简介:Objective:Implantableportthrombosis(IPT)incancerpatientsisarelativelyrarebutseverecomplication.Severalfactorsarereportedlyassociatedwiththeoccurrenceofthrombosis.WeaimedtodescribetheprevalenceandtheanatomoclinicalfeaturesofIPTobservedincancerpatientswhoweretreatedinamedicaloncologydepartmentinTunisia.Methods:Atotalof600cancerpatientswhohadportimplantationfromJanuary2013toDecember2015wereretrospectivelyidentified.Caseswithsymptomatic/incidentalIPT(radiologicallyconfirmed)werefurtheridentified.Epidemiologicalandanatomoclinicalfeatureswerecollectedfrompatientrecordsandthedepartmentdatabase.Results:Weobservedthat33ofthe600patientshadIPT;thus,theprevalencewas5.5%.Themedianagewas57years,andthegenderratiowas0.43.Overweightorobesitywasobservedin73%ofthepatients.IPToccurredmainlyinpatientswithbreast(36.4%)andcolorectal(33.3%)cancers,whichweremostlynonmetastatic(79%).Atleastoneidentifiedclassicalthromboembolicriskfactorwasfoundin13patients(smokingin9,tamoxifenin2).IPTwassymptomaticin93%ofthecases,occurringwithinanaveragetimeof56days.Implantableportswereremovedbecauseofinfectionin2casesandnonfunctionalityin3cases.IPTtreatmentwasbasedonlow-molecular-weightheparins(94%)andantivitaminK(6%)foranaverageof130days.Fourpatientshadpost-therapycomplications:onethrombosisrecurrenceandthreeinfections.Conclusions:IPTcasesinthe600patientswereobservedtooccurinobesenonmetastaticcancerpatientswithinthefirst3monthsafterIPimplantation.
简介:ObjectivesToimplantecardioverter-defibrillator(ICD)inthepatientswhohadlife-threanteningtachyarrhythmiasandwithindicationsofimplantation,thenanalyseandinvestgatetheefficacyofimplantableICDtothepatientswhohadlife-threanteningtachyarrhythmias.MethodsFromOctober2005toJanuary2009,ourdepartmenttreated18casesthatpatientshadlife-threanteningtachyarrhythmias.11casesofIschemiccardiomyopathyin,7casesofdilatedcardiomyopathy,agefrom40-76years,meanageis(55.77±15.16)years,16malepatients,2femalepatients.Etiologicaldiagnosis:CTexaminationbythecoronaryangiographyorgatedcardiovascular,11casesofclearlyischemiccardiomyopathy,7casesofdilatedcardiomyopathy.amongthemthereare3casestobeimplantedICDAfter2weeksofcardio-pulmonaryresuscitation.Theotherswhohadlife-threanteningtachyarrhythmiashavehistoryofunexplainedsyncopeornot.Amongthem,4receivedsinglechamberICDtherapy,5.receiveddualchambersand9receivedcardiacresynchronizationtherapy-defibrillators.ResultsAllpatientsweresuccessfullyimplanted.Operativetimewas1.5-5hours,X-rayexposuretimefor19-62min.shockimpedance、pacemakerthresholdandR/Aamplitudewassatisfied.3patientswereinducedVentriculartachycardia(VF)byT-shock,andwereconvertedby10-20Jshock.DuringFollow-upof2-43months,nodeathoccurredandICDfunctionwasimproved.Onopration,Atthesametimeusecardoarone,thereweretotal8episodesofventriculartachycardia/ventricularfibrillation(VT/VF)happenedin5patients,theywereterminatedbyshocksonce,2patientwithsinglechamberICDweremisdiagnosed?atrialfibrillationasaventricularfibrillationthenleadtowrongtreatment.Westartedthestabilityandthewidthoftwodiagnosticfunctions,follow-upobservationofsixmonths,nomoremisdiagnosisandwrongtreatmenthappenedagain.9casesofpatientsoccurredsupraventriculartachycardiainobservationperiodandtransferredbyantitachycardiapacing(ATP).The9patientsw
简介:Recentadvancesinoptogeneticshaveestablishedapreciselytimedandcell-specificmethodologyforunderstandingthefunctionsofbraincircuitsandthemechanismsunderlyingneuropsychiatricdisor-ders.However,thefabricationofoptrodes,akeyfunctionalelementinoptogenetics,remainsagreatchallenge.Here,wereportreliableandefficientfabricationstrategiesforchronicallyimplantableoptrodearrays.Toimprovetheperformanceofthefabricatedoptrodearrays,surfacesoftherecordingsitesweremodifiedusingoptimizedelectrochemicalprocesses.Wehavealsodemon-stratedthefeasibilityofusingthefabricatedoptrodearraystodetectseizuresinmultiplebrainregionsandinhibitictalpropagationinvivo.Furthermore,theresultsofthehistologystudyimplythattheelectrodepositionofcompositeconductingpolymersnotablyalleviatedtheinflammatoryresponseandimprovedneuronalsurvivalattheimplant/neural-tissueinterface.Insummary,weprovidereliableandefficientstrategiesforthefabricationandmodificationofcustomizedoptrodearraysthatcanfulfilltherequirementsofinvivooptogeneticapplications.
简介:Cardiologistswhoseepatientsonageneralcardiologyservicearebeginningtoseeanincreasingnumberofpatientswhohavereceivedaprimarypreventionimplantablecardiacdefibrillator(ICD)buthaveneverhaditfire.ThereareadditionallyanumberofpatientswhohaveinappropriatefiringofICDs.Inappropriateshocksoccurinupto40%ofpatientswithanICD.Themaincauseissupraventriculartachyarrhythmia,includingsinustachycardia,atrialfibrillation,andotherrapidsupraventriculararrhythmias.
简介:Theclinicalexploitationofelectricallystimulatedskeletalmusclecirculationas-sistant(SMCA)isanewtechnologyinlater80’s.Itismainlyusedforadvancedstageheartfailureandprogressiveheartdiseases.Thiskindofheartdiseaseshasahigherincidenceanditsdeathrateoccupiesfirstplaceinallkindsofheartdiseases.Thetreatmentsuchashearttransplantingisrestrictedbycertaincircumstances,soitcannotbeusedingeneral.ThewayofSMCAcanavoidmanydisadvantagessuchasex-
简介:随着临床听力学、实验听力学和计算机技术的不断发展,助听器基本上完成了从模拟线路到全数字线路的转换。开放式选配、多频段声处理、高效率降噪、多环境不同放大、反馈抑制或者仿生技术的应用,大大提高了助听器清晰度和适应性。而十几年前的深耳道式助听器技术早已基本解决了外观隐蔽的问题。技术的发展使更多的听障者受益,但同时我们还有许多的问题有待解决。