis, the incidence of microbleeds is significantly higher compared with a control group without history of CKD or stroke. We present an ESRD patient on chronic hemodialysis with a history of gradual cognitive decline and progressive CMBs. Through this case and literature review, we illustrate the need to develop detection and prediction models to treat this frequent development in ESRD patients. 相似文献
2.
Phonation threshold pressure (PTP) is the minimum subglottal pressure required to initiate vocal fold oscillation. Although potentially useful clinically, PTP is difficult to estimate noninvasively because of limitations to vocal motor control near the threshold of soft phonation. Previous investigators observed, for example, that trained subjects were unable to produce flat, consistent oral pressure peaks during/pae/syllable strings when they attempted to phonate as softly as possible (Verdolini-Marston, Titze, & Druker, 1990). The present study aimed to determine if nasal airflow or vowel context affected phonation threshold pressure as estimated from oral pressure (Smitheran & Hixon, 1981) in 5 untrained female speakers with normal velopharyngeal and voice function. Nasal airflow during /p/occlusion was observed for 3 of 5 participants when they attempted to phonate near threshold pressure. When the nose was occluded, nasal airflow was reduced or eliminated during /p/;however, individuals then evidenced compensatory changes in glottal adduction and/or respiratory effort that may be expected to alter PTP estimates. Results demonstrate the importance of monitoring nasal flow (or the flow zero point in undivided masks) when obtaining PTP measurements noninvasively. Results also highlight the need to pursue improved methods for noninvasive estimation of PTP. 相似文献
3.
A cost comparison of balloon angioplasty and stenting versus endarterectomy for the treatment of carotid artery stenosis 总被引:1,自引:0,他引:1
WD Jordan GD Roye WS Fisher D Redden HA McDowell 《Canadian Metallurgical Quarterly》1998,27(1):16-22; discussion 22-4
PURPOSE: Percutaneous transluminal angioplasty with stenting (PTAS) of the carotid artery has been advocated as an alternative treatment for high-grade stenosis. Rationale for this approach includes less morbidity, shorter recovery, and lower cost when compared with carotid endarterectomy (CEA). METHODS: The clinical results and hospital charges of patients who underwent elective treatment for carotid stenosis were reviewed. During a concurrent 14-month period, 218 patients were admitted 229 times for 234 procedures for the treatment of 239 carotid bifurcation stenoses, 109 by PTAS and 130 by CEA. Hospital charges were reviewed for each hospitalization and were categorized according to radiology, operating room, cardiac catheterization laboratory, and all other hospital charges. RESULTS: The combined incidence of postprocedure strokes and deaths were: PTAS, eight strokes (7.7%) and one death (0.9%); CEA, two strokes (1.5%) and two deaths (1.5%). Total hospital charges per admission for the two groups were $30,140 for PTAS and $21,670 for CEA. The average postprocedure length of stay for PTAS was 2.9 days (median, 2 days) and for CEA was 3.1 days (median, 3 days). Cardiac catheterization laboratory charges for the PTAS group were $12,968, whereas the operating room charges for the CEA group were $4263. When hospitalizations that were extended by complications were excluded, the average total charges for the PTAS group (n = 84) dropped to $24,848 (mean length of stay, 1.9 days) and for the CEA group (n = 111) to $19,247 (mean length of stay, 2.6 days). CONCLUSIONS: After evaluating hospital charges, PTAS for the treatment of carotid stenosis cannot currently be justified on the basis of reduced costs alone. With future cost-containing measures, total hospital charges can be reduced in both groups. 相似文献
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Geoff Fisher 《纺织导报》2002,(1):49-50
意大利织机制造商Promatech公司以Somet品牌推出了一种新型剑杆织机。这种以“Alpha”命名的织机于2001年9月底首次在一个演示间里亮相,随后又成为新加坡ITMA Asia展会上的一个亮点。Somet公司剑杆织机产品经理Piermarco Arnoldi先生说,这种新型织机操作简便,可靠性高和多用性强,能以非常高的织造速度织许多种织物。一、Alpha剑杆织机的性能1.操作简便Alpha的设计使操作工很容易接近机器和修复断头。例如:打纬点与胸梁之间的距离大幅度缩短,使操作工更容易用手来… 相似文献
6.
Telecommunications operators are undergoing massive transformations in order to metamorphose themselves into the ICT world and compete with agile, lean IT organisations. The main challenges facing telecommunications operators, such as BT, are to reduce costs and increase agility in deploying software systems for provisioning ICT services. Despite using reusable capabilities and COTS packages, the major source of increased cost lies in the heavy integration tax we incur for integrating diverse systems implemented on diverse platforms and middleware, with heterogeneous data and process models. This paper looks at cost implications of lengthy and often manual migration to-and-from systems and platforms, and shows the clear business benefits of model-driven development (MDD) as defined by the Object Management Group (OMG). It is clearly demonstrated that model-driven development has matured into a practical, industrialised, scalable and evolvable technology, culminating from decades of R&D on specification and design languages, executable formalisms and domainspecific languages and language transformations. 相似文献
7.
Prevention and Mitigation Strategies to Address Recent Brittle Fractures in Steel Bridges 总被引:1,自引:0,他引:1
Robert J. Connor Eric J. Kaufmann John W. Fisher William J. Wright 《Canadian Metallurgical Quarterly》2007,12(2):164-173
Brittle fracture results in unplanned loss of service, very costly repairs, concern regarding the future safety of the structure, and potential loss of life. These types of failures are most critical when there is no evidence of fatigue cracking leading up to the fracture and the fracture origin is concealed from view. Hence, the failure occurs without warning and the details are, essentially, noninspectable. In these cases, it appears desirable to take a proactive approach and introduce preventative retrofits to reduce the potential for future crack development. These efforts will help ensure that the likelihood of unexpected fractures is minimized. This paper examines the behavior of two bridge structures in which brittle fractures have developed in recent times, discusses the causes of the failures, and offers suggested design strategies for prevention and retrofit mitigation techniques. In situations where considerable uncertainty exists in the prediction of accumulated damage or in the ability to reliably inspect critical details, preemptive retrofit strategies appear to be highly desirable. 相似文献
8.
Extracellular single-unit discharges were obtained from 165 spontaneously active neurons within the region of the rostral ventrolateral medulla (RVLM) by glass microelectrode from 89 brain slices of the Sprague-Dawley rats. The units could be divided into three types: regular (61.8%), irregular (24.2%) and silent (14%). Acetylcholine (ACh, 0.1, 0.3 mumol/L) showed four kinds of effects on spontaneous discharges of RVLM neurons: excitatory, inhibitory, biphasic and non-responsive, counting respectively 41.8%, 20%, 3% and 35.2% of the neurons tested. The excitatory effect of ACh was dose-dependent. The effects, either excitatory or inhibitory, of ACh (n = 49) were mostly blocked by atropine (0.3 mumol/L, n = 42). The excitatory effect of ACh (n = 14) could be blocked mainly by selective antagonist of M1 receptor, pirenzepine (PZ, 30 nmol/L, n = 9), but not by selective antagonist of M2 receptor, methoctramine (MT) and AFDX-116. The inhibitory effect of ACh (n = 10) could be blocked mostly by M2 receptor antagonist MT (30 nmol/L, n = 7); and this inhibitory effect (n = 9) could be blocked mostly by another M2 receptor antagonist AFDX-116 (30 nmol/L, n = 6), but not by M1 receptor antagonist PZ. 相似文献
9.
Echo-planar techniques in MRI use a rapidly oscillating frequency-encoding gradient with the potential to produce peripheral nerve stimulation. To evaluate the incidence, type, and location of stimulation in a commercial whole-body scanner, we studied two groups: (a) 173 consecutive individuals scanned by echo-planar imaging for other purposes and (b) seven subjects who were scanned with an extensive set of 36 echo-planar sequences (with prompting after each scan to report any peripheral nerve stimulation) to test the effects of various parameters. Although only 5% of group A reported symptoms of peripheral nerve stimulation, all in group B experienced some type of stimulation, dependent primarily on direction of the oscillating gradient and location of the body within the gradient coil. Maximum stimulation typically occurred 30 to 40 cm from isocenter in the region of maximum dB/dt. Generally, y gradients produced truncal stimulation, and x gradients produced stimulation in the head. When hands were clasped over the abdomen, a tingling in the hands occasionally was felt. Patients should be instructed to keep their hands apart. 相似文献
10.
The data of nine children with post-traumatic intramural haematoma of the duodenum treated in Aghia Sophia Children's Hospital of Athens from 1967 to 1980 were retrospectively analysed. Diagnosis was preoperative in all but two children, in whom diagnosis was made during laparotomy. All but one were managed by operative intervention which consisted of simple evacuation of the haematoma and closure of the serosal incision in two out of eight children. Six out of eight children operated on were followed up for 15 years, during which they were free of symptoms. Hypotonic duodenography performed in the above patients was negative for deformity or stricture of the duodenum. 相似文献