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Sample records for asthenia

  1. Different Perspectives on Asthenia in Astronauts and Cosmonauts: International Research Literature

    Science.gov (United States)

    Sandoval, Luis; Shea, Camille; Otto, Christian; Leventon, Lauren

    2010-01-01

    The Behavioral Health and Performance (BHP) Element is one of the six elements within the NASA Human Research Program (HRP) and is responsible for managing four risks: a) The Risk of Performance Decrements due to inadequate Cooperation, Coordination, Communication and Psychological Adaptation within a Team (Team), b) the Risk of Performance Errors due to Sleep Loss, Circadian De-synchronization, Fatigue and Work Overload (Sleep), c) Risk of Behavioral Conditions (BMed), and d) the Risk of Psychiatric Disorders (BMed). The aim of this report is to address some of the recommendations made by the recent NASA HRP Standing Review Panel for the Behavioral Medicine Risk of Psychiatric Disorders. Such recommendations included: a) the inclusion of important national and international literature in English and non-English language materials; including journals, books, magazines, conference reports and b) an extensive literature review of certain types of psychological states to predict, detect, and assess adverse mental states that may negatively affect the psychological well being of the astronauts, specifically asthenia. This report was a collaborative international work effort focused on the evaluation and determination of the importance of continuing research on asthenia as a possible psychological problem that might affect the optimal psychological functioning among crewmembers during long-duration space flight missions. Russian medical personnel (flight surgeons and psychologist) have observed symptoms of asthenia (weakness, increased fatigue, irritability, and attention and memory disorders) in cosmonauts after four months in space (Myasnikov& Zamaleddinov1996; Grigorieve, 1996 ) and believe that asthenia is one of the greater risks that will affect crews? optimal psychological functioning.

  2. Perspectives on Asthenia in Astronauts and Cosmonauts: Review of the International Research Literature

    Science.gov (United States)

    Sandoval, Luis; Keeton, Kathryn; Shea, Camille; Otto, Christian; Patterson, Holly; Leveton, Lauren

    2012-01-01

    The Behavioral Health and Performance Element (BHP) is one of the 6 elements in the NASA Human Research Program (HRP) and is responsible for managing 4 of the identified and named risks to human health and performance from human space exploration: a) Risk of Behavioral Conditions (BMed), b) Risk of Psychiatric Disorders (BMed), c) Risk of Performance Decrements due to inadequate Cooperation, Coordination, Communication and Psychological Adaptation within a Team (Team), and d) Risk of Performance Errors due to Sleep Loss, Circadian De-synchronization, Fatigue and Work Overload (Sleep). Each risk is reviewed by a NASA HRP Standing Review Panel (SRP), and recently the Behavioral Medicine Risk of Psychiatric Disorders was reviewed. The aim of this report is to address one of the recommendations made by that panel, specifically the recommendation that the "literature on asthenia should be evaluated (possibly as a psychological or psychosomatic / psycho-physiological analogue of chronic fatigue syndrome)" (SRP p. 4), in addition to General Recommendation 4, which states that "all reviews must include non-English language materials as well as materials appearing in conferences reports, books, and other non-refereed journal outlets" (SRP p. 2).

  3. Effect of Reinforcing Qi and Moistening Intestine Oral Liquid on Anorectal Manometry of Asthenia Type Constipation Patients

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective: To study the change of anorectal manometry in asthenia type constipation patients and effect of reinforcing Qi and moistening intestine oral liquid (RQMI) on it. Methods: The total of 135 cases were divided into healthy group, RQMI treated group, Maren pill (MRP) treated group and prepulsid (PPS) treated group, their anal maximal voluntary squeez pressure, rectoanal contraction reflex, rectoanal inhibitory reflex, defecation reflex, rectal volume sensory threshold and rectal maximal tolerable volume were observed. Results: The rectal sensory function of patients weakened obviously and anal sphincter reactivity reduced as compared with those of healthy person (P<0.01), and both were improved by RQMI treatment (P<0.05). Conclusion: RQMI is superior to MRP and prepulside in improving anorectal dynamic abnormality in constipation patient of asthenia type.

  4. Enfoque del síndrome de astenia crónica The chronic asthenia syndrome: A clinical approach

    Directory of Open Access Journals (Sweden)

    Pablo Young

    2010-06-01

    Full Text Available El término astenia deriva del griego (¢sqsneia, a: privación, sin, esthénos: vigor, fuerza, significa ausencia de fortaleza, vigor o fuerza. Es un síntoma difícil de definir, que implica un conjunto de sensaciones vagas, distintas para cada individuo. Es un motivo habitual de consulta representando hasta el 30% de la consulta ambulatoria. A su vez, la fatiga crónica representa del 1 al 10% de estos casos, y el 0.2- 0.7% del total pertenece al síndrome de fatiga crónica. Es importante saber diferenciar la astenia de la debilidad y de la disnea, ya que los pacientes habitualmente le dan el mismo significado. El factor tiempo en la astenia es útil para su caracterización. Se definió a la fatiga como prolongada cuando su duración es mayor a un mes y crónica cuando la misma supera los 6 meses. La sistematización de las entidades capaces de provocar astenia deberá guiar la búsqueda de síntomas y signos físicos, así como la indicación de estudios complementarios. La depresión es la causa más común de fatiga, representando aproximadamente la mitad de los casos. El tratamiento más efectivo de la astenia es solucionar la causa subyacente; no obstante hasta un 20% de los pacientes queda sin diagnóstico. El diagnóstico de síndrome de fatiga crónica es de exclusión y se deben usar los criterios del consenso internacional del año 1994¹. En cuanto a su tratamiento, existe evidencia a favor de utilizar ejercicio físico graduado y terapia cognitiva. La alta frecuencia del síntoma conlleva un enorme costo social y económico consumiendo recursos de manera desmesurada, por lo que es importante que los médicos estén familiarizados con este síntoma.The term asthenia comes from the Greek (¢sqsneia, a: privation, without; esthénos: vigor, force, it means absence of strength, vigor or force. It is a symptom, difficult to define, with a set of vague sensations, different for each patient. It is a frequent cause of consult, almost

  5. 肾虚与衰老机理中西医研究概况%Mechanism of Kidney Asthenia and Aging Research

    Institute of Scientific and Technical Information of China (English)

    刘梦云; 韩旭

    2011-01-01

    衰老是人类生命过程中无法避免的规律,文章从肾虚的角度,通过对中国古典医学文献进行引证分析,并从西医自由基、内分泌、免疫、基因方面阐述肾虚与衰老的关系,得出肾虚是导致衰老的重要因素之一,只有补肾固精,才能起到延缓衰老、改善衰老症状,最终延长人类寿命.%Aging is the process of human life that can not avoid. In this article, from the perspective of kidney asthenia, we confirm the relationship between aging and kidney asthenia, not only from the classical Chinese medical literature analysis, but also from the modern medicine theory of radicals, endocrine, immune and genetic. We form the view that kidney asthenia is the important factor of aging. In order to improve symptoms of aging, eventually prolong human life, invigorating the kidney is the most important thing.

  6. Research on Molecular Mechanism of “Yin Asthenia with Internal Heat” in Asthenia Hot Syndrome Rats by Gene Chip Technology%基因芯片技术研究虚热证大鼠阴虚内热的分子机制

    Institute of Scientific and Technical Information of China (English)

    韩冰冰; 王世军

    2013-01-01

    目的:通过基因芯片技术研究虚热证大鼠肝全基因表达谱的改变,阐释虚热证大鼠“阴虚内热”的分子机制.方法:使用中药复方附子、肉桂、干姜建立虚热证大鼠模型,应用基因芯片检测各组大鼠肝脏基因表达,筛选差异表达基因,进行基因功能分类注释,荧光定量PCR验证芯片结果.结果:虚热模型组与空白对照组比较有99条基因差异表达,主要涉及防御应答,固醇代谢等功能.结论:虚热证阴虚内热的分子机制可能与刺激应答相关基因及固醇代谢相关基因两类基因的异常表达相关.%To explain molecular mechanism of “Yin Asthenia with Internal Heat” in asthenia hot syndrome rats by analysis the whole gene expression profile of the hver in rats with asthenia hot syndrome.Methods:The Asthenia hot syndrome rats models were induced by compound preparation of Traditional Chinese Medicine of Aconitum carmichaeli,Cinnamomi Cortex,Rhizoma Zingiberis.The liver gene expression in each group was detected by gene chip.We selected the differential expression genes and conducted the significant analysis on the genetic function of differential genes.A part of genes were selected to test the accuracy of results by RT-PCR.Results:As compared to the control group,in asthenia hot model group there were 99 strips of differential expression gene,mainly about function of defense response and sterol metabolic process.Conclusion:The abnormal expression of genes about defense response and sterol metabolic process in asthenia hot syndrome rats is possibly related to the substance foundation of asthenia hot syndrome.

  7. Treating Impotence from Asthenia and Liver stagnation%从虚劳肝瘀论治阳痿

    Institute of Scientific and Technical Information of China (English)

    王国强

    2014-01-01

    阳痿是指成年男子性交时,由于阴茎痿软不举,或举而不坚,或坚而不久,无法进行正常性生活的病证。中医对阳痿的认识已有3千年的历史,《素问•痿论》中又称“宗筋弛纵”和“筋萎”,“思想无穷,所愿不得,发为筋痿”。《灵枢•邪气脏腑病形》篇称阳痿为“阴痿”。《类证治裁》说“伤于内则阳不起,故阳之痿”。《伤寒杂病论》将阳痿列至虚劳篇,“男子平人,脉大为劳,极虚亦为劳”。总结历代医家思想,笔者认为应从虚劳、从肝和从瘀三个方面论治阳痿。%Impotence is an adult man’s sexual disease in which his penis fails to get hard or stay hard during the intercourse. The understanding of impotence in TCM has a history of 3000 years. In Treatise of Atrophy of Plain Question, impotence was called “loose tendon”or“tendon atrophy”,“much desire with little realization will cause impotence”. In Viscera Disease Pathogen of Miraculous Pivot, impotence was called “Yinwei”. In Leizheng Zhicai, it is said that internal damage can cause impotence. In Treatise on Febrile and Miscellaneous Diseases, impotence was listed in asthenia volume. It is said a man with big pulse is considered as atrophy and severe weakness is also atrophy. From the summary of the medical theory of doctors in various dynasty, the writer thinks impotence should be treated from the aspects of atrophy, liver and stagnation.

  8. Clinical Observation on Thermal Moxibustion Therapy for Treating Uroschesis and Enuresis of Asthenia Type%热敏灸治疗虚证癃闭临床研究

    Institute of Scientific and Technical Information of China (English)

    李哲

    2012-01-01

    目的:探讨热敏灸疗法治疗虚证癃闭的临床疗效.方法:将47例虚证癃闭遗溺患者采用随机数字表法分为治疗组和对照组.对照组22例以传统针刺百会、关元、三焦俞等腧穴治疗;治疗组25例进行热敏灸疗法治疗,3个疗程后根据目视模拟计量表减分率判定疗效.结果:治疗组治愈9例,显效12例,有效4例,无效0例,有效率100%;对照组治愈5例,显效8例,有效6例,无效3例,有效率86.36%.两组有效率比较,差异有统计学意义(P<0.05),治疗组优于对照组.结论:热敏灸疗法治疗虚证癃闭疗效显著.%Objective:To investigate the clinical efficacy of thermal moxibustion therapy in treating uroschesis and enuresis of asthenia type. Methods: 47 cases of uroschesis and enuresis of asthenia type were randomly divided into the treatment group and the control group according to the random number method. 22 cases in the control group were given the traditional acupuncture treatment of puncturing Baihui, Guanyuan and Sanjiao with syndrome differentiation and treatment, while 25 cases in the treatment group were given thermal moxibustion therapy. After three courses of treatment, the therapeutic effects were determined according to the reducing rate of the visual analog scale. Results: In the treatment group, 9 cases were cured, 12 cases were markedly effective, 4 cases were effective and the effective rate was100% ; in the control group 5 cases were cured, 8 cases were markedly effective, 6 cases were effective, 3 cases were ineffective and the effective rate was 86. 36%. Comparison of the therapeutic effects in both groups showed the difference was statistically significant (P<0. 05) and the treatment group was superior to the control group. Conclusion: The thermal moxibustion therapy has significant therapeutic effect in treating uroschesis and enuresis of asthenia type.

  9. Association of severity and sex with vasoactive substance and sexual hormone level in patients with vascular dementia in the type of kidney asthenia and blood stasis syndrome

    Institute of Scientific and Technical Information of China (English)

    Jian Du; Jing Cai; Shuanghong Shen

    2006-01-01

    BACKGROUND: Kidney asthenia is the basic cause of the development of vascular dementia (VD). Kidney asthenia lasting for a long time will result in blood stasis. Also, the cause of VD may have relationships with endothelin (ET), nitric oxide (NO), homocysteine (HCY), estrogen (E2), and testosterone (T).OBJECTIVE: To observed clinical curative effect of the kidney tonic, pancreas tonic, and blood tonic with promoting blood circulation components in treating kidney asthenia with blood stasis syndrome of VD.DESIGN : Case controlled study.SETTING: Geriatric Institute of Integrated Medicine, Fujian College of Traditional Chinese Medicine.PARTICIPANTS: A total of 70 patients, including 39 males and 31 females aged 60-80 years, were selected from Department of Neurology, Pingshan Hospital from May 2000 to September 2002. Diagnostic criteria were used for probable VD of the American Psychiatric Association. Diagnostic and Statistical of Manual of Mental Disorder, 4th ed (DSM-Ⅳ), 1994 revised, mini-mental state examination (MMSE), and criteria of kidney asthenia with blood stasis with mixed weak and sthenia syndrome of Guidelines of Clinical Research of New Chinese Medicine in Treating Dementia. According to score of kidney asthenia with blood stasis syndrome, they were classified to three groups: mild (n =22), moderate (n =33) and severe (n =15). All of them with complete chest X-Ray, ECG, blood chemistry and other related examinations, exclusive of cardiovascular, liver, kidney diseases, homeopathy and psychiatry diseases. And hereby we also select 30 normal people as the comparing group, having no substantial diseases in heart, brain, kidney, liver, lung and other main organic systems after medical examination. Of this group, 11 were males and 19 were females, ranging from 62 years old to 78 years old. There were no obvious differences between the above two groups in sex, age, and education level after statistical analysis. All patients observed in Pingxi Hospital

  10. Establishment of Gynecological Asthenia Cold Syndrome Model%妇科虚寒证大鼠模型的创建

    Institute of Scientific and Technical Information of China (English)

    徐丁洁; 成秀梅; 杜惠兰

    2011-01-01

    Objective To establish the model of gynecological asthenia cold syndrome by simulating the e-tiology of gynecological asthenia cold syndrome depending on "pathogenic cold impairing yang" in Chinese medicine theory. Methods The female SD rats were randomly divided into the model group and the normal group by randomized digital table, 20 in each group. Rats in the model group were placed in 0℃ -1℃ ice water, and the ice water was placed in 4℃ refrigerator, twice daily, 20 min each time, for a total of 30 days. The body temperature was determined and the changes of the estrous cycle were observed every day. When the body temperature decreased (with statistical difference from those of the normal group), and vaginal smears showed disordered estrous cycle, the model was successfully established. Rats were sarcrificed during the diestrus period, the correlative indices including reproductive endocrine hormones in blood [follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), testosterone (T), and progestone (P)], the thyroid function [triiodothyronine (T3), tet-raiodothyronine (T4), thyrotropic-stimulating hormone (TSH) ], the adrenal function [ plasma adrenocorticotropic hormone (ACTH) and cortisol (Cor) ], the cellular immune function [serum interleukin-2 (IL-2) ], and energy tests [including plasma cyclic adenosine monophosphate (cAMP), cyclic guanosine monophosphate (cGMP), the ratio of cAMP/cGMP, lactate dehydrogenase (LDH) ], and the index of thymus, spleen, uterus, and ovary were detected. Results Compared with the normal group, rats in the model group appeared chill, dim-color hair, purple and dark ears and claw. They were depressed, scrunched, quiet, and clumsy. They liked to stay together. Their water intake and appetite were reduced, body weight lost, body temperature significantly lowered. They passed loose stool. Their estrous cycle and diestrus were prolonged. Their plasma cGMP content, cAMP/cGMP ratio, LDH, ser-urn IL-2 content

  11. 基因芯片技术研究虚寒证大鼠肝全基因表达谱%Study of Gene Chip Technology on Whole Genome Expression of Liver of Rats with Asthenia Cold Syndrome

    Institute of Scientific and Technical Information of China (English)

    韩冰冰; 王世军; 于华芸; 赵海军; 王媛

    2011-01-01

    Objective;To study the whole genome expression of liver on asthenia cold syndrome rats by gene chip technology. Methods:The Asthenia cold syndrome rats models were induced by compound preparation of traditional Chinese medicine of Raw Gypsum,Radix gentianae、Cortex Phellodendri 、Anemarrhenae Rhizoma.The liver gene expression in each group was detected by gene chip. We selected the differential expression genes and conducted the significant analysis on the genetic function of differential genes. A part of genes were selected to test the accuracy of results by RT - PCR. Results: As compared to the control group,in asthenia cold model group there were 99 strips of differential expression gene, mainly about function of response to stimulus. Conclusion ; Many strips of gene about response to stimulus were down - regulated in asthenia cold syndrome rats, which induced down regulation of function about immune response,defense response,response to other organism. The substance foundation of asthenia cold syndrome was possibly related to these genes.%目的:采用基因芯片技术研究虚寒证大鼠肝全基因表达谱的改变.方法:使用中药复方生石膏、龙胆草、黄柏和知母建立虚寒证大鼠模型,应用基因芯片检测各组大鼠肝脏基因表达,筛选差异表达基因,进行基因功能分类注释.荧光定量PCR验证芯片结果.结果:虚寒模型组与空白对照组比较有99条基因差异表达,主要涉及刺激应答功能.结论:虚寒证可能通过多种刺激应答相关基因的下调,导致免疫应答功能、防御应答功能及对其他生物体刺激应答功能的降低.虚寒证的物质基础可能与此类基因的异常表达相关.

  12. 针灸对脾虚犬消化功能指标的影响%Effects of Acupuncture on Digestive Function Indicator in Dogs with Splenic Asthenia Syndrome

    Institute of Scientific and Technical Information of China (English)

    石达友; 李盛强; 宋晓琳; 代雪立; 肖敏华; 郭世宁

    2011-01-01

    本试验通过注射利血平复制犬脾虚证动物模型,观察犬临床体征、体重及部分消化功能指标的变化,并研究针灸对各项指标的调整作用.试验结果显示,在实验犬出现脾虚证后,其体重显著低于空白对照组( P<0.05);在经针灸治疗7d后,实验犬的胃蛋白酶、胰蛋白酶活性与胃动素水平均显著高于未经治疗的实验犬(P<0.05),而胃泌素与生长抑素均显著低于未经治疗的实验犬(P<0.05).结果表明,通过针刺脾虚犬足三里、脾俞两穴位,对改善脾虚犬临床症状、增加体重及恢复正常消化功能等方面具有明显的功效.%In this thesis, it made a splenic asthenia modeling by injection of reserpine. The clinical symptom, body weight and the part of digestive function indicator were observed. And it made a study about effect of acupuncture treatment on the observed indexes. The results showed that the body weight significantly decreased (P<0. 05) after the dog appeared splenic asthenia syndrome. After acupuncture treatment the dog with splenic asthenia syndrome for 7 days, the activity of pepsin and trypsin and the contents of motillin significantly increased (P<0. 05), but the contents of gastrin and somatostatin significantly decreased (P<0.05), compared without treated splenic asthenia dogs. The finding showed that it had an effect of acupuncture treatment splenic asthenia dogs in Zusanli and spleen points on improvement of clinical symptoms, weight gain and restoration of normal digestive function.

  13. 童康颗粒治疗小儿脾虚夹积型厌食的临床疗效观察%Clinical efficacy observation on Tongkang granula in treating pediatric anorexia of splenic asthenia and food accumulation type

    Institute of Scientific and Technical Information of China (English)

    张伟; 孙丽敏

    2012-01-01

      目的:探讨童康颗粒治疗小儿脾虚夹积型厌食的疗效.方法:观察治疗小儿厌食症60例,其中治疗组27例给予童康颗粒口服治疗,对照组33例给予四磨汤口服液口服治疗.治疗4周后,治疗组临床总有效率为95.15%,对照组总有效率为80.12%,在改善患儿食欲食量和体重方面,二者均有疗效,但治疗组优于对照组.结果:童康颗粒能有效改善脾虚夹积型厌食症患儿的厌食状况,使患儿体重增加.结论:童康颗粒组疗效优于四磨汤口服液组.%  Objective: To investigate the efficacy of Tongkang granula in treating pediatric anorexia of splenic asthenia and food accumulation type. Methods: 60 cases of pediatric anorexia were divided into two groups, 27 cases in the treated group and 33 cases in the control group. The treated group was given Tongkang granula for oral administration and the control group was given Simo decoction oral liquid. After treated for 4 weeks, the total effective rate of the treated group was 95.15% and that of the control group was 80.12%. Both two groups were effective in improving the appetite and weight of children, and the treated group was more effective. Results: Tongkang granula was effective in treating pediatric anorexia of splenic asthenia and food accumulation type and increasing children’s weight. Conclusion: Tongkang granula was more effective in pediatric anorexia than Simo decoction oral liquid.

  14. 归逍方治疗肾虚肝郁型多囊卵巢综合征临床研究%Clinical Study of Guixiao Fang on Polycystic Ovary Syndrome Patients with Kidney-Asthenia and Liver Depression Syndrome

    Institute of Scientific and Technical Information of China (English)

    杨正望; 赵娜; 全春梅

    2016-01-01

    目的:观察归逍方治疗多囊卵巢综合征肾虚肝郁证的临床疗效并探讨其作用机制。方法将60例多囊卵巢综合征患者随机分为治疗组和对照组各30例。治疗组予归逍方口服治疗,对照组予口服炔雌醇环丙孕酮片治疗,疗程3个月。观察比较两组总疗效及治疗前后促黄体生成素(LH)、卵泡刺激素(FSH)、睾酮(T)、体质量指数(BMI)、F-G评分、痤疮评分、卵巢体积、中医证候积分变化。结果治疗组总有效率为87.6%,对照组为63.3%,治疗组疗效优于对照组(P<0.05);治疗组在降低BMI、LH、中医证候积分及缩小卵巢体积方面疗效优于对照组(P<0.05);两组在降低T、LH/FSH 及改善患者多毛、痤疮方面疗效相当(P>0.05)。结论归逍方治疗肾虚肝郁型多囊卵巢综合征临床疗效确切,其作用机制可能与改善LH/FSH比值、降低T水平相关。%Objective To observe the clinical efficacy of Guixiao Fang on polycystic ovary syndrome (PCOS) patients with kidney-asthenia liver depression syndrome, and investigate the mechanism. Methods The sixty PCOS patients with kidney liver depression syndrome were randomly divided into the treatment group and the control group, 30 cases in each group. Patients in the treatment group were treated by Guixiao Fang, and the patients in the control group were given progesterone tablets of the estradiol. Results The total effective rate in treatment group is 87.6%, the control group is 63.3%, the treatment group is superior to the control group (P0.05). Conclusion Guixiao Fang shows obvious clinical effect in treating PCOS patients with kidney liver depression syndrome, its mechanism may be related with the improving LH/FSH and reducing the T level.

  15. Si-Jun-Zi decoction repairs mitochondrial damage of cells of liver,myocardium, gastric mucosa and skeletal muscle in rats with spleen asthenia%四君子汤对脾虚大鼠肝、心肌、胃黏膜和骨骼肌细胞线粒体损伤的修复作用

    Institute of Scientific and Technical Information of China (English)

    刘友章; 王昌俊; 刘静; 周俊亮; 刘兆周; 欧志穗; 金友

    2006-01-01

    著低于正常对照组(P<0.01);自然复健组显著高于脾虚模型组(P<0.05~0.01);四君子汤组大鼠各组织线粒体含量最高,除显著高于脾虚模型组和自然复健组外(P<0.05~0.01),并显著高于正常对照组(P<0.01).②实验34周末各组大鼠骨骼肌、肝、心肌、胃黏膜组织线粒体形态比较:脾虚模型组大鼠心肌细胞线粒体高度肿胀;肝细胞线粒体致密质粒减少或消失,嵴断裂;骨骼肌细胞线粒体数量减少,线粒体变小,线粒体膜结构破坏;胃壁细胞线粒体减少,线粒体内部结构不清,胃主细胞线粒体峭断裂.自然复健组大鼠各组织的线粒体形态改变较轻,四君子汤组与正常对照组接近.结论:四君子汤具有提高脾虚大鼠骨骼肌、肝、心肌、胃黏膜组织细胞线粒体含量,修复线粒体损伤的作用.%BACKGROUND: Spleen is correlated with mitochondrion. The "spleen governs movement and transformation of food and liquids" in traditional Chinese medicine refers to not only the digestion and absorption of food in gastrointestinal tract, but also the process of biological oxidation and energy production of mitochondrion.OBJECTIVE: To analyze the effects of Si-Jun-Zi decoction (SJZD), a typical prescription for invigorating spleen and replenishing qi, on repairing the mitochondrial damage of cells of liver, myocardium, gastric mucosa and skeletal muscle in rats with spleen asthenia.DESIGN: A randomized controlled observation.SETTINGS: Second Department of Internal Medicine, the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine;Guangzhou University of Traditional Chinese Medicine.MATERIALS: The experiments were carried out in the internal medicine laboratory, the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine and the testing center of Guangzhou University of Traditional Chinese Medicine from June to December in 2004. Forty SD rats were provided by the animal center of Guangzhou

  16. Effect of Electroacupuncture on Differentiation and Proliferation of Hippocampal Nerve Stem Cells in Splenic Asthenia Pedo-rats%电针对脾虚证幼鼠海马区神经干细胞增殖和分化的影响

    Institute of Scientific and Technical Information of China (English)

    卓缘圆; 杨卓欣; 吴家满

    2011-01-01

    Objective To observe the effect of electroacupuncture (EA) on the differentiation and proliferation of nerve stem cells in the hippocampal dentate gyrus (DG) in splenic asthenia pedo-rats so as to study its central mechanism. Methods A total of 72 SD male rats were randomly assigned to normal control group (n = 24). Model group (n=24) and EA group (n=24) which were further divided into 7 d, 14 d , 28 d and 49 d time-points (n = 6). Splenic asthenia model was established by intrape-ritoneal injection of reserpine and gavage of Dahuang (.Radix et Rhizoma Rhei) fluid. EA was applied to bilateral "Zusanli" (ST 36) and "Sanyinjiao" (SP 6) for 20 min, once daily for 7, 14,28 and 49 days respectively. Brdu, Nestin, gliai fibrillary acidic protein (GFAP), and neuron-specific enolase (NSE) expression in the DG of hippocampus were detected by immunohistochemis-try double staining. Results Compared with the normal control group, the numbers of Brdu, Brdu/GFAP, Brdu/NSE immunorea-ctive (IR) positive cells in the DG of hippocampus on day 7 and 14, and that of Brdu/Nestin IR-positive cells on day 7 were decreased considerably in the model group (P0.05). Conclusion EA of ST 36 and SP 6 can effectively suppress splenic asthenia syndrome-induced decrease of the numbers of Br-du, Brdu/GFAP, Brdu/Nestin and Brdu/NSE IR-positive cells in the DG of hippocampus at the early stage in the splenic asthenia rats, which may contribute to its effect in improving splenic asthenia symptoms in clinic by promoting the proliferation and differentiation of some nerve stem cells in the hippocampus.%目的:通过观察电针对脾虚证幼鼠海马齿状回区神经干细胞增殖和分化的影响,探讨电针对中枢神经细胞损伤的保护和治疗作用.方法:4周龄SD雄性大鼠,随机分为正常组、模型组、电针组,每组各24只.3组再分别随机分为7、14、28和49 d等4个亚组,每亚组6只.用利血平腹腔注射联合大黄灌胃造脾虚证模型.造模结束后,电

  17. 金匮肾气丸、右归丸对肾阳虚小鼠模型以药反证的脑基因芯片研究%Gene chip study on cerebral gene of effect of Jinkui Shenqiwan and Youguiwan on mouse model of kidney-yang asthenia with syndrome disproved accroding to therapeutic efficacy of drugs used

    Institute of Scientific and Technical Information of China (English)

    杨裕华; 李震; 孙静

    2009-01-01

    目的:在基因水平上探讨补肾中药金匮肾气丸、右归丸对肾阳虚小鼠模型的作用机制.方法:昆明种小鼠分为正常组、模型组、金匮组和右归丸组.正常组和模型组每天灌胃蒸馏水0.5 mL;金匮组和右归丸组每天分别灌胃金匮.肾气丸混悬液和右归丸混悬液0.5 mL,含生药129 mg·kg~(-1).造模组和治疗组均采用雄雌鼠比例1:6同笼喂养,雄鼠每日游泳1次,直至无力下沉时捞出,达4周,以诱导产生"劳倦过度、房室不节"肾阳虚证.观察动物的畏寒、活动及反应、饮食和皮毛等情况.用36K mouse genome array鼠脑芯片检测正常组和肾阳虚模型组鼠脑基因,并以二者荧光信号相对强度比值≥2和≤0.5筛选差异显著基因,用qRT-PCR对部分差异表达基因进行验证.结果:模型组/正常组上调基因,二药治疗组/造模组基因下调23个基因,主要是与炎症/免疫、神经传递/信号转导等相关基因;造模组/对照组下调基因而治疗组/造模组基因上调的基因有6个,其主要是与细胞周期/细胞结构、神经传递/信号转导、转录等有关基因.qRT-PCR也证实了金匮组/模型组、模型组/正常组的GH和Scgb3a1的差异表达.结论:金匮肾气丸、右归丸可使肾阳虚小鼠模型显著下凋的激素、黑色素显著上调并促进细胞增殖,从而在基因水平上探讨了金匮肾气丸和右归丸的药物作用机制及其差别.%Objective: To inquire into the cerebral gene change of effect of Jingui Shenqiwan and Yougniwan for animal model of kidney-yang asthenia eausod by excessive physical and sexual activities, which may study the effect mechanism of the medicine with syndrome disproved therapeutic efficacy of drugs used. Method: Male mice of Kunming species, weight 35-40 g, and female weight 28-35 g were randomly divided into four groups: control group, model group and treatment groups of Jigui Shenqiwan and Youguiwan in which there were ten male mice

  18. 抗脂方治疗脾虚湿热型非酒精性脂肪性肝炎临床观察%Clinical study on Kangzhi decoction in treating 92 cases of nonalcoholic fatty liver disease differentiated as syndrome type of spleen asthenia and damphess-heat

    Institute of Scientific and Technical Information of China (English)

    张盛杰; 齐艳艳; 钱慧; 李晨; 陆趣英; 明利平; 朱敏芳; 陈建杰

    2011-01-01

    Objective: To observe the therapeutic effect of Kangzhi decoction in treating non-alcoholic fatty liver disease differentiated as syndrome type of spleen asthenia and dampness-heat.Methods: One humdred eighty-two cases were divided into two groups randomly, the treatment group was treated by Kangzli decoction, the control group was treated by tiopronin, two groups were all treated for six months; The therapeutic effect of two groups, the liver function, TCh, TG, B-mode ultrasound after treatment, and the changes of the symptoms and physical signs were detected.Results: The decrease of syndrome scores was significiant difference in the treatment group comparing with the control group ( P < 0.05 ).The total effective rate was 86.9% in the treatment group and 67.7% in the control group, there was significant difference between the two groups (P <0.05).The level of ALT, AST, GGT, TCh, TG and the decrease of B-mode ultrasounds average points were significiant difference in the treatment group comparing with the control group ( P < 0.05 ).Conclusion: It indicated that Kangzhi decoction has the better therapeutic function to treat non-alcoholic fatty liver disease differentiated as syndrome type of spleen asthenia and dampness-heat, it obviously improved patients' liver function, blood lipid, B-mode ultrasound index and the clinical syndrome.%目的:观察自拟抗脂方治疗脾虚湿热型非酒精性脂肪性肝炎的临床疗效.方法:将182例患者随机分为治疗组92例和对照组90例,治疗组予中药抗脂方治疗,对照组口服硫普罗宁片,两组均治疗6个月;观察两组临床疗效及治疗后患者肝功能、甘油三酯(TG)、总胆固醇(TCh)、肝脏B超影像及症状体征变化情况.结果:治疗组与对照组比较,症候积分下降率的差异有显著性意义(P<0.05);治疗组临床总有效率为86.9%,与对照组67.7%比较差异有显著性意义(P<0.05);治疗组患者ALT、AST、GGT、TCh、TG及肝脏B超平

  19. 病毒性心肌炎病程中虚实辨证的探讨%Discussion on Differential Diagnosis of Sthenia and Asthenia Syndromes in Viral Myocarditis

    Institute of Scientific and Technical Information of China (English)

    王兆兰; 刘长虹

    2000-01-01

    @@ 病毒性心肌炎是由外感温热邪毒引起的、以心脏损害为主要病理表现的疾病.在整个病程中由心涉及肺、脾、肾等多个脏器,出现气血阴阳不同程度的病理变化,有"心动则五脏六腋皆摇"之状,病机复杂多变.

  20. 鼠脾虚证与胃窦及十二指肠组织5-HT及其受体的关系%Relationship of spleen-asthenia syndrome with 5-HT and 5- HT receptor in gastric antral and duodenal tissues

    Institute of Scientific and Technical Information of China (English)

    赵燕玲; 夏天

    2000-01-01

    目的探讨脾虚证与胃窦及十二指肠组织的5-HT及其受体的关系. 方法成年SD大鼠30只随机分为3组. A组:脾虚组(n=10);B组:对照组(n=10);C组:四君子汤治疗组(n=10). 采用免疫组化和医学图像分析系统相结合的方法,测定各组大鼠胃窦及十二指肠5-HT细胞的数目、面积、平均灰度、细胞内5-HT含量及5-HT受体阳性细胞内5-HT受体的含量. 结果①A组大鼠胃窦5-HT细胞的数目(106±8).HP-1,面积(35.1±4.0) μm2,5-HT含量(0.337±0.050) AU,5-HT受体含量(0.345±0.075) AU均高于B组(P<0.05或P<0.01),平均灰度(120±8)较B组降低(P<0.05或P<0.01);A组大鼠十二指肠5-HT细胞的数目(109±5).HP-1,面积(30.2±2.2) μm2,5-HT含量(0.341±0.031) AU,5-HT受体含量(0.319±0.031) AU均高于B组(P<0.01),平均灰度(123±4)较B组降低(P<0.01). ②C组的上述指标测定结果与B组无显著差异. 结论胃窦及十二指肠组织5-HT及其受体含量的增高可导致消化系统功能紊乱,有可能是脾虚证的一种重要病因或病机.

  1. Effect of Yougui Pill on Cerebral Gene Chip of Mice with Kidney-yang Asthenia Induced by Excessive Physical and Sexual Activity%右归丸对"劳倦过度、房室不节"肾阳虚小鼠脑基因芯片的影响

    Institute of Scientific and Technical Information of China (English)

    杨裕华; 李震

    2008-01-01

    目的 研究右归丸对"劳倦过度、房室不节"肾阳虚小鼠模型脑基因的影响,以期从基因水平上研究其药物作用机理.方法 对照组、模型组和治疗组雄性小鼠各为10只、15只和10只.对照组和模型组每日每只灌胃蒸馏水0.5ml,治疗组每日每只予右归丸混悬液0.5ml,模型组和治疗组雄雌鼠比例1∶6同笼喂养且雄鼠每日游泳30~40分钟共4周,以诱导产生"劳倦过度、房室不节"肾阳虚证.用36K鼠脑芯片检测3组鼠脑基因,并各以二者荧光信号相对强度比值≥2和≤0.5筛选差异显著基因.结果 模型组/对照组共筛选出186个差异表达基因,其中上调基因150个,下调基因36个.治疗组/模型组筛选出155个差异表达基因,其中上调基因64个,下调基因91个.模型组/对照组上调而治疗组/模型组下调的基因有32个,主要是炎症/免疫、神经传递/信号转导等基因.模型组/对照组下调而治疗组/模型组上调的基因有12个,主要是与黑色素、孤儿核受体相关的基因.结论 右归丸可使肾阳虚小鼠模型显著下调的黑色素显著上调,改善与孤儿核受体有关激素的作用并促进细胞增殖.

  2. 3.TRADITIONAL CHINESE MEDICINE

    Institute of Scientific and Technical Information of China (English)

    1992-01-01

    920220 Studies on plasma cortisol concen-tration and blood leukocyte content of gluco-corticoid receptors in patients with asthenia-cold asthenia-heat syndrome.ZHANG Guan-gyu (张广宇),XLE Zhufar (谢竹藩).Tradit & West

  3. Efficacy of melflufen, a peptidase targeted therapy, and dexamethasone in an ongoing open-label phase 2a study in patients with relapsed and relapsed-refractory multiple myeloma (RRMM) including an initial report on progression free survival

    DEFF Research Database (Denmark)

    Voorhees, P. M.; Magarotto, V.; Sonneveld, P.;

    2015-01-01

    in >10% of patients, regardless of relationship to study drug were thrombocytopenia (94%), anemia (84%), neutropenia (61%), leukopenia (42%), pyrexia (36%), asthenia (32%), fatigue and nausea (26%), bone pain (19%), cough, diarrhea, dyspnea, mucosal inflammation and upper respiratory infection (16...

  4. ASTHENIC DISORDERS IN ELDERLY PATIENTS WITH ARTERIAL HYPERTENSION: MANAGEMENT POTENTIAL OF MELDONIUM

    Directory of Open Access Journals (Sweden)

    M. E. Statsenko

    2015-09-01

    Full Text Available Aim. To assess the effect of meldonium (in combination with antihypertensive therapy on the severity of asthenic syndrome (AS in elderly patients with arterial hypertension (HT.Material and methods. Patients (n=180, >65 years old with HT (grade 1–2 and secondary somatogenic AS (assessed by the MFI-20 scale. The patients were randomized into 3 groups according to the scheme of treatment. Group 1 — intermittent treatment with meldonium (500 mg once daily for 3 months followed by a break 3 months; 2 courses. Group 2 — continuous treatment with meldonium (500 mg once daily for 12 months. Group 3 — control (receive only antihypertensive drugs. Evaluation of AS was assessed by MFI-20 scales at baseline and at week 52 of treatment.Results. AS signs attenuation was found in groups 1 and2. In group1 a number of patients with general asthenia decreased on 70.5% (p<0.05, with physical asthenia — on 47.7% (p<0.05, with reduced activity — on 33.3%, reduced motivation — on 25%. In group2 a number of patients with general asthenia decreased on 60% (p<0.05, physical asthenia — on 39.7%, reduced activity — on 79.9% (p<0.05, reduced motivation — on 12.2%, mental asthenia — on 77.7% (p<0.05. In group 3 no significant changes in these parameters were found. Moreover a number of patients with mental asthenia increased on 45.4% (p<0.05.Conclusion. Meldonium included into antihypertensive therapy can reduce the symptoms of secondary somatogenic AS. More pronounced antiasthenic effect can be achieved with meldonium taking regime 500 mg daily continuously for 52 weeks.

  5. Peginterferon plus ribavirin versus interferon plus ribavirin for chronic hepatitis C

    DEFF Research Database (Denmark)

    Hauser, Goran; Awad, Tahany; Brok, Jesper

    2014-01-01

    .96 to 1.07; 12 trials). No significant differences were reported between the two treatment groups regarding anaemia, headache, rigours, myalgia, pyrexia, weight loss, asthenia, depression, insomnia, irritability, alopecia, pruritus, skin rash, thyroid malfunction, decreased appetite, or diarrhoea. We were...

  6. Early malignant syphilis*

    Science.gov (United States)

    Ortigosa, Yara Martins; Bendazzoli, Paulo Salomão; Barbosa, Angela Marques; Ortigosa, Luciena Cegatto Martins

    2016-01-01

    Early malignant syphilis is a rare and severe variant of secondary syphilis. It is clinically characterized by lesions, which can suppurate and be accompanied by systemic symptoms such as high fever, asthenia, myalgia, and torpor state. We report a diabetic patient with characteristic features of the disease showing favorable evolution of the lesions after appropriate treatment. PMID:28300925

  7. 药物中毒性周围神经病变肌电图分析%EMG analysis of peripheral nerve lesion resulting from drug toxicity

    Institute of Scientific and Technical Information of China (English)

    张昆林; 马莎; 毛小川

    2003-01-01

    @@ INTRODUCTION Peripheral nerve lesion resulting from drug toxicity is caused by drugs which interrupt some enzymes in process of nervous metabolism and lead to loss of myelin sheath or axis- cylinder degeneration. Some drugs used in clinic can lead to peripheral nerve lesion. Patients showed symptoms such as numbness, asthenia.

  8. Muscular disease

    Institute of Scientific and Technical Information of China (English)

    1992-01-01

    920747 Studies on HLA and acetylcholinereceptor antibody in patients with my-asthenia gravis. XU Wenzhen (徐文桢), etal. Dept Neurol, West China Med Univ, Chengdu,610000. Chin J Neurol & Psychiat 1992; 25(3):150-153. Human leucocyte antigen (HLA) and acetyl-choline receptor antibody (AchRab) titer in the

  9. Unusual case of cervical syphilis with Piringer-Kuchinka-like lymphadenitis.

    Science.gov (United States)

    Moreno-Sánchez, Manuel; González-García, Raúl; García, Carlos Moreno; Monje, Florencio

    2014-12-01

    Syphilis rarely presents with cervical lymphadenopathy. We describe a patient with a cervical mass associated with weight loss, asthenia, and night sweats. The mass was excised and histological examination suggested Piringer-Kuchinka lymphadenitis, which is usually present in cervical toxoplasmosis. To the best of our knowledge, Piringer-Kuchinka lymphadenitis has not previously been reported in cervical syphilis.

  10. Neurasthenia: State-of-the-art and therapeutic approaches

    Directory of Open Access Journals (Sweden)

    Leonid Semenovich Chutko

    2013-01-01

    Full Text Available Objective: to study the efficacy of metaprot in the treatment of neurasthenia. Patients and methods. Thirty patients aged 18 to 45 years with neurasthenia (F48.0 were followed up. The patients were examined using a subjective asthenia rating scale (Multidimensional Fatigue Inventory (MFI-20, a 10-point anesthesia visual analog scale, Spielberger’s self-report scale modified by Yu.L. Khanin, and a computed Test of Variables of Attention (TOVA. Metaprot was given in a dose of 0.25 g b.i.d. after morning and evening meals as two administrations for 10 days (5 days at a 2-day interval. The results of therapy were assessed on day 30 after its course. Results. There was clinical improvement in 21 (70.0% patients after metaprot therapy. Evaluation of the patient’s status using the MFI-20 showed a significant improvement in the items of general asthenia, physical asthenia, psychic asthenia, and decreased activity. Psychophysiological examination using the TOVA revealed a significant reduction in response times, as compared to the scores obtained before the treatment, and a decrease in the number of errors in the second half of the test, which allows us to state that there is a reduction in the degree of mental exhaustion and an increase in work capacity after the treatment. Psychological tests showed no significant reduction in anxiety scores. There were no adverse reactions or complications. It has been concluded that it is promising to use metaprot to treat neurasthenia.

  11. Self-Esteem, Locus of Control and Various Aspects of Psychopathology of Adults with Visual Impairments

    Science.gov (United States)

    Papadopoulos, Konstantinos; Paralikas, Theodosis; Barouti, Marialena; Chronopoulou, Elena

    2014-01-01

    The exploratory study presented in this article looks into the possible differences in psychosocial aspects (self-esteem and locus of control) and aspects of psychopathology (depression, anxiety, melancholia, asthenia, and mania) amongst sighted adults and adults with visual impairments. Moreover, the study aims to examine the possible…

  12. Depressive Mood and Social Maladjustment: Differential Effects on Academic Achievement

    Science.gov (United States)

    Aluja, Anton; Blanch, Angel

    2004-01-01

    The Children Depression Inventory (CDI) is a multidimensional instrument that includes items of social withdrawal, anhedonia, asthenia, low self-esteem (internalized) and behavioral problems (externalized). Child depression has been related with low academic achievement, neurotic and introverted personality traits and social maladjustment defined…

  13. Addison’s Disease: A rare case report

    Directory of Open Access Journals (Sweden)

    Sanjay N. Agrawal

    2015-04-01

    Full Text Available A female patient presented with progressive weakness, asthenia and generalized hyperpigmentation. The characteristic hyperpimentation pointed towards possibility of Addison’s disease which was proved by markedly decreased plasma cortisol levels, hyponatremia and hyperkalemia. This could be one of the very few cases of Addison’s Disease reported.

  14. Postinfectious syndrome of convalescentsixodes tick-borne borreliosis

    Directory of Open Access Journals (Sweden)

    O. N. Sumlivaya

    2014-01-01

    Full Text Available The aim: to study the psycho-vegetative status of the quantitative contents of serotonin in blood platelets in patients after the Ixodes tick-borne borreliosis, to evaluate the clinical efficiency treatment by adamantilfenilamin of postinfection asthenia.Materials and methods: there was clinical supervision and inspection conducted of 118 convalescents borreliosis after a course of inpatient treatment. All patients were examined using psychovegetative tests. Platelet serotonin concentration levels were measured by enzyme immunoassay. For the treatment of postinfectious asthenia 36 convalescents received adamantilbromfenilamin in a dose of 100 mg for 25 days.Results: when tested convalescents marked change in indicators of emotional and personality disorders. Quantitative study of blood platelet serotonin content revealed a significant decrease in this indicator relative to control values. Study the correlations between obtained when testing the psycho-emotional parameters and platelet serotonin levels showed a negative correlation between serotonin and an indicator of reactive anxiety (R = -0,81, p <0,05. To correct these violations convalescents with severe asthenia postinfection were treated adamantilfenilamin. Established clinical efficacy contributing to the improvement of the quality of life.Conclusion: the research of neurotransmitter serotonin in patients during the convalescence period after borreliosis possible to evaluate the extent of potential damage to the nervous tissue in the inflammatory process and its involvement in the formation of anxiety and depressive symptoms. adamantilbromfenilamin can be recommended for rehabilitation patients with residual effects in the form of postinfectious asthenia.

  15. Persistent detection of Zika virus RNA in semen for six months after symptom onset in a traveller returning from Haiti to Italy, February 2016

    Science.gov (United States)

    Nicastri, Emanuele; Castilletti, Concetta; Liuzzi, Giuseppina; Iannetta, Marco; Capobianchi, Maria R; Ippolito, Giuseppe

    2016-01-01

    A man in his early 30s reported in January 2016 a history of fever, asthenia and erythematous rash during a stay in Haiti. On his return to Italy, ZIKV RNA was detected in his urine and saliva 91 days after symptom onset, and in his semen on day 188, six months after symptom onset. Our findings support the possibility of sexual transmission of ZIKV and highlight the importance of continuing to investigate non-vector-borne ZIKV infection. PMID:27541989

  16. Clinical experience of Professor WEI Xu-xing in treating DPN%韦绪性教授治疗糖尿病周围神经病变临证经验

    Institute of Scientific and Technical Information of China (English)

    郭素芳; 崔敏; 张爱玲; 韦绪性

    2012-01-01

      Professor WEI Xu-xing considers that diabetes is mainly because asthenia in origin and asthenia in superficiality. There are different types of deficiency on vital energy, blood, Yin and Yang, and the deficiency on both vital energy and blood was common. Asthenia in origin also has different types, stagnation of blood, and stagnation of phlegm, cold coagulation and pyretic arthralgia in collaterals. Deficiency and stagnation are promoting agents, while asthenia and impotency of qi and blood were the key points leading to appendicular muscles anaesthesia and aches. On the basis of the characteristics, deficiency of both vital energy and yin and stagnation of arteries and veins, the Xiaodan Tongbi decoction is effective in treating peripheral neuropathy of diabetes (DPN).%  韦绪性教授认为,本病乃本虚标实之证。本虚有气、血、阴、阳之不同,尤以气阴两虚为多见,标实则多为瘀血、痰阻、寒凝、燥热痹阻脉络。“虚”、“瘀”是本病的促进因素,气血“不荣”与“不通”并存是导致肢体肌肉麻木不仁、疼痛的关键。根据本病多为气阴两虚,脉络瘀阻证之特点,所研制的消瘅通痹汤治疗糖尿病周围神经病变效果显著。

  17. Comparing Voice Self-Assessment with Auditory Perceptual Analysis in Patients with Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Bauer, Vladimir

    2015-01-01

    Full Text Available Introduction Disordered voice quality could be a symptom of multiple sclerosis (MS. The impact of MS on voice-related quality of life is still controversial. Objectives The aim of this study was to compare the results of voice self-assessment with the results of expert perceptual assessment in patients with MS. Methods The research included 38 patients with relapse-remitting MS (23 women and 15 men; ages 21 to 83, mean = 44. All participants filled out a Voice Handicap Index (VHI, and their voice sample was analyzed by speech and language professionals using the Grade Roughness Breathiness Asthenia Strain scale (GRBAS. Results The patients with MS had significantly higher VHI than control group participants (mean value 16.68 ± 16.2 compared with 5.29 ± 5.5, p = 0.0001. The study established a notable level of dysphonia in 55%, roughness and breathiness in 66%, asthenia in 34%, and strain in 55% of the vocal samples. A significant correlation was established between VHI and GRBAS scores (r = 0.3693, p = 0.0225, and VHI and asthenia and strain components (r = 0.4037 and 0.3775, p = 0.012 and 0.0195, respectively. The female group showed positive and significant correlation between claims for self-assessing one's voice (pVHI and overall GRBAS scores, and between pVHI and grade, roughness, asthenia, and strain components. No significant correlation was found for male patients (p > 0.05. Conclusion A significant number of patients with MS experienced voice problems. The VHI is a good and effective tool to assess patient self-perception of voice quality, but it may not reflect the severity of dysphonia as perceived by voice and speech professionals.

  18. Comparing Voice Self-Assessment with Auditory Perceptual Analysis in Patients with Multiple Sclerosis

    Science.gov (United States)

    Bauer, Vladimir; Aleric, Zorica; Jancic, Ervin

    2014-01-01

    Introduction Disordered voice quality could be a symptom of multiple sclerosis (MS). The impact of MS on voice-related quality of life is still controversial. Objectives The aim of this study was to compare the results of voice self-assessment with the results of expert perceptual assessment in patients with MS. Methods The research included 38 patients with relapse-remitting MS (23 women and 15 men; ages 21 to 83, mean = 44). All participants filled out a Voice Handicap Index (VHI), and their voice sample was analyzed by speech and language professionals using the Grade Roughness Breathiness Asthenia Strain scale (GRBAS). Results The patients with MS had significantly higher VHI than control group participants (mean value 16.68 ± 16.2 compared with 5.29 ± 5.5, p = 0.0001). The study established a notable level of dysphonia in 55%, roughness and breathiness in 66%, asthenia in 34%, and strain in 55% of the vocal samples. A significant correlation was established between VHI and GRBAS scores (r = 0.3693, p = 0.0225), and VHI and asthenia and strain components (r = 0.4037 and 0.3775, p = 0.012 and 0.0195, respectively). The female group showed positive and significant correlation between claims for self-assessing one's voice (pVHI) and overall GRBAS scores, and between pVHI and grade, roughness, asthenia, and strain components. No significant correlation was found for male patients (p > 0.05). Conclusion A significant number of patients with MS experienced voice problems. The VHI is a good and effective tool to assess patient self-perception of voice quality, but it may not reflect the severity of dysphonia as perceived by voice and speech professionals. PMID:25992162

  19. 肾为先天之本与补肾中药对基因的影响分析%Kidney is the Congenital Base and the Analysis of the Effects of Kidney-strengthing Herbs on Gene

    Institute of Scientific and Technical Information of China (English)

    韩丽萍; 魏敏惠

    2003-01-01

    Dwells upon the theory in TCM-Kidney is the congenital base of the body \\ the relationship between kidney and heredity and the influence of kidney-strengthing herbs on the regulation of genes expression, analyses the main effect of kidney in TCM in the process of heredity and the interrelation between kidney and the regulation on genes,expression. This article is to probe into the essence of kidney asthenia in TCM according to the gene theory.

  20. A Case of Dyspnea in Pancreatic cancer Treated through Herbal Acupunture Treatment

    OpenAIRE

    2006-01-01

    Objective : This study planed to evaluate effect of oriental medicine therapy treatment method of dyspnea that happen from cancer of the pancreas patient who accompany Multiple metasis Methods : Patient complained dyspnoea during admission into dept . Of internal medicine, college of oriental medicine, Dong-eui Univ ,was appealed patient treated by Oriental medicine therapy that is of use Herb Medication and Herbal -acupuncture Treatment being diagnosed in lung asthenia including deficienc...

  1. Hereditární equinní regionální dermální astenie u koní využívaných pro hiporehabilitaci

    OpenAIRE

    Zrůstová, Jana

    2016-01-01

    This bachelor thesis is processed as a literary review, and its aim is to collect, study assessment of the current literature presented findings about disease Hereditary regional dermal asthenia in horses used for hiporehabilitation. Hiporehabilitation is a very valuable form of treatment and helps people with physical and mental health problems. It is very important though that the horse, which is an irreplaceable part of rehabilitations and theraphies, was as healthy as possible. Here...

  2. Work-related voice disorder

    OpenAIRE

    Paulo Eduardo Przysiezny; Luciana Tironi Sanson Przysiezny

    2015-01-01

    INTRODUCTION: Dysphonia is the main symptom of the disorders of oral communication. However, voice disorders also present with other symptoms such as difficulty in maintaining the voice (asthenia), vocal fatigue, variation in habitual vocal fundamental frequency, hoarseness, lack of vocal volume and projection, loss of vocal efficiency, and weakness when speaking. There are several proposals for the etiologic classification of dysphonia: functional, organofunctional, organic, and work-related...

  3. [Fibromyalgia syndrome].

    Science.gov (United States)

    Naranjo Hernández, A; Rodríguez Lozano, C; Ojeda Bruno, S

    1992-02-01

    The Fibromialgia Syndrome (FS) is a common clinical entity which may produce symtoms and signs related to multiple fields of Medicine. Typical clinical characteristics of FS include extensive pain, presence of sensitive points during exploration, morning stiffness, asthenia and non-refresing sleep. Frequently, associated rheumatologic diseases are observed, as rheumatoid arthritis, osteoarthrosis and vertebral disorders. In FS, complementary tests are usually normal. The most widely accepted hypothesis suggests that this is a disorder affecting modulation of pain sensitivity.

  4. Persistent detection of Zika virus RNA in semen for six months after symptom onset in a traveller returning from Haiti to Italy, February 2016.

    Science.gov (United States)

    Nicastri, Emanuele; Castilletti, Concetta; Liuzzi, Giuseppina; Iannetta, Marco; Capobianchi, Maria R; Ippolito, Giuseppe

    2016-08-11

    A man in his early 30s reported in January 2016 a history of fever, asthenia and erythematous rash during a stay in Haiti. On his return to Italy, ZIKV RNA was detected in his urine and saliva 91 days after symptom onset, and in his semen on day 188, six months after symptom onset. Our findings support the possibility of sexual transmission of ZIKV and highlight the importance of continuing to investigate non-vector-borne ZIKV infection.

  5. A rare case of watermelon stomach in woman with continuous ambulatory peritoneal dialysis and systemic lupus erythematosus.

    Science.gov (United States)

    Jinga, Mariana; Checheriţă, I A; Becheanu, G; Jinga, V; Peride, Ileana; Niculae, A

    2013-01-01

    We report a case of a 42-year-old woman with systemic lupus erythematosus and chronic kidney disease stage 5 undergoing continuous ambulatory peritoneal dialysis, presenting asthenia, dizziness, abdominal pain and small efforts dyspnea. After a complete physical and clinical examination, including laboratory tests, esophagogastroduodenal endoscopy and gastric lesions biopsy, she was diagnosed with gastric antral vascular ectasia. We are facing a rare case of antral vascular ectasia in a patient associating both chronic kidney disease and autoimmune disease.

  6. Muscle damage induced by black cohosh (Cimicifuga racemosa).

    Science.gov (United States)

    Minciullo, P L; Saija, A; Patafi, M; Marotta, G; Ferlazzo, B; Gangemi, S

    2006-01-01

    Extracts of black cohosh (Cimicifuga racemosa) are commonly used for the treatment of symptoms associated with menopause. Adverse events with black cohosh are rare, mild and reversible. A few number of serious adverse events, including hepatic and circulatory conditions, have been also reported, but without a clear causality relationship. We report the case of a woman with severe asthenia and very high blood levels of creatine phosphokinase and lactate dehydrogenase. The patient referred to take a dietary supplement derived from black cohosh for ameliorating menopause vasomotor symptoms. To exclude a possible involvement of this product, the patient was suggested to discontinue this therapy. After suspicion the patient showed a progressive normalization of biochemical parameters and improvement of clinical symptoms. We can hypothesise a causative role for black cohosh in the muscle damage observed in this patient. Factors suggesting an association between black cohosh and the observed myopathy included the temporal relationship between use of herbal product and asthenia and the absence of other identified causative factors. Rechallenge with the suspected agent was inadvisable for ethic reasons because of the risk of a serious relapse. This is the first time that asthenia associated with high muscle enzymes serum levels by black cohosh has been reported. In our opinion, this report is of interest because of the widespread diffusion of use of black cohosh as an alternative medicine for relief from menopausal symptoms.

  7. How to Treat Pain in the Hepatic Region Due to Chronic Hepatitis?

    Institute of Scientific and Technical Information of China (English)

    林宗广

    2004-01-01

    @@ Chronic viral hepatitis type B and C both have the symptoms of pain in the hepatic region, asthenia, poor appetite, abdominal fullness, among which pain in the hepatic region is the most commonly seen. According to the author's clinical experience, treatment based on accurate TCM differentiation can not only eliminate pain in the hepatic region but also restore the hepatic function at the same time. Differentiation includes analysis of the nature of the hepatic pain and the accompanying symptoms, and the treatment is aimed at the differentiated symptoms. The following are methods of treatment.

  8. Psychosis as a late manifestation of Sheehan's syndrome.

    Science.gov (United States)

    Reddy, Mukku Shiva Shanker; Nahar, Abhinav; Thippeswamy, Harish; Kumar, Chaturvedi Santosh

    2017-02-01

    Sheehan's syndrome occurs as a result of ischemic pituitary necrosis due to severe postpartum haemorrhage. It is one of the most common causes of hypopituitarism in underdeveloped or developing countries. Characteristic manifestations include failure to lactate or to resume menses, genital and axillary hair loss, asthenia and weakness, fine wrinkles around the eyes and lips, signs of premature aging, dry skin, hypopigmentation and other evidence of hypopituitarism. Uncommonly it can present with psychosis. There are only few case reports of psychoses in patients with Sheehan's syndrome. Our case report illustrates the relationship between psychosis and Sheehan's syndrome. The treatment challenges in managing Sheehan's syndrome and psychosis are discussed.

  9. [Asthenic syndrome in patients with burnout syndrome].

    Science.gov (United States)

    Chutko, L S; Surushkina, S Iu; Rozhkova, A V; Nikishena, I S; Iakovenko, E A

    2013-01-01

    The authors present the results of a survey of 103 patients aged 25 to 45 years with burnout syndrom. The results showed that most patients with the syndrome of burnout have clinical manifestations of asthenia, varying degrees of severity. According to psychological and psychophysiological examination in this group of patients were found attention and memory dysfunction. This study evaluated the efficacy of memoplant in the treatment of this pathology. The high efficiency of memoplant (improvement in 69.7% of cases) was detected, confirmed by the data of the clinical, psychological and neuropsychological research.

  10. Mechanism of the inhibitory effect of endogenous histamine on epilepsy in rats

    Institute of Scientific and Technical Information of China (English)

    ChenZhong

    2004-01-01

    Clinical data demonstrated that long-term epilepsy, especially among children, or ingesting anticonvulsant drugs over time are likely to result in cognitive deficits (e. g. memory or attention problems as well as other CNS side effects such as psychomotor speed abnormalities, somnolence, asthenia, and dizziness. New drug therapy has been expected. The histaminergic neuron system seems to be involved in various physiological and behavioral functions including sleep - wake cycles, stress behavior, neuroendocrine, learning and memory through histamine HI, H2 and H3 receptors. The role of brain histamine in regulating seizure susceptibility has been studied, and a possible anticonvulsant action of endogenous histamine has been postulated

  11. Clinical studies of patients with peptic ulcer TCM constitution%消化性溃疡患者中医体质的临床研究

    Institute of Scientific and Technical Information of China (English)

    徐瑾; 刘军

    2014-01-01

    Objective To investigate the clinical characteristics of TCM constitution in patients with peptic ulcer. Methods Used the cross-sectional study method, through the questionnaire survey to collect the general situation of patients and determine physical type. Descriptive analysis and χ2 test and other sstatistical methods to analyze the law of patient’s TCM constitution,as well as the relevance of Hp infection, diet etc. Results Patients with constitution of yang asthenia were the most, accounting for 21.5%. There were significant differences in infecting Hp, which between patients of constitution of yang asthenia and others (P<0.05). In the warm food for a significant difference between the two(P<0.01). Conclusion Constitution of yang asthenia is multiple physical in the patients, and it is susceptible to Hp. There is a certain correlation between fitness and diet. In future work should focus on prevention and treatrment of the patients who have constitution of yang asthenia.%目的:探讨消化性溃疡患者中医体质的临床特点。方法采用横断面研究方法,通过调查问卷收集患者的一般情况、判断体质类型,采用描述性分析、χ2检验等统计学方法,分析消化性溃疡患者体质的分布规律及其与Hp感染、饮食等的相关性。结果消化性溃疡患者体质以阳虚质患者最多,占21.5%,阳虚质患者较非阳虚患者感染Hp有显著差异(P<0.05)。在温热饮食方面,阳虚质患者与非阳虚患者存在差异(P<0.01)。结论阳虚质为消化性溃疡的易感体质,且易感染Hp。体质与饮食有一定的相关性。在今后的防治工作中应重点关注阳虚质人群。

  12. Micronodular inflammatory pseudotumor of the liver presenting in a patient with hemochromatosis; Presentacion en forma micronodular de seudotumor inflamatorio hepatico en un paciente con hemocromatosis

    Energy Technology Data Exchange (ETDEWEB)

    Sanchez, F.; Ysamat, R.; Canis, M. [H. R. U. Reina Sofia. Cordoba (Spain); Roman, G. [Hospital Infant Margarita. Cabra Cordoba (Spain)

    1999-07-01

    Inflammatory pseudotumor is a benign lesion of unknown etiology that is characterized histologically by a chronic inflammatory infiltrate and fibroblast proliferation. The presenting signs include pain in right upper quadrant, palpable mass or hepatomegaly, fever asthenia and weight loss. Ultrasonography and computed tomography show a solitary mass. The presence of more than one lesion is uncommon and the masses generally measure more than 2 cm. We present a case of diffuse micronodular inflammatory pseudotumor of the liver in a patient with cirrhosis of the liver secondary to hemochromatosis. (Author) 8 refs.

  13. Fibromyalgia syndrome: definition and diagnostic aspects

    Directory of Open Access Journals (Sweden)

    A. Alciati

    2011-09-01

    Full Text Available Although the term “fibromyalgia” (FM is relatively new, the condition characterised by chronic musculoskeletal pain that is accompanied by numerous extra-skeletal symptoms has been described in the medical literature for many years under different names. The term “fibrositis,” which was originally used in 1904 by Sir William Gowers to define a type of lumbalgia, became a synonym for diffuse musculoskeletal pain until 1976 (1. In the mid-1970s, Smythe and Moldofsky used the term “fibrositic syndrome” to describe the presence of tender points (TPs, sleep disturbances and other accompanying symptoms such as asthenia...

  14. Residual tissue post splenectomy detected by splenic scintillography with erythrocytes damaged by heat; Tejido residual postesplenectomia detectado por centellografia esplenica con eritrocitos danados por calor

    Energy Technology Data Exchange (ETDEWEB)

    Rivera B, B.; Garcia C, E.S.; Garcia O, J.R. [Centro Medico ABC, Departamento de Medicina Nuclear, Mexico, D.F. (Mexico)

    2005-07-01

    Feminine of 26 years old with diagnostic of purple thrombocytopenic idiopathic to those 4 years of age, tried with steroids and splenectomy at 11 years old. Pathway practically asymptomatic until 4 months ago she had presented asthenia, adynamia and general uneasiness, with platelet figures of 40,000 plat/microliter. It was carried out scintillographic study with damaged erythrocytes for post surgical remainder search. Its were took two-dimensional images and tomography by single photon emission (SPECT), being knitted splenic residual in area of anatomical projection of the spleen. (Author)

  15. A case of suspect “cyanosis”

    Directory of Open Access Journals (Sweden)

    Elisabetta Antonucci

    2013-05-01

    Full Text Available CLINICAL CASE A 70-year old woman was admitted to our hospital because of fever, asthenia and a suspected stroke. Her medical history showed a congenital cardiopathy (Patent Foramen Ovale, PFO. Skin and oral mucosa pigmentation, orthostatic hypotension, hypoglycemia and hyponatriemia arose the suspect of Addison’s disease. The diagnosis was confirmed by the evaluation of basal levels of plasma ACTH and serum cortisol, and serum cortisol levels after ACTH stimulation. Abdominal CT scan showed atrophy and calcification of adrenal glands. CONCLUSIONS In most cases, Addison’s disease is provoked by autoimmune destruction of the adrenal cortex; however, in our reported patient, tuberculosis could be a possible cause.

  16. New Line of Investigation in Rehabilitation of Patients Suffered from Hemorrhagic Fever with Renal Syndrome

    Directory of Open Access Journals (Sweden)

    G. M. Khasanova

    2011-01-01

    Full Text Available A new educational program for patients suffered from hemorrhagic fever with renal syndrome was worked out and applied into practice for the first time. It was revealed that patient teaching increased patient complianceand improved rehabilitation results for sure. Asthenia symptoms, arterial hypertension and inflammatory processes in uringenital system were recorded more rarely with such patients for certain. The efficiency of this educational program in combined rehabilitation after cases of hemorrhagic fever with renal syndrome proves its advisability of wide application in medical and preventive treatment institutions.

  17. Wuji Baifeng Wan White Phoenix Bolus of Black-Bone Chicken 乌鸡白凤丸

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@*Source It is a modified recipe from "Shoushi Baoyuan" (Preserving Essence to Extending Life-span) by Gong Tingxian of Ming Dynasty in beginning of 17th century, the imperial hospital listed as specific drug for royal palace. Carried in Pharmacopoeia of P.R.China (1995 Edition) *Chief Ingredients Black-bone chicken, Antler glue, Turtle shell, Oyster shell, Mantis egg-case, Ginseng root, Milkvetch root, Chinese angelica root, White peony root, Nutgrass flatsedge rhizome, Lucid asparagus root, Licorice root, Rehmannia root, Prepared rehmannia root, Chuanxiong rhizome, Stellaria root, Red sage root, Chinese yam, Gordon euryale seed, Deglued antler powder. *Explanation The black-bone chicken can replenish Liver and Kidney, Qi and blood, serve as principal drug; Antler glue, Mantis warm Kidney Yang while Turtle and Oyster shell, Asparagus, Stellaria nourish Yin to clear asthenia heat, Ginseng, Milkvetch, Yam, Licorice, Euryale tonify Spleen Qi, and Chinese angelica, Chuanxiong, Peony, Rehmannia, Red sage replenish blood and regulate menstruation. *Function Replenishing Qi and nourishing blood, regulating menstruation and arresting vaginal discharge *Indication Deficiency of both Qi and blood, pathological wasting and asthenia, aching and weak loins and knees, irregular menstruation, metrorrhagia metrostaxis, leukorrhagia

  18. Wuji Baifeng Wan White Phoenix Bolus of Black-Bone Chicken

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    *Source It is a modified recipe from "Shoushi Baoyuan" (Preserving Essence to Extending Life-span) by Gong Tingxian of Ming Dynasty in beginning of 17th century, the imperial hospital listed as specific drug for royal palace. Carried in Pharmacopoeia of P.R.China (1995 Edition)  *Chief Ingredients Black-bone chicken, Antler glue, Turtle shell, Oyster shell, Mantis egg-case, Ginseng root, Milkvetch root, Chinese angelica root, White peony root, Nutgrass flatsedge rhizome, Lucid asparagus root, Licorice root, Rehmannia root, Prepared rehmannia root, Chuanxiong rhizome, Stellaria root, Red sage root, Chinese yam, Gordon euryale seed, Deglued antler powder.  *Explanation The black-bone chicken can replenish Liver and Kidney, Qi and blood, serve as principal drug; Antler glue, Mantis warm Kidney Yang while Turtle and Oyster shell, Asparagus, Stellaria nourish Yin to clear asthenia heat, Ginseng, Milkvetch, Yam, Licorice, Euryale tonify Spleen Qi, and Chinese angelica, Chuanxiong, Peony, Rehmannia, Red sage replenish blood and regulate menstruation.  *Function Replenishing Qi and nourishing blood, regulating menstruation and arresting vaginal discharge  *Indication Deficiency of both Qi and blood, pathological wasting and asthenia, aching and weak loins and knees, irregular menstruation, metrorrhagia metrostaxis, leukorrhagia……

  19. 治白屑头风痒的敦煌古医方考析%Investigation and Analysis of Dunhuang Ancient Decoction for Treatment of Seborrhea Dermatitis

    Institute of Scientific and Technical Information of China (English)

    王凤仪; 赵党生

    2015-01-01

    Objective: The prescription principles of 5 ancient decoctions selected from Dunhuang inherited medical literatures for treating seborrhea dermatitis were analyzed in the paper to define the main diseases the decoc-tions treated, including seborrhea dermatitis, tinea capitis and alopecia areata. The syndromes can be classified into asthenia and sthenia and the prescription should be chosen according to diseases and syndromes differentiation as well as identification of the sthenia and asthenia.%分析了敦煌遗书医药文献中涉及治疗白屑头风痒类疾病的5首古医方的组方含义,明确了5首敦煌古医方主治疾病包括白屑风、白秃疮、油风。证型可分虚实两大类,临床应当辨病辨证、分别虚实而择方使用。

  20. Clinical management of carbamazepine intoxication during anti-tubercular treatment: a case report

    Directory of Open Access Journals (Sweden)

    Massimo Calderazzo

    2015-06-01

    Full Text Available We describe a 67-year-old man with medical history of focal post-stroke seizure and type 2 diabetes mellitus treated with carbamazepine, clobazam, gliclazide, insulin glargine, and omeprazole we visited for the onset in the last 7 days of asthenia, cough with mucus, breathing difficulty, chest pain, and weight loss. After clinical and laboratory tests, pulmonary tuberculosis was diagnosed, and a treatment with isoniazid, ethambutol, pyrazinamide rifampicin, and pyridoxine was started. Therapeutic drug monitoring of tuberculosis treatment documented that all drugs were in normal therapeutic range. Four days after the beginning of the treatment, we documented the improvement of fever, and three days later the patient showed sleepiness, visual disorder and asthenia. Clinical and pharmacological evaluation suggested a carbamazepine toxicity probably related to a drug interaction (Drug Interaction Probability Scale score = 6. The impossibility to switch carbamazepine for another antiepileptic drug, due to a resistant form of seizure, induced the discontinuation of tuberculosis treatment, resulting in the normalization of serum carbamazepine levels in one day (10 µg/ml and in the worsening of fever, requiring a new clinical and pharmacological evaluation. The titration dosage of carbamazepine and its therapeutic drug monitoring allowed to continue the treatment with both antitubercular drugs and carbamazepine, without the development of adverse drug reactions. To date, tuberculosis treatment was stopped and clinical evaluation, radiology and microbiology assays documented the absence of tubercular infection and no seizures appeared (carbamazepine dosage 800 mg/bid; serum levels 9.5 µg/ml.

  1. Geng Jianguo's Experiences in Syndrome Differentiation%耿建国寒热辨证经验举隅

    Institute of Scientific and Technical Information of China (English)

    崔民英; 朱智耀; 耿建国

    2015-01-01

    耿建国教授提倡继承中医辨证论治思维,学术上法于仲景,师古而不泥于古,强调从整体上把握病家的阴阳盛衰、寒热虚实变化,强调上下两纲在辨证论治过程中的重要性,立法处方则以调整阴阳平衡为根本法则,因而能执简驭繁,卓有疗效。耿建国教授认为,临床辨证论治应当以阴阳为总纲,通过四诊合参,分析病家的寒热、虚实、上下等方面的属性,来归纳阴阳的变化,从而使阴阳由抽象到具体,再由具体到抽象。%Professor Geng advocates to inherit traditional thoughts of syndrome differentia-tion. His theory comes from Zhongjing but not limited by him. He emphasizes on differentiating the variation of Yin and Yang,cold and hot,asthenia and sthenia. He also emphasizes on the importance of basic program up and down in syndrome differentiation. He holds that regulating the yin - yang balance is the cardinal prin-ciple for prescription,which can help us to solve complex problems in a simple but efficient way. Professor Geng Jianguo puts forward Yin and Yang as the basic target in syndrome differentiation. Gathering information of cold and hot,asthenia and sthenia,up and down from patients by the Four Diagnostics,analyzing and indu-cing the change of Yin and Yang maKe the concretization of Yin and Yang,and also the abstraction for it. In this paper,some of Professor Geng Jianguo's experiences in syndrome differentiation are summarized,inclu-ding classical theories and clinical examples,which showed how to analyze and induce the change of yin and yang by differentiating cold and hot,asthenia and sthenia,up and down from patients.

  2. 参苓白术散在妇产科腹部手术后康复治疗中的影响%Effect of Shenlingbaizhu powder on rehabilitation therapy of patients after obstetric and gynecological abdominal surgery

    Institute of Scientific and Technical Information of China (English)

    贺慧蕾; 高飞雁; 阳盛华

    2009-01-01

    To observe the clinical application of Shenlingbaizhu powder in the rehabilitation therapy of patients after obstetric and gynecological abdominal surgery. Methods: 100 patients undergoing obstetric and gynecological abdominal surgery were divided into observation group (50 cases) and control group (50 cases) randomly, all the cases received anti-infection and fluid replacement treat-ment. On the second day after surgery, the cases in observation group were administrated Shenlingbaizhu powder orally. The levels of C-re-active protein, IgA, IgG, IgM and symptomatic score of splenic asthenia were observed pre-operative and post-operative 24 hours and the fifth day after surgery. Results: Shenlingbaizhu powder improved the symptomatic score of splenic asthenia and the IgM level in peripheral blood, reduced the C-reactive protein level, but the levels of alexin3, alexin4, IgA and IgG changed indistinctively before and after the surgery. Conclusion: Shenlingbaizhu powder can improve the symptomatic score of splenic asthenia and immunity of patients, relieve the posttraumatic stress and immunosuppressive reaction.%目的:研究参苓白术散在促进妇产科腹部手术后康复治疗中的临床作用.方法:对100例妇产科腹部手术病例按随机配对分为观察组和对照组,各50例,两组均行围手术期抗感染补液治疗.研究组在术后第二天开始口服参苓白术散汤剂,对照组为空白组,术后不加用中药.观察术前、术后24 h及术后第5天C反应蛋白、IgA、IgG、IgM,中医脾虚夹湿症候评分.结果:参苓白术散汤剂可减轻术后脾虚夹湿证评分,提高术后外周血IgM含量,降低术后C反应蛋白含量,对提高术后血补体3、补体4、IgA、IgG含量无显著变化.结论:参苓白术散改善术后脾虚夹湿证症候,提高妇产科腹部手术术后病人的免疫力,减轻手术创伤带来的应激及免疫抑制反应.

  3. Analysis on Pathogenesis Theory of Coronary Heart Disease in Modern Chinese Medicine---Literatures Based on National and Ministerial and Provincial Scientific Researches above Second Prize%冠心病中医病因病机学说分析--基于省部级二等奖以上科技成果的文献分析

    Institute of Scientific and Technical Information of China (English)

    卢红蓉

    2014-01-01

    In order to study the coronary heart disease pathogenesis theories in modern Chinese medicine,the author researched the lit-eratures on national science and technology progress winning provincial and ministerial scientific research achievement above the second prize in diagnosis and treatment of coronary heart disease under the guidance of the theory of traditional Chinese before 2012.The results showed 33 scientific research achievement and 149 related papers.Coronary heart disease pathogenesis theory had a bigger development with representative views of blood stasis,blood stasis and toxin,phlegm and blood stasis,phlegm and blood stasis of spleen,spleen and stomach relation,collateral disease,blood stasis included Qi deficiency and blood stasis,Yang deficiency and blood stasis,Qi stagna-tion and blood stasis,phlegm and stasis of different types.Pathogenesis of various theories had different focus on asthenia of healthy qi, or asthenia of pathogenic factors,but their essence were consistent,and stressed coronary heart disease was asthenia healthy qi and as-thenia pathogenic factor syndrome.%作者为总结现代以来中医诊治冠心病的基本规律和各家特点,提炼和阐明中医诊治冠心病的基本理论框架,开展中医诊治冠心病的学术调研。作为调研内容之一,首先就2012年以前,在中医理论指导下诊治冠心病并获得国家科技进步奖或省部级二等奖以上的科技成果进行文献调研。文献调研的初步结果表明:有相关科技成果33项,期刊论文149篇。关于冠心病的病因病机,代表性学说有血瘀说、瘀毒从化说、痰瘀互结说、心脾痰瘀相关说、脾胃相关说、络病说等。其中,血瘀说又有气虚血瘀、阳虚血瘀、气滞血瘀、痰阻血瘀等不同类型。上述病机学说,有侧重正虚、邪实的差异,共同点是均强调冠心病为本虚标实之证,并据此开展了不同角度的临床和基础研究。

  4. Bilineal Acute Leukemia Associated With Fanconi Syndrome: The First Case Report

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    Ghasem Miri-Aliabad

    2016-05-01

    Full Text Available Fanconi syndrome is a metabolic disorder involving dysfunction of the renal proximal tubules, resulting in excessive urinary excretion of several metabolites. Various factors may lead to Fanconi syndrome, as it may be a genetic disease with primary or secondary etiologies, or may be acquired. In this study, we report a unique case of Fanconi syndrome with development of a relatively rare acute leukemia, a condition that has not been reported before. The case was an 8-year-old boy with familial occurrence of Fanconi syndrome, presenting with pallor, asthenia, recurrent infections, growth failure, and a variety of biochemical and hematological abnormalities. After physical examination, radiographic studies, and comprehensive laboratory analyses, Fanconi syndrome associated with bilineal acute leukemia, of myeloid and T-lymphoid lineages, was diagnosed.

  5. OUTBREAK OF ZIKA VIRUS DISEASE AND ITS COMPLICATIONS

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    Gabriela S. Tsankova

    2016-07-01

    Full Text Available Zika virus (ZIKV is an arbovirus from Flaviviridae family, genus Flavivirus. Like most of the viruses which belong to the Flavivirus genus, it replicates in and is transmitted by mosquitoes. Unlike other arbovirus infections including dengue and chikungunya, Zika virus causes a relatively mild disease. The most common symptoms of ZIKV are mild fever, arthralgia, myalgia, headache, asthenia, abdominal pain, oedema, lymphadenopathy, retro-orbital pain, conjunctivitis, and cutaneous maculopapular rash, which last for several days to a week. Although 80% of the cases with ZIKV are asymptomatic, severe complications such as microcephalia and GBS may be observed. This explains why ZIKV is more dangerous that it was thought to be and why it rapidly evolves in unexpected challenge for the international and national public health authorities.

  6. Fatigue and interleukin-6 - a multi-faceted relationship.

    Science.gov (United States)

    Grygiel-Górniak, Bogna; Puszczewicz, Mariusz

    2015-01-01

    Many connective tissue diseases are characterized by fatigue, which is described in the literature as prostration, weakness, lassitude or asthenia. In many other diseases (autoimmune, neurologic or metabolic) fatigue impinges on daily activities and thus influences the quality of life. Different molecular backgrounds are involved in the development of fatigue. Not only does the immunosuppressive treatment of autoimmune diseases reduce fatigue, but also selective nutritional components may have an effect on secretion of cytokines which are responsible for development of the sensation of tiredness (e.g. secretion of interleukin-6). The beneficial influence of selected food components (such as polyunsaturated omega-3 fatty acids, nutritional antioxidants or adequate fat intake with the diet) on proinflammatory cytokine secretion has been demonstrated in many studies. In this review, the biochemical, neurological and nutritional aspects of fatigue in autoimmune diseases are underlined.

  7. A strange case of Evans syndrome

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    Manuel Monti

    2013-12-01

    Full Text Available Evans syndrome is a rare autoimmune disease presenting hemolytic anemia, thrombocytopenia and/or neutropenia. It may be associated with other autoimmune or lymphoproliferative diseases. It can have an extremely serious disease course and, in rare cases, this can even be life-threatening. First-line treatment consists of steroids and/or immunoglobulin. Further therapy with rituximab, vincristine, cyclophosphamide and other immunosuppressive drugs can be considered in unresponsive patients. We report a case of Evans syndrome in a 54-year old woman admitted to the Emergency Department (ED for asthenia. Etiopathogenic, clinical, therapeutic and evolutive aspects are discussed. In contrast to many cases described in the literature, our patient had a satisfactory response to corticoids. We also discuss how to make a specific diagnosis, even in a suburban ED with limited resources, in order to admit patients to the appropriate hospital department and allow the correct therapy to be started as early as possible.

  8. Splenic infarction associated with sorafenib use in a hepatocellular carcinoma patient

    Institute of Scientific and Technical Information of China (English)

    Sang Ock Kim; Sang Young Han; Yang Hyun Baek; Sung Wook Lee; Ji Sun Han; Byung Geun Kim; Jin Han Cho; Kyung Jin Nam

    2011-01-01

    Sorafenib, a multitargeted tyrosine kinase inhibitor, has been shown to improve survival in patients with advanced hepatocellular carcinoma (HCC). As the clinical use of sorafenib increases, many adverse effects have been reported, such as hand-foot skin reaction, diarrhea,anorexia, asthenia, alopecia, weight loss, hypertension and arterial thromboembolism. However, there are no prior reports of splenic infarction as an adverse effect of sorafenib. Here, a case of splenic infarction in a patient with HCC who was treated with sorafenib is reported.The patient had no other predisposing factors to explain the splenic infarction except for the administration of sorafenib. The splenic infarction improved after sorafenib was discontinued; however, the HCC progressed.

  9. 安徽脊髓小脑性共济失调患者基因型与中医证型相关性%Relationship between Genotypes and Traditional Chinese Medicine Syndromes in Spinocerebellar Ataxia Patients from Anhui Province

    Institute of Scientific and Technical Information of China (English)

    程楠; 赵静; 王训; 喻绪恩; 胡纪源; 韩咏竹; 杨任民

    2012-01-01

    目的 通过探讨脊髓小脑性共济失调(spinocerebellar ataxia,SCA)患者基因型与中医证型的关系,为SCA的辨证客观化提供依据.方法 检测59例来自安徽地区的家族性或散发性SCA患者的基因型,以30例无血缘关系的健康人为对照.对这些SCA患者进行辨证分型,分析其基因型与中医证型的相关性.结果 本组59例SCA患者有17例检出SCA3基因亚型,有7例检出SCA1基因亚型.上述患者中医证型表现为肾精亏虚型、脾肾两虚型、肝肾阴虚型、肾虚血瘀型4种,且以肾精亏虚型和脾肾两虚型为主.其中SCA3基因亚型患者与脾肾两虚型相关,而SCA1基因亚型患者与上述证型均无相关性.结论 研究初步证实,不同基因亚型的SCA患者与中医证型可能存在相关性,SCA患者不同的中医证型应有其相应的分子基础.%Objective To provide a basis for the objectification of syndrome-differentiation in spinocerebellar ataxia (SCA) patients, via studying the relationship between genotypes of SCA and traditional Chinese medicine (TCM) syndromes. Methods A total of 59 familial or sporadic SCA patients from Anhui province were collected according to inclusion criteria, and their SCA genotypes were detected, and other 30 unrelated healthy people served as controls. Their TCM syndrome types were differentiated, and the relationship between SCA genotypes and TCM syndrome types were analyzed. Results Of 59 SCA patients,17 were diagnosed as SCA3 genotype, and 7 as SCA1 genotype. Four TCM syndrome types were found among these patients, including kidney essence deficiency, asthenia of both spleen and kidney, asthenia of both kidney-yin and liver-yin, and kidney deficiency complicated with blood stasis, with kidney essence deficiency and asthenia of both spleen and kidney being the most common types. The SCA3 genotype was significantly related to asthenia of both spleen and kidney, while SCA1 genotype did not correlate with any of the four TCM

  10. Hemolytic uremic syndrome as a primary manifestation of acute human immunodeficiency virus infection.

    Science.gov (United States)

    Gomes, A M; Ventura, A; Almeida, C; Correia, M; Tavares, V; Mota, M; Seabra, J

    2009-05-01

    Hemolytic uremic syndrome may be associated with human immunodeficiency virus infection but it occurs in advanced stages of human immunodeficiency virus disease. As in other forms of hemolytic uremic syndrome plasmapheresis seems to be the treatment of choice. The authors present an unusual case of hemolytic uremic syndrome associated with acute human immunodeficiency virus infection in a 38 year-old black male. The patient was admitted with fever, asthenia, nausea, diarrhea, and reduced urinary output. He was found to have anemia, thrombocytopenia and severe renal failure. Hemolytic uremic syndrome was diagnosed and he was started on plasmapheresis and hemodialysis. Serological tests were consistent with acute human immunodeficiency virus infection: the enzyme linked immunosorbent assay for human immunodeficiency virus was weakly positive, Western Blot test was negative and human immunodeficiency virus RNA quantification was positive, with > 1,000,000 copies/microl. After 4 daily treatment sessions, patient's clinical condition improved and hemoglobin, platelets, lactic dehydrogenase and renal function normalized.

  11. [Technical guidelines for the prevention, diagnosis and treatment of Zika virus infection].

    Science.gov (United States)

    Barrera-Cruz, Antonio; Díaz-Ramos, Rita Delia; López-Morales, Ana Belem; Grajales-Muñiz, Concepción; Viniegra-Osorio, Arturo; Zaldívar-Cervera, Jaime Antonio; Arriaga-Dávila, José Jesús

    2016-01-01

    Infection Zika virus is an emerging disease in the Americas region, which is caused by Zika virus (ZIKV), an arbovirus of the flavivirus genus. The ZIKV is transmitted by the bite of Aedes mosquitoes, both in urban and jungle area. After the mosquito bite, the disease symptoms usually appear after an incubation period of three to twelve days. The infection may be asymptomatic or presented with fever and not purulent conjunctivitis, headache, myalgia, arthralgia, asthenia, maculopapular rash, edema in lower limbs and, less frequently, retro-orbital pain, anorexia, vomiting, diarrhea or pain abdominal. Symptoms last for 4-7 days and are self-limiting. Neurological and autoimmune complications are rare. Since 2014 it has been detected native circulation of Zika virus in the Americas. So far, there is no specific antiviral treatment or effective vaccine, so it's giving priority symptomatic and supportive treatment for the acute phase and make an early diagnosis of atypical and severe forms.

  12. Health care of people at work. Workers exposed to lead. I. Inorganic lead

    Energy Technology Data Exchange (ETDEWEB)

    Waldron, H.A.

    1978-01-01

    The risks associated with exposure to inorganic lead and the means by which these risks can be minimized are outlined. Lead is used to make a variety of metal products, the grids and oxides in storage batteries, pigments, chemicals, and also for lead plating. In the United States about 70% of the total lead consumption is related to transportation. Uptake of inorganic lead is by ingestion and inhalation. About 90% of the total body burden of lead is contained within the skeletal tissues. Lead is excreted in the kidney, in sweat, and in milk. Toxic effects are directed against the blood, the nervous system, and the kidney. Symptoms of lead poisoning are abdominal pain, constipation, vomiting, asthenia, paresthesia, psychological symptoms, and diarrhea. Physical and biological monitoring can serve to protect workers. Diagnosis of lead poisoning is not easy. Treatment involves removal from exposure and/or treatment with a chelating agent.

  13. [Syndrome overlap: autoimmune hepatitis and autoimmune cholangitis].

    Science.gov (United States)

    Guerra Montero, Luis; Ortega Alvarez, Félix; Marquez Teves, Maguin; Asato Higa, Carmen; Sumire Umeres, Julia

    2016-01-01

    Autoimmune hepatitis, primary biliary cirrhosis, primary sclerosing cholangitis and autoimmune cholangitis are chronic autoimmune liver disease, usually present separate, the cases where characteristics of two of the above is observed liver disease is commonly referred to as Overlap Syndromes (OS). Although there is no consensus on specific criteria for the diagnosis of OS identification of this association is important for initiating appropriate treatment and prevent its progression to cirrhosis or at least the complications of cirrhosis and death. We report the case of awoman aged 22 cirrhotic which debuted are edematous ascites, severe asthenia and jaundice compliant diagnostics SS criteria and initially present any response to treatment with ursodeoxycholic acid and oral corticosteroids, but ultimately finished performing a transplant orthotopic liver.

  14. Regorafenib: A novel tyrosine kinase inhibitor: A brief review of its therapeutic potential in the treatment of metastatic colorectal carcinoma and advanced gastrointestinal stromal tumors

    Directory of Open Access Journals (Sweden)

    P Thangaraju

    2015-01-01

    Full Text Available Regorafenib is a novel oral multitargeted tyrosine kinase inhibitor having both antitumor and anti-angiogenic activities. Regorafenib was recently approved by US Food and Drug Administration in February 25, 2013 in the treatment for patients with advanced gastrointestinal stromal tumor and for the treatment of patients with metastatic colorectal carcinoma after disease progression or intolerance to imatinib mesylate and sunitinib therapy. Oral regorafenib demonstrates a high level of efficacy with acceptable tolerability with the 160 mg daily for 3 weeks followed by 1 week off schedule; a continuous schedule could be of interest. Hypertension, mucositis, hand foot skin reaction, diarrhea and asthenia are the most common side-effects. Regardless of these encouraging results, studies investigating, adjuvant and neoadjuvant settings are awaited, as well as trials using regorafenib in combination with chemotherapy or other targeted therapies. Clinical trials investigating regorafenib in other tumor types are ongoing.

  15. First report of orchitis in man caused by Brucella abortus biovar 1 in Ecuador.

    Science.gov (United States)

    Ron-Román, Jorge; Saegerman, Claude; Minda-Aluisa, Elizabeth; Benítez-Ortíz, Washington; Brandt, Jef; Douce, Richard

    2012-09-01

    We present a 44-year-old man from a rural community in northern Ecuador who worked on a cattle farm where he was involved with primary veterinary care, including assistance during births (or calving) and placenta retention and artificial insemination, with minimal precautions. In September of 2009, quite abruptly, he developed asthenia and hypersomnia without any apparent cause or symptoms like fever, chills, or night sweats. On November 14, 2009, he suffered from pain and edema in the right testicle that coincided with pain in the abdomen. Clinical, serological, and bacteriological investigations confirmed the first case of unilateral orchitis in man in Ecuador caused by Brucella abortus biovar 1. Because brucellosis is a neglected disease, special attention should be given to it in the training of medical and veterinary students.

  16. Hodgkin's Lymphoma Revealed by Hemophagocytic Lymphohistiocytosis in a Child

    Science.gov (United States)

    Benmiloud, Sarra; Hbibi, Mohamed; Chaouki, Sana; Abourazzak, Sana; Hida, Moustapha

    2014-01-01

    Hemophagocytic lymphohistiocytosis (HLH) is a severe life-threatening disorder, responsible for extensive phagocytosis of hematopoietic cells and causing a multisystem organ failure. If lymphomas are common causes of HLH, the association with Hodgkin's lymphoma is rarely described in children. We report a case of a 9-year-old boy presenting with HLH as an initial manifestation of Hodgkin's lymphoma. He has been suffering from persistent high fever, asthenia, weight loss, and hepatosplenomegaly with no lymphadenopathy. The diagnosis of HLH secondary to infectious disease was initially worn. The patient received high-dose intravenous immunoglobulin with broad-spectrum antibiotics. However, his state got worse with the onset of dry cough and pleural effusion. Histopathologic examination of pleural fluid showed the presence of Reed-Sternberg cells. The outcome was favorable after treatment by corticosteroid and chemotherapy. Hodgkin's lymphoma revealed by HLH is a source of delayed diagnosis and should be borne in mind in children. PMID:25328742

  17. Churg-Strauss syndrome and hemorragic vasculitis

    Directory of Open Access Journals (Sweden)

    Rui Moreira Marques

    2011-12-01

    Full Text Available Churg-Strauss syndrome (CSS is a rare syndrome characterized by sinusitis, asthma and peripheral eosinophilia. This vasculitic syndrome affects medium and small-sized vessels, the lung being the most commonly affected organ, followed by the skin. The authors report a case of a 59-year-old male with a past history of asthma and allergic rhinitis. He presented necrohemorragic lesions in the distal phalanx of the 2nd, 3rd and 4th fingers of the lefthand and petechial lesions in the plant of both feet, accompanied by asthenia, anorexia and weight loss. The analytical study revealed leukocytosis with eosinophilia, elevated inflammatory parameters and p-ANCA positive antibodies. The diagnosis of CSS was established based on clinical and histopathological data. Cutaneous manifestations of hemorragic vasculitis are rare in CSS syndrome but can be the first manifestation of the disease. The recognition of this presentation is important for the early diagnosis and treatment of this syndrome.

  18. Folk medicine used to heal malaria in Calabria (southern Italy

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    Tagarelli Antonio

    2010-09-01

    Full Text Available Abstract In Italy, malaria was an endemic disease that was eradicated by the mid-20th century. This paper evaluates the prophylactic and therapeutic remedies used by folk medicine to cure malaria in Calabria (southern Italy. The data has been collected by analysing works of physicians, ethnographers, folklorists and specialists of the study of Calabrian history between the end of the 19th century and the 20th century. The data collected have allowed us to describe the most common cures used by the Calabrian people to treat malaria and the most evident symptoms of this disease, such as intermittent fever, hepato-spleenomegaly, asthenia and dropsy. This approach uncovered a heterogeneous corpus of empirical, magical and religious remedies, which the authors have investigated as evidences of past "expert medicine" and to verify their real effectiveness in the treatment of malaria.

  19. Non-celiac gluten sensitivity and rheumatic diseases.

    Science.gov (United States)

    Isasi, Carlos; Tejerina, Eva; Morán, Luz M

    2016-01-01

    Celiac disease is an autoimmune systemic disease having among its clinical manifestations frequent symptoms common to rheumatologic diseases such as musculoskeletal pain, asthenia, and cognitive fatigue. It is associated with other autoimmune diseases like Sjögren disease. It is a well-characterized disease with specific diagnostic tests. Non-celiac gluten sensitivity is an emerging entity with symptoms similar to celiac disease, but without specific diagnostic tests. The concept of non-celiac gluten sensitivity and its diagnostic problems are reviewed, and the hypothesis of its association with fibromyalgia, spondyloarthritis, and autoimmune conditions is proposed. Clinical observations supporting the hypothesis are described, highlighting the benefit of treating non-celiac gluten sensitivity.

  20. [Aggressive NK/T cell leukemia/lymphoma associated with EBV].

    Science.gov (United States)

    Sousa, Jamira; Cabezuelo, Lourdes; Almeida, Sérgio; Filipe, Carlos; Simão, Adélia; Carvalho, Armando; Nascimento Costa, J

    2011-12-01

    The authors describe an unusual case of a young man presenting with fever, asthenia, anorexia and jaundice, associated to hepatosplenomegaly, evolving rapidly to multiorganic failure. Final diagnosis revealed an aggressive NK cell leukemia/lymphoma associated to the Epstein-Barr virus (EBV). The diagnosis, suggested clinically and after bone marrow immunophenotyping, was confirmed by morphologic and immunohistochemical findings on the post-mortem hepatic and splenic biopsy .The tumor cells were positive for CD3 and cytotoxic molecules, TIA, granzyme B and perforin. The herein reported case is a rare clinical entity, only recently recognized and with a difficult early diagnosis. We emphasize the necessity to exclude a Natural Killer cell malignancy in cases with identical characteristics.

  1. Metastatic esthesioneuroblastoma secreting adrenocorticotropic hormone in pediatric patients.

    Science.gov (United States)

    Galioto, Silvestre; Di Petrillo, Alessandro; Pastori, Mauro; Arecchi, Alberto

    2011-09-01

    The purpose of this article was to report a pediatric case of secondary cervical esthesioneuroblastoma involving the parapharyngeal lymph nodes. A 3-year-old boy came to our clinical observation because of a right lymphonodal mass evidenced by nuclear magnetic resonance and a diagnosis of Cushing syndrome associated with ectopic adrenocorticotropic hormone secretion, moon face, central obesity, asthenia, and hirsutism. At the age of 10 months, the patient underwent endoscopic surgery for asportation of the World Health Organization stage IV esthesioneuroblastoma. At 38 months of age, the patient underwent right parapharyngeal lymphadenectomy with surgical access by a double mandibulectomy. After surgery, serum ACTH, cortisolemia, and urinary excretion of cortisol were within the reference range. Blood pressure was recorded at 110/70 mm Hg. Moon face disappeared, as well as central obesity and hirsutism. Clinical report is presented together with brief review of literature.

  2. Diagnostic criteria of the state of the distributed brain stem regulatory structures in cerebrovascular diseases

    Directory of Open Access Journals (Sweden)

    Pogorelov A.V.

    2014-11-01

    Full Text Available The clinical-neurophysiological study of 62 patients with history of subtentorial ischemic stroke was carried out in order to determine the criteria of dysfunction of morphologically distributed stem regulatory structures. It was revealed that these disorders are sustainable with the possibility of recourse and influence on the course of stroke. It was marked the influence of this disorders on the levels of consciousness, severity of state, recovery rate, asthenia level, sleep function. Manifestations of cerebral cardiac syndrome, impaired attention, orientation reaction, speed of sensomotoric acts are also marked. Patients with these disorders have low rates of recovery of functions. Neurophysiological criteria of these disorders are the lack of expressive reactions in electroencephalography, reduction of their overall level, instability of rhythm - generating structures and others.

  3. A Case of Dyspnea in Pancreatic cancer Treated through Herbal Acupunture Treatment

    Directory of Open Access Journals (Sweden)

    Park Sang-Eun

    2006-02-01

    Full Text Available Objective : This study planed to evaluate effect of oriental medicine therapy treatment method of dyspnea that happen from cancer of the pancreas patient who accompany Multiple metasis Methods : Patient complained dyspnoea during admission into dept . Of internal medicine, college of oriental medicine, Dong-eui Univ ,was appealed patient treated by Oriental medicine therapy that is of use Herb Medication and Herbal -acupuncture Treatment being diagnosed in lung asthenia including deficiency of Eum and insufficiency of Gi of the lung(폐허(肺虛, the fire due to deficiency(허화(虛火, and loving warfare of symptoms evaluated through VAS (visual analog scales. Results & Conclusion : Patient's difficulty in breathing symptoms took a favorable turn after treatment. This study means that Oriental medicine therapy that is difficulty in breathing symptoms that happen from patient surely has effectiveness.

  4. High Incidence of Respiratory Involvement in a Cluster of Brucella suis-Infected Workers from a Pork Processing Plant in Argentina.

    Science.gov (United States)

    Wallach, J C; García, J L; Cardinali, P S; Seijo, A P; Benchetrit, A G; Echazarreta, S E; Garro, S L; Deodato, B; Baldi, P C

    2016-12-29

    Epidemiological and clinical aspects of Brucella suis infection in 17 workers from a pork processing plant in Argentina occurring between January 2014 and July 2015 are presented. All patients reported working 9 h daily without adequate personal protection garment. Blood cultures were positive for Brucella spp. in 14 of the 17 patients (82.3%). All isolates were identified as B. suis biovar 1. Although fever, sweats, asthenia, myalgia and hepatic involvement were the most frequent clinical manifestations, an unusually high incidence of respiratory involvement was found. From 13 patients in which chest radiography was performed, four (30%) had radiological abnormalities, including lobar pneumonia in two cases (one with pleural effusion) and interstitial involvement in other two. The high frequency of respiratory involvement in our series makes necessary to consider brucellosis in the differential diagnosis of respiratory diseases in pork processing plant employees.

  5. [Maternal adrenal necrosis in the third trimester of pregnancy: a rare complication of antiphospholipid syndrome].

    Science.gov (United States)

    Legendre, G; Vauthier-Brouzes, D; Cornet, A; Al Hawari, M; Renard-Penna, R; Piette, J-C; Dommergues, M

    2008-04-01

    Adrenal necrosis, a rare life threatening complication of antiphospholipid syndrome, is difficult to diagnose during pregnancy. We report the case of a 33-year-old woman with bilateral adrenal necrosis which started during the third trimester of her second pregnancy. Antiphospholipid syndrome had been diagnosed few years ago, after a thrombotic event. The pregnancy was uneventful until 36 weeks plus five days, when the patient was admitted for bilateral back ache, initially considered as uterine contractions. Labour was induced because pain persisted and was associated with major thrombocytopenia. A healthy infant was delivered vaginally on the second day, adrenal failure was diagnosed based on intense asthenia, persistent severe lumbar pain, low blood sodium and cortisol. Bilateral adrenal oedema was documented by CT scan and MRI. Symptoms resolved following administration of hydrocortisone and fludrocortisone. This case illustrates the difficulty to diagnose adrenal necrosis in the third trimester of pregnancy.

  6. Encephalitozoonosis in household pet Nederland Dwarf rabbits (Oryctolagus cuniculus).

    Science.gov (United States)

    Valencakova, A; Balent, P; Petrovova, E; Novotny, F; Luptakova, L

    2008-05-31

    The paper presents the results of examination of 32 domestically bred rabbits, the breed Nederland Dwarf of Oryctolagus cuniculus, for the presence of Encephalitozoon cuniculi microsporidian species. The results of serological tests for E. cuniculi in 32 rabbits are reviewed along with other follow-up studies of clinical cases. Blood samples were taken from 7 asymptomatic rabbits and 25 rabbits showing neurological and ocular signs suggestive of encephalitozoonosis. In the asymptomatic group, 5 out of 7 rabbits were seropositive (71%). 16 rabbits with clinical diseases showed neurological sings, including torticollis, circus-like movements, loss of weight; 6 of them also showed ataxia, anorexia, asthenia of hind-limbs and 3 showed ocular signs. All 25 rabbits were seropositive. The spores of E. cuniculi were isolated from the faecal samples or kidneys and brain of an animal and subsequently were used for DNA isolation and PCR analysis.

  7. Prolonged QT interval in a man with anorexia nervosa

    Science.gov (United States)

    Macías-Robles, María Dolores; Perez-Clemente, Ana María; Maciá-Bobes, Carmen; Alvarez-Rueda, María Asunción; Pozo-Nuevo, Sergio

    2009-01-01

    Anorexia nervosa is an eating disorder characterized by the avoidance of food intake, which usually leads to a weight loss. Cardiac co-morbility is common and we can find sometimes a mass loss from the left ventricle, which can be seen by echocardiography. But the commonest complications are rhythm variations, typically bradycardia with a prolonged QT interval in up to a 40% of the cases, which altogether elevates ventricular tachycardia and sudden death risk. We present the case of a male who was diagnosed with anorexia nervosa and developed asthenia, a long QT interval and also a severe both hypokalaemia and hypomagnesaemia. We intend to discuss the pathogenic paths as well as prophylactic and therapeutic measures to this potentially-lethal pathology. PMID:19646241

  8. Hodgkin lymphoma in a patient with mosaic trisomy 18: First clinical observation.

    Science.gov (United States)

    Motta, Serena; Sala, Debora; Sala, Alessandra; Cazzaniga, Giovanni; Giudici, Giovanni; Villa, Nicoletta; Biondi, Andrea; Selicorni, Angelo

    2016-03-01

    We report the case of a 17-year-old boy with a mosaic trisomy 18, who was diagnosed with Hodgkin lymphoma. The patient showed only poor growth and two muscular ventricular septal defects; no facial dysmorphims were present. He was admitted to our hospital because of asthenia and weight loss; a mediastinal enlargement was found and an histological diagnosis of nodular sclerosis Hodgkin lymphoma on mediastinal biopsy was performed. Contextually, a chromosomal analysis on bone marrow aspirate and on peripheral blood revealed a mosaic trisomy 18. This result was confirmed also with cytogenetic analysis on skin fibroblasts. While there is a well-documented association between trisomy 18 and solid cell tumors, this is, to our knowledge, the first reported case of Hodgkin lymphoma in a patient with a mosaic trisomy 18, enlarging the spectrum of possible oncologic manifestations of the disease.

  9. Simultaneous Hodgkin′s disease and kaposi sarcoma in a renal transplant recipient

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    Yaich S

    2010-01-01

    Full Text Available A 38-year-old women underwent first cadaver kidney transplantation. Her panel re-active antibody was 0%, and she had never previously been transfused nor pregnant. She received induction therapy with antithymoglobulin (ATG as standard protocol and maintained on immuno-suppressive treatment of cyclosporine A, mycophenolate mofetil (MMF, and prednisone. Nine months after transplantation, she presented with anorexia, asthenia and weight loss. Cutaneous Ka-posi′s sarcoma and a Hodgkin disease were diagnosed. MMF was discontinued and cyclosporin A was switched to sirolimus. She also received a poly-chemotherapy associated with 4 courses of rituximab. Twelve months later, the patient had normal graft function and both malignancies were in complete remission.

  10. Analysis of traditional chinese medical identification and effective factors about sub-healthy people with depressive tendency*%亚健康抑郁倾向人群的中医辨识及影响因素分析

    Institute of Scientific and Technical Information of China (English)

    黄彦; 黄祎; 张太君; 江洪; 成建国

    2013-01-01

    目的 了解亚健康抑郁倾向人群的基本特征,明确其体质类型、心理状态、应对方式、应激事件发生等.方法 采用进行横断面调查,利用EPI软件建立数据库,以SAS8.1软件进行统计分析.结果 抑郁倾向女性易发生,20~40岁人群发生率最高,大专以上学历最多见,职业以党政机关办事人员及专业技术人员为主,并与家庭不和、人际关系不协调、生活环境改变等应激事件有关;抑郁倾向人群以虚性体质(阳虚、阴虚)为主,SCL-90量表各因子阳性结果发生率高于健康人群(P<0.01),社会应对方式以消极应对为主,生活质量评分低于健康人群水平(P<0.05).结论 亚健康抑郁倾向人群女性多见,以虚性体质的高学历、脑力劳动者为主,同时与家庭不和、人际关系不协调、生活环境改变等特定应激事件有关.%Objective To find out traditional chinese medical constitution characters, mentation, coping style and other related factors in sub-healthy people with depressive tendency. Methods Individual Physical and Moral Health Investigation Scale was used to complete epidemiology cross section investigation;EPI software was used to establish database;SAS8. 1 was used to analyze data and complete statistical analysis. Results The depressive tendency of sub-healthy people was more common in women, and the incidence rate of depressive tendency was highest in 20 - 40 years old age, especially in well-educated people with junior college educational background. And the main careers with more common depressive tendency were government functionaries and professionals. The depressive tendency was closely related to some stress events, such as disharmony of family, uncoordinated interpersonal relationship, and the changes of living environment etc. People with depressive tendency were more common in asthenia constitution (yang asthenia,yin asthenia). And the incidence of positive results of each factor in SCL-90

  11. REGULATING THE PSYCHOSOMATIC HEART RATE DISORDERS THROUGH THE USE OF ANTI-STRESS MASSAGE

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    Doina MÂRZA-DĂNILĂ

    2016-09-01

    Full Text Available The symptoms of the so-called functional cardiovascular disorders, in which emotional factors can have an etiological importance, is diverse, comprising tachycardia, anxiety palpitations, various forms of arrhythmia and neurocirculatory asthenia. No matter the causes, they can be related to one's lifestyle, personality and one's own way of perceiving everyday stress and reacting to it. Considering that anti-stress massage can help to achieve mental and physical relaxation in subjects and change their perception of the events they experience, and through this, regulate the psychosomatic heart rate disorders, diminish chronic fatigue and depression and, as such, can help prevent the emergence of the Karōshi syndrome, 19 sessions were applied to 4 subjects, over the course of 4 months. Their results, compared to the ones from other 4 subjects, proved that anti-stress massage has helped to gradually regulate the heart rate of the subjects on which it was applied.

  12. Fibromyalgic syndromes: could growth hormone therapy be beneficial?

    Science.gov (United States)

    Cuatrecasas, Guillem

    2009-06-01

    Fibromyalgia is a chronic, idiopathic condition in which patients experience pain, asthenia and fatigue. The pathogenesis of the condition is unknown, and numerous mechanisms have been postulated, including neural hypersensitivity and autoimmunity. Symptoms of fibromyalgia are broadly similar to those of growth hormone deficiency (GHD), and there is evidence of decreased GH secretion and functional GHD in a subset of patients with fibromyalgia. Use of GH therapy in this patient population therefore represents a rational treatment strategy. Preliminary placebo-controlled trials have shown that GH therapy can significantly improve signs and symptoms of fibromyalgia and quality of life in patients receiving the current standard of care. Despite the use of relatively high doses of GH in these patients, treatment is well tolerated. Several mechanisms of action for GH in fibromyalgia have been suggested, including both central and peripheral effects.

  13. Guillain-Barré Syndrome following Treatment with Sunitinib Malate

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    Ziad Kanaan

    2014-01-01

    Full Text Available Sunitinib malate (Sutent, SU011248 is an oral multitargeted tyrosine kinase inhibitor (TKI used for the treatment of metastatic renal cell carcinoma and imatinib (Gleevec—resistant gastrointestinal stromal tumor (GIST with few reported side effects including asthenia, myelosuppression, diarrhea, and mucositis. Scarce literature exists regarding the rare but often serious toxicities of sunitinib. Autoimmune and neurological side effects have been linked to sunitinib’s inhibition of VEGF receptors with a corresponding increase in VEGF levels, which is associated with development of different neuropathies. We hereby report an interesting case of Guillain-Barré syndrome in a middle-aged patient with metastatic renal cell carcinoma following sunitinib treatment.

  14. 健脾行气法治疗功能性消化不良临床观察%Clinical Observation of Using Spleen Invigorating and Qi Promoting Method to Treat Functional Dyspepsia

    Institute of Scientific and Technical Information of China (English)

    张庆; 梁超

    2011-01-01

    Objective: To observe the clinical curative effect using spleen invorating and Promoting Qi method to threat functional dyspepsia, and approach the superiority in the Traditional Chinese Medicine to treat chronic appetite systemic disease.Methods: To utilize the method of invigorating spleen and promoting Qi to differentiate symptoms and signs and add or to decrease according of clinical symptom to treat thirty examples of the type of splenic asthenia and gas-sluggish of functional dyspepsia, and thirty examples of control group. The treatment group was given prescription according to the method of invigorating spleen and Qi promoting to add or to decrease; the control group was treated by means of domperidone. The average course of treatment was four weeks. Contrasting the index of two sets, such as the total effective rate, total accumulated points of symptom, the improve of major clinical symptom and so on, as well as to make out the judgement. Results: The total effective rate of curity group was 90%, and the control group was 67.9%, there was significant difference between the two groups, P<0. 05,to hint that the total curative effect of curity group surpass the control group to use the method of invigorate spleen and invigorating spleen and promoting Qi to cure the type of splenic asthenia and gas sluggish of functional cyspepsia. Conclusion: The curative effect is indeed that according to the method of respiration technique and respiration technique to treat the type of splenic asthenia and gas sluggish of functional dyspepsia, and it also is one of effective method to treat functional dyspepsia.%目的:观察健脾行气法治疗脾虚气滞型功能性消化不良的临床疗效,并探讨中医药在治疗慢性脾胃系统疾病中的优势.方法:将确诊为脾虚气滞型功能性消化不良患者58例随机分为治疗组30例,对照组28例.治疗组予以根据健脾行气法拟定的运脾行气汤加减治疗;对照组予以多

  15. 3种不同中医证型艾滋病患者外周血CD+4CD+25调节性T细胞的表达%Expression of CD+4CD+25 regulatory T cell in peripheral blood of HIV/AIDS patients with different TCM syndromes

    Institute of Scientific and Technical Information of China (English)

    陈晓蓉; 杨宗国; 沈芳; 王江蓉; 卢洪洲; 杨悦娅

    2011-01-01

    objective: To observe the expression level of CD4+CD25+ regulatory T cell in peripheral blood of HIV/AIDS patients with different TCM syndromes, and to probe the immune negative regulation ability of HIV/AIDS. Methods: Based on the symptoms,signs,tongue manifestations, pulse conditions of AIDS patients, according to the thought of TCM Treatment with syndrome differentiation ,we divided the 97 HIV/AIDS patients into 3 different syndrome type, deficiency of pulmonary and renal syndrome, qi asthenia and blood stasis syndrome, and deficiency of spleen and renal syndrome, in order to observe the expression level of CD4+ CD25+ regulatory T cell in peripheral blood of HIV/AIDS patients with different TCM syndromes and 30cases of normal in control group. Results: The statistical significance of the expression level of CD4+ CD25+ regulatory T cell was observed among the 3 kinds of syndrome and control group (P<0.001). The deficiency of spleen and renal syndrome own the highest expression level of CD4+CD25+ regulatory T cell, followed by deficiency of pulmonary and renal syndrome, and qi asthenia and blood stasis syndrome. Conclusion: The expression level of CD4+CD25+ regulatory T cell of HIV/AIDS patients with different TCM syndromes has being reduced gradually from the deficiency of spleen and renal syndrome, to the deficiency of pulmonary and renal syndrome, and to the qi asthenia and blood stasis syndrome.%目的:观察不同中医证型艾滋病患者CD+4CD+25调节性T细胞(以下简称CD+4CD+25T细胞)的表达水平,探讨不同证型艾滋病免疫负调节能力.方法:根据艾滋病患者的症状、体征、舌象、脉象,按照中医辨证论治思路,分为肺肾不足、气虚血瘀、脾肾亏虚3种证型,设正常对照组30名,收集病例97例,观察不同证型艾滋病患者及正常对照组外周血CD+4CD+25T细胞的表达水平.结果:正常对照组、脾肾亏虚、肺肾不足、气虚血瘀各组患者CD+4CD+25T细胞的表

  16. Infección por Citomegalovarius con compromiso hepático en adultos inmunocompetentes Cytomegalovirus infection with hepatic involvement in immunocompetent adults

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    Claudia Vujacich

    2006-06-01

    presented fever and asthenia, mild to moderate increase of transaminases and serological findings compatible with recent cytomegalovirus infection. We excluded patients with a history of transfusions, drug abuse, immunodeficiencies, preexistent hepatic impairment or serological findings compatible with acute hepatitis A, B and C (HAV, HBV, HCV and Epstein Barr virus (EBV. The laboratory diagnosis of recent cytomegalovirus infection was made by especific IgM detection (ELISA or a significant increase of specific IgG. The most frequent symptoms were fever (85% and asthenia (83%, followed by cephalea (25%, splenomegaly (20%, adenomegalies (22%, pharyngitis (25%, myalgias (25% and hepatomegaly (19%. All the patients showed moderate increase of transaminases and lymphomonocytosis (73/73. In average, ALT was increased by 6 fold and AST by 3.5 fold. The clinical characteristics that differentiate CMV infection from Epstein-Barr infection are the lesser frequency of adenomegalies and pharyngitis in the former. The differential diagnosis of CMV infection with hepatic involvement from acute hepatitis A and B, is based on the absence of jaundice, the lower elevation of transaminases, the intense lymphomonocytosis and the presence of specific IgM against CMV that are characteristic of CMV infection. In conclusion, in previously healthy young adults with fever, intense asthenia, lymphomonocytosis and moderate increase in transaminases levels, cytomegalovirus infection should be investigated.

  17. 急性心肌梗死虚实证型的发病节气规律分析%Investigation on the Relationship Between the Onset Solar Term of Acute Myocardial Infarction and Its Syndrome Types

    Institute of Scientific and Technical Information of China (English)

    陈景利; 何明丰; 刘绍辉; 梁章荣; 徐劲松; 张英俭; 高振和

    2011-01-01

    Objective:To study the relationship between the solar term of onset of acute myocardial infarction (AMI) and its asthenia and sthenia syndrome in Traditional Chinese Medicine(TCM). Methods:The clinical data about the patients with AMI hospitalized in Foshan Hospital of TCM from February 4th 2003 (Beginning of Spring) to February 3rd 2008 (Beginning of Spring) was collected and to be analysed with circular distribution when the onset solar term being regarded as the angle coordinate. And then,the disease characteristics of solar terms were analysed by these datas. Results:The main onset solars of 430 patients with sthenia syndrome were Light Snow,Heavy Snow,Lesser Cold,Beginning of Spring,Rain Water,Awakening from Hibernation,Spring Equinox and Fresh Green which occurred mostly in the winter and the spring. The its peak occurred at the Beginning of Spring. And the solar terms of onset of the asthenia syndrome occurred mainly at Greater Heat,Light Snow, Heavy Snow, Lesser Cold, Greater Cold which showed it mostly in winter. There was no specific peak onset point in the deficiency syndrome. Conclusion:There is a close relationship between periodicity of the solar.terms and onset of asthenia and sthenia syndrome in AMI.The dialectical prevention should be more emphasized in secondary prevention of AMI. Meanwhile,the prevention of AMI should be payed more attention to during solar term above-mentioned.%目的:探寻急性心肌梗死(AMI)发病节气与虚实证型的关系.方法:收集2003年2月4日(立春)-2008年2月3日(立春)笔者所在医院AMI病例资料,将发病节气化为角度坐标进行圆形分布统计,分析A-Ml虚实证的发病节气特点.结果:430例AMT患者中实证多发于小雪、大雪、小寒、立春、雨水、惊蛰、春分、清明等节气,主要集中于冬春两季,发病节气高峰点为立春时节.虚证多发于大暑、小雪、大雪、小寒、大寒等节气,主要集中于冬季,不存在特定高峰点.结论:AMI虚

  18. Psychosocial value of space simulation for extended spaceflight

    Science.gov (United States)

    Kanas, N.

    1997-01-01

    There have been over 60 studies of Earth-bound activities that can be viewed as simulations of manned spaceflight. These analogs have involved Antarctic and Arctic expeditions, submarines and submersible simulators, land-based simulators, and hypodynamia environments. None of these analogs has accounted for all the variables related to extended spaceflight (e.g., microgravity, long-duration, heterogeneous crews), and some of the stimulation conditions have been found to be more representative of space conditions than others. A number of psychosocial factors have emerged from the simulation literature that correspond to important issues that have been reported from space. Psychological factors include sleep disorders, alterations in time sense, transcendent experiences, demographic issues, career motivation, homesickness, and increased perceptual sensitivities. Psychiatric factors include anxiety, depression, psychosis, psychosomatic symptoms, emotional reactions related to mission stage, asthenia, and postflight personality, and marital problems. Finally, interpersonal factors include tension resulting from crew heterogeneity, decreased cohesion over time, need for privacy, and issues involving leadership roles and lines of authority. Since future space missions will usually involve heterogeneous crews working on complicated objectives over long periods of time, these features require further study. Socio-cultural factors affecting confined crews (e.g., language and dialect, cultural differences, gender biases) should be explored in order to minimize tension and sustain performance. Career motivation also needs to be examined for the purpose of improving crew cohesion and preventing subgrouping, scapegoating, and territorial behavior. Periods of monotony and reduced activity should be addressed in order to maintain morale, provide meaningful use of leisure time, and prevent negative consequences of low stimulation, such as asthenia and crew member withdrawal

  19. Early versus deferred treatment for smoldering multiple myeloma: a meta-analysis of randomized, controlled trials.

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    Minjie Gao

    Full Text Available Whether patients with smoldering multiple myeloma (SMM needed to receive early interventional treatment remains controversial. Herein, we conducted a meta-analysis comparing the efficacy and safety of early treatment over deferred treatment for patients with SMM.MEDLINE and Cochrane Library were searched to May 2014 for randomized controlled trials (RCTs that assessed the effect of early treatment over deferred treatment. Primary outcome measure was mortality, and secondary outcome measures were progression, response rate, and adverse events.Overall, 5 trials including 449 patients were identified. There was a markedly reduced risk of disease progression with early treatment (Odds Ratio [OR] = 0.13, 95% confidence interval [CI] = 0.07 to 0.24. There were no significant differences in mortality and response rate (OR = 0.85, 95% CI = 0.45 to 1.60, and OR = 0.63, 95% CI = 0.32 to 1.23, respectively. More patients in the early treatment arm experienced gastrointestinal toxicities (OR = 10.02, 95%CI = 4.32 to 23.23, constipation (OR = 8.58, 95%CI = 3.20 to 23.00 and fatigue or asthenia (OR = 2.72, 95%CI = 1.30 to 5.67. No significant differences were seen with the development of acute leukemia (OR = 2.80, 95%CI = 0.42 to 18.81, hematologic cancer (OR = 2.07, 95%CI = 0.43 to 10.01, second primary tumors (OR = 3.45, 95%CI = 0.81 to 14.68, nor vertebral compression (OR = 0.18, 95%CI = 0.02 to 1.59.Early treatment delayed disease progression but increased the risk of gastrointestinal toxicities, constipation and fatigue or asthenia. The differences on vertebral compression, acute leukemia, hematological cancer and second primary tumors were not statistically significant. Based on the current evidence, early treatment didn't significantly affect mortality and response rate. However, further much larger trials were needed to provide more evidence.

  20. Safety and efficacy of sunitinib in patients from Latin America: subanalysis of an expanded access trial in metastatic renal cell carcinoma

    Science.gov (United States)

    Barrios, Carlos H; Herchenhorn, Daniel; Chacón, Matías; Cabrera-Galeana, Paula; Sajben, Peter; Zhang, Ke

    2016-01-01

    Background Sunitinib is an approved treatment for metastatic renal cell carcinoma (mRCC). The safety profile and efficacy of sunitinib were confirmed in a global expanded access trial (ClinicalTrials.gov identifier: NCT00130897). This report presents a subanalysis of the final trial data from patients in Latin America. Methods Treatment-naïve or previously treated mRCC patients aged ≥18 years received oral sunitinib at a starting dose of 50 mg/day on a 4-weeks-on/2-weeks-off schedule. Treatment continued until disease progression, unacceptable toxicity, or withdrawal of consent. Safety was assessed regularly, and tumor measurements were scheduled per local practice (using Response Evaluation Criteria in Solid Tumors). Results In total, 348 patients from Latin America received sunitinib. Overall, 75% of patients had two or more sites of metastatic disease, 28% were aged ≥65 years, 14% had an Eastern Cooperative Oncology Group performance status ≥2, 9% had brain metastases, 9% had no prior nephrectomy, and 5% had non-clear cell RCC. Median treatment duration was 8 months, and median follow-up was 15.1 months. In total, 326 patients (94%) discontinued treatment, primarily due to death (41%) or lack of efficacy (22%). Most treatment-related adverse events were of mild to moderate severity (grade 1/2). Mucosal inflammation (reported in 54% of patients), diarrhea (53%), and asthenia (41%) were the most common any-grade treatment-related adverse events. Asthenia (12%), neutropenia (10%), and fatigue and thrombocytopenia (both 9%) were the most common grade 3/4 treatment-related adverse events. In total, 311 patients were included for tumor response, of whom eight (3%) had a complete response and 46 (15%) a partial response, yielding an objective response rate of 17%. Median duration of response, progression-free survival, and overall survival were 26.7, 12.1, and 16.9 months, respectively. Conclusion The efficacy and safety profile of sunitinib in patients with m

  1. Subcutaneous Administration of Bortezomib in Combination with Thalidomide and Dexamethasone for Treatment of Newly Diagnosed Multiple Myeloma Patients

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    Shenghao Wu

    2015-01-01

    Full Text Available Objective. To investigate the efficacy and safety of the treatment of the newly diagnosed multiple myeloma (MM patients with the therapy of subcutaneous (subQ administration of bortezomib and dexamethasone plus thalidomide (VTD regimen. Methods. A total of 60 newly diagnosed MM patients were analyzed. 30 patients received improved VTD regimen (improved VTD group with the subQ injection of bortezomib and the other 30 patients received conventional VTD regimen (VTD group.The efficacy and safety of two groups were analyzed retrospectively. Results. The overall remission (OR after eight cycles of treatment was 73.3% in the VTD group and 76.7% in the improved VTD group (P>0.05. No significant differences in time to 1-year estimate of overall survival (72% versus 75%, P=0.848 and progression-free survival (median 22 months versus 25 months; P=0.725 between two groups. The main toxicities related to therapy were leukopenia, neutropenia, thrombocytopenia, asthenia, fatigue, and renal and urinary disorders. Grade 3 and higher adverse events were significantly less common in the improved VTD group (50% than VTD group (80%, P=0.015. Conclusions. The improved VTD regimen by changing bortezomib from intravenous administration to subcutaneous injection has noninferior efficacy to standard VTD regimen, with an improved safety profile and reduced adverse events.

  2. Rural tourism: a risk factor for schistosomiasis transmission in Brazil

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    Martin Johannes Enk

    2010-07-01

    Full Text Available This paper reports an outbreak of acute schistosomiasis among 38 tourists who rented a country house in the district of Igarapé, the metropolitan region of Belo Horizonte, Brazil, during a holiday period in 2006. A total number of 32 individuals were positive for Schistosoma mansoni. Results of stool examinations revealed individual S. mansoni egg counts per gram of faeces (epg ranging from 4-768 epg with a geometric mean egg count of 45. The most frequent clinical symptoms were abdominal pain (78.1%, headache (75%, fever (65.6%, dry cough (65.2% and both diarrhoea and asthenia (59.4%. A malacological survey of the area, where 22 specimens of Biomphalaria glabrata were collected, revealed three (13.6% specimens eliminating Schistosoma cercariae. This investigation re-confirms a recently described pattern of schistosomiasis infection, resulting in the acute form of the disease and connected to rural tourism, which contributes to the spread of the disease among the middle-class and into non-endemic areas. The lack of specific knowledge about acute schistosomiasis among health services causes an increased number of unnecessary diagnostic procedures and delays in accurate diagnosis and treatment, resulting in considerable discomfort for the patients.

  3. Tuberculosis and histoplasmosis co-infection in AIDS patients.

    Science.gov (United States)

    Agudelo, Carlos A; Restrepo, Carlos A; Molina, Diego A; Tobón, Angela M; Kauffman, Carol A; Murillo, Carolina; Restrepo, Angela

    2012-12-01

    Abstract. Coinfection with tuberculosis in some countries occurs in 8-15% of human immunodeficiency virus (HIV) -infected patients who have histoplasmosis. This coinfection interferes with prompt diagnosis, and treatment is difficult because of drug interactions. We retrospectively reviewed the cases of 14 HIV-infected patients who had concomitant tuberculosis and histoplasmosis. The most frequent clinical manifestations were weight loss (85.7%), asthenia (78.5%), and fever (64.2%). The diagnosis of histoplasmosis was made primarily by histopathology (71.4%), and the diagnosis of tuberculosis was made by means of direct microscopic examination (71.4%). Death occurred in two patients, and relapse of both infections occurred in one patient. Moxifloxacin was substituted for rifampicin in six patients, with good outcomes noted for both infections. The clinical presentation does not readily identify acquired immunodeficiency syndrome (AIDS) patients who have tuberculosis and histoplasmosis. The use of a fluoroquinolone as an alternative agent in place of rifampicin for tuberculosis allows effective therapy with itraconazole for histoplasmosis.

  4. COMPARATIVE STUDY OF EMOTIONAL DISORDERS STRUCTURE IN PATIENTS BEFORE AND AFTER ORTHOTOPIC LIVER TRANSPLANTATION

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    T. G. Mikhaylichenko

    2011-01-01

    Full Text Available Being based on a private experience, authors considered necessary to study features of emotional disorders that will allow understanding the mechanism of mental adaptation to disease at patients before and after OLT. In comparative research of structure of emotional frustration at the patients making the most numerous groups of patients before transplantation of a liver (viral hepatitis and autoimmune liver diseases, 129 persons, from them 75 before OLT are included at entering into a waiting list and 54 to through 22 ± 9 days after OLT. Distinctions in structure of emotional frustration are revealed: at patients with autoimmune liver diseases be- fore OLT and viral hepatitis after OLT the semiology combined with disturbing-depressive experiences and hypochondriac fixings is brightly expressed neurotic, them distinguishes high level of personal uneasiness. For patients with autoimmune liver diseases after OLT and viral hepatitis before OLT are characteristic moderately expressed neurotic frustration of an asthenia circle and low level of personal and situational anxiety. 

  5. [Clinical problems in medical mycology: Problem number 49].

    Science.gov (United States)

    Negroni, Ricardo; Depardo, Roxana; Messina, Fernando; García, Julián; Santiso, Gabriela; Mingrone, Verónica; Marin, Emmanuel; Arechavala, Alicia

    2016-01-01

    The case of a 59-year-old female born in Buenos Aires (Argentina) is presented. She had been diagnosed with HIV in 2007 and received highly active antiretroviral therapy until 2011; she also suffered from diabetes type 2. She had received empirical treatment (pyrimethamine-clindamycin) for cerebral toxoplasmosis. Fifteen days later she suffered a drug-induced skin disorder and was treated in the Dermatology Service of the Hospital Muñiz with corticosteroids. After five weeks she was readmitted to the Infectious Disease Unit due to asthenia, weight loss, left hip pain and weakness in all four limbs. Septic arthritis and aseptic hip necrosis were ruled out. Blood cultures were positive for Staphylococcus aureus and Escherichia coli. The patient received intravenous antibiotics, but before being discharged Acinetobacter baumannii was isolated from blood, catheter and urine cultures, and a new series of antibiotics were prescribed. On the 3rd day she presented encephalic facies, changes of behaviour and disorientation, without nuchal rigidity, Kernig and Brudzinski signs or focal signs. An X-ray computed tomography did not show parenchymal lesions. A yeast identified as Candida albicans was isolated in a cerebrospinal fluid culture. The same yeast was recovered in a new cerebrospinal fluid sample. The isolate was susceptible to amphotericin B and susceptible dose dependent to fluconazole. The patient was treated with amphotericin B (0.7mg/kg plus 800mg fluconazole daily). Three weeks later, new cerebrospinal fluid cultures were negative. Unfortunately, the patient died soon afterwards.

  6. Severe somatoform and dysautonomic syndromes after HPV vaccination: case series and review of literature.

    Science.gov (United States)

    Palmieri, Beniamino; Poddighe, Dimitri; Vadalà, Maria; Laurino, Carmen; Carnovale, Carla; Clementi, Emilio

    2016-08-09

    Human papilloma virus (HPV) is recognized as a major cause for cervical cancer among women worldwide. Two HPV vaccines are currently available: Gardasil(®) and Cervarix(®). Both vaccines enclose viral antigenic proteins, but differ as to the biological systems of culture and the adjuvant components. Recently, a collection of symptoms, indicating nervous system dysfunction, has been described after HPV vaccination. We retrospectively described a case series including 18 girls (aged 12-24 years) referred to our "Second Opinion Medical Network" for the evaluation of "neuropathy with autonomic dysfunction" after HPV vaccination. All girls complained of long-lasting and invalidating somatoform symptoms (including asthenia, headache, cognitive dysfunctions, myalgia, sinus tachycardia and skin rashes) that have developed 1-5 days (n = 11), 5-15 days (n = 5) and 15-20 days (n = 2) after the vaccination. These cases can be included in the recently described immune dysfunction named autoimmune/inflammatory syndrome induced by adjuvants (ASIA). HPV vaccine, through its adjuvant component, is speculated to induce an abnormal activation of the immune system, involving glia cells in the nervous system too. Further researches should aim at defining the pathological and clinical aspects of these post-vaccination diseases and identifying a genetic background predisposing to these adverse reactions.

  7. Caprylic triglyceride as a novel therapeutic approach to effectively improve the performance and attenuate the symptoms due to the motor neuron loss in ALS disease.

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    Wei Zhao

    Full Text Available Amyotrophic lateral sclerosis (ALS is a neurodegenerative disorder of motor neurons causing progressive muscle weakness, paralysis, and finally death. ALS patients suffer from asthenia and their progressive weakness negatively impacts quality of life, limiting their daily activities. They have impaired energy balance linked to lower activity of mitochondrial electron transport chain enzymes in ALS spinal cord, suggesting that improving mitochondrial function may present a therapeutic approach for ALS. When fed a ketogenic diet, the G93A ALS mouse shows a significant increase in serum ketones as well as a significantly slower progression of weakness and lower mortality rate. In this study, we treated SOD1-G93A mice with caprylic triglyceride, a medium chain triglyceride that is metabolized into ketone bodies and can serve as an alternate energy substrate for neuronal metabolism. Treatment with caprylic triglyceride attenuated progression of weakness and protected spinal cord motor neuron loss in SOD1-G93A transgenic animals, significantly improving their performance even though there was no significant benefit regarding the survival of the ALS transgenic animals. We found that caprylic triglyceride significantly promoted the mitochondrial oxygen consumption rate in vivo. Our results demonstrated that caprylic triglyceride alleviates ALS-type motor impairment through restoration of energy metabolism in SOD1-G93A ALS mice, especially during the overt stage of the disease. These data indicate the feasibility of using caprylic acid as an easily administered treatment with a high impact on the quality of life of ALS patients.

  8. Zika virus:A review of literature

    Institute of Scientific and Technical Information of China (English)

    Saeed Reza Jamali Moghadam; Samaneh Bayrami; Sepideh Jamali Moghadam; Raheleh Golrokhi; Fatemeh Golsoorat Pahlaviani; SeyedAhmad SeyedAlinaghi

    2016-01-01

    Zika virus (ZIKV) has two lineages:African and Asian. Mosquito-borne flaviviruses are thought to replicate initially in dendritic cells and then spread to lymph nodes and the blood stream. Risk for infection through blood transfusion, sexual practices and perinatal transmission exists. The possible routes of perinatal transmission are during delivery, breastfeeding and by close contact between the mother and her newborn. Also, muco-cutaneous exposures to the virus by infected blood or monkey bite, organ transplantation or hemodialysis are the other routes of ZIKV transmission. There are two types of ZIKV infection;Zika fever and congenital infection. Clinical presentation of Zika fever varies from asymptomatic infections to a self-limiting febrile disease with low grade fever, conjunctivitis, maculopapular rash, headache, retro-orbital pain and arthritis/arthralgia with periarticular edema, myalgia, vertigo, vomiting and asthenia. This clinical feature could be mistaken for dengue or chikungunya fevers. Microcephaly is the most important and frequently reported clinical picture of suspected congenital Zika syndrome. Labo-ratory tests are needed for diagnosis of ZIKV infection, because there is no known pathognomonic clinical, biochemical or radiological features. RT-PCR is the most well-liked assay. Serum samples are tested by immunoglobulin G ELISA with ZIKV antigen. Samples are also tested by immunoglobulin M ELISA. There is no certified vaccine or therapeutic medication. In asymptomatic or uncomplicated patients, treatment is not necessary.

  9. Influence of methods of physical rehabilitation on quality of life in patients with toxic hepatitis

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    Shmatova E.A.

    2013-11-01

    Full Text Available He purpose was to improve the state of the quality of life in patients with chronic toxic hepatitis in-patient treatment phase by the use of comprehensive program of physical rehabilitation. We examined 84 patients, including 55 - and 29 men - women. Quality of life was measured using a questionnaire SF - 36. The data obtained were compared with those of healthy people - donors. Found that patients significantly reduced quality of life condition. A program of physical rehabilitation with the use of complex tools: physiotherapy, massage, segmental massage, treatment status, respiration system Yoga. On 10 - 15 day in-patient revealed a positive trend against other major symptoms of the disease. At 6 - 7 day disappeared signs asthenia, improved mood, appetite, depression and aggression disappeared, abdominal pain, heaviness in the right upper quadrant. It has also the normalization of the excretory function of the gastrointestinal - intestinal tract. Patients pay attention to the improvement of the symptoms: dyspnea, normalize heart rate, decrease pain and numbness in the legs.

  10. Frequency and clinical features of dengue infection in a schoolchildren cohort from medellin, Colombia.

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    Restrepo, Berta Nelly; Piedrahita, Leidy Diana; Agudelo, Ivony Yireth; Parra-Henao, Gabriel; Osorio, Jorge E

    2012-01-01

    To determine the incidence of dengue infection, we established active surveillance of febrile episodes in a cohort of schoolchildren from three schools in Medellin, Colombia. We followed a cohort of 2,379 schoolchildren in 2010 and followed 1,840 of these children the following year. During the follow-up time, 264 schoolchildren displayed 297 febrile episodes; of these, 23 episodes (7.7%) were caused by acute dengue infection. All four dengue serotypes were found, and all of the cases were mild. The most common symptoms in the dengue cases compared with those in other febrile illness were asthenia (96% versus 87%), anorexia (78% versus 57%), rhinorrhea (65.2% versus 58%), abdominal pain (56.5% versus 47.8%), arthralgia (43% versus 33%), and positive tourniquet test (13% versus 3%). This difference was not statistically significant. Pulse was elevated, and systolic arterial pressure was lower in dengue cases compared with other febrile illness (P < 0.05). Mosquito indexes were determined in 8 children's houses and in the schools. Aedes aegypti adults were found in both households and in schools, whereas Aedes aegypti larvae were found only in schools. These results showed an elevated dengue frequency in children, with symptoms similar to those of other febrile illness and transmission risk in households and schools.

  11. A ten-year follow-up of human leptospirosis in Uruguay: an unresolved health problem

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    Felipe Schelotto

    2012-04-01

    Full Text Available Leptospira spp. are delicate bacteria that cannot be studied by usual microbiological methods. They cause leptospirosis, a zoonotic disease transmitted to humans through infected urine of wild or domestic animals. We studied the incidence of this disease in the Uruguayan population, its epidemiologic and clinical features, and compared diagnostic techniques. After examining 6,778 suspect cases, we estimated that about 15 infections/100,000 inhabitants occurred yearly, affecting mainly young male rural workers. Awareness about leptospirosis has grown among health professionals, and its lethality has consequently decreased. Bovine infections were probably the principal source of human disease. Rainfall volumes and floods were major factors of varying incidence. Most patients had fever, asthenia, myalgias or cephalalgia, with at least one additional abnormal clinical feature. 30-40% of confirmed cases presented abdominal signs and symptoms, conjunctival suffusion and altered renal or urinary function. Jaundice was more frequent in patients aged > 40 years. Clinical infections followed an acute pattern and their usual outcome was complete recovery. Laboratory diagnosis was based on indirect micro-agglutination standard technique (MAT. Second serum samples were difficult to obtain, often impairing completion of diagnosis. Immunofluorescence was useful as a screening test and for early detection of probable infections.

  12. Skin Rashes on Leg in Brucellosis: a Rare Presentation.

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    Seyed Hossein Shahcheraghi

    2015-06-01

    Full Text Available Brucellosis is the most widespread zoonotic infection in the world. The disease is endemic in countries bordering the Mediterranean Sea. It is an important re-emerging infectious disease. This disease is closely associated with the evolution of mankind as an agrarian society linked to the practice of shepherding and popularization of animal husbandry. The patients with this disease are typically present with chills, fever, asthenia and sweating. This paper describes a patient with brucellosis and skin rashes on the leg. A 41-year-old man presented with fever, ataxia, and dysarthria. He was a shepherd. The patient reported the loss of appetite, arthralgia and weight loss during previous five months. Finally, he was diagnosed with brucellosis by positive blood culture and high titer for Brucella agglutination test. The clinical manifestation of brucellosis is very broad, ranging from asymptomatic infection to serious debilitating disease. Current patient had skin rashes on his leg. Brucellosis must be considered in the differential diagnosis of acute infections, especially if there is a history of fresh milk product ingestion and living in an endemic region.

  13. Analysis of Chen Xiuyuan's Differential Treatment of Puerperal Disorders%陈修园辨治产后病探析

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    崔为

    2009-01-01

    This article summarizes Chen Xiuyuan's differential therapy for puerperal disorder. In response to the physiological and pathological characteristics of puer-peral disorders, the author advanced many points in treating the disease, including that the asthenia and sthenia of puerperal alternate chill and fever or postpartum lochia should be discriminated clearly, paying attention to spleen-stomach, removing blood stasis first, applying warm and supplement therapy simultaneously and purgative therapy shouldn't be applied to postpartum constipation ,etc.%总结陈修园关于产后疾病的辨治方法 ,针对产后生理、病理特性,提出对产后寒热、恶露等症,需明辨虚实、真假;治疗产后病证注重脾胃,以祛瘀为先,温补相兼,以及产后便秘不宜轻下等诸多临证要旨和观点.

  14. Strengthening fibular muscle for children's congenital pes equinovarus%加强腓骨肌治疗小儿先天性马蹄内翻足

    Institute of Scientific and Technical Information of China (English)

    高书林; 唐伟椿; 白德明

    2001-01-01

    目的介绍一种解决先天性马蹄内翻足肌力不平衡的手术方法和效果。方法在行足后内侧软组织松解术时,将长屈肌与腓骨长肌吻合,加强腓侧肌力。结果随访23足,22足外观满意。其中2足踝关节活动受限,1足畸形完全复发。结论畸形复发是由于腓骨肌持续无力造成的。加强腓侧肌的力量是治疗先天性马蹄内翻足的有效手术方式。%Objective To introduce a surgical treatment for muscular imbalance in congenital talipes equinovarus and its effects. Method Musculus flexor hallucis longus with musculus peroneus longus were anastomosed to strengthen fibular muscle producing posterointernal lysis for clubfoot. Results Among following up 23 feet , appearances of 22 feet were satisfactory, two feet of which were limited in motion of ankle joint, and one foot was relapsed. Conclusion Deformity recurrence results from persistent asthenia of fibular muscles. Strengthening fibular muscle is one of the effective surgical treatments for congenital talipes equinovarus.

  15. Hodgkin’s Lymphoma Revealed by Hemophagocytic Lymphohistiocytosis in a Child

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    Sarra Benmiloud

    2014-01-01

    Full Text Available Hemophagocytic lymphohistiocytosis (HLH is a severe life-threatening disorder, responsible for extensive phagocytosis of hematopoietic cells and causing a multisystem organ failure. If lymphomas are common causes of HLH, the association with Hodgkin’s lymphoma is rarely described in children. We report a case of a 9-year-old boy presenting with HLH as an initial manifestation of Hodgkin’s lymphoma. He has been suffering from persistent high fever, asthenia, weight loss, and hepatosplenomegaly with no lymphadenopathy. The diagnosis of HLH secondary to infectious disease was initially worn. The patient received high-dose intravenous immunoglobulin with broad-spectrum antibiotics. However, his state got worse with the onset of dry cough and pleural effusion. Histopathologic examination of pleural fluid showed the presence of Reed-Sternberg cells. The outcome was favorable after treatment by corticosteroid and chemotherapy. Hodgkin’s lymphoma revealed by HLH is a source of delayed diagnosis and should be borne in mind in children.

  16. Agranulocytosis in a patient with acute Parvovirus B19 infection: a case study

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    Carlo Di Donato

    2016-03-01

    Full Text Available The definition of neutropenia is the reduction in the absolute number of neutrophils below 1.5×109. The chapter about acquired neutropenias affecting the adult population is of particular interest to the internist. PC, 75 years old man, was hospitalized because of fever, asthenia. In anamnesis: recent diagnosis of ulcerative pancolitis treated with mesalazine and corticosteroid therapy. During the hospitalization, to the fever resolution, we witnessed to a gradual reduction in the value of neutrophils leucocytes until the complete agranulocytosis. We set a therapy with granulocytes colony stimulating factors, and antifungal. The osteo-medullar biopsy confirmed a pure aplasia of the granulocyte marrow series without any evidence of cancer. The subsequent clinical development was favorable, with stable apyrexia and recovery of leucocytes count. Few days after, we received the positive response on the research of anti-Parvovirus B19 immunoglobulin M and in qualitative polymerase chain reaction. The patient was discharged with diagnosis agranulocytosis in patient with acute infection of Parvovirus B19. Neutropenia associated with Parvovirus infection is not frequent and is related to the presence of hematological diseases or condition of immunosuppression. The peculiarity of the case described is the complete agranulocytosis found: in fact in literature, only rare cases are described. Patient gave his informed consent.

  17. Necrotizing fasciitis with group A Streptococci and Eggerthella lenta as a complication of Varicella in a child – case presentation –

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    Claudia Cambrea Simona

    2014-02-01

    Full Text Available Necrotizing fasciitis is a life threatening condition that can be quickly spread through the flesh surrounding the muscle. The disease can be polymicrobial, or caused by group A beta hemolytic Streptococci, or by Clostridium spp. We present a case of a 7 years old girl, which was hospitalized in Children Infectious Diseases Department in a 7th day of chickenpox (hematic crusts all over the body, high fever, asthenia, vomiting, oligoanuria, and tumefaction, pain and functio lessa in the right thigh. In a very short time in the right thigh swelling, edema and congestion have increased gradually, and in the third highest middle thigh the ecchymotic areas appeared evolving towards bubbles and blisters which included the right thigh and calf. After excluding the diagnosis of thrombophlebitis was raised suspicion of necrotizing fasciitis. CT pelvic scan evidenced pelvic asymmetry by maximus and medium right gluteal muscles swelling with important inflammatory infiltrate extended laterally in the subcutaneous adipose tissue. In blood culture was isolated Eggerthella lenta, and from throat swab was isolated group A Streptococci. Treatment consists of a combination of antibiotics associated with intravenous immunoglobulin administration. Despite medical treatment evolution worsened and required transfer in a pediatric surgery department where emergent surgical debridement associated with intensive antibiotic therapy was done. After this intervention evolution was slowly favorable without major limb dysfunction. Polymicrobial necrotizing fasciitis is a severe disease, which if recognized early can have a

  18. Primary melanoma of the adrenal gland: a case report and review of the literature

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    Machuca-Santacruz José

    2011-07-01

    Full Text Available Abstract Background Primary melanoma of the adrenal gland is exceptionally rare as demonstrated by the few cases reported in the medical literature, and it has a high fatality rate. We present the case of a patient with two relapses and survival to date. Case report We describe the case of a 58-year-old Caucasian woman who consulted her doctor with symptoms of asthenia, anorexia and weight loss. A mass was palpated in her abdomen at the height of the left hypochondrium. A computed tomographic scan revealed a retroperitoneal mass measuring 10 cm × 15 cm originating in the left adrenal gland. A left nephroadrenalectomy and splenectomy were performed. Histopathologically, the retroperitoneal mass corresponded to a melanoma, and no primary melanoma was found in any other location. The patient was treated with interferon-α-2b. Three years after her diagnosis the patient presented with a retroperitoneal relapse of the mass measuring 7.2 cm, which was removed. Five years after the first relapse a new retroperitoneal relapse mass was diagnosed, which was also removed. Since then the patient has been healthy and free from illness. Conclusion Histological and immunohistochemical studies, together with the criteria described by Ainsworth et al. and Carstens et al., allowed us to diagnose primary melanoma of the adrenal gland.

  19. Renal thrombotic microangiopathy caused by interferon beta-1a treatment for multiple sclerosis

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    Mahe J

    2013-08-01

    Full Text Available Julien Mahe,1 Aurélie Meurette,2 Anne Moreau,3 Caroline Vercel,2 Pascale Jolliet1,4 1Clinical Pharmacology Department, Institute of Biology, University Hospital, Nantes, France; 2Clinical Nephrology and Immunology Department, University Hospital, Nantes, France; 3Laboratory of Pathology, University Hospital, Nantes, France; 4EA 4275 Biostatistics, Pharmacoepidemiology and Subjective Measures in Health Sciences, University of Nantes, Nantes, France Abstract: Interferon beta-1a is available as an immunomodulating agent for relapsing forms of multiple sclerosis. Common side effects include flu-like symptoms, asthenia, anorexia, and administration site reaction. Kidney disorders are rarely reported. In this study we describe the case of a woman who has been undergoing treatment with interferon beta-1a for multiple sclerosis for 5 years. She developed a hemolytic-uremic syndrome with intravascular hemolysis in a context of severe hypertension. A kidney biopsy showed a thrombotic microangiopathy. This observation highlights an uncommon side effect of long-term interferon beta-1a therapy. Pathophysiological mechanisms leading to this complication might be explained by the antiangiogenic activity of interferon. Keywords: thrombotic microangiopathy, interferon beta, hemolytic-uremic syndrome, antiangiogenic activity

  20. Meningoencephalitis caused by a zygomycete fungus (Basidiobolus associated with septic shock in an immunocompetent patient: 1-year follow-up after treatment

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    M. Auxiliadora-Martins

    2010-08-01

    Full Text Available Zygomycosis is an infection caused by opportunistic fungi of the Zygomycetes class, specifically those from the Mucorales and Entomophthorales orders. It is an uncommon disease, mainly restricted to immunocompromised patients. We report a case of a 73-year-old male patient with a history of fever (39°C lasting for 1 day, accompanied by shivering, trembling, and intense asthenia. The patient was admitted to the intensive care unit with complex partial seizures, and submitted to orotracheal intubation and mechanical ventilation under sedation with midazolam. The electroencephalogram showed evidence of non-convulsive status epilepticus. There is no fast specific laboratory test that permits confirmation of invasive fungal disease. Unless the physician suspects this condition, the disease may progress rapidly while the patient is treated with broad-spectrum antibiotics. Differential diagnosis between fungal and bacterial infection is often difficult. The clinical presentation is sometimes atypical, and etiological investigation is not always successful. In the present case, the histopathological examination of the biopsy obtained from the right temporal lobe indicated the presence of irregular, round, thick-walled fungi forming papillae and elongated structures of irregular diameter, with no septa, indicative of zygomycete (Basidiobolus. Treatment with liposomal amphotericin B and fluconazole was initiated after diagnosis of meningoencephalitis by zygomycete, with a successful outcome.

  1. Effect of Laryngopharyngeal Neuromuscular Electrical Stimulation on Dysphonia Accompanied by Dysphagia in Post-stroke and Traumatic Brain Injury Patients: A Pilot Study

    Science.gov (United States)

    2016-01-01

    Objective To investigate the effect of laryngopharyngeal neuromuscular electrical stimulation (NMES) on dysphonia in patients with dysphagia caused by stroke or traumatic brain injury (TBI). Methods Eighteen patients participated in this study. The subjects were divided into NMES (n=12) and conventional swallowing training only (CST, n=6) groups. The NMES group received NMES combined with CST for 2 weeks, followed by CST without NMES for the next 2 weeks. The CST group received only CST for 4 weeks. All of the patients were evaluated before and at 2 and 4 weeks into the study. The outcome measurements included perceptual, acoustic and aerodynamic analyses. The correlation between dysphonia and swallowing function was also investigated. Results There were significant differences in the GRBAS (grade, roughness, breathiness, asthenia and strain scale) total score and sound pressure level (SPL) between the two groups over time. The NMES relative to the CST group showed significant improvements in total GRBAS score and SPL at 2 weeks, though no inter-group differences were evident at 4 weeks. The improvement of the total GRBAS scores at 2 weeks was positively correlated with the improved pharyngeal phase scores on the functional dysphagia scale at 2 weeks. Conclusion The results demonstrate that laryngopharyngeal NMES in post-stroke or TBI patients with dysphonia can have promising effects on phonation. Therefore, laryngopharyngeal NMES may be considered as an additional treatment option for dysphonia accompanied by dysphagia after stroke or TBI. PMID:27606266

  2. Spatial distribution of the human development index, HIV infection and AIDS-Tuberculosis comorbidity: Brazil, 1982 - 2007

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    Antonio Luiz Rodrigues-Júnior

    2014-01-01

    Full Text Available INTRODUCTION: AIDS epidemic has given visibility to the incidence of tuberculosis, for being the most frequent opportunistic infection. It is known that individuals who are socially vulnerable are more susceptible to HIV transmission and tuberculosis as well. OBJECTIVE: This study aims to conduct a geoepidemiological study on HIV/AIDS, AIDS-Tuberculosis co-infection and social vulnerability. METHOD: This is an ecological study using incidence rates and the human development index to produce thematic maps and a descriptive analysis of epidemiology. The records of reported cases of HIV/AIDS from 1982 to 2007 were used, considering as cases of AIDS-Tuberculosis those records that were positively diagnosed with tuberculosis and those records with unknown diagnosis of tuberculosis, but showing compatible signs and symptoms with tuberculosis (fever, cough, cachexia and asthenia. RESULTS: The maps allowed the identification of areas with social differences and different patterns of incidence of HIV/AIDS and AIDS-Tuberculosis; regional differences were similar to those found by Josué de Castro, in 1940; regions with higher human development index values also showed higher incidence HIV/AIDS and AIDS-Tuberculosis. CONCLUSION: The prevention of HIV infection must be geographically specific, given socioeconomic and cultural differences. Although official records show decline in AIDS-TB co-infection, treatment of cases of HIV/AIDS should observe the occurrence of opportunistic diseases, which should be notified and/or updated.

  3. Real case of primitive embryonal duodenal carcinoma in a young man

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    Barbieux, Julien; Memeo, Riccardo; De Blasi, Vito; Suciu, Sebastian; Faucher, Vanina; Averous, Gerlinde; Roy, Catherine; Marescaux, Jacques; Mutter, Didier; Pessaux, Patrick

    2017-01-01

    We report here the case of a young man suffering from a rare germ cell tumour. The patient was a 25-year-old man who was referred to our centre for asthenia, stinging epigastric pain, and an iron deficiency anaemia. Gastroscopy revealed a circumferential vegetating lesion on the second portion of the duodenum. The lesion was indurated at the third portion of the duodenum, responsible for a tight stenosis. A computerized tomography-scan of the chest, abdomen and pelvis, and a pancreatic MRI showed a circumferential lesion with a bi-ductal dilatation (i.e., of the common bile duct and Wirsung’s duct) without metastatic localisation. The patient underwent a pancreaticoduodenectomy with lymph node dissection including all cellular adipose tissues of the hepatic pedicle from the hepatic common artery and of the retroportal lamina. Histological findings were suggestive of a duodenal embryonal carcinoma with pancreatic infiltration. This is the second published case highlighting the duodenal primitive localisation of an embryonal carcinoma with pancreatic infiltration. PMID:28216981

  4. Intensive Farmaco- Surveillance of Interferon Alpha 2b Recombinant in Multiple Sclerosis.

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    Leslie Pérez Ruiz

    2007-12-01

    Full Text Available Background: The interferon alpha 2b recombinant, produced in Cuba, is used in the treatment of different illnesses, such as the multiple sclerosis. For its commercialization it is needed to know its safety scope. Objective: To assess the adverse reactions of interferon alpha 2b recombinant in the treatment of multiple sclerosis. Method: During the period between 1996 and 2006, 70 clinical histories and data collection notebooks of patients included in the randomized double blind national clinical trial phase IV were revised. This trial was developed in the Clinic of Multiple Sclerosis of the Hospital "Dr. Gustavo Aldereguía Lima" in Cienfuegos. With regard to the total of manifested adverse reactions we analyzed type, length, and use of a given treatment to counteract them, intensity level (light, moderate, serious or lethal and causality level (definitive, probable, possible, conditional or not related. Results: 53 patients out of the total presented 207 adverse reactions to interferon. The most frequent were: fever, migraine, chills, arthralgia, asthenia and myalgia, being most of them moderate collateral effects of definitive character. In 197 patients the outcome was favorable. Conclusion: The use of the interferon alpha 2b recombinant was safe in the treatment of the multiple sclerosis in these patients. 

  5. Idiopathic Parkinson's disease: vocal and quality of life analysis

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    Luiza Furtado e Silva

    2012-09-01

    Full Text Available OBJECTIVE: To compare voice and life quality of male patients with idiopathic Parkinson's disease, with individuals without disease (Control Group. METHODS: A cross-sectional study that evaluated the voice of individuals with Parkinson's disease, the group was composed of 27 subjects, aged from 39 to 79 years-old (average 59.96. The Control Group was matched on sex and age. Participants underwent voice recording. Perceptual evaluation was made using GRBASI scale, which considers G as the overall degree of dysphonia, R as roughness, B as breathiness, A as asthenia, S as strain and I as instability. The acoustic parameters analyzed were: fundamental frequency, jitter, shimmer, and harmonic to noise ratio (NHR. For vocal self-perception analysis, we used the Voice Related Quality of Life protocol. RESULTS: Fundamental frequency and jitter presented higher values in the Parkinson's group. NHR values were higher in the Control Group. Perceptual analysis showed a deviation ranging. The vocal disorder self-perception demonstrated a worse impact on quality of life. CONCLUSIONS: Individuals with Parkinson's disease have an altered voice quality and a negative impact on quality of life.

  6. Postnatal acquired toxoplasmosis patients in an infectious diseases reference center

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    Cassius Schnell Palhano Silva

    2008-10-01

    Full Text Available Infection caused by Toxoplasma gondii, toxoplasmosis, is one of the most frequent zoonoses in the world; it normally affects both genders equally. Humans are one of several possible intermediate hosts, and the disease is oligosymptomatic in most cases. Vertical transmission is an important cause of fetal malformation and sequels in newborns. Approximately 10% of postnatal cases present multiple manifestations, ranging from low fever and mild lymphadenopathy to severe encephalitis. In moderate cases, lesions such as retinochoroiditis may emerge during acute infection or even years later. We analyzed 313 cases of toxoplasmosis from 1992 to 2004, including 261 acute cases. Most patients were women (68.1%, and 39% of these were pregnant. Among acute infection cases, 64.8% presented symptomatic disease; the most frequent manifestations were lymphadenomegaly (59.8%, fever (27.2%, headache (10.7%, asthenia (10%, weight loss (8.4%, myalgia (8%, retinochoroiditis (3.4% and hepatosplenomegaly (1.5%. Although ocular lesions by T. gondii are well documented as a possible consequence of postnatal infection, two patients developed retinochoroiditis only two years after primary infection. This demonstrates the need for toxoplasmosis case surveillance, even long after acute manifestations.

  7. Effect of Sipjeondaebo-tang on cancer-induced anorexia and cachexia in CT-26 tumor-bearing mice.

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    Choi, Youn Kyung; Jung, Ki Yong; Woo, Sang-Mi; Yun, Yee Jin; Jun, Chan-Yong; Park, Jong Hyeong; Shin, Yong Cheol; Cho, Sung-Gook; Ko, Seong-Gyu

    2014-01-01

    Cancer-associated anorexia and cachexia are a multifactorial condition described by a loss of body weight and muscle with anorexia, asthenia, and anemia. Moreover, they correlate with a high mortality rate, poor response to chemotherapy, poor performance status, and poor quality of life. Cancer cachexia is regulated by proinflammatory cytokines such as interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), and tumor necrosis factor- α (TNF- α). In addition, glucagon like peptide-1 (GIP-1), peptide YY (PYY), ghrelin, and leptin plays a crucial role in food intake. In this study, we investigated the therapeutic effects of one of the traditional herbal medicines, Sipjeondaebo-tang (Juzen-taiho-to in Japanese; SJDBT), on cancer anorexia and cachexia in a fundamental mouse cancer anorexia/cachexia model, CT-26 tumor-bearing mice. SJDBT was more significantly effective in a treatment model where it was treated after anorexia and cachexia than in a prevention model where it was treated before anorexia and cachexia on the basis of parameters such as weights of muscles and whole body and food intakes. Moreover, SJDBT inhibited a production of IL-6, MCP-1, PYY, and GLP-1 and ameliorated cancer-induced anemia. Therefore, our in vivo studies provide evidence on the role of SJDBT in cancer-associated anorexia and cachexia, thereby suggesting that SJDBT may be useful for treating cancer-associated anorexia and cachexia.

  8. Mechanisms of anorexia-cachexia syndrome and rational for treatment with selective ghrelin receptor agonist.

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    Esposito, Angela; Criscitiello, Carmen; Gelao, Lucia; Pravettoni, Gabriella; Locatelli, Marzia; Minchella, Ida; Di Leo, Maria; Liuzzi, Rita; Milani, Alessandra; Massaro, Mariangela; Curigliano, Giuseppe

    2015-11-01

    Cancer cachexia is a multi-organ, multifactorial and often irreversible syndrome affecting many patients with cancer. Cancer cachexia is invariably associated with weight loss, mainly from loss of skeletal muscle and body fat, conditioning a reduced quality of life due to asthenia, anorexia, anaemia and fatigue. Treatment options for treating cancer cachexia are limited. The approach is multimodal and may include: treatment of secondary gastrointestinal symptoms, nutritional treatments, drug, and non-drug treatments. Nutritional counselling and physical training may be beneficial in delaying or preventing the development of anorexia-cachexia. However, these interventions are limited in their effect, and no definitive pharmacological treatment is available to address the relevant components of the syndrome. Anamorelin is a first-in-class, orally active ghrelin receptor agonist that binds and stimulates the growth hormone secretagogue receptor centrally, thereby mimicking the appetite-enhancing and anabolic effects of ghrelin. It represents a new class of drug and an additional treatment option for this patient group, whose therapeutic options are currently limited. In this review we examine the mechanisms of anamorelin by which it contrasts catabolic states, its role in regulation of metabolism and energy homeostasis, the data of recent trials in the setting of cancer cachexia and its safety profile.

  9. Hematology and serum biochemistry in debilitated, free-ranging raccoon dogs (Nyctereutes procyonoides) infested with sarcoptic mange.

    Science.gov (United States)

    Kido, Nobuhide; Kamegaya, Chihiro; Omiya, Tomoko; Wada, Yuko; Takahashi, Maya; Yamamoto, Yasuhiko

    2011-12-01

    Frequent outbreaks of Sarcoptes scabiei infestation in raccoon dogs (Nyctereutes procyonoides) have been reported in Japan. Although many raccoon dogs are brought to Kanazawa Zoological Garden (Yokohama, Kanagawa, Japan) because of S. scabiei infestation and debilitation, some of them die of asthenia. The clinical status of severely debilitated raccoon dogs must be determined to save their lives. In this study, we compared hematological and serum biochemical values between severely debilitated and nondebilitated raccoon dogs infested with S. scabiei. The total protein, albumin, glucose, and calcium values of debilitated raccoon dogs were significantly lower than those of nondebilitated raccoon dogs. On the other hand, debilitated raccoon dogs had significantly higher aspartate aminotransferase, total bilirubin, blood urea nitrogen, sodium, chloride, and phosphorus values than did nondebilitated raccoon dogs. The increase in the blood urea nitrogen value was particularly dramatic. The present study revealed that debilitated raccoon dogs infested with S. scabiei exhibited abnormal hematological values compared with nondebilitated raccoon dogs infested with S. scabiei. Clinically, the raccoon dogs developed malnutrition and sepsis if the mange infestation was untreated. Moreover, dehydration associated with appetite loss may have resulted in insufficient renal perfusion. These findings suggest that chronic S. scabiei infestations debilitated the raccoon dogs and resulted in physiological changes that were detected with hematological and serum biochemical tests.

  10. Doctor, my son is so tired... about a case of hereditary fructose intolerance.

    Science.gov (United States)

    Guery, M J; Douillard, C; Marcelli-Tourvieille, S; Dobbelaere, D; Wemeau, J L; Vantyghem, M C

    2007-12-01

    We present the case of a 17-year-old male who was diagnosed at birth with hereditary fructose intolerance (HFI). The patient complained of morning-time asthenia and post-prandial drowsiness despite a correct sleep pattern. The physical examination and biological check-up only showed severe vitamin C deficiency (fructose-free diet. A change in diet associated with a supplementation in vitamin C was advised, with an increase in vegetable intake, principally avoiding carrots, onions, leaks and tinned sweet-corn. This case offers the opportunity for a review of this rare disease. Two kinds of fructose metabolism disorders (both autosomal recessive) are recognized: 1) essential fructosuria caused by a deficiency of fructokinase, which has no clinical consequence and requires no dietary treatment; 2) HFI, linked to three main mutations identified in aldolase B gene that may be confirmed by fructose breath test, intravenous fructose tolerance test, and genetic testing. In HFI, fructose ingestion generally induces gastro-intestinal (nausea and vomiting, abdominal pain, meteorism) and hypoglycemic symptoms. Fasting is well tolerated. If the condition remains undiagnosed, it leads to liver disease with hepatomegaly, proximal tubular dysfunction, and slow growth and weight gain. In conclusion, endocrinologists should be aware of this rare metabolic disease in order to provide careful follow-up, particularly important when the patient reaches adulthood. Moreover, hypoglycemia induced by fructose absorption, unexplained liver disease, irritable bowel syndrome or familial gout in an adult is suggestive of the diagnosis.

  11. Chronic polyarthritis in a patient affected by sarcoidosis and chronic HCV infection. Case report and review of the literature

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    A. Carcassi

    2011-09-01

    Full Text Available Sarcoidosis is a systemic granulomatous disease of unknown etiology that has a wide variety of clinical manifestation. Lung involvement may slowly undergo pulmonary fibrosis. Chronic sarcoid arthritis is a rare, usually non destructive arthropathy; may be a mono, oligo or polyarthritis. Knees, ankles, shoulders, wrists and small joint of the hands and feet may be involved. It can involve skin, eyes, exocrine glands such as salivary and lacrimal glands, and many other tissues. We describe the case of a 77 years old woman with a history of rhinopharyngitis with epistaxis and chronic laryngitis since youth; a dry mouth and throat, a erytematous, infiltrative skin lesion in the forehead and in the nape of the neck, a purple lesion of the left ear and nose, skin distrophy of the hands from 30 years before. She underwent an operation for a left femoral fracture with emotrasfusion 14 years ago. Then she developed a polyarthritis of the small joints of the hands (II, III and IV right DIP, I, III, e V left DIP; III and V bilateral PIP, knees, tarsi, toes and left elbow. An HCV chronic hepatitis was discovered 6 years before. She is affected by productive cough, dysphonia, dyspnea at rest, feveret, cephalea and asthenia for over 5 years. Laboratory examination revealed leukopenia, HCV hepatitis with anti HCV, HCV-RNA, transaminases elevated and cryoglobulinemia. HCV may be involved in the etiopathogenesis of rheumatic diseases, lung fibrosis and may moreover contribuite to the onset or progression of sarcoidosis; the possible pathogenesis is discussed.

  12. Work-related voice disorder

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    Paulo Eduardo Przysiezny

    2015-04-01

    Full Text Available INTRODUCTION: Dysphonia is the main symptom of the disorders of oral communication. However, voice disorders also present with other symptoms such as difficulty in maintaining the voice (asthenia, vocal fatigue, variation in habitual vocal fundamental frequency, hoarseness, lack of vocal volume and projection, loss of vocal efficiency, and weakness when speaking. There are several proposals for the etiologic classification of dysphonia: functional, organofunctional, organic, and work-related voice disorder (WRVD.OBJECTIVE: To conduct a literature review on WRVD and on the current Brazilian labor legislation.METHODS: This was a review article with bibliographical research conducted on the PubMed and Bireme databases, using the terms "work-related voice disorder", "occupational dysphonia", "dysphonia and labor legislation", and a review of labor and social security relevant laws.CONCLUSION: WRVD is a situation that frequently is listed as a reason for work absenteeism, functional rehabilitation, or for prolonged absence from work. Currently, forensic physicians have no comparative parameters to help with the analysis of vocal disorders. In certain situations WRVD may cause, work disability. This disorder may be labor-related, or be an adjuvant factor to work-related diseases.

  13. Pulmonary Valve Infective Endocarditis in an Adult Patient with Severe Congenital Pulmonary Stenosis and Ostium Secundum Atrial Septal Defect

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    Juan Lacalzada

    2010-01-01

    Full Text Available A hypertensive 76-year-old man with severe pulmonary valve stenosis (PVS and recent initiation of haemodialysis was referred with fever, chills, and asthenia. One month prior, he had been admitted with similar symptoms. Transthoracic echocardiography (TTE had shown a PVS and no valve vegetations were observed. Following discharge, he was readmitted with fever and blood cultures positive for Staphylococcus haemolyticus. A new TTE revealed two pulmonary valve vegetations and a previously undetected ostium secundum-type atrial septal defect (ASD, confirmed by transesophageal echocardiography. The clinical course was uneventful with intravenous antibiotic treatment and the patient was safely discharged. This is a case of pulmonary valve infective endocarditis (IE. The incidence of right-sided IE is on the rise due to the increased number of patients using central venous lines, pacing, haemodialysis and other intravascular devices. Pulmonary valve IE is extremely rare, especially in structurally normal hearts. The case reported here, presents a combination of predisposing factors, such as severe congenital PVS, the presence of a central venous catheter, and haemodialysis. The fact that it was an older patient with severe congenital PVS and associated with a previously undiagnosed ASD, is also an unusual feature of this case, making it even more interesting.

  14. Psychosocial issues in space: results from Shuttle/Mir

    Science.gov (United States)

    Kanas, N.; Salnitskiy, V.; Grund, E. M.; Weiss, D. S.; Gushin, V.; Bostrom, A.; Kozerenko, O.; Sled, A.; Marmar, C. R.

    2001-01-01

    Important psychosocial issues involving tension, cohesion, leader support, and displacement of negative emotions were evaluated in a 4 1/2-year study involving five U.S. and four Russian Shuttle/Mir space missions. Weekly mood and group climate questionnaires were completed by five U.S. astronauts, eight Russian cosmonauts, and 42 U.S. and 16 Russian mission control subjects. There were few findings that supported our hypothesized changes in tension, cohesion, and leader support in crew and ground subjects using various time models, although crewmembers reported decreasing leader support in the 2nd half of the missions, and astronauts showed some evidence of a novelty effect in the first few weeks. There was no evidence suggesting a 3rd quarter effect among crewmembers on any of the 21 subscales evaluated. In contrast, there was strong evidence to support the hypothesized displacement of tension and negative emotions from crewmembers to mission control personnel and from mission control personnel to management. There were several significant differences in response between Americans vs. Russians, crewmembers vs. mission control personnel, and subjects in this study vs. people in comparable groups on Earth. Subject responses before, during, and after the missions were similar, and we did not find evidence for asthenia in space. Critical incidents that were reported generally dealt with events on-board the Mir and interpersonal conflicts, although most of the responses were from a relatively small number of subjects. Our findings have implications for future training and lead to a number of countermeasures.

  15. Large gangliocytic paraganglioma of the duodenum:A rare entity

    Institute of Scientific and Technical Information of China (English)

    Alejandra; Gordillo; Hernández; Eduardo; Dominguez-Adame; Lanuza; Auxiliadora; Cano; Matias; Rosario; Perez; Huertas; Katherine; Maria; Gallardo; Rodriguez; Purificacion; Gallinato; Perez; Fernando; Oliva; Mompean

    2015-01-01

    Gangliocytic paragangliomas are rare tumors that almost exclusively occur within the second portion of the duodenum. Although these tumors generally have a benign clinical course, they have the potential to recur or metastasize to regional lymph nodes. The case report presented here describes a 57-year-old female patient with melena, progressive asthenia, anemia, and a mass in the second-third portion of the duodenum that was treated by local excision. The patient was diagnosed with a friable bleeding tumor. The histologic analysis showed that the tumor was a 4 cm gangliocytic paraganglioma without a malignant cell pattern. In the absence of local invasion or distant metastasis, endoscopic resection represents a feasible, curative therapy. Although endoscopic polypectomy is currently considered the treatment of choice, it is not recommended if the size of the tumor is > 3 cm and/or there is active or recent bleeding. Patients diagnosed with a gangliocytic paraganglioma should be closely followed-up for possible local recurrence.

  16. Uncontrolled seizures resulting from cerebral venous sinus thrombosis complicating neurobrucellosis

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    Fardin Faraji

    2013-01-01

    Full Text Available Cerebral venous sinus thrombosis is a rare form of stroke caused by thrombosis in venous sinuses of the brain. In this study, we reported on a patient with venous sinus thrombosis and brucellosis who presented with uncontrolled seizure despite being treated with anti-epileptic drugs at high doses. The case was a 33-year-old woman with a history of controlled complex partial seizure who presented with headache, asthenia, and uncontrolled seizure for one month. She was febrile and a brain CT scan indicated hemorrhagic focus in the left posterior parietal and the temporal lobe. Magnetic resonance imaging and magnetic resonance venography also proved venous sinus thrombosis in the left transverse sinus. Besides [In addition], a laboratory assessment confirmed brucellosis. Following the treatment with anti-coagulant, anti-brucellosis, and anti-epileptic agents, the patient was discharged in good condition with medical orders. Clinical suspicion and accurate evaluation of a patient′s history is the most important clue in diagnosis and treatment of brucellosis and cerebral venous sinus thrombosis, especially in uncontrolled seizure in patients who had previously been under control.

  17. Skin Rashes on Leg in Brucellosis: a Rare Presentation.

    Science.gov (United States)

    Shahcheraghi, Seyed Hossein; Ayatollahi, Jamshid

    2015-01-01

    Brucellosis is the most widespread zoonotic infection in the world. The disease is endemic in countries bordering the Mediterranean Sea. It is an important re-emerging infectious disease. This disease is closely associated with the evolution of mankind as an agrarian society linked to the practice of shepherding and popularization of animal husbandry. The patients with this disease are typically present with chills, fever, asthenia and sweating. This paper describes a patient with brucellosis and skin rashes on the leg. A 41-year-old man presented with fever, ataxia, and dysarthria. He was a shepherd. The patient reported the loss of appetite, arthralgia and weight loss during previous five months. Finally, he was diagnosed with brucellosis by positive blood culture and high titer for Brucella agglutination test. The clinical manifestation of brucellosis is very broad, ranging from asymptomatic infection to serious debilitating disease. Current patient had skin rashes on his leg. Brucellosis must be considered in the differential diagnosis of acute infections, especially if there is a history of fresh milk product ingestion and living in an endemic region.

  18. Frequency and Clinical Features of Dengue Infection in a Schoolchildren Cohort from Medellin, Colombia

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    Berta Nelly Restrepo

    2012-01-01

    Full Text Available To determine the incidence of dengue infection, we established active surveillance of febrile episodes in a cohort of schoolchildren from three schools in Medellin, Colombia. We followed a cohort of 2,379 schoolchildren in 2010 and followed 1,840 of these children the following year. During the follow-up time, 264 schoolchildren displayed 297 febrile episodes; of these, 23 episodes (7.7% were caused by acute dengue infection. All four dengue serotypes were found, and all of the cases were mild. The most common symptoms in the dengue cases compared with those in other febrile illness were asthenia (96% versus 87%, anorexia (78% versus 57%, rhinorrhea (65.2% versus 58%, abdominal pain (56.5% versus 47.8%, arthralgia (43% versus 33%, and positive tourniquet test (13% versus 3%. This difference was not statistically significant. Pulse was elevated, and systolic arterial pressure was lower in dengue cases compared with other febrile illness (P<0.05. Mosquito indexes were determined in 8 children’s houses and in the schools. Aedes aegypti adults were found in both households and in schools, whereas Aedes aegypti larvae were found only in schools. These results showed an elevated dengue frequency in children, with symptoms similar to those of other febrile illness and transmission risk in households and schools.

  19. Renal cell carcinoma: complete pathological response in a patient with gastric metastasis of renal cell carcinoma.

    Science.gov (United States)

    García-Campelo, Rosario; Quindós, Maria; Vázquez, Diana Dopico; López, Margarita Reboredo; Carral, Alberto; Calvo, Ovidio Fernández; Soto, José Manuel Rois; Grande, Enrique; Durana, Jesús; Antón-Aparicio, Luis Miguel

    2010-01-01

    A 75-year-old-man, with a 2-month history of abdominal pain, underwent a standard diagnostic workup that included a CT scan that showed a large right renal mass and subcentimeter nodes in the right and left lung lobes. In December 2003, the patient underwent right nephrectomy with adrenalectomy and a diagnosis of renal cell carcinoma (pT3N0M0 stage) was made. No further treatment was proposed and patient was followed up regularly. In October 2006, the annual gastrointestinal endoscopy showed asymptomatic multilobulated and polypoid masses in the gastric fundus and gastric body that corresponded to metastasis of the renal carcinoma that had been resected three years ago. Surgical treatment was refused and oral treatment with sunitinib (50 mg/day consecutively for 4 weeks followed by 2 weeks off) was initiated. Patient completed one cycle and development of acute toxicity (grade 3 asthenia, anorexia and mucositis) led to treatment interruption. After recovering from acute toxicity, the patient was proposed to reinitiate treatment with dose reduction, but he refused any medical treatment. At the follow-up visit, three months later, the gastrointestinal endoscopy showed four unspecific 2 mm nodules without malignant evidence. The whole-body CT did not reveal any other abnormality except for the known lung nodes. PET scan six months after treatment confirmed complete gastric response.

  20. An overview of the brucellosis epidemic conditions in Iran

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    fallah rostami Fatemeh

    2016-01-01

    Full Text Available Brucellosis is as one of the most important infection common disease between human and cattle, which nowadays considered as one of serious health systems dilemma specifically in developing countries.Among brucellosis different species are the cause of infection, 4 species namely B.melitensis, BSuis, B.abortus , B.canis are the most major cause of disease in human(1.Indeed, in Iran that is considered as an endemic area of hygienic organization, B. melitensis is as the most prevalent cause of infection in human. This bacterium generally will transfer to human from contact with contaminated animals or the consumption of cattle production such as unpasteurized dairy (raw milk, soft cheese, cream or even via breathe can transfer to human. But the transfer of infection from person to person is very infrequent.Of course there is some evidence of transfer in a bone marrow transplanting. The most prevalent clinical symptoms of this disease are fever, night sweat, asthenia and anorexia (2.Naturally this infection involved different systems and organs in human body and the one of most major part of body can be mentioned to nervous system, muscuskeletal and also some organs like joints, heart and liver.Diagnosis of this infection can be made by some various laboratory tests like SAT, 2ME. But some misdiagnosis instances are very common. Thus, World Health Organization (WHO exposed in its report that the number of infected cases are maybe ten folds more than scale which stated by health organizations.

  1. [Dengue: a re-emerging disease. A clinical and epidemiological study in 57 Spanish travelers].

    Science.gov (United States)

    Gascón, J; Giner, V; Vidal, J; Jou, J M; Mas, E; Corachán, M

    1998-11-07

    Dengue infection is nowadays considered a re-emergent disease. It has a worldwide tropical and subtropical distribution. The dengue virus in a member of the flavivirus family composed by 4 different serotypes. The virus is transmitted by mosquitos of the Aedes genus. With the increment of travels to the endemic areas, dengue is now observed frequently in our country. We analyzed 57 patients, 30 with imported dengue (ID) and 27 with dengue fever suffered during the trip (DDT). This series is compared with other published ones and a review of the subject is presented. Patients with ID followed a protocol as a febril syndrome returning from the tropics. Dengue was diagnosed through a compatible clinico-epidemiological history, the absence of other ferbil illness and positivity of specific serology. All patients had travelled to endemic areas (Central America 28 cases, Indian subcontinent 15, South-East Asia 10, South America 2, West Africa one, and Pacific one). The following were the most important clinical characteristics: fever and asthenia (100%), headache (98%), mialgia (84%), arthralgia (72%), morbilliform rash (61%) and retroocular pain (65%). For ID cases, the most helpful analitical results were: leucopenia (70%), reactive lymphocytes in peripheral blood smear (70%), thrombocytopenia (70%), and increased hepatic enzymes ALAT (53%), ASAT (63%) and LDH (100% in the 7 patients tested for this enzyme). Dengue must be included in differential diagnosis of fever in patients coming back to travels to tropical areas.

  2. [Spanish consensus statement for diagnosis and treatment of paroxysmal nocturnal haemoglobinuria].

    Science.gov (United States)

    Villegas, Ana; Arrizabalaga, Beatriz; Bonanad, Santiago; Colado, Enrique; Gaya, Anna; González, Ataúlfo; Jarque, Isidro; Núñez, Ramiro; Ojeda, Emilio; Orfao, Alberto; Ribera, José-María; Vicente, Vicente; Urbano-Ispizua, Álvaro

    2016-03-18

    Paroxysmal nocturnal haemoglobinuria (PNH) is an acquired clonal disorder of the haematopoietic progenitor cells due to a somatic mutation in theX-linked phosphatidylinositol glycan class A gene. The disease is characterized by intravascular haemolytic anaemia, propensity to thromboembolic events and bone marrow failure. Other direct complications of haemolysis include dysphagia, erectile dysfunction, abdominal pain, asthenia and chronic renal failure (65% of patients). The disease appears more often in the third decade of life and there is no sex or age preference. Detection of markers associated with glucosyl phosphatidyl inositol deficit by flow cytometry is currently used in the diagnosis of PNH. For years, transfusions have been the mainstay of therapy for PNH. A breakthrough in treatment has been the approval of the humanized monoclonal antibody eculizumab, which works by blocking the C5 complement protein, preventing its activation and therefore haemolysis. Several studies have confirmed that treatment with eculizumab avoids or decreases the need for transfusions, decreases the probability of thrombosis, improves the associated symptomatology and the quality of life in patients with PNH, showing an increase in survival. Because of rapid advances in the knowledge of the disease and its treatment, it may become necessary to adapt and standardize clinical guidelines for the management of patients with PNH.

  3. Phase II study of capecitabine as palliative treatment for patients with recurrent and metastatic squamous head and neck cancer after previous platinum-based treatment

    Science.gov (United States)

    Martinez-Trufero, J; Isla, D; Adansa, J C; Irigoyen, A; Hitt, R; Gil-Arnaiz, I; Lambea, J; Lecumberri, M J; Cruz, J J

    2010-01-01

    Background: Platinum-based therapy (PBT) is the standard therapy for recurrent and/or metastatic head and neck cancer (HNC), but the incidence of recurrence remains high. This study evaluates the efficacy and tolerability of capecitabine as palliative monotherapy for recurrent HNC previously treated with PBT. Methods: Patients aged 18–75 years, with Eastern Cooperative Oncology Group performance status 0–2, squamous HNC with locoregional and/or metastatic recurrence previously treated with PBT and adequate organ functions, were included. Capecitabine (1.250 mg m−2 BID) was administered on days 1–14 every 21 days for at least two cycles. Results: A total of 40 male patients with a median age of 58 years were analysed. All patients received a median number of four cycles of capecitabine (range: 1–9) and the median relative dose intensity was 91%. Seven patients were not evaluable for response. Overall response rate was 24.2%. Median time to progression and overall survival were 4.8 and 7.3 months, respectively. Haematological adverse events (AEs) grade 3/4 were reported in six patients. Most common grade 3/4 non-haematological AEs were asthenia (12.5%), palmar-plantar eritrodisestesia (10%), mucositis (10%), dysphagia (10%) and diarrhoea (7.5%). Conclusions: Capecitabine seems to be an active, feasible and well-tolerated mode of palliative treatment for advanced HNC patients who have previously received PBT schedules. PMID:20485287

  4. An Unusual Presentation of Plasma Cells – Castleman Disease: A Case Report

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    Mihăilă Mariana

    2016-06-01

    Full Text Available We present the case of a 76 year old female patient admitted in the Department of Cardiology for physical asthenia, profuse sweating and dyspnea with orthopnea for about one month. Clinical and paraclinical assessments performed at admission confirmed the diagnosis of cardiac tamponade. Surgical intervention was performed and 400 mL of clear effusion were drained. Post-operative evolution was marked by recurrence of symptoms, requiring after 3 weeks a new drainage of 600 mL of clear effusion, and biopsy of the pericardium was performed. Pathological exam described serous pericarditis with chronic inflammatory infiltrate, xanthogranulomatous reaction intricated in the pericardium and mesothelial hyperplasia. The patient was subsequently transferred to the Department of Internal Medicine for further investigations. Physical examination showed a patient with altered general status, pallor, vesicular murmur absent in both bases, presenting cutaneous hyperpigmentation at the level of the right hemi-abdomen and hip with posterior extension, and a peripheral indurated erythematous plaque. The patient presented nodular masses of 3 cm in the right latero-cervical and bilateral axillary regions, non-adherent to the superficial structures, as well as adenopathic blocks in both inguinal regions. CT scan of the thorax and abdomen showed moderate bilateral pleuresia, minimal pericardial effusion (15 mm and multiple adenopathies on both sides of the diaphragm. Skin biopsy was performed, as well as bone marrow aspirate and excision of a right axillary lymph node. Pathological exams and immunohistochemistry tests confirmed the diagnosis of Plasma Cells Castleman disease.

  5. Unresponsiveness of Experimental Canine Leishmaniosis to a New Amphotericin B Formulation

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    Leticia Hernández

    2015-01-01

    Full Text Available This study was designed to evaluate the efficacy and safety of a novel free polyaggregated amphotericin B (FPA formulation used to treat experimental canine leishmaniosis (CanL caused by Leishmania infantum. Eight healthy beagles were intravenously challenged with 5×107 promastigotes per mL of L. infantum. One year after infection, they received an intravenous dose of FPA (5 mg/kg every 2 weeks three times. Dogs were assessed monthly for clinical signs, serology, and parasite detection during a follow-up period of 6 months. Transient adverse effects (i.e., hypotension, diarrhea, bodyweight loss, fever, and asthenia were observed within 24–48 hours after treatment in 4 animals. In three dogs mean clinical signs scores were reduced. Antibody titers measured by immunofluorescence antibody test (IFAT had significantly diminished at the end of the study, although according to bone marrow smears and cultures a high percentage of dogs tested positive for the parasite at 6 months posttreatment (PT6. Real-time quantitative PCR (rtQ-PCR on blood, bone marrow, and urine samples revealed the presence of parasitic DNA in all animals at PT6, although blood loads of the parasite were reduced. These findings indicate that FPA at the dosing regimen used did not achieve clinical or parasitological cure in dogs experimentally infected with L. infantum.

  6. Voice features of Parkinson's disease patients with subthalamic nucleus deep brain stimulation.

    Science.gov (United States)

    Tanaka, Yasuhiro; Tsuboi, Takashi; Watanabe, Hirohisa; Kajita, Yasukazu; Fujimoto, Yasushi; Ohdake, Reiko; Yoneyama, Noritaka; Masuda, Michihito; Hara, Kazuhiro; Senda, Joe; Ito, Mizuki; Atsuta, Naoki; Horiguchi, Satoshi; Yamamoto, Masahiko; Wakabayashi, Toshihiko; Sobue, Gen

    2015-05-01

    Voice and speech disorders are one of the most important issues after subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson's disease patients; however, their characteristics remain unclear. We performed a comprehensive voice evaluation including the multi-dimensional voice program for acoustic analysis, the GRBAS scale for perceptual analysis, and the evaluation of the voice handicap index (VHI) for psychosocial analysis. In total, 68 patients who had undergone STN-DBS (37 assessed in the on- and off-stimulation conditions) and 40 who had been treated with medical therapy alone were evaluated. Further, we performed laryngoscopic examinations in 13 STN-DBS and 19 medical-therapy-alone patients. The STN-DBS group, especially females, showed widespread impairment of voice parameters and significantly poorer VHI scores than the medical-therapy-alone group. The degree of voiceless (DUV) and strained voice were the most impaired factors in the STN-DBS group; and DUV significantly improved after stopping stimulation. Furthermore strained voice, breathiness, and asthenia improved after stopping stimulation. Laryngoscopic examination showed that abnormal laryngeal muscle contraction and incomplete glottal closure were more prominent in the STN-DBS group than in the medical-therapy-alone group. We demonstrated that (1) more widespread voice impairment in females, (2) poorer voice-related QOL, (3) worse DUV and strained voice, and (4) abnormal laryngeal muscle contraction were the characteristic voice and laryngeal findings in the STN-DBS group compared with those in the medical-therapy-alone group.

  7. Epididymoorchitis as the First Finding in Patients with Brucellosis

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    Ayhan Karaköse

    2013-01-01

    Full Text Available Purpose. Acute scrotal pain as the first symptom of brucellosis is rarely observed. We aimed to evaluate the data of male patients with brucellosis and epididymoorchitis as the initial diagnosis. Material and Methods. The data of seven patients presented with testicular pain, hyperemia, swelling, and increased fever were reviewed. Concomitant focal diseases as well as clinical, laboratory, and radiological findings were retrospectively evaluated. Results. The mean age of the patients was 22.28 ± 7.78 (16–35 years. All patients presented with scrotal pain, swelling, and increased sweating. Additional findings included fever, asthenia, arthralgia, dysuria, shiver and rash, weight loss, and vomiting in 6, 5, 4, 4, 3, 2, and 1 patient, respectively. In all of 7 patients, the agglutination tests of Rose-Bengal and Wright were positive. Coombs test was positive only in 3 patients. The patients underwent antibiotic and conservative treatment. No relapse was observed following the treatment. Conclusion. In endemic regions, epididymoorchitis caused by brucellosis should be considered in the differential diagnosis of patients presenting with acute scrotal pain. Clinical and serological findings are sufficient for the diagnosis. Conservative management combined with antibiotic therapy is adequate for managing brucellar epididymoorchitis.

  8. Lipoplatin monotherapy: A phase II trial of second-line treatment of metastatic non-small-cell lung cancer.

    Science.gov (United States)

    Ravaioli, A; Papi, M; Pasquini, E; Marangolo, M; Rudnas, B; Fantini, M; Nicoletti, S V L; Drudi, F; Panzini, I; Tamburini, E; Gianni, L; Pasini, G

    2009-02-01

    Lipoplatin is a liposome encapsulated form of cisplatin. phase i studies on lipoplatin have demonstrated that the compound has an excellent toxicity profile. therefore we performed a phase ii trial in heavily pre-treated patients with advanced non-small-cell lung cancer (NSClC), performance status 0-2 in which the primary endpoint was response rate and secondary endpoints were safety and overall survival.Nineteen patients, average age 64 years old, with stage iV NSClC, were treated with lipoplatin 100 mg/m(2) every two weeks, as second line chemotherapy.We observed 1 partial remission (5.2%) and 3 stable diseases (15.9%). Time to progression (ttp) was 16 weeks and median overall survival (OS) was 31 weeks (7.2 months). We observed G1-G2 toxicity during chemotherapy, mainly gastrointestinal with nausea and vomiting (4 patients), asthenia (3 patients), mucositis (2 patients) and anemia (4 patients).Our phase ii study does not support a more extensive use of lipoplatin in phase III studies. An increase of dosage and a better selection of patients are mandatory to understand the real therapeutic activity of lipoplatin.

  9. Low toxicity and anticancer activity of a novel liposomal cisplatin (Lipoplatin) in mouse xenografts.

    Science.gov (United States)

    Boulikas, Teni

    2004-07-01

    Cisplatin has been one of the most widely used and most effective cytotoxic agents in the treatment of malignancies but causes severe adverse reactions including nausea/vomiting, renal toxicity, gastrointestinal toxicity, peripheral neuropathy, asthenia, and ototoxicity. A liposomal formulation of cisplatin, Lipoplatin, was developed in order to reduce the systemic toxicity of cisplatin. A single treatment of rats with 30 mg/kg Lipoplatin resulted in no toxicity whereas 2 or 3 weekly administrations at 30 mg/kg to rats gave neutropenia but no nephrotoxicity. On the contrary, a single injection to rats of 5 mg/kg cisplatin resulted in severe nephrotoxicity. Thus, Lipoplatin is less toxic than cisplatin in rats. Intraperitoneal or intravenous injection of Lipoplatin to SCID (severe combined immunodeficient) mice with subcutaneous breast MCF-7 or prostate LNCaP human tumors resulted in size reduction of the tumors; histological examination of the treated tumors in xenografts was consistent with apoptosis in tumor cells; thus, Lipoplatin appears to exert its cytotoxic effects to tumors in a mechanism similar to that of cisplatin. The preclinical studies reported here set the foundation for the clinical use of Lipoplatin as an exciting new drug with lower toxicity than cisplatin, endowed with proapoptotic properties.

  10. Clinical overview on Lipoplatin: a successful liposomal formulation of cisplatin.

    Science.gov (United States)

    Boulikas, Teni

    2009-08-01

    Nanoparticle formulations for packaging existing drugs have been used to treat cancer. Lipoplatin is a liposomal cisplatin encapsulated into liposome nanoparticles of an average diameter of 110 nm. Lipoplatin has substantially reduced the renal toxicity, peripheral neuropathy, ototoxicity, myelotoxicity as well as nausea/vomiting and asthenia of cisplatin in Phase I, II and III clinical studies with enhanced or similar efficacy to cisplatin. During clinical development, 10- to 200-fold higher accumulation of Lipoplatin in solid tumors compared to adjacent normal tissue was found in patients. Targeting of tumor vasculature by Lipoplatin in animals suggested its antiangiogenesis potential and Lipoplatin was proposed to act like a double-sword: as chemotherapy and an antiangiogenesis drug. Lipoplatin has finished successfully one Phase III non-inferiority clinical study as first-line against NSCLC in its combination with paclitaxel showing statistically significant reduction in nephrotoxicity; two more Phase III studies are in progress, one in NSCLC with gemcitabine also showing noninferiority with reduced toxicity and another in squamous cell carcinoma of the head and neck with 5-fluorouracil. A registrational Phase II/III study against pancreatic cancer is in progress under the orphan drug status granted to Lipoplatin by the European Medicines Agency. Phase II studies are continuing in advanced breast cancer with vinorelbine and gastrointestinal cancers with radiotherapy and 5-fluorouracil. The highlights of the clinical development of Lipoplatin are reviewed.

  11. 艾滋病相关性腹泻中医综合疗法探析%Explore in the Comprehensive Therapy of TCM to AIDS Related Diarrhea

    Institute of Scientific and Technical Information of China (English)

    张亚萍; 邓鑫; 李永亮

    2011-01-01

    腹泻是艾滋病患者一种非常普遍的临床症状,严重影响患者的生活质量.艾滋病患者腹泻的病机主要在脾,以脾虚失运为主.在防治上,运用健脾益气的中药和艾灸综合疗法对于改善艾滋病患者腹泻症状,提高患者生活质量,维持机体免疫功能,减缓疾病的发展等都有积极的意义.%Diarrhea which is a common clinical symptom of patients with AIDS influences the quality of patients ' life significandy. The pathogenesis of AIDS related diarrhea lies mainly in the spleen with losing transport because of splenic asthenia as the most common syndrome type. To prevent or treat it with comprehensive therapy of strengthening spleen and replenishing Qi and moxibustion can help to alleviate the symptoms, improve the quality of life, maintain the immune function of the body and slow down the steps of the development of the disease.

  12. CARACTERÍSTICAS CLÍNICO EPIDEMIOLOGICAS DE LOS PACIENTES CON LEUCEMIA AGUDA DEL SERVICIO DE HEMATOLOGIA DEL HOSPITAL ALMANZOR AGUINAGA ASENJO

    Directory of Open Access Journals (Sweden)

    Ana María Polo-Capuñay

    2014-01-01

    Full Text Available Objective: To identify the organisms that conform the normal flora of the external auditory canal. Material and Methods: Retrospective, transversal and descriptive. We reviewed a total of 55 medical records with a diagnosis of acute leukemia, taken from the HNAAA registration office during the period from January 2005 to March 2010. Results: During the study period, 142 cases were diagnosed with Leukemia, 105 (73.94% were acute leukemia. Of the 105 cases, 55 were evaluated. Of these 39 were males and 16 females. The most common age group was between 31-55 years (30.9% and the least frequent was 0-2 years (3.6%. 38 patients (69.1% were diagnosed as outpatients and 17 (30.9% diagnosed in emergency. Acute lymphocytic leukemia is more common in men than in women. The type of acute leukemia was undetermined for 7.27%. Within the initial manifestations collected we found more anemia, pallor, fever, body aches, and others (gingival, abdominal pain and vomiting, whereas we found fewer asthenia, fatigue, and bleeding. For laboratory data, 20 patients (69.1% had leukopenia, 33 patients (98.2% had thrombocytopenia and 48 patients (87.3% presented low hemoglobin. Conclusions: The prevalence of acute leukemia was 73.94%. The predominant age group was between 31-55 years. The most common signs and symptoms developed during the disease were, splenomegaly, hepatomegaly, anemia, bruising and petechiae. (Horiz Med 2014; 14(1: 18-23

  13. Clinical and laboratory diagnosis of dengue fever in travelers

    Directory of Open Access Journals (Sweden)

    N. I. Khokhlova

    2015-01-01

    Full Text Available The paper presents the analysis of clinical and laboratory symptoms in 35 adult patients with denger fever, Novosibirsk residents, which travelled in endemic countries, mostly Tailand. The classic form of the disease was determined in all cases. The moderate form was in 71,5% patients, the severe form was in the rest ones. The diagnosis of dengue was verified by detection of specific immunoglobulin M and in some cases immunoglobulin G and also virus dengue NS1 antigen by immunochromatography. The dominant clinical symptoms in observed patients were fever for 3–8 days (100%, mostly high one (71,4%, asthenia (97,1%, anorexia (100%, myalgia or/and arthralgia (77,1%, exantema (60%, hepatomegaly (62,8%. The gematologic indicators were represented with thrombocytopenia in 91,4% patients (from 167 to 20×109/l и leucopenia in 85,7% patients (from 3,9 to 1,1×109/l. The cytolitic syndrom was revealed in 80% patients with predominance of aspartate aminotransferase activity in early period of the disease. 

  14. [Ulcerative colitis initial presentation with multiple extra-intestinal manifestations].

    Science.gov (United States)

    Marques, M Raquel; Oliveira, Susana; Gorjão Clara, J P

    2010-01-01

    Multiple extraintestinal diseases are present in 0.3- 4.5 % of inflammatory bowel disease patients. A 39-year-old woman was admitted with a 3 months history of cervicalgia with functional incapacity, asthenia, tibio-tarsal bilateral arthritis and bloody diarrhoea. She had ferropenic anemia, SR-120 mm, creatinine clearance-42 mL/min, proteinuria-1.2 g/24h. Colonoscopy with biopsy showed active ulcerative rectossigmoiditis. She had bilateral sacroileitis more pronounced at the right side which was suggestive of ankylosing spondylitis. HLA B27 was positive. Because of colestasis, colangio-MRI and CPRE were done and were suggestive of primary sclerosing colangitis. Renal disease was interpreted as an analgesic nephropathy versus glomerulonephritis associated with ulcerative colitis. Cardiac ecodoppler showed pericardial thickening with a thin pericardial effusion. Full improvement of gastrointestinal complaints was observed with 5-ASA topic enemas, sulfassalazine, corticosteroids and azathioprine and full remission of ankylosing spondylitis with adalimumab. This case illustrates extraintestinal wide involvement as the initial presentation of ulcerative colitis, remarking its systemic nature.

  15. Sella turcica atypical teratoid/rhabdoid tumor complicated with lung metastasis in an adult female.

    Science.gov (United States)

    Moretti, Costanzo; Lupoi, Domenico; Spasaro, Francesca; Chioma, Laura; Di Giacinto, Paola; Colicchia, Martina; Frajoli, Mario; Mocini, Renzo; Ulisse, Salvatore; Antonelli, Manila; Giangaspero, Felice; Gnessi, Lucio

    2013-01-01

    Here we present the case of a 60-year-old woman with a rare sellar region atypical teratoid/rhabdoid tumor (AT/RT), complicated by lung metastasis and treated with neurosurgery, radiotherapy, and chemotherapy. The patient had recurrent headache associated with left cavernous sinus syndrome after a previous endonasal transsphenoidal resection for a presumptive pituitary macroadenoma. Pituitary magnetic resonance imaging showed a tumor regrowth in the original location with a haemorrhagic component involving the left cavernous sinus. A near complete transsphenoidal resection of the sellar mass was performed followed by 3 months of stereotactic radiotherapy. Because of a worsening of the general clinical conditions, respiratory failure, and asthenia, the patient underwent a contrast enhanced computer tomography of the whole body which showed the presence of lung metastasis. The histopathological diagnosis on samples from pituitary and lung tissues was AT/RT. The patient survived 30 months after diagnosis regardless chemotherapy. In the adult, the AT/RT should be considered as a possible rare, aggressive, and malignant neoplasm localized in the sella turcica.

  16. Why are astrocytes important?

    Science.gov (United States)

    Verkhratsky, Alexei; Nedergaard, Maiken; Hertz, Leif

    2015-02-01

    Astrocytes, which populate the grey and white mater of the brain and the spinal cord are highly heterogeneous in their morphology and function. These cells are primarily responsible for homeostasis of the central nervous system (CNS). Most central synapses are surrounded by exceedingly thin astroglial perisynaptic processes, which act as "astroglial cradle" critical for genesis, maturation and maintenance of synaptic connectivity. The perisynaptic glial processes are densely packed with numerous transporters, which provide for homeostasis of ions and neurotransmitters in the synaptic cleft, for local metabolic support and for release of astroglial derived scavengers of reactive oxygen species. Through perivascular processes astrocytes contribute to blood-brain barrier and form "glymphatic" drainage system of the CNS. Furthermore astrocytes are indispensible for glutamatergic and γ-aminobutyrate-ergic synaptic transmission being the supplier of neurotransmitters precursor glutamine via an astrocytic/neuronal cycle. Pathogenesis of many neurological disorders, including neuropsychiatric and neurodegenerative diseases is defined by loss of homeostatic function (astroglial asthenia) or remodelling of astroglial homoeostatic capabilities. Astroglial cells further contribute to neuropathologies through mounting complex defensive programme generally known as reactive astrogliosis.

  17. 强直性脊柱炎骨密度及炎性标志物与寒、热证候的相关性研究%On the Correlation Between Bone Density and Inlfammatory Marker and Cold and Heat Syndromes in Patients with Ankylosing Spondylitis

    Institute of Scientific and Technical Information of China (English)

    许森; 马骁; 陶庆文

    2016-01-01

    目的:观察强直性脊柱炎患者骨密度、炎性标志物的变化,研究其与强直性脊柱炎寒热不同证候的相关性。方法:依照纳入标准选取146例强直性脊柱炎患者,以双光能X法检测腰椎、股骨骨密度,与31例健康体检者(健康对照组)比较。同时将全部强直性脊柱炎患者以中医辨证分为肾虚督寒组和肾虚湿热组,分别检测足骨超声硬度指数、C-反应蛋白、红细胞沉降率、免疫球蛋白G、免疫球蛋白M、免疫球蛋白A、补体C3、补体C4。分析寒热证型之间的指标差异。结果:强直性脊柱炎组与健康对照组比较,三角区、股骨粗隆、腰椎双光能X法骨密度差异有统计学意义(P 0.05)。结论:强直性脊柱炎患者骨密度明显降低,且是强直性脊柱炎患者不同寒热证候的共同特征。肾虚湿热证炎性标志物补体C3水平高于肾虚督寒证。%[ABSTRACT]Objective:To observe the changes of bone density and inlfammatory markers in patients with ankylosing spondylitis to study their correlation with cold and heat syndromes.Methods:One hundred and forty six cases of ankylosing spondylitis were selected according to the inclusion criteria.The double light energy X method was used to detect the bone density of the lumbar spine and femur,which was compared with that of 31 health examinees(the health control group).All patients with ankylosing spondylitis according to traditional Chinese medicine syndrome differentiation were divided into a Shenxu Duhan Group(a group with syndromes of kidney asthenia and cold governor meridian)and a Shenxu Shire Group(a group with syndromes of kidney asthenia and heat dampness).Both groups were detected on the aspects of foot bone ultrasound bone mineral density(BMD),C-reactive protein(CRP),red blood cell sedimentation rate,immunoglobulin G,immunoglobulin M,immunoglobulin A,and complements C3 and C4.The index differences between cold and heat

  18. 上海某区老年高血压患者生存质量与中医体质相关分析%Correlation Analysis on Life Quality and TCM Constitutions of Elderly Patients with Hypertension in a Community in Shanghai

    Institute of Scientific and Technical Information of China (English)

    尉敏琦; 诸光花; 周热娜; 王健; 朱鸿雁

    2016-01-01

    gentleness type, and the biased constitution was dominated by qi deficiency, yang asthenia, yin asthenia and phlegmatic hygrosis. The relationship between life quality and TCM constitutions may be existent. If TCM constitutions tended to be gentleness type, the physical score and the psychological score would be higher, which leaded to better quality of life. Conclusion TCM constitution characteristics are associated with quality life of elderly hypertension patients in the community. Intervention targeted on the results of TCM constitution identification would be better to prevent and control hypertension and improve health level and quality of life.

  19. 中医药治疗8946例艾滋病患者临床观察%Clinical Observation on 8946 AIDS Cases Treated by Traditional Chinese Medicine

    Institute of Scientific and Technical Information of China (English)

    王健; 毛宇湘; 邓鑫; 李晓东; 王军文; 梁碧颜; 闫世艳; 陆嘉明; 徐立然; 王玉光; 方路; 张国梁; 李秀惠

    2011-01-01

    目的 观察中医药治疗艾滋病病毒(HIV)感染者及艾滋病(AIDS)患者的临床疗效.方法 收集全国17个省(市)、自治区从2004~2009年采用中医药治疗的HIV/AIDS患者8946例,对患者治疗后4个时间点(12、24、36、48个月)的症状体征、证候分布、CD4+计数、治疗情况及病例脱落死亡情况进行观察分析.结果中医药对发热、乏力、气短、咳嗽、纳呆、腹泻、皮疹等症状有明显疗效,其中以乏力改善最为突出.无症状期患者CD4+计数随时间的变化而降低,艾滋病期患者CD4+计数随时的变化而升高,12、24、36、48个月时与治疗初始时比较,差异均有统计学意义(P<0.05或P<0.01).结论中医药可阶段性地提高和稳定患者免疫功能,改善症状体征,提高其生存质量.%Objective To observe the therapeutic effect of TCM treatment on HIV infected persons and AIDS patients.Methods The 8946 HIV/AIDS patients treated by TCM in the year 2004~2009 were collected.Symptoms and signs, syndrome distribution, CD4 counting, treatment, case-off, and death of the patients were observed and analyzed 12, 24, 36, and 48 months after treatment.Results TCM treatment was very effective in relieving the symptoms such as fever, asthenia, shortness of breath, loss of appetite, diarrhea, and skin rashes, of which, the improvement of asthenia was most significant.The CD4 counting of the patients in the asymptomatic period decreased along with the time going on, while that of the AIDS patients increased along with the time going on.The difference was statistically significant (P<0.05 or P<0.01) after 12, 24, 36, and 48 months treatment as compared with the baseline.Conclusion TCM therapy is able to enhance and stabilize the immunologic function, improve the symptoms and signs, and improve the survival quality of the patients.

  20. 失眠患者血清甲状腺激素及多巴胺水平与中医证型的关系%Correlation between Serum Thyroid Hormone and Dopamine Levels and Chinese Medicine Syndrome Types

    Institute of Scientific and Technical Information of China (English)

    黄俊山; 樊建锋; 刘芳; 曾雪爱; 钟静瑜

    2011-01-01

    internal disturbance by phlegm-heat group > the Xin-Pi deficiency group. The serum TH level was sequenced from high to low as the excessive fire due to yin deficiency group > the depressed Gan transforming into fire group > the internal disturbance by phlegm-heat group > the control group > the Xin-Pi deficiency group. Conclusions Serum DA levels in insomnia patients were in line with the disease course and the dynamic change from sthenia to asthenia in Chinese syndrome types. Serum DA levels,as one of pathological factors constituting the sthenia syndrome or the asthenia syndrome, may be taken as an objective indicator in Chinese medicine syndrome typing.

  1. 数据挖掘技术在糖尿病中医证候及方药中的应用%Data Mining Technique in Application of Syndromes and Prescriptions of Traditional Chinese Medicine for Dia-betes

    Institute of Scientific and Technical Information of China (English)

    郭燕周; 马建伟

    2015-01-01

    Data Mining is a process of identifying the interesting mode and knowledge from mass data. It relates to many subjects and includes many mining methods such as clustering analysis, association rules, scale-free network a-nalysis and etc. The article, which divided into four parts, reviewed applications of data mining technique in syndromes and prescriptions of traditional Chinese medicine ( TCM) for diabetes in recent years. The first part was mainly about the possibility of applications on data mining technique in syndromes and prescriptions of TCM for diabetes. The second part was summarized the conditions that clinicians used data mining analyzed TCM syndromes from diabetes, diabetes compli-cations and combination diseases of diabetes. The third part was summarized the application situation of data mining tech-nique from literature and clinic. According to the results that clinicians had obtained by data mining, the last part was summarized that diabetes syndromes mainly were dryness-heat and Yin asthenia, deficiency of both Qi and Yin, and as-thenia of both Yin and Yang, and the deficiency of both QI and YIN was the most one. Mongolian Milkvetch Root, Reh-mannia Dride Rhizome, Radix Pseudostellariae, Ophiopogonis Japonicus and Salvia Miltiorrhiza Bunge were the most fre-quently used drugs in treatment of diabetes, and the common use of pair drugs were Mongolian Milkvetch Root and Di-oscorea Batatas, Mongolian Milkvetch Root and Angelica, Dioscorea Batatas and Cornus Officinalis and etc. The article also analyzed the shortcomings, effect and significance of data mining technique in TCM research.%数据挖掘是指从大量数据中挖掘有趣模式和知识的过程. 它涉及多学科领域,包含多种挖掘方法,常用的有聚类分析、关联规则、无尺度网络分析等. 现将近几年数据挖掘在糖尿病中医证候、方药规律研究领域的应用作一综述. 文章分四部分内容:第一部分主要概述数据挖掘及其在糖尿病

  2. Macroglobulinemia de Waldenström - remissão completa após tratamento com rituximabe Successful outcome in Waldenström's macroglobulinemia treated with rituximab

    Directory of Open Access Journals (Sweden)

    Flavia C. F. Pimenta

    2008-10-01

    Full Text Available A macroglobulinemia de Waldenström (MW é uma patologia rara dos linfócitos B caracterizada pela produção monoclonal de IgM, e que pode manifestar-se clinicamente com fadiga, astenia, perda de peso, sangramento de mucosas e do trato gastrintestinal, lifonodonomegalias, hepatoesplenomegalia e alterações neurológicas. A doença é mais comum em pacientes idosos, e seus sintomas são decorrentes da hiperviscosidade sangüínea. Na MW observa-se hipergamaglobulinemia com pico monoclonal na eletroforese de proteínas séricas, níveis elevados de IgM e demais imunoglobulinas normais ou diminuídas, imunofenotipagem com linfócitos B CD19+, CD20+ e CD24+, aspirado de medula óssea hipercelular, e biópsia de medula óssea hipercelular com infiltração difusa de linfócitos, linfócitos plasmocitóides e plasmócitos. Atualmente, anticorpos monoclonais estão sendo usados na terapêutica da MW com grande sucesso. O rituximabe, anticorpo monoclonal anti -CD20, tem mostrado excelentes resultados no tratamento da MW, inclusive naqueles indivíduos que não obtiveram resposta adequada ao tratamento convencional. Nós reportamos o caso de uma mulher de 78 anos de idade com história de fadiga, astenia, anorexia, sonolência, inquietação, urticária, dificuldade para deambular e perda excessiva de peso, aproximadamente 22 kg em um período de cinco meses, cujo tratamento foi realizado com rituximabe. O objetivo deste relato é apresentar uma paciente com diagnóstico de MW e revisar aspectos clínicos e terapêutico atual da doença.Waldenström's macroglobulinemia is a rare pathology of B lymphocytes characterized by the production of monoclonal IgM, causing clinical manifestations which may include fatigue, asthenia, weight loss, bleeding of the mucosa and intestinal tract, lymphadenomegaly, hepatosplenomegaly and neurological alterations. The disease is more frequent among elderly patients and its symptoms are a result of the hyperviscosity of

  3. 肺胀阳虚水泛证动物模型的建立方法%Establish animal model with water over-flowing syndrome due to lung-yang deficiency

    Institute of Scientific and Technical Information of China (English)

    韦衮政; 和菊花; 刘涛; 钱锐; 张馨予; 储丽英; 祁向荣

    2011-01-01

    目的 探讨肺胀阳虚水泛证动物模型的造模方法.方法 大鼠随机分为空白对照组;氢化可的松对照组;阿霉素对照组;阿霉素低剂量组;阿霉素高剂量组.序贯应用香烟反复熏吸、气管内注入脂多糖、野百合碱腹腔注射、氢化可的松肌肉注射及阿霉素腹腔注射对大鼠进行造模,然后观察大鼠的精神、形态、活动等,测量尿量,采用心脏超声心动图分阶段检查心脏结构及功能,最后切开胸腹腔探查胸腹脏器情况.结果 应用香烟反复熏吸、气管内注入脂多糖、野百合碱腹腔注射后可引起大鼠疲倦、消瘦、咳嗽、喘促等慢性支气管炎的表现,氢化可的松肌肉注射后可以出现大鼠畏寒、弓背、缩身、体毛枯疏蓬松等肺阳虚表现,阿霉素腹腔注射后可以出现大鼠心肌肥厚、心脏扩大、射血分数下降,严重者形成心包积液、胸腔积液、腹腔积液等水泛表现.结论 序贯应用香烟反复熏吸、气管内注入脂多糖、野百合碱腹腔注射、氢化可的松肌肉注射及阿霉素腹腔注射对大鼠进行造模,可以形成肺胀阳虚水泛证动物模型.%Objective To discuss the establishment method of animal model with water over-flowing syndrome due to Lung-yang asthenia. Methods The eperimental rats were divided into five groups, blank controller, hydrocortisone group, doxorubicin controller, low-dose doxorubicin group and high-dose doxorubicin group. All rats were passively smoked repeatedly, and were injected in sequence with lipopolysaccharide intratracheally, monocrotaline intraperitoneally, hydrocortisone intramuscularly, doxorubicin intraperitoneally. Then the activities, shape and spirit of rats were observed, the volume of urine were, determined, the cardiac structures and function were checked by heart ultrasound, and finally the rats were dissected to examinate the internal organs's conditions in the thoracic cavity and abdominal cavity. Results

  4. Analyze the Eighth Item of Pulse Syndrome Complex and Treatment of Miscellaneous Gynecological Diseases from Jinkui Yaolve%《金匮要略·妇人杂病脉证并治》第八条浅析

    Institute of Scientific and Technical Information of China (English)

    杨娇娇; 徐光星

    2016-01-01

    [目的]探析《金匮要略》“妇人杂病脉证并治”篇第八条原文旨意。[方法]通过对《金匮要略》“妇人杂病脉证并治”篇的仔细研读、思考,并参阅历代医家对第八条条文的注解,围绕妇人杂病的因机证治对本条原文进行分析、阐释。[结果]《金匮要略》“妇人杂病脉证并治”篇第八条为妇女诸病纲领,“因虚、积冷、结气”六字为其病因机要,而“因虚”居六字之首;第2句“久成肺痈”之“痈”字当是“痿”字之误;病证“凝坚在上”、“在中盘结”,男女均可出现,非女子独有,“肺痿”、“寒疝”、“胁腹痛”、“脐下关元痛”、“劳热”、“肌肤甲错”等证在《金匮要略》其它篇章各有专述及记载;病证“在下”则专属妇人杂病,以经带诸病为主,证属虚寒夹瘀(郁)型。[结论]《金匮要略》妇人杂病脉证并治,开后世辨治妇人杂病之先河,随人类社会之发展,时代之更替,仲景对妇科杂病的认识至今仍具借鉴意义。%Objective]To explore and analyze its original implication of the eighth article in Chapter 22 from Jinkui Yaolve. [Methods]Through learning the Jinkui Yaolve closely and referring to the explanations of masters of generations,base on the original text to analyze and elaborate the etiology, pathogenesis, syndromes and therapeutic principles with regard to miscellaneous gynecological diseases.[Results] The eighth item is the general program of miscellaneous gynecological diseases,its principal pathogenic factors include deficiency, stale chills and stagnation of Qi.Moreover,the deficiency plays a leading role in the pathogenesis.Through exploring deeply,I hold that the pulmonary abscess is actually the pulmonary asthenia in the second sentence.When the pathogenic factors attack the body,the triple energizers manifest different symptoms and signs.There is no difference between male

  5. Antisynthetase syndrome suspected as drug-induced myopathy: a case report%误诊为药源性肌病的抗合成酶综合征1例

    Institute of Scientific and Technical Information of China (English)

    王雪梅; 赵红; 张俊霞; 杨亚君; 蔡凤霞; 谢雯; 蔡皓东

    2013-01-01

    1例42岁男性慢性乙型肝炎患者口服拉米夫定(100 mg,1次/d)和阿德福韦酯(10 mg,1次/d)治疗,约1个月后出现四肢肌肉酸痛、乏力,双下肢水肿.实验室检查:肌酸激酶9368 U/L,肌红蛋白>4317 μg/L.肌电图示右侧三角肌肌源性损害.疑为横纹肌溶解症.停用拉米夫定及阿德福韦酯,肌酸激酶下降,肌无力症状好转.1年后,患者再次出现双下肢水肿并腹胀伴间断发热.肌酸激酶5546 U/L,肌红蛋白>1200 μg/L,抗Jo-1抗体阳性.诊断:多发性肌炎,抗合成酶综合征.给予保肝、利尿、营养神经等治疗.2周后,加用恩替卡韦0.5 mg、1次/d抗病毒治疗.2个月后,给予糖皮质激素治疗.1个月后,患者四肢肌肉酸痛、无力症状基本缓解,复查肌酸激酶正常.%A 42-year-old man with chronic hepatitis B was treated with combined use of lamivudine 100 mg once daily and adefovir dipivoxil 10 mg once daily.After a month the patient developed muscle aches in his extremities,asthenia and edema in his lower extremities.Laboratory tests showed that creatine kinase and myoglobin were 9368 U/L and > 4317 μg/L,respectively.Electromyography indicated a myogenic lesion of right deltoid muscle.Rhabdomyolysis was suspected.Lamivudine and adefovir dipivoxil were stopped.The creatine kinase levels decreased and symptoms of muscular weakness improved.One year later,the patient had recurred edema in his lower extremities,abdominal distension and intermittent fever.Creatine kinase and myoglobin were 5546 U/L and > 1200 μg/L,anti-Jo-1 antibody was positive.The patient was diagnosed with polymyositis and antisynthetase syndrome.He was given treatment with liverprotective,diuretics and neurotrophic agents.Two weeks later,he was given entecavir 0.5 mg once daily.Two months later,he was given glucocorticoid treatment.One month later,the muscle aches and asthenia improved,and his creatine kinase levels dropped to normal.

  6. 副肿瘤综合征与神经系统损害的相关分析%Study on relationship between paraneoplastic syndrome and nerver system injury

    Institute of Scientific and Technical Information of China (English)

    郭晓玲; 李柱一

    2002-01-01

    Non-metastatic or invaded neoplasms sometimes produce distal effects in nervous system,nerve-muscle junction and muscle i.e paraneoplastic syndrome(PNS).PNS is diverse in clinical symptoms.Nervous system symptoms and neoplasm may occur simultaneously or months-years earlier.So,clinical diagnosis and management are very difficult.Here is our report about clinical manifestations in 23 PNS patients admitted in our department. 1 Subjects data 25 PNS patients including 18 males and 7 females,aging from 20~ 76(mean age:54.2) were included in our study.Tumors consisted of pulmonary cancer(n=16),digestive system tumor(n=3),leukemia(n=1),cervical carcinoma(n=1). All nervous system symptoms occur earlier than neoplasm esp.in cervical carcinoma patients(1 month~ 6 year,mean:10 months). Serum tumor markers was increased in 22 cases.Clinical symptoms:myasthenic syndrome was observed in 11 subjects,asthenia of extremities in 8 subjects,asthenia of bilateral lower limbs in 3 subjects,peripheral neuropathy in 9 subjects,numbness of limbs in 4 cases,brachia plexus injury in 1 subject,greater occipital nerve pain in 2 cases,ischialgia neuralgia in 1 subjects,muscle atrophy in 6 subjects,acute transverse myelophthy in 1 subject,progressive multifocal leukoencephalopathy in 1 subject. 2 Discussion Myasthenic syndrome is more common among these symptoms such as myopathy,peripheral neuropathy,spinal disease,encephalopathy.PNS is diverse in clinical manifestations.According to these symptoms,tumor is very available if diagnosis of nervous system disease could not be confirmed.Prostatic carcinoma,mammary carcinoma,digestive system tumor,cervical carcinoma,adrenal tumor esp. pulmonary carcinoma may be the causes of PNS.PNS may occur 15 years earlier than neoplasms.Once PNS is determined,disease status should be actively observed and primary lesion be surveyed.Diagnosis could be confirmed if (1)Aged over 40;(2)Existence of serum tumor markers.CEA,TPA and NSE increased in 22 subjects

  7. Safety and efficacy of sunitinib in patients from Latin America: subanalysis of an expanded access trial in metastatic renal cell carcinoma

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    Barrios CH

    2016-09-01

    Full Text Available Carlos H Barrios,1 Daniel Herchenhorn,2 Matías Chacón,3 Paula Cabrera-Galeana,4 Peter Sajben,5 Ke Zhang6 1Department of Medicine, PUCRS School of Medicine, Porto Alegre, 2Division of Clinical Oncology, Instituto Nacional do Câncer, Rio de Janeiro, Brazil; 3Clinical Oncology, Alexander Fleming Institute, Buenos Aires, Argentina; 4Department of Medical Oncology, Instituto Nacional de Cancerología, México, Centro Oncológico Issemym Edomex, México; 5Pfizer Oncology, New York, NY, 6Pfizer Oncology, La Jolla, CA, USA Background: Sunitinib is an approved treatment for metastatic renal cell carcinoma (mRCC. The safety profile and efficacy of sunitinib were confirmed in a global expanded access trial (ClinicalTrials.gov identifier: NCT00130897. This report presents a subanalysis of the final trial data from patients in Latin America.Methods: Treatment-naïve or previously treated mRCC patients aged ≥18 years received oral sunitinib at a starting dose of 50 mg/day on a 4-weeks-on/2-weeks-off schedule. Treatment continued until disease progression, unacceptable toxicity, or withdrawal of consent. Safety was assessed regularly, and tumor measurements were scheduled per local practice (using Response Evaluation Criteria in Solid Tumors.Results: In total, 348 patients from Latin America received sunitinib. Overall, 75% of patients had two or more sites of metastatic disease, 28% were aged ≥65 years, 14% had an Eastern Cooperative Oncology Group performance status ≥2, 9% had brain metastases, 9% had no prior nephrectomy, and 5% had non-clear cell RCC. Median treatment duration was 8 months, and median follow-up was 15.1 months. In total, 326 patients (94% discontinued treatment, primarily due to death (41% or lack of efficacy (22%. Most treatment-related adverse events were of mild to moderate severity (grade 1/2. Mucosal inflammation (reported in 54% of patients, diarrhea (53%, and asthenia (41% were the most common any-grade treatment

  8. [Thrombotic thrombocytopenic purpura disclosing cancer: apropos of 2 cases].

    Science.gov (United States)

    Girard, P; Tardy, B; Page, Y; Mosnier, J F; Tardy-Poncet, B; Bertrand, J C

    1995-01-21

    Thrombotic thrombocytopenic purpura (TTP) causes severe haemolytic anaemia, thrombopenia, fever and neurological and renal involvement. Currently five large aetiologic groups have been identified: viral or bacterial infection, drugs, conjunctive tissue diseases, pregnancy and solid tumours. We observed two cases resulting from an adenocarcinoma. In the first case, a 71-year-old man with chronic silicosis, the presenting signs were asthenia, fever, epistaxis with diffus purpura and spontaneous haematomas of the lower limbs. Diagnosis of TTP was based on routine laboratory tests and the patient responded well to fresh frozen plasma. On the 5th day of treatment, haemoglobin level dropped sharply and melana occurred. Upper digestive tract endoscopy revealed a tumoural formation of the antrum-fundic junction and histology examination of the biopsy confirmed the diagnosis of adenocarcinoma. Ten months after gastrectomy the patient was in excellent health with no relapse of the TTP. In the second case, the presenting signs included spontaneous haematomas, rectorrhagia and low grade fever. Microscopic haematuria and renal failure were observed in addition to the biological syndrome of TTP. The patient responded poorly to fresh frozen plasma and packed cell transfusions. Plasma exchange was equally unsuccessful. The disease continued a fulminant course and the diagnosis of adenocarcinoma located in a pulmonary lymph nodes was made at autopsy. These rare cases of TTP caused by cancer emphasize the importance of a thorough aetiological research. Plasma exchange has been shown to be effective but mortality at 1 year approximately 85% in cancer related cases. Early diagnosis and specific anti-cancer therapy might improve prognosis. We report our personal experience with 16 other similar cases.

  9. Background and targets of psychological help for women with thyroid pathology

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    Олена Вікторівна Варібрус

    2016-01-01

    Full Text Available In patients with thyroid pathologies takes place the strong layer of psychic displacements of prenosological level that cause psychological maladjustment.The aim of research was elaboration of the complex measures of medical and psychological help based on the study of the special features of psycho-emotional sphere, coping, types of reaction on disease, somatogenic victimhood and life quality in women with thyroid pathologies.Contingent. In the research took part the women with diseases of TG – group with thyroid pathologies (GT attended with its hyper- (59patients, group 1-G1 and hypofunction (54 patients group 2 – G2. For comparison there was formed the group of somatically healthy women (50 patients, control group – CG.Results. In women with endocrinopathies of TG there were revealed high rates of psychopathological anxiety – mainly in women with hyperthyroidism, and depression and asthenia – in ones with hypothyroidism, predominance of maladaptive coping mechanisms – confusion, emotional discharging, self-incrimination, aggressiveness, deviation and types of reaction on disease with inter- and intrapsychic maladjustment – the domination of anxious, anxious and sensitive, hypochondriac, hypochondriac and sensitive types, high somatogenic victimhood as an inclination to aggressive, self-destructive victim behavior in interrogated with hyperfunction and dependent and noncritical in ones with hypofunction of thyroid gland, the significant decrease of life quality. On the base of received results there were separated targets of medical and psychological influence and were defined interventional measures.Conclusions. The correction of psychic disorders in patients with hormonal pathology of TG must be realized on two directions: the prescriptions of medicamentous therapy and normalization of physical health that is carried out by doctor-endocrinologist – an operations on psychobiological factor and psychological interventions

  10. Varied presentations of Sheehan′s syndrome at diagnosis: A review of 18 patients

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    Delmalya Sanyal

    2012-01-01

    Full Text Available Introduction: Sheehan′s syndrome (SS occurs due to ischemic pituitary necrosis as a result of severe postpartum hemorrhage (PPH. Aims and Objectives: The aim of the present study was to review the presenting features of SS at diagnosis. Materials and Methods: We retrospectively reviewed 18 cases of SS at diagnosis. Presenting clinical features, laboratory data, pituitary hormone deficiencies, and magnetic resonance imaging (MRI of the sella were analyzed. Results: Age ranged from 28-71 years with a mean age of 47 ± 14.44 years. Time to diagnosis of SS was 6-33 years with a mean of 15.35 ± 6.74 years. Four (22.2% patients were referred from emergency for hyponatremia, one each (5.6% for hypotension, hypoglycemia, and vomiting. Three (16.7% patients presented with asthenia and weight loss, two (11.1% with slightly raised thyroid stimulating hormone (TSH. Only six (33.3% presented with classic features of amenorrhea. None presented with isolated lactational failure or apoplexy after PPH. Seventeen (94.4% patients had lactational failure; thirteen (72.2% did not menstruate following last delivery. Lactotroph and gonadotroph failure were present in all at diagnosis but corticotrophs preservation was documented in three (16.7% and thyrotroph in two (11.1% patients. Twelve (66.7% patients had empty sella while six (33.3% had partial empty sella on MRI. Conclusion: SS has variable features at diagnosis and may present to different specialties. The clinical features of hypopituitarism are often subtle, leading to delay in diagnosis. History of PPH, lactational failure and cessation of menses are important clues. Thyrotroph, corticotroph axis may be preserved in some SS patients.

  11. Comparing acoustic and perceptual voice parameters in female teachers based on voice complaints

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    Maryam Faghani Abukeili

    2014-04-01

    Full Text Available Background and Aim: Teachers are a large group of professional voice users that several risk factors and voice demands causes various voice complaints among them. As the voice is multidimensional, the aim of this study was acoustic and perceptual measurement of teachers’ voice and comparing the findings between two groups with many and few voice complaints.Methods: Sixty female teachers of high school in Sari, north of Iran, were chosen by available sampling to participate in this cross-sectional study. According to a voice complaints questionnaire, 21 subjects located in few voice complaints and 31 in many voice complaints group. After a working day, subjects completed a voice self-assessment questionnaire. Also, teachers’voice were recorded during three tasks including sustained vowels /a/ and /i/, text reading and conversational speech. Acoustic parameters were analyzed by Praat software and 2 speech-language pathalogists performed auditory-perceptual assessment by GRBAS ( Grade, Roughness, Breathiness, Asthenia, Strain scale. Results: Comparing of the voice self-assessment between the two groups demonstrated statistically significant difference (p<0.05; however results of the acoustic and auditory-perceptual measurement did not show significant diffrence.Conclusion: Despite prevalent voice problems in teachers, there are various conditions in terms of complaints and assessments methods. In this study, only a remarkable deviation documented in the client-based assessments in many voice compliants group in comparison with few voice compliants, which would be probably related to different individual’s perception of voice problem between two groups. These results support paying attention to self-assessments in clinical process of voice problems.

  12. A phase 2 study of the cytotoxic immunoconjugate CMB-401 (hCTM01-calicheamicin) in patients with platinum-sensitive recurrent epithelial ovarian carcinoma.

    Science.gov (United States)

    Chan, Stephen Y; Gordon, Alan N; Coleman, Robert E; Hall, James B; Berger, Mark S; Sherman, Matthew L; Eten, Catharine B; Finkler, Neil J

    2003-04-01

    The compound CMB-401 is an immunoconjugate consisting of the monoclonal antibody (MAb) hCTM01 directed against polymorphic epithelial mucin covalently bound to the cytotoxic antibiotic calicheamicin by an amide linker. We evaluated CMB-401 as monotherapy for the treatment of recurrent platinum-sensitive epithelial ovarian carcinoma (EOC). Twenty-one 21 women aged 38 to 80 years with recurrent EOC (recurrence >6 months after initial platinum-containing chemotherapy) were enrolled. Tumor response and serum cancer antigen 125 (CA125) levels were assessed before and after active treatment. After an initial intravenous (i.v.) dose of hCTM01 (without calicheamicin), the calicheamicin-linked CMB-401 (16 mg/m(2 ) i.v.) was administered over 60 min for up to 7 cycles, with 4 weeks between cycles. Nineteen patients were evaluable. Measurable changes observed following administration of CMB-401 did not meet the criteria for partial remission (PR). CMB-401 was not effective as monotherapy for this type of EOC. Adverse events experienced by patients in the study included nausea (95%), asthenia (90%), abdominal pain (62%), headache (57%), anorexia (57%), and diarrhea (57%), mostly at a toxicity grade level of 1 or 2. Based on published efficacy of conjugates that deliver calicheamicin via hybrid (bifunctional) linkers [e.g. gemtuzumab ozogamicin (Mylotarg) in acute myeloid leukemia], we hypothesize that the amide linker used in CMB-401 may have contributed to its failure to induce PR in patients in this study. Use of hybrid linkers to target hCTM01 or other antibodies to EOC may warrant further investigation.

  13. Fatal cold agglutinin-induced haemolytic anaemia: a case report

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    Reverberi Roberto

    2010-08-01

    Full Text Available Abstract Introduction Cold agglutinin disease usually develops as a result of the production of a specific immunoglobulin M auto-antibody directed against the I/i and H antigens, precursors of the ABH and Lewis blood group substances, on red blood cells. Autoimmune and lymphoproliferative disorders, Mycoplasma pneumoniae and other infections can be associated with the production of cold agglutinins. In its classic presentation with haemolytic anaemia and Raynaud's syndrome, cold agglutinin disease is usually idiopathic. Several factors play a role in determining the ability of a cold agglutinin to induce a haemolytic anaemia such as antibody concentration and temperature range, in particular the highest temperature at which antibodies interact with red blood cells. Case presentation A 48-year-old Caucasian man presented to our hospital with symptoms of extreme asthenia caused by severe anaemia. The transfusion of red blood cells (O Rh-positive, started as prescribed by the emergency guidelines in force without pre-transfusion tests, induced fatal haemolysis because of the presence of high levels of anti-H antibodies in his blood, that reacted with the large amount of H antigen in universal (0 red blood cells. Conclusion Emergency transfusion of universal red blood cells (0 Rh-positive or negative is usually accepted by the international guidelines in force in emergency departments. In this report we describe a rare complication caused by the very high concentration in the recipient of cold agglutinins and the activation of the complement system, responsible for red blood cell lysis and consequent fatal cardiovascular shock. We conclude that emergency transfusion of universal red blood cells (0 Rh-positive or negative may be dangerous and its risk should be assessed against the risk of delaying transfusion until the pre-transfusion tests are completed.

  14. TCM diagnosis thoughts and methods on constipation caused by 5-HT3 receptor antagonist%5-HT3受体拮抗剂所致便秘中医诊治思路与方法

    Institute of Scientific and Technical Information of China (English)

    冷启宁; 盛军章; 任志兵

    2013-01-01

      目的:研究中医治疗5-HT3受体拮抗剂所致便秘的思路与方法。方法:通过对肿瘤化疗病人因应用5-HT3受体拮抗剂而出现的不良反应-便秘的症状、舌象、脉象进行辨证分析,得出辨证结论,分析治疗方法。结果:5-HT3受体拮抗剂所致便秘中医辨证为阴虚燥结,治以滋阴通腑泻热,方药选用增液承气汤。结论:增液承气汤是治疗5-HT3受体拮抗剂所致便秘的有效方剂,而且能提高5-HT3受体拮抗剂的止吐效果。%Objective:To investigate the TCM therapy thoughts and methods of constipation caused by 5-HT3 receptor antagonist. Methods:The adverse reactions caused by application of 5-HT3 receptor antagonist, including constipation, tongue manifestation and pulse manifestation were analyzed based on different symptoms and signs. Results:The constipation caused by 5-HT3 receptor antagonist was diagnosed as yin asthenia and fluid-consuming constipation. Zengye Chengqi decoction was used to Ziyin Tongfu and Xieye. Conclusion:Zengye Chengqi decoction was effective on treating constipation caused by 5-HT3 receptor antagonist, and it could also improve the vomit-stopping effect of 5-HT3 receptor antagonist.

  15. Miliary tuberculosis infection during hepatitis C treatment with sofosbuvir and ledipasvir plus ribavirin.

    Science.gov (United States)

    Ballester-Ferré, Maria Pilar; Martínez, Fernando; Garcia-Gimeno, Natalia; Mora, Francisco; Serra, Miguel A

    2017-01-28

    Chronic hepatitis C virus (HCV) infection is one of the main causes of chronic liver disease worldwide. In the last 5 years, treatment for HCV infection has experienced a marked development. In 2014, the use of ledipasvir/sofosbuvir with or without concomitant weight-based ribavirin was approved with a very significant increase in the sustained virological response. However, new side effects have been associated. We report the first case of an HCV infected patient treated for 12 wk with the combination of sofosbuvir/ledipasvir plus ribavirin who developed a miliary tuberculosis (TB) infection while on therapy. The patient was a 65-year-old woman, who referred malaise, asthenia, hyporexia, 7 kg weight loss, productive cough, evening fever and night sweats, right after finishing the treatment. The chest computed tomography-scan revealed a superior mediastinal widening secondary to numerous lymphadenopathies with extensive necrosis and bilateral diffuse lung miliary pattern with little subsequent bilateral pleural effusion, highly suggestive of lymph node tuberculosis with lung miliary spread. A bronchoscopy was performed and bronchial suction showed more than 50 acid-alcohol resistant bacillus per line. A Mycobacterium tuberculosis DNA was detected in blood by polymerase chain reaction, which confirmed the diagnosis of miliary tuberculosis. Some cases of TB infection have been identified with α-interferon-based therapy and with the triple therapy of pegylated interferon, ribavirin and boceprevir or telaprevir. However, significant infection has not been reported with sofosbuvir/ledipasvir plus ribavirin. We believe that the case is relevant to increase awareness of opportunistic infections and particularly TB infection. Although the international guidelines offer no recommendation regarding TB screening, we wonder whether it would be advisable to screen for opportunistic infections prior to the introduction of HCV therapy.

  16. Health status of radiation workers in an institute of nuclear research

    Energy Technology Data Exchange (ETDEWEB)

    Popescu, F.; Paunescu, G.; Stroe, F. [Inst. of Public Health, Bucharest (Romania); Andrei, N.

    2000-05-01

    The aim of this study was the identification of the changes in health condition of workers from an institute of nuclear research. Thirty-five workers (25 male and 10 female) radiation exposed to low doses of ionizing radiation were admitted in the Radiopathology Centre Bucharest, after a selection performed during the annual check-up. The workers have had different professions: nuclear fuel processor, engineer laboratory technician, electrician, instrument technician. The time of exposure to ionizing radiation was between 6 to 25 years. Medical specialists in occupational health, dermatology, ophthalmology, O.R.L., endocrinology, haematology, neurology and psychology investigated them. The following lab tests were performed: haematological examination, biochemical examination, immunology tests, alergology skin tests, functional lung tests and cardiogram. No special problems concerning the exposure to ionizing radiation were found, but the following diseases were detected in some extent: neurasthenia, high blood pressure, ischemic heart disease, digestive system disorders, endocrinology disorders and anaemia. High blood pressure, ischemic heart disease and digestive system disorders were related with stress or job strain. Anaemia occurred in connection with gynaecological disorders. Some thyroid dysfunction appeared because of low dietary iodine content in the Sub-Carpathian region. The focus of the psychological exam was the identification of the effect of different factors (exogenous, endogenous or multidimensional) over a person, that could influence the psychological potential. The psychological exam reveals the following disturbances: asthenia, tiredness, chronic fatigue, psycho-emotional impairment, lapses of attention, anxiety. These disturbances may be in relation both with job strain (especially a substantial stress factor for nuclear fuel processor and engineer laboratory technician) and the syndrome of workplace. (author)

  17. The expanding spectrum of HCV-related cryoglobulinemic vasculitis: a narrative review.

    Science.gov (United States)

    Dammacco, Franco; Racanelli, Vito; Russi, Sabino; Sansonno, Domenico

    2016-08-01

    Cryoglobulinemic vasculitis (CV) is a small-to-medium-vessel vasculitis that appears in 10-15 % of patients chronically infected with hepatitis C virus (HCV). The classic symptom triad of CV, purpura/asthenia/arthralgia, is accompanied by clinical features that include glomerulonephritis, neuropathy, interstitial pneumonitis, and cardiomyopathy, ranging in their severity from mild to life threatening. The risk of developing non-Hodgkin lymphoma is also higher. The cumulative 10-year survival rate of CV patients is significantly lower than in the age- and sex-matched general population, with death typically caused by nephropathy, malignancies, liver involvement, and severe infections. Unfailing serological stigmata include both a cryoglobulin IgM fraction with rheumatoid factor activity and decreased complement C4 levels. On peripheral B cells, the expression of the CD81 B cell receptor is reduced while that of the CD19 receptor is increased. A monoclonal B cell lymphocytosis develops in almost one-third of patients. HCV-related proteins (but not HCV-RNA genomic sequences) can be detected on biopsy samples by immunofluorescence and immunohistochemistry and involve the vessel lumen, vessel walls, and the perivascular spaces of the skin, kidney, and peripheral nerves, supporting the pathogenetic role of HCV in the onset of a widespread microvasculitis. Based on the demonstration of HCV infection in the large majority of CV patients, a therapeutic regimen consisting of once-weekly pegylated interferon-α and the daily administration of ribavirin results in a sustained virologic response in ~50 % of patients. In those with refractory and relapsing disease, addition of the anti-CD20 monoclonal antibody rituximab has significantly increased the overall response rates. The extension to CV of latest-generation direct-acting antivirals, strikingly successful in non-CV HCV-positive patients, has yielded high complete response rates according to the few studies published

  18. 骨痹汤治疗原发性骨质疏松症腰背痛疗效观察%GUBITANG FOR THE TREATMENT OF LOW BACK PAIN CAUSED BY PRIMARY OSTEOPOROSIS

    Institute of Scientific and Technical Information of China (English)

    陈大伟; 熊昌源

    2011-01-01

    目的:评价骨痹汤治疗原发性骨质疏松症腰背痛的临床疗效.方法:2009年1月至2010年8月,对80例原发性骨质疏松症引起的腰背痛用骨痹汤治疗.结果:80例患者中,显效24例(30%);好转48例(60%);无效8例(l0%),总有效率为90%.起效时间最短为7天,最长15天.服药时间最短为30天,最长90天.随访时间最短为3月,最长18月.结论:骨痹汤可以明显缓解原发性骨质疏松症引起的的腰背痛、全身骨痛、乏力等临床症状.%Objective: To evaluate the effect of Gubitang for the treatment of low back pain caused by primary osteoporosis. Methods: Eighty cases of low back pain caused by primary osteoporosis were recruited from January 2009 to August 2010, and treated with Gubitang. Results: Out of 80 cases, 24 (30%) showed marked improvement; 48 (60%) showed improvement; 8 (10%) were of no effect. The total effective rate is 90%. The onset of therapeutic effect started in 7th to 15th day. The medication lasted for 30-90 days. The follow-up period lasted for 3 ~ 18 months. Conclusion: Gubitang can significantly ease the low back pain caused by primary osteopotosis. There were also improvement of the whole body pain, the asthenia and other symptoms caused by osteoporosis.

  19. Effectiveness and safety of pemetrexed for non-small cell lung cancer in the Andalusian Public Health System

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    María Antonia Pérez-Moreno

    2016-11-01

    Full Text Available Objective: To evaluate effectiveness and safety profile of pemetrexed in patients with locally advanced or metastatic non-small-cell lung cancer (NSCLC when it´s used on real clinical practice in Andalusia (a Spanish region with 8.5 million inhabitants, 2014 census data. Methods: An observational multicentre retrospective study was conducted. Adult patients with locally advanced/metastatic NSCLC who received pemetrexed in any hospital in the Andalusian Public Health System during the last term of 2011 were included. We collected patients´ baseline characteristics, diagnostic and treatment data, effectiveness variables (response to treatment with pemetrexed and overallsurvival and main adverse reactions detected. Results: 172 patients from 17 hospitals were included (77.33% were men, median age 63 years old (between 34 and 83. The predominant histology was adenocarcinoma (84.30% and 85.20% were diagnosed of lung cancer with IV-stage. 78.49% had been smokers at some point in their lives. Median overall survival from the start of pemetrexed was 9 months (95%CI, 4.1-13.9. Progression of the disease was the most frequent response (33.14%, only one patient had complete response. Stable disease was associated with a higher probability of survival. Main adverse reactions detected were asthenia, haematological reactions, gastrointestinal reactions and termal o mucous toxicity. No patients discontinued treatment for serious toxicity. Conclusions: Pemetrexed resulted quite effective in NSCLC when it was used on real clinical practice, with higher survival in non-squamous histology and patients with the best score of Eastern Cooperative Oncology Group scale. The toxicity profile was well tolerated. Prospective studies would be needed to confirm the effect of prognostic factors observed

  20. Multiple ovarian cysts in a young girl with severe hypothyroidism.

    Science.gov (United States)

    Panico, Annalisa; Lupoli, Gelsy Arianna; Fonderico, Francesco; Colarusso, Sara; Marciello, Francesca; Poggiano, Maria Rita; Del Prete, Michela; Magliulo, Raffaele; Iervolino, Paolo; Lupoli, Giovanni

    2007-12-01

    Case study of a young female patient with severe hypothyroidism due to autoimmune thyroiditis and multiple ovarian cysts is reported. A 14-year 7-month-old girl presented with pelvic and abdominal pain and severe asthenia. Her last menstrual period was 10 months before presentation. Physical examination showed obesity; apathetic and flat expression; periorbital puffiness; pale, cold, dry skin and slow sustained reflexes; swelling in the hands and feet; no galactorrhea; a hardly palpable thyroid gland; and ovaries with a palpable irregular surface. Her heart rate was 90 bpm with a blood pressure within the normal range (110/70 mmHg). Laboratory findings showed severe hypothyroidism (thyroid-stimulating hormone [TSH]: 960 mIU/L), gravis macrocytic anemia, hyperfibrinogenemia, and hyperprolactinemia. Imaging examinations revealed a normal-size thyroid with irregular echogenicity, strongly hypoechogenous area at the neck ultrasonography, bilateral multilocular ovarian masses with cystic components at pelvic ultrasound and computed tomography, and both anterior and posterior pericardial effusion at echocardiography. As soon as thyroid replacement therapy was initiated, all symptoms progressively disappeared and biochemical and hormonal values normalized, while the right ovary did not decrease in size during the follow-up period. For this reason, our patient underwent right ovarian wedge resection 14 months after the initiation of medication replacement. Ovarian histological examination showed a benign ovarian cyst with extensive hemorrhage and myxedematous infiltration. It is concluded that it is important to recognize early in young girls the association between large multiple ovarian cysts and high elevated levels of TSH in order to resolve this disorder with substitutive therapy.

  1. Research of TCM common syndrome of fever with AIDS%艾滋病发热的中医常见证候特点研究

    Institute of Scientific and Technical Information of China (English)

    李鹏宇; 郭会军

    2012-01-01

    目的:通过研究艾滋病与非艾滋病患者发热的症状体征,探讨艾滋病发热的中医常见证候特点,为临床治疗提供参考.方法:采用现状调查方法,设计制定《发热临床调查表》,制定相关操作规程,如实填写调查表,采用SPSS 19.0统计软件进行数据分析.结果:艾滋病组发热以气虚发热和血虚发热为主,属于内伤发热;对照组则以风寒风热表证、实证常见,属于外感发热.结论:脾肾亏虚乃属艾滋病发热的主要病机特点和前提,内伤正气虚衰是艾滋病发热的常见证候特点.%Objective: Through studying AIDS and non-AIDS fever sufferers in symptoms and signs, to explore TCM syndrome features of AIDS fever, and provide reference for clinical treatment. Methods: We adopted the spot questionnaire, designed the fever clinical questionary, layed down related operating rules, filled in questionary truly and correctly, analyzed data using SPSS 19.0. Results: AIDS group fever dued to qi deficiency and blood deficiency, belonging to the fever by internal injury; wind-cold and wind-heat exterior syndrome and excess-syndrome, belonging to the exogenous fever, was the common symptoms of control group. Conclusion: Spleen-kidney asthenia is the primary pathogenesis characteristics of AIDS fever, internal injury and deficiency of genuine qi is the common syndrome characteristics of AIDS fever.

  2. A case of osseous scintigraphy showing focuses of multifocal tuberculosis; Un cas de scintigraphie osseuse montrant des foyers de tuberculose multifocale

    Energy Technology Data Exchange (ETDEWEB)

    Faurous-Vanaud, R. [Services de Medecine Nucleaire, Clinique Clementville, Montpellier (France); Faurous, P. [CRLC, Montpellier (France); Kalfa, G.; Collet, H. [Services de Medecine Nucleaire, Clinique Clementville, Montpellier (France); Couty, H.; Artus, J.C. [CRLC, Montpellier (France)

    1997-12-31

    Incidence of tuberculosis in developed countries presents in the last years a spectacular boost. However, the osteo-articular system is afflicted by tuberculosis only in a few percent of cases and the multifocal character represents less than 5% of osseous tuberculosis. It is presented here a case of multifocal osseous tuberculosis only to stress its rarity. A woman 28 years old from Djibouti presents since 8 months an asthenia and dorsal pains long thought as psychalgia. The examination has shown a major vertebral stiffness and limitation of right haunch. The radiographs showed a scoliosis centered on D8 with modifications. The biologic data are VS = 90, CRP = 124 and the hemogram is normal. The intradermal reaction (10 U of tuberculin) is phlyctenular. The TDM indicates lytic vertebral extension on D7 - D8, the osseous scintigraphy with MDP - 99 mTc indicates no anomaly in the vascular arrival time; a few minutes after injection: dorsal and upper and of right femur hyperactivity; 2 h after injection: hyper-fixation of D7 to D9 and of the upper end of right femur. The IRM indicates para-vertebral abscess of D7 to D9 with epidural abscess; abscess in the upper part of the loge of right adductors with osseous affliction of the femur`s upper end; a bacillary infectious process was a priori evoked. The patient was then placed under quadruple antibiotic-therapy anti-tuberculous care. In case of anomalous multifocal osseous scintigraphy the tuberculous affliction is part of the differential diagnosis, particularly in the immigrant populations or in HIV+ persons

  3. Live-attenuated, tetravalent dengue vaccine in children, adolescents and adults in a dengue endemic country: randomized controlled phase I trial in the Philippines.

    Science.gov (United States)

    Capeding, Rosario Z; Luna, Imelda A; Bomasang, Emily; Lupisan, Socorro; Lang, Jean; Forrat, Remi; Wartel, Anh; Crevat, Denis

    2011-05-17

    A recombinant live attenuated tetravalent dengue vaccine (TDV) is safe and immunogenic in adults and children in dengue-naïve populations. Data are needed in dengue endemic populations. In a phase I, randomized, controlled, blind-observer study in the Philippines, groups of participants aged 2-5, 6-11, 12-17, and 18-45 years received either three TDV vaccinations at months 0, 3.5, and 12 (TDV-TDV-TDV group) or licensed typhoid vaccination at month 0 and TDV at months 3.5 and 12 (TyVi-TDV-TDV group) and were followed for safety (including biological safety and vaccine virus viremia) and immunogenicity. No serious adverse vaccine related events and no significant trends in biological safety parameters were reported. Injection site pain, headache, malaise, myalgia, fever, and asthenia were reported most frequently, as mild to moderate in most cases and transient. Reactogenicity did not increase with successive vaccinations and was no higher in children than in adults and adolescents. Low levels of vaccinal viremia were detected in both groups after each TDV vaccination. After three TDV vaccinations, the seropositivity rates against serotypes 1-4 were: 91%, 100%, 96%, 100%, respectively, in 2-5 year-olds; 88%, 96% 96%, 92% in 6-11 year-olds; 88%, 83%, 92%, 96% in adolescents; and 100% for all serotypes in adults. A similar response was observed after two doses for the TyVi-TDV-TDV group. The safety profile of TDV in a flavivirus endemic population was consistent with previous reports from flavivirus naïve populations. A vaccine regimen of either three TDV vaccinations administered over a year or two TDV vaccinations given more than 8 months apart resulted in a balanced antibody response to all four dengue serotypes in this flavivirus-exposed population, including children.

  4. Eribulin in pretreated metastatic breast cancer patients: results of the TROTTER trial-a multicenter retrospective study of eribulin in real life.

    Science.gov (United States)

    Garrone, Ornella; Montemurro, Filippo; Saggia, Chiara; La Verde, Nicla; Vandone, Anna Maria; Airoldi, Mario; De Conciliis, Enrico; Donadio, Michela; Lucio, Francesco; Polimeni, Maria Antonia; Oletti, Maria Vittoria; Giacobino, Alice; Merlano, Marco Carlo

    2016-01-01

    This retrospective multicenter analysis was aimed to evaluate clinical activity and tolerability of eribulin in pretreated metastatic breast cancer patients in clinical practice. Patients treated with eribulin from January 2012 to July 2013 were enrolled in the observational study from 10 italian hospitals. Tumor and toxicity evaluation were performed according to Agenzia Italiana Farmaco. One-hundred and thirteen patients were included in the study. Median age 62 years old. 71.7 % of the patients had visceral involvement and the majority had a burden of disease involving two or more organs with a median number of 2 (1-6). The median number of previous chemotherapy regimens for advanced disease was 3 (1-10). Median number of eribulin cycles was 4 (1-27). Overall response rate was 24 % (95 % CI 16.0-31.8). Clinical benefit rate, was 35.4 % (95 % CI 26.6-44.2). At a median follow-up of 29.6 months (8.3-41.9) the median progression free survival was 3.3 months (0.6-26.7; 95 % CI 2.4-4.2), and the median overall survival 11.6 months (0.6-33.3; 95 % CI 8.7-14.5). No correlation was recorded between subtypes in terms of ORR and CBR. Toxicity was manageable. Main common grade 3-4 toxicities were neutropenia (19.4 %), febrile neutropenia (0.9 %), asthenia (3.5 %), abnormal liver function test (1.8 %), stomatitis (0.9 %). Our results confirm that treatment with eribulin is feasible and safe in real-world patients.

  5. Epidemiology, clinical manifestations, and diagnosis of Chikungunya fever: lessons learned from the re-emerging epidemic.

    Science.gov (United States)

    Mohan, Alladi; Kiran, D H N; Manohar, I Chiranjeevi; Kumar, D Prabath

    2010-01-01

    Chikungunya fever, caused by "Chikungunya virus," is an arbovirus disease transmitted by the bite of infected mosquitoes belonging to the genus Aedes. Chikungunya fever epidemics have been reported from several countries around the world. The disease that was silent for nearly 32 years re-emerged in the October 2005 outbreak in India that is still ongoing. The incubation period ranges from 3 to 12 days. The onset is usually abrupt and the acute stage is characterized by sudden onset with high-grade fever, severe arthralgias, myalgias, and skin rash. Swollen tender joints and crippling arthritis are usually evident. In the chronic stage, relapses that include sensation of fever, asthenia, exacerbation of arthralgias, inflammatory polyarthritis, and stiffness may be evident. Neurological, ocular, and mucocutaneous manifestations have also been described. Chronic arthritis may develop in about 15% of the patients. Viral culture is the gold standard for the diagnosis of Chikungunya fever. Reverse transcription polymerase chain reaction and real-time loop-mediated isothermal amplification have also been found to be useful. Serodiagnostic methods for the detection of immunoglobulin M and immunoglobulin G antibodies against Chikungunya virus are more frequently used. Chikungunya is a self-limiting disease; however, severe manifestations such as meningoencephalitis, fulminant hepatitis, and bleeding manifestations may sometimes be life-threatening. Treatment is symptomatic and supportive. Prevention by educating the community and public health officials, vector control measures appear to be the best approach at controlling Chikungunya fever as no commercially available vaccine is available for public use in India for this condition presently.

  6. Final results from the large sunitinib global expanded-access trial in metastatic renal cell carcinoma

    Science.gov (United States)

    Gore, M E; Szczylik, C; Porta, C; Bracarda, S; Bjarnason, G A; Oudard, S; Lee, S-H; Haanen, J; Castellano, D; Vrdoljak, E; Schöffski, P; Mainwaring, P; Hawkins, R E; Crinò, L; Kim, T M; Carteni, G; Eberhardt, W E E; Zhang, K; Fly, K; Matczak, E; Lechuga, M J; Hariharan, S; Bukowski, R

    2015-01-01

    Background: We report final results with extended follow-up from a global, expanded-access trial that pre-regulatory approval provided sunitinib to metastatic renal cell carcinoma (mRCC) patients, ineligible for registration-directed trials. Methods: Patients ⩾18 years received oral sunitinib 50 mg per day on a 4-weeks-on–2-weeks-off schedule. Safety was assessed regularly. Tumour measurements were scheduled per local practice. Results: A total of 4543 patients received sunitinib. Median treatment duration and follow-up were 7.5 and 13.6 months. Objective response rate was 16% (95% confidence interval (CI): 15–17). Median progression-free survival (PFS) and overall survival (OS) were 9.4 months (95% CI: 8.8–10.0) and 18.7 months (95% CI: 17.5–19.5). Median PFS in subgroups of interest: aged ⩾65 years (33%), 10.1 months; Eastern Cooperative Oncology Group performance status ⩾2 (14%), 3.5 months; non-clear cell histology (12%), 6.0 months; and brain metastases (7%), 5.3 months. OS was strongly associated with the International Metastatic Renal-Cell Carcinoma Database Consortium prognostic model (n=4065). The most common grade 3/4 treatment-related adverse events were thrombocytopenia (10%), fatigue (9%), and asthenia, neutropenia, and hand–foot syndrome (each 7%). Conclusion: Final analysis of the sunitinib expanded-access trial provided a good opportunity to evaluate the long-term side effects of a tyrosine kinase inhibitor used worldwide in mRCC. Efficacy and safety findings were consistent with previous results. PMID:26086878

  7. Pernicious anemia: new insights from a gastroenterological point of view.

    Science.gov (United States)

    Lahner, Edith; Annibale, Bruno

    2009-11-07

    Pernicious anemia (PA) is a macrocytic anemia that is caused by vitamin B(12) deficiency, as a result of intrinsic factor deficiency. PA is associated with atrophic body gastritis (ABG), whose diagnosis is based on histological confirmation of gastric body atrophy. Serological markers that suggest oxyntic mucosa damage are increased fasting gastrin and decreased pepsinogen I. Without performing Schilling's test, intrinsic factor deficiency may not be proven, and intrinsic factor and parietal cell antibodies are useful surrogate markers of PA, with 73% sensitivity and 100% specificity. PA is mainly considered a disease of the elderly, but younger patients represent about 15% of patients. PA patients may seek medical advice due to symptoms related to anemia, such as weakness and asthenia. Less commonly, the disease is suspected to be caused by dyspepsia. PA is frequently associated with autoimmune thyroid disease (40%) and other autoimmune disorders, such as diabetes mellitus (10%), as part of the autoimmune polyendocrine syndrome. PA is the end-stage of ABG. Long-standing Helicobacter pylori infection probably plays a role in many patients with PA, in whom the active infectious process has been gradually replaced by an autoimmune disease that terminates in a burned-out infection and the irreversible destruction of the gastric body mucosa. Human leucocyte antigen-DR genotypes suggest a role for genetic susceptibility in PA. PA patients should be managed by cobalamin replacement treatment and monitoring for onset of iron deficiency. Moreover, they should be advised about possible gastrointestinal long-term consequences, such as gastric cancer and carcinoids.

  8. Discussion on Main Ideas of Yunqi Theory in Diagrammatizing Main Ideas in Su Wen%《新刊图解素问要旨论》五运六气要旨之探讨

    Institute of Scientific and Technical Information of China (English)

    杨威; 于峥; 于志静

    2014-01-01

    《新刊图解素问要旨论》为金代刘完素所著,经弟子马宗素整理、校订、刊发,仅有一部清抄本传世。该书详细阐释五运六气格局及其医学意义,论及大小运、平气运及“年月日时同”等,养生重应时之所宜补衰抑盛,诊病参脉候推生克,治病从标本察顺逆,提倡知常御变,综合考量运气加临、脏腑虚实、疾病演变等,为后学者临证体验提供了线索与依据。%Diagrammatizing Main Ideas in Su Wen, as the only codex handed down from Qing Dynasty, was written by Liu Wansu in Jin Dynasty, and was collated and revised by his disciple Ma Zongsu. This book elaborates Yunqi (Five Evolutive Phases and Six Climatic Factors) Theory in detail, expounds major and minor Evolutive Phases, normal Evolutive Phases, and the concept of the changes of Yunqi are similar in a year, a month, and a day. It also advocates that health cultivation requires human beings to follow laws of nature, invigorate asthenia-syndromes and restrain excess. Furthermore, it argues that doctors should deduce generation and restriction in the Five Evolutive Phases through palpating, and treat diseases by observing primary and secondary symptoms and signs in due or reverse order. In addition, it promotes that human beings should notice normal features and unusual changes in climatic factors, consider the theory of Yunqi, deficiency and excess of organs, and evolution of disease synthetically, in order to provide learners with clues and basic theories in clinical practice.

  9. Personality features in ultra-high risk for psychosis: a comparative study with schizophrenia and control subjects using the Temperament and Character Inventory-Revised (TCI-R).

    Science.gov (United States)

    Fresán, Ana; León-Ortiz, Pablo; Robles-García, Rebeca; Azcárraga, Mariana; Guizar, Diana; Reyes-Madrigal, Francisco; Tovilla-Zárate, Carlos Alfonso; de la Fuente-Sandoval, Camilo

    2015-02-01

    Several variables have been identified as risk factors for conversion to overt psychosis in ultra-high risk for psychosis (UHR) individuals. Although almost two-thirds of them do not experience a transition to psychosis, they still exhibit functional disabilities. Other subjective developmental features may be useful for a more precise identification of individuals at UHR. Avoidant behaviors are consistently reported in schizophrenia and in UHR individuals and may be the reflection of a pattern of personality. Thus, personality features in UHR individuals deserves further research. The objective of the present study was to compare temperament and character dimensions between UHR individuals, patients with schizophrenia and healthy controls. One hundred participants (25 UHR individuals, 25 schizophrenia patients and 50 control subjects) where evaluated with the Temperament and Character Inventory-Revised (TCI-R). Univariate ANOVAs followed by Bonferroni tests were used. UHR individuals and schizophrenia patients exhibited higher levels of Harm Avoidance (HA) when compared to control subjects. For HA1 Anticipatory worry vs Uninhibited optimism and HA4 Fatigability & asthenia, UHR and schizophrenia groups showed similar scores and both groups were higher compared to control subjects. With respect to Cooperativeness (CO), UHR and schizophrenia reported lower scores than control subjects, in particular CO2 Empathy vs Social disinterest and CO3 Helpfulness vs unhelpfulness. This study replicates and extends the consideration of HA as a psychopathological related endophenotype and gives us further information of the possible role of personality features in the expression of some of the social dysfunctions observed both in prodromal subjects and schizophrenia patients.

  10. Multiple lymphomatous polyposis of the gastrointestinal tract

    Directory of Open Access Journals (Sweden)

    Maria Isete Fares Franco

    Full Text Available CONTEXT: Gastrointestinal multiple lymphomatous polyposis is a rare type of malignant lymphoma that has aggressive biological behavior, early systemic dissemination and poor prognosis. It is considered to be a manifestation of non-Hodgkin lymphoma and represents the gastrointestinal counterpart of mantle cell nodal lymphoma. OBJECTIVE: A case of gastrointestinal multiple lymphomatous polyposis is presented and the anatomopathological, clinical, diagnostic and treatment aspects of this unusual neoplasia are discussed. CASE REPORT: The patient was a 59-year-old white male with a complaint of asthenia, night sweating, alteration in intestinal habit and weight loss over the preceding two months. The physical examination showed pallid mucosa and a palpable mass in the epigastrium and mesogastrium. Endoscopy of the upper digestive tract showed the presence of gastric and duodenal polyps. An opaque enema showed multiple polypoid lesions, especially in the cecum. A rectal biopsy revealed infiltration of the mucosa and submucosa by diffuse lymphoma consisting of small cleaved cells. Immunohistochemical study showed lymphocytes that expressed the antibody CD20 (L-26 and light-chain kappa (k immunoglobulin, but not light-chain lambda (l immunoglobulin. The patient presented a condition of acute intestinal obstruction with the presence of a mesenteric mass formed by agglutinated lymph nodes that surrounded the proximal ileum, thereby obstructing its lumen. He was submitted to a segmental enterectomy and gastrotomy with excisional biopsies of the gastric polypoid lesions. After two cycles of chemotherapy there was a worsening of the general state, with an increase in the dimensions of the abdominal masses and sepsis, accompanied by progressive respiratory insufficiency, leading to death.

  11. Clinical and laboratory profile of HIV-positive patients at the moment of diagnosis in Bahia, Brazil

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    Márcia Sampaio Sá

    2007-08-01

    Full Text Available In Brazil, current trends of the AIDS epidemic include an increase in transmission through heterosexual contact, predominantly from men to women, with more cases of AIDS in women and more children contaminated by vertical transmission. There is also a high proportion of cases in poor people or people living in small towns. HIV-infected patients with high levels of immunodeficiency are frequently hospitalized after their first visit to the clinic due to opportunistic infections, characteristic of advanced disease. This study characterized the clinical and laboratory pattern of AIDS in a sample of patients attended for the first time in the AIDS clinic of the Federal University of Bahia Hospital (HUPES in Salvador, Brazil. We revised medical charts of cases of subjects registered at the outpatient AIDS clinic from January 1997 to December 2003. The demographics, clinical data, and laboratory characteristics were analyzed to determine the degree of immunodeficiency at the time of admission. A total of 377 patients were evaluated (58.6% were male, with a mean sample age of 33.4 years. The most frequent clinical manifestations were asthenia, weight loss, fever, anemia, dermatitis, oral thrush and diarrhea. CDC criteria were not adequate to define the initial cases. After admission to the outpatient clinic, nearly 25% of the patients were hospitalized immediately, indicating delay in the diagnosis. In Bahia, the initial presentation of HIV-infected patients to health care assistance is occurring at a late stage of the disease, when signs and symptoms of immunodeficiency are already established. Efforts are necessary to construct strategies to make an early diagnosis of these patients, improve the quality of care, and guarantee the benefits of antiretroviral therapy, when it is indicated.

  12. A successful case on traditional Chinese fumigation-soaking therapy in treating diabetic peripheral neuropathy

    Institute of Scientific and Technical Information of China (English)

    Hongfang Liu; Huayang Wu; Lizhong Zhang; Jinxi Zhao

    2006-01-01

    AIM: To investigate the scheme of inducing the diabetic peripheral neuropathy (DNP) symptoms by combine Chinese traditional medicine with modern medicine. METHODS: Patient hospitalized on April 1, 2005. Main symptoms in hospitalization: His bilateral fingers and toe tips felt stabbing pain, numb, cold, assuming a type of sock set which alleviated after he had a rest and aggravated after exercise. He had also got the symptom of dizziness, asthenia, eating little food, very thin bowel and body pain which had influence on his sleeping. Physical examination in hospital: The bilateral lower limbs which got a hyperpathia did not swell. The bilateral dorsum pedis artery pulsation was atlenuarive. The skin temperature was not high. Other nerve system examination had been discovered abnormal. Diagnosis: Traditional Chinese medical diagnosis: Xiaokebing (blood stasis for insufficiency of qi, blockage of meridian and collaterals). Modern medical diagnosis: Diabetes type 2, DNP, diabetic lower limbs artery obliteration, diabetic foot (0 level), diabetic retinopathy, coronary atherosclerotic heart disease, hypertension, chronic bronchitis, chronic obstructive pulmonary emphysema. Carried on the former therapy plan that continued to use insulin to control blood glucose, depressed blood pressure and total plasma lipoprotein etc. Meanwhile used the therapy of bilateral feet medicinal bath (Sanling 30 g, Ezhu 30 g, Ruxiang 30 g, Moyao 30 g, Zhichuanwu 30 g, Zhicaowu 30 g, Weilingxian 30 g, Mugua 30 g, Sangzhi 30 g), boiled in water, 1 dose everyday, soak feet twice a day, 20-30 minutes once, < 37 ℃. RESULTS: Seven days later, the pain of bilateral feet alleviated obviously, and the bilateral dorsum pedis artery pulsation enhanced. Blood glucose and total plasma lipoprotein had no changes. CONCLUSION: The symptoms of DNP such as pain, coldness, numbness of the lower limbs can be induced by combining feet medicinal bath (fumigation-soaking) treatment with modern medicine.

  13. Pernicious anemia: New insights from a gastroenterological point of view

    Institute of Scientific and Technical Information of China (English)

    Edith Lahner; Bruno Annibale

    2009-01-01

    Pernicious anemia (PA) is a macrocytic anemia that is caused by vitamin B_(12) deficiency, as a result of intrinsic factor deficiency. PA is associated with atrophic body gastritis (ABG), whose diagnosis is based on histological confirmation of gastric body atrophy. Serological markers that suggest oxyntic mucosa damage are increased fasting gastrin and decreased pepsinogen Ⅰ. Without performing Schilling's test,intrinsic factor deficiency may not be proven, and intrinsic factor and parietal cell antibodies are useful surrogate markers of PA, with 73% sensitivity and 100% specificity. PA is mainly considered a disease of the elderly, but younger patients represent about 15% of patients. PA patients may seek medical advice due to symptoms related to anemia, such as weakness and asthenia. Less commonly, the disease is suspected to be caused by dyspepsia. PA is frequently associated with autoimmune thyroid disease (40%) and other autoimmune disorders, such as diabetes mellitus (10%), as part of the autoimmune polyendocrine syndrome. PA is the end-stage of ABG. Longstanding Helicobacter pylori infection probably plays a role in many patients with PA, in whom the active infectious process has been gradually replaced by an autoimmune disease that terminates in a burned-out infection and the irreversible destruction of the gastric body mucosa. Human leucocyte antigen-DR genotypes suggest a role for genetic susceptibility in PA. PA patients should be managed by cobalamin replacement treatment and monitoring for onset of iron deficiency. Moreover, they should be advised about possible gastrointestinal long-term consequences, such as gastric cancer and carcinoids.

  14. Fiebre manchada por rickettsias en el Delta del Paraná: Una enfermedad emergente Rickettsial spotted fever in the Paraná Delta: An emerging disease

    Directory of Open Access Journals (Sweden)

    Alfredo Seijo

    2007-12-01

    Full Text Available Se comunica un caso de fiebre manchada por rickettsia autóctono del delta del Paraná correspondiente a la provincia de Buenos Aires. Luego de cinco días de haber permanecido en una región cercana a la localidad de ingeniero Otamendi, partido de Campana, el paciente presentó un síndrome febril agudo caracterizado por hipertermia con escalofríos y sudoración, mialgias, cefalea, astenia y discreta odinofagia, seguido a las 72 horas por un exantema maculopapuloso congestivo con elementos purpúricos, de distribución universal. En la región preauricular izquierda se observaba una lesión papuloerosiva, producida cinco días antes de iniciada la fiebre por una garrapata adquirida en el lugar. El cuadro clínico remitió rápidamente con la administración de doxiciclina. Por inmunofluorescencia indirecta se identificaron anticuerpos reactivos contra el grupo de rickettsias causantes de fiebres manchadas (CDC, Atlanta, EE.UU.. Se realizan consideraciones sobre la especie de rickettsia, el vector involucrado y la posibilidad que la enfermedad fuera debida a Rickettsia parkeri.We describe a case of rickettsial spotted fever in the Paraná Delta region of Buenos Aires province in Argentina. The patient developed an acute febrile syndrome characterized by myalgias, headache, asthenia and moderate odynophagia, followed by a diffuse macular, papular, and purpuric exanthema. The patient had been bitten recently by a tick on the left preauricular region and an erosive papular lesion was evident at the bite site. An indirect immunofluorescence antibody assay identified antibodies reactive with spotted fever group rickettsiae in the patient's serum. The patient improved rapidly with doxycycline. Several considerations relating to the identity of the rickettsial species and tick vector are discussed, including the possibility that this patient's illness may have been caused by Rickettsia parkeri.

  15. Carcinosarcoma of the colon: report of a case with morphological, ultrastructural and molecular analysis

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    Ferrero Stefano

    2006-07-01

    Full Text Available Abstract Background Carcinosarcoma of the colon is a rare histopathological entity with uncertain histogenesis, that shows both epithelial and mesenchymal malignant differentiation. Carcinosarcoma rarely affects the gastrointestinal tract and only few cases are reported in the colon. Herein we describe a carcinosarcoma of the ascending colon, with morphological, ultrastructural and molecular analysis. Case presentation An 81-year-old man was hospitalised for asthenia, weight loss and iron-deficiency anaemia. The patient underwent colonoscopy and adenocarcinoma was diagnosed by endoscopic biopsy. A right hemicolectomy was performed and, during surgical operation, liver metastases were detected. Histological examination of the surgical specimen revealed areas of both carcinomatous and sarcomatous differentiation, completely separated by fibrous septae. The sarcomatous component exhibited areas of smooth muscle and osteoblastic differentiation, with focal osteoid material deposition. Molecular analysis conducted separately on the epithelial and mesenchymal components revealed the same p53 gene mutation (R282W in exon 8 and identical polymorphisms in p53 exon 4, in EGFR exons 20 and 21, and in c-kit exon 17. Microsatellite markers analysis revealed a common loss of heterozygosis on 18q. Overall, the data are consistent with a common origin of the two tumor components. The patient was treated with 8 cycles of oral capecitabine (1250 mg/m2 twice a day for 14 days repeated every 28 days and two years after surgery is alive with liver metastases. Conclusion Carcinosarcoma of the colon is a rare tumour with both epithelial and sarcomatous components. Molecular analysis of the current case suggests the histogenesis from a common cell progenitor.

  16. 小儿慢性粒细胞白血病12例临床分析%Clinical features of 12 children with chronic myeloid leukemia

    Institute of Scientific and Technical Information of China (English)

    刘兆娥; 宋惠霄; 陈力军

    2010-01-01

    Objective To study the clinical and laboratory characteristics and treatments in children with chronic myelogenous leukemia (CML). Methods Respective analyze of the clinical and laboratory data of twelve pediatric patients with CML from December 1994 to October 2009 was performed. Results The disease predominately affected children from 5 to 9 years old (50 % of the patients), with a higher prevalence in boys than girls (gender ratio: 5:1). The duration before the diagnosis was different from three days to one year. The main presenting symptoms were fever, bleeding,asthenia, and complaints related to splenomegaly.Some cases were diagnosed incidentally. Markedly raised leukocyte and platelet counts were common.Conclusion CML in children is rare, and average level of WBC count seems to be much higher than adult.%目的 探讨儿童慢性粒细胞白血病(CML)的临床、实验室特点及其治疗.方法 回顾性分析1994年12月至2009年10月收治的12例CML患儿临床及实验室资料.结果 CML多见于5~9岁的患儿,男女之比为5∶1.出现症状或体征至明确诊断的时间为3 d~1年.常见症状为发热、出血、乏力;部分因体检发现血象异常或脾大而就诊.白细胞及血小板数量明显增多.结论 CML小儿少见,症状不典型,其白细胞数与成年人相比有显著差别.

  17. Colorectal cancer in geriatric patients: Endoscopic diagnosis and surgical treatment

    Institute of Scientific and Technical Information of China (English)

    Andreas Kirchgatterer; Pius Steiner; Dietmar Hubner; Eva Fritz; Gerhard Aschl; Josef Preisinger; Maximilian Hinterreiter; Bernhard Stadler; Peter Knoflach

    2005-01-01

    AIM: To investigate the prevalence of colorectal cancer in geriatric patients undergoing endoscopy and to analyze their outcome.METHODS: All consecutive patients older than 80 years who underwent lower gastrointestinal endoscopy between January 1995 and December 2002 at our institution were included.Patients with endoscopic diagnosis of colorectal cancer were evaluated with respect to indication, localization and stage of cancer, therapeutic consequences, and survival.RESULTS: Colorectal cancer was diagnosed in 88 patients (6% of all endoscopies, 55 women and 33 men, mean age 85.2 years). Frequent indications were lower gastrointestinal bleeding (25%), anemia (24%) or sonographic suspicion of tumor (10%). Localization of cancer was predominantly the sigmoid colon (27%), the rectum (26%), and the ascending colon (20%). Stage Dukes A was rare (1%), but Dukes D was diagnosed in 22% of cases. Curative surgery was performed in 54 patients (61.4%), in the remaining 34 patients (38.6%)surgical treatment was not feasible due to malnutrition and asthenia or cardiopulmonary comorbidity (15 patients), distant metastases (11 patients) or refusal of operation (8 patients).Patients undergoing surgery had a very low in-hospital mortality rate (2%). Operated patients had a one-year and three-year survival rate of 88% and 49%, and the survival rates for nonoperated patients amounted to 46% and 13% respectively.CONCLUSION: Nearly two-thirds of 88 geriatric patients with endoscopic diagnosis of colorectal cancer underwent successful surgery at a very low perioperative mortality rate, resulting in significantly higher survival rates. Hence,the clinical relevance of lower gastrointestinal endoscopy and oncologic surgery in geriatric patients is demonstrated.

  18. Subclinical myopathy in patients with colorectal cancer: clinical-pathological characterization and search for tissue markers

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    Massimo Vecchiato

    2012-03-01

    Full Text Available Skeletal muscle in patients with cancer undergoes many morphological changes due to immuno-inflammatory factors of tumor origin or treatment.T he latest event of these changes is cancer cachexia. Aim of the study is to identify myopathic features in skeletal muscle biopsies from weight stable patients with colorectal cancer and without cachexia or asthenia / weakness, that could possibly provide new diagnostic and prognostic cancer biomarkers. Morphometric analyses and immunohistochemical studies were performed on intraoperative muscle biopsies from patients with colorectal cancer and from weight stable patients undergoing surgery for benign non-inflammatory conditions. A rectus abdominis biopsy was taken in all patients and controls.A correlation between histopathologic findings and clinical characteristics, circulating inflammatory biomarkers and markers of muscle necrosis,surgery data and cancer phenotype were investigated.. Forty four patients (21male/23 female and 17 controls (6 male/11 female (p=NS were studied. In cancer patients’biopsies we observed asubclinical myopathy characterized by an abnormal distribution of myonuclei, which are localized inside the myofiber rather than at the periphery, and by the presence of regenerating muscle fibers. The percentage of myofibers with internalized nuclei is significantly higher in patients (median= 9%, IQR= 3.7-18.8 than in controls (median= 2.7%, IQR= 1.7-3.2 ( p=0.0002. In patients we observed an inverse correlation between the number of centronucleated fibers and the presence of node metastasis (N+(ρ=-0.64 (p=0.002. Patients affected with colorectal cancer display early sign of a myopathy, characterized by centronucleated and regenerating myofibers. This myopathy appears to be associated with an early stage of neoplasia and it could be an adaptive response of muscle to cancer. We hope a future application of these findings as a possible early diagnostic and prognostic biomarker of

  19. Cancer-associated malnutrition, cachexia and sarcopenia: the skeleton in the hospital closet 40 years later.

    Science.gov (United States)

    Ryan, Aoife M; Power, Derek G; Daly, Louise; Cushen, Samantha J; Ní Bhuachalla, Ēadaoin; Prado, Carla M

    2016-05-01

    An awareness of the importance of nutritional status in hospital settings began more than 40 years ago. Much has been learned since and has altered care. For the past 40 years several large studies have shown that cancer patients are amongst the most malnourished of all patient groups. Recently, the use of gold-standard methods of body composition assessment, including computed tomography, has facilitated the understanding of the true prevalence of cancer cachexia (CC). CC remains a devastating syndrome affecting 50-80 % of cancer patients and it is responsible for the death of at least 20 %. The aetiology is multifactorial and complex; driven by pro-inflammatory cytokines and specific tumour-derived factors, which initiate an energy-intensive acute phase protein response and drive the loss of skeletal muscle even in the presence of adequate food intake and insulin. The most clinically relevant phenotypic feature of CC is muscle loss (sarcopenia), as this relates to asthenia, fatigue, impaired physical function, reduced tolerance to treatments, impaired quality of life and reduced survival. Sarcopenia is present in 20-70 % depending on the tumour type. There is mounting evidence that sarcopenia increases the risk of toxicity to many chemotherapy drugs. However, identification of patients with muscle loss has become increasingly difficult as 40-60 % of cancer patients are overweight or obese, even in the setting of metastatic disease. Further challenges exist in trying to reverse CC and sarcopenia. Future clinical trials investigating dose reductions in sarcopenic patients and dose-escalating studies based on pre-treatment body composition assessment have the potential to alter cancer treatment paradigms.

  20. Temperament and character properties of primary focal hyperhidrosis patients

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    Ak Mehmet

    2013-01-01

    Full Text Available Abstract Background Primary focal hyperhidrosis is a health problem, which has negative effects on the patient's quality of life and significantly affects the patients’ daily activities, social and business life. The aim of this study is to evaluate temperament and character properties of patients diagnosed with primary focal hyperhidrosis. Methods Fifty-six primary focal hyperhidrosis (22.42 ± 7.80 and 49 control subjects (24.48 ± 5.17 participated in the study. Patients who met the diagnostic criteria for PFH were referred to psychiatry clinic where the subjects were evaluated through Structured Clinical Interview for DSM Disorders-I and Temperament and Character Inventory. Results In order to examine the difference between the PFH and control group in terms of temperament and character properties, one-way Multivariate Analysis of Variance (MANOVA was conducted. In terms of temperament properties, PFH group took significantly higher scores than control group in Fatigability and asthenia dimension. In terms of character properties, PFH group scored significantly lower than control group in Purposefulness , Resourcefulness , Self-Directedness and scored significantly higher than control group in Self-forgetfulness and Self-Transcendence. Conclusion Temperament and character features of PFH patients were different from healthy group and it was considered that these features were affected by many factors including genetic, biological, environmental, socio-cultural elements. During the follow-up of PFH cases, psychiatric evaluation is important and interventions, especially psychotherapeutic interventions can increase the chances of success of the dermatological treatments and can have a positive impact on the quality of life and social cohesion of chronic cases.

  1. Diagnosis and multi-modality treatment of adult pulmonary plastoma:Analysis of 18 cases and review of literature

    Institute of Scientific and Technical Information of China (English)

    Yun-Xi Wang; Jing Zhang; Xiang-Yang Chu; Yi Liu; Fang Li; Zhan-Bo Wang; Li-Xin Wei

    2014-01-01

    The clinical data of18 patients withPB fromApril1989 toApril2013 was analyzed retrospectively, including11 men and7 women, aged45 and76 years old(mean53 years).There were12 cases of PB occurring in right lung and other cases in left lung.Among them,3 patients had no symptoms, and15 patients displayed symptoms of cough, chest pain, asthenia or minor haemoptysis. Overall,11 patients had a preoperative diagnosis of lung cancer,7 patients were preoperatively diagnosed as the other diseases, which included lung benign tumor(n=5) and mediastinal mass (n=2).All patients received a radical resection.Six patients received postoperative cisplatin-based chemotherapy, and two patients received postoperative irradiation with the dose of55Gy. Histologically,14 cases of18 patients had biphasic pulmonary blastoma and four cases had well differentiated fetal adenocarcinoma.A total of12 patients died in a period of6-36 months after operation, and1 case was lost after2 years of follow up.The median survival time was19 months. PB is a rare primary lung malignant embryonal neoplasm.Despite its assumed embyonal origin, the tumor has a predilection for adults.A preoperative correct diagnosis is very difficult in spite of modern diagnostic imaging and biopsy techniques.Surgical resection is the main method for diagnosis and treatment.Postoperative chemotherapy or irradiation can help eliminate tumor remnants.Its prognosis is very poor, especially for the biphasic type.

  2. En-Bloc Transplant of the Liver, Kidney and Pancreas: Experience from a Latin American Transplant Center

    Science.gov (United States)

    Caicedo, Luis A.; Villegas, Jorge I.; Serrano, Oscar; Millán, Mauricio; Sepúlveda, Mauricio; Jiménez, Diego; García, Jairo; Posada, Juan G.; Mesa, Liliana; Duran, Carlos; Schweineberg, Johanna; Dávalos, Diana; Manzi, Eliana; Sabogal, Angie; Aristizabal, Ana María; Echeverri, Gabriel J.

    2017-01-01

    Case series Patient: Male, 38 • Male, 48 Final Diagnosis: En-bloc transplantation (liver, kidney, pancreas) Symptoms: Encephalopathy • adynamia • ascites • asthenia Medication: — Clinical Procedure: En-bloc transplantation Specialty: Transplantology Objective: Unusual setting of medical care Background: En-bloc transplantation is a surgical procedure in which multiple organs are transplanted simultaneously. It has some similarities with multi-organ transplantation but offers certain advantages. This report highlights the experience of our interdisciplinary group regarding the treatment and follow-up of patients who received en-bloc transplantation, with the aim of encouraging the development of this surgical technique. Case Report: The first case is a 38-year-old patient with type 1 diabetes mellitus, liver cirrhosis, and chronic kidney failure who received an en-bloc transplant of the liver, pancreas, and kidney with no intraoperative complications. He had a prolonged hospital stay due to anemia and systemic inflammatory response syndrome, which were resolved successfully. At follow-up, he had no requirement for insulin or for dialysis, or for new interventions. The second case describes a 48-year-old patient with type 2 diabetes mellitus, renal failure, and liver cirrhosis who received an en-bloc transplant of the liver, pancreas, and kidney with no complications. During the postoperative period, the patient suffered a possible episode of acute tubular necrosis, which evolved towards improvement, with a tendency to normal metabolic and renal functioning, with no additional events. The patient is currently in follow-up and is insulin-independent. Conclusions: En-bloc transplantation is a safe procedure, which is technically simple and which achieves excellent results. This procedure is indicated in patients with end-stage renal disease, cirrhosis, and diabetes mellitus that is difficult to control. PMID:28148909

  3. A brief contextualization on IgG4 tubulointerstitial nephritis based on a case report in south Brazil.

    Science.gov (United States)

    Pêgas, Karla Lais; Cambruzzi, Eduardo; Lobato, Gisele

    2016-06-01

    IgG4-related disease (IgG4RD) is a recent inflammatory process of supposed autoimmune etiology, which is characterized by elevated serum IgG4 levels, dense lymphoplasmacytic infiltration rich in IgG4-positive plasma cells and storiform fibrosis. Tubulointerstitial nephritis is the most common renal manifestation, with different degrees of kidney dysfunction and variable clinical findings. Herein, the authors describe a new case of IgG4 tubulointerstitial nephritis (IgG4TN), and discuss clinic and pathologic criteria. Male patient, 72 years-old, was admitted on hospital service with clinical complaint of asthenia, loss of strength, emaciation, and anosmia. Previous history included type 2 diabetes mellitus. Laboratorial data included normochromic anemia, proteinuria, and creatinine elevation. Bilateral kidney ultrassonography/computed tomography revealed a heterogenous parenchyma, with diffuse irregular dense zones, areas of fibrosis on upper poles, and hydronephrosys. Kidney biopsy showed a dense interstitial lymphoplasmacytic infiltrate, with more than 50 plasma cell per high power field, irregular areas of fibroblastic and collagenous fibrosis, focal tubulitis, and normal glomeruli. Immunofluorescence revealed mild granular deposition of C3c and IgG in the tubular basement membrane. Immunohistochemestry was positive for CD138, lambda and Kappa light chains, and IgG4 (around forty five IgG4 positive plasma cells per high power field). IgG4 serum level was increased. The diagnosis of IgG4TN was then established. The patient received corticotherapy and strict control of glycemia with insulin, with marked improvement of symptoms and creatinine levels.

  4. 剖宫产术后腹胀的原因分析及护理对策%Reason analysis and nursing countermeasure about abdominal distension after cesar ean section

    Institute of Scientific and Technical Information of China (English)

    吴晓兰; 温清霞; 吴晓丽

    2011-01-01

    探讨剖宫产术后腹胀的原因及护理对策.对2009年1月至2010年1月在我院接受剖宫产术的200例患者进行回顾性分析,总结术后腹胀原因及护理对策.本组200例患者中出现腹胀患者30例,发生率为15%.其中术前不当饮食、气体吞咽、腹肌无力、长期卧床、胃肠道准备不充分等是造成剖宫产术后腹胀的主要原因.针对发病原因实施科学系统的护理能有效减少腹胀的发生.%To investigate the reason and nursing countermeasure about abdominal distension after cesarean section.The 200 cases with cesarean section in our hospital from January in 2009 to January in 2010 were analyzed retrospectively,and the reason and nursing countermeasure about abdominal distension were summerized.There were 30 case with abdominal distension after cesarean section in 200 cases with cesarean section,and the incidence rate was 15%.There improper diet before operation,swallowing gases,abdominal muscles asthenia,lying in bed and insufficiency bowel preparation were the main reasons causing the abdominal distension after cesarean ection.The systematic nursing intervention is effective to reduce the incidence rate of abdominal distension after cesarean section sccording to the development reason of disease.

  5. Voice Quality After Treatment of Early Vocal Cord Cancer: A Randomized Trial Comparing Laser Surgery With Radiation Therapy

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    Aaltonen, Leena-Maija, E-mail: leena-maija.aaltonen@hus.fi [Department of Otorhinolaryngology–Head and Neck Surgery, Helsinki University Central Hospital, and University of Helsinki, Helsinki (Finland); Rautiainen, Noora; Sellman, Jaana [Institute of Behavioural Sciences, University of Helsinki, Helsinki (Finland); Saarilahti, Kauko [Department of Oncology, Helsinki University Central Hospital, and University of Helsinki, Helsinki (Finland); Mäkitie, Antti; Rihkanen, Heikki [Department of Otorhinolaryngology–Head and Neck Surgery, Helsinki University Central Hospital, and University of Helsinki, Helsinki (Finland); Laranne, Jussi; Kleemola, Leenamaija [Department of Otorhinolaryngology–Head and Neck Surgery, Tampere University Hospital, and University of Tampere, Tampere (Finland); Wigren, Tuija [Department of Oncology, Tampere University Hospital, and University of Tampere, Tampere (Finland); Sala, Eeva [Department of Otorhinolaryngology–Head and Neck Surgery, Turku University Hospital, and University of Turku, Turku (Finland); Lindholm, Paula [Department of Oncology, Turku University Hospital, and University of Turku, Turku (Finland); Grenman, Reidar [Department of Otorhinolaryngology–Head and Neck Surgery, Turku University Hospital, and University of Turku, Turku (Finland); Joensuu, Heikki [Department of Oncology, Helsinki University Central Hospital, and University of Helsinki, Helsinki (Finland)

    2014-10-01

    Objective: Early laryngeal cancer is usually treated with either transoral laser surgery or radiation therapy. The quality of voice achieved with these treatments has not been compared in a randomized trial. Methods and Materials: Male patients with carcinoma limited to 1 mobile vocal cord (T1aN0M0) were randomly assigned to receive either laser surgery (n=32) or external beam radiation therapy (n=28). Surgery consisted of tumor excision with a CO{sub 2} laser with the patient under general anaesthesia. External beam radiation therapy to the larynx was delivered to a cumulative dose of 66 Gy in 2-Gy daily fractions over 6.5 weeks. Voice quality was assessed at baseline and 6 and 24 months after treatment. The main outcome measures were expert-rated voice quality on a grade, roughness, breathiness, asthenia, and strain (GRBAS) scale, videolaryngostroboscopic findings, and the patients' self-rated voice quality and its impact on activities of daily living. Results: Overall voice quality between the groups was rated similar, but voice was more breathy and the glottal gap was wider in patients treated with laser surgery than in those who received radiation therapy. Patients treated with radiation therapy reported less hoarseness-related inconvenience in daily living 2 years after treatment. Three patients in each group had local cancer recurrence within 2 years from randomization. Conclusions: Radiation therapy may be the treatment of choice for patients whose requirements for voice quality are demanding. Overall voice quality was similar in both treatment groups, however, indicating a need for careful consideration of patient-related factors in the choice of a treatment option.

  6. Latent Autoimmune Diabetes in Adults: a case report.

    Science.gov (United States)

    Bermúdez, Valmore; Aparicio, Daniel; Colmenares, Carlos; Peñaranda, Lianny; Luti, Yettana; Gotera, Daniela; Rojas, Joselyn; Cabrera, Mayela; Reyna, Nadia; Velasco, Manuel; Israili, Zafar H

    2010-01-01

    Latent Autoimmune Diabetes in Adults (LADA) is an autoimmune endocrine disorder in which despite the presence of antipancreatic islets antibodies in the moment of diagnostics, the progression to beta-cell secretory insufficiency is slow. It is often confused with others types of diabetes and therefore the management is frequently inadequate. We report a clinical case of a 23-year-old man with diagnosis of type 2 diabetes since 6 months ago, poorly controlled with a sulfonylurea, who initially presented 2 months ago from polyuria, polydipsia, and asthenia and 6 kg weight loss. History of past illness was negative, however, his mother relates exclusive breastfeeding during the first 15 days of life and later (until the 6 months) he was fed with infant formula (S-26). Family history revealed a first-degree relative (father) with diabetes mellitus secondary to steroid administration due to diagnosis of bone marrow hypoplasia. Also presents second-degree family history (uncle and grandfather) of type 2 diabetes mellitus. There were no pathologic findings at the physical examination. Anthropometry and laboratory tests were as follows: body mass index (BMI) = 19.66 kg/m, basal and postprandial glycemia = 108, and 276 mg/dL respectively, glycated haemoglobin = 8.9%, basal and postprandial C-peptide (2 hours) = 1.9, and 3.2 ng/mL, homeostasis model assessment of beta cell function: 87.5%, homeostasis model assessment of insulin resistance: 1.6. LADA presumptive diagnosis was confirmed with presence of autoantibodies anti-tyrosin-phosphatase and GAD65. At the time of diagnosis, individuals with LADA present an onset age <50, BMI <25 kg/m2, low magnitude postprandial and basal hyperglycemia, normal or close to normal C-peptide values, and thus not occur with acute hyperglycemic crises. Insulin therapy preserves pancreatic b-cell function, at the point that eventually prescribed insulin doses need to be reduced.

  7. Epidemiology, clinical manifestations, and diagnosis of chikungunya fever: Lessons learned from the re-emerging epidemic

    Directory of Open Access Journals (Sweden)

    Mohan Alladi

    2010-01-01

    Full Text Available Chikungunya fever, caused by "Chikungunya virus," is an arbovirus disease transmitted by the bite of infected mosquitoes belonging to the genus Aedes. Chikungunya fever epidemics have been reported from several countries around the world. The disease that was silent for nearly 32 years re-emerged in the October 2005 outbreak in India that is still ongoing. The incubation period ranges from 3 to 12 days. The onset is usually abrupt and the acute stage is characterized by sudden onset with high-grade fever, severe arthralgias, myalgias, and skin rash. Swollen tender joints and crippling arthritis are usually evident. In the chronic stage, relapses that include sensation of fever, asthenia, exacerbation of arthralgias, inflammatory polyarthritis, and stiffness may be evident. Neurological, ocular, and mucocutaneous manifestations have also been described. Chronic arthritis may develop in about 15% of the patients. Viral culture is the gold standard for the diagnosis of Chikungunya fever. Reverse transcription polymerase chain reaction and real-time loop-mediated isothermal amplification have also been found to be useful. Serodiagnostic methods for the detection of immunoglobulin M and immunoglobulin G antibodies against Chikungunya virus are more frequently used. Chikungunya is a self-limiting disease; however, severe manifestations such as meningoencephalitis, fulminant hepatitis, and bleeding manifestations may sometimes be life-threatening. Treatment is symptomatic and supportive. Prevention by educating the community and public health officials, vector control measures appear to be the best approach at controlling Chikungunya fever as no commercially available vaccine is available for public use in India for this condition presently.

  8. First line chemotherapy with planned sequential administration of gemcitabine followed by docetaxel in elderly advanced non-small-cell lung cancer patients: a multicenter phase II study

    Science.gov (United States)

    Tibaldi, C; Vasile, E; Antonuzzo, A; Di Marsico, R; Fabbri, A; Innocenti, F; Tartarelli, G; Amoroso, D; Andreuccetti, M; Dico, M Lo; Falcone, A

    2008-01-01

    This multicenter phase II study evaluated, in chemonaive patients with stage IIIB–IV NSCLC, age ⩾70 and with a performance status 0–2, the activity, efficacy and tolerability of planned sequential administration of gemcitabine 1200 mg m−2 on days 1 and 8 every 3 weeks for three courses followed by three cycles of docetaxel 37.5 mg m−2 on days 1 and 8 every 3 weeks, provided there was no evidence of disease progression. A total of 56 patients entered the study. According to intention-to-treat analysis, the objective response rate was 16.0% (95% CI 7.6–28.3%); 23 patients (41.0%) had stable disease and 24 patients (43%) had progressive disease. Five patients who had a stable disease after three courses of gemcitabine obtained a conversion to partial response by docetaxel. Median time to progression was 4.8 months (95% CI 3.6–6.0 months) and median duration of survival was 8.0 months (95% CI 5.6–10.5 months). The 1-year survival rate was 34%. No grade 4 haematological toxicity was observed and grade 3 neutropenia and thrombocytopenia were reported in 5.4 and 3.6% of the patients, respectively. Grade 3/4 mucositis and grade 3 diarrhoea, both occurred in 3.6% of the patients and grade 3 asthenia was observed in 9% of patients. One patient reported a grade 4 skin toxicity. No treatment-related deaths occurred. Sequential gemcitabine and docetaxel is a well-tolerated and effective regimen in elderly advanced NSCLC patients. PMID:18212755

  9. Cetuximab in combination with irinotecan/5-fluorouracil/folinic acid (FOLFIRI in the initial treatment of metastatic colorectal cancer: a multicentre two-part phase I/II study

    Directory of Open Access Journals (Sweden)

    Cals Laurent

    2009-04-01

    Full Text Available Abstract Background This study was designed to investigate the efficacy and safety of the epidermal growth factor receptor (EGFR inhibitor cetuximab combined with irinotecan, folinic acid (FA and two different doses of infusional 5-fluorouracil (5-FU in the first-line treatment of EGFR-detectable metastatic colorectal cancer. Methods The 5-FU dose was selected on the basis of dose-limiting toxicities (DLTs during part I of the study. Patients received cetuximab (400 mg/m2 initial dose and 250 mg/m2/week thereafter and every 2 weeks irinotecan (180 mg/m2, FA (400 mg/m2 and 5-FU (either low dose [LD], 300 mg/m2 bolus plus 2,000 mg/m2 46-hour infusion, n = 7; or, high-dose [HD], 400 mg/m2 bolus plus 2,400 mg/m2; n = 45. Results Only two DLTs occurred in the HD group, and HD 5-FU was selected for use in part II. Apart from rash, commonly observed grade 3/4 adverse events such as leucopenia, diarrhoea, vomiting and asthenia occurred within the expected range for FOLFIRI. Among 52 patients, the overall response rate was 48%. Median progression-free survival (PFS was 8.6 months (counting all reported progressions and the median overall survival was 22.4 months. Treatment facilitated the resection of initially unresectable metastases in fourteen patients (27%: of these, 10 patients (71% had no residual tumour after surgery, and these resections hindered the estimation of PFS. Conclusion The combination of cetuximab and FOLFIRI was active and well tolerated in this setting. Initially unresectable metastases became resectable in one-quarter of patients, with a high number of complete resections, and these promising results formed the basis for the investigation of FOLFIRI with and without cetuximab in the phase III CRYSTAL trial.

  10. Panobinostat as part of induction and maintenance for elderly patients with newly diagnosed acute myeloid leukemia: phase Ib/II panobidara study

    Science.gov (United States)

    Ocio, Enrique M.; Herrera, Pilar; Olave, María-Teresa; Castro, Nerea; Pérez-Simón, José A.; Brunet, Salut; Oriol, Albert; Mateo, Marta; Sanz, Miguel-Ángel; López, Javier; Montesinos, Pau; Chillón, María-Carmen; Prieto-Conde, María-Isabel; Díez-Campelo, María; González, Marcos; Vidriales, María-Belén; Mateos, María-Victoria; San Miguel, Jesús F.

    2015-01-01

    This phase Ib/II trial combined the pan-deacetylase inhibitor panobinostat with chemotherapy followed by panobinostat maintenance in elderly patients with newly diagnosed acute myeloid leukemia. Patients with prior history of myelodysplastic syndrome were excluded and 38 evaluable patients were included in the study (median age: 71 years; range: 65–83). Study patients received an induction with idarubicin (8 mg/m2 iv days 1–3) plus cytarabine (100 mg/m2 iv days 1–7) plus panobinostat po at escalating doses (days 8, 10, 12, 15, 17 and 19) that could be repeated in non-responding patients. Patients achieving complete remission received a consolidation cycle with the same schema, followed by panobinostat maintenance (40 mg po 3 days/week) every other week until progression. Thirty-one patients were treated at the maximum tolerated dose of panobinostat in the combination (10 mg) with good tolerability. Complete remission rate was 64% with a time to relapse of 17.0 months (12.8–21.1). Median overall survival for the whole series was 17 months (5.5–28.4). Moreover, in 4 of 5 patients with persistent minimal residual disease before maintenance, panobinostat monotherapy reduced its levels, with complete negativization in two of them. Maintenance phase was well tolerated. The most frequent adverse events were thrombocytopenia (25% grades 3/4), and gastrointestinal toxicity, asthenia and anorexia (mainly grades 1/2). Five patients required dose reduction during this phase, but only one discontinued therapy due to toxicity. These results suggest that panobinostat is one of the first novel agents with activity in elderly acute myeloid leukemia patients, and suggest further investigation is warranted, particularly in the context of maintenance therapy. This trial is registered at clinicaltrials.gov identifier: 00840346. PMID:26160880

  11. Study on the Correlation between Chinese Medical Syndrome Types and Serum Levels of PLTP and CETP in Coronary Heart Disease Patients%冠心病患者血清磷脂转运蛋白及胆固醇脂转运蛋白水平与中医证型相关性研究

    Institute of Scientific and Technical Information of China (English)

    祝娉婷; 卜平; 孙云; 郑新梅

    2011-01-01

    Objective To study the correlation between the serum levels of phospholipid transfer protein ( PLTP), cholesteryl ester transfer protein (CETP), and Chinese medical syndrome types of coronary heart disease (CHD) patients, thus probing a new pathway for the objectivity of CHD syndrome typing and developing therapeutic drugs. Methods 201 patients with CHD confirmed by coronary angiography were selected. The comprehensive analysis database by the four examination methods was established using generally accepted standard for Chinese medical syndrome typing. Twenty healthy subjects were randomly recruited as the control group. Serum samples were separated from venous blood. The serum activities of PLTP and CETP were assayed by ELISA. The triglyceride (TG) content was determined using acetic acetone coloring method. Contents of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C)were determined using precipitation floating enzyme couplet method. Results Serum levels of PLTP, CETP, and TC of CHD patients of all Chinese medical syndrome types were significantly higher than those of the control group, showing statistical difference ( P < 0. 05, P < 0. 01 ). Statistical difference existed in serum levels of TG,HDL-C, and LDL-C of all Chinese medical syndrome types when compared with the control group ( P<0. 05, P<0. 01 ). Statistical difference existed in serum levels of PLTP between the sthenia in superficiality groups of all Chinese medical syndrome types and the asthenia in origin groups of all Chinese medical syndrome types ( P <0.05). Statistical difference existed in serum levels of TG, HDL-C, and LDL-C between the sthenia in superficiality groups of all Chinese medical syndrome types and the asthenia in origin groups of all Chinese medical syndrome types ( P <0.05, P <0.01 ). Conclusions The serum PLTP levels of CHD patients of sthenia in superficiality significantly increased. Changes in

  12. 功能性便秘穴位埋线治疗经络穴位文献计量研究%The Bibliometrical Study on Meridians and Acupoints in Catgut Embedding Therapy for Functional Constipation

    Institute of Scientific and Technical Information of China (English)

    张冲; 付跃馨; 代晓琴; 万军

    2016-01-01

    , and SPSS 22.0 was used in statistical analyzing. Results:There were totally 73 articles met the inclusion criteria;there were 34 acupoints appeared in screening statistics of 14 meridians (the top 11 points were Tianshu, Dachangshu, Zusanli, Shangjuxu, Qihai, Guanyuan, Daheng, Zhong-wan, Zhigou, Shenshu, Zhongji), which belong to 8 channels (urinary bladder channel>stomach channel>conception vessel>spleen channel>large in-testine channel>tri-jiao channel, liver channel, governor vessel);there were 23 acupoints appeared in screening statistics of meridians and acupoints selection by syndrome differentiation (the top 11 points were Quchi, Qihai, Geshu, Yanglingquan, Zhigou, Shangjuxu, Pishu, Weishu, Shenshu, Guanyuan, Zhongwan), which belong to 10 channels (large intestine channel>conception vessel>urinary bladder channel>liver channel>gallbladder channel>stomach channel>spleen channel>tri-jiao channel>kidney channel), the syndrome differentiation methods were mostly excess and deficien-cy syndrome differentiation and eight principal syndrome differentiation, asthenia syndrome often used Pishu and Qihai, sthenia syndrome used Shangjuxu and Zhigou;heat syndrome used Hegu and Quchi, cold syndrome used Pishu, Weishu, Shenshu and Guanyuan;qi stagnation used Yan-glingquan, Xingjian, Zhongwan, Zhigou and Taichong, qi asthenia used Pishu, Qihai, Zusanli and Shenque, blood asthenia used Xuehai and Geshu;yin deficiency used Taixi, yang deficiency used Qihai and Guanyuan. Conclusion:The acupoints of back-shu points, front-mu points and lower con-fluent points are usually chosen in catgut embedding therapy for functional constipation;urinary bladder channel of foot taiyang, stomach channel of foot yangming, conception vessel and spleen channel of foot taiyin are usually used;channels in acupoints selection with syndrome differentiation are mostly points on large intestine channel and conception vessel, and followed by back-shu points on urinary bladder channel, liver and

  13. Histoplasmose pulmonar aguda: relato de uma microepidemia Acute pulmonary histoplasmosis: report of an outbreak

    Directory of Open Access Journals (Sweden)

    Erick Malheiro Leoncio Martins

    2003-06-01

    Full Text Available Os autores relatam uma microepidemia de histoplasmose pulmonar, com cinco crianças que desenvolveram a doença em um período de 7 a 14 dias após a limpeza de um forno desativado para produção de carvão vegetal. Todas apresentaram quadro de febre alta persistente, tosse seca, astenia e anorexia, com 28 dias de evolução. Quando buscaram atendimento médico, uma delas encontrava-se taquipnéica, febril, com hepatomegalia e palidez cutânea, estando as restantes em regular estado geral e já sem febre. As radiografias de tórax demonstravam, em todos os casos, infiltrados reticulonodulares grosseiros, difusos e bilaterais, além de linfonodomegalias hilares. As tomografias computadorizadas evidenciaram pequenos nódulos difusos, com distribuição aleatória, além das linfonodomegalias. Os diagnósticos foram confirmados por meio da imunodifusão em gel para Histoplasma capsulatum, que foi positiva em todas as amostras pareadas coletadas com 15 dias de intervalo. Apenas uma criança necessitou de internação, por causa de importante queda no estado geral, sendo realizado tratamento de suporte e observação. Todas as crianças evoluíram com melhora clínica, sem o uso de antifúngicos, e foram submetidas a tomografias de controle após cerca de 50 dias, que demonstraram importante regressão das lesões.The authors report a pulmonary histoplasmosis outbreak occurring in five children after the cleaning of a deactivated coal furnace. The symptoms were high fever, dry cough, asthenia and anorexia. By the time parents seeked for medical care, only one child remained symptomatic with fever, tachypnea and hepatomegaly. All the patients had similar radiological findings. Chest films showed diffuse, bilateral, reticulonodular infiltrates and lymph node enlargement. Computed tomography showed small nodules with a random distribution and hilar and mediastinal lymph nodes. Diagnosis was confirmed by positive gel immunodiffusion for Histoplasma

  14. Rabdomiólisis por spinning en nueve pacientes Rhabdomyolysis caused by spinning in nine patients

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    Javier Montero

    2009-02-01

    Full Text Available La rabdomiólisis es un síndrome que resulta de la destrucción del músculo esquelético. Aquella producida por ejercicio se observa luego de un esfuerzo físico intenso. Un tipo de actividad física basado en el pedaleo sobre bicicleta fija llamado spinning o indoor cycling, que trae consigo los fundamentos teóricos del ciclismo sobre una bicicleta estática, ha sido descrito excepcionalmente como factor precipitante de rabdomiólisis. Se realizó un estudio retrospectivo que evaluó la presentación clínica y complicaciones ocurridas en 9 pacientes que desarrollaron rabdomiólisis por pedaleo sobre bicicleta fija. Los síntomas predominantes fueron mialgias, astenia, eliminación de orinas oscuras e impotencia funcional de miembros inferiores. Todos presentaron elevaciones significativas de las enzimas musculares y los valores de creatinfosfoquinasa variaron entre 1.650 y 165 000 UI/l. Sólo un paciente presentó insuficiencia renal y otro hipocalcemia; ambos parámetros se normalizaron con el tratamiento instaurado. No se halló relación entre el aumento de enzimas musculares y la aparición de complicaciones. El objetivo del trabajo es presentar una serie de casos de rabdomiólisis por este deporte y alertar sobre el posible riesgo de dicha actividad.Rhabdomyolysis is a syndrome that results from the destruction of the skeletal muscle. The one produced by exercise is observed after an intense physical effort. A form of high-intensity exercise called spinning or indoor cycling that involves using a stationary bicycle, has been exceptionally reported as a generating factor of muscular damage in the medical literature. A retrospective study was performed to assess the clinical presentation and the complications shown by nine patients who experienced rhabdomyolysis caused by indoor cycling. The prevailing symptoms were myalgias, asthenia, myoglobinuria and functional impotence of the lower limbs. All the patients showed significant muscular

  15. Evaluation of the safety and efficacy of pregabalin in older patients with neuropathic pain: results from a pooled analysis of 11 clinical studies

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    Zlateva Gergana

    2010-11-01

    Full Text Available Abstract Background Older patients are typically underrepresented in clinical trials of medications for chronic pain. A post hoc analysis of multiple clinical studies of pregabalin in patients with painful diabetic peripheral neuropathy (DPN or postherpetic neuralgia (PHN was conducted to evaluate the efficacy and safety of pregabalin in older patients. Methods Data from 11 double-blind, randomized, placebo-controlled clinical studies of pregabalin in patients with DPN or PHN were pooled. Efficacy outcomes included change in Daily Pain Rating Scale score, ≥30% and ≥50% responders, and endpoint pain score ≤3. Safety was based on adverse events (AEs. Primary efficacy was analyzed by analysis of covariance with terms for treatment, age category, protocol, baseline pain, and treatment-by-age category interaction. Results 2516 patients (white, n = 2344 [93.2%]; men, n = 1347 [53.5%]; PHN, n = 1003 [39.9%]; pregabalin, n = 1595 were included in the analysis. Patients were grouped by age: 18 to 64 years (n = 1236, 65 to 74 years (n = 766, and ≥75 years (n = 514. Baseline mean pain and sleep interference scores were comparable across treatment and age groups. Significant improvements in endpoint mean pain were observed for all pregabalin dosages versus placebo in all age groups (p ≤ 0.0009, except for the lowest dosage (150 mg/day in the youngest age group. Clinically meaningful pain relief, defined as ≥30% and ≥50% pain response, was observed in all age groups. The most common AEs were dizziness, somnolence, peripheral edema, asthenia, dry mouth, weight gain, and infections. The relative risks for these AEs increased with pregabalin dose, but did not appear related to older age or type of neuropathic pain. Conclusions Pregabalin (150-600 mg/day significantly reduced pain in older patients (age ≥65 years with neuropathic pain and improvements in pain were comparable to those observed in younger patients. Titration of pregabalin to the

  16. Oncostatic activity of pineal neuroendocrine treatment with the pineal indoles melatonin and 5-methoxytryptamine in untreatable metastatic cancer patients progressing on melatonin alone.

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    Lissoni, Paolo; Rovelli, Franco; Frassineti, Andrea; Fumagalli, Luca; Malysheva, Ola; Conti, Ario; Maestroni, Georges

    2000-01-01

    OBJECTIVE: The recent advances in psycho-neuro-endocrino-immunology have demonstrated the existence of several endogenous neuroendocrine substances, capable of affecting both tumor growth and host anticancer immune defenses. The pineal gland would represent one of the most important organs releasing antiproliferative and immunostimulating substances, the most known of them is melatonin (MLT). However, MLT would not be the only pineal indole provided by antitumor activity. Other pineal indoles, namely 5-methoxytryptamine (5-MTT), would play antitumor effects, by either inhibiting cancer cell proliferation or stimulating the anticancer immunity. Preliminary data have shown that MLT may deserve antitumor activity in the treatment of human neoplasms, whereas at present there are no clear data about 5-MTT. In an attempt to obtain some preliminary data about the anticancer properties of 5-MTT in humans, we have evaluated the efficacy of MLT plus 5-MTT in untreatable advanced cancer patients progressing on MLT alone. METHODS: The study included 73 untreatable advanced solid tumor patients, who had progressed after two months of MLT therapy alone. According to tumor histotype, patients were randomized to receive MLT alone (20 mg/day orally in the evening) or MLT plus 5-MTT (1 mg at noon orally), every day for at least two months. The clinical response was evaluated according to WHO criteria. RESULTS: A partial response (PR) occurred in two patients treated with MLT + 5-MTT and in none of the patients receiving MLT alone. A stable disease (SD) was achieved in only 2/37 patients on MLT therapy alone, and in 8/36 patients receiving MLT plus 5-MTT. Therefore, the percent of non-progressing patients (SD + PR) obtained with MLT plus 5-MTT was significantly higher than that obtained with MLT alone. Moreover, the relief of asthenia and depressant symptoms was significantly higher in patients concomitantly treated with 5-MTT. DISCUSSION: This preliminary study would suggest that

  17. Inhibition of the mammalian target of rapamycin (mTOR in advanced pancreatic cancer: results of two phase II studies

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    Zhang Yujian

    2010-07-01

    Full Text Available Abstract Background The phosphoinositide 3-kinase (PI3K/Akt pathway is constitutively activated in pancreatic cancer and the mammalian target of rapamycin (mTOR kinase is an important mediator for its signaling. Our recent in vitro studies suggest that prolonged exposure of pancreatic cancer cells to mTOR inhibitors can promote insulin receptor substrate-PI3K interactions and paradoxically increase Akt phosphorylation and cyclin D1 expression in pancreatic cancer cells (negative feedback loop. The addition of erlotinib to rapamycin can down-regulate rapamycin-stimulated Akt and results in synergistic antitumor activity with erlotinib in preclinical tumor models. Methods Two studies prospectively enrolled adult patients with advanced pancreatic cancer, Eastern Cooperative Oncology Group performance status 0-1, adequate hematologic, hepatic and renal parameters and measurable disease. In Study A, temsirolimus was administered intravenously at 25 mg weekly. In Study B, everolimus was administered orally at 30 mg weekly and erlotinib was administered at 150 mg daily. The primary endpoint in both studies was overall survival at 6 months. Secondary endpoints included time to progression, progression-free survival, overall survival, response rate, safety and toxicity. Pretreatment tumor biopsies were analyzed by immunofluorescence and laser scanning cytometry for the expression of pmTOR/mTOR, pAkt/Akt, pErk/Erk, pS6, p4EBP-1 and PTEN. Results Five patients enrolled in Study A; Two patients died within a month (rapid disease progression and hemorrhagic stroke, respectively. One patient developed dehydration and another developed asthenia. Sixteen patients enrolled in Study B.: 12 males, all ECOG PS = 1. Median cycles = 1 (range 1-2. Grade 4 toxicity: hyponatremia (n = 1, Grade 3: diarrhea (n = 1, cholangitis (n = 3, hyperglycemia (n = 1, fatigue (n = 1. Grade 2: pneumonia (n = 2, dehydration (n = 2, nausea (n = 2, neutropenia (n = 1, mucositis (n = 2

  18. 黄精减毒颗粒剂对美沙酮维持不良反应的控制效果的研究%Control effect of Huangjing Jiandu gradule on adverse reaction of Methadone maintenance treatment

    Institute of Scientific and Technical Information of China (English)

    刘晗; 韩铁军; 朱军红; 叶方; 王鹏; 严峻; 王俊丽; 刘欣

    2011-01-01

    目的:观察黄精减毒颗粒剂对美沙酮维持导致不良反应的控制作用和效果.方法:选择2010年在武汉市精神卫生中心第一戒毒门诊的美沙酮维持治疗者200例,随机分成治疗组100例,对照组100例.治疗组口服黄精减毒颗粒剂和美沙酮,对照组R服美沙酮.结果:治疗组对便秘、性功能障碍(阳痿)、闭经、自汗、排尿困难和乏力的有效率分别达95.00%、86.25%、66.67% 、90.00%、87.50%和78.75%,与对照组有显著性差别(P<0.05),结论:黄精减毒颗粒剂能有效控制美沙酮维持导致的综合不良反应,对提高美沙酮维持的依从性有积极的促进作用.%Objective: To observe the controlling effect of Huangjing ( Rhizoma Polygonati) toxin-reducing granules on the adverse reaction induced by methadone maintenance. Methods; 200 patients under methadone maintenance in 2010 at the 1st Abstinence Clinic, Wuhan Center of Mental Health, were randomly divided into a treatment group and a control group of 100 each. The treatment group received the granules and methadone orally, while the control group took methadone only. Results: The granules were effective for constipation, sexual malfunction, menopause, spontaneous sweating, urination difficulty, and asthenia in most patients of the treatment group (95. 00% , 86. 25% , 66. 67% , 90.00% , 87.50% and 78.75%, respectively), showing significant differences from those of the controls (P<0.05). Conclusion: Huangjing toxin-reducing granules can effectively control the adverse reaction induced by methadone maintenance, and promote the patients' compliance with methadone maintencance.

  19. Dalfampridine extended release tablets: 1 year of postmarketing safety experience in the US

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    Jara M

    2013-03-01

    Full Text Available Michele Jara,1 Graham Barker,2 Herbert R Henney 3rd1 1Acorda Therapeutics, Inc, Ardsley, NY, USA; 2Biogen Idec, Inc, Maidenhead, Berkshire, UK Background: Dalfampridine extended release tablets (dalfampridine-ER; prolonged-, modified, or sustained-release fampridine in some countries were approved in the US to improve walking in patients with multiple sclerosis, as demonstrated by improvement in walking speed. Postmarketing safety experience is available from exposure of approximately 46,000 patients in the US from product approval through March 2011. Objective: To provide a descriptive analysis of all spontaneously reported postmarketing adverse events (AEs for dalfampridine-ER since product launch. Methods: AE data were extracted from the safety database from product launch through March 31, 2011; AEs were classified using the Medical Dictionary for Regulatory Activities. Seizure cases were reviewed for patient demographics, time to event from treatment onset, and presence of additional risk factors. Results: The most frequently reported postmarketing AEs were similar to those reported during clinical development: dizziness, insomnia, balance disorder, headache, nausea, urinary tract infection, asthenia, and back pain (all included in US product labeling. New clinically significant findings are related to lack of efficacy and inappropriate dosing. Of the approximately 46,000 patients exposed, 85 seizures were reported (~5.4/1000 patient-years, of which 82 were reported or confirmed by a health care practitioner (~5.2/1000 patient-years. Beyond the intrinsic multiple sclerosis-related seizure risk, more than half of the 85 cases (62% had an additional potential risk factor for seizure including a previous history of convulsions, renal impairment, incorrect dosing, or use of concurrent medications with a labeled seizure risk. Duration of treatment prior to the seizure ranged from one dose to 365 days; 26/85 (31% patients suffered a seizure

  20. 论刘氏中医在胸痹病证中的调理气机治疗之法%To Explore the Treatment Method of Liu Traditional in Obstruction of Regulation Qiji in Chest

    Institute of Scientific and Technical Information of China (English)

    于洋

    2015-01-01

    胸痹心痛是由于正气亏虚,气滞、瘀血、痰浊、寒凝而引起心脉痹阻不畅,临床以膻中或左胸部发作性憋闷、疼痛为主要临床表现的一种病证。胸痹心痛是威胁中老年人生命健康的重要心系病证之一,随着现代社会生活方式及饮食结构的改变,发病有逐渐增加的趋势,因而本病越来越引起人们的重视。由于本病表现为本虚标实,有着复杂的临床表现及病理变化,通过研究刘氏中医在胸痹病证中的调理气机治疗之法,减少麻痹心痛对患者的影响,提高治疗质量。%Chest pain due to qi deficiency, qi stagnation, blood stasis, phlegm, cold coagulation is caused by poor heart vessel blockage, clinical to tanzhong or left chest seizure of suffocation, pain as the main clinical manifestations of a disease and syndrome. Chest pain is the threat to the elderly health important heart disease and syndrome of, with the change of lifestyle and dietary structure in the modern society, the incidence of gradually increasing trend, and the disease has attracted more and more attention. Due to the forms of the disease is the syndrome of asthenia in superifciality, with complicated clinical manifestations and pathological changes. Therefore this paper study on Liu's traditional Chinese medicine in chest diseases conditioning gas treatment method, in order to reduce the paralysis heartache for patients, improve the quality of treatment.

  1. Meta-analysis of adjunctive levetiracetam in refractory partial sei

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    ZHANG Ying

    2012-10-01

    Full Text Available Objective To evaluate the effects and tolerability of adjunctive levetiracetam (LEV in refractory partial seizures. Methods Relevant research articles about randomized controlled trials of adjunctive LEV in refractory partial seizures from January 1998 to December 2010 were retrieved from Cochrane Library, MEDLINE, EMbase, Social Sciences Citation Index (SSCI, VIP, Chinese National Knowledge Infrastructure (CNKI database, China Biology Medicine (CBM. Two reviewers independently evaluated the quality of the included articles and abstracted the data. A Meta-analysis was conducted by using RevMan 5.0 software. Results According to the enrollment criteria, eleven prospective, randomized controlled clinical trials with a total of 1192 in LEV group and 789 in placebo group were finally selected. The reduction in three endpoints (a 50% or greater reduction of partial seizure frequency per week, a 75% or greater reduction of partial seizure frequency per week and seizure free was significant in LEV group than placebo group. There was no significance between LEV group and placebo group in the withdrawl rate (1000 mg/d: OR = 1.180, 95%CI: 0.690-2.010, P = 0.540; 2000 mg/d: OR = 1.530, 95%CI: 0.770-3.030, P = 0.230; 3000 mg/d: OR = 1.000, 95% CI: 0.620-1.600, P = 1.000. The following adverse events were associated with LEV: somnolence (OR = 1.720, 95%CI: 1.280-2.310, P = 0.000, dizziness (OR = 1.490, 95%CI: 1.000-2.220, P = 0.050, asthenia (OR = 1.670, 95%CI: 1.140-2.240, P = 0.008, nasopharyngitis (OR = 1.120, 95% CI: 0.710-1.760, P = 0.630, psychiatric and behavioral abnormalities (OR = 2.120, 95% CI: 1.370-3.280, P = 0.000. Conclusion LEV is effective and well tolerated when added to existing therapy in patients with refractory partial seizures compared with control drugs. Further studies are needed to identify the effects of monotherapy of LEV in partial seizures.

  2. Discussion on the Treatment of Children with Asthma in Remission Stage from Healthy Qi Deficiency and Pathogenic Factor Excess%从正虚邪实探讨中医药对小儿哮喘缓解期的治疗

    Institute of Scientific and Technical Information of China (English)

    邢琼琼; 赵霞

    2016-01-01

    Objective] The treatment of pediatric asthma in remission period is summarized from the positive and negative aspects, in order to provide new ideas and methods for clinical treatment. [Methods] By consulting the related literatures on the traditional Chinese medicine treatment of children with asthma in remission phase, the paper mainly summarized the different physicians' understanding of pathogenesis and approaches to the treatment of pediatric asthma in remission stage. [Results]The treatment of physicians for pediatric asthma in remission phase can be divided into asthenia healthy qi and sthenia pathogenic factor syndrome.The treatment of healthy qi deficiency mainly includes treating lung,spleen,kidney seperately;curing lung-spleen,lung- kidney, spleen-kidney ;treating three viscera meanwhile.The therapy of pathogenic excess contains treating wind,phlegm,stasis respectively;curing phlegm-stasis. [Conclusion]The treatment of traditional Chinese medicine for pediatric asthma has a unique advantage in improving children's physique, reducing the frequency of asthma attacks, and improve children's life quality which has significant clinical effect.%[目的]从正虚和邪实两方面对小儿哮喘缓解期的治疗方法进行总结,以期能为临床治疗提供新的思路与方法。[方法]将近年关于中医药治疗小儿哮喘缓解期的文献进行检索,整理、归纳各医家对小儿哮喘缓解期的病机认识和治疗方法。[结果]各医家对小儿哮喘缓解期的治疗从正虚和邪实两方面论治,从正虚治疗主要包括单独从肺、从脾、从肾论治,从肺脾、肺肾、脾肾治疗以及从肺脾肾三脏综合论治;而从邪实治疗则包括单独从风、从痰、从瘀论治以及痰瘀综合治疗。[结论]中医药对小儿哮喘缓解期的治疗有着独特的优势即在改善患儿体质、减少哮喘发作次数、以及提高患儿生存质量等方面临床疗效显著。

  3. Masitinib treatment in patients with progressive multiple sclerosis: a randomized pilot study

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    Vermersch Patrick

    2012-06-01

    Full Text Available Abstract Background Treatment options for patients suffering from progressive forms of multiple sclerosis (MS remain inadequate. Mast cells actively participate in the pathogenesis of MS, in part because they release large amounts of various mediators that sustain the inflammatory network. Masitinib, a selective oral tyrosine kinase inhibitor, effectively inhibits the survival, migration and activity of mast cells. This exploratory study assessed the safety and clinical benefit of masitinib in the treatment of primary progressive MS (PPMS or relapse-free secondary progressive MS (rfSPMS. Methods Multicenter, randomized, placebo-controlled, proof-of-concept trial. Masitinib was administered orally at 3 to 6 mg/kg/day for at least 12 months, with dose adjustment permitted in event of insufficient response with no toxicity. The primary response endpoint was the change relative to baseline in the multiple sclerosis functional composite score (MSFC. Clinical response was defined as an increase in MSFC score relative to baseline of > 100%. Results Thirty-five patients were randomized to receive masitinib (N = 27 or placebo (N = 8. Masitinib was relatively well tolerated with the most common adverse events being asthenia, rash, nausea, edema, and diarrhea. The overall frequency of adverse events was similar to the placebo group, however, a higher incidence of severe and serious events was associated with masitinib treatment. Masitinib appeared to have a positive effect on MS-related impairment for PPMS and rfSPMS patients, as evidenced by an improvement in MSFC scores relative to baseline, compared with a worsening MSFC score in patients receiving placebo; +103% ± 189 versus -60% ± 190 at month-12, respectively. This positive, albeit non-statistically significant response was observed as early as month-3 and sustained through to month-18, with similar trends seen in the PPMS and rfSPMS subpopulations. A total of 7/22 (32

  4. Effects of first-dose volume and exercise on the efficacy and tolerability of bowel preparations for colonoscopy in Chinese people

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    Qin Y

    2016-04-01

    Full Text Available Ying Qin, Wei Liu, Songbai Lin, Xiangfeng Li International Medical Services, Peking Union Medical College Hospital, Beijing, People’s Republic of China Aim: This study was designed to compare the efficacy and tolerability of bowel preparations with and without the higher first-dose volume of polyethylene glycol (PEG solution or exercise after drinking PEG solution in Chinese people. Methods: A total of 330 participants who had a colonoscopy done in Peking Union Medical College Hospital were randomly and evenly assigned to three groups. Participants in Group A ingested 1 L PEG solution and then ingested 2 L PEG solution at a rate of 250 mL every 15 minutes. Participants in Group B ingested 3 L PEG solution at a rate of 250 mL every 15 minutes and then exercised more than 10 minutes after ingesting each liter of PEG solution. Participants in Group C ingested 3 L PEG solution at a rate of 250 mL every 15 minutes. Experienced gastrointestinal endoscopists rated the efficacy of bowel preparations based on the Boston Bowel Preparation Scale score. A questionnaire regarding participants’ symptoms associated with bowel preparations was administered to evaluate participants’ tolerability. Results: The three groups had insignificant difference in the percentages of participants’ symptoms including dizziness, nausea, stomach ache, bloating, and asthenia. However, the percentages of participants having hunger sensation, sleep disturbance, and anal discomfort were significantly higher in groups with the higher first-dose volume of PEG solution or exercise after drinking PEG solution than without them. The three groups had insignificant difference in the Boston Bowel Preparation Scale score. Conclusion: Whether to add the higher first-dose volume of PEG solution and exercise after drinking PEG solution or not, all participants achieved a similar quality of bowel preparations. Bowel preparations without the additional first-dose volume of PEG

  5. Clinical Characteristics of Cerebrovascular Pathology with Patients Suffering from Ph-Negative Myeloproliferative Disease

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    Marine M. Tanashyan

    2016-09-01

    Full Text Available Background: Disturbances of microcirculation play a significant role in the development and progression of both acute and chronic cerebrovascular diseases (CVD and may be associated with different hemogram abnormalities. One of the reasons of the prothrombogenic state of the endothelium is the increase in the number of blood corpuscles leading to (non-Ph myeloproliferative disorders (MPD including essential thrombocythemia (ET, polycythemia vera (PV, and primary myelofibrosis (PM. Materials and Methods: The study included 167 patients: 102 patients with Ph-MPD and the control group comprising 65 patients with CVD. According to MPD subtype, the patients were divided into three groups: patients with ET (37%, n = 38, male/female 7/31, age 52 ± 7 years, those with PV (40%, n = 41, male/female 20/21, age 50 ± 6 years and those with PM (23%, n = 23, male/female 5/18, age 54 ± 4 years. Results: In 79% (n = 81 of cases in the study group (with Ph-MPD, patients had chronic CVD, with the most frequently identified symptoms being asthenia (92% and headache (72%. Headache in Ph-MPD patients was more frequently (86% associated with PM, while in patients with PV and ET it was equally distributed (70%. Neurological symptoms in 53% of cases were associated with focal changes of the brain on MRI localized in the subcortical area of the frontal and parietal lobes. Twenty-one (21% patients suffered an acute cerebrovascular accident, 8 of them had thrombotic occlusion of one of the internal carotid arteries leading to hemispheric infarcts. Endothelial function (as measured by flow-dependent dilation of the brachial artery was severely impaired in all study groups (median 5% with normal cut-off at 10%, the lowest degree of vasodilator activity being specific for patients with a history of stroke (p = 0.011. Conclusion: Patients suffering from MPD had asymptomatic focal changes in the brain in the absence of concomitant vascular disease (hypertension

  6. Safety of long-term use of linezolid: results of an open-label study

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    Vazquez JA

    2016-09-01

    Full Text Available Jose A Vazquez,1 Anthony C Arnold,2 Robert N Swanson,3 Pinaki Biswas,3 Matteo Bassetti4 1Section of Infectious Diseases, Medical College of Georgia, Georgia Regents University, Augusta, GA, USA; 2UCLA Department of Ophthalmology, Jules Stein Eye Institute, Los Angeles, CA, USA; 3Clinical Research, Global Innovative Pharmaceutical, Pfizer Inc., New York, NY, USA; 4Infectious Diseases Division, Santa Maria della Misericordia University Hospital, Udine, Italy Objective: The objective of this study was to assess the long-term safety of linezolid in patients with chronic infections requiring treatment for ≥6 weeks. Enhanced monitoring for optic neuropathy was included to characterize the early development of this side effect and to identify ophthalmologic tests that might be valuable in early detection of this event. Methods: This was a multicenter, open-label, pilot study of patients aged ≥18 years on long-term linezolid therapy. Matched control patients were included for baseline assessment comparison. Patients were assessed at study entry, monthly while on treatment, at the end of treatment, and 30 days following the last dose. Aggregate ocular safety data were reviewed. Response to treatment was reported. Results: The study was terminated owing to slow enrollment. Twenty-four patients received linezolid; nine patients were included as matched controls. Linezolid was prescribed for a median of 80.5 days (range, 50–254 days. In patients with a reported clinical outcome, the majority were considered improved or cured. Common treatment-related adverse events (AEs included anemia, peripheral neuropathy, polyneuropathy, vomiting, and asthenia, and were consistent with the known safety profile. Most AEs resolved or stabilized with discontinuation of treatment. Results of ophthalmologic tests in the one case adjudicated as probable linezolid-associated optic neuropathy revealed abnormal color vision, characteristic changes in the optic disk

  7. Pemetrexed single agent chemotherapy in previously treated patients with locally advanced or metastatic non-small cell lung cancer

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    Bearz Alessandra

    2008-07-01

    Full Text Available Abstract Background The main objective of this study was to evaluate the safety of second-line pemetrexed in Stage IIIB or IV NSCLC. Methods Overall, 95 patients received pemetrexed 500 mg/m2 i.v. over Day 1 of a 21-day cycle. Patients also received oral dexamethasone, oral folic acid and i.m. vitamin B12 supplementation to reduce toxicity. NCI CTC 2.0 was used to rate toxicity. All the adverse events were graded in terms of severity and relation to study treatment. Dose was reduced in case of toxicity and treatment was delayed for up to 42 days from Day 1 of any cycle to allow recovering from study drug-related toxicities. Tumor response was measured using the RECIST criteria. Results Patients received a median number of 4 cycles and 97.8% of the planned dose. Overall, 75 patients (78.9% of treated reported at least one adverse event: 34 (35.8% had grade 3 as worst grade and only 5 (5.2% had grade 4. Drug-related events occurred in 57.9% of patients. Neutropenia (8.4% and leukopenia (6.3 % were the most common grade 3/4 hematological toxicities. Grade 3 anemia and thrombocytopenia were reported in 3.2% and 2.1% of patients, respectively. Diarrhea (6.3%, fatigue (3.2% and dyspnea (3.2% were the most common grade 3/4 non-hematological toxicities. The most common drug-related toxicities (any grade were pyrexia (11.6%, vomiting, nausea, diarrhea and asthenia (9.5% and fatigue (8.4%. Tumor Response Rate (CR/PR in treated patients was 9.2%. The survival at 4.5 months (median follow-up was 79% and the median PFS was 3.1 months. Twenty patients (21.1% died mainly because of disease progression. Conclusion Patients with locally advanced or metastatic NSCLC could benefit from second-line pemetrexed, with a low incidence of hematological and non-hematological toxicities.

  8. Perfil epidemiológico do beribéri notificado de 2006 a 2008 no Estado do Maranhão, Brasil Epidemiological profile of reported beriberi cases in Maranhão State, Brazil, 2006-2008

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    Estela Maura Padilha

    2011-03-01

    Full Text Available O objetivo do estudo foi descrever o perfil epidemiológico dos casos e óbitos de beribéri notificados de 2006-2008 no Estado do Maranhão, Brasil. Informações foram obtidas de fichas de notificação da Secretaria de Estado da Saúde do Maranhão e utilizou-se o Índice Global de Moran para avaliar autocorrelação espacial. Foram notificados 1.207 casos e 40 óbitos. Regiões oeste e central mostraram forte presença de autocorrelação espacial da incidência. Ocorrência de casos e óbitos concentrou-se de maio a agosto, em homens jovens (20-40 anos. Hábito de consumir álcool e fumar esteve presente entre os óbitos; baixa renda e ocupação com atividade pesada, entre os casos. Os sintomas mais comuns foram diminuição da força, dormência e edema das pernas, dificuldade para caminhar e dor na panturrilha. O perfil dos acometidos e os sintomas, exceto edema de membros inferiores, são característicos de beribéri seco. É pertinente que estudos sobre seu ressurgimento no país sejam aprofundados.This study aimed to describe the epidemiological profile of beriberi cases and related deaths reported from 2006 to 2008 in Maranhão State, Brazil. Data were obtained from beriberi notification forms at the State Health Department. The global Moran index was used to evaluate spatial auto-correlation. 1207 cases and 40 deaths were reported. The western and central regions of the State showed strong spatial auto-correlation of incidence rates. Cases and deaths were concentrated from May to August, in young men (20-40 years. Regular alcohol consumption and smoking were recorded among fatal cases. Low income and heavy labor were widespread among cases. Common symptoms were asthenia, numbness, and swollen legs, difficulty walking, and calf pain. The profile of cases and their symptoms (except swollen legs are characteristic of dry beriberi. We recommend further studies on the resurgence of beriberi in Brazil.

  9. Ebola Virus Disease Outbreak in Isiro, Democratic Republic of the Congo, 2012: Signs and Symptoms, Management and Outcomes.

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    Thomas Kratz

    Full Text Available Data collected during the 2012 Ebola virus disease (EVD epidemic in the Democratic Republic of the Congo were analysed for clinical signs, symptoms and case fatality of EVD caused by Bundibugyo virus (BDBV, establishment of differential diagnoses, description of medical treatment and evaluation of the quality of clinical documentation. In a quantitative observational prospective study, global epidemiological data from 52 patients (34 patients within the community, 18 patients treated in the Ebola Treatment Centre were entered anonymously into a database, subsequently matched and analysed. Relevant findings include an over-representation of females among community EVD cases (85.3% and of community EVD cases in the age group of 15-54 years (82.4%. All ETC patients had fever (55.6% of all 18 ETC patients during their hospital stay or self-reported fever (88.2% upon admission at some point of time during their illness. Major symptoms of ETC patients during hospital stay included asthenia (82.4%, anorexia (82.4%, myalgia (70.6%, sore throat/difficulty swallowing (70.6%, arthralgia (76.5% and nausea (70.6%. Gastrointestinal signs and symptoms (nausea, diarrhoea, vomiting (76.4% as well as general pain (94.1% were frequent in ETC patients. The median duration of EVD was 18 days, while the mean incubation period was 11.3 days. Differential diagnosis of EVD included malaria (28.3%, intestinal parasitosis (10.9%, and infectious syndrome (10.9%. There was also an important variation in clinical evolvement. Quality of documentation was adversely affected by the way patient file contents were transferred from inside to outside the high-risk zone, entailing a mean mismatch value of 27.3% between patient file contents inside vs. outside the high-risk zone. This study adds further description of EVD (frequently non-specific signs and symptoms, non frequent bleeding, a long incubation period, long duration of disease and emphasizes the need for improving

  10. nab-Paclitaxel plus gemcitabine for metastatic pancreatic cancer: a subgroup analysis of the Western European cohort of the MPACT trial

    Science.gov (United States)

    Tabernero, Josep; Kunzmann, Volker; Scheithauer, Werner; Reni, Michele; Shiansong Li, Jack; Ferrara, Stefano; Djazouli, Kamel

    2017-01-01

    Purpose The global Phase III MPACT trial demonstrated superior efficacy of nab-paclitaxel plus gemcitabine over gemcitabine alone as first-line treatment for metastatic pancreatic cancer. Region was a randomization stratification factor in the MPACT trial. This subgroup analysis of MPACT examined efficacy and safety of patients treated in Western Europe. Patients and methods Patients received nab-paclitaxel plus gemcitabine or gemcitabine alone as first-line treatment for metastatic pancreatic cancer as previously described. A total of 76 patients were included in this analysis (n=38 for each arm). Results Differences between the overall Western European cohort and the intention-to-treat population included lower percentages of male patients (46% and 58%, respectively) and patients with biliary stents (8% and 17%), and higher percentages of patients with Karnofsky performance status of 90–100 (78% and 60%) and primary tumors in the body of the pancreas (48% and 31%). The median overall survival was 10.7 months with nab-paclitaxel plus gemcitabine vs 6.9 months with gemcitabine alone (hazard ratio [HR]: 0.82 [95% confidence interval (CI): 0.48–1.40]; P=0.471). Median progression-free survival was 5.3 vs 3.7 months, respectively (HR: 0.70 [95% CI: 0.37–1.33]; P=0.277). The independently assessed overall response rate was 18% vs 5% (response rate ratio, 3.50 [95% CI: 0.78–15.78]; P=0.076). The most common grade ≥3 adverse events with nab-paclitaxel plus gemcitabine and gemcitabine alone were neutropenia (46% vs 33%, respectively), leukopenia (35% vs 19%), anemia (22% vs 0%), asthenia (21% vs 6%), thrombocytopenia (14% vs 3%), and peripheral neuropathy (13% vs 3%). Conclusion Although a statistically significant difference between the treatment arms was not reached for efficacy endpoints, this study does report treatment benefit and a manageable safety profile associated with nab-paclitaxel plus gemcitabine in patients treated in Western Europe with

  11. Paniculitis mesentérica: experiencia en nuestro centro Mesenteric panniculitis: Experience in our center

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    L. Delgado Plasencia

    2007-05-01

    Full Text Available A pesar de que se han reconocido distintos factores precipitantes en la paniculitis mesentérica, su etiología en determinados casos es incierta. Presentamos un análisis retrospectivo de 8 pacientes afectados de paniculitis mesentérica en un periodo comprendido entre mayo 2000 hasta diciembre 2006. En nuestra serie la edad media de presentación fue 63 años, siendo la mayoría de pacientes varones (proporción 3:1. Las manifestaciones clínicas más frecuentes fueron el dolor abdominal (n = 4 y la astenia (n = 4. Tres casos se presentaron como cuadro de obstrucción y tres casos presentaron antecedentes de cirugía abdominal. El antecedente más común fue el tabaquismo (5 casos eran fumadores activos y 2 exfumadores y hubo un paciente que desarrolló un linfoma folicular en el seguimiento. Revisamos la literatura para analizar nuestros resultados y formular una hipótesis. En nuestra opinión, pensamos que debe ser analizada de forma más exhaustiva la relación entre el tabaco y sus componentes con la aparición de la enfermedad debido a la fuerte asociación encontrada en este estudio.Although several etiological factors have been associated with mesenteric panniculitis, the exact etiology in some cases remains unknown. Herein, we present a retrospective analysis of 8 patients affected with this disorder performed between May 2000 and December 2006. In our series the mean age at which patients presented was 63 years. The majority of the patients were male (with a male: female ratio of 3:1. The most common clinical manifestations were abdominal pain (n = 4 and asthenia (n = 4. Three cases presented with obstructive symptoms and three had a history of abdominal surgery. Notably, seven had a background of tobacco use (five smokers and two ex-smokers and one patient developed follicular lymphoma. A literature research was carried out to analyze our results and formulate a new hypothesis. In our opinion, we believe that the study of causal

  12. Syndrome Differentiation and Treatment Experience of Lichen Planus%扁平苔藓证治经验

    Institute of Scientific and Technical Information of China (English)

    周宝宽

    2011-01-01

    目的:总结周宝宽主任医师辨证论治扁平苔藓经验.方法:以医案形式阐述扁平苔藓的病因病机、证型、治法、方药.结果:病因病机为风湿热邪侵袭肌肤,阻滞经络;肝郁气滞,脾失健运,湿热火毒内生;肝肾阴虚,虚火上炎;内外因相合,蕴结肌肤;上述诸因阻于皮肤、黏膜导致肌肤失养形成风热相搏证、血虚风燥证、肝郁气滞证、阴虚内热等证.治疗原则为疏风、清热、利湿、解毒、疏肝、活血、化瘀、滋阴、降火等.常用方剂为消风散、逍遥散、当归饮子、知柏地黄汤.结论:辨证论治扁平苔藓疗效显著.%Objective: To summarize syndrome differentiation and treatment experience of lichen planus in clinic. Methods: Discuss etiopathogenisis, pathogenesis, pattern of syndrome, method of treatment, formulas and tnedicinals based on medical records. Results : Etiopathogenisis and pathogenesis of lichen planus are wind dampness and heat injury muscle and skin, blocked on meridians; stagnation of QI due to depression of the liver, dys-splenism, damp-heat and virulent fire produced from the interior; hepatic and renal yin deficiency, hyperactivity of deficient fire;coincide of exterior and interior evil, gathering on muscle and skin; those causes blocked in skin and blocked result in failure of skin and muscle to be nourished, generate syndrome of wind-heat fighting, syndrome of blood deficiency wind-dryness syndrome, syndrome of stagnation of QI due to depression of the liver, syndrome of yin asthenia generating intrinsic heat. Treatment principles of lichen planus are, eliminating wind,eliminating heat, damp elimination, neutralize poison, disperse the depressed liver-energy, promoting blood flow, resolve stasis, nourish yin, downbear fire, etc. Frequently used decoction is Xaiofeng Yin, Danggui Yinzi, Zhibai Dihaung Tang. Conclusions:Syndrome differentiation and treatment shows a better therapeutic effect for lichen planus.

  13. 990例精神分裂症患者中医证候构成比分析%Analysis of 990 patients with Schizophrenia on syndromes composition ratio in TCM

    Institute of Scientific and Technical Information of China (English)

    张宏耕; 丁杰豪; 陈胜才; 董明树; 王小平; 王哲; 黄若华; 陈裕根; 宋炜熙; 杨宗亮; 唐云; 莫祥德; 王国强; 欧阳国华; 王瑞见

    2011-01-01

    Objective To explore the composition ratio of the syndromes in TCM of Schizophrenia so as to establish a criterion of common TCM syndromes for Schizophrenia. Methods According to the ways of clinical epidemiology, differentiation and syndromes' indexes in TCM were investigated in 990 Schizophrenia patients in 10 investigative sites such as Hunan,Jiangsu and so on. Results There were 16 kinds of syndrome types in Schizophrenia. According to order of composition ratio, the first five syndrome types were phlegm-fire inter-harassing19.9%, cardiosplenic astheniall.9%, hepatocholic fire ll.l%, asthenic yin and excessive yang 9.6% and hepatic stagnation disturbing spleen 8.6%. Conclusion The common TCM syndromes types of Schizophrenia are as followings: phlegm-fire inter-harassing, cardiosplenic asthenia, hepatocholic fire, asthenic yin and excessive yang and hepatic stagnation disturbing spleen,which is related, in total scores, to PANSS Scale.%目的 了解精神分裂症中医证候类型的构成比例,为建立精神分裂症常见中医证候标准提供依据.方法 采用临床流行病学调查方法,对湖南、江苏等10个调查点990例精神分裂症患者进行了中医辨证及证候指标调查.结果 精神分裂症患者存在16种证候类型,依据其构成比大小,排前5位的依次是:痰火内扰证19.9%,心脾两虚证11.9%,肝胆火盛证11.1%,阴虚火旺证9.6%和肝郁犯脾证8.6%.结论 精神分裂症的常见中医证候是痰火内扰、心脾两虚、肝胆火盛、阴虚火旺和肝郁犯脾5类,精神分裂症常见中医证型与PANSS量表总分之间存在一定关系.

  14. Gefitinib Plus Interleukin-2 in Advanced Non-Small Cell Lung Cancer Patients Previously Treated with Chemotherapy

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    Bersanelli, Melissa, E-mail: melissa.bersanelli@alice.it; Buti, Sebastiano; Camisa, Roberta [Oncology Unit, University Hospital of Parma, Via Gramsci, 14, 43126 Parma (Italy); Brighenti, Matteo; Lazzarelli, Silvia [Oncology Unit, Azienda Istituti Ospitalieri di Cremona, Largo Priori, 1, 26100 Cremona (Italy); Mazza, Giancarlo [Radiology Division, Spedali Civili di Brescia, P.le Spedali Civili,1, 25123 Brescia (Italy); Passalacqua, Rodolfo, E-mail: melissa.bersanelli@alice.it [1Oncology Unit, University Hospital of Parma, Via Gramsci, 14, 43126 Parma (Italy)

    2014-09-30

    The activation of lymphocytes by gefitinib treatment has been described. In this phase II pilot trial, we explored the possible synergism between IL-2 and gefitinib for non-small cell lung cancer (NSCLC) treatment. From September, 2003, to November, 2006, 70 consecutive patients with advanced, progressive NSCLC, previously treated with chemotherapy, received oral gefitinib 250 mg daily. The first 39 patients received gefitinib alone (G group). The other 31 also received subcutaneous IL-2 (GIL-2 group): 1 MIU/m{sup 2} (Million International Unit/m{sup 2})twice a day on Days 1 and 2, once a day on Days 3, 4, 5 every week for four consecutive weeks with a four-week rest period. Median follow-up was 25.2 months. Grade 3–4 toxicity of gefitinib was represented by skin rash (7%), asthenia/anorexia (6%) and diarrhea (7%); patients treated with IL-2 showed grade 2–3 fever (46%), fatigue (21%) and arthralgia (13%). In the GIL-2 group and G-group, we respectively observed: an overall response rate of 16.1% (6.4% complete response) and 5.1% (only partial response); a disease control rate of 41.9% and 41%; a median time to progression of 3.5 (CI 95% = 3.2–3.8) and 4.1 (CI 95% = 2.6–5.7) months; a median overall survival of 20.1 (CI 95% = 5.1–35.1) and 6.9 (CI 95% = 4.9–8.9) months (p = 0.002); and an actuarial one-year survival rate of 54% and 30%. Skin toxicity (p < 0.001; HR = 0.29; CI 95% = 0.16–0.54) and use of IL-2 (p < 0.001; HR = 0.33; CI 95% = 0.18–0.60) were independently associated with improvement of survival. In this consecutive, non-randomized, series of advanced NSCLC patients, the use of IL-2 increased the efficacy of gefitinib.

  15. Analysis of Second Round Expert Questionnaires About-Traditional Chinese Medicine Criteria of Schizophrenic Syndromes%精神分裂症中医癫证证候标准第二轮专家咨询问卷分析

    Institute of Scientific and Technical Information of China (English)

    何韬; 宋炜熙; 邓婷; 张宏耕

    2011-01-01

    Objective To explore the common TCM criterions of schizophrenic syndromes (depressed psychosis).Methods Second round expert questionnaires were designed according to the results of the first round, and 61 experts were consulted around the country.Delphi method was used for statistical analysis.Results The active coefficient of the experts was 89.7%.The authoritative grade of the experts was 0.776.Among the syndromes, the items whose came up to mean >1.5, full mark ratio >50%, coefficient of variation <40%, rank sum of the indexes >90, there were 7 cases with the syndrome of stagnation and phlegm retention of the hepatic- qi, 13 cases with the syndrome of cardiosplenic asthenia, 10 cases with the syndrome of hepatic - qi stagnation, 9 cases with the syndrome of asthenic yin causing excessive pyrexia, 10 cases with the syndrome of phlegm stagnation, 9 cases with the syndrome of hepatic stagnation causing splenic deficiency, 11 cases with the syndrome of asthenic splenonephro- yang, and 10 cases with the syndrome of hepatopyrexia and pyrophlegm.Conclusions The symptoms such as whose satisfy the condition above act as the main symptoms of syndromes above in schizophrenia (depressed psychosis) in TCM.%目的 探讨精神分裂症(癫证)常见中医证型的证候标准.方法 根据第一轮专家咨询问卷结果设计第2轮问卷,向全国专家进行问卷征询,用专家咨询法进行统计分析.结果 专家积极系数为89.7%;权威程度为0.776;在各证型中,符合均数>1.5,满分比>50%,变异系数90的证候指标痰气郁结证有7个;心脾两虚证共13个;肝郁气滞证共10个,阴虚火旺证共9个,痰湿内阻证共10个,肝郁脾虚证共9个,脾肾阳虚证共11个,肝火痰热证共10个.结论 证候指标中具有上述条件者可作为精神分裂症(癫证)上述中医证型的主症.

  16. Prospective study of Chikungunya virus acute infection in the Island of La Reunion during the 2005-2006 outbreak.

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    Frederik Staikowsky

    Full Text Available BACKGROUND: Chikungunya virus (CHIKV is a recently re-emerged arthropod borne virus responsible for a massive outbreak in the Indian Ocean and India, and extended to Southeast Asia as well as Italy. CHIKV has adapted to Aedes albopictus, an anthropophilic mosquito species widely distributed in Asia, Europe, Africa and America. Our objective was to determine the clinical and biological features of patients at the acute phase of CHIKV infection. METHODS AND FINDINGS: A prospective study enrolled 274 consecutive patients with febrile arthralgia recorded at the Emergency Department of the Groupe Hospitalier Sud-Réunion between March and May 2006. Three groups were defined: one group of 180 viremic patients (positive CHIKV RT-PCR, one group of 34 patients with acute post-viremic infection (negative CHIKV RT-PCR, positive anti-CHIKV IgM and negative IgG, and one group of 46 uninfected patients (negative CHIKV RT-PCR, anti-CHIKV IgM and IgG. Bivariate analyses of clinical and biological features between groups were performed. Patients with CHIKV viremia presented typically with asymmetrical bilateral polyarthralgia (96.5% affecting the lower (98% and small joints (74.8%, as well as asthenia (88.6%, headache (70%, digestive trouble (63.3%, myalgia (59%, exanthems (47.8%, conjunctival hyperhemia (23% and adenopathy (8.9%. Vertigo, cutaneous dysesthesia, pharyngitis and haemorrhages were seldom observed. So far unreported symptoms such as chondrocostal arthralgia (20%, entesopathies (1.6%, talalgia (14% were also noted. Prurit was less frequent during the viremic than post-viremic phase (13.9% vs. 41.2%; p<0.001, whereas lymphopenia was more frequent (87.6% vs. 39.4%; p<0.001. Others biological abnormalities included leukopenia (38.3%, thrombocytopenia (37.3%, increased ASAT and ALAT blood levels (31.6 and 7.3%, respectively and hypocalcemia (38.7%. Lymphopenia <1,000/mm(3 was very closely associated with viremic patients (Yule coefficient 0.82, positive

  17. Clinical, biological and genetic analysis of 8 cases of congenital isolated adrenocorticotrophic hormone (ACTH deficiency.

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    Luu-Ly Pham

    Full Text Available BACKGROUND: Congenital isolated adrenocorticotrophic hormone (ACTH deficiency may be rare, but it could be an underestimated cause of neonatal death. Our objective was to shorten the time between first symptoms and diagnosis. METHODS: This single-centre retrospective case-cohort study was carried out on eight consecutive patients. RESULTS: Two had the neonatal form and 6 the late onset form. Six were admitted to an intensive care unit at least once for seizures with hypoglycemia, major hypothermia, fever, and/or collapsus. The 2 neonatal cases presented with hypoglycemia and in a state of "apparent death" at birth or hypothermia (29°C at 6 days. All 6 late onset cases had also been admitted to an emergency department 1-3 times, but had left hospital incorrectly diagnosed. Their first symptoms were noted at 3-12.3 years, and they were diagnosed at 3.3-14.4 years. All had hypoglycemia, and 4 had had seizures. The presenting symptoms were vomiting and/or abdominal pain, asthenia, irritability, difficulty with physical activities, and anorexia. The school performance of 4 deteriorated. Two underwent psychotherapy and treatment for depression, which was stopped when Hydrocortisone® replacement therapy began. The plasma concentrations in spontaneous hypoglycemia were: ACTH<5 to 17.1 pg/mL, with concomitant cortisol <3.5 to 37 ng/mL. The plasma dehydroepiandrosterone sulfate (DHAS concentrations were low in the 7 evaluated. The coding sequence of TPIT was normal in all. CONCLUSION: Several unexplained symptoms in a child, mainly gastro-intestinal symptoms and seizures due to hypoglycemia, may indicate ACTH deficiency. A low or normal basal plasma ACTH despite concomitant low cortisol at 8 a.m. and/or in spontaneous hypoglycemia, associated with low DHAS, in a patient not given corticosteroids is highly suggestive of ACTH deficiency. The isolated character of ACTH deficiency must be confirmed by determining the other hypothalamic-pituitary functions

  18. 运用因子分析探讨急性冠脉综合征证候要素及靶位特征%Syndrome elements and target characteristics of acute coronary syndrome investigated by applying factor analysis

    Institute of Scientific and Technical Information of China (English)

    张莹; 李庆祥

    2013-01-01

    Objective It is to study the syndrome elements of acute coronary syndrome ( ACS) , thus to provide for evidences for syndrome differentiation and treatment for this disease. Methods 315 ACS patients were selected and their clinical information of TCM was collected. Syndrome elements and target characteristics were extracted through frequency statistics and factor analysis. Results There were 16 common factors extracted by factor analysis. By literature search and expert panel proposal, 8 types of TCM syndromes were found. Frequency of occurrences reduced in order of Qi deficiency, Yang deficiency, Yin deficiency among the syndromes of deficiency in origin and reduced in order of blood stasis, phlegm stagnancy, Qi stagnation, cold coagulation, accumulating heat among the syndromes of excess in superficiality. Conclusion The syndrome elements of ACS; phlegm stagnancy, blood stasis, Yang deficiency of, Qi deficiency, Qi stagnation, cold coagulation, accumulating heat, Yin deficiency. Characteristic of disease was asthenia in origin and excess in superficiality. Disease located in heart and covered lung, spleen, liver and kidney.%目的 探讨急性冠脉综合征(ACS)证候要素,为ACS辨证治疗提供依据.方法 以315例ACS患者的临床资料为基础,运用频数分析、因子分析的方法,探索ACS的证侯要素及其靶位特征.结果 中医症状部分共提取16个公因子,根据文献研究以及专家组建议,将16个公因子归属为8个证候要素.本虚证候要素比例由高至低依次为:气虚>阳虚>阴虚,标实证候要素出现比例由高至低依次为:血瘀>痰饮>气滞>寒凝>热蕴.结论 ACS的证候要素是痰饮、血瘀、阳虚、气虚、气滞、寒凝、热蕴、阴虚;病性为本虚标实,病位在心,病变脏腑涉及肺、脾、肝、肾.

  19. Imported submicroscopic malaria in Madrid

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    Ramírez-Olivencia Germán

    2012-09-01

    Full Text Available Abstract Background Submicroscopic malaria (SMM can be defined as low-density infections of Plasmodium that are unlikely to be detected by conventional microscopy. Such submicroscopic infections only occasionally cause acute disease, but they are capable of infecting mosquitoes and contributing to transmission. This entity is frequent in endemic countries; however, little is known about imported SMM. The goals of this study were two-fold: a to know the frequency of imported SMM, and b to describe epidemiological, laboratorial and clinical features of imported SMM. Methods A retrospective study based on review of medical records was performed. The study population consisted of patients older than 15 years attended at the Tropical Medicine Unit of Hospital Carlos III, between January 1, 2002 and December 31, 2007. Routinely detection techniques for Plasmodium included Field staining and microscopic examination through thick and thin blood smear. A semi-nested multiplex malaria PCR was used to diagnose or to confirm cases with low parasitaemia. Results SMM was diagnosed in 104 cases, representing 35.5% of all malaria cases. Mean age (IC95% was 40.38 years (37.41-43.34, and sex distribution was similar. Most cases were in immigrants, but some cases were found in travellers. Equatorial Guinea was the main country where infection was acquired (81.7%. Symptoms were present only in 28.8% of all SMM cases, mainly asthenia (73.3% of symptomatic patients, fever (60% and arthromialgias (53.3%. The associated laboratory abnormalities were anaemia (27.9%, leukopaenia (15.4% and thrombopaenia (15.4%. Co-morbidity was described in 75 cases (72.1%. Conclusions Results from this study suggest that imported SMM should be considered in some patients attended at Tropical Medicine Units. Although it is usually asymptomatic, it may be responsible of fever, or laboratory abnormalities in patients coming from endemic areas. The possibility of transmission in SMM has

  20. Bromocriptine improves glycaemic control and serum lipid profile in obese Type 2 diabetic subjects: a new approach in the treatment of diabetes.

    Science.gov (United States)

    Cincotta; Meier; Cincotta Jr

    1999-10-01

    Bromocriptine, a potent dopamine D(2) receptor agonist, has been shown to reduce insulin resistance, glucose intolerance and hyperlipidaemia in both numerous animal studies and in Phase II studies. Bromocriptine has been used worldwide for over 20 years to treat Parkinson's disease, macroprolactinoma and other disorders; it has been found to be generally safe. We therefore investigated the possible beneficial effects of Ergoset(R) (Ergo Science Corp.), a new quick release formulation of bromocriptine, on glycaemic control and serum lipid profile in obese Type 2 diabetic subjects in two large Phase III studies. A large, randomised, double-blind placebo-controlled study was conducted in which Ergoset was given once daily at 8 am. (4.8 mg maximum dose) for 24 weeks as adjunctive therapy to sulphonylurea (485 subjects) to obese Type 2 diabetics held on a weight- maintaining diet. Treatment efficacy parameters included change from baseline in glycated haemoglobin A(1c) (HbA(1c)), fasting and post-prandial serum glucose, insulin, triglyceride and free fatty acid levels. Baseline glycated haemoglobin, fasting glucose, insulin, triglyceride and free fatty acid levels did not differ between treatment groups. and on average were 9.4 +/- 0.05%, 222 +/- 2 mg/dl, 24 +/- 1 µU/ml, 248 +/- 11 mg/dl, and 850 +/- 32 µEq/l, respectively. A similarly designed study of Ergoset as monotherapy in Type 2 diabetics (154 subjects) with similar baseline clinical characteristics was conducted. Addition of Ergoset treatment to sulphonylurea reduced percent glycated HbA(1c) by 0.55 (P fasting and post-prandial glucose by 23 and 26 mg/dl (P fasting and post-prandial triglycerides by 72 and 63 mg/dl (P fasting and post-prandial free fatty acids by 150 and 165 µEq/l (P < 0.05), relative to placebo. Twelve percent of all Ergoset subjects, compared to 3% of placebo subjects, withdrew from the study due to adverse events. The most common events causing withdrawal were nausea, dizziness, asthenia

  1. Activity of topotecan given intravenously for 5 days every three weeks in patients with advanced non-small cell lung cancer pretreated with platinum and taxanes: a phase II study.

    Science.gov (United States)

    Gonzalez, Emilio Esteban; Villanueva, Noemi; Fra, Joaquin; Berros, Jose Pablo; Jimenez, Paula; Luque, María; Muñiz, Isabel; Blay, Pilar; Fernandez, Yolanda; Vieitez, José María; Muriel, Carolina; Sanmamed, Miguel; Coto, Pablo Pardo; Izquierdo, Marta; Estrada, Enrique; Lacave, Angel J

    2011-12-01

    Topotecan, a semi-synthetic camptothecin analogue with topoisomerase I interaction, has shown to be an active agent in the treatment of advanced refractory lung cancer. This paper describes the authors' experience with this drug when used as a single agent in patients (pts) with advanced non-small cell lung cancer (NSCLC) refractory to platinum- and taxane-containing chemotherapy regimens. Thirty-five patients with NSCLC refractory to previous chemotherapy and KI ≥ 60% were included in the study. Their characteristics are as follows: median age of 52 years (range 43-69) and Karnofsky PS of 70 (60-80); 27 were male and 8 were female. Twenty-one (60%) patients had adenocarcinoma; eleven (31.4%), squamous cell, and three (8.5%), undifferentiated carcinoma. There was a median of two disease sites and two prior chemotherapy regimens. Topotecan was administered at a dose of 1.25 mg/m(2) I.V. daily for 5 days, repeated every 21 days until disease progression, maximal response, or intolerable toxicity. After 73 cycles, patients received a median of 2 treatment cycles (1-9). All patients except one were considered evaluable for toxicity; eight episodes (24%) of nausea/vomiting and two episodes (6%) of grade 1-2 asthenia, respectively, were reported. Four (12%) patients developed grade 1-2 anemia and two (6%) subjects suffered grade 3 anemia. Seven (21%) patients had grade 1-2 neutropenia and one (3%) presented grade 5 neutropenia. In 33 patients evaluable for activity of the 35 subjects included in the study; one (2.8%) presented a partial response; nine (25.7%) had stable disease, and 23 (65.7%) exhibited disease progression. Median time to progression and overall survival were 54 (12-210) and 70 (12-324) days, respectively. Intravenous topotecan at that dose and administration schedule displays scant activity in terms of response rate in individuals with advanced NSCLC previously treated with platinum and taxanes. The role and usefulness of chemotherapy in this setting

  2. Hypopituitarism manifested as hyponatremia in old patients: A report of two cases and review of literature%2例表现为低钠血症的老年腺垂体功能减退症报告及文献复习

    Institute of Scientific and Technical Information of China (English)

    孙般若; 李昱芃; 成晓玲; 邵迎红; 李剑; 田慧

    2011-01-01

    目的 探讨表现为低钠血症的老年腺垂体功能减退症的诊断.方法 对2例以低钠血症的老年腺垂体功能减退症患者的病历资料进行回顾性分析,并对相关文献进行复习.结果 2例病例均有明确头颈部放射治疗史,起病隐匿,以低钠血症等不典型症状为主要表现,在明确诊断后经糖皮质替代治疗低钠血症纠正,乏力、纳差等症状缓解.结论 老年腺垂体功能减退患者,可表现为低钠血症等不典型症状,需要临床医师提高对低钠血症的认识,重视头颈部放射治疗病史及可能病因的采集,早诊断、早治疗,使患者受益.%Objective To study the diagnosis of hypopituitarism manifested as hyponatremia in old patients. Methods Clinical data about 2 patients with hypopituitarism manifested as hyponatremia were retrospectively analyzed with its related literature reviewed. Results The 2 patients had a history of head and neck radiotherapy. The onset of their disease was insidious. Their main clinical manifestations were the atypical symptoms of hyponatremia. Symptoms such as asthenia and poor appetite were improved after hyponatremia was treated with replacement therapy. Conclusion Hypopituitarism can be manifested as hyponatremia in old patients and should be early diagnosed and treated. Medical doctors should improve their ability to recognize hyponatremia and pay their attention to the history of head and neck radiotherapy, and its etiological factors.

  3. Regulative Effect of Artificial Northern Chinese Caterpillar Fungus on mRNA Expression of GnRH Cell in Hypothalamus%人工栽培北冬虫夏草子实体对大鼠下丘脑GnRH细胞mRNA表达的调节作用

    Institute of Scientific and Technical Information of China (English)

    徐维蓉; 王奕; 雍丽; 叶其明

    2009-01-01

    目的 观察人工栽培北冬虫夏草子实体细粉和复合粉对下丘脑促性腺激素释放激素细胞(GnRH细胞)作用的影响.方法 用腺嘌呤加入饲料喂饲大鼠,造成大鼠肾阳虚模型,用人工栽培的北冬虫夏草子实体细粉和复合粉进行治疗,通过分子原位杂交的方法 显示下丘脑GnRH细胞的mRNA表达以观察北冬虫夏草子实体细粉对其的影响.结果 与正常组相比,模型组的Gn-RH细胞杂交信号减弱,阳性细胞数减少,而中药组GnRH杂交信号及阳性细胞数较模型组有提高趋势.结论 人工栽培的北冬虫夏草子实体细粉和复合粉可促进大鼠下丘脑GnRH细胞的mRNA表达,增加GnRH分泌,从而调节大鼠的生殖功能.%Objective To observe the effects of artificial cultivated northern Chinese caterpillar fungus' fruiting body powder and compound powder on ganadotropin- re-leasing hormone(GnRH) cells in hypothalamus. Methods Establish the model of kidney-yang asthenia by feeding male rats with forage mixed with adenine, then treat the rats with northern Chinese caterpillar fungus' fruiting body powder and compound powder. In situ hybridization was used to study the expression of the mRNA of GnRH cells in hypothalamus aod the effect of northern Chinese caterpillar fungus' fruiting body on the GnRH cells. Results Compared with the normal group, hybridization signal of GnRH mRNA in the model group weakened, and the positive cell count decreased, while hybridization signal of GnRH mRNA and the positive cell count in the Chinese medicine group had the tendency to increase,. Conclusion Artificial cultivated northern Chinese, caterpillar thngus' fruiting body powder and compound powder can promote the expression of the mRNA of GnRH cell in hypothalamus, and inerems the secre, tion of GnRH, thus to regulate the reproduction function of the rats.

  4. [Epidemic of autochthonous hepatic and intestinal amebiasis in a place near Grenoble].

    Science.gov (United States)

    Ambroise-Thomas, P; Goullier, A; Grillot, R; Lascaud, D; Rivoire, L; Perrin, Y

    1975-01-01

    We had the opportunity of studying an epidemic of autochthonous amoebiasis occurring in the autumn of 1974 in a small town of 4000 inhabitants 30 km from Grenoble. Attention was originally attracted by the occurrence in this town of two cases of hepatic amoebiasis and one of intestinal amoebiasis identified by rectoscopy. Systematic investigations (coproctic examinations and serological tests for amoebiasis by indirect antibody fluorescence) were then carried out on everyone in the locality with digestive disorders which were possibly referable to amoebiasis, and on the other members of their families. A total number of 148 coproctic examinations were made and in two cases revealed the presence of vegetative forms of Entamoeba histolytica. In both cases the infestation provoked few symptoms (asthenia, vague abdominal discomfort, intermittent and apparently banal diarrhoea). On the other hand 20 out of 94 serological tests revealed positive results, 14 of which were equal to or greater than a titre of 1/100, a level at which all risks of non-specificity are virtually ruled out under our experimental conditions. Material reasons made it impossible to subject these cases to repeated faecal checks, but in two of them at least the rectoscopic appearances were very suggestive of subacute intestinal amoebiasis. Moreover, amoebic disease appears to be well confirmed by the results obtained among the patients as a whole by treatment with Metroinidazole. A variety of hypotheses on the origin of this epidemic have been put forward and then abandoned (market garden produce, receipt by certain families of exotic frut from overseas). In actual fact water seems to be the point of departure, for, although specimens of water taken at 7 different levels in the water supply system failed to reveal the presence of a single amoeba, bacteriological analyses during autumn 1974 showed signs of faecal contamination. The locality, which is situated at the foot of the Chartreuse massif

  5. ED-33ELDERLY PATIENTS WITH GLIOBLASTOMA: SHOULD BE TREATED IN A DIFFERENT WAY?

    Science.gov (United States)

    Salgado, Maria Angeles Vaz; del Toro, Jacobo Muñoz; Cerco, José Antonio Gutierrez; Urzaiz, Luis Ley; Mena, Alfredo Carrato; Pian, Hector; Olmos, Vanessa Pachón; Rueda, Ana Gomez; de Pedro, Marta Del Alamo

    2014-01-01

    BACKGROUND: The management of glioblastoma (GB) in elderly patients is not well established, since until recently they have been excluded from randomized trials and there are concerns about the toxicity. METHODS: The authors retrospectively reviewed 53 patients at a single institution from 2005 to 2013. Patients were 70 years of age and older with histologically confirmed GB. RESULTS: Median age was 75 years (70-88y). Fifty-six percent men, 43% women. Majority had some kind of minor morbidity (89%), mainly arterial hypertension (55%). Complete resection was performed in 52%. Biopsy in 8%. 90% had presurgical KPS >70. Seven (14%) had worse KPS after surgery. 71% received radiotherapy, in 45% 60 Gy and in 26% 30 Gy. Nearly 40% were treated with concomitant and adjuvant temozolomide. The median number of cycles was 4,43 (1-14). 6% had grade 3 or 4 neutropenia or trombocitopenia. 24% had grade 1 asthenia or nausea and vomits. Median overall survival (OS) for the whole cohort was 7,36 m (95% CI 4,8-9,8). Median progression free survival was 5.9 m (3-8.7m). Treatment with temozolomide concomitant and adjuvant (Stupp regimen) was associated with longer OS (11,16 vs 4,1m p = 0.008 ). The median OS was 8,3 m. for those who received radiotherapy and 1,5m for those who did not (p = 0,046). No statistical differences were found between those treated with 60 or 30 Gy (p = 0.143). Nearly 10% was older than 80. Median OS in these patients was 4,2m even though 71% had a complete resection. CONCLUSION: In our experience, in selected patients with newly diagnosed glioblastoma over the age of 70, more intensive treatment was associated with prolonged OS, and results are close to those obtained in younger patients. Nevertheless these are retrospective data, selection bias should be considerer. Further randomized trial should be conducted to investigate this topic.

  6. Injectable interferon beta-1b for the treatment of relapsing forms of multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Slobodan M Jankovic

    2010-03-01

    -specific reactions, insomnia, influenza-like syndrome, asthenia, headache, myalgia, hypoesthesia, nausea, paresthesia, myasthenia, chills and depression. Efficacy of IFN-β1b in  relapsing-remitting MS is higher than that of IFN-β1a, and similar to the efficacy of glatiramer acetate. These facts promote IFN-β1b as one of the most important drugs in the spectrum of immunological therapies for this debilitating disease.Keywords: multiple sclerosis, interferon beta 1b, mechanism of action, efficacy, safety

  7. Fisiología de la sarcopenia: Similitudes y diferencias con la caquexia neoplásica Psysiology of sarcopenia: Similarities and differences with neoplasic cachexia (muscle impairments in cancer and aging

    Directory of Open Access Journals (Sweden)

    Josep M. Argilés

    2006-05-01

    Full Text Available Las alteraciones que acontecen durante el proceso canceroso y el envejecimiento comparten bastantes vías metabólicas así como también mediadores. Dado que afectan a gran cantidad de personas, la caquexia cancerosa y la sarcopenia del envejecimiento podrían ser dianas para futuras investigaciones clínicas. La caquexia cancerosa es un síndrome caracterizado por una gran pérdida de peso, anorexia, astenia y anemia. De hecho, muchos de los pacientes que mueren de cáncer avanzado sufren caquexia. El grado de caquexia está inversamente correlacionado con el tiempo de supervivencia de los pacientes y siempre implica una mala prognosis. En los últimos años, las enfermedades e incapacidades relacionadas con la edad han despertado un gran interés e importancia sanitaria. Concretamente, el desgaste muscular, también conocido como sarcopenia, disminuye la calidad de vida de la población geriátrica, aumentando la morbilidad y decreciendo la esperanza de vida. Deberían dedicarse más investigaciones al esclarecimiento de los factores/mediadores del proceso caquéctico (asociados a la pérdida de las reservas grasas y de tejido muscular tanto en caquexia como en sarcopenia, ya que podría ser una buena estrategia terapéutica para la prevención y el tratamiento de la pérdida de masa muscular tanto en la enfermedad como durante el envejecimiento sano.Muscle wasting during cancer and ageing share many common metabolic pathways and mediators. Due to the size of the population involved, both cancer cachexia and ageing sarcopenia may represent targets for future promising clinical investigations. Cancer cachexia is a syndrome characterized by a marked weight loss, anorexia, asthenia and anemia. In fact, many patients who die with advanced cancer suffer from cachexia. The degree of cachexia is inversely correlated with the survival time of the patient and it always implies a poor prognosis. In recent years, age-related diseases and disabilities

  8. Epidemiology of Chikungunya fever outbreak in Western Jamaica during July–December 2014

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    Pham PN

    2017-01-01

    Full Text Available Phuong N Pham,1 LaQueena T Williams,1 Uduak Obot,1 Luz A Padilla,1 Maung Aung,2 Tomi F Akinyemiju,1 April P Carson,1 Pauline E Jolly1 1Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA; 2Epidemiology Unit, Western Regional Health Authority, Ministry of Health, Montego Bay, Jamaica Objective: Our study describes the 2014 Chikungunya outbreak in Western Jamaica in terms of geographic distribution and trend of the outbreak over time, and evaluates clinical symptoms of the disease based on pre-existing conditions.Methods: We conducted a retrospective, cross-sectional study of 609 clinically defined ­Chikungunya virus (CHIKV fever cases that occurred in the four parishes of the Western Regional Health Authority of Jamaica from July 2014 to December 2014. Cases were not confirmed by laboratory tests but met clinical and epidemiological criteria of CHIKV fever.Results: Our results show a propagated spread of CHIKV fever during the outbreak period with the peak at the end of October. Main urban cities, such as Montego Bay and Lucea, were identified as places that had high numbers of cases. Fever and arthralgia were the two most common clinical symptoms in CHIKV patients. Although a majority (80% of infants aged <2 years had up to four symptoms (80%, the percentage of infants with higher numbers of symptoms (9–10 was higher than in older age groups. However, back pain was found to occur significantly more in older patients. Those with arthritis as a pre-existing condition were more likely to experience headache, asthenia, back pain, and periarticular edema.Conclusion: These findings can help public health officials develop more effective programs to prevent the spread of CHIKV outbreaks by focusing on crowded urban cities. The findings indicate that those who are likely to develop a higher number of symptoms, such as young infants and people with pre-existing conditions, such as arthritis, should be more closely

  9. Clinical Experience of Professor WU Sheng-yuan Using Qianyang Fengsui Dan in Treatment of Rheumatism%吴生元教授应用潜阳封髓丹治疗风湿病的经验

    Institute of Scientific and Technical Information of China (English)

    李兆福; 刘维超; 彭江云; 吴生元

    2013-01-01

    Fengsui Dan first appeared in “Qixiao Liangfang”writed by Dong Su in Ming dynasty and Qianyang Dan was invented by Zheng Qinan in Qing dynasty,but later medical scientists often use the two together,which is called Qianyang Fengsui Dan by Wu Pei-heng. Professor Wu Sheng-yuan is good at using the recipe in treatment of rheumatism. Through compatibility of medicines on the basis of the original prescription(amomum villosum,monkshood,tortoiseshell,liquorice and cortex phellodendri),He can make Qianyang Fengsui Dan have some effects,such as clearing upper-jiao,warming lower-jiao,guiding fire to origin,making Qi belongs to the kidney,supporing Yang Qi and producing Yin jin,etc. It has a good curative effect in treatment of rheumatism,such as heat in the upper and cold in the lower syndrome,and cold-heat complex syndrome resulted by nonhoming lower-jiao archaeus and flaming of asthenia-fire,so which is worth further studying and spreading.%封髓丹首见于明·董宿《奇效良方》,潜阳丹为清·郑钦安所创,后世医家常将二者合方应用,吴佩衡称之为“潜阳封髓丹”。吴生元教授擅用潜阳封髓丹治疗风湿病,在原方的基础上(砂仁、附子、龟板、甘草、黄柏)加减配伍,能清上温下,引火归元,纳气归肾,助阳生津,对于下元不藏、虚火上浮之上热下寒、寒热错杂之风湿病具有良好的疗效,值得深入研究和推广应用。

  10. Saturnismo: a propósito de un caso Lead poisoning: A case report

    Directory of Open Access Journals (Sweden)

    Pablo Honorio Labanda Urbano

    2012-06-01

    Full Text Available Profesora de pintura sobre vidrio y restauración de vidrieras de 65 años acude a la Unidad Médica de Valoración de Incapacidades del Instituto Nacional de la Seguridad Social (INSS con diagnóstico de exposición laboral a plomo. La paciente ha permanecido en Incapacidad Temporal por astenia durante varios meses, y se le detecta tras una reincorporación al trabajo plumbemia elevada, asociada a otros síntomas típicos de la intoxicación por plomo, por lo que se la separa de su ambiente de trabajo. Finalmente, el Equipo de Valoración de Incapacidades, reunido para valorar su caso resuelve Incapacidad Laboral Permanente Total derivada de enfermedad profesional para trabajos en que haya exposición a plomo y otros ototóxicos, exposición a ruidos de riesgo, y para aquellos trabajos en que sea necesaria una comunicación verbal fluida en frecuencias conversacionales normales. Con este caso clínico pretendemos revisar los síntomas del cuadro clínico de saturnismo, así como hacer una reflexión sobre los efectos de la prevención de riesgos para el trabajador.Lead poisoning is most commonly caused by occupational exposure. We report a case of a 65-year-old woman, paint teacher, which was working in reparation of stained glass window. She consults the Medical Incapacity Valoration Unit of National Institute of Social Security with diagnosis of lead occupational intoxication. The patient was not able to word for several months because of presenting asthenia. After reporting for work high lead blood levels were detected, in association with physical symptoms. She was evaluated by a tribunal which settled total long sick-leave due to occupational lead exposure and was restricted for loud works and other ones that need verbal communication in conversational frequencies. With this clinical case we try to check the symptoms of lead poisoning, as well as to think about the effects of prevention of occupational hazards.

  11. Imported malaria in pregnancy in Madrid

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    Jiménez Beatriz C

    2012-04-01

    Full Text Available Abstract Background Malaria in pregnancy is associated with maternal and foetal morbidity and mortality in endemic areas, but information on imported cases to non-endemic areas is scarce. The aim of this study was to describe the clinical and epidemiological characteristics of malaria in pregnancy in two general hospitals in Madrid, Spain. Methods Retrospective descriptive study of laboratory-confirmed malaria in pregnant women at the Fuenlabrada University Hospital and the Príncipe de Asturias University Hospital, in Madrid, over a six- and 11-year period, respectively. Relevant epidemiological, clinical and laboratory data was obtained from medical records. Results There were 19 pregnant women among 346 malaria cases (5.4%. The average age was 27 years. The gestational age (trimester was: 53% 3rd, 31% 1st, 16% 2nd. All but one were multigravidae. Three were HIV positive. All were sub-Saharan immigrants: two were recently arrived immigrants and seventeen (89% had visited friends and relatives. None had taken prophylaxis nor seeked pre-travel advice. Presentation: 16 symptomatic patients (fever in fourteen, asthenia in two, three asymptomatic. Median delay in diagnosis: 7.5 days. Laboratory tests: anaemia (cut off Hb level 11 g/dl 78.9% (mild 31.6%, moderate 31.6%, severe 15.8% thrombocytopaenia 73.7%, hypoglycaemia 10.5%. All cases were due to Plasmodium falciparum, one case of hyperparasitaemia. Quinine + clindamycin prescribed in 84%. Outcomes: no severe maternal complications or deaths, two abortions, fifteen term pregnancies, no low-birth-weight newborns, two patients were lost to follow-up. Conclusions Though cases of malaria in pregnancy are uncommon, a most at risk group is clearly defined: young sub-Saharan mothers visiting friends and relatives without pre-travel counselling and recently-arrived immigrants. The most common adverse maternal and foetal effects were anaemia and stillbirth. Given that presentation can be asymptomatic

  12. Effects analyzing of reinforcing the Primordial Qi in the process of prevention and treatment to patients with AIDS-related diarrhea%试析培补元气在艾滋病相关性腹泻防治中的作用

    Institute of Scientific and Technical Information of China (English)

    张亚萍; 梁健; 邓鑫; 李永亮

    2011-01-01

    艾滋病相关性腹泻的发生主要责之于脾虚湿盛,与肺脾肾等脏腑功能失调密切相关.元气是人体生命活动的原动力,具有推动和调节人体脏腑生理活动之功;同时,元气也是正气的重要组成部分,对维持人体的免疫功能有着重要的作用.脾胃水谷精气对元气有滋养之功,两者相互为用,密切相关.从培补元气人手防治艾滋病相关性腹泻,是中医学“治病求本”思想的体现.培补元气,不仅对推动和激发艾滋病患者脏腑功能活动、改善机体虚弱的状态、提高其免疫功能有重要作用,而且对减轻患者腹泻的症状、减少腹泻发生的次数、提高患者的生活质量都有积极的影响.%The main cause of the onset of AIDS-related diarrhea is damp abundance due to spleen asthenia syndrome and the function situation of lung, spleen, and kidney has a lot to do with it. Primordial Qi is the primitive active power of human actions and can promote and regulate the physiological activities of human being. Meanwhile, Primordial Qi which is the major components of vital Qi has a lot to do with the maintenance of immune function of human being. The nutrients grown and transformed in the spleen and stomach moisten the vital Qi. These two has a close relationship and react to each other. To prevent and treat AIDS-related diarrhea by cultivating and promote Primordial Qi embodies the thoughts of TCM which goes treating a disease by removing its cause. Reinforcing the Primordial Qi can not only stimulate the functional activities of Zang-Fu, better the general condition of body and improve the immune function of the patients with AIDS, but also has positive effects in eliminating the symptoms of diarrhea, decreasing the frequency of the occurrence of diarrhea and improving the quality of life.

  13. Delayed effort-induced swelling with myofasciitis and systemic manifestations: A so far unrecognized type of pressure-induced urticaria

    Science.gov (United States)

    Bursztejn, Anne-Claire; Lipsker, Dan

    2017-01-01

    Abstract Diseases characterized by recurrent symptoms with prolonged intervals without any clinical manifestations can pose diagnostic difficulties. Some diagnoses will be obvious but other situations can be very challenging. To nosologically delineate a new entity characterized by recurrent flares of induration of the forearms and legs with swelling of the extremities accompanied by intense fatigue and variable other symptoms. Retrospective observational study of patients recorded from 2000 to 2015. All patients included were seen during a consultation at the Dermatology Department of the University Hospital of Strasbourg, France. We retrieved the medical records from patients seen and recorded over the last 16 years having induration of the extremities, the forearm and the legs occurring between 4 and 12 hours after a physical effort accompanied by systemic signs that lasted for a few days. We analyzed in detail the clinical and biological features, evolution, and treatments of these patients. We included 6 males, with a mean age of 47 years; mean age at disease onset was 42. All patients were initially misdiagnosed as having rheumatic disorders. The mean delay before diagnosis was 5 years. The main complaint was painful induration or muscle soreness of the forearms and the legs associated with transient functional impairment and prolonged asthenia for a mean duration of 3.5 days. Induration of the deep soft tissues was very suggestive of myofasciitis. The delay between the triggering physical effort and the swelling was between 6 and 12 hours. Physical effort as triggering factor was never spontaneously mentioned. Two patients had partial response to high dose antihistamines and 2 other patients to the interleukin-1 inhibitor anakinra. One patient responded to hydroxychloroquine. The very stereotypical presentation in those 6 patients suggests that this is a recognizable entity characterized by effort-induced induration of forearms and/or legs, due to deep

  14. Epidemiology, clinical, immune, and molecular profiles of microsporidiosis and cryptosporidiosis among HIV/AIDS patients

    Directory of Open Access Journals (Sweden)

    Wumba R

    2012-07-01

    Neelsen stainings, real-time polymerase chain reaction (PCR, immunofluorescence indirect monoclonal antibody, nested PCR-restriction fragment length polymorphism, and PCR amplification and sequencing. Odds ratio (OR and 95% confidence intervals were used to quantify the risk.Results: Of the 242 HIV patients, 7.8%, 0.4%, 5.4%, 0.4%, 2%, 10.6%, and 2.8% had Enterocytozoon bieneusi, Encephalitozoon intestinalis, Cryptosporidium spp., Isospora belli, pathogenic intestinal protozoa, nonpathogenic intestinal protozoa, and helminths, respectively. We found five genotypes of E. bieneusi: two older, NIA1 and D, and three new, KIN1, KIN2, and KIN3. Only 0.4% and 1.6% had Cryptosporidium parvum and Cryptosporidium hominis, respectively. Of the patients, 36.4%, 34.3%, 31%, and 39% had asthenia, diarrhea, a CD4 count of <100 cells/mm³, and no antiretroviral therapy (ART, respectively. The majority of those with opportunistic intestinal parasites and C. hominis, and all with C. parvum and new E. bieneusi genotypes, had diarrhea, low CD4+ counts of <100 cells/mm³, and no ART. There was a significant association between Entamoeba coli, Kaposi sarcoma, herpes zoster, chronic diarrhea, and asthenia, and the presence of 28 cases with opportunistic intestinal parasites. Rural areas, public toilets, and exposure to farm pigs were the univariate risk factors present in the 28 cases with opportunistic intestinal parasites. In logistic regression analysis, a CD4 count of <100 cells/mm³ (OR = 4.60; 95% CI 1.70–12.20; P = 0.002, no ART (OR = 5.00; 95% CI 1.90–13.20; P < 0.001, and exposure to surface water (OR = 2.90; 95% CI 1.01–8.40; P = 0.048 were identified as the significant and independent determinants for the presence of opportunistic intestinal parasites.Conclusion: E. bieneusi and Cryptosporidium are becoming more prevalent in Kinshasa, Congo. Based on the findings, we recommend epidemiology surveillance and prevention by means of hygiene, the emphasis of sensitive PCR methods, and

  15. Diagnosis and clinical manifestations of subacute combined degeneration of the spinal cord:Analysis of 21 cases

    Institute of Scientific and Technical Information of China (English)

    Yanhong Shou; Caifeng Li; Dongsheng Fan; Yang Shen; Jun Zhang; Weizhong Xiao; Shuqing Zhao; Jinsheng Liu; Wei Sui

    2007-01-01

    BACKGROUND: Subacute combined degeneration of the spinal cord is caused by vitamin B12 deficiency and is a kind of degenerative disease owing the characteristics of nervous system diseases. In addition,different patients have variously clinical manifestations and various prognoses after vitamin B12 therapy.OBJECTIVE: To investigate and analyze diagnosis, clinical manifestations and prognosis of subacute combined degeneration of the spinal cord.DESIGN: Case analysis.SETTING: Department of Neurology, the Third Hospital of Peking University.PARTICIPANTS: A total of 21 subacute combined dcgeneration of the spinal cord patients including 14 males and 7 females aged from 33 to 82 years were selected from Department of Neurology, the Third Hospital of Peking University from January 1999 to December 2005. Duration from onset to final diagnosis lasted for 1.5 - 108 months. All patients had typically clinical manifestations; meanwhile, level of serum vitamin B12 was decreased and/or vitamin B12 therapy was effective. All patients provided the confirmed consent.METHODS: Clinical data of 21 subacute combined degeneration of the spinal cord patients were retrospectively analyzed, while general data and clinical characteristics were recorded at the same time.Levels of blood routine, serum vitamin B12 and homocysteine were measured at the phase of hospitalization.Normal value of serum vitamin B12 was 187 - 1 059 ng/L and normal value of serum homocysteine was 5 -15 μ mol/L. All patients received neuroelectrophysiological examination and 15 patients received MRI examinations of spinal cord. After final diagnosis, patients were given vitamin B12 therapy. And follow-up was performed to investigate the prognosis.prognosis.RESULTS: Clinical data of 21 patients and follow-up data of 20 patients were involved in the final analysis typically clinical manifestations. The original symptoms included numbness of lower and/or upper limbs (5 cases), unstable gait (3 cases), limb asthenia (4

  16. 置氧法治疗对老年慢性硬膜下血肿患者脑组织结构和功能的保护作用%Protective effect of oxygen-exchange therapy on cerebral tissue structure and function in the elderly with chronic subdural hematoma

    Institute of Scientific and Technical Information of China (English)

    董欣明; 袁玉会; 潘蔚然; 王成林

    2005-01-01

    BACKGROUND: Traditionally, cranial perforate-rinse-dram operation and tube drainage were often used in the treatment of chronic subdural hematoma in the elderly, recently,instead of which oxygen-exchange therapy through dural puncture via cranium is more and more used.OBJECTIVE: To investigate the reliability and safety of the new operation-method using oxygen-exchange in treating the older people with chronic subdural hematoma in comparison with traditional cranial perforate-rinse-dram operation.DESIGN: Retrospective case analysis.SETTING: The Department of Neurosurgery, the Second Clinical College of China Medical University.PARTICIPANTS: Eleven male patients (meanly 62 years of age)who had undertaken oxygen-exchange therapy via skull without drain tube in the Department of Neurosurgery, Second Clinical College of China Medical College from January 1997 to December 2004 were enrolled in the study, with an average disease history of 1.5 months. Among them, 10 subjects suffered from head injury to different extent within 7 weeks on average. Main chief complaint was headache, and Unilateral limb asthenia above Ⅳ was found in 5 cases asking for medical service. As shown by CT and MRI, all the subjects were diagnosed as having chronic subdural hematoma located at supratentorium, 5 cases in the right side and 6 in the left side. Volume of hematom was calculated as the following formula: volume of hematom=length×width×number of layers (1 cm thick for one layer). And the range of volume was from 70 mL to 140 mL, and the average value was 105 mL. The hematom in all the cases was found to move to the midline to different extents.METHODS: Patients in lateral recumbent position were undertaken boring at the CT-located thickest area with bone awl of 0.4-0.5 cm under local anesthesia. After boring, 14-size lumbar puncture needle with trochar was used to acupuncture dura mater then moving the needle core so that blood was discharged. Then 10 mL medical oxygen was perfused

  17. Patients admitted in an Intensive Care Unit with severe clinical manifestations of Influenza, october-december 2009

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    Yenisey Quintero Mendez

    2011-04-01

    Full Text Available A descriptive study of a series of cases was carried out, where 109 patients with the presumptive diagnosis of severe clinical pictures of Influenza were included, the total of them admitted in one of our Intensive Care Units (ICU, prepared for that purpose during the recent pandemic, during the period comprised between October 1 and December 31, 2009. There were 62 women (56,9%, of which 19 were pregnant or postpartum women (17,4%. The mean age of the sick persons of this serie was of 52,53 ± 22,54 years. The beginning of symptoms before the time of admission revealed an average of 4,90 ± 4,37 days. The predominant symptoms were: cough in 93 patients (85,3%, dyspnea in 86 (78,9%, fever in 76 (68,8% and general symptoms of asthenia and anorexia in 76 (68,8%. In the physical exam, the most frequent signs were: polypnea in 86 (78,9% and wet rales in 65 (59,6%. Personal antecedents were informed by patients suffering arterial hypertension in 31 (28,4%, bronchial asthma and chronic obstructive lung disease in 26 (23,9%, diabetes in 19 (17,4%, ischemic heart disease in 19 (17,4%, alcoholism in 5 (4,6% and valvulopathies in 4 (3,7%. Among the signs found in the thorax´s radiographies at the moment of admission, it prevailed the pattern of radiopacity diffuse hilar and bilateral parahilar in 31 patients (28,4%, followed by bilateral diffuse opacities toward medial and inferiors lobes in 16 (14,7%, unilateral diffuse radiopacity in 12 (11,0%, increment in the broncovascular network in 13 (11,9%, lobar consolidation in 7 (6,4% and pleural esfusion in 5 (4,6%. In 25 cases the initial X-ray films were normal. In electrocardiograms, alterations were verified of ST-T in 12 sick persons (11,0%, sinusal tachicardia in 12 (11,0%, supraventricular arrhythmias (that included acute auricular fibrillation and supraventricular paroxysmal tachicardia in 7 (6,4% and ventricular arrhythmias in 2 (1,8%. The complications verified with more frequency were the

  18. Çanakkale Muharebelerimde Cephede ve Cephe Dışında Sağlık Hizmetleri

    Directory of Open Access Journals (Sweden)

    Ahmet ESENKAYA

    2011-04-01

    Full Text Available It is essential to know not only the shooting-war in the combats occurred in different fronts in the Gallipoli peninsula like Seddülbahir, Arıburnu, Anafartalar and Suvla, but also how the medical services such as hospital was operated in those fronts. With launching the Gallipoli campaign, the entente states aimed at a front which would last very shortly and bring many gains. However, their all expectations came to naught. The Gallipoli became a long-duration battle-front and resulted in more casualties than expected. On the other hand, that situation was a resurrection for Turkish people. Nevertheless, the price of the victory was very high. Due to long-term battle, there were so many injuries as much as the number of deaths. The case of injury was accompanied by pediculosis, malaria, cholera, dysentery, paratyphoid, typhus, icterus, inflammation and scorbutic. Besides, the war environment also brought about some other health problems among soldiers. These were in general insomnia, asthenia, irregular heartbeats and deafness. Despite all these problems, hygenic measures were carried out sensitively. The Turkish Medical Department averted any imminent spread of infectious disease among the army which was deployed in a narrow area. In 9 months, 110.220 injuries, 70.939 patients and those who needed sick leave were sent to the hospitals of "Menzil" and "Kızılay". In this period, 48.268 patients and 22.619 injuries were treated at hospitals. Surprisingly, the deathrate at hospitals was low. Only 11.6 per cent of patients and 2.7 per cent of injuries were lost. The hospitals of the fifth army were dominantly in østanbul. When the hospitals reached full capacity, the army and Kızılay began to use the public buildings such as schools as hospitals, just like the Balkan wars. Since most of their students were in the battle, the medical schools, Gülhane and østanbul, interrupted their education and became additional military hospitals. This

  19. 王国三治疗癫痫经验%Experience of WANG Guo-san in treating epilepsy

    Institute of Scientific and Technical Information of China (English)

    赵立新; 张春丽; 赵建新

    2011-01-01

    王国三认为癫痫在急性发作期以痰扰心窍为关键,非急性发作期尤以肾虚是癫痫发病之根.总结其治法与用药特点,急性发作期重在清心豁痰开窍,善用栀子、石菖蒲、远志、瓜蒌、生半夏等;潜镇安神法贯彻始终,常用龙骨、牡蛎、紫贝齿、磁石、龙齿、珍珠母等;非急性发作期以调补气血为主,喜用太子参、当归、白芍、龙眼肉、柏子仁、酸枣仁等,并注重温阳补肾,善用补骨脂、巴戟天、肉苁蓉、淫羊藿等.并认为多数就诊患者病程已久,或久服抗癫痫西药有副作用,切勿一味疏肝理气,或一派虫类熄风止痉,必须时时顾护正气.%According to the theory made by WANG Guo-san, it is critical that the phlegm blocked the heart in the acute stage,kidney asthenia is the fundamental reason of epilepsy's occurrence out of acute stage. Make summary of his medication experience,the methods of clearing the heart,sweeping phlegm and opening the orifices are very important in acute stage,the herbs of common gardenia fruit,thinleaf milkwort root,mongolian snakegourd fruit and ternate pinellia are commonly used.The methods of subduing,settling and quieting the spirit remain consistent from the start to the very end, the herbs of dragon's bones,common oyster shell,arabia cowry shell,magnetite,dragon's teeth and nacre crc.are commonly used. In the non acute stage, the methods of regulating qi and blood are mainly suggested,the commonly used herbs are different leaves pseudostellaria root tuber, chinese angelica, white peony root, dried longan pulp, chinese arborvilae seed and spine date seed. Meanwhile,the methods of warming yang and invigorating the kidney are emphasized usually,suggested herbs including fructus psoraleae,medicinal morinda root,desertliving cistanche herb,short-homed epimedium herb etc. Doctor WANG also believes that most patients have long disease history,the anti-epileptic have side effect.In avoiding of the

  20. O laboratório clínico livre de mercúrio The clinical laboratory free of mercury

    Directory of Open Access Journals (Sweden)

    Evelyn Rodrigues

    2011-06-01

    contaminated fish. It affects the central nervous system and the inhalation of mercury vapors cause asthenia, fatigue, anorexia, weight loss and gastrointestinal disturbances. The contamination detection is carried out through hair and blood sample analysis. The replacement of mercury-containing equipment used in health services is crucial in order to reduce environmental and occupational hazards. OBJECTIVE: To describe the implementation of "Zero Mercury" program at the Central Laboratory Division of University of São Paulo Medical School Hospital - CLD/USP-MSH (Divisão de Laboratório Central do Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo [DLC/HC-FMUSP]. METHODS: The project was developed within the period of three years (2008-2010. During its elaboration, the action plans were defined, including a training program for the team responsible for the implementation of equipment and reagent replacement. RESULTS: By the end of the project, CLD/USP-MSH received an honorable mention by the Brazilian Ministry of Labor and Employment for the fulfillment of "Mercury Zero" program requirements. CONCLUSION: A mercury-free laboratory environment requires managerial commitment, a consistent action plan and staff awareness of health and environmental risks.

  1. Tentative suggestion of chronic gastritis TCM syndrome differentiation flowchart based on gastric mucosa image%据胃黏膜像慢性胃炎辨证流程图的初步构思

    Institute of Scientific and Technical Information of China (English)

    燕东; 王维武; 白宇宁

    2015-01-01

    目的:研究慢性胃炎的胃黏膜像表现与中医辨证之间的关系,进一步探寻简明实用的微观辨证方法。方法通过调查表收集396例慢性胃炎患者的胃镜下胃黏膜像表现,同时行中医辨证分型,行数据统计分析得出结论。结果脾胃湿热型较其他型易出现胆汁反流,黏液池呈黄绿色;全胃炎多发生于脾胃虚弱(含虚寒)型;胃络瘀阻型在黏膜以白相为主、镜下诊断为萎缩性胃炎等方面较其他型多见,出现黏膜糜烂者也明显多于其他证型;胃络瘀阻型及胃阴不足型黏膜血管网改变的比例较高。据此可建立据胃黏膜像辨证流程图。结论部分胃黏膜像与慢性胃炎的中医辨证之间存在一定程度的关联,据此建立的胃黏膜像辨证流程图简明实用,可为临床中医诊治提供参考帮助。%Objective It is to study the relationship between the gastric mucosa image and TCM syndrome differentiation of chronic gastritis patients, to further explore a practical and concise approach of microscopic differentiation.Methods TCM syndrome differentiations were performed on in 396 gastritis patients who were collected by schedule of survey, and their gastric mucosa images were analyze.Then the relationship between the syndrome differentiation and image was analyzed.Results The patients of dampness-heat of spleen and stomach syndrome were more easily get bile reflux and yellow-green mucus pool( P<0.05).The patients of weakness of the spleen and the stomach syndrome (including asthenia-cold) were more easily get the full stomach inflammation(P<0.05).The patients of gastric blood stasis syndrome were more easily get a pale mucosa and be diagnosed as atrophic gastritis than other syndromes(P<0.05).Gastric blood stasis syndrome showed significant association with mucosalerosion and such patients always get a higher risk of mucosalerosion than the ones of other syndromes(P<0.01). Gastric blood stasis

  2. Síndrome Poliglandular Autoinmune Tipo II: Posible Asociación con HLA DRB1*-DQB1* Possible association of Type II Autoimmune Polyendrocrine Syndrome with HLA DRB1*-DQB1*

    Directory of Open Access Journals (Sweden)

    M.S. Mallea Gil

    2010-12-01

    Full Text Available Los síndromes poliendocrinos autoinmunes (APS asocian enfermedades endocrinas autoinmunes con otros desórdenes autoinmunes no endocrinos. El APS tipo II se caracteriza por compromiso primario suprarrenal, tiroideo y/o DM tipo I. Presentamos un paciente masculino de 46 años que fue internado por astenia, adinamia, hiporexia, severa disminución de peso, mareos y vómitos. Antecedente de obesidad y diabetes diagnosticada 3 años antes. Presentaba hipotensión arterial, hiperpigmentación de mucosas y pliegues, anemia, hiponatremia e hipoglucemias frecuentes a pesar de la disminución de la dosis de insulina. Se diagnosticó insuficiencia suprarrenal, concomitantemente con hipotiroidismo y diabetes tipo 1, todas de origen autoinmune, iniciándose reemplazo hormonal. Se encontró una posible asociación del HLA DRB1*-DQB1* en los estudios genéticos. Conclusiones: Nuestro paciente presenta el HLA DQB1*0302 descripto en el APSII, pero el HLA DRB1 *08 encontrado no está descripto en este síndrome ni en ningún otro desorden autoinmune. En pacientes con Diabetes tipo 1 que disminuyan el requerimiento insulínico, habría que descartar insuficiencia suprarrenal, un componente del APS II, como factor etiológico, a pesar de su baja prevalencia.Autoimmune polyendocrine syndromes (APS are the association of autoimmune endocrine diseases with other non-endocrine autoimmune disorders. Type II APS is defined by occurrence of Addison´s disease with thyroid autoimmune disease and/or type 1 diabetes mellitus. We present a 46-year-old male patient who was hospitalized because of asthenia, adynamia, hyporexia, severe loss of weight, dizziness and vomiting. Diabetes mellitus had been diagnosed 3 years earlier when he was obese. He presented arterial hypotension, anemia, darkening of the skin and oral mucosa, hyponatremia and frequent hypoglycemia although his insulin dose was decreased. Adrenal insufficiency was diagnosed together with hypothyroidism and type

  3. Meta-analysis of EGFR tyrosine kinase inhibitors compared with chemotherapy as second-line treatment in pretreated advanced non-small cell lung cancer.

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    Ning Li

    Full Text Available Since efficacy and safety of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs versus chemotherapy in the treatment of patients with pretreated advanced non-small cell lung cancer (NSCLC remain controversial, we performed a meta-analysis to compare them.An internet search of several databases was performed, including PubMed, Embase, and the Cochrane database. Randomized trials that compared an EGFR-TKI with chemotherapy in the second-line setting were included. The outcomes were progression-free survival (PFS, overall survival (OS, objective response rate (ORR, and grade 3-4 toxicities. The PFS, OS for the EGFR mutation-positive (EGFR M+ and EGFR mutation-negative (EGFR M- subgroups were pooled. The pooled hazard ratios (HRs and odds ratios (ORs with their corresponding confidence intervals (CIs were calculated on the STATA software.Our meta-analysis combined 3,825 patients from 10 randomized trials. Overall, EGFR-TKIs and second-line chemotherapy have equivalent efficacy in terms of PFS (HR, 1.03; 95%CI, 0.87-1.21; P = 0.73; I2 = 78.7%, Pheterogeneity<0.001, OS (HR, 1.00; 95%CI, 0.92-1.08; P = 0.90; I2 = 0.0%, Pheterogeneity = 0.88, and ORR (OR, 1.34; 95%CI, 0.86-2.08; P = 0.20; I2 = 73.1%, Pheterogeneity<0.001. However, subgroup analysis based on EGFR mutation status showed that second-line chemotherapy significantly improved PFS (HR, 1.35; 95%CI, 1.09-1.66; P = 0.01; I2 = 55.7%, Pheterogeneity = 0.046 for EGFR M- patients, whereas OS was equal (HR, 0.96; 95%CI, 0.77-1.19; P = 0.69; I2 = 0.0%, Pheterogeneity = 0.43; EGFR-TKIs significantly improved PFS (HR, 0.28; 95%CI, 0.15-0.53; P<0.001; I2 = 4.1%, Pheterogeneity = 0.35 for EGFR M+ patients, whereas OS was equal (HR, 0.86; 95%CI, 0.44-1.68; P = 0.65; I2 = 0.0%, Pheterogeneity = 0.77. Compared with chemotherapy, EGFR-TKIs led to more grade 3-4 rash, but less fatigue/asthenia disorder, leukopenia and

  4. Capítulo 4: histoplasmose Chapter 4: histoplasmosis

    Directory of Open Access Journals (Sweden)

    Miguel Abidon Aidé

    2009-11-01

    asymptomatic. The symptoms of acute or epidemic histoplasmosis are high fever, cough, asthenia and retrosternal pain, as well as enlargement of the cervical lymph nodes, liver and spleen. The most common radiological findings are diffuse reticulonodular infiltrates in both lungs, as well as hilar and mediastinal lymph node enlargement. In chronic pulmonary histoplasmosis, the clinical and radiological manifestations are identical to those of reinfection with pulmonary tuberculosis. Histoplasmosis is diagnosed by means of the identification or culture growth of the fungus in sputum or fiberoptic bronchoscopy specimens. Histopathological examination reveals the fungus itself within or surrounding macrophages, as well as granulomatous lesions with or without caseous necrosis. Double agar gel immunodiffusion is the most easily used and readily available serologic test for making the immunological diagnosis. Acute histoplasmosis with prolonged symptoms requires treatment, as do the disseminated or chronic pulmonary forms of the disease. The drug of choice is itraconazole.

  5. Reaproveitamento do sangue em cirurgia com circulação extracorpórea: utilização de processadora por fluxo descontínuo Re-utilization of blood in surgery with extracorporeal circulation: utilization of discontinous flow procedure

    Directory of Open Access Journals (Sweden)

    Maurício Galantier

    1987-04-01

    -transfusion, total hemodilution during perfusion, re-utilization of suctioned blood as well as re-utilization of the oxygenative residual blood (by processing them in discontinuous flow procedure were used. With those methods, there was a significant reduction of transfused volume (324ml in average at trans-operative and 272ml at post-operative period; 34% of patients did not receive blood during operation; 36% did not utilize post-operatively and 20% did not use it during the whole period of hospitalization. Also significant anemia was not noted (hematocrit in immediate post-operative was 38.4% and at the 5th post-operative day 35.9% what lessens the risk of asthenia, sleepness, inaction, lung secretion and thromboembolic phenomenon, mainly in elderly patients, without interfering in the total cost of surgery.

  6. [Contraception and hepatogastroenterology].

    Science.gov (United States)

    Grimaud, J C; Bourliere, M

    1989-05-01

    Complications of oral contraceptives (OCs) affecting the gastrointestinal tract, liver and pancreas are rare but potentially serious. Hepatobiliary complications are by far the most frequent and varied. Hepatic lesions will probably decline in frequency as low-dose OCs replace higher dosed pills. Intrahepatic cholestasis induced by OCs resembles that of pregnancy. There may be a genetic predisposition to both conditions involving a dose-dependent estrogen effect of decreasing bile secretion. Intrahepatic cholestasis appears within 6 cycles of OC use. Symptoms include pruritus with anorexia, asthenia, vomiting, and weight loss without fever, rash or abdominal pain. Termination of OCs clears the condition without sequelae within 1-3 months, sometimes after a temporary aggravation. A moderate and asymptomatic cytolysis may appear when OC treatment is begun. Sinusoidal dilatation has been conclusively linked to OCs although few cases have been published. Clinical manifestations other than hepatomegaly are variable. Abdominal pain and fever are the most common. The condition is not related to duration of use and disappears 5-15 days after OC use is terminated. The relative risk of Budd-Chiari syndrome in OC users is estimated at 2.37. OCs increase the prevalence of hepatic adenomas as a function of duration of treatment. They are usually discovered fortuitously but may be revealed by vague abdominal pains. Hemorrhagic complications are more likely in OC users. It may be difficult to distinguish between adenomas, hepatocellular carcinoma, and focal nodular hyperplasia. A puncture biopsy guided by sonography may aid diagnosis. The natural history of adenomas is poorly understood and treatment remains controversial. OCs do not appear to increase the risk of focal nodular hyperplasia but they increase the size of the tumor and the risk of hemorrhage. OCs should be terminated because of risk of hemorrhage. Surgical resection is not indicated unless there are complication or

  7. Wilson病患者神经心理特征与中医证型的相关研究%Study on Correlation between Neuropsychological Features and Chinese Medical Syndrome Types in Patients with Wilson's Disease

    Institute of Scientific and Technical Information of China (English)

    王共强; 王明姝; 童广安; 孙丹丹; 张龙; 胡文彬

    2013-01-01

    correlations between the integrals of Chinese medical syndrome types and results of the 3 tests were analyzed. Results (1) There was statistical difference in the total scores of R'SPM, the word interference time of CWT, and interference effects of TMT among the 3 syndrome types (P GSYDS >GDDHS. The severity of asthenia was higher than that of sthenia.

  8. Ebola Virus Disease (EVD and Women's Health Care in Pregnancy

    Directory of Open Access Journals (Sweden)

    Arash Khaki

    2015-01-01

    sex or the use of condoms during sex, as well as avoidance of breastfeeding and contact with the mucous membranes of the eye for at least 3 months after recovery, are still recommended to avoid possible exposure to EBOV in the aforementioned immunologically protected sites. Male survivors may be able to transmit the disease via semen for nearly two months(2. Pregnancy The number of infected women was slightly higher than the number of infected men.In research that done by Mupapa in 2000 confirmed, Among 105 women 15% were pregnant and one of those survived. The mortality rate among pregnant woman with Ebola virus was slightly higher (93.3% than during the overall epidemic in the area (77%. The mortality rate for non-pregnant women was 70%(6-7. Pregnant women might suffer hemorrhage due to various reasons such as Placenta Previa or abortion, making it difficult to diagnose Ebola in pregnant women. During an outbreaks of Ebola each expectation mother with bleeding receives care as a suspected Ebola patient, they may need blood transfusion and/or abortion and post-abortion care(6-7. Symptoms in Pregnancy Most clinical sign of ebola disease in pregnant women are: fever, asthenia, abdominal pain, conjunctivitis, anorexia, diarrhea, hiccups, arthralgia, shock, dysphagia, nausea, vomiting, retrosternal pain, cutaneous eruptio, increased respiratory rate. All infected women had with signs of hemorrhage, including severe genital bleeding, melena, gum bleeding, ecchymosis, bleeding at injection sites, hematemesis, petechia, and hematuria, respectively(7. Neuropsychiatric symptoms in pregnant women Headache, anxiety, decreased consciousness, apathy, coma, delirium, and convulsions, respectively(7. Abortion Spontaneous abortion is frequent. A high frequency of abortion has also been observed during infection. Previous study was confirmed that (67% of the pregnancy ended with an abortion in infected women with Ebola virüs(7.

  9. 针灸治疗脑卒中后认知障碍研究进展%Research progress on treating post-stroke cognitive impairment with acupuncture and moxibustion

    Institute of Scientific and Technical Information of China (English)

    王嘉麟; 张志军; 胡皓; 张岩; 吴业清; 池学洋; 高明超; 吴浩; 段锦秀; 郭晓; 董洪坦; 邢佳; 贺立娟; 朱晓晨; 郭蓉娟; 张允岭; 金香兰; 王玲玲; 孟宪慧

    2015-01-01

    认知障碍是脑卒中患者常见并发症,导致患者日常生活能力、社会适应能力、生活质量明显下降,并且严重影响患者躯体、行为和情绪等康复,目前西药治疗效果不突出。中医认为本病病位在脑,病性为本虚标实,病机为髓减脑消,病理因素主要痰瘀蒙蔽脑窍,窍闭神匿,神失所用。针灸治疗中风后认知功能障碍临床已取得客观疗效,针刺治疗的具体方法包括体针法、醒脑开窍针刺法、头针法、项针、电针、眼针等。临床中多种针灸方法联合,或与药物、认知功能训练等结合使用,可延缓病情进展、明显改善患者生存质量。临床上认知测验是识别和诊断认知障碍的重要工具。%Cognitive impairment as a common complication of stroke, could lead to the decrease of daily life ability, social adaptation ability and life quality of patients and influence the recovery of physical, behavior and emotion, while the therapeutic effect of western medicine in treatment of cognitive impairment after stroke was not significant Traditional Chinese medicine hold that the disease location of this disease was in the brain. The character of the disease was deficient in origin and asthenia in superficiality, and the pathogenesis was encephala reducing. The pathological factors of this disease included phlegm-stasis, phlegm-stasis beclouded in brain and lead to spirit hidden and out of run. Treating cognitive impairment after stroke with acupuncture and moxibustion had achieved objective curative effect. The acupuncture therapy included body acupuncture therapy, acupuncture therapy of restoring consciousness, scalp acupuncture therapy, nape acupuncture, electro-acupuncture, eye acupuncture and so on. A variety of ac-upuncture and moxibustion therapy combined with medicines and cognitive function training could delay progression of disease and improve the life quality of patients. Cognitive test was the

  10. “儿科宗师”钱乙的组方规律与用药特色探析%Analyze the Prescriptions Organization Principle and Medicine Usage Characteristics of Qian Yi, the Great Master of Pediatrics

    Institute of Scientific and Technical Information of China (English)

    刘敏; 闫军堂; 刘晓倩; 王庆国; 潘利叶

    2014-01-01

    Objective]To analyze the prescriptions organization principle and medicine usage characteristics of Qian Yi, the great master of pediatrics. [Method]Through reading the book, Xiao'er Yao Zheng Zhi Jue, we analyze Qian Yi's medical records and prescriptions and summarize his medicine usage characteristics. [Result]We summarize the prescriptions organization principle and medicine usage characteristics as seven respects. They are changing old prescriptions, creating new prescriptions, medicate gently, never reinforcing the sluggish and violent, noticing the ascending and descending qi activity, medicating accurately and drug forms changeable, and so on.[Conclusion]Qian Yi medicated accurately and gently, noticed the children physiological and pathological Characteristics and the cold or heat, asthenia or sthenia degree of five zang-organs. Under the principle of trying one's best to remove the pathogenic factors, he emphasized that elimination did not harm healthy qi as wel as reinforcement did not stagnate pathogenic factors, and medicated either reinforcing and eliminating in combination or cold and warm simultaneously. Qian Yi strived to medicate gently, to reverse the doctors' abusing aromatic and violent medicine in that era. That has a great influence on the medicine usage of pediatricians in later era.%[目的]探讨“儿科宗师”钱乙的组方规律与用药特色。[方法]通过研读《小儿药证直诀》,对钱乙的临床验案及方剂药物进行分析与归纳,总结其组方用药的学术特色。[结果]钱乙的组方规律与用药特色为以下七个方面,即:化裁古方,创制新方,用药务求柔润,力戒呆补峻补,注意升降气机,用药精专以及剂型多变等。[结论]钱乙制方遣药,精炼轻灵,处处注意到小儿生理病理特点及五脏的虚实寒热,在祛邪务尽的原则下,力求攻不伤正,补不滞邪,或消补兼施,或寒温并投,并从柔润方面下功夫,以

  11. Carotid Doppler and transcranial Doppler in diagnosing transient ischemic attack: A healthy control

    Institute of Scientific and Technical Information of China (English)

    Huiling Chen; Jinhua Qiu; Hongying Liu

    2006-01-01

    BACKGROUND: If changes of hemodynamics in internal or external cranial artery and stenosis of atherosclerosis are found early, patients with transient ischemic attack (TIA) may be treated at an early phase so as to prevent and decrease the onset of cerebral infarction. Carotid Doppler can analyze carotid canal wall, hemodynamic properties and stenosis, and changes of plaque morphology; however, transcranial Doppler (TCD)can evaluate vascular stenosis and occlusion and judge collateral circulation in cranium through detecting velocity and direction of blood flow. Can the association of them increase the diagnostic rate of TIA?OBJECTIVE: To evaluate the effect of the association of carotid Doppler and TCD on TIA in internal carotid artery.DESIGN: Contrast observational study.SETTING: Department of Neuroelectrophysiology, Central People's Hospital of Huizhou.PARTICIPANTS: A total of 54 patients with TIA in internal carotid artery were selected from the Department of Neurology of Huizhou Central People's Hospital from May 2004 to June 2005. There were 35 males and 24 females aged 46-81 years. The clinical situation was asthenia of single limb, hemiplegia, anaesthesia of single upper or lower limb, hemianesthesia, sensory disorder and aphasia. The symptoms lasted for less than 2 hours. All cases were diagnosed with CT, and those who had pathological changes of acute cerebral infarction and history of cardiac disease were excluded. Additionally, 50 healthy subjects who were regarded as control group were selected from the Department of Neurology of Huizhou Central People's Hospital. There were 30 males and 20 females aged 45-80 years. All subjects were consent.METHODS: HD15000 color Doppler ultrasound (Philips Company, USA) and Muliti-DopX2 TCD (DWL Company, Germany) were used to detect hemodynamics, stenosis and distribution of atherosclerosis in carotid artery and internal carotid artery. Evaluation of marker: Stenosis was calculated by the ratio between the minimal

  12. 太原地区绝经综合征流行病学调查%Epidemiological Investigation of Menopausal Syndrome in Taiyuan

    Institute of Scientific and Technical Information of China (English)

    赵晔

    2015-01-01

    Objective To discuss the TCM syndrome distribution characteristics and relative factors of women who are 40-60 years old living in Wanbailin district of Taiyuan and help to lay a foundation for the standardization, normalization of syndrome and clinical diagnosis and treatment. Methods The author adopted the method of random sampling . And the object are 228 women diagnosed with syndrome. Besides that the author conducted epidemiological cross-sectional analysis in the form of questionnaire survey. Results The age of high incidence was 45-54, and the average age is 49.57 years old. The usual symptoms are as follows:hot flushes and sweat out , anxiety, insomnia, paracenesthesia, tiredness dizziness. The patients with menopause syndrome is more tired and headachy, but less hot flushed and sweat out. Syndrome of asthenia of both yin and Yang deficiency of kidney yin, kidney yin deficiency, deficiency of liver yin and kidney yin are the most common. Conclusion Menopausal syndrome is influenced by many factors, such as the patient's age, occupation, cultural degree distribution, the author find that the work stress has correlation with the occurrence of menopausal syndrome. Chinese medicine symptom frequency above 80%are:sweating forgetful,irritability. kidney and liver hold the mostly symptoms. Common clinical syndrome is that both yin and yang deficiency of kidney yin, kidney yin deficiency ,deficiency of liver yin and kidney yin and the stagnation of liver qi .%目的 探讨太原地区40~60岁绝经综合征女性的中医证候分布特点及相关因素,为绝经综合征辨证的规范化、标准化和临床诊治奠定一定基础.方法 采用随机取样的方法,抽取太原市万柏林社区诊断为绝经综合征妇女为调查对象,并以问卷调查的形式进行流行病学横断面调查.结果 本次调查的288例绝经综合征患者平均年龄49.57岁.高发年龄段为45~54岁.Kupperman症状评分中围绝经期患者疲乏无力、头痛积

  13. 贵阳市社区居民脑血管病及危险因素问卷调查%Questionnaire Survey of Cerebrovascular Disease and Risk Factors In The GUIYANG City Community

    Institute of Scientific and Technical Information of China (English)

    井绪西; 陈赞军; 付桂丽; 侯丽; 陈安强; 金建平; 刘康; 龙胜利; 梁忠明; 翁颖; 尤丛笑; 张曦

    2009-01-01

    Objective To investigate morbidity,risk factors and clinical symptom of cerebrovascular disease in the Guiyang community. Methods In the sixteen cornmunity,19715 people above 30 years-old were selected. The data of four groups(30 ~ 39,40 ~ 49,50 ~ 59, ≥60years-old) was comparatively analyzed. Results The morbidity of the cerebrovascular disease was 5.1% in last five years in the sixteen community. The incidence of smoking and drinking in 30 ~ 49 years-old two groups was the highest-level comparated other groups. The mor-bidity of the cerebrovascular disease,the hypertension, the diabetes mellitus, the coronary heart disease, and the hyperlipoidemia was raise as they continue into old age. The incidence of clinical symptom of cerebrovascular disease for instance dizzy, asthenia, Unilateral hypodynamia, unilateral neglect and simple eye blurred vision and so on was raise as they continue into old age. Conclusion In order to prevent and control the cerebrovascular disease of people in community, we should focus on its clinical features, take appropriate measures, such as quist smoking, controlling drinking and Primary Prevent in the under 49 years-old people. The above 49 years-old should take secondary and third prevention, such as pay close attention to their blood pressure, blood sugar, blood-fat and so on. We should guide their periodic physical examination, timing hospitalize, proper dose and ad-justing diet composition, strengthening physical exercise.%目的 探讨贵阳市社区居民脑血管病患病情况、危险因素、与脑血管病相关的临床症状的发生率.方法 采用采用分层整群随机方法对16个社区的30岁以上居民问卷调查,按年龄每10岁(60岁以上归入一组)一组分别统计.结果 各个年龄段5年累加的脑血管病患病率为5.1%;吸烟、饮酒率在30~49岁两个年龄段最高;脑血管病、高血压、糖尿病、冠心病、高血脂均随年龄增大而患病率增加;而与脑血管病

  14. 聚类分析与主成分分析在颈椎病中医证型规范化研究中的应用%Cluster analysis and principal component analysis in traditional medical syndrome types and Standardization of cervical spondylosis

    Institute of Scientific and Technical Information of China (English)

    王春晓; 谢兴文; 李宁

    2011-01-01

    BACKGROUND: Recently, the classification of cervical spondylosis is relatively single, lacking the features of Chinese medicinesyndrome types in dialectically treating the disease. The previous methods of classifying cervical spondylosis are Ihe summaries□f personal experiences without objective base. Therefore, il is significant to investigate syndrome classification using clusteranalysis and principal component analysis.OBJECTIVE: To investigate the distribution traits in cervical spondylosis according to different symptom types of traditionalChinese medicine using cluster analysis and principal analysis.METHODS: The questionnaire was designed according to the clinical manifestations in cervical spondylosis patients. Symptoms,clinical signs, tongue, pulsa and other diagnostic messages of 575 patients were collected, to analyze 98 common symptomsusing cluster analysis and principal component analysis.RESULTS AND CONCLUSION: According to the results of cluster analysis, the disease could be divided into eight categories:dampness-heat energizer, phlegm and wet resistance channels and collaterals, deficiency of qi and blood, deficiency ofliver-Kidney yin. Deficiency of (tie spleen and kidney-yang/. Blood stasis and qi stagnation, cold dampness resistance channelsand collaterals, deficiency of liver and spleen. We found that mosl of their disease mechanisms were "state of evil domination",which was caused by qi stagnation, dampness-heat, cold dampness, phlegm-dampness, blood stasis. Meanwhile, because of theexistence of asthenia of healthy 171, the main representation was deficiency of yin, deficiency of yang, deficiency of qi anddeficiency of blood. Cluster analysis and principle component analysis are scientific to some extent used in the research oftraditional Chinese medical syndrome types.%背景:目前对于颈椎病的中医分型相对单一,缺乏各型颈椎病一一分型辨治的中医特色与特点.以往各型颈椎病分型主要是以个人经验

  15. Eighty three cases of post transfusion HCV infection: a 10-year follow up%由一个献血员所致83例丙型肝炎病毒感染者10年的自然转归

    Institute of Scientific and Technical Information of China (English)

    邓开盛; 程明亮; 任红; 刘三都

    2011-01-01

    目的 了解输血后丙型肝炎病毒感染者的临床特征及其自然病史.方法 采用横断面调查与回顾性调查相结合的方法,对1998年1月-2002年7月输受同一供血者血液的83侈HCV感染患者进行临床资料调查,同时进行抗-HCV,HCV RNA,肝功能生物化学指标,腹部B型超声检查.计量资料用7检验,计数资料用x2检验,等级资料用秩和检验.结果 抗-HCV阳性83例,HCV RNA阳性56例,丙型肝炎慢性化率为67.4%,其中男性76.3%(29/38),女性60.00%(27/45),两者差异无统计学意义(x2=2.99,P=0.11).HCV RNA阳性组的平均年龄为(36.54±14.37)岁,HCV RNA阴性组平均年龄为(27.43±12.51)岁,差异有统计学意义(T=-2.41,P=0.018).供血者感染HCV基因为1b型.HCV RNA阳性患者中有10例表现为轻度乏力、纳差、腹胀,9例ALT轻度升高,12例B型超声检查提示有慢性肝炎改变,1例为肝硬化失代偿期.结论 输血后感染HCV者临床表现隐匿,慢性化与受感染时的年龄有一定关系.%Objective To find out clinical characteristics and natural history of post transfusion HCV infection. Methods 83 subjects who have received the blood from a same blood donor from January 1998 to July 2002 were investigated by the method combining cross-sectional study with retrospective study. HC V-antibody, HCV RNA, liver function, abdomen B-ultrasound and Fibroscan were detected. Results The HCV-antibody were all positive. The HCV RNA of 56 out of the 83 cases were positive. The chronicity rates of hepatis C were 76.3% (29/38) in male patients and 60.00% (27/45) in female patients respectively, without significant difference (x2 = 2.99, P = 0.11). The average age of the HCV RNA positive patients was (36.54 ± 14.37) years old. The average age of the HCV RNA negative patients was (27.43 ± 12.51) years old. A significant difference (T = -2.41, P = 0.018) existed between. The HCV genotype was typelb. Among the HCV RNA positive patients, 10 cases were with mild asthenia

  16. AL Amyloidosis

    Directory of Open Access Journals (Sweden)

    Desport Estelle

    2012-08-01

    Full Text Available Abstract Definition of the disease AL amyloidosis results from extra-cellular deposition of fibril-forming monoclonal immunoglobulin (Ig light chains (LC (most commonly of lambda isotype usually secreted by a small plasma cell clone. Most patients have evidence of isolated monoclonal gammopathy or smoldering myeloma, and the occurrence of AL amyloidosis in patients with symptomatic multiple myeloma or other B-cell lymphoproliferative disorders is unusual. The key event in the development of AL amyloidosis is the change in the secondary or tertiary structure of an abnormal monoclonal LC, which results in instable conformation. This conformational change is responsible for abnormal folding of the LC, rich in β leaves, which assemble into monomers that stack together to form amyloid fibrils. Epidemiology AL amyloidosis is the most common type of systemic amyloidois in developed countries with an estimated incidence of 9 cases/million inhabitant/year. The average age of diagnosed patients is 65 years and less than 10% of patients are under 50. Clinical description The clinical presentation is protean, because of the wide number of tissues or organs that may be affected. The most common presenting symptoms are asthenia and dyspnoea, which are poorly specific and may account for delayed diagnosis. Renal manifestations are the most frequent, affecting two thirds of patients at presentation. They are characterized by heavy proteinuria, with nephrotic syndrome and impaired renal function in half of the patients. Heart involvement, which is present at diagnosis in more than 50% of patients, leading to restrictive cardiopathy, is the most serious complication and engages prognosis. Diagnostic methods The diagnosis relies on pathological examination of an involved site showing Congo red-positive amyloid deposits, with typical apple-green birefringence under polarized light, that stain positive with an anti-LC antibody by immunohistochemistry and

  17. Therapeutic Effects of Taurine Combined with Silibinin in 100 Patients with Non-alcoholic Steatohepatitis%牛磺酸联合水飞蓟宾治疗非酒精性脂肪性肝炎100例

    Institute of Scientific and Technical Information of China (English)

    何仁辉; 白宇鹏

    2013-01-01

    Objective To evaluate the therapeutic effects of taurine combined with silibinin in patients with non-alcoholic steatohepatitis(NASH).Methods 200 cases of NASH patients were randomly divided in the treatment group(100 cases)and the control group(100 cases).Patients in the treatment group received taurine combined with silibinin for 24 weeks,and patients in thecontrol group received silibinin for 24 weeks.All patients were recommended to abstain from alcohol,improve dining structure,take moderate aerobic exercises,and keep body weight.Clinical symptoms,blood pressures,body mass indexes (BMI)and waist circumferences were observed before and after treatment in all patients ;liver functions,blood lipid and fasting glucose levels were tested,type-B ultrasonic and CT images were evaluated before and after treatment in all panents.Results After treatment,the significant improvement of clinical symptoms and laboratory tests;type-B ultrasonic and CT examination showed that steatohepatitits were ameliorated in both groups(P<0.05).Therapeutic effects in the treatment group were superior to those in the control group in aspect of symptoms amelioration including asthenia,liver area discomfort,nausea and vomiting,decrease of systolic and diastolic blood pressure,BMI,serum ALT,GGT,triglyceride and cholesterol levels;in addition,ultrasonic or CT examination showed that extents of steatohepatitits amelioration were better in the treatment group(P<0.05).Waist circumferences reduced significantly after treatment in women in the control group,men and women in the treatment group (P<0.05).Conclusion Taurine is effective in patients with NASH,and combination of taurine and silibinin has superior treatment efficacy compared with taurine alone in patients with NASH.%目的 评价牛磺酸联合水飞蓟宾治疗非酒精性脂肪性肝炎(NASH)的疗效.方法 将200例NASH患者随机分为治疗组(100例)和对照组(100例).治疗组采用牛磺酸联合水飞蓟宾治疗,对

  18. Intensive Farmaco- Surveillance of Interferon Alpha 2b Recombinant in Multiple Sclerosis. Farmacovigilancia intensiva al interferón alfa 2b recombinante en la esclerosis múltiple.

    Directory of Open Access Journals (Sweden)

    Hailen Bobillo López

    Full Text Available

    Background: The interferon alpha 2b recombinant, produced in Cuba, is used in the treatment of different illnesses, such as the multiple sclerosis. For its commercialization it is needed to know its safety scope. Objective: To assess the adverse reactions of interferon alpha 2b recombinant in the treatment of multiple sclerosis. Method: During the period between 1996 and 2006, 70 clinical histories and data collection notebooks of patients included in the randomized double blind national clinical trial phase IV were revised. This trial was developed in the Clinic of Multiple Sclerosis of the Hospital "Dr. Gustavo Aldereguía Lima" in Cienfuegos. With regard to the total of manifested adverse reactions we analyzed type, length, and use of a given treatment to counteract them, intensity level (light, moderate, serious or lethal and causality level (definitive, probable, possible, conditional or not related. Results: 53 patients out of the total presented 207 adverse reactions to interferon. The most frequent were: fever, migraine, chills, arthralgia, asthenia and myalgia, being most of them moderate collateral effects of definitive character. In 197 patients the outcome was favorable. Conclusion: The use of the interferon alpha 2b

  19. Colectomia direita associada à gastroduodenopancreatectomia em bloco por tumor infiltrativo de cólon: relato de caso Right colectomy associated to gastroduodenopancreatectomy in bloc for infiltrative colon tumor: case report

    Directory of Open Access Journals (Sweden)

    Maria Auxiliadora Prolungatti Cesar

    2009-09-01

    gastroduodenopancreatectomy. CASE REPORT: Man,73 years old, white, that for eight months presented asthenia,and lost approximately 20kg. Physical examination: mass in right flank of approximately 15cm. The colonoscopy demonstrated right tumor of colon, adenocarcinoma. Durin a surgery it was observed ascending tumoral mass involving colon until hepatic angle invading the second to the third duodenal portion. Right colectomy associated with gastroduodenopancreatectomy was performed. The pathological exam differentiated adenocarcinoma of duodenal and pancreatic thick intestine with metastasis and angio-lymphatic infiltration. The patient survived for 8 months. CONCLUSION: The gastroduodenopancreatectomy must be considered the absence of distant metastasis and when the clinical condition of the patient not to allow and was the behavior adjusted for this patient.

  20. 股骨头坏死及髋关节置换后髋关节解剖参数变化的10年跟踪**☆%Changes in anatomical parameters of the hip following femoral head necrosis and hip replacement:A 10-year follow-up survery

    Institute of Scientific and Technical Information of China (English)

    宋雅伟; 张曦元; 戎科

    2013-01-01

    leading to the periarticular soft tissue contraction asthenia. Attention should be paid to maintaining and restoring the deformed parts. The traction after hip replacement recovered the center edge angle somewhat. As a result of long-term curtch walking, the compression on the healthy side was less than that of the ordinary people. A natural form of gravity-assisted traction was shown in the lower limbs. We should pay attention to the recovery of relative acetabular position on the healthy side. As a result of femoral head necrosis, femoral head col apse was observed in the overload area, joint cavity and pelvic height was decreased obviously. After operation, the femoral head and relative acetabular position on the healthy side were restored somewhat, but relative ipsilateral position difference was more obvious.

  1. 青年男性中医体质分类与生殖健康的相关性研究%The correlation study on TCM body constitution classification and the reproductive system diseases in young man

    Institute of Scientific and Technical Information of China (English)

    吉保民; 胡海翔; 罗少波

    2011-01-01

    目的 研究青年男性中医体质辨证分类与生殖健康的相关性。方法 对749例调查对象通过填写“男性体质调查表”,结合查体进行体质辨证,以期了解男性体质类型的构成及其与生殖健康的关系。结果 接受调查者年龄在18~35岁。包皮过长者中,气郁质、瘀血质明显多于平和质(P<0.01);前列腺炎患者中,湿热质、气郁质明显多于平和质(P<0.01);精索静脉曲张患者中,气虚质、瘀血质多于平和质(P<0.01);包茎患者中,阳虚质明显多于平和质(P<0.01);早泄患者中,气虚质、阴虚质、特禀质明显多于平和质(P<0.01);勃起功能障碍患者中,阴虚质、特禀质明显多于平和质(P<0.01);不育症患者中,阳虚质、阴虚质、瘀血质明显多于平和质(P<0.01)。结论 青年男性中医体质辨证类型与生殖系统健康状况有一定相关性。%Objective To study the correlation between the body constitution classifications of traditional Chinese medicine (TCM)and the reproductive system diseases in young man. Methods All 749 objects took physical examination about the reproductive system diseases, filled in the questionnaire of male body constitution, and differentiated TCM classifications of body constitution. Results The incidence rate of redundant prepuce of depressed vital energy constitution and stagnant blood constitution was obviously higher than balance constitution (P<0.01) , the incidence rate of prostatitis of dampness-heat constitution and depressed vital energy constitution was obviously higher than balance constitution (P<0.01), the incidence rate of varicocele of Qi asthonia constitution and stagnant blood constitution was obviously higher than balance constitution(P<0.01), the incidence rate of phimosis of Yang deficiency constitution was obviously higher than balance constitution (P<0.01) , the incidence rote of prospermia of Qi asthenia constitution

  2. Whole brain radiation therapy with simultaneously integrated brain metastases boost a planning and effect study%脑转移癌螺旋断层放疗剂量学特点和近期疗效分析

    Institute of Scientific and Technical Information of China (English)

    路娜; 王雅棣; 姚波; 陈点点; 刘清智

    2014-01-01

    included cerebral edema ,asthenia ,alopecia ,decreased hearing and memory.Conclusion Whole brain radiotherapy combined with simultaneous integrated boost-tomotherapy has bet-ter dosimetric characteristics and safe in clinics ,and can be used in radiotherapy for brain metastases.

  3. Cultural differences in patterns of mood states on board the International Space Station

    Science.gov (United States)

    Boyd, Jennifer E.; Kanas, Nick; Gushin, Vadim I.; Stephanie Saylor

    2007-10-01

    Based on our previous studies of astronauts and cosmonauts, we hypothesized that the patterning of mood states among International Space Station (ISS) crewmembers would vary by culture, regardless of the overall frequency of these states in each cultural group. Russian clinicians recognize a pattern of distress known as asthenia. According to the asthenia model, depression should covary with fatigue. According to the American model of psychological distress, depression and fatigue are two separate syndromes and therefore would be less likely to covary within individuals. Previously, we found support for this cultural difference in patterns of mood states in two data sets. Our team's new study of ISS personnel provided an opportunity to replicate these analyses again. Results show the predicted cultural differences for crewmembers during flight. These results are consistent with Russian space psychologists’ concept of asthenization, which is believed to be an early indicator of stress among cosmonauts during long-duration space missions. However, American astronauts manifest distress differently. It is important to use culturally appropriate assessment strategies in order to detect stress reactions accurately while they are still mild, because they have the potential to seriously disrupt future international space missions, such as a flight to Mars. Russian Abstract КУЛTУPAЛЬHЫE PAЗЛИХИЯ ПPOФИЛEЙ HACTPOEHИЙ HA БOPTУ MКC Ha бaзe нaщиx пpeдыдyщиx иccлeдoвaний кocмoнaвтoв и acтpoнaвтoв, мы пpeдcтaвили гипoтнзy o тoм; чтo пpoфили нacтpoeний cpeди члeнoв экипaжa Meждyнapoднoй Кocмичecкoй Cтaнции (MКC) paзличны в paзныx кyльтypax, нecмoтpя нa aбcoлютнoe кoличecтвo этиx cocтoяний в кaждoй гpyппe. Poccийcкиe cпeциaлиcты coзнaют cиндpoм диcкoмфopтa нaзывaeмый≪acтeния≫. C

  4. Risk factors for cardiorespiratory failure in infants with hand, foot and mouth disease and establishment of risk score model%手足口病心肺衰竭危险因素分析及其风险评分模型的建立

    Institute of Scientific and Technical Information of China (English)

    付海燕; 石伟娜; 王晓明; 赵欣; 刘俊莹; 殷润开; 殷春兰; 贾彬; 李海花; 张静

    2012-01-01

    infection,rashes,drowsiness,vomiting,abnormal respiratory rhythm,limb asthenia, convulsion, the time from eruption of skin rash or oral ulcer to the appearance of central nervous system symptoms, peripheral blood leukocytes, percentage of lymphocyte, and random glucose level. Logistic regression was used to examine the relationship between risk factors and cardiorespiratory failure. A risk score model was built according to the above factors. The predictive effect of the model was evaluated by sensitivity, specificity, consistency and area under receiver operating characteristic (ROC)curve. Results In the multivariable analysis,4 variables in the risk evaluation model (the highest temperature, vomiting, random glucose level and abnormal respiratory rhythm) remained independent predictors of the outcome. The risk score model highly predicted cardiorespiratory failure. The area under the ROC curve for the evaluation model was 0.994. When the prediction was performed based on the existing date using the presut model, the sensitivity,specificity and consistency of the model were 94.12%(64/68) ,97.71%(128/132)and 94.48%( 192/199), respectively. Conclusions The risk score model was a quantitative and effective tool for predicting cardiorespiratory failure in infants with hand,foot and mouths disease.

  5. Epidemiology of Chronic Diabetic Complications and Research of Symptoms of Traditional Chinese Medicine amongNewly- diagnosed Type 2 Diabetes%新诊断2型糖尿病慢性并发症的调查分析及中医证型的研究

    Institute of Scientific and Technical Information of China (English)

    李洁; 杜续; 杨兴智; 钟文; 龚光明; 亓鲁光; 文後

    2011-01-01

    ciency syndrome (r = 0. 113, P < 0. 05), the blood stasis syndrome significantly ( r = 0. 196, P<0.01) . Conclusions The the mor bidity of newly-diagnosed type 2 diabetes mellitus chronic complications is high, awareness rate is low. "The sugar toxin" and "the lipid toxin" possibly is the important factor which accelerate occurrence of chronic complications, the prevention should pay great atten tion to control the multiple risk factors. Characteristics of diabetic chronic complications is " asthenia in origin and excess in superficiali ty" . "Deficiency、 blood stasis" are throughout diabetes and its chronic complications. "Qi and yin deficiency, hlegm-damp and blood stasis blocking venation" possibly is the common pathologic foundation causing the diabetic chronic complications.%目的:调查新诊断2型糖尿病(T2DM)患者的临床特征及慢性并发症情况,探讨新诊断T2DM的中医证型与慢性并发症的关系.方法:根据本研究的病例纳入及排除标准,按照统一制定的调查表对成都中医药大学附属医院2008年12月~2010年12月内分泌科的门诊及住院新诊断T2DM患者,采集其临床及中医辨证分型资料,按照有无并发症分组,进行相关统计学分析,比较两组间的差异.结果:被纳入的188例新诊断T2DM患者中,有111例存在至少1种慢性并发症,患病率高达59.04%.在有慢性并发症组中,合并脂代谢紊乱的患病率最高,达61.3%.新诊断T2DM的中医证型仍以气阴两虚证为主,虚证证候比例显著高于实证,气虚证候频率大于阴虚证候,实热证候频率不足20%,两组的虚证证候之间无显著性差异(P>0.05),两组实证证候中痰湿证和血瘀证的P值均<0.01,有显著性差异;糖尿病大血管病变与气虚、阴虚、血瘀证呈正相关(r =0.102、0.107、0.118,P<0.05),与痰湿证呈显著性正相关(r=0.166,P<0.01);糖尿病微血管病变与气虚证呈正相关(r=0.113,P<0.05),与血

  6. 妊娠中期合并神经系统疾病21例临床分析%Clinical Analysis of Pregnancy in Second Trimester among 21 Women with Nervous System Diseases

    Institute of Scientific and Technical Information of China (English)

    谢峰; 董会卿; 王凤英; 沈霞光

    2013-01-01

    Objective:To investigate the clinical characteristics,diagnosis,treatment,outcome of pregnancy in second trimester among pregnant women(14~27w) with nervous system diseases. Methods:The clinical data of 21 pregnant women in second trimester with nervous system diseases who were treated in Xuanwu hospital in nearly 10 years were retrospectively analyzed. Results: Among the 21 patients, 18 patients were complicated with brain damage,in which 4 patients with epilepsy,3 with intracranial venous sinus thrombosis,2 with vascular malformations,2 with intracranial aneurysms,2 with cerebral infarction,2 with encephalitis,3 with acute inflammatory demyelinatiny encephalomyelitis,2 with Spinal cord arteriovenous malformation,1 with my-asthenia gravis.The main clinical features were:headache.nausea,vomiting,convulsion,even status epileptic-us,numbness,general fatigue. After diagnosis by examination such as EEG,CT,MRI,MRV,DSA,and so on, and corresponding treatment according to the type of nervous system, among the 21 patients, 19 are alive,and out of them 1 is discharged,out of them 1 died.2 cases remain functionally impaired. 12 routine in ethacridine totally amniotic cavity induced puncture,4 cases of drug abortion,1 case accepted the caesarean section.2 cases maintain pregnancy to term cesarean section technique,the newborn live. Conclusions:The patients in second trimester complicated with nervous system diseases should be payed special attention, diagnosed as soon as possible and treated actively. For the mother's safety,termination of pregnancy should be conducted after evaluation of the necessity of middle induced labor after stabilizing the condition of nervous system diseases, and the safe method shouled be choosed to terminate the pregnancy.%目的:探讨妊娠中期合并神经系统疾病的临床特点、诊断、治疗方法和妊娠结局.方法:回顾性分析首都医科大学宣武医院近十年收治的妊娠中期合并神经系统疾病21例

  7. 反流性食管炎中医证型及舌象与胃镜下表现的相关性研究%Correlation Study between TCM Syndrome Types, Tongue Signs and Endoscopic Manifestation of Reflux Esophagitis

    Institute of Scientific and Technical Information of China (English)

    李贞玉; 刘敏

    2013-01-01

    目的 研究反流性食管炎(RE)中医证型及舌象与胃镜下表现的相关性.方法 对102例符合入选条件的RE患者的流行病学信息、中医证型、舌象及食管黏膜胃镜下表现进行观察和分析.结果 在102例RE患者中,病程较短者以热证、实证多见,病程长者以虚证多见,不同病程的RE患者中医证型分布差异具有统计学意义(P<0.05).RE胃镜下分级为Ⅰ级的患者多为肝胃郁热、脾胃湿热、肝胃不和证,Ⅱ级者多为脾胃湿热及脾胃虚弱证,Ⅲ级者以脾胃虚弱及胃阴不足证为主,不同中医证型的胃镜下分级的差异有统计学意义(P<0.01).幽门螺杆菌(Hp)阳性的RE患者在脾胃湿热及肝胃郁热证型中分布较多,不同中医证型的Hp感染的差异有统计学意义(P<0.05).食管黏膜粗糙不平的RE患者以淡红舌多见,其他食管黏膜各损伤类型均以红舌常见,食管黏膜充血、水肿、糜烂、渗出物增多均以薄黄苔多见,黏膜粗糙不平以白腻苔多见,舌象与食管黏膜表现分布差异具有统计学意义(P<0.05).结论 RE中医证型与病程、胃镜下表现、Hp感染之间以及RE舌象与食管黏膜表现之间存在一定的相关性.%Objective To study the relationship between TCM syndrome types, tongue signs and gastroscopic manifestation of reflux esophagitis (RE). Methods The epidemiologic messages, TCM syndrome types, tongue signs and the gastroscopic manifestation of 102 RE patients were observed and analyzed. Results Patients with short-term course mainly showed heat and sthenia syndrome, while asthenia syndrome was common in long-lasting course. The TCM syndrome distribution was statistically significant different between RE patients with different disease courses (P<0.05). RE can be classified into three grades according to the gastroscopic manifestation with statistically significant difference (P<0.01). Grade I was mainly in type of stagnant heat in liver and stomach

  8. Analysis on the clinical characteristics and treatment of intracranial venous and sinus thrombosis%颅内静脉系统血栓形成的临床特征与疗效分析

    Institute of Scientific and Technical Information of China (English)

    陈书红; 周广喜

    2011-01-01

    middle-aged women. The common causes were pregnancy, infection, immunological disorder, etc. Acute or subacute clinieal characteristics were headache (71.43%, 10/14), aeizure (35.71%, 5/14), asthenia (21.43%, 3/14), and CSF pressure was aignificantly high in most patients. The imaging findings were cerebral venous and sinus occlusion and cerebral parenchymal impairment (infarction, hemorrhage, brain edema). There were 7 and 5 effective cases in argatroban group and heparin group, respectively (Z = - 0.067, P = 0.950). In both group, the neural function [National Institute of Health Stroke Scale (NIHSS) score] was significantly improved after treatment (P = 0.007). Conclusion Intracranial venoua and sinus thrombosis should be highly suspected in patients who have no common risk factors for stroke, but with acute intracranial hypertensive symptoms such as headache, vomitinS, and cortex symmetric infarction on CT scanning. AlthouSh cerebral angiography is the golden gtandard for the diagnosis of intracranial venous and sinus thrombosis, most patients can be early diagnosed by magnetic resonance imaging (MRI) and magnetic resonance venography (MRV). The difference in curative effect is not aignificant between argatroban and heparin. The patient with intracranial venous and sinus thrombosis may get more benefit when anticoagulant therapy ia given earlier and actively.

  9. 参附强心丸对腺嘌呤致肾阳虚大鼠温阳利水作用及机制研究%Research of Effects and Mechanism of Shenfuqiangxin Pills on the Warming Yang for Diuresis of Kidney-yang Deficiency Rats Caused by AdenineΔ

    Institute of Scientific and Technical Information of China (English)

    王梓; 张浩; 郝迪; 李旭; 袁玲; 王蕾

    2015-01-01

    OBJECTIVE:To probe into the effects and mechanism of Shenfuqiangxin pills on the warming yang for diuresis of chronic renal failure rats via the link of signs, renal function, neuroendocrine hormone, serum electrolytes and renal tissue morphology, etc.METHODS:The CRF model of rat was established by“unilateral nephrectomy combined with gavageing adenine”, the rats were divided into the model control, dexamethasone group and the dosage group with Shenfuqiangxin pills of 2.14 g/kg, 1.07 g/kg, 0.54 g/kg in crude drug via the random number table.The indexes of neuroendocrine hormone, renal function, blood electrolytes, body temperature, ratio of the kidney weight versus kidney volume and the form of organization of kidney in rates were observed.RESULTS: Some asthenia signs like sparse fur, sedentary lying and emaciation were observed in rats in mode group.The general conditions in three dosage groups of Shenfuqiangxin pills had been significantly improved.Level of UREA and CREA contents increased significantly in mode group,which in three dosage groups of Shenfuqiangxin pills were significantly lower than that in mode group.In mode group and three dosage groups of Shenfuqiangxin pills, angiotensinⅡ( AngⅡ) were significantly lower than that of sham-operation group, but aldosterone (ALD) were significantly higher than that of sham-operation group.Compared with the mode group, ALD in dosage group with 2.14 g/kg Shenfuqiangxin pills and dexamethasone group were obviously decreased, the differences were statistically significant ( P <0.05 ).Hyperkalemia, low calcium and hyperphosphatemia of rats were observed in the mode group, dosage group with 2.14 g/kg Shenfuqiangxin pills could correct hypocalcemia, and three dosage groups of Shenfuqiangxin pills all could correct hyperphosphatemia; the dexamethasone group could correct hyperkalemia, low calcium and hyperphosphatemia of rats,the differences were statistically significant(P<0.05).The body temperature of rats in

  10. 乌头属植物中毒事件的病因判定%An etiological judgment of a poisoning event caused by Acontium plant

    Institute of Scientific and Technical Information of China (English)

    谢立璟; 王效俊; 侯小平; 刘全儒; 王英伟; 龙鑫; 马沛滨; 孙承业

    2013-01-01

    Disease Control and Prevention (CDC) hastened to the scene to conduct epidemiological investigation,to obtain the clinical features of the poisoning patients,and to collect the specimen of blood and vomitus of patients and the fresh sample of suspicious poisonous plants.Chinese Center for Disease Control and Prevention organized the relevant institutes to conduct morphological and DNA molecular identification of the poisonous plant,toxin detection of the blood and vomitus specimen.The above-mentioned results were synthesized to determine the poisoning reason and provide guidance for clinical diagnosis and treatment.Results On May 30,2010,13 staffs in a metal company in Tacheng District picked and ate the "wild celery" which grew in nearby mountain.Within 15 to 30 minutes after eating the "wild celery",they successively developed numbness in mouth,lips,and limbs,as well as asthenia,nausea and vomiting.They were sent to a local hospital,4 patients died on the way to the hospital,other 9 patients received rescue therapy in the hospital,2 of them died about 4 hours after poisoning despite resuscitation attemempts.The morphological identification of fresh sample of suspected poisonous plants was demonstrated as Aconitum,Raunnculaceae.Aconitine was detected in a vomitus specimen and 3 blood specimens.The aconitine content in blood specimens were 0.17,0.25 and 0.48 μg/L,respectively.The result of DNA molecular identification showed that the fresh leaves of suspected poisonous plants collected from the scene belonged to the same species of Acontium.This event was determined as a sudden poisoning event caused by picking and eating Acontium stems and leaves by mistaken.Conclusion The etiological judgment model for poisoning event might play an important guiding role in the determination of the cause of poisoning events.

  11. Factor analysis of TCM patterns in 200 patients with chronic glomerulo-nephritis%200例慢性肾小球肾炎中医证候因子分析研究

    Institute of Scientific and Technical Information of China (English)

    王剑飞; 王耀献; 何萍; 于瀚; 王佳麟; 刘玉宁

    2016-01-01

    目的 依据临床流行病学方法和原则,通过回顾性临床调研,对200例慢性肾小球肾炎患者中医证候进行研究,探求慢性肾小球肾炎正虚与邪实的证候分布特点.通过采用因子分析法对中医证候的分布规律进行分析和归纳,客观再现慢性肾小球肾炎中医证候的本质.方法 采用问卷调查的形式对患者临床症状进行记录.运用因子分析统计学方法提取支配慢性肾小球肾炎四诊变量的公因子,根据专业知识对其进行分析和解释.结果 ①因子分析结果得出13个公因子,其中因子10的出现率最高,其包括的中医证候为湿热证和瘀血证;单纯本虚证的因子中以气虚为主的因子8的出现率最高.②传统人为证候分析与因子分析结果之间存在显著差异(P<0.01).结论 慢性肾小球肾炎本虚证以气虚发生率最高,而标实证以湿热和瘀血最为多见,提示湿热和瘀血是慢性肾小球肾炎的重要病机.因子分析虽不能代替传统中医辨证,但能对中医证候进行较理想的分离,顺利得到独立的证候分组,特别是发生率在前3位的证候中两者都包括了瘀血证和气虚证,这也验证了临床证候研究部分的主要研究结论.%Objective In accordance with the method and principle of clinical epidemiology,a retrospec-tive survey of 200 patients with chronic glomerulonephritis was carried out to study the rules of TCM pat-terns,ao as to discover the distribution features of asthenia of healthy qi and sthenia of pathogenic fac-tors.By using the factor analysis to analyze and summarize the distribution rules of TCM patterns,the na-ture of TCM pattern of chronic glomerulonephritis was explored.Methods The clinical symptoms of the 200 patients were recorded by using questionnaire responses.By the method of factor analysis,the com-mon factors which dominated the variables of four diagnosis for chronic glomerulonephrits were extracted, analyzed and interpreted

  12. Alteração de mobilidade de prega vocal unilateral: avaliação subjetiva e objetiva da voz nos momentos pré e pós-fonoterapia Unilateral vocal fold mobility alteration: objective and subjective evaluation of voice quality on prior and post speech therapy

    Directory of Open Access Journals (Sweden)

    Ana Cristina Cortes Gama

    2011-08-01

    through chart review, which analyzed the recorded voices of 12 individuals with otorhinolaringology diagnosis of unilateral vocal fold paralysis. The collected material was the sustained emission of the vowel /a/, and then connected speech. The voices before and after therapy were analyzed by using GRBASI scale. The parameters for spectrographic analysis were: shape of the spectrographic tracing, degree of browning of harmonics, stability of the tracing of harmonics, presence of noise, presence of harmonics, presence of sub-harmonics and harmonics definition. The measurement of the maximum phonation time for the vowel /a/ represented the highest value among three emissions. The obtained data were submitted to statistical analysis through Wilcoxon Test Ranking. RESULTS: in the perceptual analysis, the parameter that has changed in the post-treatment was breathiness (B (p=0.003, followed by dysphonia grade (G (p=0.004 and asthenia (A (p=0,01, and those results were statistically significant. As for the spectrogram, we found an improvement of the tracing in 91% of patients, and the changed parameters were: increase in number of harmonics (32% and reduction in noise (24%. Measurement of the maximum phonation time of the vowel /a/ was higher in the post-speech therapy (p = 0.003. CONCLUSION: speech therapy treatment of unilateral vocal fold paralysis improved perceptual-hearing and spectrographic data and the maximum phonation time of voice.

  13. 温脾补肾法联合高效抗逆转录病毒治疗对HIV/AIDS患者免疫功能影响的研究%Research on the effects of warming spleen and tonifying kidney combined with HAART on immune function of HIV/AIDS patients

    Institute of Scientific and Technical Information of China (English)

    吴广伟; 朱克武; 李茂清; 陈美玲; 肖学义

    2014-01-01

    +/CD8+,blood routine,liver and kidney function of two groups were observed before and after treatment,and we compared the clinical efficacy of two groups.Results ① Clinical benefit rate of treatment group and control group were 100% and 87.5% respectively,the difference between 2 groups was statistically significant (P < 0.05); ② Karovsky performance status and weight were improved in the treatment group (P < 0.05) and the TCM symptoms asthenia,the total clinical syndrome scores were better than those of control group after the treatment (all P < 0.05).③ CD4+ cell and white blood cell count of the treatment group were (264.97 ± 52.94)/mm3 and (6.94 ± 0.97)109/ L,which were better than (238.73 ± 50.13)/mm3 and (5.57 ± 1.29) 109/L in the control group (P < 0.05); ④ There was no obvious adverse reaction during treatment in two groups.Conclusion Warming spleen and tonifying kidney combined with HAART therapy can significantly improve the clinical symptoms of HIV/AIDS patients,and can enhance immune function and improve their quality of life,which may play a certain role in realization functional cure of HIV/AIDS.

  14. 白癜风患者中医体质临床研究%A clinical research on the somatotypes of patients with vitiligo from traditional Chinese medical view

    Institute of Scientific and Technical Information of China (English)

    潘毅; 许灿龙; 张思; 张超; 徐丽梅; 蔡瑞康

    2016-01-01

    ObjectiveTo investigate the characteristics of the constitution of the patients with vitiligo from traditional Chinese medical view, thus to provide epidemiological evidence for traditional Chinese medicine(TCM) treatment based on differential diagnosis of diseases, symptoms and signs, and constitutions.MethodsQuestionnaires were iflled by 296 patients with vitiligo, which designed including the following items: sex, age, course of disease, somatotypes in TCM, tongue demonstrations, pulse tracings, etc. The data were statistically analyzed to summarize the relationship between somatotypes and above factors.ResultsThe constituent ratio of the pathological somatotypes and balanced somatotypes was 82.16% and 17.84% respectively. There was significant difference between the two groups (P<0.01). The difference between the constituent ratio of various somatotypes patients with vitiligo has statistical signiifcance (χ2=99.506, P=0.000). This signiifcant difference also exists in different sex or ages (χ2=25.008,P=0.002,χ2=101.236,P=0.000, respectively) but not in different course of disease (χ2=7.692, P=0.464). There was signiifcant difference between different tongue demonstrations and pulse tracings (body of the tongue:χ2=392.381,P=0.000, coated tongue:χ2=345.646,P=0.000,pulse tracings:χ2=159.986,P=0.000, respectively). Red or carmoisine in color and big or fat in shape were frequently seen in the body of the tongue, so was white and greasy fur in coated tongue. Sunken or wiry pulse with small pulses were most common in vitiligo patients (P<0.01).ConclusionThe balanced constitution is the most common type of TCM somatotypes in vitiligo patients, followed by deifciency of vital energy, yin asthenia and other pathological constitution. The somatotypes of patients with vitiligo do have correlation with sex or ages but not the course of disease.%目的:探讨白癜风患者中医体质特点,为临床辨病、辨证、辨体质结合治疗白癜风提供

  15. Clinical application of digital orthopedics technique for surgical treatment of cranio-cervical junction diseases%数字骨科技术在颅颈交界疾患外科治疗中的临床应用

    Institute of Scientific and Technical Information of China (English)

    艾福志; 尹庆水; 夏虹; 张宇; 万磊

    2011-01-01

    prototype (CAD-RP) for all cases.Preoperational screw-insertion simulation of the model was performed for some cases to obtain the accurate angle and direction for the screw insertion.The drilling-gnided template of posterior C1/C2 transpedicualr screw was designed for some complicated posterior operations.The surgical treatments included 30 receiving transoral atlantoaxial reduction plate (TARP) internal fixation, 7 receiving afiantoaxial transpedicular screw internal fixation, and 6 receiving occipito-cervical internal fixation.Results Postoperatively thesymptoms of neck pain and extremity anesthesia or asthenia were improved to different degrees in all the 43 cases.Five patients of E degree (motor score was 100) preoperatively remained unchanged after the operation, but their neck pain was completely resolved.Nine of the 33 patients of D degree were improved to E degree after operation; the other 24 patients had no degree changes, but their motor scores increased to 86-100, with a mean of 96.2 ±4.1.Five patients of C degree improved to D degree.The motor score of the 38 patients of D and E degrees was increased by 5-35 ( 15.2 ±9.1 ) after operation.No neurological, vascular complications or screw-loosening was observed during a follow up of 3-12 months ( a mean of 7.3 months).Some patients receiving TARP internal fixation developed slight dizziness, which disappeared 2-4 weeks postoperatively.Conclusion The digital orthopedics techniques, including preoperative screw insertion simulation on the craniocervical model and the application of drilling-guided template for the C1/C2 transpedicular screw insertion, make the complicated cranio-cervical operation simple, safe and effective.

  16. Testes genéticos na eqüideocultura

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    Eduardo Geraldo Alves Coelho

    2008-07-01

    the progresses in the area of the animal genetics, which allow identifying, not only anomalies, but also several genes of economical interest. With the aid of the cytogenetics, individuals with alterations in the number or in the structure of the chromosomes can be identified, which in many cases affect mainly the reproduction. Also the genealogy confirmation, previously done by blood type and now by DNA tests, has extremely important role, not just for guaranteeing the origin of the animals. Due to a reliable pedigree, the breeder can identify the origin of genetic problems and can reduce or even eliminate them. With the tools of the molecular biology, today, we can identify individuals that present desirable or undesirable genes, allowing us to select them early, reducing the costs of the producer and increasing the joined value of the animals. Among those genes we can detach the ones that identify carriers or affected animals for undesirable genetic mutations such as: SCID (Severe Combined Immunodeficiency Disease, HYPP (Hyperkalemic Periodic Paralysis, HERDA (Hereditary Equine Regional Dermal Asthenia, etc. Also the identification of the genes that determine the coat color or coat pattern can already be made directly or indirectly (through genetic markers, as it is the case of the genes for the coat colors Overo, Tobiano, etc. With the progresses in the study of the equine genoma much more will be available soon, which will certainly bring larger contributions to the world horse breeding industry.

  17. Tabletas bucales oravescentes de fentanilo en el dolor episódico: revisión de datos clínicos Fentanyl oravescentes buccal tablets for episodic pain: review of clinical data

    Directory of Open Access Journals (Sweden)

    M. Nabal

    2012-02-01

    breakthrough pain Methods: non systematic review of the literature published in Medline supplemented by manual search of related work and grey literature. Keywords: "Breakthrough pain" OR "Cancer pain" AND "Fentanyl buccal tablets" OR "Rapid onset opioids." Limits: Language: English or Spanish and studies in adults over 18 years. Inclusion criteria: clinical work with content related to the presentation of oral fentanyl "oravescente". Exclusion criteria referring to work pharmacokinetics or pharmacodynamics of the drug or its dosage, the work of general epidemiological nature and those that were not obtained in full text even though the query to several databases and national libraries. Results: from the 29 papers found, 12 studies were included following the inclusion and exclusion criteria. 4 were randomized double blind clinical trials, 1 was a multicenter open, 1 systematic review, 4 non-systematic reviews and 2 expert opinion papers. The four trials confirm that the analgesic effect is present 5 minutes after administration of the drug. There were significant differences with placebo since the 10 minutes till the 90 minutes. These differences kept stable for 2 hours. The Sum of Pain Intensity Differences (SPID is favourable to the drug compared to placebo at 60 minutes after administration (p < 0.0001. It is noted that side effects mentioned were mild nausea (32%, vomiting (24%, asthenia (18%, constipation (15% and headache (15%. No reference to neurocognitive changes at times of peak plasma concentration or behaviors of addiction or abuse were detected. The non systematic reviews offer the expert insight on the treatment of breakthrough pain with an independent position. They criticized the inclusion criteria of randomized trials for introducing significant bias in the sample selection and the lack of oral fentanyl compared with standard treatments available. Conclusions: fentanyl tablets "oravescentes" have proven more effective than placebo in the episodic pain caused

  18. Rheumatoid arthritis complicated by peripheral neuropathy: an analysis of lesion characteristics in 5 cases%类风湿关节炎伴发周围神经病变5例特征分析

    Institute of Scientific and Technical Information of China (English)

    曾学军; 沈敏; 唐福林

    2005-01-01

    , is uncommon.OBJECTIVE: To analyze the clinical manifestations and laboratory findings of RA complicated by peripheral neuropathy in 5 cases.DESIGN: A retrospective case analysis based on patients as subjects.SETTING: Department of Rheumatism and Immunity, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College.PARTICIPANTS: Totally 567 RA patients were admitted to Peking Union Medical College Hospital from January 1983 to December 2002, including 5 cases of peripheral neuropathy. All the cases met the criteria for RA formulated by American Rheumatism Association(ARA), according to which 5 cases of peripheral neuropathy in the active phase were confirmed due to RA. The laboratory indexes in 5 cases accorded with the active core indexes of RA.METHODS: Clinical data of 5 cases of RA were analyzed, and symptoms of peripheral neuropathy, as well as the indexes recorded electrophysiologically and in laboratory were recorded and assessed MAIN OUTCOME MEASURES: Sex, age, course of disease, severity of muscle strength disorder and sensory disorder, electromyography(EMG),biopsy of muscle and nerve, and related laboratory indexes.RESULTS: Five cases were enrolled, including 2 males and 3 females, 42 to 60 years of age(meanly 52 years old), and the course of disease ranged 1 to 14 years, and 5.4 years on the average. Four cases were hospitalized for neurological manifestations, accounting for 80% (4/5), and the other one appeared to have decreased muscle strength and hypoalgesia. Asthenia and numbness of limbs and hypoalgesia of the distal of limbs occurred in 4 cases,paraesthesia in 3 cases, foot drop in 2 cases, carpoptosis in 1 case, myatrophy in 3 cases, decreased muscle strength in 5 cases, and tendon areflexia in 3 cases; joint swelling or pain during the appearance and aggravation of peripheral neuropathy in 4 cases, increased erythrocyte sedimentation, increased level of C-reactive protein, high-titer rheumatoid factor

  19. 新诊断2型糖尿病慢性并发症的调查分析及其中医证型的研究%Epidemiology of Chronic Diabetic Complications and Research of Symptoms of Traditional Chinese Medicine of Newly - diagnosed Type 2 Diabetes

    Institute of Scientific and Technical Information of China (English)

    龚光明; 亓鲁光; 李洁; 杨兴智; 钟文; 文俊

    2012-01-01

    with qi deficiency syndrome,yin deficiency syndrome,the blood stasis syndrome(r=0. 102,0. 107,0. 118 ,P <0.05) ,phlegm-damp syndrome significantly (r =0. 166, P <0. 01). Diabetes microvascular pathological changes have positive correlation with qi deficiency syndrome(r=0. 113, P < 0.05),the blood stasis syndrome significantly (r =0. 196, P < 0.01). Conclusion: The morbidity of newly -diagnosed type 2 diabetes mellitus chronic complications is high, awareness rate is low. The sugar toxin and the lipid toxin possibly are the important factor which accelerate occurrence of chronic complications, the prevention should pay great attention to control the multiple risk factors. Charac-teristics of diabetic chronic complications is "asthenia in origin and excess in superficiality". Deficiency and blood stasis are throughout diabetes and its chronic complications. Qi and yin deficiency,phlegm -damp and blood stasis blocking venation possibly are the common pathologic foundation causing the diabetic chronic complications.%目的:调查新诊断2型糖尿病(T2DM)患者的临床特征及慢性并发症情况,探讨新诊断T2DM的中医证型与慢性并发症的关系.方法:根据本研究的病例纳入及排除标准,按照统一制定的调查表对成都中医药大学附属医院2008年12月-2010年12月内分泌科的门诊及住院新诊断T2DM患者,采集其临床及中医辨证分型资料,按照有无并发症分组,进行相关统计学分析,比较两组间的差异.结果:被纳入的188例新诊断T2DM患者中,有111例存在至少1种慢性并发症,患病率高达59.04%.在有慢性并发症组中,合并脂代谢紊乱的患病率最高,达61.3%.经非条件Logistic 回归分析,WHR、低密度脂蛋白胆固醇(LDL - C)、胰岛素分泌指数对数值(InHOMA -β)低下、血流变学异常均为T2DM慢性并发症发生的危险因素.新诊断T2DM的中医证型仍以气阴两虚证为主,虚证证候比例显著高于实证,气虚证候频率大于阴

  20. 喉显微手术与传统术式治疗声带任克水肿的对照研究%A Comparative Study Between Laryngeal Microsurgery and Traditional Operation in the Treatment of Reinke’ s Edema of Vocal Cords

    Institute of Scientific and Technical Information of China (English)

    黄建强; 洪育明; 石小伟

    2016-01-01

    Objective To investigate the clinical efficacy of the self-retaining laryngeal microsurgical operation in the treatment of Reinke ’ s edema of vocal cords . Methods There were 24 cases of Reinke ’ s edema who were treated with self-retaining laryngoscope mucosal stripping surgery of vocal cords from January 2004 to December 2009 ( traditional group ) , while another group of 32 cases of Reinke ’ s edema were treated with self-retaining laryngoscopic microsurgery lateral submucosal incision micro-flap operation of vocal cords from January 2010 to December 2015 ( laryngeal microsurgery group ) .The two groups were executed with electronic laryngoscopy and subjective voice evaluation GRBAS ( The Speech and Language Institute of Japanese in 1979, G: Grade, R:Roughness, B:Breathness, A:Asthenia, S:Strain) in pre-operation and post-operation (1 week, 3 weeks, 8 weeks).The wound healing time of vocal cords , hoarseness improved time and voice improvement were retrospectively compared between the two groups . Results The patients in laryngeal microsurgery group had earlier voice hoarse improvement and more rapid mucosal epithelial of vocal cords recovery time in post-operation as compared with the patients in the traditional group [voice improving time, (7.3 ±1.9) d vs. (11.3 ±2.7) d, t=-6.481, P=0.000;mucosal epithelial of vocal cords recovery time , (12.2 ±3.1) d vs.(20.1 ±3.4) d, t=-9.062, P=0.000].The results of pre-operative voice evaluation with GRBAS showed no significant differences between the two groups, but the results of post-operative evaluation of each session (1 week, 3 weeks, 8 weeks) showed that the main data were statistically different.The GRBAS score of laryngeal microsurgery group was lower than that of traditional group in post -operation, especially after 8 weeks (8 weeks after post-operation, G:1.0 ±0.8 vs.1.6 ±0.2, t=-3.584, P=0.000; R:1.0 ±0.9 vs. 1.5 ±0.4, t=-2.536, P=0.014;B:1.0 ±0.6 vs.1.4 ±0.5, t=-2.647, P=0.011).In laryngeal