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| 1 | 将卒中纳入心血管风险预测工具美国心脏协会/美国卒中协会对医疗卫生专业人员的声明显示文摘背景和目的目前美国针对心血管事件风险预测以及一级和二级预防的指南声明均使用绝对风险估计值来识别血管事件高危患者以及可从特定干预措施中获益的患者。然而,这些指南并未明确地包括卒中患者。本指南对现有证据和争论进行概述以支持:(1)将卒中(尤其是动脉粥样硬化性卒中)患者纳入心血管病绝对风险增高的患者群体;(2)将卒中纳入血管性疾病风险预测工具的转归预测因素。方法和结果写作组成员由委员会联合主席基于先前在相关领域的研究成果来提名,并得到美国心脏协会(American Heart Association,AHA)卒中委员会科学声明监督委员会以及文稿监督委员会的批准。作者采用系统文献回顾(覆盖1980年1月至2010年3月期间的文献)并参考以往公布的指南、个人资料以及专家观点,以归纳现有证据,提出当前知识的不足,并根据AHA标准对适当的问题制定推荐意见。所有写作组成员均有机会对推荐意见进行评论并批准了最终版本。经广泛的AHA内部同行评议以及卒中委员会领导阶层和科学声明监督委员会的审阅后,最终获得AHA科学咨询和协调委员会的批准。将卒中患者(尤其是动脉粥样硬化性卒中患者)纳入冠状动脉和心血管病绝对高危人群的原因如下。首先,有证据显示,缺血性卒中患者发生致死性和非致死性心肌梗死或猝死的绝对风险增高,10年绝对风险≥20%,这一风险阈值已被一些指南用于定义冠状动脉疾病风险等危症。其次,纳入动脉粥样硬化性卒中的原因与纳入糖尿病、周围血管病、慢性肾脏病以及其他动脉粥样硬化性疾病的原因相同,尽管尚缺乏在所有人群或患者中风险增高的统一证据。再次,缺血性卒中的大动脉粥样硬化性卒中亚型与其他这些疾病的病理生理学机制相同。将卒中纳入高危因素将导致高危人群的数量扩大约10%。然而,由于卒中的异质性,尚不确定其他卒中亚型,包括出血性卒中以及非动脉粥样硬化性卒中亚型,是否应被视为具有相同水平的风险,因此有待进一步研究。鉴于卒中对残疾和死亡的影响、卒中与其他血管性疾病预防措施的相似性以及卒中在某些人群中较冠状动脉疾病更高的重要性,将卒中、心肌梗死和猝死纳入心血管事件风险预测工具的转归预测因素是合适的。美国以外的指南常常将卒中患者纳入心血管高危人群,并将卒中作为心脏终点的一个相关转归事件。结论动脉粥样硬化性卒中患者应被纳入会进一步发生冠状动脉粥样硬化事件的高危患者(10年≥20%)。是否应纳入非动脉粥样硬化卒中亚型尚不确定。对于一级预防,缺血性卒中应被纳入绝对风险评估方案的心血管疾病转归事件。将动脉粥样硬化性卒中作为一个高危因素或者更宽泛地将缺血性卒中视作一种转归事件纳入,可能对心血管病的预防具有重要意义,因为被评定为高危风险的患者数量将大幅增加。 | Daniel T. Lackland Mitchell S.V. Elkind Ralph D'Agostino Sr Mandip S. Dhamoon David C. Goff Jr Randall T. Higashida Leslie A. McClure Pamela H. Mitchell Ralph L. Sacco Cathy A. Sila Sidney C. Smith Jr David Tanne David L. Tirschwell Emmanuel Touze Lawrence R. Wechsler 4:~ 尤寿江(译) 于海龙(译) 刘慧慧(译) 张霞(译) 刘春风(译) | 2012 | 国际脑血管病杂志2012,20,11: | 13 |
| 2 | Risk of colon cancer in hereditary non-polyposis colorectal cancer patients as predicted by fuzzy modeling:Influence of smoking显示文摘瞄准:为了调查一个模糊逻辑模型是否能预言肤色,表面的癌症(CRC ) 风险由在世袭 non-polyposis 肤色吸表面的癌症(HNPCC ) 病人产生了。方法:从 Creighton 大学世袭癌症研究所登记的 340 个 HNPCC 失配修理(MMR ) 变化搬运人为当模特儿被选择。年龄依赖者曲线被产生阐明开发 CRC 的概率上的在基因变化(hMLH1 或 hMSH2 ) 之间的联合效果,性,和吸烟地位。结果:在男 hMSH2 变化搬运人的吸烟显著地增加的 CRC 风险(P <
0.05 ) 。hMLH1 变化为男性相对 hMSH2 变化搬运人扩充了 CRC 风险(P <
0.05 ) 。男性们非为 hMLH1 比女性有 CRC 的显著地更高的风险吸烟者(P <
0.05 ) , hMLH1 吸烟者(P <
0.1 ) 并且 hMSH2 吸烟者(P <
0.1 ) 。以在在男性的 hMSH2 的一种剂量依赖者方式的吸烟支持的 CRC (P <
0.05 ) 。有 hMSH2 变化的女性和与 hMLH1 组一起的两性仅仅在广泛的吸烟历史以后表明了吸烟效果(P <
0.05 ) 。结论:由在 HNPCC 病人吸烟的 CRC 提升依赖于基因变化,性和年龄。这些数据证明模糊建模可以启用临床的风险分数的明确的表达,从而允许 CRC 预防策略的 individualization。 | Rhonda M Brand David D Jones Henry T Lynch Randall E Brand Patrice Watson Ramesh Ashwathnayaran Hemant K Roy | 2006 | World Journal of Gastroenterology2006,12,28: | 5 |
| 3 | Quality in the technical performance of colonoscopy and the continuous quality improvement process for colonoscopy: recommendations of the U.S. Multi-Society Task Force on Colorectal Cancer显示文摘 | Douglas K Rex John H Bond Sidney Winawer Theodore R Levin Randall W Burt David A Johnson Lynne M Kirk Scott Litlin David A Lieberman Jerome D Waye James Church John B Marshall Robert H Riddell | 2002 | The American Journal of Gastroenterology2002,,6: | 3 |
| 4 | Adjunctive MSCs enhance myelin formation by xenogenic oligodendrocyte precursors transplanted in the retina显示文摘 | Aileen Arriola Mary E Kiel Yufang Shi Randall D McKinnon | 2010 | Cell Research2010,20,6: | 3 |
| 5 | Treatment of relapsing autoimmune pancreatitis with immunomodulators and rituximab: the Mayo Clinic experience显示文摘 | Phil A Hart Mark D Topazian Thomas E Witzig Jonathan E Clain Ferga C Gleeson Robin R Klebig Michael J Levy Randall K Pearson Bret T Petersen Thomas C Smyrk Aravind Sugumar Naoki Takahashi Santhi S Vege Suresh T Chari | 2013 | Gut2013,,11: | 2 |
| 6 | Treatment of relapsing autoimmune pancreatitis with immunomodulators and rituximab: the Mayo Clinic experience显示文摘 | Phil A Hart Mark D Topazian Thomas E Witzig Jonathan E Clain Ferga C Gleeson Robin R Klebig Michael J Levy Randall K Pearson Bret T Petersen Thomas C Smyrk Aravind Sugumar Naoki Takahashi Santhi S Vege Suresh T Chari | 2013 | Gut2013,,11: | 2 |
| 7 | Advances in the Treatment and Outcome of Brainstem Cavernous Malformation Surgery: A Single-Center Case Series of 300 Surgically Treated Patients显示文摘 | Adib A Abla Gregory P Lekovic Jay D Turner Jean G de Oliveira Randall Porter Robert F Spetzler | 2011 | Neurosurgery2011,,2: | 2 |
| 8 | MRI-based measurement of hippocampal volume in patients with ccrnhat- related posttraumatic stress disorder显示文摘 | BREMNER J D RANDALL P SCOTT T M | 1995 | Am J Psychiatry1995,152,7: | 2 |
| 9 | The effect of fermentation products on enhanced biologicial phosphorous removal, polyphosphate storage, and microbial population dynamics显示文摘 | RANDALL A A BENEFIELD L D HILL W E | 1994 | Wat Sci Technol1994,30,6: | 1 |
| 10 | Modeling the exchanges of energy,water,and carbon between the continents and the atmosphere显示文摘 | Sellers P J Dickinson R E Randall D A | 1997 | Science1997,275,5299: | 1 |
| 11 | Nitrate Losses through Subsurface Tile Drainage in Conservation Reserve Program, Alfalfa, and Row Crop Systems显示文摘 | RANDALL G W HUGGINS D R | 1997 | Environ Qual1997,,26: | 1 |
| 12 | Immunolocalization of H+-ATPase the gill epithelia of rainbow trout显示文摘 | Lin H Pfeiffer D Vogl A Pan J Randall D | 1994 | The Journal of experimental biology1994,195,1: | 1 |
| 13 | Synthesis of Vinyl Polymer-silica Colloidal Nanocomposites Prepared Using Commercial Alcoholic Silica Sols显示文摘 | Percy M J Amalvy J I Randall D P | 2004 | Langmuir2004,20,: | 1 |
| 14 | Fluoroquinolone treatment of experimental Salmonella enterica serovarTyphimurium DT104 infections in chickens selects for both gyrA mutations and changes in efflux pump gene expression CJ3显示文摘 | Randall L P Eaves D J Cooles S W | 2005 | J Antimicrob Chemother2005,56,2: | 1 |
| 15 | Nitrate nitrogen in surface waters as influenced by climatic conditions and agricultural practices显示文摘 | Randall G W Mulla D J | | 0,,: | 1 |
| 16 | Colo- rectal cancer screening显示文摘 | RANDALL W B JAMES S B KELLI B D | 2010 | J Natl Compr Cane Netw2010,8,: | 1 |
| 17 | Amplification of padlock probes for DNA diagnostics by cascade rolling circle amplification or the polymerase chain reaction 显示文摘 | THOMAS D C NARDONE G A RANDALL S K | 1999 | Archives of Pathology & Laboratory Medicine1999,123,12: | 1 |
| 18 | Induction of phosphorus removal in an enhanced biological phosphorus removal bacterial population显示文摘 | A A Randall L D Benefield W E Hill | 1997 | Water Research1997,31,: | 1 |
| 19 | Is smaller necessarily better? A systematic review comparing the effects of minilaparo- scopic and conventional laparoscopic cholecystectomy on patient outcomes 显示文摘 | Mccloy R Randall D Schug SA | 2008 | Surg Endosc2008,22,12: | 1 |
| 20 | Nitrate nitrogen in surface waters as influenced by climatic conditions and agricultural practices显示文摘 | Randall G W Mulla D J | 2001 | Journal Environmental Quality2001,30,: | 1 |