WorldWideScience

Sample records for twenty-four patients underwent

  1. Twenty-Four-Hour Mobility During Acute Hospitalization in Older Medical Patients

    DEFF Research Database (Denmark)

    Pedersen, Mette Merete; Bodilsen, Ann Christine; Petersen, Janne

    2013-01-01

    BACKGROUND: Inactivity during hospitalization in older medical patients may lead to functional decline. This study quantified 24-hour mobility, validated the accelerometers used, and assessed the daily level of basic mobility in acutely admitted older medical patients during their hospitalization...

  2. Twenty-four hour radioactive iodine uptake in 35 patients with amiodarone associated thyrotoxicosis

    Energy Technology Data Exchange (ETDEWEB)

    Martino, E.; Aghini-Lombardi, F.; Lippi, F.; Baschieri, L.; Safran, M.; Braverman, L.E.; Pinchera, A.

    1985-12-01

    Amiodarone associated thyrotoxicosis (AAT) occurs in approximately 10% of patients treated with this iodine rich drug in areas of mild iodine deficiency. The thyroid radioactive iodine uptake (RAIU) is usually undetectable or very low in iodine-induced thyrotoxicosis. In the present study, 35 patients with AAT were evaluated. Twelve patients had no thyroid abnormalities by physical exam and all had 24-hr RAIU less than or equal to 4%. In contrast, nine of 11 patients with AAT and diffuse goiters and eight of 12 patients with AAT and nodular goiters had RAIU values greater than 8%. In patients with AAT and goiter it appears possible that the thyroid fails to adapt normally to the excess iodide load, resulting in an inappropriately high RAIU in the presence of excess plasma iodine.

  3. Remission and rheumatoid arthritis: Data on patients receiving usual care in twenty-four countries

    DEFF Research Database (Denmark)

    Sokka, Tuulikki; Hetland, Merete Lund; Mäkinen, Heidi

    2008-01-01

    OBJECTIVE: To compare the performance of different definitions of remission in a large multinational cross-sectional cohort of patients with rheumatoid arthritis (RA). METHODS: The Questionnaires in Standard Monitoring of Patients with RA (QUEST-RA) database, which (as of January 2008) included 5...

  4. Remission and rheumatoid arthritis: Data on patients receiving usual care in twenty-four countries

    DEFF Research Database (Denmark)

    Sokka, Tuulikki; Hetland, Merete Lund; Mäkinen, Heidi;

    2008-01-01

    OBJECTIVE: To compare the performance of different definitions of remission in a large multinational cross-sectional cohort of patients with rheumatoid arthritis (RA). METHODS: The Questionnaires in Standard Monitoring of Patients with RA (QUEST-RA) database, which (as of January 2008) included 5...... exercise were statistically significantly associated with remission. CONCLUSION: The use of different definitions of RA remission leads to different results with regard to remission rates, with considerable variation among countries and between sexes. Reported remission rates in clinical trials...

  5. Twenty-four-hour intraocular pressure patterns in a symptomatic patient after ab interno trabeculotomy surgery

    Directory of Open Access Journals (Sweden)

    Mansouri K

    2014-11-01

    Full Text Available Kaweh Mansouri,1 Felipe A Medeiros,2 Robert N Weinreb2 1Glaucoma Sector, Department of Ophthalmology, Geneva University Hospitals, Geneva, Switzerland; 2Hamilton Glaucoma Center and Department of Ophthalmology, University of California, San Diego, La Jolla, CA, USA Abstract: We report the results of repeated ambulatory continuous 24-hour intraocular pressure (IOP monitoring with a contact lens sensor (CLS in a glaucoma patient with ocular pain after ab interno trabeculotomy (Trabectome™ surgery. Our findings show that a combined prostaglandin–pilocarpine treatment reduced nighttime IOP peaks and relieved the patient’s symptoms. Keywords: 24-hour, Trabectome contact lens sensor, prostaglandin–pilocarpine treatment

  6. Effects of Twenty-four Move Shadow Boxing Combined with psychosomatic relaxation on Depression and Anxiety in Patients with Type-2 Diabetes.

    Science.gov (United States)

    Zheng, Yingying; Zhou, Yiyi; Lai, Qiujia

    2015-06-01

    The aim of the current study was to observe the effects of Twenty-four Move Shadow Boxing combined with psychosomatic relaxation on depression and anxiety in patients with Type-2 Diabetes. One hundred and twenty (120) patients with Type-2 Diabetes and depressive/anxious symptoms were divided into intervention group (60 cases) and control group (60 cases) according to the minimum distribution principle of unbalanced indicators. Twenty-four Move Shadow Boxing group used this intervention combined with psychosomatic relaxation. Control group underwent conventional treatment. All the patients in the two groups completed the Self-rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) before and after treatment. Among the 52 people included in the statistical analysis, the recovery rate was 13.3%. The differences between depression and anxiety scores in the intervention group before and after treatment were statistically significant (PBoxing and psychosomatic relaxation has a beneficial auxiliary therapeutic effect on depression and anxiety accompanying Type-2 Diabetes.

  7. Twenty-Four-Hour Urinary Aldosterone Predicts Inappropriate Left Ventricular Mass Index in Patients with Primary Aldosteronism

    Directory of Open Access Journals (Sweden)

    Chi-Sheng Hung

    2013-01-01

    Full Text Available Objective. Primary aldosteronism (PA is associated with inappropriate left ventricular hypertrophy (LVH in relation to a given gender and body size. There is no ideal parameter to predict the presence of LVH or inappropriate LVH in patients with PA. We investigate the performance of 24-hour urinary aldosterone level, plasma renin activity and aldosterone-to-renin ratio on this task. Methods. We performed echocardiography in 106 patients with PA and 31 subjects with essential hypertension (EH in a tertiary teaching hospital. Plasma renin activity, aldosterone concentration, and 24-hour urinary aldosterone level were measured. Results. Only 24-hour urinary aldosterone was correlated with left ventricular mass index (LVMI and excess LVMI among these parameters. The multivariate analysis revealed the urinary aldosterone level as an independent predictor for LVMI and excess LVMI. Analyzing the ability of urinary aldosterone, plasma aldosterone concentration, and plasma aldosterone-to-renin ratio to identify the presence of LVH (ROC AUC = 0.701, 0.568, 0.656, resp. and the presence of inappropriate LV mass index (defined as measured LVMI in predicting LVMI ratio >135% (ROC area under curve = 0.61, 0.43, 0.493, resp. revealed the better performance of 24-hour urinary aldosterone. Conclusions. In conclusion, 24-hour urinary aldosterone level performed better to predict the presence of LVH and inappropriate LVMI in patients with PA.

  8. [Changes of twenty-four-hour profile blood pressure and its correction of patients with arterial hypertension on the background of combined antihypertensive therapy application].

    Science.gov (United States)

    Solomennchuk, T M; Slaba, N A; Prots'ko, V V; Bedzaĭ, A O

    2014-01-01

    The aim of this research was the study of efficiency and endurance antihypertensive therapy on the basis of fixed combination of enalapril and hydrochlorothiazide (HCTZ) and enalapril and HCTZ in combination with amlodipine according to the twenty-four-hour (? day-and-night) monitoring of blood pressure (? 24H BPM) of patients with arterial hypertension (AH) 2-3 severity. The study included 33 patients with 2-3 grade of hypertension (average age--54,40 ± 3.45 years). All patients performed ? 24H BPM before treatment and after 12 weeks of therapy. The combination of enalapril and HCTZ allowed to achieve target levels of blood pressure in 79% of patients, amlodipine additional purpose--in 86% of patients. We found that this therapy has a corrective effect on daily blood pressure profile, significantly reducing the load pressure and blood pressure variability. During treatment with the combination of enalapril and HCTZ combination of enalapril, HCTZ with amlodipine optimal daily profile of blood pressure after 12 weeks of reaching respectively 63.1% and 71.4% of patients. The treatment with combination of enalapril and HCTZ and adding of amlodipine is characterized by good endurance and high adherence to treatment.

  9. Neurocognitive performance and behavioral symptoms in patients with attention-deficit/hyperactivity disorder during twenty-four months of treatment with methylphenidate.

    Science.gov (United States)

    Wang, Liang-Jen; Chen, Chih-Ken; Huang, Yu-Shu

    2015-04-01

    This study investigated the trends in neurocognitive function and behavioral symptoms among patients with attention-deficit/hyperactivity disorder (ADHD) during 24 months of treatment with methylphenidate in a clinical setting. Study participants consisted of 181 ADHD patients with a mean age of 13.4±2.5 years (ages ranged from 8 to 18 years; 151 boys and 30 girls) who were prescribed oral short-acting methylphenidate two or three times daily, with each dose ranging between 0.3 and 1.0 mg/kg. At baseline and 6, 12, 18, and 24 months from baseline, neurocognitive function was assessed using the Test of Variables of Attention (TOVA) on the day the patient was off medication, and behavioral symptoms were evaluated using the Swanson, Nolan, and Pelham Version IV Scale for ADHD (SNAP-IV) parent form, the SNAP-IV teacher form, and the ADHD-Rating Scale (completed by a child psychiatrist). Of the 181 ADHD patients at the initial visit, 103 (56.9%) completed the study. During the 24-month methylphenidate treatment, only the commission errors in TOVA significantly improved; however, the omission errors, response time, response time variability, response sensitivity, and ADHD score did not. The behavioral symptoms of ADHD, observed by various informants, all declined substantially, and were significantly correlated with each other during the long-term follow-up. The severity of teacher ratings was lower than that of parent and psychiatrist ratings. However, the teacher-rated inattention symptoms showed the strongest correlations with TOVA performance. Findings suggest that neurocognitive deficits in ADHD patients, except inhibition ability, might be long lasting in realistic settings. In addition, obtaining behavior profile assessments from multiple informants, especially from teachers, is vital for establishing a complete understanding of ADHD patients.

  10. Twenty-four-hour Tl-201 delayed scan underestimates myocardial viability in patients with acute myocardial infarction after percutaneous transluminal coronary angioplasty

    Energy Technology Data Exchange (ETDEWEB)

    Mochizuki, Teruhito; Sugawara, Yoshifumi; Kikuchi, Takanori; Ikezoe, Junpei [Ehime Univ., Matsuyama (Japan). School of Medicine; Murase, Kenya; Higashino, Hiroshi; Miyagawa, Masao

    2001-04-01

    Myocardial viability in area at risk of acute myocardial infarction (AMI) after reperfusion therapy may be underestimated by the 24-hour images due to reverse redistribution (r-RD). Subjects were 37 AMI patients in whom Tc-99m pyrophosphate (PYP)/Tl-201 dual-isotope SPECT was positive. The 24-hour delayed scan was performed with only a Tl window. One month later, follow up rest Tl SPECT was performed to evaluate myocardial viability. In early (at PYP/Tl-201 dual-isotope SPECT), 24-hour, and one month follow up Tl studies, Tl uptake in the area of AMI was scored into four grades: 3 as normal to 0 as severely reduced. The scores were evaluated. Among the 37 AMI lesions, there were 16 r-RD, 3 RD, 16 fixed defect (FD) and 2 normal (positive PYP and normal Tl). Mean Tl scores were early; 1.4{+-}1.1, 24-hr; 0.9{+-}0.9 and one month; 1.3{+-}1.1. The 24-hour Tl score was lower than the early and one month Tl scores (p<0.01). Reverse redistribution is frequently observed in an area at risk where PYP SPECT was positive. Nuclear medicine physicians should be aware of the existence of frequent r-RD in Tl scan to avoid the underestimation of myocardial viability in the acute phase after PTCA. (author)

  11. Twenty-four-week effects of liraglutide on body composition, adherence to appetite, and lipid profile in overweight and obese patients with type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Rondanelli M

    2016-03-01

    Full Text Available Mariangela Rondanelli,1 Simone Perna,1 Paolo Astrone,2 Annalisa Grugnetti,2 Sebastiano Bruno Solerte,2 Davide Guido3,4 1Endocrinology and Nutrition Unit, Section of Human Nutrition, Department of Public Health, Experimental and Forensic Medicine, Agency for Elderly People Services, Santa Margherita Hospital, University of Pavia, Pavia, Italy; 2Section of Geriatrics and Gerontology, Department of Internal Medicine, Agency for Elderly People Services, Santa Margherita Hospital, University of Pavia, Pavia, Italy; 3Medical and Genomics Statistics Unit, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; 4Biostatistics and Clinical Epidemiology Unit, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy Background: Liraglutide has well-known effects on glucose patterns. However, its several other metabolic properties are still controversial. Given this background, the aims of the present study are to evaluate the effects of 24-week liraglutide treatment on body composition, appetite, and lipid profile in overweight and obese type 2 diabetes mellitus (T2DM patients. Methods: A cohort study was carried out on overweight and obese T2DM patients with glycosylated hemoglobin A1c equal to 6% (42 mmol/mol-10% (86 mmol/mol, under a 3-month treatment (at least with maximal dose of metformin as stable regime, by adding liraglutide at doses up to 3 mg/d. Body composition markers were measured by dual-energy X-ray densitometry at baseline and after 24 weeks of liraglutide treatment. Glucose control was monitored by glucose, glycosylated hemoglobin A1c, insulin, and homeostasis model assessment. Finally, the appetite sensation and plasma lipids were also evaluated. Results: Twenty-eight subjects (male/female: 16/12, mean age: 58.75±9.33 years, body mass index: 34.13±5.46 kg/m2 were evaluated. Accounting for the adjustment for age, sex, and duration of diabetes, we noted significant

  12. Clinical, functional and genetic analysis of twenty-four patients with chronic granulomatous disease - identification of eight novel mutations in CYBB and NCF2 genes.

    Science.gov (United States)

    Martel, Cécile; Mollin, Michelle; Beaumel, Sylvain; Brion, Jean Paul; Coutton, Charles; Satre, Véronique; Vieville, Gaëlle; Callanan, Mary; Lefebvre, Christine; Salmon, Alexandra; Pagnier, Anne; Plantaz, Dominique; Bost-Bru, Cécile; Eitenschenck, Laurence; Durieu, Isabelle; Floret, Daniel; Galambrun, Claire; Chambost, Hervé; Michel, Gérard; Stephan, Jean-Louis; Hermine, Olivier; Blanche, Stéphane; Blot, Nathalie; Rubié, Hervé; Pouessel, Guillaume; Drillon-Haus, Stephanie; Conrad, Bernard; Posfay-Barbe, Klara M; Havlicekova, Zuzana; Voskresenky-Baricic, Tamara; Jadranka, Kelecic; Arriazu, Maria Cristina; Garcia, Luis Alberto; Sfaihi, Lamia; Mansour, Lamia Sfaihi Ben; Bordigoni, Pierre; Stasia, Marie José

    2012-10-01

    Chronic granulomatous disease is an inherited disorder in which phagocytes lack a functional NADPH oxidase and cannot produce superoxide anions. The most common form is caused by mutations in CYBB encoding gp91phox. We investigated 24 CGD patients and their families. Twenty-one mutations in CYBB were classified as X91(0), X91(+) or X91(-) variants according to cytochrome b (558) expression. Point mutations in encoding regions represented 50 % of the mutations found in CYBB, splice site mutations 27 %, deletions and insertions 23 %. Eight mutations in CYBB were novel leading to X91(0)CGD cases. Two of these were point mutations: c493G>T and a double mutation c625C>G in exon 6 and c1510C>T in exon 12 leading to a premature stop codon at Gly165 in gp91phox and missense mutations His209Arg/Thr503Ile respectively. Two novel splice mutations in 5'intronic regions of introns 1 and 6 were found. A novel deletion/insertion c1024_1026delCTG/insT results in a frameshift introducing a stop codon at position 346 in gp91phox. The last novel mutation was the insertion of a T at c1373 leading to a frameshift and a premature stop codon at position 484 in gp91phox. For the first time the precise size of two large mutations in CYBB was determined by array-comparative genomic hybridization and carriers' status were evaluated by multiplex ligation-dependent probe amplification assay. No clear correlation between clinical severity and CYBB mutations could be established. Of three mutations in CYBA, NCF1 and NCF2 leading to rare autosomal recessive CGD, one nonsense mutation c29G>A in exon 1 of NCF2 was new.

  13. High-dose statin pretreatment decreases periprocedural myocardial infarction and cardiovascular events in patients undergoing elective percutaneous coronary intervention: a meta-analysis of twenty-four randomized controlled trials.

    Directory of Open Access Journals (Sweden)

    Le Wang

    Full Text Available BACKGROUND: Evidence suggests that high-dose statin pretreatment may reduce the risk of periprocedural myocardial infarction (PMI and major adverse cardiac events (MACE for certain patients; however, previous analyses have not considered patients with a history of statin maintenance treatment. In this meta-analysis of randomized controlled trials (RCTs, we reevaluated the efficacy of short-term high-dose statin pretreatment to prevent PMI and MACE in an expanded set of patients undergoing elective percutaneous coronary intervention. METHODS: We searched the PubMed/Medline database for RCTs that compared high-dose statin pretreatment with no statin or low-dose statin pretreatment as a prevention of PMI and MACE. We evaluated the incidence of PMI and MACE, including death, spontaneous myocardial infarction, and target vessel revascularization at the longest follow-up for each study for subgroups stratified by disease classification and prior low-dose statin treatment. RESULTS: Twenty-four RCTs with a total of 5,526 patients were identified. High-dose statin pretreatment was associated with 59% relative reduction in PMI (odds ratio [OR]: 0.41; 95% confidence interval [CI]: 0.34-0.49; P<0.00001 and 39% relative reduction in MACE (OR: 0.61; 95% CI: 0.45-0.83; P = 0.002. The benefit of high-dose statin pretreatment on MACE was significant for statin-naive patients (OR: 0.69; 95% CI: 0.50-0.95; P = 0.02 and prior low dose statin-treated patients (OR: 0.28; 95% CI: 0.12-0.65; P = 0.003; and for patients with acute coronary syndrome (OR: 0.52; 95% CI: 0.34-0.79; P = 0.003, but not for patients with stable angina (OR: 0.71; 95% CI 0.45-1.10; P = 0.12. Long-term effects on survival were less obvious. CONCLUSIONS: High-dose statin pretreatment can result in a significant reduction in PMI and MACE for patients undergoing elective PCI. The positive effect of high-dose statin pretreatment on PMI and MACE is significant for statin-naïve patients and patients

  14. High-Dose Statin Pretreatment Decreases Periprocedural Myocardial Infarction and Cardiovascular Events in Patients Undergoing Elective Percutaneous Coronary Intervention: A Meta-Analysis of Twenty-Four Randomized Controlled Trials

    Science.gov (United States)

    Wang, Le; Peng, Pingan; Zhang, Ou; Xu, Xiaohan; Yang, Shiwei; Zhao, Yingxin; Zhou, Yujie

    2014-01-01

    Background Evidence suggests that high-dose statin pretreatment may reduce the risk of periprocedural myocardial infarction (PMI) and major adverse cardiac events (MACE) for certain patients; however, previous analyses have not considered patients with a history of statin maintenance treatment. In this meta-analysis of randomized controlled trials (RCTs), we reevaluated the efficacy of short-term high-dose statin pretreatment to prevent PMI and MACE in an expanded set of patients undergoing elective percutaneous coronary intervention. Methods We searched the PubMed/Medline database for RCTs that compared high-dose statin pretreatment with no statin or low-dose statin pretreatment as a prevention of PMI and MACE. We evaluated the incidence of PMI and MACE, including death, spontaneous myocardial infarction, and target vessel revascularization at the longest follow-up for each study for subgroups stratified by disease classification and prior low-dose statin treatment. Results Twenty-four RCTs with a total of 5,526 patients were identified. High-dose statin pretreatment was associated with 59% relative reduction in PMI (odds ratio [OR]: 0.41; 95% confidence interval [CI]: 0.34–0.49; Pstatin pretreatment on MACE was significant for statin-naive patients (OR: 0.69; 95% CI: 0.50–0.95; P = 0.02) and prior low dose statin-treated patients (OR: 0.28; 95% CI: 0.12–0.65; P = 0.003); and for patients with acute coronary syndrome (OR: 0.52; 95% CI: 0.34–0.79; P = 0.003), but not for patients with stable angina (OR: 0.71; 95% CI 0.45–1.10; P = 0.12). Long-term effects on survival were less obvious. Conclusions High-dose statin pretreatment can result in a significant reduction in PMI and MACE for patients undergoing elective PCI. The positive effect of high-dose statin pretreatment on PMI and MACE is significant for statin-naïve patients and patients with prior treatment. The positive effect of high-dose statin pretreatment on MACE is significant for

  15. ALGORITHM FOR MANAGEMENT OF HYPERTENSIVE PATIENTS UNDERWENT UROLOGY INTERVENTIONS

    Directory of Open Access Journals (Sweden)

    S. S. Davydova

    2015-09-01

    Full Text Available Aim. To study the efficacy of cardiovascular non-invasive complex assessment and pre-operative preparation in hypertensive patients needed in surgical treatment of urology dis- eases.Material and methods. Males (n=883, aged 40 to 80 years were included into the study. The main group consisted of patients that underwent laparotomic nephrectomy (LTN group; n=96 and patients who underwent laparoscopic nephrectomy (LSN group; n=53. Dynamics of ambulatory blood pressure monitoring (ABPM data was analyzed in these groups in the immediate postoperative period. The efficacy of a package of non-invasive methods for cardiovascular system assessment was studied. ABPM was performed after nephrectomy (2-nd and 10-th days after surgery in patients with complaints of vertigo episodes or intense general weakness to correct treatment.Results. In LTN group hypotension episodes or blood pressure (BP elevations were observed in 20 (20.8% and 22 (22.9% patients, respectively, on the 2-nd day after the operation. These complications required antihypertensive treatment correction. Patients with hypotension episodes were significantly older than patients with BP elevation and had significantly lower levels of 24-hour systolic BP, night diastolic BP and minimal night systolic BP. Re-adjustment of antihypertensive treatment on the 10-th postoperative day was required to 2 (10% patients with hypotension episodes and to 1 (4.5% patient with BP elevation. Correction of antihypertensive therapy was required to all patients in LSN group on the day 2, and to 32 (60.4% patients on the 10-th day after the operation. Reduction in the incidence of complications (from 1.2% in 2009 to 0.3% in 2011, p<0.001 was observed during the application of cardiovascular non-invasive complex assessment and preoperative preparation in hypertensive patients.Conclusion. The elaborated management algorithm for patients with concomitant hypertension is recommended to reduce the cardiovascular

  16. Coronary risk factors in patients underwent coronary artery bypass grafting.

    Science.gov (United States)

    Safaei, Nasser; Alikhah, Hossein; Abadan, Younes

    2011-01-01

    Coronary Artery Disease (CAD) risk increases with increasing number of risk factors. This study was aimed to assess different coronary risk factors among Coronary Artery Bypass Grafting (CABG) surgery patients. A total of 700 patients younger than 45 or older than 65 years and underwent CABG in Tabriz Shahid Madani Heart Center since 2003 to 2007 were enrolled. We examined the probable differences of CAD risk factors between male and female groups and age groups. We also assessed the change of risk factors presentation in last 5 years. There was not significant difference between risk factor numbers in 65 years groups, but smoking and dyslipidemia was more prevalent in patients 65 years old. Hypertension and diabetes mellitus was more prevalent in patients > 65 old than < 45 years old; also differences were found between males and females patients, so that dyslipidemia, diabetes and hypertension were more prevalent in women than men. Some risk factors were recognized as acting more on one gender than the other. Also, the majority of patients have one or more risk factors, but different age and gender groups may have different risk factors that suggest the need for exact programming for appropriate prophylactic and therapeutic interventions in all groups.

  17. Frequency of Helicobacter pylori in patients underwent endoscopy

    Directory of Open Access Journals (Sweden)

    Ahmet Tay

    2012-06-01

    Full Text Available Objectives: The aim of this study was to investigate thefrequency of Helicobacter pylori in patients underwent endoscopyeastern Anatolia.Materials and methods: The patients whose endoscopicantral biopsies were taken for any reason in our endoscopyunit in February-June 2010 period were includedand retrospectively investigated. The frequency of Helicobacterpylori was determined as separating the patientsaccording to general, sex and the age groups. Antral biopsieswere stained with hematoxylin-eosin and modified giemsamethod and examined under light microscope andreported as (+ mild, (++ moderate, (+++ severe positiveaccording to their intensities.Results: Biopsy specimens of 1298 patients were includedinto the study. The mean age was 47.5 ± 17.5 years(range 14-88 and 607 of these patients (47% were male.Histopathological evaluation revealed that, 918 of the patientswere (71% positive and 379 (29% were negativefor Helicobacter pylori. Approximately 60% of our patientshad mild, 29% had moderate and 11% had severe positivityfor Helicobacter pylori. No significant difference wasfound in the frequency of Helicobacter pylori betweenwomen and men. The frequencies of Helicobacter pyloriwere 73.2%, 71.5%, 68.6% and 70.4%, respectively, inthe age groups of 14-30 years, 31-45 years, 46-60 yearsand 61-88 years.Conclusion: The frequency of Helicobacter pylori was71% in Eastern Anatolia Region. No statistically significantdifference was found between genders and agegroups in term of the frequency of Helicobacter pylori.

  18. Pigmented Villonodular Synovitis in a Patient who Underwent Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Nevzat Dabak

    2014-09-01

    Full Text Available Pigmented villonodular synovitis (PVNS is a rare, benign, but a locally aggressive tumor. It is characterized by the proliferation of synovial membrane, but it can also be seen in tendon sheaths and bursae. Clinical presentation of solitary lesions include compression and locking of the joint suggesting loose bodies in the joint and a subsequent findings of an effusion, whereas diffuse lesions manifest with pain and chronic swelling. In this article, we presented a curious case of PVNS in a female patient who have been followed up due to an acetabular cystic lesion. She underwent total hip arthroplasty for severe osteoarthritis of the hip joint and associated pain. The diagnosis of PVNS was established intraoperatively. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 235-7

  19. Interventional radiology procedures in adult patients who underwent liver transplantation

    Institute of Scientific and Technical Information of China (English)

    Roberto Miraglia; Luigi Maruzzelli; Settimo Caruso; Mariapina Milazzo; Gianluca Marrone; Giuseppe Mamone; Vincenzo Carollo; Salvatore Gruttadauria; Angelo Luca; Bruno Gridelli

    2009-01-01

    Interventional radiology has acquired a key role in every liver transplantation (LT) program by treating the majority of vascular and non-vascular post-transplant complications, improving graft and patient survival and avoiding, in the majority of cases, surgical revision and/or re-transplantation. The aim of this paper is to review indications, technical consideration, results achievable and potential complications of interventional radiology procedures after deceased donor LT and living related adult LT.

  20. Twenty-four percent of patients with clinical chorioamnionitis in preterm gestations have no evidence of either culture-proven intraamniotic infection or intraamniotic inflammation.

    Science.gov (United States)

    Oh, Kyung Joon; Kim, Sun Min; Hong, Joon-Seok; Maymon, Eli; Erez, Offer; Panaitescu, Bogdan; Gomez-Lopez, Nardhy; Romero, Roberto; Yoon, Bo Hyun

    2017-06-01

    Recent studies on clinical chorioamnionitis at term suggest that some patients with this diagnosis have neither intraamniotic infection nor intraamniotic inflammation. A false-positive diagnosis of clinical chorioamnionitis in preterm gestation may lead to unwarranted preterm delivery. We sought to determine the frequency of intraamniotic inflammation and microbiologically proven amniotic fluid infection in patients with preterm clinical chorioamnionitis. Amniocentesis was performed in singleton pregnant women with preterm clinical chorioamnionitis (23 ng/mL. Nonparametric and survival techniques were used for analysis. Among patients with preterm clinical chorioamnionitis, 24% (12/50) had neither microbiologic evidence of intraamniotic infection nor intraamniotic inflammation. Microbial invasion of the amniotic cavity was present in 34% (18/53) and intraamniotic inflammation in 76% (38/50) of patients. The most common microorganisms isolated from the amniotic cavity were the Ureaplasma species. Finally, patients without microbial invasion of the amniotic cavity or intraamniotic inflammation had significantly lower rates of adverse outcomes (including lower gestational age at delivery, a shorter amniocentesis-to-delivery interval, acute histologic chorioamnionitis, acute funisitis, and significant neonatal morbidity) than those with microbial invasion of the amniotic cavity and/or intraamniotic inflammation. Among patients with preterm clinical chorioamnionitis, 24% had no evidence of either intraamniotic infection or intraamniotic inflammation, and 66% had negative amniotic fluid cultures, using standard microbiologic techniques. These observations call for a reexamination of the criteria used to diagnose preterm clinical chorioamnionitis. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. QUALITY OF LIFE OF FEMALE PATIENTS, WHO UNDERWENT RECTAL CANCER SURGERY

    OpenAIRE

    S. V. Averyanova; L. M. Bardenstein; O. M. Konopazkova; E. A. Dementyeva; Velsher, L.Z.

    2013-01-01

    Quality of life is the second most important clinical outcome criteria for cancer patients after survival. Quality of life shows the completeness of social rehabilitations of patients, who underwent radical treatment. In present study quality of life of 41 rectal cancer patients, who underwent abdominoperineal resection (n = 22) or anterior resection (n = 19) was assessed using SF-36 questionnaire. All patients without permanent colostomy had better postoperative quality of life. The phycho-e...

  2. QUALITY OF LIFE OF FEMALE PATIENTS, WHO UNDERWENT RECTAL CANCER SURGERY

    Directory of Open Access Journals (Sweden)

    S. V. Averyanova

    2013-01-01

    Full Text Available Quality of life is the second most important clinical outcome criteria for cancer patients after survival. Quality of life shows the completeness of social rehabilitations of patients, who underwent radical treatment. In present study quality of life of 41 rectal cancer patients, who underwent abdominoperineal resection (n = 22 or anterior resection (n = 19 was assessed using SF-36 questionnaire. All patients without permanent colostomy had better postoperative quality of life. The phycho-emotional state of patients with permanent colostomy progres-sively decreases. The present study is important for developing an individualized rehabilitation programme for female rectal cancer patients.

  3. Serum Zn levels in dysphagic patients who underwent endoscopic gastrostomy for long term enteral nutrition

    National Research Council Canada - National Science Library

    Santos, Carla Adriana; Fonseca, Jorge; Brito, José; Fernandes, Tânia; Gonçalves, Luísa; Sousa Guerreiro, António

    2014-01-01

    .... The aim of the present study was the evaluation of serum zinc in patients who underwent endoscopic gastrostomy and its relationship with serum proteins, whole blood zinc, and the nature of underlying disorder...

  4. Measurement of recent thymic output function in uremia patients who underwent maintenance hemodialysis

    Institute of Scientific and Technical Information of China (English)

    李永新

    2012-01-01

    Objective To determine the recent thymic output of naive T cells in patients with uremia who underwent maintenance hemodialysis (MHD) . Methods Fifteen consecutive patients with uremia were recruited from Affiliated Oncology Hospital of Zhengzhou University between October 2010 and October 2011 and were subjected to

  5. Mitochondrial DNA haplogroups are associated with severe sepsis and mortality in patients who underwent major surgery.

    Science.gov (United States)

    Jiménez-Sousa, Maria Angeles; Tamayo, Eduardo; Guzmán-Fulgencio, María; Heredia, María; Fernández-Rodríguez, Amanda; Gómez, Esther; Almansa, Raquel; Gómez-Herreras, José I; García-Álvarez, Mónica; Gutiérrez-Junco, Sandra; Bermejo-Martin, Jesús F; Resino, Salvador

    2015-01-01

    To analyse whether mitochondrial DNA (mtDNA) haplogroups are associated with severe sepsis and mortality after major surgery. We performed a case-control study on 240 cardiac or abdominal surgery patients developing severe sepsis (Case-group) and 267 cardiac or abdominal surgery patients without severe sepsis and with systemic inflammatory response syndrome (SIRS, Control-group). Furthermore, a longitudinal substudy was performed for analysing the survival in septic patients. Only European white patients within the N macro-cluster were included. Case-group underwent cardiac surgery had lower frequencies of cluster HV (p = 0.005) and haplogroup H (p = 0.005) and higher frequencies of cluster JT (p = 0.028) than Control-group; but no significant differences were found for abdominal surgery. Besides, both cluster HV and haplogroup H were associated with decreased odds of severe sepsis (adjusted odds ratio (aOR) = 0.45 (95%CI = 0.25; 0.82); p = 0.009 and aOR = 0.48 (95%CI = 0.26; 0.87); p = 0.015, respectively) among patients underwent cardiac surgery. In Case-group, 45.4% (109/240) patients died with a survival median of 39 (95%CI = 31.4; 46.62) days. When the clusters were examined, 41% (55/134) patients within cluster HV died versus 71.4% (10/14) patients within cluster IWX (p = 0.018). Additionally, patients within cluster IWX had an increased risk of death (adjusted hazard ratio (aHR) = 2.22; (95%CI = 1.14; 4.34); p = 0.019). European mitochondrial haplogroups might be related to the onset of severe sepsis in patients who underwent major cardiac surgery, but not in patients underwent major abdominal surgery. Besides, mtDNA haplogroups could have influence on mortality in septic patients. Copyright © 2014 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  6. [Comparison of body weight loss in gastrectomy patients who underwent only surgery and those who underwent surgery followed up with S-1 adjuvant chemotherapy].

    Science.gov (United States)

    Aoyama, Toru; Yoshikawa, Takaki; Shirai, Junya; Hayashi, Tsutomu; Ogata, Takashi; Cho, Haruhiko; Yukawa, Norio; Oshima, Takashi; Rino, Yasushi; Ozawa, Yukihiro; Kitani, Yuichi; Wada, Hiroo; Masuda, Munetaka; Tsuburaya, Akira

    2012-11-01

    Body weight loss is a common outcome in patients with gastric cancer who have undergone gastrectomy. However, the rate of body weight loss after surgery is unknown. In this retrospective study, we selected patients who underwent radical gastrectomy for gastric cancer and were diagnosed with Stage II or III disease. Further, we compared the body weight loss after surgery between patients in the surgery alone group and the S-1 adjuvant chemotherapy group. We evaluated 163 patients, of which 81 underwent only surgery, and 82 underwent surgery followed up with S-1 adjuvant chemotherapy. The body weight loss rate at 1, 3, and 6 months in the surgery alone group were 93.1%, 92.9%, and 94.9%, while those in the S-1 adjuvant group were 92.9%, 90.4%,and 91.9%, which was a significant difference. Body weight loss after gastrectomy was higher in the S-1 adjuvant group than in the surgery alone group. Further, nutritional support is required for these patients to maintain body weight after surgery.

  7. Evolution of elderly patients who underwent cardiac surgery with cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Alain Moré Duarte

    2016-01-01

    Full Text Available Introduction: There is a steady increase in the number of elderly patients with severe cardiovascular diseases who require a surgical procedure to recover some quality of life that allows them a socially meaningful existence, despite the risks.Objectives: To analyze the behavior of elderly patients who underwent cardiac surgery with cardiopulmonary bypass.Method: A descriptive, retrospective, cross-sectional study was conducted with patients over 65 years of age who underwent surgery at the Cardiocentro Ernesto Che Guevara, in Santa Clara, from January 2013 to March 2014.Results: In the study, 73.1% of patients were men; and there was a predominance of subjects between 65 and 70 years of age, accounting for 67.3%. Coronary artery bypass graft was the most prevalent type of surgery and had the longest cardiopulmonary bypass times. Hypertension was present in 98.1% of patients. The most frequent postoperative complications were renal dysfunction and severe low cardiac output, with 44.2% and 34.6% respectively.Conclusions: There was a predominance of men, the age group of 65 to 70 years, hypertension, and patients who underwent coronary artery bypass graft with prolonged cardiopulmonary bypass. Renal dysfunction was the most frequent complication.

  8. Effect of using pump on postoperative pleural effusion in the patients that underwent CABG

    Directory of Open Access Journals (Sweden)

    Mehmet Özülkü

    2015-08-01

    Full Text Available Abstract Objective: The present study investigated effect of using pump on postoperative pleural effusion in patients who underwent coronary artery bypass grafting. Methods: A total of 256 patients who underwent isolated coronary artery bypass grafting surgery in the Cardiovascular Surgery clinic were enrolled in the study. Jostra-Cobe (Model 043213 105, VLC 865, Sweden heart-lung machine was used in on-pump coronary artery bypass grafting. Off-pump coronary artery bypass grafting was performed using Octopus and Starfish. Proximal anastomoses to the aorta in both on-pump and off-pump techniques were performed by side clamps. The patients were discharged from the hospital between postoperative day 6 and day 11. Results: The incidence of postoperative right pleural effusion and bilateral pleural effusion was found to be higher as a count in Group 1 (on-pump as compared to Group 2 (off-pump. But the difference was not statistically significant [P>0.05 for right pleural effusion (P=0.893, P>0.05 for bilateral pleural effusion (P=0.780]. Left pleural effusion was encountered to be lower in Group 2 (off-pump. The difference was found to be statistically significant (P<0.05, P=0.006. Conclusion: Under the light of these results, it can be said that left pleural effusion is less prevalent in the patients that underwent off-pump coronary artery bypass grafting when compared to the patients that underwent on-pump coronary artery bypass grafting.

  9. Assessment of the epidemiological profile of patients with dentofacial deformities who underwent orthognathic surgery.

    Science.gov (United States)

    Castro, Vanessa; do Prado, Celio Jesus; Neto, Antonio Irineu Trindade; Zanetta-Barbosa, Darceny

    2013-05-01

    The present study aimed to establish the profile of patients who underwent orthognathic surgery in a private clinic by evaluating their demographic characteristics, their facial types, and aspects related to the surgical procedures that were performed. The sample consisted of 419 medical records from male and female patients aged 15 to 62 years who underwent orthognathic surgery between 2001 and 2011. A single examiner collected data by evaluating a database of information extracted from medical records, particularly radiographic and photographic analyses. The following criteria were evaluated: gender, age, skin color, type of orthognathic surgery, type of associated temporomandibular joint (TMJ) surgery, complications, and recurrences. Seventeen patients were rejected because they had incomplete records. The average age of the patients was 28.5 years old; most were females (255 patients) and faioderm (295 patients). The most prevalent facial pattern was Pattern III (n = 166, 41.3%). Orthognathic surgery that affected the maxilla, jaw, and chin was the most prevalent type (n = 199, 49.5% of cases). A genioplasty was performed concurrently with combined surgeries and single-jaw surgery in 76.86% of patients (n = 309). TMJ surgery was performed concomitantly with orthognathic surgery in 4% of cases (n = 16). The most common postoperative complication was infection/inflammation (n = 12). We concluded that there was a higher frequency of orthognathic surgery among women and young people, the brunette skin phenotype was prevalent, and most patients had a combination of maxillary and mandibular problems.

  10. Serum Zn levels in dysphagic patients who underwent endoscopic gastrostomy for long term enteral nutrition

    Directory of Open Access Journals (Sweden)

    Carla Adriana Santos

    2014-02-01

    Full Text Available Background and aims: Dysphagic patients who underwent endoscopic gastrostomy (PEG usually present protein-energy malnutrition, but little is known about micronutrient malnutrition. The aim of the present study was the evaluation of serum zinc in patients who underwent endoscopic gastrostomy and its relationship with serum proteins, whole blood zinc, and the nature of underlying disorder. Methods: From patients that underwent gastrostomy a blood sample was obtained minutes before the procedure. Serum and whole blood zinc was evaluated using Wavelength Dispersive X-ray Fluorescence Spectroscopy. Serum albumin and transferrin were evaluated. Patients were studied as a whole and divided into two groups: head and neck cancer (HNC and neurological dysphagia (ND. Results: The study involved 32 patients (22 males, aged 43-88 years: HNC = 15, ND = 17. Most (30/32 had low serum zinc, 17/32 presented normal values of whole blood zinc. Only two, with traumatic brain injury, presented normal serum zinc. Serum zinc levels showed no differences between HNC and ND patients. There was no association between serum zinc and serum albumin or transferrin. There was no association between serum and whole blood zinc. Conclusions: Patients had low serum zinc when gastrostomy was performed, similar in HNC and ND, being related with prolonged fasting and unrelated with the underlying disease. Decrease serum zinc was unrelated with low serum proteins. Serum zinc was more sensitive than whole blood zinc for identifying reduced zinc intake. Teams taking care of PEG-patients should include zinc evaluation as part of the nutritional assessment, or include systematic dietary zinc supply.

  11. Twenty-Four-Hour Ambulatory Blood Pressure Monitoring in Hypertension

    Science.gov (United States)

    2012-01-01

    oscillometry. The device avoids some of the pitfalls of conventional office or clinic blood pressure monitoring (CBPM) using a cuff and mercury sphygmomanometer such as observer bias (the phenomenon of measurement error when the observer overemphasizes expected results) and white coat hypertension (the phenomenon of elevated BP when measured in the office or clinic but normal BP when measured outside of the medical setting). Research Questions Is there a difference in patient outcome and treatment protocol using 24-hour ABPM versus CBPM for uncomplicated hypertension? Is there a difference between the 2 technologies when white coat hypertension is taken into account? What is the cost-effectiveness and budget impact of 24-hour ABPM versus CBPM for uncomplicated hypertension? Research Methods Literature Search Search Strategy A literature search was performed on August 4, 2011 using OVID MEDLINE, MEDLINE In-Process and Other Non-Indexed Citations, EMBASE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Cochrane Library, and the International Agency for Health Technology Assessment (INAHTA) for studies published from January 1, 1997 to August 4, 2011. Abstracts were reviewed by a single reviewer. For those studies meeting the eligibility criteria, full-text articles were obtained. Reference lists were also examined for any additional relevant studies not identified through the search. Articles with unknown eligibility were reviewed with a second clinical epidemiologist and then a group of epidemiologists until consensus was established. The quality of evidence was assessed as high, moderate, low, or very low according to GRADE methodology. Inclusion Criteria English language articles; published between January 1, 1997 and August 4, 2011; adults aged 18 years of age or older; journal articles reporting on the effectiveness, cost-effectiveness, or safety for the comparison of interest; clearly described study design and methods; health technology

  12. Dysphagia among Adult Patients who Underwent Surgery for Esophageal Atresia at Birth

    Directory of Open Access Journals (Sweden)

    Valérie Huynh-Trudeau

    2015-01-01

    Full Text Available BACKGROUND: Clinical experiences of adults who underwent surgery for esophageal atresia at birth is limited. There is some evidence that suggests considerable long-term morbidity, partly because of dysphagia, which has been reported in up to 85% of adult patients who undergo surgery for esophageal atresia. The authors hypothesized that dysphagia in this population is caused by dysmotility and/or anatomical anomalies.

  13. Sarcopenia: a new predictor of postoperative complications for elderly gastric cancer patients who underwent radical gastrectomy.

    Science.gov (United States)

    Zhou, Chong-Jun; Zhang, Feng-Min; Zhang, Fei-Yu; Yu, Zhen; Chen, Xiao-Lei; Shen, Xian; Zhuang, Cheng-Le; Chen, Xiao-Xi

    2017-05-01

    A geriatric assessment is needed to identify high-risk elderly patients with gastric cancer. However, the current geriatric assessment has been considered to be either time-consuming or subjective. The present study aimed to investigate the predictive effect of sarcopenia on the postoperative complications for elderly patients who underwent radical gastrectomy. We conducted a prospective study of patients who underwent radical gastrectomy from August 2014 to December 2015. Computed tomography-assessed lumbar skeletal muscle, handgrip strength, and gait speed were measured to define sarcopenia. Sarcopenia was present in 69 of 240 patients (28.8%) and was associated with lower body mass index, lower serum albumin, lower hemoglobin, and higher nutritional risk screening 2002 scores. Postoperative complications significantly increased in the sarcopenic patients (49.3% versus 24.6%, P sarcopenia (odds ratio: 2.959, 95% CI: 1.629-5.373, P Sarcopenia, presented as a new geriatric assessment factor, was a strong and independent risk factor for postoperative complications of elderly patients with gastric cancer. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Undergrading and understaging in patients with clinically insignificant prostate cancer who underwent radical prostatectomy

    Directory of Open Access Journals (Sweden)

    Irai S. Oliveira

    2010-06-01

    Full Text Available PURPOSE: The aim of our study is to evaluate the undergrading and understaging rates in patients with clinically localized insignificant prostate cancer who underwent radical prostatectomy. MATERIALS AND METHODS: Between July 2005 and July 2008, 406 patients underwent radical prostatectomy for clinical localized prostate cancer in our hospital. Based on preoperative data, 93 of these patients fulfilled our criteria of non-significance: Gleason score < 7, stage T1c, PSA < 10 ng/mL and percentage of affected fragments less than 25%. The pathologic stage and Gleason score were compared to preoperative data to evaluate the rate of understaging and undergrading. The biochemical recurrence free survival of these operated insignificant cancers were also evaluated. RESULTS: On surgical specimen analysis 74.7% of patients had Gleason score of 6 or less and 25.3% had Gleason 7 or greater. Furthermore 8.3% of cases showed extracapsular extension. After 36 months of follow-up 3.4% had biochemical recurrence, defined by a PSA above 0.4 ng/mL. CONCLUSIONS: Despite the limited number of cases, we have found considerable rates of undergrading and understaging in patients with prostate cancer whose current definitions classified them as candidates for active surveillance. According to our results the current definition seems inadequate as up to a third of patients had higher grade or cancer outside the prostate.

  15. Functional assessment of patients with cervical myelopathy who underwent surgical treatment

    Directory of Open Access Journals (Sweden)

    Thiago Pereira Coutinho

    2014-03-01

    Full Text Available OBJECTIVE: Evaluate and correlate the functional response of patients with cervical myelopathy with the current clinical scores in patients who underwent surgical treatment. METHODS: We analyzed medical records of 34 patients with cervical myelopathy who underwent four different types of surgery. All patients were evaluated preoperatively and postoperatively with the application of the JOA and Nurick questionnaires. RESULTS: Functional clinical improvement was statistically significant. The mean preoperative JOA was 8.5 ± 3.06 and 10.7 ± 3.9 in the postoperative; Nurick was 3.2 ± 1.1 preoperatively and 2.8 ± 1.3 postoperatively. CONCLUSION: There is benefit with the surgical procedure in patients with cervical myelopathy. The neurological function after surgery depends on the previous function (the higher the duration of the previous symptoms, the greater the progression of the disease and, therefore, worse the neurological function and the age is not a relevant factor of improvement, as already shown in other series. The clinical functional improvement of patients is visible with surgical treatment, regardless of surgical technique.

  16. Anesthetic management of patient with Sjogren's syndrome who underwent cesarean section: a case report

    Science.gov (United States)

    Kim, Na Eun; Lee, Jae Hyuk; Lee, Jun Yong

    2016-01-01

    Sjogren's syndrome is one of the most common autoimmune disorders and has a female predominance. Maternal circulating autoantibodies such as anti-Ro/SSA and anti-La/SSB antibodies can cause congenital heart block of fetus, and in severe case, emergency pacemaker implantation may be needed for neonate. Therefore, it is very important to understand maternal and fetal condition and pay attention to the status of the neonate during delivery. In this paper, we present a case of patient with Sjogren's syndrome who underwent cesarean section under spinal anesthesia. PMID:27274376

  17. Surrogate pregnancy in a patient who underwent radical hysterectomy and bilateral transposition of ovaries.

    Science.gov (United States)

    Azem, Foad; Yovel, Israel; Wagman, Israel; Kapostiansky, Rita; Lessing, Joseph B; Amit, Ami

    2003-05-01

    To evaluate IVF-surrogate pregnancy in a patient with ovarian transposition after radical hysterectomy for carcinoma of the cervix. Case report. A maternity hospital in Tel Aviv that is a major tertiary care and referral center. A 29-year-old woman who underwent Wertheim's hysterectomy for carcinoma of the uterine cervix and ovarian transposition before total pelvic irradiation. Standard IVF treatment, transabdominal oocyte retrieval, and transfer to surrogate mother. Outcome of IVF cycle. A twin pregnancy in the first cycle. This is the second reported case of controlled ovarian stimulation and oocyte retrieval performed on a transposed ovary.

  18. Effect of different pneumoperitoneum pressure on stress state in patients underwent gynecological laparoscopy

    Institute of Scientific and Technical Information of China (English)

    Ai-Yun Shen

    2016-01-01

    Objective:To observe the effect of different CO2 pneumoperitoneum pressure on the stress state in patients underwent gynecological laparoscopy.Methods:A total of 90 patients who were admitted in our hospital from February, 2015 to October, 2015 for gynecological laparoscopy were included in the study and divided into groups A, B, and C according to different CO2 pneumoperitoneum pressure. The changes of HR, BP, and PetCO2 during the operation process in the three groups were recorded. The changes of stress indicators before operation (T0), 30 min during operation (T1), and 12 h after operation (T2) were compared. Results: The difference of HR, BP, and PetCO2 levels before operation among the three groups was not statistically significant (P>0.05). HR, BP, and PetCO2 levels 30 min after pneumoperitoneum were significantly elevated when compared with before operation (P0.05). PetCO2 level 30 min after pneumoperitoneum in group B was significantly higher than that in group A (P0.05).Conclusions:Low pneumoperitoneum pressure has a small effect on the stress state in patients underwent gynecological laparoscopy, will not affect the surgical operation, and can obtain a preferable muscular relaxation and vision field; therefore, it can be selected in preference.

  19. Prognostic nomogram for patients with hepatocellular carcinoma underwent adjuvant transarterial chemoembolization following curative resection

    Science.gov (United States)

    Jing, Chu-Yu; Fu, Yi-Peng; Zheng, Su-Su; Yi, Yong; Shen, Hu-Jia; Huang, Jin-Long; Xu, Xin; Lin, Jia-Jia; Zhou, Jian; Fan, Jia; Ren, Zheng-Gang; Qiu, Shuang-Jian; Zhang, Bo-Heng

    2017-01-01

    Abstract Adjuvant transarterial chemoembolization (TACE) is a major option for postoperative hepatocellular carcinoma (HCC) patients with recurrence risk factors. However, individualized predictive models for subgroup of these patients are limited. This study aimed to develop a prognostic nomogram for patients with HCC underwent adjuvant TACE following curative resection. A cohort comprising 144 HCC patients who received adjuvant TACE following curative resection in the Zhongshan Hospital were analyzed. The nomogram was formulated based on independent prognostic indicators for overall survival (OS). The performance of the nomogram was evaluated by the concordance index (C-index), calibration curve, and decision curve analysis (DCA) and compared with the conventional staging systems. The results were validated in an independent cohort of 86 patients with the same inclusion criteria. Serum alpha-fetoprotein (AFP), hyper-sensitive C-reactive protein (hs-CRP), incomplete tumor encapsulation, and double positive staining of Cytokeratin 7 and Cytokeratin 19 on tumor cells were identified as independent predictors for OS. The C-indices of the nomogram for OS prediction in the training cohort and validation cohort were 0.787 (95%CI 0.775–0.799) and 0.714 (95%CI 0.695–0.733), respectively. In both the training and validation cohorts, the calibration plot showed good consistency between the nomogram-predicted and the observed survival. Furthermore, the established nomogram was superior to the conventional staging systems in terms of C-index and clinical net benefit on DCA. The proposed nomogram provided an accurate prediction on risk stratification for HCC patients underwent adjuvant TACE following curative resection. PMID:28296727

  20. Outcome of Patients Underwent Emergency Department Thoracotomy and Its Predictive Factors

    Directory of Open Access Journals (Sweden)

    Shahram Paydar

    2014-08-01

    Full Text Available Introduction: Emergency department thoracotomy (EDT may serve as the last survival chance for patients who arrive at hospital in extremis. It is considered as an effective tool for improvement of traumatic patients’ outcome. The present study was done with the goal of assessing the outcome of patients who underwent EDT and its predictive factors. Methods: In the present study, medical charts of 50 retrospective and 8 prospective cases underwent emergency department thoracotomy (EDT were reviewed during November 2011 to June 2013. Comparisons between survived and died patients were performed by Mann-Whitney U test and the predictive factors of EDT outcome were measured using multivariate logistic regression analysis. P < 0.05 considered statistically significant. Results: Fifty eight cases of EDT were enrolled (86.2% male. The mean age of patients was 43.27±19.85 years with the range of 18-85. The mean time duration of CPR was recorded as 37.12±12.49 minutes. Eleven cases (19% were alive to be transported to OR (defined as ED survived. The mean time of survival in ED survived patients was 223.5±450.8 hours. More than 24 hours survival rate (late survived was 6.9% (4 cases. Only one case (1.7% survived to discharge from hospital (mortality rate=98.3%. There were only a significant relation between ED survival and SBP, GCS, CPR duration, and chest trauma (p=0.04. The results demonstrated that initial SBP lower than 80 mmHg (OR=1.03, 95% CI: 1.001-1.05, p=0.04 and presence of chest trauma (OR=2.6, 95% CI: 1.75-3.16, p=0.02 were independent predictive factors of EDT mortality. Conclusion: The findings of the present study showed that the survival rate of trauma patients underwent EDT was 1.7%. In addition, it was defined that falling systolic blood pressure below 80 mmHg and blunt trauma of chest are independent factors that along with poor outcome.

  1. Study of the seroma volume changes in the patients who underwent Accelerated Partial Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dae Ho; Son, Sang Jun; Mun, Jun Ki; Seo, Seok Jin; Lee, Je Hee [Dept. of Radiation Oncology, Seoul National University Hospital, Seoul (Korea, Republic of)

    2016-06-15

    By analyzing seroma volume changes in the patients who underwent Partial breast radiation therapy after breast conserving surgery, we try to contribute to the improvement of radiotherapy effect. Enrolled 20 patients who underwent partial breast radiation therapy by ViewRay MRIdian System were subject. After seeking for the size of the removed sample in the patients during surgery and obtained seroma volume changes on a weekly basis. On the Basis of acquired volume, it was compared with age, term from start of the first treatment after surgery, BMI (body mass index) and the extracted sample size during surgery. And using the ViewRay MRIdian RTP System, the figure was analyzed by PTV(=seroma volume + margin) to obtain a specific volume of the Partial breast radiation therapy. The changes of seroma volume from MR simulation to the first treatment (a week) is 0~5% in 8, 5~10% in 3, 10 to 15% in 2, and 20% or more in 5 people. Two patients(A, B patient) among subjects showed the biggest change. The A patient's 100% of the prescribed dose volume is 213.08 cc, PTV is 181.93 cc, seroma volume is 15.3 cc in initial plan. However, while seroma volume decreased 65.36% to 5.3 cc, 100% of the prescribed dose volume was reduced to 3.4% to 102.43 cc and PTV also did 43.6% to 102.54 cc. In the case of the B patient, seroma volume decreased 42.57% from 20.2 cc to 11.6 cc. Because of that, 100% of the prescribed dose volume decreased 8.1% and PTV also did to 40%. As the period between the first therapy and surgery is shorter, the patient is elder and the size of sample is smaller than 100 cc, the change grow bigger. It is desirable to establish an adaptive plan according to each patient's changes of seroma volume through continuous observation. Because partial breast patients is more sensitive than WBRT patients about dose conformity in accordance with the volume change.

  2. Clinicopathological Features of Cervical Esophageal Cancer: Retrospective Analysis of 63 Consecutive Patients Who Underwent Surgical Resection.

    Science.gov (United States)

    Saeki, Hiroshi; Tsutsumi, Satoshi; Yukaya, Takafumi; Tajiri, Hirotada; Tsutsumi, Ryosuke; Nishimura, Sho; Nakaji, Yu; Kudou, Kensuke; Akiyama, Shingo; Kasagi, Yuta; Nakashima, Yuichiro; Sugiyama, Masahiko; Sonoda, Hideto; Ohgaki, Kippei; Oki, Eiji; Yasumatsu, Ryuji; Nakashima, Torahiko; Morita, Masaru; Maehara, Yoshihiko

    2017-01-01

    The objectives of this retrospective study were to elucidate the clinicopathological features and recent surgical results of cervical esophageal cancer. Cervical esophageal cancer has been reported to have a dismal prognosis. Accurate knowledge of the clinical characteristics of cervical esophageal cancer is warranted to establish appropriate therapeutic strategies. The clinicopathological features and treatment results of 63 consecutive patients with cervical esophageal cancer (Ce group) who underwent surgical resection from 1980 to 2013 were analyzed and compared with 977 patients with thoracic or abdominal esophageal cancer (T/A group) who underwent surgical resection during that time. Among the patients who received curative resection, the 5-year overall and disease-specific survival rates of the Ce patients were significantly better than those of the T/A patients (overall: 77.3% vs 46.5%, respectively, P = 0.0067; disease-specific: 81.9% vs 55.8%, respectively, P = 0.0135). Although total pharyngo-laryngo-esophagectomy procedures were less frequently performed in the recent period, the rate of curative surgical procedures was markedly higher in the recent period (2000-1013) than that in the early period (1980-1999) (44.4% vs 88.9%, P = 0.0001). The 5-year overall survival rate in the recent period (71.5%) was significantly better than that in the early period (40.7%, P = 0.0342). Curative resection for cervical esophageal cancer contributes to favorable outcomes compared with other esophageal cancers. Recent surgical results for cervical esophageal cancer have improved, and include an increased rate of curative resection and decreased rate of extensive surgery.

  3. [Incidence and risk factors of postoperative cognitive dysfunction in patients underwent coronary artery bypass grafting surgery].

    Science.gov (United States)

    Ge, Yali; Ma, Zhengliang; Shi, Hongwei; Zhao, Yamei; Gu, Xiaoping; Wei, Haiyan

    2014-10-01

    To investigate the incidence rate and the risk factors for postoperative cognitive dysfunction (POCD) in patients underwent coronary artery bypass grafting surgery. A total of 147 patients underwent elective coronary artery bypass grafting (CABG) surgery between January to July 2013 were included in this study. POCD was diagnosed using a neuropsychological test battery. All enrolled patients were interviewed on the day before surgery, the seventh day and 3 months after surgery, respectively, by the same researcher, and were divided into two groups based on the results: the POCD group and the non-POCD group. The information, including age, sex, body mass index, educational status, comorbidities, history of smoking and drinking, ASA grade, left ventricular ejection fraction, operation method, duration of operations, regional cerebral oxygen saturation, the lowest haemoglobin concentrations and the haemoglobin concentration decline rate during the operation, tracheal catheter retention time, postoperative pain on visual analogue scales (VAS) and systemic inflammatory response syndrome score (SIRS score), were recorded based on a schedule of survey. Multivariate logistic regression was used to analyze the risk factors for POCD. A total of 101 patients finished this study. On 7 days and 3 months after surgery, 38 and 21 cases showed POCD, with an incidence rate at 37.6% and 20.8%, respectively. Interestingly, there was no significant difference in incidence of POCD between CABG and OPCABG group on both 7 days and 3 months after surgery (P>0.05). The logistic stepwise regression analysis indicated that the risk factors for POCD included advanced age (OR=1.177, 95%CI 1.071-1.292, P=0.001), the haemoglobin concentration decline rate (OR=1.334, 95%CI 1.152-1.545, PSIRS score (OR=2.815, 95%CI 1.014-7.818, P=0.047). The incidence rate of POCD was 37.6% and 20.8% on 7 days and 3 months after surgery respectively. Advanced age, the haemoglobin concentration decline rate and

  4. Newly Developed Sarcopenia as a Prognostic Factor for Survival in Patients who Underwent Liver Transplantation.

    Directory of Open Access Journals (Sweden)

    Ja Young Jeon

    Full Text Available The relationship between a perioperative change in sarcopenic status and clinical outcome of liver transplantation (LT is unknown. We investigated whether post-LT sarcopenia and changes in sarcopenic status were associated with the survival of patients.This retrospective study was based on a cohort of 145 patients from a single transplant center who during a mean of 1 year after LT underwent computed tomography imaging evaluation. The cross-sectional area of the psoas muscle of LT patients was compared with that of age- and sex-matched healthy individuals. The Cox proportional hazards regression model was used to determine whether post-LT sarcopenia and changes in sarcopenic status affect post-LT survival.The mean age at LT of the 116 male and 29 female patients was 50.2 ± 7.9 years; the mean follow-up duration was 51.6 ± 32.9 months. All pre-LT patients with sarcopenia still had sarcopenia 1 year after LT; 14 (15% patients had newly developed sarcopenia. The mean survival duration was 91.8 ± 4.2 months for non-sarcopenic patients and 80.0 ± 5.2 months for sarcopenic patients (log-rank test, p = 0.069. In subgroup analysis, newly developed sarcopenia was an independent negative predictor for post-LT survival (hazard ratio: 10.53, 95% confidence interval: 1.37-80.93, p = 0.024.Sarcopenia in LT recipients did not improve in any of the previously sarcopenic patients and newly developed within 1 year in others. Newly developed sarcopenia was associated with increased mortality. Newly developed sarcopenia can be used to stratify patients with regard to the risk of post-LT mortality.

  5. Newly Developed Sarcopenia as a Prognostic Factor for Survival in Patients who Underwent Liver Transplantation

    Science.gov (United States)

    Ock, So Young; Xu, Weiguang; Lee, Jung-Dong; Lee, Jei Hee; Kim, Hae Jin; Kim, Dae Jung; Lee, Kwan Woo; Han, Seung Jin

    2015-01-01

    Introduction The relationship between a perioperative change in sarcopenic status and clinical outcome of liver transplantation (LT) is unknown. We investigated whether post-LT sarcopenia and changes in sarcopenic status were associated with the survival of patients. Method This retrospective study was based on a cohort of 145 patients from a single transplant center who during a mean of 1 year after LT underwent computed tomography imaging evaluation. The cross-sectional area of the psoas muscle of LT patients was compared with that of age- and sex-matched healthy individuals. The Cox proportional hazards regression model was used to determine whether post-LT sarcopenia and changes in sarcopenic status affect post-LT survival. Results The mean age at LT of the 116 male and 29 female patients was 50.2 ± 7.9 years; the mean follow-up duration was 51.6 ± 32.9 months. All pre-LT patients with sarcopenia still had sarcopenia 1 year after LT; 14 (15%) patients had newly developed sarcopenia. The mean survival duration was 91.8 ± 4.2 months for non-sarcopenic patients and 80.0 ± 5.2 months for sarcopenic patients (log-rank test, p = 0.069). In subgroup analysis, newly developed sarcopenia was an independent negative predictor for post-LT survival (hazard ratio: 10.53, 95% confidence interval: 1.37–80.93, p = 0.024). Conclusion Sarcopenia in LT recipients did not improve in any of the previously sarcopenic patients and newly developed within 1 year in others. Newly developed sarcopenia was associated with increased mortality. Newly developed sarcopenia can be used to stratify patients with regard to the risk of post-LT mortality. PMID:26619224

  6. High patient satisfaction in 445 patients who underwent fast-track hip or knee replacement

    DEFF Research Database (Denmark)

    Specht, Kirsten; Kjaersgaard-Andersen, Per; Kehlet, Henrik;

    2015-01-01

    Background and purpose - Patient satisfaction is important in fast-track total hip and knee replacement (THR, TKR). We assessed: (1) how satisfied patients were with the treatment; (2) factors related to overall satisfaction; and (3) whether there was a difference between THR and TKR regarding...... length of stay (LOS) and patient satisfaction. Patients and methods - In this follow-up study, a consecutive series of 445 patients undergoing THR and TKR completed a questionnaire 2 weeks after discharge. LOS and short-term patient satisfaction with the fast-track management were measured. Patient...... satisfaction was measured using a numerical rating scale (NRS; 0-10). Results - For THR, the median satisfaction score was 9-10 and for TKR it was 8.5-10 in all parameters. Older THR patients had higher overall satisfaction. No association was found between overall satisfaction following THR or TKR and sex...

  7. Fundus fluorescein angiographic findings in patients who underwent ventricular assist device implantation.

    Science.gov (United States)

    Ozturk, Taylan; Nalcaci, Serhad; Ozturk, Pelin; Engin, Cagatay; Yagdi, Tahir; Akkin, Cezmi; Ozbaran, Mustafa

    2013-09-01

    Disruption of microcirculation in various tissues as a result of deformed blood rheology due to ventricular assist device (VAD) implantation causes novel arteriovenous malformations. Capillary disturbances and related vascular leakage in the retina and choroidea may also be seen in patients supported by VADs. We aimed to evaluate retinal vasculature deteriorations after VAD implantation. The charts of 17 patients who underwent VAD implantation surgery for the treatment of end-stage heart failure were retrospectively reviewed. Eight cases (47.1%) underwent pulsatile pump implantation (Berlin Heart EXCOR, Berlin Heart Mediprodukt GmbH, Berlin, Germany); however, nine cases (52.9%) had continuous-flow pump using centrifugal design (HeartWare, HeartWare Inc., Miramar, FL, USA). Study participants were selected among the patients who had survived with a VAD for at least 6 months, and results of detailed ophthalmologic examinations including optic coherence tomography (OCT) and fundus fluorescein angiography (FA) were documented. All of the 17 patients were male, with a mean age of 48.5 ± 14.8 years (15-67 years). Detailed ophthalmologic examinations including the evaluation of retinal vascular deteriorations via FA were performed at a mean of 11.8 ± 3.7 months of follow-up (6-18 months). Mean best-corrected visual acuity and intraocular pressure were found as logMAR 0.02 ± 0.08 and 14.6 ± 1.9 mm Hg, respectively in the study population. Dilated fundoscopy revealed severe focal arteriolar narrowing in two patients (11.8%), and arteriovenous crossing changes in four patients (23.5%); however, no pathological alteration was present in macular OCT scans. In patients with continuous-flow blood pumps, mean arm-retina circulation time (ARCT) and arteriovenous transit time (AVTT) were found to be 16.8 ± 3.0 and 12.4 ± 6.2 s, respectively; whereas those with pulsatile-flow blood pumps were found to be 17.4 ± 3.6 and 14.0 ± 2.1 s in patients (P=0.526 and P=0

  8. PROPHYLAXIS OF SURGICAL SITE INFECTION WITH VANCOMYCIN IN 513 PATIENTS THAT UNDERWENT TO LUMBAR FUSION

    Directory of Open Access Journals (Sweden)

    Nicolas Scheverin

    2015-09-01

    Full Text Available Objective:To assess the prophylactic effects of local vancomycin on an infection of the surgical site in patients undergoing lumbar instrumented fusion.Methods:Retrospective study from January 2011 to June 2014 in patients with symptomatic and refractory lumbar spine stenosis and listhesis who underwent instrumented pedicle screw spinal fusion. Two groups of patient were analyzed, one using vancomycin on the surgical site, vancomycin group (VG and the control group (CG without topical vancomycin. The routine prophylactic procedures were performed in both groups: aseptic scrub technique, skin preparation, preoperative intravenous antibiotic therapy. The VG received a dose of 1g of vancomycin mixed with the bone graft every three spinal levels fused and the group consisted of 232 patients.Results:513 patients were analyzed, 232 in the VG and 281 in the CG. There was no statistical difference between the groups when the sex, mean surgery length, and mean bleeding volume were considered. The rate of infection for VG was reduced from 4.98% to 1.29% when compared with CG.Conclusion:The use of vancomycin added to the bone graft in posterior spinal fusion is associated with significantly lower rates of infection.

  9. SELENIUM IN DYSPHAGIC PATIENTS WHO UNDERWENT ENDOSCOPIC GASTROSTOMY FOR LONG TERM ENTERAL FEEDING.

    Science.gov (United States)

    Santos, Carla Adriana; Fonseca, Jorge; Carolino, Elisabete; Lopes, Teresa; Guerreiro, António Sousa

    2015-12-01

    endoscopic gastrostomy (PEG) patients usually present protein-energy malnutrition, but little is known about selenium deficiency. We aimed to assess serum selenium evolution when patients underwent PEG, after 4 and 12 weeks. We also evaluated the evolution of albumin, transferrin and Body Mass Index and the influence of the nature of the underlying disease. a blood sample was obtained before PEG (T0), after 4 (T1) and 12 (T3) weeks. Selenium was assayed using GFAAS (Furnace Atomic Absorption Spectroscopy). The PEG patients were fed through homemade meals. Patients were studied as a whole and divided into two groups: head and neck cancer (HNC) and neurological dysphagia (ND). we assessed 146 patients (89 males), between 21-95 years old: HNC-56; ND-90. Normal values of selenium in 79% (n=115); low albumin in 77, low transferrin in 94, low values for both serum proteins in 66. Low BMI in 78. Selenium has slow evolution, with most patients still displaying normal Selenium at T3 (82%). Serum protein levels increase from T0 to T3, most patients reaching normal values. The nature of the underlying disease is associated with serum proteins but not with selenium. low serum selenium is uncommon when PEG is performed, after 4 and 12 weeks of enteral feeding and cannot be related with serum proteins levels or dysphagia cause. Enteral nutrition using customized homemade kitchen meals is satisfactory to prevent or correct Selenium deficiency in the majority of PEG patients. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  10. LOW SERUM CHROMIUM IS RARE IN PATIENTS THAT UNDERWENT ENDOSCOPIC GASTROSTOMY FOR LONG TERM ENTERAL FEEDING.

    Science.gov (United States)

    Santos, Carla Adriana; Fonseca, Jorge; Carolino, Elisabete; Guerreiro, António Sousa

    2017-01-01

    Patients that underwent Percutaneous Endoscopic Gastrostomy (PEG) present with protein-energy malnutrition. Trace elements are required in small quantities and Chromium (Cr) displays a major role in the metabolism. This study aims to evaluate Cr levels and its relationship with serum proteins, BMI and underlying diseases during the first 3 months of PEG feeding. Prospective observational study during 3-months, when PEG was performed (T0), after 4 (T1), and 12 weeks (T3). Initial evaluation included: age, gender, underlying disease, NRS-2002, BMI, serum albumin, transferrin and Cr concentration. At T1 and T3 a blood sample was collected for Cr, albumin and transferrin. A Graphite Furnace Atomic Absorption Spectroscopy was used to assess Cr. According with the underlying disease, patients were divided into two groups: head and neck cancer (HNC) and neurological dysphagia (ND). All patients were fed with homemade meals. A one hundred and twenty-nine patients (80 males), 26-95 years old were studied: HNC-52; ND-77. The observed data included low mean values of BMI from 71 patients; low Cr-8, low albumin-70, low transferrin-85 and 57 with both proteins low. Albumin was associated with survival time ( P =0.024) and there was a significant correlation between albumin and Cr (r=0.217, P =0.012). A good evolution of Cr and proteins values was observed, with no low Cr levels at T3. Low serum Cr is rare in PEG-patients, with no relationship to other studied parameters. For the minority of patients displaying low Cr before gastrostomy, homemade PEG meals seem to be effective.

  11. Comparative analysis of pain in patients who underwent total knee replacement regarding the tourniquet pressure

    Directory of Open Access Journals (Sweden)

    Marcos George de Souza Leão

    Full Text Available ABSTRACT OBJECTIVES: To evaluate through the visual analog scale (VAS the pain in patients undergoing total knee replacement (TKR with different pressures of the pneumatic tourniquet. METHODS: An observational, randomized, descriptive study on an analytical basis, with 60 patients who underwent TKR, divided into two groups, which were matched: a group where TKR was performed with tourniquet pressures of 350 mmHg (standard and the other with systolic blood pressure plus 100 mmHg (P + 100. These patients had their pain assessed by VAS at 48 h, and at the 5th and 15th days after procedure. Secondarily, the following were also measured: range of motion (ROM, complications, and blood drainage volume in each group; the data were subjected to statistical analysis. RESULTS: After data analysis, there was no statistical difference regarding the incidence of complications (p = 0.612, ROM (p = 0.202, bleeding after 24 and 48 h (p = 0.432 and p = 0.254 or in relation to VAS. No correlation was observed between time of ischemia compared to VAS and bleeding. CONCLUSIONS: The use of the pneumatic tourniquet pressure at 350 mmHg or systolic blood pressure plus 100 mmHg did not influence the pain, blood loss, ROM, and complications. Therefore the pressures at these levels are safe and do not change the surgery outcomes; the time of ischemia must be closely observed to avoid major complications.

  12. Influence of perioperative administration of amino acids on thermoregulation response in patients underwent colorectal surgical procedures

    Directory of Open Access Journals (Sweden)

    Zeba Snježana

    2007-01-01

    Full Text Available Background. Hypothermia in the surgical patients can be the consequence of long duration of surgical intervention, general anesthesia and low temperature in operating room. Postoperative hypothermia contributes to a number of postoperative complications such as arrhythmia, myocardial ischemia, hypertension, bleeding, wound infection, coagulopathy, prolonged effect of muscle relaxants. External heating procedures are used to prevent this condition, but some investigations reported that infusion of aminoacids during surgery can induce thermogenesis and prevent postoperative hypothermia. Case report. We reported two males who underwent major colorectal surgery for rectal carcinoma. One patient received Aminosol 15% solution, 125 ml/h, while the other did not. The esophageal temperatures in both cases were measured every 30 minutes during the operation and 60 minutes after in Intensive Care Unit. We were monitoring blood pressure, heart rate, ECG, and shivering. Patient who received aminoacids showed ameliorated postoperative hypothermia without hypertension, arrhythmia, or shivering, while the other showed all symptoms mentioned above. Conclusion. According to literature data, as well as our findings, we can conclude that intraoperative intravenous treatment with amino acid solution ameliorates postoperative hypothermia along with its complications. .

  13. Evaluation of 118 Thyroid Cancer Patients Who Underwent a Re-operation after Local Resection

    Institute of Scientific and Technical Information of China (English)

    Jianping Hang; Dong Meng; Liqi Li

    2005-01-01

    OBJECTIVE To evaluate the incidence of residual thyroid cancer and cervical lymph node metastasis following a previous local resection for thyroid cancer, and to discuss methods of a reoperation.METHODS From 1994~2005, 118 patients with thyroid cancer who had previously been treated with a nodule-resection or subtotal Iobectomy in other hospitals underwent a surgical re-operation.RESULTS The incidence of residual cancer at the primary site was 38.1%. The lymph node metastasis rate at the central area was 39.8%.The rate of lymph node metastasis in patients with enlarged lymph nodes in the ipsilateral internal jugular chain was 37.5%. The rate of laryngeal recurrent nerve injury was 15.2% in other hospitals while that of the second operation in our hospital was 1.6%.CONCLUSION Nodule-resection or subtotal Iobectomy alone is not indicated for patients with thyroid cancer because of the high rate of local residual cancer. It is important to be familiar with the anatomy of the laryngeal recurrent nerve for thyroid surgery. Exploration to the central area is necessary for differentiated thyroid cancer.

  14. Incidence of venous thromboembolism among patients who underwent major surgery in a public hospital in Singapore

    Directory of Open Access Journals (Sweden)

    Anindya P. Susanto

    2014-03-01

    Full Text Available Background: Venous thromboembolism (VTE is a fatal yet potentially preventable complication of surgery. Routine thromboprophylaxis is still unequivocal prescription is problematic due to perception of low VTE incidence among Asian population. This study aims to investigate the incidence of VTE and thromboprophylaxis prescription among patients undergoing major surgery in a Singapore hospital.Methods: This was a cross-sectional study. Data were obtained from medical record of 1,103 patients who had underwent major orthopaedic or abdominal surgery in 2011-2012 at Khoo Teck Puat Hospital, Singapore. Incidence of VTE events either in the same admission or re-admission in less than one month time were noted as study parameters.Results: Incidence of VTE was 2.1% (95% CI: 1.67 - 2.53 of which 1.3% and 0.8% were DVT and PE cases respectively. Age, gender, history of VTE, ischemic heart disease, and mechanical prophylaxis were associated with VTE incidence based on bivariate analysis. The prescription of pharmacological thromboprophylaxis was associated with prior anticoagulant medication, type of surgery, and incidence of new bleeding. Conclusion: Subsequent to major surgeries, VTE is as common in Asian patients as published data in other populations. Pharmacologic thromboprophylaxis should be considered as recommended in non-Asian guidelines.Keywords: thromboprophylaxis, venous thromboembolism

  15. Assessment of Patients Who Underwent Nasal Reconstruction After Non-Melanoma Skin Cancer Excision.

    Science.gov (United States)

    Uzun, Hakan; Bitik, Ozan; Kamburoğlu, Haldun Onuralp; Dadaci, Mehmet; Çaliş, Mert; Öcal, Engin

    2015-06-01

    Basal and squamous cell carcinomas are the most common malignant cutaneous lesions affecting the nose. With the rising incidence of skin cancers, plastic surgeons increasingly face nasal reconstruction challenges. Although multiple options exist, optimal results are obtained when "like is used to repair like". We aimed to introduce a simple algorithm for the reconstruction of nasal defects with local flaps, realizing that there is always more than one option for reconstruction. We retrospectively reviewed 163 patients who underwent nasal reconstruction after excision of non-melanoma skin cancer between March 2011 and April 2014. We analyzed the location of the defects and correlated them with the techniques used to reconstruct them. There were 66 males and 97 females (age, 21-98 years). Basal cell carcinoma was diagnosed in 121 patients and squamous cell carcinoma in 42. After tumor excision, all the defects were immediately closed by either primary closure or local flap options such as Limberg, Miter, glabellar, bilobed, nasolabial, V-Y advancement, and forehead flaps. Obtaining tumor-free borders and a pleasing aesthetic result are major concerns in nasal reconstruction. Defect reconstruction and cosmesis are as important as rapid recovery and quick return to normal daily activities, and these should be considered before performing any procedure, particularly in elderly patients.

  16. THE EXPERIENCE OF TREGALOZA BASED LUBRICANT USAGE FOR PATIENTS WHO UNDERWENT EXCIMER LASER SURGERY

    Directory of Open Access Journals (Sweden)

    E. Eskina

    2016-01-01

    Full Text Available Purpose: to evaluate the tregalose based eye drops effectiveness in patients who underwent PRK or TransPRK surgery. patients and methods: 50 patients with moderate myopia were examined before, 7 days and 1 month after PRK or TransPRK surgery made by SCHWIND Amaris excimer laser by the same surgeon. In addition to conventional diagnostics, Schirmer test and tear break up time were performed as well as ODSI questionare and Oxford index of ocular surface disorders were investigated. Patients were divided in two groups, Study group — “Thealos” group and “Control” group. In both groups patients have started using non preservative eye drops based on tregalosa and hyaluronic acid 4-th day after surgery respectively. results: The tear film breakup time was significantly better in “Thealos” group (7,22±3,61 sec 7 days postop and 9,36±3,68 sec 1 month postop in comparison to «Control” group 5,21±0,25 (р<0,01 sec and 7,21±2,85 sec respectively (р<0,05 as well as ocular surface index score in “Thealos” group post surgery was less (0,26±0,38 и 0,85±0,31 marks 7 days postop (р<0,05 and 0,09±0,19 and 0,21±0,4 (р<0,05 1 month postop respectively. There were no other statistically significant differences found in analysed data. Conclusion: Using of “Thealoz” non-preservative eye drops leads to faster recovery after surface excimer laser ablations in terms of dry eye manifestation, those as tearfilm stability and ocular surface index score, measured using “Oxford” scale. Moistening properties of tregaloze solution could be compared with those of hyaluronic acid solution.

  17. Association of PTP1B with Outcomes of Breast Cancer Patients Who Underwent Neoadjuvant Chemotherapy

    Science.gov (United States)

    Rivera Franco, Monica M.; Leon Rodriguez, Eucario; Martinez Benitez, Braulio; Villanueva Rodriguez, Luisa G.; de la Luz Sevilla Gonzalez, Maria; Armengol Alonso, Alejandra

    2016-01-01

    PTP1B is involved in the oncogenesis of breast cancer. In addition, neoadjuvant therapy has been widely used in breast cancer; thus, a measurement to assess survival improvement could be pathological complete response (pCR). Our objective was to associate PTP1B overexpression with outcomes of breast cancer patients who underwent neoadjuvant chemotherapy. Forty-six specimens were included. Diagnostic biopsies were immunostained using anti-PTP1B antibody. Expression was categorized as negative (<5%) and overexpression (≥5%). Patients’ responses were graded according to the Miller–Payne system. Sixty-three percent of patients overexpressed PTP1B. There was no significant association between PTP1B overexpression and pCR (P = 0.2). However, when associated with intrinsic subtypes, overexpression was higher in human epidermal growth factor receptor 2-positive-enriched specimens (P = 0.02). Ten-year progression-free survival showed no differences. Our preliminary results do not show an association between PTP1B over-expression and pCR; however, given the limited sample and heterogeneous treatment in our cohort, this hypothesis cannot be excluded. PMID:27840578

  18. Predictors of weight regain in patients who underwent Roux-en-Y gastric bypass surgery.

    Science.gov (United States)

    Shantavasinkul, Prapimporn Chattranukulchai; Omotosho, Philip; Corsino, Leonor; Portenier, Dana; Torquati, Alfonso

    2016-11-01

    Roux-en-Y gastric bypass (RYGB) is a highly effective treatment for obesity and results in long-term weight loss and resolution of co-morbidities. However, weight regain may occur as soon as 1-2 years after surgery. This retrospective study aimed to investigate the prevalence of weight regain and possible preoperative predictors of this phenomenon after RYGB. An academic medical center in the United States. A total of 1426 obese patients (15.8% male) who underwent RYGB during January 2000 to 2012 and had at least a 2-year follow-up were reviewed. We included only patients who were initially successful, having achieved at least 50% excess weight loss at 1 year postoperatively. Patients were then categorized into either the weight regain group (WR) or sustained weight loss (SWL) group based upon whether they gained≥15% of their 1-year postoperative weight. Weight regain was observed in 244 patients (17.1%). Preoperative body mass index was similar between groups. Body mass index was significantly higher and percent excess weight loss was significantly lower in the WR group (Pweight regain was 19.5±9.3 kg and-.8±8.5 in the WR and SWL groups, respectively (Pweight loss. Moreover, a longer duration after RYGB was associated with weight regain. Multivariate analysis revealed that younger age was a significant predictor of weight regain even after adjusting for time since RYGB. The present study confirmed that a longer interval after RYGB was associated with weight regain. Younger age was a significant predictor of weight regain even after adjusting for time since RYGB. The findings of this study underscore the complexity of the mechanisms underlying weight loss and regain after RYGB. Future prospective studies are needed to further explore the prevalence, predictors, and mechanisms of weight regain after RYGB. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  19. Twenty-four-hour blood pressure among Greenlanders and Danes: relationship to diet and lifestyle

    DEFF Research Database (Denmark)

    Jørgensen, Marit Eika; Pedersen, M.B.; Siggaard, Cecilie

    2002-01-01

    the influence of Arctic food and lifestyle on blood pressure. Four groups of healthy subjects were recruited for the study. Group I: Danes in Denmark consuming European food; group II: Greenlanders in Denmark consuming European food; group III: Greenlanders in Greenland consuming mainly European food; and group......, outdoor temperature, and lifestyle factors. Greenlanders have a lower 24-h diastolic blood pressure than Danes, and it is suggested that genetic factors are mainly responsible for the lower blood pressure level among Greenlanders. Twenty-four-hour blood pressure among Greenlanders and Danes: Relationship...... to diet and lifestyle - ResearchGate. Available from: http://www.researchgate.net/publication/11001663_Twenty-four-hour_blood_pressure_among_Greenlanders_and_Danes_Relationship_to_diet_and_lifestyle [accessed Oct 7, 2015]....

  20. [A patient with EDTA-dependent pseudothrombocytopenia who underwent emergent clipping surgery for a ruptured aneurysm].

    Science.gov (United States)

    Yamaguchi, M; Mayumi, M; Kasuya, T

    1998-01-01

    A 42-year-old female with EDTA-dependent pseudothrombocytopenia underwent emergent clipping surgery for a ruptured aneurysm. On admission, the platelet count was low, but bleeding time and coagulation test were within normal limits. The blood smear anticoagulated with EDTA revealed remarkable agglutination of platelets, while heparinized blood showed a normal level. Diagnosis of EDTA-dependent pseudothrombocytopenia was made. The progressive drop in platelet count occurred within 10 minutes in the presence of EDTA. The autocounter misjudged the agglutination of platelets as red or white blood cells. The earlier study reported the incidence of this diseases as 0.07%. This disease is often misdiagnosed. Therefore, thrombocytopenia without any clinical symptom should be considered as showing a possible symptom of EDTA-dependent pseudothrombocytopenia.

  1. Comparison of propofol effect with Ketamine for sedation induction in pediatric patients who underwent cardiol catheterization

    Directory of Open Access Journals (Sweden)

    Houshang Shahryari

    2010-04-01

    Full Text Available Background: The goals for sedation in pediatric patients scheduled to undergo cardiac catheterization include immobility, analgesia, cardiovascular and respiratory stability. We investigated the effects of Propofol and Ketamine on hemodynamic, respiratory status, sedation level, pain score and recovery period in pediatric patients undergoing cardiac catheterization. Methods: We preformed a randomized clinical trial study on 40 pediatric patients. The patients were randomly assigned to two groups, so that 20 patients received Ketamine and 20 patients received Propofol. In all patients, sedation was started with Midazolam (0.03mg/kg, then followed by Propofol in the first group and Ketamine in the second one. The hemodynamic responses, respiratory parameters, recovery characteristics (Ramsey scale, pain score VAS and relevant adverse effects of the two groups were recorded. Data was analyzed using Paired T Test, ANOVA and Stearman correlation coefficient. Results: Five patients in the Propofol group andon patients in the Ketamine group experienced a transient decrease in mean systolic blood pressure greater than 10% of baseline(p=0.034. Time to full recovery (mean ± SD was not significantly different in the Propofol group and Ketamine group (1.8 min vs. 2.9 min, P > 0.05. Pain scores were significantly different in both groups (P= 0.010. Patients’ heart rates were significantly higher in Ketamine group(P=0.029. No significant difference in respiratory rate was recorded in both groups(p›0.05. Conclusion: Both Ketamine and Propofol are useful and safe in pediatric patients undergoing cardiac catheterization but it seems that it is better to use Propofol in stable hemodynamic pediatric patients under continuous blood pressure monitoring.

  2. Comparing efficacy of preemptively used dexketoprofen and tramadol for postoperative pain in patients underwent laparoscopic cholecystectomy

    Directory of Open Access Journals (Sweden)

    Süreyya Özkan

    2015-03-01

    Full Text Available Objective: In our study, we aimed to compare effects of preoperative dexketoprofen and tramadol administered by intravenous route on intraoperative and postoperative analgesic consumption, postoperative pain, durations of hospital stay and patient satisfaction in patients, undergoing laparoscopic cholecystectomy. Methods:After approval of ethic committee and written consent of patients were obtained, 60 patients between 18-70 years old with ASA I-II were included in the study. After routine monitorization and 20 minutes before induction of anesthesia, dexketoprofen 50 mg in 100 cc 0.9% NaCl was administered in Dexketoprofen Group and tramadol 100 mg in 100 cc 0.9% NaCl in Tramadol Group as intravenous infusion during 20 minutes. Intraoperative hemodynamic parameters, analgesic-anesthetic consumptions and complications of patients, on whom standard general anesthesia was applied, were recorded. Pain severity, degree of sedation, morphine consumptions and hemodynamic parameters were recorded at postoperative 30 th minute, and 4 th, 8th, 12th and 24 th hours. Additional analgesia requirement, times for requiring first analgesia, duration of hospital stay, postoperative complications and patient satisfactions were recorded. Results: Intraoperative analgesic-anesthetic consumptions, postoperative visual analogue scale (VAS scores, sedation degrees, intravenous patient controlled analgesia (PCA and morphine consumptions, times for requiring first analgesic, durations of hospital stay, intraoperative-postoperative complications developed and patient satisfactions were similar in both groups. Consequently, postoperative analgesic efficacy of pre-emptive dexketoprofen intravenous 50 mg and tramadol intravenous 100 mg administered was found to be similar in cases, who had laparoscopic cholecystectomy operation. Conclusion:Because VAS scores were low in our patients, morphine consumptions with intravenous PCA were similar in both groups, and there wasn

  3. Application of a buprenorphine transdermal patch for the perioperative analgesia in patients who underwent simple lumbar discectomy

    Science.gov (United States)

    Tang, Jian; Fan, Jin; Yao, Yilun; Cai, Weihua; Yin, Guoyong; Zhou, Wei

    2017-01-01

    Abstract This study aimed to investigate the perioperative analgesic effect of a buprenorphine transdermal patch in patients who underwent simple lumbar discectomy. In total, 96 patients were randomly divided into parecoxib intravenous injection (Group A), oral celecoxib (Group B), and buprenorphine transdermal patch groups (Group C). The pain status, degree of satisfaction, adverse effects, and condition in which the patient received tramadol hydrochloride for uncontrolled pain were recorded on the night before surgery, postoperative day 1, postoperative day 3, and postoperative day 5. The degree of patient satisfaction in Group C was higher than that in Groups A and B, with minimal adverse effects. The buprenorphine transdermal patch had a better perioperative analgesic effect in patients who underwent simple lumbar discectomy. PMID:28514299

  4. Analysis of Recurrence Management in Patients Who Underwent Nonsurgical Treatment for Acute Appendicitis.

    Science.gov (United States)

    Liang, Tsung-Jung; Liu, Shiuh-Inn; Tsai, Chung-Yu; Kang, Chi-Hsiang; Huang, Wei-Chun; Chang, Hong-Tai; Chen, I-Shu

    2016-03-01

    The recurrence rate for acute appendicitis treated nonoperatively varies between studies. Few studies have adequately evaluated the management of these patients when appendicitis recurs. We aimed to explore the recurrence rate and management of patients with acute appendicitis that were first treated nonoperatively.We identified patients in the Taiwan National Health Insurance Research Database who were hospitalized due to acute appendicitis for the first time between 2000 and 2010 and received nonsurgical treatment. The recurrence and its management were recorded. Data were analyzed to access the risk factors for recurrence and factors that influenced the management of recurrent appendicitis.Among the 239,821 patients hospitalized with acute appendicitis for the first time, 12,235 (5.1%) patients were managed nonoperatively. Of these, 864 (7.1%) had a recurrence during a median follow-up of 6.5 years. Appendectomy was performed by an open and laparoscopic approach in 483 (55.9%) and 258 (29.9%) patients, respectively. The remaining 123 (14.2%) patients were again treated nonsurgically. Recurrence was independently associated with young age, male sex, percutaneous abscess drainage, and medical center admission by multivariable analysis. In addition, age appendicitis, percutaneous abscess drainage, nor length of first time hospital stay had an influence on the selection of surgical approach.In conclusion, a laparoscopic appendectomy can be performed in recurrent appendicitis cases, and its application may not be related to previous appendicitis severity.

  5. Thromboprophylaxis and Incidence of Venous Thromboembolism in Patients With Hemophilia A or B Who Underwent High-Risk Orthopedic Surgeries.

    Science.gov (United States)

    Raza, Shahzad; Kale, Gautam; Kim, Daniel; Akbar, Syed A; Holm, Lisa; Naidzionak, Ulad; Hossain, Akm M; Dong, Xiang; Doll, Donald C; Freter, Carl E; Hopkins, Tamara

    2016-03-01

    Total hip replacement (THR) and total knee arthroplasty (TKA) carry a high risk of postoperative venous thromboembolism (VTE); therefore, anticoagulation prophylaxis is recommended in these patients. Unfortunately, there are no guidelines about VTE prophylaxis in patients with hemophilia who underwent these high-risk surgeries. To determine whether these patients have high risk of VTE, we conducted a retrospective study on patients with hemophilia who underwent elective THR/TKA at our institute from 2004 to 2012. Postoperatively, we collected information on duration and method of factor VIII/IX infusion, VTE-prophylaxis, and complications. There were 23 patients with hemophilia, 18 (78%) with hemophilia A and 5 (22%) with hemophilia B, who underwent high-risk surgeries (39% THR and 61% TKA). The VTE prophylaxis included sequential compression device, 12 (52%), and prophylactic enoxaparin, 1 (4%). Ten (43%) patients did not receive VTE prophylaxis. At 1-year follow-up, we did not find any evidence of clinical VTE in our patients. Better risk stratification is needed to identify patients who would benefit from pharmacological prophylaxis.

  6. Evaluation of fever in the immediate postoperative period in patients who underwent total joint arthroplasty.

    Science.gov (United States)

    Athanassious, Christian; Samad, Adil; Avery, Anthony; Cohen, Jason; Chalnick, David

    2011-12-01

    Forty percent to 50% of patients may experience an immediate postoperative fever. Research suggests that these are of aseptic cause due to inflammatory mediators. This is a retrospective analysis of fevers in total hip arthroplasty (THA) and total knee arthroplasty (TKA) patients from 2006 to 2008. Thirty-six percent of THA and 31% of TKA patients developed a fever, with most developing a maximum temperature on postoperative day (POD) 2. The maximum mean temperature between the THA and TKA group was not significantly different. Fevers in the immediate postoperative period are a normal variant in patients undergoing THA or TKA. Urinalysis, urine culture and sensitivity, and chest x-ray are not required during this period because most of these fevers stem from aseptic causes. Copyright © 2011 Elsevier Inc. All rights reserved.

  7. Serum zinc evolution in dysphagic patients that underwent endoscopic gastrostomy for long term enteral feeding.

    Science.gov (United States)

    Santos, Carla Adriana; Fonseca, Jorge; Lopes, Maria Teresa Martins; Carolino, Elisabete; Guerreiro, António Sousa

    2017-03-01

    Patients undergoing endoscopic gastrostomy (PEG) present with protein-energy malnutrition (PEM) but little is known about zinc status. Our aim was to evaluate serum zinc, its relationship with serum proteins and with the nature of the underlying disorder, during the first 3 months of PEG feeding. Prospective observational study during a 3-month period after gastrostomy. Data was collected at initial PEG procedure (T0), after 4 (T1) and 12 weeks (T3). Initial evaluation included: age, gender, disorder causing dysphagia, Neurological Dysphagia (ND) or Head and Neck Cancer (HNC), NRS-2002, BMI, albumin, transferrin, zinc. At T1 and T3, a blood sample was collected for zinc, albumin, transferrin. Serum zinc evaluation was performed with ICP-AES - Inductively Coupled Plasma-Atomic Emission Spectroscopy. Patients were fed with homemade meals. A total of 146 patients (89 males), 21-95 years were studied: HNC-56, ND-90 and low BMI in 78. Initial low zinc in 122; low albumin in 77, low transferrin in 94; low values for both proteins in 66. Regarding the serum protein evolution, their levels increase T0-T3, most patients reaching normal values. zinc has a slower evolution, most patients still displaying low zinc at T3. Significant differences between the 3 moments for zinc (p=0.011), albumin (p<0.0001) and transferrin (p=0.014). PEG patients are prone to PEM and zinc deficiency. Most patients present decreased zinc, suggesting that zinc deficiency is common in PEG candidates and is not corrected during 3 months of enteral feeding. Zinc deficiency should be expected and teams taking care of PEG patients should use zinc supplementation.

  8. Adenomyosis:Pathologies associated in a set of patients underwent hysterectomy

    Institute of Scientific and Technical Information of China (English)

    Luis Humberto Sordia-Hernandez; Julio Herrero; Arturo Morales Martinez; Jose Mara Gris; Donato Saldivar Rodriguez; Oscar Vidal Gutierrez; Celina Castro

    2012-01-01

    Objective:To determine if a relationship exists between the histopathological diagnosis of adenomyosis and the clinical conditions and pathologies that are more commonly related to it in patients undergoing hysterectomy. Methods:Retrospective, comparative, case-control study was conducted. With previous approval by ethics committee, we included 794 patients undergoing hysterectomy at a University Hospital. The Medical records and pathology reports of patients undergoing hysterectomy over a two-year period were reviwed. Clinical conditions and associated pathologies, in patients with and without adenomyosis, were reviewed and compared. Statistical analysis was done using the Chi-square test. Results:Adenomyosis was reported in 140 out of 794 patients, 17.6%(95%CI:15.1-20.4). No differences in adenomyosis prevalence were found among patients with or without uterine fibroids, 20.2%(75/371) vs. 15.5%(65/423);endometrial polyps, 9.7%(6/62) vs. 18.3%(134/732);and the presence or lack of endometrial hyperplasia 13.9%(5/36) vs. 17.4%(135/758). The prevalence of adenomyosis among patients with endometriosis was 40.7%(11/27), and among those without this diagnosis, 16.8%(129/767). This difference was significant (P=0.001). A history of two or more curettages was also positively related to adenomyosis. Conclusions:There was a statistically significant difference in the prevalence of adenomyosis in women with endometriosis when compared to women without endometriosis. A higher incidence of adenomyosis was found in patients with a history of two or more curettages. Trauma to the endometrium could explain the higher incidence of adenomyosis in both conditions.

  9. Comparison of intraoperative and postoperative complications based on ASA risks in patients who underwent percutaneous nephrolithotomy

    Science.gov (United States)

    Karakaş, Hüseyin Buğra; Çiçekbilek, İzzet; Tok, Adem; Alışkan, Tamer; Akduman, Bülent

    2016-01-01

    Objective In this study we aimed to evaluate intraoperative and postoperative complications which developed according to pre-operative American Society of Anesthesiologists (ASA) risk criteria in patients who had undergone percutaneous nephrolithotomy (PNL). Material and methods Five hundred and sixty patients who had undergone PNL between 2002 and 2014 were included in the study. Patients operated on the ipsilateral kidney, those with solitary kidney or the cases who had previously undergone more than one access were excluded from this study. Preoperative anesthesia risks were determined according to preoperative classification developed by ASA. Postoperative complications were evaluated using Clavien Complication Grading Scale. Results The mean age of the cases was 47±14 years. The 57% (n=319) of the cases were male, 241 (43%) of them were female. The average indwell time of nephrostomy catheter was 2.88±1.00 (1–8), and length of hospital stay was 4.91±1.54 (2–17) days. When the cases were assessed according to ASA risk groups, intraoperative complications were observed in 9 (5.5%) ASA I, 27 (8.6%) ASA II, and 18 (22%) ASA III patients and and distribution of the patients was statistically significant (pPNL operations in terms of intraoperative complications. PMID:27635291

  10. Serum copper evolution in patients that underwent endoscopic gastrostomy for long term enteral feeding

    Directory of Open Access Journals (Sweden)

    Carla Adriana Santos

    Full Text Available Background and aims: Copper (Cu is a well studied trace element but little is known about Cu evolution in long term endoscopic gastrostomy (PEG feeding. We aimed to evaluate the evolution serum Cu since the gastrostomy until 12 weeks after the procedure in PEG patients fed with homemade meals. Methods: A prospective observational study was performed evaluating serum copper, albumin, transferrin and body mass index (BMI at the time of the gastrostomy, 4 weeks and 12 weeks after. Data also included age, gender, NRS 2002 and nature of the underlying disease causing dysphagia: head and neck cancer (HNC or neurological dysphagia (ND. After gastrostomy, patients were fed with homemade PEG meals. Results: One hundred and forty-six patients enrolled, 89 men, aged 21-95 years, 90 with neurologic dysphagia (ND, and 56 with head and neck cancer (HNC. 78 (53% showed low BMI. Initially, Cu ranged 42-160 µg/dl (normal: 70-140 µg/dl; 130 patients (89% presented normal Cu, 16 (11% presented hypocupremia, 53% low albumin (n = 77, and 94 (65% low transferrin. After 4 weeks, 93% presented normal Cu, 7% presented hypocupremia, low albumin was present in 34%, and low transferrin in 52%. After 12 weeks, 95% presented normal Cu, 5% presented hypocupremia, low albumin was present in 25%, and low transferrin in 32%. Comparing age, gender, underlying disease, BMI, albumin and transferrin, there were no significant differences on serum Cu. Conclusions: Most patients present normal serum Cu when gastrostomy is performed. For patients presenting hypocupremia before gastrostomy, homemade meals are effective for normalizing serum Cu.

  11. Concomitant mediastinal and extrarenal retroperitoneal angiomyolipomas in a patient who previously underwent ipsilateral radical nephrectomy

    Directory of Open Access Journals (Sweden)

    Carl Sheng-Chen Wen

    2014-12-01

    Full Text Available The association of the tuberous sclerosis complex with angiomyolipoma (AML arising from the retroperitoneum and mediastinum has not been reported in the literature. We present the first case in which a patient presented with a combined retroperitoneal extrarenal and posterior mediastinal AML. Interestingly, the ipsilateral retroperitoneal AML emerged 15 years after radical nephrectomy for the left renal AML.

  12. Speech and Swallowing Data in Individual Patients Who Underwent Glossectomy after Prosthetic Rehabilitation

    Directory of Open Access Journals (Sweden)

    Viviane de Carvalho

    2016-01-01

    Full Text Available Maintaining oral function in patients undergoing glossectomy boosts interventions such as prosthetic rehabilitation. However, current literature still fails in the presentation of results of prosthetic rehabilitation in relation to speech or swallowing. The objective of this research is to evaluate the effectiveness of prosthetic rehabilitation on voice, speech, and swallowing in patients undergoing glossectomy by performing a systematic literature review and meta-analysis of individual cases. Studies were identified by relevant electronic database and included all dates available. The criteria used were sample with any n; resection due to malignant tumors, restricted to tongue and/or floor of mouth; type of prosthetic rehabilitation; and description of the oral functions outcomes with prosthesis. For the meta-analysis of individual data, associations between the variables of interest and the type of prosthesis were evaluated. Thirty-three of 471 articles met the selection criteria. Results on speech and/or voice and swallowing were reported in 27 and 28 articles, respectively. There were improvement of speech intelligibility and swallowing in 96 patients and in 73 patients, respectively, with prosthesis. Based on the available evidences, this article showed that prosthetic rehabilitation was able to improve oral functions and can be a strategy used with surgical reconstruction in selected cases.

  13. QOL-associated factors in elderly patients who underwent cardiovascular surgery.

    Science.gov (United States)

    Terashima, Kiyoko; Yoshimura, Yoko; Hirai, Kazuyoshi; Kusaka, Yukinori

    2012-03-01

    Quality of life (QOL) was compared between elderly patients treated with cardiac surgery (cardiac surgery group) and general elderly nonoperated individuals (control group) to clarify differences in QOL-associated factors between the two groups. The cardiac surgery group consisted of 82 patients aged 72.5 years at approximately 2 years after discharge, and the control group consisted of 95 elderly individuals aged 77 years living at home. QOL was measured based on interviews using two scales: disease-specific QOL and Short Form (36) Health Survey (SF-36) in the cardiac surgery group, and SF-36 in the control group. Associated factors included the Tokyo Metropolitan Institute of Gerontology (TMIG) index of competence, living with one's spouse, exercise habit, and the number of past medical history items. There was no cardiac surgery procedure-associated significant difference in disease-specific QOL. When comparing SF-36 between groups, the physical health level was significantly lower in the cardiac surgery group, but no significant difference was noted in the mental health level. Regarding physical health level of SF-36-associated factors, mental health level was a negative factor in both groups. In the cardiac surgery group, age was a negative factor. In the control group, the TMIG index and number of past medical history items were positive and negative factors, respectively. As elderly people with high physical health levels after cardiac surgeries may have low mental health levels, physicians and nurses need to be aware and address this situation.

  14. Vaginal and pelvic recurrence rates based on vaginal cuff length in patients with cervical cancer who underwent radical hysterectomies.

    Science.gov (United States)

    Kim, K; Cho, S Y; Park, S I; Kim, B J; Kim, M H; Choi, S C; Ryu, S Y; Lee, E D

    2011-09-01

    The objective of this study was to determine the association of vaginal cuff length (VCL) with vaginal and pelvic recurrence rates in patients with cervical cancer who underwent radical hysterectomies. The clinicopathologic characteristics were collected from the medical records of 280 patients with cervical cancer who underwent radical hysterectomies. The association of VCL with 3-year vaginal and pelvic recurrence rates was determined using a Z-test. The association of VCL with other clinicopathologic characteristics was also determined. The VCL was not associated with 3-year vaginal and pelvic recurrence rates. The 3-year vaginal recurrence rate was 0%-2% and the 3-year pelvic recurrence rate was 7%-8%, independent of VCL. The VCL and the age of patients had an inverse relationship. However, the VCL was not associated with histologic type, FIGO stage, clinical tumor size, tumor size in the surgical specimen, depth of invasion, lymphovascular space invasion, parametrial involvement, lymph node involvement, and adjuvant therapy. One-hundred ninety of 280 patients (68%) underwent adjuvant therapies following radical hysterectomies. Although it is limited by the high rate of adjuvant therapy, the current study suggested that the VCL following radical hysterectomy in patients with cervical cancer was not associated with vaginal and pelvic recurrence rates. Copyright © 2011 Elsevier Ltd. All rights reserved.

  15. Optical Coherence Tomography Parameters in Morbidly Obese Patients Who Underwent Laparoscopic Sleeve Gastrectomy

    Directory of Open Access Journals (Sweden)

    Berna Dogan

    2016-01-01

    Full Text Available Purpose. To investigate changes in optical coherence tomography parameters in morbidly obese patients who had undergone laparoscopic sleeve gastrectomy (LSG. Methods. A total of 41 eyes of 41 morbidly obese patients (BMI ≥ 40 who had undergone LSG were included in study. The topographic optic disc parameters, central macular thickness (CMT, total macular volume (TMV, and retinal ganglion cell layer (RGCL were measured by spectral-domain optical coherence tomography (SD-OCT. Subfoveal choroidal thickness (SFCT was measured by enhanced deep imaging-optical coherence tomography (EDI-OCT. Results. The mean CMT was 237.4±24.5 μm, 239.3±24.1 μm, and 240.4±24.5 μm preoperatively, 3 months postoperatively, and 6 months postoperatively, respectively (p<0.01. The mean TMV was 9.88±0.52 mm3, 9.96±0.56 mm3, and 9.99±0.56 mm3 preoperatively, 3 months postoperatively, and 6 months postoperatively, respectively (p<0.01. The mean RGCL was 81.2±6.5 μm, 82.7±6.6 μm, and 82.9±6.5 μm preoperatively, 3 months postoperatively, and 6 months postoperatively, respectively (p<0.01. The mean SFCT was 309.8±71.8 μm, 331.0±81.4 μm, and 352.7±81.4 μm preoperatively, 3 months postoperatively, and 6 months postoperatively, respectively (p<0.01. No statistically significant differences were found between the preoperative values and 3- and 6-month postoperative values in rim area (p=0.34, disc area (p=0.64, vertical cup/disc ratio (p=0.39, cup volume (p=0.08, or retinal nerve fiber layer (p=0.90. Conclusions. Morbidly obese patients who undergo LSG experience a statistically significant increase in CMT, TMV, SFCT, and RGCL at 3 months and 6 months after surgery.

  16. The Mid-Term Results of Patients who Underwent Radiofrequency Atrial Fibrillation Ablation Together with Mitral Valve Surgery

    Directory of Open Access Journals (Sweden)

    Abdurrahim Çolak

    Full Text Available Abstract Objetive: Saline-irrigated radiofrequency ablation, which has been widely used for surgical treatment of atrial fibrillation in recent years, is 80-90% successful in achieving sinus rhythm. In our study, our surgical experience and mid-term results in patients who underwent mitral valve surgery and left atrial radiofrequency ablation were analyzed. Methods: Forty patients (15 males, 25 females; mean age 52.05±9.9 years; range 32-74 underwent surgery for atrial fibrillation associated with mitral valvular disease. All patients manifested atrial fibrillation, which started at least six months before the surgical intervention. The majority of patients (36 patients, 90% were in NYHA class III; 34 (85% patients had rheumatic heart disease. In addition to mitral valve surgery and radiofrequency ablation, coronary artery bypass, DeVega tricuspid annuloplasty, left ventricular aneurysm repair, and left atrial thrombus excision were performed. Following discharge from the hospital, patients' follow-up was performed as outpatient clinic examinations and the average follow-up period of patients was 18±3 months. Results: While the incidence of sinus rhythm was 85.3% on the first postoperative day, it was 80% during discharge and 71% in the 1st year follow-up examination. Conclusion: Radiofrequency ablation is an effective method when it is performed by appropriate surgical technique. Its rate for returning to sinus rhythm is as high as the rate of conventional surgical procedure.

  17. [Evaluation of the antithrombotic strategy in low thrombotic risk patients who underwent aortic valve replacement wth bioprosthesis].

    Science.gov (United States)

    Aceves-Velázquez, Eduardo; Vieyra-Herrera, Gerardo; Rodríguez-Chávez, Laura; Herrera-Alarcón, Valentín

    2017-07-15

    According to current guidelines, in patients without additional risk factors who underwent aortic valve replacement with a bioprosthesis, anticoagulation in the first 3 months after surgery is still a matter of debate. According to current evidence, aspirin in low doses is a reasonable alternative to vitamin K antagonists (VKA). We compared the incidence of thrombotic and hemorrhagic complications in patients with low thrombotic risk who underwent aortic valve replacement with a bioprosthesis in the National Institute of Cardiology of Ignacio Chávez of Mexico. The hypothesis: aspirin as monotherapy has a beneficial effect compared to VKA. The studied patients were the low thrombotic risk patients who underwent aortic valve replacement with a bioprostesis in the National Institute of Cardiology of Ignacio Chávez of Mexico from 2011 to 2015. The groups studied were: aspirin only, VKA only and the combination of VKA plus aspirin. The patients were retrospectively followed during 12 months and the thrombotic and hemorrhagic complications were documented. Two hundred thirty-one patients were analized. Only one patient presented a hemorrhagic complication in the VKA only group. No thrombotic complications were observed. In the present study no thrombotic complications were observed in patients who did not receive anticoagulation in the first 3 months after a aortic valve replacement with a bioprosthesis after a follow up period of 12 months. This suggests that the use of aspirin only is safe during this period. Copyright © 2017 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.

  18. Analysis of 137 Patients Who Underwent Endoscopic Transsphenoidal Pituitary Adenoma Resection Under High-Field Intraoperative Magnetic Resonance Imaging Navigation.

    Science.gov (United States)

    Zhang, Huaping; Wang, Fuyu; Zhou, Tao; Wang, Peng; Chen, Xiaolei; Zhang, Jiashu; Zhou, Dingbiao

    2017-08-01

    Pure endoscopic resection has become the most popular surgical approach for pituitary adenoma. Intraoperative magnetic resonance imaging (iMRI) systems have been in use for endoscopic resection of pituitary adenomas. This study aimed to evaluate the effectiveness of iMRI and neuroimaging navigation techniques during endoscopic endonasal transsphenoidal surgery of pituitary adenomas. Data from 137 patients who underwent resection of endoscopic pituitary adenoma under 1.5T iMRI navigation were collected and analyzed. Of patients, 92 underwent complete resection and 45 had residual tumor on real-time iMRI. Twenty-three patients underwent further surgery, and total resection was achieved in 19. Extent of total resection increased from 67.15% to 81.02%. iMRI revealed 3 patients with bleeding in the surgical area, which was successfully treated during the surgery. Review images obtained 3 months after surgery showed 26 patients with residual tumor; 14 patients had the same volume as intraoperatively, and 12 patients had a volume less than that observed intraoperatively. Residual tumor volume in the suprasellar region was less than that seen intraoperatively in 11 of 15 (73.3%) patients. The use of iMRI and neuronavigation not only leads to a higher rate of tumor resection but also helps in detecting and removing hematomas in the surgical area. Follow-up examinations of extent of residual tumor at 3 months postoperatively were consistent with intraoperative results. Residual tumor volume in the suprasellar region was usually less than that observed intraoperatively. Copyright © 2017. Published by Elsevier Inc.

  19. Short-term Survival of Patients with Lung Metastases from Colorectal and Non-colorectal Cancer Who Underwent Pulmonary Metastasectomy.

    Science.gov (United States)

    Lumachi, Franco; Mazza, Francesco; Del Conte, Alessandro; Lo Re, Giovanni; Ermani, Mario; Chiara, Giordano B; Basso, Stefano M M

    2015-06-01

    The lung is a common site of metastases, whose prevalence varies as a function of the primary tumor site, which is usually colorectal cancer (CRC), breast carcinoma, or genitourinary cancers, such as ovary, urinary bladder and renal cell carcinomas. The aim of the present study was to analyze whether the site of primitive tumor affects overall survival (OS) of patients with lung metastases (LMs) who underwent pulmonary metastasectomy. The data of 41 patients with surgically treated CRC (Group A=22 patients) and non-colorectal carcinomas (Group B=19 patients), who developed matachronous LMs and underwent pulmonary metastasectomy with curative intent, were analyzed. The origin of non-colorectal LMs was genitourinary cancer in nine and breast cancer in 10 patients. Overall, there were 22 men and 19 women, with a median age of 65 years (range=31-80); 18 patients had a solitary metastatic tumor, while 23 had two or more LMs. Twenty-nine patients underwent wedge resection, through thoracotomy or video-assisted thoracic surgery, while 12 underwent pulmonary lobectomy. Seventy-five LMs were resected with a 5-tear OS of 48.8%. No difference was found between elderly (≥65 year-old) and younger patients (p=0.26), and between those with solitary or multiple LMs (p=0.62) in terms of survival rate. The female patients had a worse OS (31.6% vs. 63.6%; odds ratio (OR)=3.79, 95% confidence interval (CI)=1.03-13.91, p=0.003) compared to males, independent of the origin of primary cancer. There was no difference in the cumulative survival rates (OR=1.65, 95%CI=0.48-5.69, p=0.42) between Groups and the log-rank test (p=0.75) was not significant. In conclusion, the main pathological characteristics of metastatic lesions and advanced age do not appear to be associated with a poor prognosis in patients with LMs, while the female gender is a negative prognostic factor. Thus, the primary tumor site should not be considered a major criterion in selecting patients for pulmonary

  20. Predictors of survival in patients who underwent video‐assisted thoracic surgery talc pleurodesis for malignant pleural effusion

    Science.gov (United States)

    Yoon, Dong Woog; Choi, Yong Soo; Kim, Jhingook; Kim, Hong Kwan; Zo, Jae Ill; Shim, Young Mog

    2016-01-01

    Background Patients with malignant pleural effusion have a limited life expectancy. An increase in pleural and oncological treatment options and more accurate prognostic evaluation may help individualize treatment strategies. The aim of this study was to identify the prognostic indicators of overall survival (OS) after video‐assisted thoracic surgery (VATS) talc pleurodesis for malignant pleural effusion. Methods We examined the medical records of all consecutive patients with malignant pleural effusion who underwent VATS talc pleurodesis from 2006 to 2008 at the Samsung Medical Center. Univariate and multivariate analyses were used to identify predictors of OS after VATS talc pleurodesis. Results During the study period, 91 patients underwent VATS talc pleurodesis to treat malignant pleural effusion. Early (within 30 days) and late (within 90 days) postoperative mortality rates were 9.9% (9 patients), and 25.3% (23), respectively. Median survival time after VATS talc pleurodesis was 10.5 months. The postoperative respiratory complication rate was 11% (10 patients), and included pneumonia (9) and acute respiratory distress syndrome (4). Multivariate analysis revealed that preoperative chemotherapy (P = 0.012), preoperative radiotherapy (P = 0.003), and Eastern Cooperative Oncology Group (ECOG) performance score 3 or 4 (P = 0.013) were independent risk factors of OS after VATS talc pleurodesis. Conclusions We identified previous chemotherapy or radiotherapy and poor performance status (ECOG 3 or 4) as significant predictors of OS after VATS talc pleurodesis. These prognostic factors can help surgeons select candidates for VATS pleurodesis for malignant pleural effusion. PMID:27385980

  1. Tumor deposit is a poor prognostic indicator in patients who underwent simultaneous resection for synchronous colorectal liver metastases

    Directory of Open Access Journals (Sweden)

    Lin Q

    2015-01-01

    Full Text Available Qi Lin,# Ye Wei,# Li Ren,# Yunshi Zhong,# Chunzhi Qin, Peng Zheng, Pingping Xu, Dexiang Zhu, Meiling Ji, Jianmin XuDepartment of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China#These authors contributed equally to this workBackground: Tumor deposits are one of the important influencing factors among the different editions of Tumor, Node, Metastasis classification. Incidence and prognosis of tumor deposits in stage I, II, and III colorectal cancer patients has been explored. The aim of this study was to determine the prognostic value of tumor deposits in stage IV colorectal cancer patients who underwent simultaneous resection for synchronous colorectal liver metastases (SCRLM.Methods: Clinicopathological and outcome data of 146 consecutive SCRLM patients who underwent simultaneous R0 resection between July 2003 and July 2013 were collected from our prospectively established SCRLM database. The prognostic value of tumor deposits was evaluated by Kaplan–Meier and Cox regression analysis.Results: Tumor deposits were detected in 41.8% (61/146 of these SCRLM patients. Tumor deposits were significantly correlated with lymph node metastasis and nerve invasion of the primary tumors (P=0.002, P=0.041; respectively. The Kaplan–Meier survival analysis revealed that the overall survival (OS and disease-free survival (DFS of SCRLM patients with tumor deposits were significantly poorer than those with no tumor deposits (P=0.039, P=0.001; respectively. And with multivariate analysis, we found that positive tumor deposits were significantly associated with shorter DFS independent of lymph node status (P=0.002. Subgroup analysis found that of the 57 SCRLM patients with negative lymph node status, the OS and DFS of patients with positive tumor deposits were significantly shorter than those with negative tumor deposits (P=0.002 and P=0.031, respectively. Of the 89 patients with positive lymph node status, the OS of

  2. Posterior Reversible Encephalopathy Syndrome Resolving Within 48 Hours in a Normotensive Patient Who Underwent Thoracic Spine Surgery

    Science.gov (United States)

    Vakharia, Kunal; Siasios, Ioannis; Dimopoulos, Vassilios G.; Pollina, John

    2016-01-01

    Posterior reversible encephalopathy syndrome (PRES) usually manifests with severe headaches, seizures, and visual disturbances due to uncontrollable hypertension. A patient (age in the early 60s) with a history of renal cell cancer presented with lower-extremity weakness and paresthesias. Magnetic resonance imaging (MRI) of the thoracic spine revealed a T8 vertebral body metastatic lesion with cord compression at that level. The patient underwent preoperative embolization of the tumor followed by posterior resection and placement of percutaneous pedicle screws and rods. Postoperatively, the patient experienced decreased visual acuity bilaterally. Abnormal MRI findings consisted of T2 hyperintense lesions and fluid-attenuated inversion recovery changes in both occipital lobes, consistent with the unique brain imaging pattern associated with PRES. The patient’s blood pressure was normal and stable from the first day of hospitalization. The patient was kept on high-dose steroid therapy, which was started intraoperatively, and improved within 48 hours after symptom onset. PMID:26858804

  3. The Role of Speech Therapy in Patients Who Underwent Laryngeal Microsurgery due to Phonotraumatic Lesions and Lesions Unrelated to Phonotrauma

    Science.gov (United States)

    Macedo, Claudia de Assis Corrêa de; Macedo, Evaldo Dacheux de; Malafaia, Osvaldo; Catani, Guilherme Simas do Amaral; Ido, Jorge Massaki; Stahlke, Henrique Jorge

    2014-01-01

    Introduction The role of the speech-language pathology in the multiprofessional team dealing with laryngology and the voice has been recognized for a long time. Scientific studies in this field recommend therapies for laryngeal microsurgeries; few of the studies, however, effectively evaluate the result of postoperative speech therapy. Objective To compare speech therapy evaluation and treatment among patients with phonotraumatic lesions and patients with lesions unrelated to phonotrauma who underwent laryngeal microsurgery. Methods This study was performed at IPO Hospital (Paranaense Institute of Otorhinolaryngology, Curitiba, Paraná, Brazil) between February 2010 and February 2011. Of 254 patients who underwent laryngeal microsurgery, 208 patients were included in the study and divided in two groups: group A with phonotraumatic lesions (n = 131) and group B with lesions unrelated to phonotrauma (n = 77). The number of sessions and the functional result after speech therapy were evaluated. Results The number of postoperative phonotherapy sessions after microsurgery was up to 10 sessions in 89.31% and 87.71% for groups A and B, respectively. Phonotherapy treatment showed a better functional evolution in group A (92.37%). Conclusion A significant difference was observed only in functional evolution, which was better in the group with phonotraumatic lesions (p < 0.0001). PMID:25992078

  4. The Role of Speech Therapy in Patients Who Underwent Laryngeal Microsurgery due to Phonotraumatic Lesions and Lesions Unrelated to Phonotrauma

    Directory of Open Access Journals (Sweden)

    Macedo, Claudia de Assis Corrêa de

    2014-02-01

    Full Text Available Introduction The role of the speech-language pathology in the multiprofessional team dealing with laryngology and the voice has been recognized for a long time. Scientific studies in this field recommend therapies for laryngeal microsurgeries; few of the studies, however, effectively evaluate the result of postoperative speech therapy. Objective To compare speech therapy evaluation and treatment among patients with phonotraumatic lesions and patients with lesions unrelated to phonotrauma who underwent laryngeal microsurgery. Methods This study was performed at IPO Hospital (Paranaense Institute of Otorhinolaryngology, Curitiba, Paraná, Brazil between February 2010 and February 2011. Of 254 patients who underwent laryngeal microsurgery, 208 patients were included in the study and divided in two groups: group A with phonotraumatic lesions (n = 131 and group B with lesions unrelated to phonotrauma (n = 77. The number of sessions and the functional result after speech therapy were evaluated. Results The number of postoperative phonotherapy sessions after microsurgery was up to 10 sessions in 89.31% and 87.71% for groups A and B, respectively. Phonotherapy treatment showed a better functional evolution in group A (92.37%. Conclusion A significant difference was observed only in functional evolution, which was better in the group with phonotraumatic lesions (p < 0.0001.

  5. Impact of Lipoprotein(a) on Long-term Outcomes in Patients With Diabetes Mellitus Who Underwent Percutaneous Coronary Intervention.

    Science.gov (United States)

    Konishi, Hirokazu; Miyauchi, Katsumi; Shitara, Jun; Endo, Hirohisa; Wada, Hideki; Doi, Shinichiro; Naito, Ryo; Tsuboi, Shuta; Ogita, Manabu; Dohi, Tomotaka; Kasai, Takatoshi; Okazaki, Shinya; Isoda, Kikuo; Suwa, Satoru; Daida, Hiroyuki

    2016-12-15

    Patients with diabetes mellitus (DM) are at twofold to fourfold higher cardiovascular risk than those without DM. Serum levels of lipoprotein(a) (Lp(a)) can be risk factors for adverse events. However, the clinical implications of Lp(a) in patients with DM who underwent percutaneous coronary intervention (PCI) is unknown. The aim of the study was to determine the role of Lp(a) in patients with DM who underwent PCI. A total of 3,508 patients were treated by PCI from 1997 to 2011 at our institution. Among them, we analyzed consecutive 1,546 patients with DM. Eligible 1,136 patients were divided into 2 groups (high Lp(a) [n = 575] and low Lp(a) [n = 561]) by the median of Lp(a) levels. The number of chronic kidney disease, multivessel disease, and the level of LDL-C were higher in the group with high Lp(a) than with low Lp(a). The median follow-up period was 4.7 years. Event rate of all-cause death was same between the 2 groups (p = 0.37). However, cumulative incidence of cardiac death and acute coronary syndrome was significantly higher in the high Lp(a) than in the low Lp(a) group (p = 0.03). Multivariable analysis selected a high Lp(a) level as an independent predictor of cardiac death and acute coronary syndrome (hazard ratio 1.20; 95% confidence interval 1.00 to 1.42; p = 0.04). In conclusion, a high Lp(a) value could be associated with advanced cardiac events after PCI for patients with DM. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Sepsis associated delirium mimicking postoperative delirium as the initial presenting symptom of urosepsis in a patient who underwent nephrolithotomy.

    Science.gov (United States)

    Nag, Deb Sanjay; Chatterjee, Abhishek; Samaddar, Devi Prasad; Singh, Harprit

    2016-05-16

    We report a case of 70 years old male who underwent percutaneous nephrolithotomy for renal calculi. After an uneventful recovery from anaesthesia, the patient developed delirium which manifested as restlessness, agitation, irritability and combative behavior. All other clinical parameters including arterial blood gas, chest X-ray and core temperature were normal and the patient remained haemodynamically stable. But 45 min later the patient developed florid manifestations of septic shock. He was aggressively managed in a protocolized manner as per the Surviving Sepsis Guidelines in the Critical Care Unit and recovered completely. There are no case reports showing postoperative delirium as the only initial presentation of severe sepsis, with other clinical parameters remaining normal. Both urosepsis and sepsis associated delirium have very high mortality. High index of suspicion and a protocolized approach in the management of sepsis can save lives.

  7. Resistance Pattern of Antibiotics in Patient Underwent Open Heart Surgery With Nosocomial Infection in North of Iran.

    Science.gov (United States)

    Davoudi, Alireza; Najafi, Narges; Alian, Shahriar; Tayebi, Atefe; Ahangarkani, Fatemeh; Rouhi, Samaneh; Heydari, Amirhosein

    2015-08-06

    Patients who undergo cardiac surgery appear to be at increased risk for the development of Nosocomial infections (NIs). The development of antibiotic-resistant infections has been associated with significantly greater hospital mortality rates compared to similar infections caused by antibiotic-sensitive pathogens. The purpose of this study is survey of Nis and antibiotic resistance patterns of causative bacteria among patients who underwent open heart surgery in the north of Iran during a 2-year period between September 2012 and September 2014. In this cross-sectional study we evaluated 187 patients that underwent open heart surgery with NIs. Demographic feature, clinical characteristics and risk factors of each infection were recorded. The antibiotic susceptibility test was performed using the Minimum inhibitory concentration (MIC) method according to the standard protocol of Clinical & Laboratory Standards Institute (CLSI). Detection of Extended-spectrum beta-lactamase (ESBL) producing bacteria was performed by the double-disk synergy (DDS) test; also Methicillin-resistant Staphylococcus (MRSA) strains were identified by MRSA Screen Agar. The collected data were analyzed using the SPSS software (ver. 16) and, descriptive statistics were used. Out Of total of 2253 hospitalized patients who underwent open heart surgery, 187(5.05%) patients had NIs. 51.9% of the patients were female. The rates of surgical site infection (SSI), respiratory tract infection, endocarditis, Urinary tract infection (UTI), blood Infection and mediastinitis were 27.80, 25.66%, 17.64, 17.11% 8.55% and 3.20% respectively. E.coli and S.aureus were the most causative agents of NIs. The rate of ESBL-producing bacteria was 14.28- 71.42% among enterobacteriaceae and the rate of MRSA was 54.2% among S.aureus strains. All isolated Acinetobacter.spp were Multi-drug resistance (MDR). We showed that the rate of NIs among these high-risk patients was in the average level. But the emergence of MRSA and

  8. Comparison of Outcomes in Patients Who Underwent Deep Anterior Lamellar Keratoplasty and Those Converted to Penetrating Keratoplasty

    Directory of Open Access Journals (Sweden)

    Yusuf Koçluk

    2017-03-01

    Full Text Available Objectives: To compare clinical outcomes of cases who underwent deep anterior lamellar keratoplasty (DALK and cases who were converted to penetrating keratoplasty (PKP from DALK surgery. Materials and Methods: The records of 54 patients for whom DALK surgery was planned and were operated for different diagnoses between March 2013 and June 2015 were retrospectively analyzed. Patients were divided into two groups: group 1 (PKP group consisted of 23 cases who were converted to PKP due to Descemet’s membrane perforation at any stage of surgery; group 2 (DALK group consisted of 31 patients whose surgery could be completed as DALK. Preoperative and postoperative follow-up results were evaluated in each group. Results: Corrected distance visual acuity (CDVA increased in the postoperative period according to baseline in both groups. However, there was no statistically significant difference in the rates of CDVA increase between the groups (p=0.142. The mean astigmatism measured by corneal topography at final examination was 5.8±2.3 diopters in group 1 and 5.4±1.8 diopters in group 2. The difference between groups was not statistically significant (p=0.430. The groups were not statistically different regarding postoperative pachymetry (p=0.453. The grafts in all 54 patients (100% were clear at final postoperative examination. There were no statistically significant differences between the groups in terms of postoperative complications. Conclusion: Similar clinical outcomes were obtained in our study for patients who underwent DALK and those whose procedure was converted from DALK to PKP.

  9. Comparison of Outcomes in Patients Who Underwent Deep Anterior Lamellar Keratoplasty and Those Converted to Penetrating Keratoplasty

    Science.gov (United States)

    Koçluk, Yusuf; Alyamaç Sukgen, Emine; Burcu, Ayşe

    2017-01-01

    Objectives: To compare clinical outcomes of cases who underwent deep anterior lamellar keratoplasty (DALK) and cases who were converted to penetrating keratoplasty (PKP) from DALK surgery. Materials and Methods: The records of 54 patients for whom DALK surgery was planned and were operated for different diagnoses between March 2013 and June 2015 were retrospectively analyzed. Patients were divided into two groups: group 1 (PKP group) consisted of 23 cases who were converted to PKP due to Descemet’s membrane perforation at any stage of surgery; group 2 (DALK group) consisted of 31 patients whose surgery could be completed as DALK. Preoperative and postoperative follow-up results were evaluated in each group. Results: Corrected distance visual acuity (CDVA) increased in the postoperative period according to baseline in both groups. However, there was no statistically significant difference in the rates of CDVA increase between the groups (p=0.142). The mean astigmatism measured by corneal topography at final examination was 5.8±2.3 diopters in group 1 and 5.4±1.8 diopters in group 2. The difference between groups was not statistically significant (p=0.430). The groups were not statistically different regarding postoperative pachymetry (p=0.453). The grafts in all 54 patients (100%) were clear at final postoperative examination. There were no statistically significant differences between the groups in terms of postoperative complications. Conclusion: Similar clinical outcomes were obtained in our study for patients who underwent DALK and those whose procedure was converted from DALK to PKP.

  10. Long-term follow-up of clinical symptoms in TMD patients who underwent occlusal reconstruction by orthodontic treatment.

    Science.gov (United States)

    Imai, T; Okamoto, T; Kaneko, T; Umeda, K; Yamamoto, T; Nakamura, S

    2000-02-01

    Fifty-eight patients (mean age 18.4 years) who had received splint therapy for internal derangement of the temporomandibular joint (TMJ) were examined retrospectively to investigate the efficacy of occlusal reconstruction by orthodontic treatment. The subjects were divided into three groups: 18 patients (mean age 18.6 years) who underwent orthodontic treatment combined with the use of splints (ST group); 27 patients (mean age 18.2 years) who underwent orthodontic treatment without the use of splints (NST group); and 13 patients (mean age 17.9 years) who received only splint therapy for temporomandibular joint disorders (TMD; control group). TMJ sound, pain on movement and restriction of mandibular movement were examined at the initial examination (T1), at the end of the splint therapy for TMD or beginning of orthodontic treatment (T2), at the end of orthodontic treatment (T3), and at recall or 1 year after orthodontic treatment (T4). The following results were found. (1) The percentage of patients with no joint sound at T2 was 20-30 per cent. The percentage of such patients in both the ST and NST groups increased to over 50 per cent at T3, but slightly decreased to 39-50 per cent at T4. There were no significant inter-group differences at any time point. (2) The number of patients who had no pain on movement at T2 was 60-80 per cent. The percentage of such patients in both the ST and NST groups increased to over 90 per cent at T3, but then slightly decreased to 80 per cent at T4. There were no significant inter-group differences at any time point. (3) None of the patients showed restriction of movement of the TMJ at T2 or T4. One patient in the ST group was found to have restriction at T3. There were no significant inter-group differences at any time point. (4) The most frequent type of malocclusion in both ST and NST groups was anterior open bite. These results suggest that TMD symptoms that have been eliminated by splint therapy are not likely to recur due to

  11. Elevated Preoperative Serum Hs-CRP Level as a Prognostic Factor in Patients Who Underwent Resection for Hepatocellular Carcinoma.

    Science.gov (United States)

    Liu, Yu-Bin; Ying, Jie; Kuang, Su-Juan; Jin, Hao-Sheng; Yin, Zi; Chang, Liang; Yang, Hui; Ou, Ying-Liang; Zheng, Jiang-Hua; Zhang, Wei-Dong; Li, Chuan-Sheng; Jian, Zhi-Xiang

    2015-12-01

    To evaluate the effects of preoperative highly sensitive C-reactive protein (Hs-CRP) in serum on the prognostic outcomes of patients with hepatocellular carcinoma (HCC) following hepatic resection in Chinese samples.From January 2004 to December 2008, a total of 624 consecutive HCC patients who underwent hepatic resection were incorporated. Serum levels of Hs-CRP were tested at preoperation via a collection of venous blood samples. Survival analyses adopted the univariate and multivariate analyses.In our study, among the 624 screened HCC patients, 516 patients were eventually incorporated and completed follow-up. Positive correlations were found regarding preoperative serum Hs-CRP level and tumor size, Child-Pugh class, or tumor stage (all P Hs-CRP levels at preoperation (both P Hs-CRP-normal group, the overall survival (OS) and recurrence-free survival rates were evidently decreased in the Hs-CRP-elevated group. Further, preoperative serum Hs-CRP level might be having possible prediction effect regarding survival and recurrence of HCC patients after hepatic section in the multivariate analysis.Preoperative increased serum Hs-CRP level was an independent prognostic indicator in patients with HCC following hepatic resection in Chinese samples.

  12. Twenty-four hour Holter monitoring in finishing cattle housed outdoors.

    Science.gov (United States)

    Frese, D A; Thomason, J D; Reinhardt, C; Bartle, S; Rethorst, D; Loneragan, G H; Thomson, D

    2017-04-01

    Atrial premature complexes have been reported to be the most common arrhythmia in cattle and is suspected to be secondary to systemic disease, especially gastrointestinal disease. In order to properly identify pathologic arrhythmia in cattle, the normal rhythm and arrhythmia prevalence should be defined. The objective of this study was to determine the normal heart rate, rhythm, number of ventricular premature complexes (VPCs), and atrial premature complexes (APCs) in unrestrained Angus steers. Twenty-seven client owned steers with unremarkable physical examinations and serum biochemical analyses were used. Twenty-four hour Holter monitors, attached by a custom-made harness, were retrospectively evaluated. Three lead electrocardiographic registrations of good quality and normal sinus rhythm were obtained from all steers in the study. The mean heart rate was 66.8 bpm ± 16.4 bpm. Ventricular premature complexes were rare (noted in 14.8% of steers), and APCs were common (noted in 85% of the steers). Simple second degree AV block was observed in 18.5% of the steers. In summary, healthy steers have rare single VPCs, although it is possible for an individual animal to have apparent more frequent VPCs. Mean heart rate varies with a diurnal pattern similar to other species. Atrial premature complexes are the most prevalent abnormality observed in feedlot steers. Copyright © 2016 Elsevier B.V. All rights reserved.

  13. Effects of brewing conditions on the antioxidant capacity of twenty-four commercial green tea varieties.

    Science.gov (United States)

    Sharpe, Erica; Hua, Fang; Schuckers, Stephanie; Andreescu, Silvana; Bradley, Ryan

    2016-02-01

    A novel paper-based Nanoceria Reducing Antioxidant Capacity (NanoCerac) assay for antioxidant detection (Sharpe, Frasco, Andreescu, & Andreescu, 2012), has been adapted for the first time as a high-throughput method, in order to measure the effect of brewing conditions and re-infusion on the antioxidant capacity of twenty-four commercial green teas. The oxygen radical absorbance capacity (ORAC) assay, frequently applied to complex foods and beverages, was used as a comparator measure of antioxidant capacity. A novel measure of sustained antioxidant capacity, the total inherent antioxidant capacity (TI-NanoCerac and TI-ORAC) was measured by infusing each tea six times. Effects of brewing conditions (temperature, brew time, etc.) were assessed using one popular tea as a standard. Both NanoCerac and ORAC assays correlated moderately (R(2) 0.80 ± 0.19). The average first-brew NanoCerac, TI-NanoCerac, first-brew ORAC and TI-ORAC were: 0.73 ± 0.1 GAE/g tea; 2.4 ± 0.70 mmolGAE/g tea; 1.0 ± 0.3 mmolTE/g tea and 2.1 ± 0.71 mmolTE/g tea respectively. Brewing conditions including water temperature and infusion time significantly affected antioxidant capacity. The high-throughput adaptation of the original NanoCerac assay tested here offered advantages over ORAC, including portability and rapid analysis.

  14. Preoperative and Postoperative (1st and 3rd Month Metabolic Data of Patients Who Underwent Bariatric Surgery

    Directory of Open Access Journals (Sweden)

    Nilüfer Özdemir Kutbay

    2015-03-01

    Full Text Available Purpose: The growing prevalence of obesity has become a major concern. The efficacy of medical treatment, diet and behavior therapy in morbidly obese patients is limited. Obesity surgery is a treatment option for selected morbidly obese patients. Material and Method: Data of 47 patients (n=39 women, 8 men who underwent bariatric surgery were investigated. Results: Out of 47 patients, 20 underwent Roux-en-Y gastric bypass (RYGB (43% and 27 had sleeve gastrectomy (SG (57%. The mean age of the patients was 37±9.5 (19-59 years. 17% of patients were men and 83% were women. In the analysis of data on weight that could be found for 31 out of 47 patients, we detected preoperative and postoperative (1st and 3rd month mean weight values as 125.4±15.9 kg, 112.7±13.2 kg (p<0.001 and 100.9±17.5 kg (p<0.001, respectively. In addition, the analysis of the data on mean fasting plasma glucose (FPG levels which could be found for 23 out of 47 patients, showed us that preoperative and postoperative (1st and 3rd month FPG levels were 100.9±17.5 mg/dL, 91.6±10.9 mg/dL (p=0.03 and 87.3±2.0 mg/dL, respectively. Only 1 patient had diabetes before the surgery. In the RYGB group, the mean change in weight was 12.4±5.5 kg in the 1st month and 22.2±8.6 kg in the 3rd month (compared to the weights in the preoperative period. Moreover, in the SG group, the mean change in weight was 13.7±4.5 kg in the 1st month and 23.4±5.8 kg in the 3rd month. No statistically significant difference was found between the weight changes in the 1st and the 3rd month as for surgery types. Discussion: After bariatric surgery, significant loss in weight and reduction in FPG occurred in short-term.

  15. Accuracy of bone SPECT/CT for identifying hardware loosening in patients who underwent lumbar fusion with pedicle screws

    Energy Technology Data Exchange (ETDEWEB)

    Hudyana, Hendrah; Maes, Alex [AZ Groeninge, Department of Nuclear Medicine, Kortrijk (Belgium); University Hospital Leuven, Department of Morphology and Medical Imaging, Leuven (Belgium); Vandenberghe, Thierry; Fidlers, Luc [AZ Groeninge, Department of Neurosurgery, Kortrijk (Belgium); Sathekge, Mike [University of Pretoria, Department of Nuclear Medicine, Pretoria (South Africa); Nicolai, Daniel [AZ Groeninge, Department of Nuclear Medicine, Kortrijk (Belgium); Wiele, Christophe van de [AZ Groeninge, Department of Nuclear Medicine, Kortrijk (Belgium); University Ghent, Department of Radiology and Nuclear Medicine, Ghent (Belgium)

    2016-02-15

    The aim of this retrospective study was to evaluate the accuracy of bone SPECT (single photon emission computed tomography)/CT (computed tomography) in diagnosing loosening of fixation material in patients with recurrent or persistent back pain that underwent lumbar arthrodesis with pedicle screws using surgery and clinical follow-up as gold standard A total of 48 patients (median age 49 years, range 21-81 years; 17 men) who had undergone lumbar spinal arthrodesis were included in this retrospective analysis. SPECT/CT results were compared to the gold standard of surgical evaluation or clinical follow-up. Positive SPECT/CT results were considered true positives if findings were confirmed by surgery or if clinical and other examinations were completely consistent with the positive SPECT/CT finding. They were considered false positives if surgical evaluation did not find any loose pedicle screws or if symptoms subsided with non-surgical therapy. Negative SPECT/CT scans were considered true negatives if symptoms either improved without surgical intervention or remained stable over a minimum follow-up period of 6 months. Negative SPECT/CT scans were determined to be false negatives if surgery was still required and loosening of material was found. The median length of time from primary surgery to bone SPECT/CT referral was 29.5 months (range 12-192 months). Median follow-up was 18 months (range 6-57) for subjects who did not undergo surgery. Thirteen of the 48 patients were found to be positive for loosening on bone SPECT/CT. Surgical evaluation (8 patients) and clinical follow-up (5 patients) showed that bone SPECT/CT correctly predicted loosening in 9 of 13 patients, while it falsely diagnosed loosening in 4 patients. Of 35 negative bone SPECT/CT scans, 12 were surgically confirmed. In 18 patients, bone SPECT/CT revealed lesions that could provide an alternative explanation for the symptoms of pain (active facet degeneration in 14 patients, and disc and sacroiliac

  16. Transcranial doppler sonography in two patients who underwent decompressive craniectomy for traumatic brain swelling: report of two cases

    Directory of Open Access Journals (Sweden)

    Bor-Seng-Shu Edson

    2004-01-01

    Full Text Available The role of decompressive craniectomy in the treatment of severe posttraumatic cerebral swelling remains quite a controversial issue. To the best of our knowledge, there is no study demonstrating the effect of decompressive craniectomy on cerebral blood flow (CBF velocity by means of transcranial Doppler sonography (TCD. We present two patients who developed traumatic brain swelling and uncontrollable intracranial hypertension with coma and signs of transtentorial herniation. One patient underwent bifrontal, while the second, unilateral, frontotemporoparietal decompressive craniectomy with dural expansion. In both patients, TCD examinations were performed immediately before and after surgery to study the cerebral hemodynamic changes related to the operations. Pre and postoperative TCD examinations demonstrated a significant increase in blood flow velocity in the intracranial arteries in both subjects. In conclusion, our cases suggest that decompressive craniectomy with dural expansion may result in elevation of CBF velocity in patients with massive brain swelling. The increase in CBF velocity appears to occur not only in the decompressed hemisphere, but also on the opposite side.

  17. Malignant peripheral nerve sheath tumors (MPNST – Clinicopathological study and treatment outcome of twenty-four cases

    Directory of Open Access Journals (Sweden)

    DattaGupta Sidharth

    2006-08-01

    Full Text Available Abstract Background Malignant peripheral nerve sheath tumor (MPNST is biologically an aggressive tumor for which the treatment of choice is the surgery. We reviewed the clinical profile, diagnostic methods, treatment patterns, and outcome of twenty-four MPNST patients in this study. Patients and methods A retrospective analysis of 24 MPNST patients, treated from 1994 to 2002, in the department of Surgical Oncology at All India Institute of Medical Sciences, New Delhi, was done. A combination of gross, histopathological and immunohistochemical findings, and proliferation markers (MIB1 were considered for diagnosis and grade of the MPNST. Survival analysis was done by the Kaplan-Meier method and differences were evaluated with the log-rank test. Multivariate analysis was carried out by using Cox's proportional hazards model by using SPSS (Version 9, Chicago, Illinois software. Results MPNST constituted 12% of all soft tissue sarcomas, where 21% (5/24 of patients had associated Von Recklinghausen's disease (VRHD. A higher incidence of male preponderance and multifocal MPNST were noted in the present series. At a mean follow-up of 38 months, 13 (54 % patients had relapse of disease and 5-year over all and disease free survival were 58% and 35% respectively. In univariate analysis, sex (p = 0.05, tumor depth (p p p = 0.04, cellular differentiation (p p = 0.05 for overall survival. However, in multivariate analysis, cellular differentiation (p p Conclusion MPNSTs constituted a significant proportion (12% of soft tissue sarcoma in our medical center. Heterogeneous differentiation and multifocality of the tumor were few distinct features of MPNST. Sex and cellular differentiation were noticed as the new adverse prognostic factors and adjuvant radiotherapy has been proved to be a significant treatment tool in the current series.

  18. Prosthetic reconstruction with an obturator using swing-lock attachment for a patient underwent maxillectomy: A clinical report

    Science.gov (United States)

    2016-01-01

    Patients who underwent resection of maxilla due to benign or malignant tumor, or accident will have defect in palatal area. They get retention, support and stability from remaining tissues which are hardly optimal. The advantage of swing-lock attachment design is having multiple contacts on labial and lingual side of the abutment teeth by retentive strut and palatal bracing component. Because the force is distributed equally to abutment teeth, abutment teeth of poor prognosis can be benefited from it. It is also more advantageous to cover soft tissue defects which are hard to reach with conventional prosthesis. A 56-year-old female patient who had undergone a maxillectomy due to malignant melanoma complaining of loose and unstable surgical obturator. Surveyed crowns were placed on #12, 26, and 27. Teeth #11, 21, 22, and 23 had lingual rest seat and #24 had mesial rest seat to improve stability and support of the obturator. This clinical report presents the prosthetic management of a patient treated with obturator on the maxilla using swing-lock attachment to the remaining teeth. PMID:27826392

  19. Single-center report of 5-year follow-up on 94 patients underwent transmyocardial laser revascularization

    Institute of Scientific and Technical Information of China (English)

    QU Zheng; ZHENG Ju-bing; ZHANG Zhao-guang

    2007-01-01

    Background Transmyocardial laser revascularization (TMLR) has been used in the treatment of patients with end-stage coronary artery disease (CAD) since 1990. The aim of this study was to evaluate the long-term effectiveness of TMLR in patients with diffuse CAD.Methods Ninety-four consecutive patients underwent TMLR in one center from July 1997 to December 2000. The follow-up data of these patients were obtained through face-to-face, mail questionnaires, or telephone interviews in July 2004 and December 2004. Four cases failed to respond. Mean follow-up time was (5.5±1.0) years.Results Mean Canadian Cardiovascular Society (CCS) angina scores of TMLR patients were 3.1±0.8 at baseline,1.7±0.9 at 1 year (P<0.05), 1.7±0.9 at 3 years (P<0.05), and 1.9±0.9 at 5 years (P<0.05). At an average of 5 years, 69%of the patients had ≥ 1 angina class reduction, mean NYHA class level (1.9±0.9) ameliorated compared to the baseline (2.5±0.7, P<0.001), the rate of re-hospitalization was 2.7 times/person. Kaplan-Meier survival rate was 87% at 1 year,69% at 3 years and 64% at 5 years. The causes of death were attributed more to heart failure (58.9%) and myocardial infraction (14.7%) after TMLR. The patients with no angina relief, or who died after TMLR, had a higher percentage of preoperative unstable anginas or prior myocardial infraction compared to the survivors. The assorted shapes of myocardial laser channels were detected in some patients by the color Doppler velocity technique.Conclusions TMLR provided a long-term improvement in the quality of life, including CCS angina class or NYHA heart functional class for about 70% of Chinese patients with severely disabling angina pectoris. The various myocardial laser channels would always be visible after TMLR. 5-years after TMLR as a sole therapy, the survival rate of the patients was 64%.

  20. Twenty-four-hour esophageal pH monitoring in children and adolescents with chronic and/or recurrent rhinosinusitis

    Directory of Open Access Journals (Sweden)

    V.R.S.G. Monteiro

    2005-02-01

    Full Text Available Gastroesophageal reflux (GER disorder was studied in children and adolescents with chronic and/or recurrent rhinosinusitis not associated with bronchial asthma. Ten children with a clinical and radiological diagnosis of chronic and/or recurrent rhinosinusitis, consecutively attended at the Pediatric Otolaryngology Outpatient Clinic, Federal University of São Paulo, were evaluated. Prolonged esophageal pH monitoring was used to investigate GER disorder. The mean age of the ten patients evaluated (eight males was 7.4 ± 2.4 years. Two patients presented vomiting as a clinical manifestation and one patient presented retrosternal pain with a burning sensation. Twenty-four-hour esophageal pH monitoring was performed using the Sandhill apparatus. An antimony probe electrode was placed in the lower third of the esophagus, confirmed by fluoroscopy and later by a chest X-ray. The parameters analyzed by esophageal pH monitoring included: total percent time of the presence of acid esophageal pH, i.e., pH below 4 (<4.2%; total number of acid episodes (<50 episodes; number of reflux episodes longer than 5 min (3 or less, and duration of the longest reflux episode (<9.2 min. One patient (1/10, 10% presented a 24-h esophageal pH profile compatible with GER disorder. This data suggest that an association between chronic rhinosinusitis not associated with bronchial asthma and GER disorder may exist in children and adolescents, especially in those with compatible GER disorder symptoms. In these cases, 24-h esophageal pH monitoring should be performed before indicating surgery, since the present data suggest that 10% of chronic rhinosinusitis surgeries can be eliminated.

  1. Low-intensity Laser (660 NM) has Analgesic Effects on Sternotomy of Patients Who Underwent Coronary Artery Bypass Grafts

    Science.gov (United States)

    Fernandes, Gilderlene Alves; Araújo Júnior, Raimundo de Barros; Lima, Andréa Conceição Gomes; Gonzaga, Isabel Clarisse Albuquerque; de Oliveira, Rauirys Alencar; Nicolau, Renata Amadei

    2017-01-01

    Background: The aim of this study was to evaluate the efficacy of low-level laser therapy for reducing the acute pain of sternotomy in patients who underwent a coronary artery bypass graft (CABG). Methods: This study was conducted with ninety volunteers who electively submitted to CABG. The volunteers were randomly allocated into three groups of equal size (n = 30): control, placebo, and laser (λ of 660 nm and spatial average energy fluency of 1.06 J/cm2). Pain when coughing was assessed by a visual analog scale (VAS) and McGill Pain Questionnaire, according to sensory, affective, evaluative, and miscellaneous domains. The patients were followed for 1 month after the surgery. Results: The laser group had a greater decrease in pain with analogous results, as indicated by both the VAS and the McGill questionnaire (P ≤ 0.05) on sensory and affective scores, on days 6 and 8 postsurgery compared to the placebo and control groups. Conclusion: Laser seems to be effective promoting pain reduction after coronary-arterial bypass grafting. PMID:28074796

  2. Severity of gastroesophageal reflux disease influences daytime somnolence:A clinical study of:t34 patients underwent upper panendoscopy

    Institute of Scientific and Technical Information of China (English)

    Pál Demeter; Katalin Várdi Visy; N(o)ra Gyulai; R(o)bert Sike; Tamás G T(o)th; János Novák; Pál Magyar

    2004-01-01

    AIM: To asses the relationship between severity of gastroesophageal refluxe disease and Epworth sleepiness scale as an indicator of daytime somnolence.METHODS: One hundred and thirty-four patients underwent an upper panendoscopy as indicated by the typical reflux symptoms and were also investigated with regard to somnolence. Sleepiness was evaluated by Epworth Sleepiness Scale, which was compared to the severity of endoscopic findings (Savary-Miller/modified by Siewert). Patients with psychiatric disorders or being on sedato-hypnotics as well as shift workers were excluded from the study. The relationship between the severity of the reflux disease and daytime somnolence was analyzed with the help of multivariate regression analysis.RESULTS: A positive tendency was found between the severity of the reflux disease and the corresponding Epworth Sleepiness Scale. In the case of the more severe type -Savary-Miller Ⅲ - at least a mild hypersomnia was found.For this group daytime somnolence was significantly higher than in the case of the non-erosive type of Gastroesophageal Reflux Disease representing the mildest stage of reflux disease.CONCLUSION: The severity of Gastroesophageal Reflux Disease influences daytime somnolence.

  3. Assessment of quality of life of patients who underwent anterior cruciate ligament reconstruction and a rehabilitation program

    Directory of Open Access Journals (Sweden)

    Moises Cohen

    2004-12-01

    Full Text Available Introduction: Quality of life can be defined as the expression of aconceptual model that tries to represent patient’s perspectivesand his/her level of satisfaction expressed by numbers. Theobjective of this study is to evaluate the parameters of quality oflife of 23 patients who underwent surgery for anterior cruciateligament reconstruction. Methods: We adopted SF-36, a generichealth-related evaluation questionnaire, to obtain informationregarding several aspects of patients’ health conditions, and theLysholm questionnaire, specific to evaluate the symptoms andfunction of the knee. The questionnaires were applied at two stagesof the treatment: pre- and postoperatively (after the rehabilitationprogram. Results: Before surgery, the Lysholm questionnairepresented the following results: excellent in 4% of the cases, goodin 22%, fair in 22%, and poor in 52%. After surgery (Lysholm e SF-36 the correlation level was approximately 44% (p = 0.041.Discussion: The correlation between the Lysholm and the SF-36questionnaires showed the following: the lower the level of pain,the higher the Lysholm score. The high scores presented by theLysholm questionnaire are directly proportional to physical andemotional aspects, and to functional capacity. Conclusion:Analysis of both questionnaires, as well as of their correlation,showed some improvement in patients´ quality of life. We werealso able to demonstrate the importance and usefulness of applyingthe two questionnaires at three different moments: before, duringand after physiotherapeutic intervention.

  4. 65. Impact of focused echocardiography in clinical decision of patients presented with STMI, underwent primary percutenouse angioplasty

    Directory of Open Access Journals (Sweden)

    M. Qasem

    2016-07-01

    Full Text Available Echocardiography in coronary artery diseases is an essential, routine echocardiography prior to primary percutaneous angioplasty is not clear. In our clinical practice in primary angioplasty we faced lots of complications either before or during or after the procedure. Moreover, lots of incidental findings that discovered after the procedure which if known will affect the plan of management. One-hundred-nineteen consecutive underwent primary angioplasty. All patients underwent FE prior to the procedure in catheterization lab while the patient was preparing for the procedure. FE with 2DE of LV at base, mid and apex, and apical stander views. Diastology grading, E/E′ and color doppler of mitral and aortic valve were performed. (N = 119 case of STMI were enrolled, mean age 51 ± 12 year. Eleven cases (9.2% had normal coronary and normal LV function. Twenty cases (17% of MI complication detected before the procedures: RV infarction 8.4% (5.1% asymptomatic and 3.3% symptomatic, ischemic MR (8.4%, LV apical aneurysm (0.8%, significant pericardial effusion (0.80%. Acute pulmonary edema in 17 cases (14.3%: six cases (5.1% developed acute pulmonary edema on the cath lab with grade 3 diastolic dysfunction and E/E ′  >20, 9 cases (7.6% develop acute pulmonary edema in CCU with grade 2–3 diastolic dysfunction and E/E′ 15–20. 2 cases (2.7% develop acute pulmonary in CCU with grade 1–2 diastolic dysfunction and E/E′ 9–14. One case (0.8% presented cardiac tamponade 2 h post PCI. Incidental finding not related to STMI were as follow: 2 cases (1.7% with severe fibro degenerative MR, 2 cases (1.7% with mild to moderate AR and 2 cases (1.7% with mild to moderate AS. Isoled CABG 5/4.2% and CABG and MVR 2/1.7%. FE play an important role in guiding the management, early detection the incidental findings and complication post PCI.

  5. Ipsilateral pleural recurrence after diagnostic transthoracic needle biopsy in pathological stage I lung cancer patients who underwent curative resection.

    Science.gov (United States)

    Moon, Seong Mi; Lee, Dae Geun; Hwang, Na Young; Ahn, Soohyun; Lee, Hyun; Jeong, Byeong-Ho; Choi, Yong Soo; Shim, Young Mog; Kim, Tae Jeong; Lee, Kyung Soo; Kim, Hojoong; Kwon, O Jung; Lee, Kyung Jong

    2017-09-01

    The relationship between transthoracic needle biopsy (TTNB) and pleural recurrence of cancer after curative lung resection remains unclear. We aimed to assess whether TTNB increases the ipsilateral pleural recurrence (IPR) rate and identify other potential risk factors for pleural recurrence after surgery. This retrospective study included 392 patients with p-stage I non-small cell lung cancer with solid or part-solid nodules after curative lung resection in 2009-2010. Imbalances among the characteristics were adjusted using an inverse probability-weighted method based on propensity scoring. Multivariate Cox's regression analysis and the Kaplan-Meier method were used to determine independent risk factors for IPR. A total of 243 (62%) patients received TTNB, while 149 (38%) underwent an alternate, or no, diagnostic technique. IPR was significantly more frequent in the TTNB group (p=0.004), while total recurrence was similar between the groups (p=0.098). After applying the weighted model, diagnostic TTNB (hazard ratio [HR], 5.27; 95% confidence interval [CI], 1.49-18.69; p=0.010), microscopic visceral pleural invasion (HR, 2.76; 95% CI, 1.08-7.01; p=0.033) and microscopic lymphatic invasion (HR, 3.25; 95% CI, 1.30-8.10; p=0.012) were associated with an increased frequency of IPR. Among patients who received TTNB, microscopic lymphatic invasion was a risk factor for IPR (HR, 2.74; 95% CI, 1.10-6.79; p=0.030). The diagnostic TTNB procedure is associated with pleural recurrence but may be unrelated to overall recurrence-free survival in early lung cancer. Moreover, microscopic lymphatic invasion could be a risk factor for pleural recurrence. TTNB should be carefully considered before lung resection and close follow-up to detect if pleural recurrence is needed. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. A systematic review of methods for quantifying serum testosterone in patients with prostate cancer who underwent castration.

    Science.gov (United States)

    Comas, I; Ferrer, R; Planas, J; Celma, A; Regis, L; Morote, J

    2017-03-02

    The clinical practice guidelines recommend measuring serum testosterone in patients with prostate cancer (PC) who undergo castration. The serum testosterone concentration should be <50ng/dL, a level established by using a radioimmunoassay method. The use of chemiluminescent immunoassays (IA) has become widespread, although their metrological characteristics do not seem appropriate for quantifying low testosterone concentrations. The objective of this review is to analyse the methods for quantifying testosterone and to establish whether there is scientific evidence that justifies measuring it in patients with PC who undergo castration, through liquid chromatography attached to a mass spectrometry in tandem (LC-MSMS). We performed a search in PubMed with the following MeSH terms: measurement, testosterone, androgen suppression and prostate cancer. We selected 12 studies that compared the metrological characteristics of various methods for quantifying serum testosterone compared with MS detection methods. IAs are standard tools for measuring testosterone levels; however, there is evidence that IAs lack accuracy and precision for quantifying low concentrations. Most chemiluminescent IAs overestimate their concentration, especially below 100ng/dL. The procedures that use LC-MSMS have an adequate lower quantification limit and proper accuracy and precision. We found no specific evidence in patients with PC who underwent castration. LC-MSMS is the appropriate method for quantifying low serum testosterone concentrations. We need to define the level of castration with this method and the optimal level related to better progression of the disease. Copyright © 2017 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Characteristics of speech production in patients with T1 glottic cancer who underwent laser cordectomy or radiotherapy.

    Science.gov (United States)

    Hong, Yong Tae; Park, Min Ju; Hong, Ki Hwan

    2017-10-04

    Laser cordectomy (LC) or radiotherapy (RT) is often recommended in the early stage of laryngeal cancer. We conducted perceptual and acoustic analysis to compare sustained vowel and stop consonants since there is no article evaluating both the sustained vowel and stop consonants. Eventually, we might determine which management is superior in terms of speech production. A total of 28 patients who underwent LC and RT for early T1 glottic cancer were selected. The sustained vowel /a/ and bilabial stop consonants were used to assess the perceptual scores. The fundamental frequency (Fo), jitter, shimmer and noise-to-harmonic ratio (NHR) levels for sustained vowels were evaluated. Voice onset time (VOT), vowel duration (VD) and closure duration of the bilabial plosives were analyzed. A receiver operating characteristic curve analysis was used to evaluate significant results statistically. The GRBAS and discrimination scores were not significantly different between two groups. Fo and jitter were significantly higher in the LC than RT. The cut-off value was statistically higher in the LC group and statistically lower in the RT group. The VOT was significantly longer in the LC than RT. The cut-off value of the /pipida/ VOT was statistically longer in the LC group and statistically shorter in the RT group. The differences may have been due to muscular fibrosis after RT. Movements of vocal cords with fibrosis were sluggish, when impulsion developed to pronounce the initial /p/ sound, so the VOT was shortened and the VD was longer after RT.

  8. Biomimetic Synthesis of Twenty-four Long-chained Diketones as Precursors for Muscone and Further Macrocyclic Ketones

    Institute of Scientific and Technical Information of China (English)

    GUO,Yuan; CHEN,Kang-yu; LI,Jian-Li; SHI,Zhen

    2008-01-01

    The one-carbon unit transfer reaction of tetrahydrofolate coenzyme was initiated. Bisbenzimidazolium salts were used as a tetrahydrofolate coenzyme model, and thus the biomimetic synthesis of twenty-four acyclic dike-tones as precursors for macrocyclic ketones was successfully accomplished by using the addition-hydrolysis reac-tion of the bisbenzimidazolium salts with alkyl magnesium halide, wherein six diketones have not been reported in literature. Accordingly, a short route to muscone analogues was provided.

  9. Retrospective comparison between preoperative diagnosis by International Consensus Diagnostic Criteria and histological diagnosis in patients with focal autoimmune pancreatitis who underwent surgery with suspicion of cancer

    DEFF Research Database (Denmark)

    Ikeura, Tsukasa; Detlefsen, Sönke; Zamboni, Giuseppe

    2014-01-01

    OBJECTIVE: The objective of this study was to compare the preoperative diagnosis by International Consensus Diagnostic Criteria (ICDC) with histological diagnosis in patients with focal autoimmune pancreatitis (AIP) who underwent surgery. METHODS: Thirty patients (type 1 AIP in 23 and type 2 AIP ...

  10. Twenty-four hour blood flow in the forefoot after reconstructive vascular surgery

    DEFF Research Database (Denmark)

    Jelnes, R

    1986-01-01

    Local blood flow in the forefoot (SBF) was measured continuously during 24 hours by 133xenon clearance technique in 10 patients prior to and at least 1 year after successful reconstructive vascular surgery for severe arterial insufficiency (mean: 18 months, range: 12-36). A group of 10 patients...... with normal peripheral circulation served as a control group. In spite of a considerable increase of the ankle/arm systolic blood pressure index--preoperative: 0.30 +/- 0.12, postoperative: 0.78 +/- 0.28 (mean +/- 1 SD)--the SBF decreased by 50% (p less than 0.001) following reconstructive vascular surgery...... are explained by the reappearance of peripheral vasoregulatory mechanisms. Postreconstructive hyperemia was evaluated by the same technique. The changes in SBF following surgery in the positions supine, awake and supine, asleep were found to be insignificant (0.80 less than p less than 0.90). It is concluded...

  11. Twenty-four hour blood flow in the forefoot after reconstructive vascular surgery

    Energy Technology Data Exchange (ETDEWEB)

    Jelnes, R.

    1986-08-01

    Local blood flow in the forefoot (SBF) was measured continuously during 24 hours by 133xenon clearance technique in 10 patients prior to and at least 1 year after successful reconstructive vascular surgery for severe arterial insufficiency (mean: 18 months, range: 12-36). A group of 10 patients with normal peripheral circulation served as a control group. In spite of a considerable increase of the ankle/arm systolic blood pressure index--preoperative: 0.30 +/- 0.12, postoperative: 0.78 +/- 0.28 (mean +/- 1 SD)--the SBF decreased by 50% (p less than 0.001) following reconstructive vascular surgery during day activities. During sleep, however, SBF increased by 80% (p less than 0.001). The relative changes in SBF from day to night at the postoperative examination did not differ from that of the control group, i.e., the normal 24-hour blood flow pattern had been obtained. These changes in SBF are explained by the reappearance of peripheral vasoregulatory mechanisms. Postreconstructive hyperemia was evaluated by the same technique. The changes in SBF following surgery in the positions supine, awake and supine, asleep were found to be insignificant (0.80 less than p less than 0.90). It is concluded that the long-term postreconstructive hyperemia merely is a reflection of the normal 24-hour blood flow pattern.

  12. Estimation of absorbed dose of radiosensitive organs and effective sose in patients underwent abdominopelvic spiral CT scan using impact CT patient dosimetry

    Directory of Open Access Journals (Sweden)

    Ayoub Amirnia

    2017-05-01

    Full Text Available Background: Due to the presence of radiosensitive organs in the abdominopelvic region and increasing the number of requests for CT scan examinations, concerns about increasing radiation doses in patients has been greatly elevated. Therefore, the goal of this study was to determine the absorbed dose of radiosensitive organs and the effective dose in patients underwent abdominopelvic CT scan using ImPACT CT patient dosimetry Calculator (version 1.0.4, Imaging Performance Assessment on Computed Tomography, www.impactscan.org. Methods: This prospective cross-sectional study was conducted in Imam Reza Hospital from November to February 2015 February 2015 in the Imam Reza Hospital, in Urmia, Iran. The demographic and dosimetric information of 100 patients who underwent abdominopelvic CT scan in a 6-slice CT scanner were obtained through the data collection forms. The demographic data of the patients included age, weight, gender, and BMI. The dosimetric parameters included pitch value, CT dose volume index (CTDIvol, dose-length product (DLP, tube voltage, tube current, exposure time, collimation size, scan length, and scan time. To determine the absorbed dose of radiosensitive organs and also the effective dose in patients, ImPACT CT patient dosimetry calculator was used. Results: The results of this study demonstrated that the mean and standard deviation (SD of patients' effective dose in abdominopelvic CT scan was 4.927±0.164 mSv. The bladder in both genders had the greatest mean organ dose, which was 64.71±17.15 mGy for men and 77.56±18.48 mGy for women (P<0.001. Conclusion: The effective dose values of this examination are in the same range as previous studies, as well as International Commission on Radiological Protection (ICRP recommendations. However, the radiation dose from CT scan has the largest contribution to the medical imaging. According to the ALARA principle, it is recommended that the scan parameters, especially mAs, should be

  13. Retrospective analysis of prognostic factors in 205 patients with laryngeal squamous cell carcinoma who underwent surgical treatment.

    Directory of Open Access Journals (Sweden)

    Si-Yi Zhang

    Full Text Available OBJECTIVES: To investigate the most important factors affecting the prognosis of the patients with squamous cell carcinoma (SCC of the larynx. METHODS: Based on the clinical and follow-up data, 205 patients with SCC of the larynx receiving total laryngectomy, partial laryngectomy, or CO2 laser surgery in GuangDong General Hospital were retrospectively analyzed. A survival analysis was performed by the Kaplan-Meier method and a multivariable analysis of prognostic factors was carried out using the Cox proportional hazard model. RESULTS: Subtypes of carcinoma included 69.8% glottic and 30.2% supraglottic. Most patients were in N0 stage (77.6%, and 22.4% patients were in N1∼N3 stage. Over half of the patients were in T1∼T2 stage (55.1%, 20.0% in T3, and 24.9% in T4. Mean follow-up duration was 49.2 months. The survival rates 1, 2, and 3 years after the surgery were 99.0%, 91.7%, and 81.5%, respectively. The survival rate for those patients with clinical stage IV was significantly lower than for those with clinical stage I and II (p<0.001 and p = 0.013, respectively. The disease-free progression rates 1, 2, and 3 years after the surgery were 83.9%, 74.6%, and 71.2%, respectively. Futhermore, those patients with a Charlson score of 1 to 2 and ≥3 had higher risk of mortality than those with a Charlson score of 0 (hazard ratios of 1.8 and 2.41 p = 0.042 and p = 0.008. Multivariable analysis revealed that clinical stage, surgical margin, and comorbidity were significantly associated with both mortality and disease-free progression. CONCLUSION: The surgical resection margin, clinical stage, and comorbidity were independent factors affecting the laryngeal cancer prognosis. The survival rates were lower for patients with advanced laryngeal cancer, positive surgical margins, or severe comorbidity, suggesting the importance of early diagnosis, early treatment, negative surgical margins, and conditions of comorbidity.

  14. Complete Immediate Paraplegia Reversal after Performing Aorto-Lumbar Bypass on the Patient who Underwent Aortoiliac Reconstruction.

    Science.gov (United States)

    Banzic, Igor; Sladojevic, Milos; Ilic, Nikola; Koncar, Igor; Davidovic, Lazar; Brankovic, Milos

    2016-08-01

    Although both internal iliac arteries were saved during operation, the patient developed paraplegia immediately after aortoiliac reconstruction due to the spinal cord ischemia. We report a successfully treated immediate postoperative paraplegia by performing second operation and creating bypass from the bifurcated Dacron graft to the previously detected nonpaired huge lumbar artery.

  15. Food pattern and quality of life in metabolic syndrome patients who underwent coronary artery bypass grafting in Taiwan.

    Science.gov (United States)

    Tung, Heng-Hsin; Tseng, Li-Hua; Wei, Jeng; Lin, Cheng-Hsin; Wang, Tsae-Jyy; Liang, Shu-Yuan

    2011-12-01

    Metabolic syndrome is associated with poor operative outcomes of coronary artery bypass grafting surgery (CABG). A healthy food pattern for metabolic syndrome patients is necessary not only in the initial stage to prevent cardiovascular disease but for those who experience cardiovascular problems and undergo heart surgery. Empirical studies that explore food pattern and quality of life metabolic syndrome patients who undergo CABG are lacking. Therefore, the objectives of this study are to explore the food pattern and quality of life of metabolic syndrome patients who undergo CABG and to examine the relationship between these two variables. A descriptive, correlational and cross section design was conducted. Through convenience sampling, 104 patients were recruited. Data were collected through three instruments: a demographic questionnaire; the Chinese Food Frequency Questionnaire-Short Form (Short C-FFQ), used to assess food pattern; and the Taiwanese version of the Medical Outcomes Study Short Form 36-Health Survey (SF-36), used to assess quality of life. Descriptive analysis, one-way analysis of variance (ANOVA) and Pearson correlation were used to analyze the data. The results indicated that patients who ate fruit more frequently tended to have a better quality of life, while the intake of fried food was more frequently associated with a poor quality of life. The use of these data gives the health care provider a better understanding of food pattern and their impact on quality of life in this population. Such an understanding can be used to develop targeted interventions to promote health in this and in other populations.

  16. Development and Validation of Risk Matrices for Crohn's Disease Outcomes in Patients Who Underwent Early Therapeutic Interventions.

    Science.gov (United States)

    Dias, Cláudia Camila; Rodrigues, Pedro Pereira; Coelho, Rosa; Santos, Paula Moura; Fernandes, Samuel; Lago, Paula; Caetano, Cidalina; Rodrigues, Ângela; Portela, Francisco; Oliveira, Ana; Ministro, Paula; Cancela, Eugénia; Vieira, Ana Isabel; Barosa, Rita; Cotter, José; Carvalho, Pedro; Cremers, Isabelle; Trabulo, Daniel; Caldeira, Paulo; Antunes, Artur; Rosa, Isadora; Moleiro, Joana; Peixe, Paula; Herculano, Rita; Gonçalves, Raquel; Gonçalves, Bruno; Sousa, Helena Tavares; Contente, Luís; Morna, Henrique; Lopes, Susana; Magro, Fernando

    2017-04-01

    The establishment of prognostic models for Crohn's disease [CD] is highly desirable, as they have the potential to guide physicians in the decision-making process concerning therapeutic choices, thus improving patients' health and quality of life. Our aim was to derive models for disabling CD and reoperation based solely on clinical/demographic data. A multicentric and retrospectively enrolled cohort of CD patients, subject to early surgery or immunosuppression, was analysed in order to build Bayesian network models and risk matrices. The final results were validated internally and with a multicentric and prospectively enrolled cohort. The derivation cohort included a total of 489 CD patients [64% with disabling disease and 18% who needed reoperation], while the validation cohort included 129 CD patients with similar outcome proportions. The Bayesian models achieved an area under the curve of 78% for disabling disease and 86% for reoperation. Age at diagnosis, perianal disease, disease aggressiveness and early therapeutic decisions were found to be significant factors, and were used to construct user-friendly matrices depicting the probability of each outcome in patients with various combinations of these factors. The matrices exhibit good performance for the most important criteria: disabling disease positive post-test odds = 8.00 [2.72-23.44] and reoperation negative post-test odds = 0.02 [0.00-0.11]. Clinical and demographical risk factors for disabling CD and reoperation were determined and their impact was quantified by means of risk matrices, which are applicable as bedside clinical tools that can help physicians during therapeutic decisions in early disease management.

  17. Association ofMitochondrial T16519C polymorphism with Coronary Artery Disease (CAD in Iranian patients underwent coronary angiography

    Directory of Open Access Journals (Sweden)

    Reza Ghadiri Rad

    2016-09-01

    Full Text Available Early diagnosis, before manifestation of symptoms or identifying susceptibility to diseases can reduce the severity and prevalence and may even control or inhibit the disease progression. Now the relationship between the incidence of cardiovascular diseases and certain types of haplotypes of human mtDNA (mitochondrial DNA have been substantiated and investigation of the frequency of particular types of cases and controls can reveal this connection. Substitution of T to C at nucleotide position 16189 in the hypervariable D-loop of the control region (CR of mitochondrial DNA (mtDNA has attracted research interest because of its suspected association with various multifactorial diseases. The objective of the current study was to identify and evaluate different haplotype mtDNA and examine their relationship to the incidence of coronary artery disease in different haplogroups in Iranian patients visiting SINA hospital in Tehran. A total of 70 participants (including 40 males and 30 females visiting the Cath Lab (angiography of SINA hospital were selected according to the index of stenosis (CSI. After obtaining informed consent, approximately 5cc of blood sample from each patient was taken and sent to the laboratory. Total DNA (50 µg of blood samples were extracted using primers of D-Loop- a specific region of mtDNA, the replicative samples (HVS regions were then seperated by electrophoresis process and quality of amplicon (product was confirmed. This step was followed by sequencing and compared with the reference sequence. According to the SNP, polymorphisms and mutations, and the percentage of their presence in case and control populations were studied and the data analyzed. Items have been composed of haplotype 263 A>G (maximum with 62 samples from 34 patients and 23 healthy and 5 mild cases, 310-311 insC with 61 samples from 35 patients, 21 healthy and 5 slight, variant 750 A>G with 59 persons of 33 patients, 20 healthy and 6 average, other SNP

  18. The predictive value of three-dimensional Doppler ultrasonography in determining implantation in patients underwent in vitro fertilization

    Directory of Open Access Journals (Sweden)

    Yusuf Çakmak

    2015-12-01

    Full Text Available Objective: The aim of this study is to evaluate the relationship between endometrial and sub-endometrial blood flow and implantation rate in patients whose undergone in vitro fertilization. Methods: A prospective study was conducted. Long protocol and antagonist regimens were administered to the patients. Endometrial and sub-endometrial blood flow was evaluated by using 3 dimensional Doppler ultrasonography on the day of oocyt retrieval measurement. For comparison pregnant and non-pregnant women in terms of endometrial and sub-endometrial blood flow, t test was used. The p value was considered statistically meaningful as 0.05. In long protocol group, the number of embryo was greater in pregnant women than non-pregnant women (p=0.012. The number of transferred embryo increased pregnancy rate almost 3.5 fold (p=0.002. Conclusion: The endometrial and subendometrial blood flow is not reliable factor in prediction pregnancy or implantation.

  19. 米诺环素软膏治疗牙周炎的效果%Effect of minocycline ointment on the patients underwent periodontitis

    Institute of Scientific and Technical Information of China (English)

    郑艺; 汤洪毅; 陈京华

    2014-01-01

    目的:观察米诺环素软膏治疗牙周炎的效果。方法:90例牙周炎患者随机分为两组:米诺环素组和碘甘油组。米诺环素组患者使用米诺环素软膏,碘甘油组患者使用碘甘油和替硝唑。记录两组患者的治疗效果。结果:米诺环素组患者的治疗效果比碘甘油组的好( P<0.05)。结论:米诺环素软膏治疗牙周炎患者的效果良好。%Objective To observe the effect of Minocycline ointnent on the patients underwent periodontitis. Method Ninety patients underwent periodontitis were randonly divided into two groups:ninocycline group and iodine glycerin group. In the ninocycline group,the patients were adninistrated with ninocycline ointnen. In the iodine glycerin group,the patients were adninistrated with iodine glycerin and tinidazole. The therapeutic effect in both groups were recorded. Results The therapeutic effect in ninocycline group was better than that in iodine glycerin group(P<0. 05). Conclusion Minocycline ointnent is effective for the patients underwent periodontitis.

  20. Comparative Effects of Statin Therapy versus Renin-Angiotensin System Blocking Therapy in Patients with Ischemic Heart Failure Who Underwent Percutaneous Coronary Intervention.

    Science.gov (United States)

    Won, Jumin; Hong, Young Joon; Jeong, Myung Ho; Park, Hyuk Jin; Kim, Min Chul; Kim, Woo Jin; Kim, Hyun Kuk; Sim, Doo Sun; Kim, Ju Han; Ahn, Youngkeun; Cho, Jeong Gwan; Park, Jong Chun

    2016-05-01

    Statins and renin-angiotensin system (RAS) blockers are key drugs for treating patients with an acute myocardial infarction (AMI). This study was designed to show the association between treatment with statins or RAS blockers and clinical outcomes and the efficacy of two drug combination therapies in patients with ischemic heart failure (IHF) who underwent revascularization for an AMI. A total of 804 AMI patients with a left ventricular ejection fraction <40% who undertook percutaneous coronary interventions (PCI) were analyzed using the Korea Acute Myocardial Infarction Registry (KAMIR). They were divided into four groups according to the use of medications [Group I: combination of statin and RAS blocker (n=611), Group II: statin alone (n=112), Group III: RAS blocker alone (n=53), Group IV: neither treatment (n=28)]. The cumulative incidence of major adverse cardiac and cerebrovascular events (MACCEs) and independent predictors of MACCEs were investigated. Over a median follow-up study of nearly 1 year, MACCEs had occurred in 48 patients (7.9%) in Group I, 16 patients (14.3%) in Group II, 3 patients (5.7%) in Group III, 7 patients (21.4%) in Group IV (p=0.013). Groups using RAS blocker (Group I and III) showed better clinical outcomes compared with the other groups. By multivariate analysis, use of RAS blockers was the most powerful independent predictor of MACCEs in patients with IHF who underwent PCI (odds ratio 0.469, 95% confidence interval 0.285-0.772; p=0.003), but statin therapy was not found to be an independent predictor. The use of RAS blockers, but not statins, was associated with better clinical outcomes in patients with IHF who underwent PCI.

  1. The predictive value of chronic kidney disease for assessing cardiovascular events under consideration of pretest probability for coronary artery disease in patients who underwent stress myocardial perfusion imaging.

    Science.gov (United States)

    Furuhashi, Tatsuhiko; Moroi, Masao; Joki, Nobuhiko; Hase, Hiroki; Masai, Hirofumi; Kunimasa, Taeko; Fukuda, Hiroshi; Sugi, Kaoru

    2013-02-01

    Pretest probability of coronary artery disease (CAD) facilitates diagnosis and risk stratification of CAD. Stress myocardial perfusion imaging (MPI) and chronic kidney disease (CKD) are established major predictors of cardiovascular events. However, the role of CKD to assess pretest probability of CAD has been unclear. This study evaluates the role of CKD to assess the predictive value of cardiovascular events under consideration of pretest probability in patients who underwent stress MPI. Patients with no history of CAD underwent stress MPI (n = 310; male = 166; age = 70; CKD = 111; low/intermediate/high pretest probability = 17/194/99) and were followed for 24 months. Cardiovascular events included cardiac death and nonfatal acute coronary syndrome. Cardiovascular events occurred in 15 of the 310 patients (4.8 %), but not in those with low pretest probability which included 2 CKD patients. In patients with intermediate to high pretest probability (n = 293), multivariate Cox regression analysis identified only CKD [hazard ratio (HR) = 4.88; P = 0.022) and summed stress score of stress MPI (HR = 1.50; P probability. In patients with intermediate to high pretest probability, CKD and stress MPI are independent predictors of cardiovascular events considering the pretest probability of CAD in patients with no history of CAD. In assessing pretest probability of CAD, CKD might be an important factor for assessing future cardiovascular prognosis.

  2. Retrospective, Demographic, and Clinical Investigation of the Causes of Postoperative Infection in Patients With Lumbar Spinal Stenosis Who Underwent Posterior Stabilization.

    Science.gov (United States)

    Yaldiz, Can; Yaldiz, Mahizer; Ceylan, Nehir; Kacira, Ozlem Kitiki; Ceylan, Davut; Kacira, Tibet; Kizilcay, Gokhan; Tanriverdi, Taner

    2015-07-01

    Owing to the increasing population of elderly patients, a large number of patients with degenerative spondylosis are currently being surgically treated. Although basic measures for decreasing postoperative surgical infections (PSIs) are considered, it still remains among the leading causes of morbidity and mortality. The aim of this retrospective analysis is to present possible causes leading to PSI in patients who underwent surgery for lumbar degenerative spondylosis and highlight how it can be avoided to decrease morbidity and mortality. The study included 540 patients who underwent posterior stabilization due to degenerative lumbar stenosis between January 2013 and January 2014. The data before and after surgery was retrieved from the hospital charts. Patients with degenerative lumbar stenosis who were operated upon in this study had >2 levels of laminectomy and facetectomy. For this reason, posterior stabilization was performed for all the patients included in this study. Determining the causes of postoperative infection (PI) following spinal surgeries performed with instrumentation is a struggle. Seventeen different parameters that may be related to PI were evaluated in this study. The presence of systemic diseases, unknown glove perforations, and perioperative blood transfusions were among the parameters that increased the prevalence of PI. Alternatively, prolene sutures, double-layered gloves, and the use of rifampicin Sv (RIS) decreased the incidence of PI. Although the presence of systemic diseases, unnoticed glove perforations, and perioperative blood transfusions increased PIs, prolene suture material, double-layered gloves, and the use of RIS decreased PIs.

  3. Analysis of the Use of Extracorporeal Circulation on the In-Hospital Outcomes of Dialytic Patients Who Underwent Myocardial Revascularization Surgery

    Science.gov (United States)

    Miranda, Matheus; Branco, João Nelson Rodrigues; Vargas, Guilherme Flora; Hossne Jr, Nelson Americo; Yoshimoto, Michele Costa; da Fonseca, José Honorio de Almeida Palma; Pestana, José Osmar Medina de Abreu; Buffolo, Enio

    2016-01-01

    Background Myocardial revascularization surgery is the best treatment for dyalitic patients with multivessel coronary disease. However, the procedure still has high morbidity and mortality. The use of extracorporeal circulation (ECC) can have a negative impact on the in-hospital outcomes of these patients. Objectives To evaluate the differences between the techniques with ECC and without ECC during the in-hospital course of dialytic patients who underwent surgical myocardial revascularization. Methods Unicentric study on 102 consecutive, unselected dialytic patients, who underwent myocardial revascularization surgery in a tertiary university hospital from 2007 to 2014. Results Sixty-three patients underwent surgery with ECC and 39 without ECC. A high prevalence of cardiovascular risk factors was found in both groups, without statistically significant difference between them. The group "without ECC" had greater number of revascularizations (2.4 vs. 1.7; p <0.0001) and increased need for blood components (77.7% vs. 25.6%; p <0.0001) and inotropic support (82.5% vs 35.8%; p <0.0001). In the postoperative course, the group "without ECC" required less vasoactive drugs, (61.5% vs. 82.5%; p = 0.0340) and shorter time of mechanical ventilation (13.0 hours vs. 36,3 hours, p = 0.0217), had higher extubation rates in the operating room (58.9% vs. 23.8%, p = 0.0006), lower infection rates (7.6% vs. 28.5%; p = 0.0120), and shorter ICU stay (5.2 days vs. 8.1 days; p = 0.0054) as compared with the group with ECC surgery. No difference in mortality was found between the groups. Conclusion Myocardial revascularization with ECC in patients on dialysis resulted in higher morbidity in the perioperative period in comparison with the procedure without ECC, with no difference in mortality though.

  4. Analysis of the Use of Extracorporeal Circulation on the In-Hospital Outcomes of Dialytic Patients Who Underwent Myocardial Revascularization Surgery

    Directory of Open Access Journals (Sweden)

    Matheus Miranda

    Full Text Available Abstract Background: Myocardial revascularization surgery is the best treatment for dyalitic patients with multivessel coronary disease. However, the procedure still has high morbidity and mortality. The use of extracorporeal circulation (ECC can have a negative impact on the in-hospital outcomes of these patients. Objectives: To evaluate the differences between the techniques with ECC and without ECC during the in-hospital course of dialytic patients who underwent surgical myocardial revascularization. Methods: Unicentric study on 102 consecutive, unselected dialytic patients, who underwent myocardial revascularization surgery in a tertiary university hospital from 2007 to 2014. Results: Sixty-three patients underwent surgery with ECC and 39 without ECC. A high prevalence of cardiovascular risk factors was found in both groups, without statistically significant difference between them. The group "without ECC" had greater number of revascularizations (2.4 vs. 1.7; p <0.0001 and increased need for blood components (77.7% vs. 25.6%; p <0.0001 and inotropic support (82.5% vs 35.8%; p <0.0001. In the postoperative course, the group "without ECC" required less vasoactive drugs, (61.5% vs. 82.5%; p = 0.0340 and shorter time of mechanical ventilation (13.0 hours vs. 36,3 hours, p = 0.0217, had higher extubation rates in the operating room (58.9% vs. 23.8%, p = 0.0006, lower infection rates (7.6% vs. 28.5%; p = 0.0120, and shorter ICU stay (5.2 days vs. 8.1 days; p = 0.0054 as compared with the group with ECC surgery. No difference in mortality was found between the groups. Conclusion: Myocardial revascularization with ECC in patients on dialysis resulted in higher morbidity in the perioperative period in comparison with the procedure without ECC, with no difference in mortality though.

  5. Relation of Coronary Artery Calcium Score and Risk of Cancer (from a Danish Population-Based Follow-up Study in Patients Who Underwent Cardiac Computed Tomography)

    DEFF Research Database (Denmark)

    Vinter, Nicklas; Christesen, Amanda M.S.; Mortensen, Leif S.

    2017-01-01

    of 28,549 cancer-free patients identified in the Western Denmark Heart Registry. All patients underwent cardiac computed tomography for measurement of CACS for suspected coronary artery disease. The outcome was an incident cancer diagnosis: total, tobacco-related, lung, prostate, breast, and colorectal......Evidence of a causal link between atherosclerosis and cancer is sparse and conflicting. Therefore, we examined the association between extent of coronary atherosclerosis determined by coronary artery calcium score (CACS) and risk of cancer. We conducted a historical population-based cohort study...

  6. Increased incidence of hypotension in elderly patients who underwent emergency airway management: an analysis of a multi-centre prospective observational study.

    Science.gov (United States)

    Hasegawa, Kohei; Hagiwara, Yusuke; Imamura, Taichi; Chiba, Takuyo; Watase, Hiroko; Brown, Calvin A; Brown, David Fm

    2013-01-01

    Although the number of elderly increases disproportionately throughout the industrialised nations and intubation-related cardiovascular compromise is associated with hospital mortality, no emergency medicine literature has reported the direction and magnitude of effect of advanced age on post-intubation hypotension. We seek to determine whether advanced age is associated with an increased rate of hypotension at airway management in emergency departments (EDs). We conducted an analysis of a multi-centre prospective observational study of 13 Japanese EDs from April 2010 to March 2012. Inclusion criteria were all adult non-cardiac-arrest patients who underwent emergency intubation. We excluded patients in whom airway management was performed for shock or status asthmaticus as the principal indication. Patients were divided into two groups defined a priori: age ≥ 65 years old (elderly group) and age airway management at 13 EDs. Among these, the database recorded 3,872 intubations (capture rate 96%). Of 1,903 eligible patients, 975 patients were age ≥ 65 years (51%) and 928 patients were age advanced age had an adjusted OR for post-intubation hypotension of 2.6 (95% CI, 1.3-5.6; P = 0.01). In this large multi-centre study of ED patients who underwent emergent airway management, we found that elderly patients have a significantly higher risk of post-intubation hypotension. These data provide implications for the education and practice of ED airway management that may lead to better clinical outcomes and improved patient safety.

  7. Spinopelvic balance evaluation of patients with degenerative spondylolisthesis L4L5 and L4L5 herniated disc who underwent surgery

    Directory of Open Access Journals (Sweden)

    Viviane Regina Hernandez Nunes

    Full Text Available ABSTRACT OBJECTIVE: To correlate spinopelvic balance with the development of degenerative spondylolisthesis and disk herniation. METHODS: This was a descriptive retrospective study that evaluated 60 patients in this hospital, 30 patients with degenerative spondylolisthesis at the L4-L5 level and 30 with herniated disk at the L4-L5 level, all of whom underwent Surgical treatment. RESULTS: Patients with lumbar disk herniation at L4-L5 level had a mean tilt of 8.06, mean slope of 36.93, and mean PI of 45. In patients with degenerative spondylolisthesis at the L4-L5 level, a mean tilt of 22.1, mean slope of 38.3, and mean PI of 61.4 were observed. CONCLUSION: This article reinforces the finding that the high mean tilt and PI are related to the onset of degenerative spondylolisthesis, and also concluded that the same angles, when low, increase the risk for disk herniation.

  8. Serum cystatin c is not superior to serum creatinine for early diagnosis of contrast-induced nephropathy in patients who underwent angiography.

    Science.gov (United States)

    Xu, Qian; Wang, Na-Na; Duan, Shao-Bin; Liu, Na; Lei, Rong; Cheng, Wei; Zhou, Shun-Ke

    2017-09-01

    Iodiated contrast-induced nephropathy (CIN) is a serious complication of contrast-enhanced imaging. The aim of this study was to evaluate the diagnostic sensitivities and specificities of serum cystatin C (sCys C) and serum creatinine (sCr) for CIN and to further investigate difference of the incidence, risk factors, and in-hospital and 3-month prognosis of CIN according to sCys C criteria and sCr criteria. We prospectively evaluated 213 patients who underwent angiography. The sCr and sCys C concentrations were detected before and at 48 hours, 72 hours after the procedure. The incidence, risk factors, and in-hospital and 3-month prognosis of CIN were analyzed. Receiver operating characteristic curve (ROC) analysis was performed for sCr and sCys C 48 hours after procedure. The incidence of CIN was 24.4% (sCys C criteria) and 8% (sCr criteria). Diabetes mellitus, dehydration, and hypoalbuminemia were independent risk factors for CIN. Area under the ROC of sCys C 48 hours after procedure was not superior to sCr (0.715 vs 0.790, P=.178). The mortality of patients with CIN in sCr criteria increased significantly (PC was not superior to sCr for predicting CIN in the patients who underwent angiography. © 2016 Wiley Periodicals, Inc.

  9. Comparison of Estimations Versus Measured Oxygen Consumption at Rest in Patients With Heart Failure and Reduced Ejection Fraction Who Underwent Right-Sided Heart Catheterization.

    Science.gov (United States)

    Chase, Paul J; Davis, Paul G; Wideman, Laurie; Starnes, Joseph W; Schulz, Mark R; Bensimhon, Daniel R

    2015-12-01

    Cardiac output during right-sided heart catheterization is an important variable for patient selection of advanced therapies (cardiac transplantation and left ventricular assist device implantation). The Fick method to determine cardiac output is commonly used and typically uses estimated oxygen consumption (VO2) from 1 of 3 published empirical formulas. However, these estimation equations have not been validated in patients with heart failure and reduced ejection fraction (HFrEF). The objectives of the present study were to determine the accuracy of 3 equations for estimating VO2 compared with direct measurement of VO2 and determine the extent clinically significant error occurred in calculating cardiac output of patients with HFrEF. Breath-by-breath measurements of VO2 from 44 patients who underwent cardiac catheterization (66% men; age, 65 ± 11 years, left ventricular ejection fraction, 22 ± 6%) were compared with the derived estimations of LaFarge and Miettinen, Dehmer et al, and Bergstra et al. Single-sample t tests found only the mean difference between the estimation of LaFarge and Miettinen and the measured VO2 to be nonsignificant (-10.3 ml/min ± 6.2 SE, p = 0.053). Bland-Altman plots demonstrated unacceptably large limits of agreement for all equations. The rate of ≥25% error in the equations by LaFarge and Miettinen, Dehmer et al, and Bergstra et al occurred in 11%, 23%, and 45% of patients, respectively. Misclassification of cardiac index derived from each equation for 2 clinically important classifications: cardiogenic shock-21%, 23%, and 32% and hypoperfusion-16%, 16%, and 25%; respectively. In conclusion, these findings do not support the use of these empiric formulas to estimate the VO2 at rest in patients with HFrEF who underwent right-sided heart catheterization.

  10. Outcome of Triple Antiplatelet Therapy Including Cilostazol in Elderly Patients with ST-Elevation Myocardial Infarction who Underwent Primary Percutaneous Coronary Intervention: Results from the INTERSTELLAR Registry.

    Science.gov (United States)

    Jang, Ho-Jun; Park, Sang-Don; Park, Hyun Woo; Suh, Jon; Oh, Pyung Chun; Moon, Jeonggeun; Lee, Kyounghoon; Kang, Woong Chol; Kwon, Sung Woo; Kim, Tae-Hoon

    2017-06-01

    Compared with dual antiplatelet therapy including aspirin and clopidogrel, triple antiplatelet therapy including cilostazol has a mortality benefit in patients with ST-segment elevation myocardial infarction. However, whether the mortality benefit persists in elderly patients is not clear. From 2007 to 2014, 1278 patients with ST-segment elevation myocardial infarction who underwent primary percutaneous coronary intervention were retrospectively analyzed. The patients were divided into four groups by age (antiplatelet strategy (triple or dual antiplatelet therapy). We compared the mortality rates between the triple and dual antiplatelet therapy groups. There were 1052 (male, 85%; mean age, 56.3 ± 10.4 years) patients in the young group and 241 (male, 52.7%; mean age, 80.3 ± 4.5 years) patients in the elderly group. In the young and elderly groups, 220 (20.9%) and 28 (12.3%) patients were treated with triple antiplatelet therapy. During a 1-year follow-up period, 80 patients died (4.2% in the young group vs. 15.5% in the elderly group). Kaplan-Meier survival analysis revealed that triple antiplatelet therapy was associated with a lower mortality rate in the young group (log-rank, p = 0.005). Although there were more angiographic high-risk patients in the elderly group, similar mortality rates were reported (log-rank, p = 0.803) without increased bleeding rates (1 vs. 3.6% in the elderly group, p = 0.217). Triple antiplatelet therapy might be a better antiplatelet regimen than dual antiplatelet therapy for patients with ST-segment elevation myocardial infarction. Although this benefit was strong in patients aged <75 years, no definite increase in major bleeding was seen for elderly patients (aged ≥75 years).

  11. Effect of advanced blood pressure control with nifedipine delayed-release tablets on the blood pressure in patients underwent nasal endoscope surgery

    Institute of Scientific and Technical Information of China (English)

    Qing-Hua Xiao; Li Yang; Rong-Ping Chen; Wei-Dong Qiu

    2016-01-01

    Objective:To explore the effect of advanced blood pressure control with nifedipine delayed-release tablets on the blood pressure in patients underwent nasal endoscope surgery and its feasibility.Methods:A total of 80 patients who were admitted in ENT department from June, 2012 to June, 2015 for nasal endoscope surgery were included in the study and randomized into the observation group and the control group with 40 cases in each group. The patients in the observation group were given nifedipine delayed-release tablets for advanced blood pressure control before operation, and were given routine blood pressure control during operation; while the patients in the control group were only given blood pressure control during operation. The changes of blood pressure, mean central arterial pressure, and heart rate before anesthesia (T0), after intubation (T1), during operation (T2), extubation when waking (T3), 30 min after extubation (T4), and 3 h after back to wards (T5) in the two groups were compared. The intraoperative situation and the surgical field quality in the two groups were compared.Results: SBP, DBP, and MAP levels at T1-5 in the two groups were significantly lower than those at T0. SBP, DBP, and MAP levels at T2 were significantly lower than those at other timing points, and were gradually recovered after operation, but were significantly lower than those at T0. The effect taking time of blood pressure reducing, intraoperative nitroglycerin dosage, and postoperative wound surface exudation amount in the observation group were significantly less than those in the control group. The surgical field quality scores in the observation group were significantly superior to those in the control group.Conclusions:Advanced blood pressure control with nifedipine delayed-release tablets can stabilize the blood pressure during the perioperative period in patients underwent nasal endoscope surgery, and enhance the surgical field qualities.

  12. The tumor-to-breast volume ratio (TBR) predicts cancer-specific survival in breast cancer patients who underwent modified radical mastectomy.

    Science.gov (United States)

    Wen, Jiahuai; Ye, Feng; Huang, Xiaojia; Li, Shuaijie; Yang, Lu; Xiao, Xiangsheng; Xie, Xiaoming

    2016-06-01

    Breast cancer is the most common cancer in women globally, and tumor size measured as the largest diameter of the tumor focus is currently used in tumor-lymph node-metastasis (TNM) staging for prognosis and treatment decisions. The present study utilized the tumor-to-breast volume ratio (TBR) to evaluate the relative tumor size and determined the prognostic impact of TBR on survival in patients with breast cancer. Two thousand twenty-five consecutive breast cancer patients who underwent modified radical mastectomy between January 2002 and December 2008 at Sun Yat-Sen University Cancer Center were enrolled in this retrospective study. Kaplan-Meier analysis was used to assess the prognostic effect of TBR on cancer-specific survival (CSS), and univariate log-rank test and multivariate Cox proportional hazards regression model were performed to identify independent prognostic factors. The optimal cutoff value of TBR was determined to be 1.70 %, and 1473 and 552 patients were categorized to low-TBR and high-TBR groups, respectively. In the whole patient cohort, CSS was significantly shorter in the high-TBR group (110.2 vs 128.5 months, P breast cancer patients (hazard ratio (HR) 1.489, 95 % CI 1.130-1.961, P = 0.005). High TBR was independently associated with poor prognosis in breast cancer patients. This variable may serve as a valuable parameter to predict the outcomes of breast cancer.

  13. Intraoperative dexmedetomidine and postoperative cerebral hyperperfusion syndrome in patients who underwent superficial temporal artery-middle cerebral artery anastomosis for moyamoya disease

    Science.gov (United States)

    Seo, Hyungseok; Ryu, Ho-Geol; Son, Je Do; Kim, Jeong-Soo; Ha, Eun Jin; Kim, Jeong-Eun; Park, Hee-Pyoung

    2016-01-01

    Abstract Dexmedetomidine, a selective α2-agonist, reduces cerebral blood flow and has neuroprotective effects against cerebral ischemia/reperfusion injury in experimental animals. We examined whether intraoperative dexmedetomidine would reduce the incidence of postoperative cerebral hyperperfusion syndrome (CHS) after superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis in patients with moyamoya disease. The electronic medical records of 117 moyamoya patients who underwent STA-MCA anastomosis were reviewed retrospectively. The patients were divided into 2 groups: 48 patients received intraoperative dexmedetomidine (Group D), while 69 patients did not (Group ND). The incidence (primary outcome), onset, and duration of postoperative CHS were noted. The incidence of postoperative CHS was 45.8% and 40.6% in groups D and ND, respectively (P = 0.708). The duration of postoperative CHS was shorter in group D than in group ND (median [Q1–Q3], 5 [3–7] vs 8 [5–10] days, P = 0.021). There was no significant difference in the onset of CHS between group D and group ND (0 [0–2] vs 1 [0–3] days, P = 0.226). In conclusion, intraoperative dexmedetomidine did not reduce the incidence of postoperative CHS, although it reduced the duration of CHS, in patients who had undergone direct revascularization surgery for moyamoya disease. PMID:28033272

  14. Quality of life after contralateral prophylactic mastectomy in newly diagnosed high-risk breast cancer patients who underwent BRCA1/2 gene testing.

    Science.gov (United States)

    Tercyak, Kenneth P; Peshkin, Beth N; Brogan, Barbara M; DeMarco, Tiffani; Pennanen, Marie F; Willey, Shawna C; Magnant, Colette M; Rogers, Sarah; Isaacs, Claudine; Schwartz, Marc D

    2007-01-20

    Recent studies indicate that high-risk breast cancer patients (ie, women who carry mutations in BRCA1/2 genes) who opt for contralateral prophylactic mastectomy (CPM) have a substantially reduced risk of developing contralateral breast cancer. However, the immediate and long-term impact of this decision on women's quality of life and psychosocial functioning is largely unknown. In this study, we compared the impact of BRCA1/2 genetic test result and CPM on these outcomes among newly diagnosed breast cancer patients who opted for CPM at the time of their definitive surgical treatment versus patients who did not. Participants were 149 high-risk women who underwent genetic counseling and testing for alterations in the BRCA1/2 genes. We measured self-reported quality of life, cancer-specific distress, and genetic testing-specific distress using standardized instruments before receipt of genetic test results and again 1 and 12 months later. Compared with patients who chose breast conservation or unilateral mastectomy, those who chose mastectomy of the affected breast and CPM of the unaffected breast did not report diminished quality of life or elevated distress. With respect to quality of life and distress, patients who choose CPM fare as well as those who do not in the first year after surgery.

  15. Pediatric keratoconus and iontophoretic corneal crosslinking: refractive and topographic evidence in patients underwent general and topical anesthesia, 18 months of follow-up.

    Science.gov (United States)

    Magli, Adriano; Chiariello Vecchio, Elisabetta; Carelli, Roberta; Piozzi, Elena; Di Landro, Felicia; Troisi, Salvatore

    2016-08-01

    To evaluate the efficiency and safety of iontophoretic transepithelial corneal crosslinking in pediatric patients with progressive keratoconus underwent general or topical anesthesia in 18 months follow-up. 13 patients (13 eyes) diagnosed with progressive keratoconus underwent corneal CXL with iontophoresis (I-CXL). Riboflavin solution was administered by iontophoresis for 5 min, and then UV-A irradiation (10 mW/cm) was performed for 9 min. Preoperative and post-operative visits at 1, 6, 12, and 18 months assessed the following parameters: uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), slit-lamp biomicroscopy, corneal topography, optical tomography, and pachymetry with Pentacam (Oculus Optikgeräte GmbH, Wetzlar, Germany), endothelial biomicroscopy (Konan Specular Microscope; Konan Medical, Inc., Hyogo, Japan). The paired Student t test was used to compare data during the follow-up. 10 males and 3 females with a mean age of 15.4 ± 1.7 years (range 11-18 years) were included. The results showed a stabilization of the refractive UCVA and BCVA as early as the first post-operative month, with a slight improvement over time. The Kmax remained stable throughout follow-up (p = 0.04). Transepithelial collagen crosslinking by iontophoresis, unlike other transepithelial techniques seems to halt pediatric keratoconus progression over 18 months. This is the second study evaluating CXL with iontophoresis in pediatric patients with progressive keratoconus with 18 months of follow-up using two different ways of anesthesia.

  16. Protein C, protein S, antithrombin III, and hyperfibrinogenemia in deep vein thrombosis (DVT among patients who underwent high risk orthopaedic surgery

    Directory of Open Access Journals (Sweden)

    Ismail Ismail

    2004-03-01

    Full Text Available Post operative DVT  is believed to be rare in Indonesia, and so is trombophilia. It is necessary to know  the incidence of postoperative DVT in Indonesia and thrombophlia profile (protein C, S, AT III deficiency and hyperfibrinogenemia in DVT and non DVT patient who underwent orthopedic surgery involving the hip and knee (high risk surgery. A cross sectional study was conducted in 20 patients who underwent surgery  involving the hip (total hip replacement  and fixation of proximal femoral fracture and knee (total knee replacement and fixation of  distal femoral fracture. Protein C, protein S, antithrombin III, and fibrinogen were examined in day 5 post operative, as well as with compression/Doppler USG between day 10 to 21 post operative, and confirmed by venography  if USG findings was positive. Post operative DVT were found in 5 of  20  patients (25%. Deficiency of protein C (P= 0.46 protein S (P= 0.81, antithrombin III (P= 0.46, and hyperfibrinogenemia (P= 0.0547 did not correlate to post operative DVT. However, hyperfibrinogenemia was found to be a risk factor to post operative DVT (attributable risk= 1. Other confounding factor such as diabetes mellitus (P= 1.0, obesity (P= 0.28, hypertention (P= 1.0, hypertrigliseridemia, and hypercholesterolemia did not correlate to post operative DVT. The study suggested  the existence of postoperative DVT cases  in Indonesia. Hyperfibrinogenemia is a risk factor to promote post operative DVT. Deep vein thrombosis  did not correlate to protein S, protein C, and antithrombin III deficiency. (Med J Indones 2004; 13: 24-30Keywords: Thrombophilia, hip, knee, venography

  17. Simplified Chinese version of the Forgotten Joint Score (FJS) for patients who underwent joint arthroplasty: cross-cultural adaptation and validation.

    Science.gov (United States)

    Cao, Shiqi; Liu, Ning; Han, Wuxiang; Zi, Yunpeng; Peng, Fan; Li, Lexiang; Fu, Qiwei; Chen, Yi; Zheng, Weijie; Qian, Qirong

    2017-01-14

    The Forgotten Joint Score (FJS) is a newly developed health-related quality of life (HRQoL) questionnaire designed to evaluate the awareness after total knee arthroplasty (TKA). This study cross-culturally adapted and psychometrically validated a simplified Chinese version of the FJS (SC-FJS). Cross-cultural adaptation was performed according to the internationally recognized guidelines. One-hundred and fifty participants who underwent primary TKA were recruited in this study. Cronbach's α and intra-class correlations were used to determine reliability. Construct validity was analyzed by evaluating the correlations between SC-FJS and the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the short form (36) health survey (SF-36). Each of the 12 items was properly responded and correlated with the total items. SC-FJS had excellent reliability [Cronbach's α = 0.907, intra-class correlation coefficient (ICC) = 0.970, 95% CI 0.959-0.978). Elimination of any one item in all did not result in a value of Cronbach's α of  0.05) correlation with mental subscale of SF-36. SC-FJS demonstrated excellent acceptability, internal consistency, reliability, and construct validity, which can be recommended for patients who underwent joint arthroplasty in Mainland China.

  18. Surgical treatment of cavus foot in Charcot-Marie-tooth disease: a review of twenty-four cases: AAOS exhibit selection.

    Science.gov (United States)

    Faldini, Cesare; Traina, Francesco; Nanni, Matteo; Mazzotti, Antonio; Calamelli, Carlotta; Fabbri, Daniele; Pungetti, Camilla; Giannini, Sandro

    2015-03-18

    Charcot-Marie-Tooth disease is the single most common diagnosis associated with cavus foot. The imbalance involving intrinsic and extrinsic muscles has been suggested as the main pathogenetic cause of cavus foot in this disease. The goal of surgical treatment is to correct the deformity to obtain a plantigrade foot. In the presence of a flexible deformity and the absence of degenerative arthritis, preserving as much as possible of the overall range of motion of the foot and ankle is advisable. Twenty-four cavus feet in twelve patients with Charcot-Marie-Tooth disease were included in the study. Clinical evaluation was summarized with the Maryland Foot Score. Radiographic evaluation assessed calcaneal pitch, Meary angle, Hibb angle, and absence of degenerative joint changes. Only patients who had a flexible deformity, with varus of the heel reducible in the Coleman-Andreasi test, and did not have degenerative joint arthritis were included in this study. Surgical treatment consisted in plantar fasciotomy, midtarsal osteotomy, extensor hallucis longus tendon transfer to the first metatarsal (Jones procedure), and dorsiflexion osteotomy of the first metatarsal. Mean follow-up was six years (range, two to thirteen years). The mean Maryland Foot Score was 72 preoperatively and 86 postoperatively. The postoperative result was rated as excellent in twelve feet (50%), good in ten (42%), and fair in two (8%). Mean calcaneal pitch was 34° preoperatively and 24° at the time of the latest follow-up, the mean Hibb angle was 121° preoperatively and 136° postoperatively, and the mean Meary angle was 25° preoperatively and 2° postoperatively. Plantar fasciotomy, midtarsal osteotomy, the Jones procedure, and dorsiflexion osteotomy of the first metatarsal yielded adequate correction of flexible cavus feet in patients with Charcot-Marie-Tooth disease in the absence of fixed hindfoot deformity. The fact that the improvement in the outcome score was only modest may be attributable

  19. [Prophylactic effect of CsA, MTX, MMF combined with ATG on GVHD in patients underwent unrelated peripheral blood hematopoietic stem cell transplantation].

    Science.gov (United States)

    Li, Xiao-Hong; Gao, Chun-Ji; Da, Wan-Ming; Yu, Li; Wu, Xiao-Xiong; Li, Hong-Hua; Ma, Jian; Cao, Yong-Bin

    2010-04-01

    This study was aimed to investigate the prophylactic effect of CsA, MTX and MMF combined with ATG on graft versus host disease (GVHD) after unrelated donor peripheral blood hematopoietic stem cell transplantation (URD-PBHSCT). 33 patients underwent URD-PBHSCT with unrelated donor of HLA matched or 1 locus mismatched. The clinical data of all cases were retrospectively analyzed. URD-PBHSCT recipients received cyclosporin A+short term MTX+mycophenolate mofetil (MMF)+antithymocyte globulin to prevent GVHD (URD-ATG group), while 13 out of 33 patients were given additionally anti-CD25 antibody (URD-ATG+CD25 group). The results showed that engraftment was successfully achieved in 100% of all patients. In URD-ATG+CD25 group and URD-ATG group, the incidence of aGVHD were 23.07% and 45%, the incidence of cGVHD were 0 and 47.4% respectively. The latter was significantly higher than the former (pMMF+ATG as the prophylaxis of GVHD for UDR-PBSCT is effective. Reducing the dose of ATG may be good for patient in progression status.

  20. Prognostic Nomograms for Pre- and Postoperative Predictions of Long-Term Survival for Patients Who Underwent Liver Resection for Huge Hepatocellular Carcinoma.

    Science.gov (United States)

    Li, Yuntong; Xia, Yong; Li, Jun; Wu, Dong; Wan, Xuying; Wang, Kui; Wu, Mengchao; Liu, Jingfeng; Lau, Wan Yee; Shen, Feng

    2015-11-01

    Liver resection is an effective treatment in select patients with huge hepatocellular carcinoma (HCC, diameter ≥10 cm). This study aimed to develop nomograms for pre- and postoperative predictions of overall survival (OS) for these patients. There were 464 consecutive patients who underwent liver resection for huge HCC at the Eastern Hepatobiliary Surgery Hospital (EHBH) between January 2008 and December 2009. They were collected and divided into a training cohort (n = 310) and an internal validation cohort (n = 154). Another 90 patients who were operated on at the Fujian Medical University (FMU) between January 2008 and April 2010 served as an external validation cohort. The surgical morbidity, mortality, time to recurrence, and OS were observed. Two prognostic nomograms were developed based separately on the data obtained before and after surgery. Discrimination and predictive accuracy of the models were measured using concordance index (C-index), calibration curves, and validation study. The postoperative 4-year tumor recurrence and OS rates were, respectively, 79.0% and 41.2% in the patients from the EHBH and 78.8% and 37.6% in those from the FMU. Independent predictors of OS on multivariable analysis using pre- and postoperative data were respectively incorporated into the 2 nomograms. In the training cohort, calibration curves for the probability of 4-year postoperative survival fitted well. The C-indexes of the pre- and postoperative nomograms in predicting OS were 0.75 (95% CI 0.72 to 0.78) and 0.78 (95% CI 0.75 to 0.81), respectively. The internal and external validation studies optimally supported these results. The 2 nomograms achieved accurate pre- or postoperative predictions of long-term survival for patients with huge HCC after liver resection. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  1. "Blame it on the Comorbidities": A 5-Year Follow-Up of 53 Chronic Dialysis-Dependent Patients Who Underwent Cardiac Surgery.

    Science.gov (United States)

    Deutsch, Oliver; Rippinger, Nathalie; Spiliopoulos, Kyriakos; Eichinger, Walter; Gansera, Brigitte

    2016-10-01

    Objectives This study evaluates midterm survival rates and risk factors for mortality of chronic dialysis-dependent patients undergoing cardiac surgery. Methods Fifty-three dialysis-dependent patients (34 males, aged 67 ± 12 years) with end-stage renal disease operated within March 2007 and May 2012 were analyzed retrospectively. Survival rates were calculated using Kaplan-Meier methods. Predictors of midterm survival were identified with multivariate Cox-regression analysis. Results Twenty-three patients received isolated coronary artery bypass graft surgery, 17 received isolated valve replacement, and 13 received combined procedures. Thirty-day mortality was 24.5% (n = 13). Follow-up was complete for 94.3% (n = 50). Survival rates at 1, 3, and 5 years were: 82, 50, and 17%, respectively. Neither age, gender, poor ejection fraction, emergency, ECC/X-clamp (cross-clamp) time, nor use of left internal thoracic artery or right internal thoracic artery had any influence on midterm survival. Causes of death within midterm follow-up period were related to cardiac events in 16% and neurological events in 16%. In the majority (47%), cause of death was associated with peripheral arterial disease (PAD).The only comorbidity, which could be identified as a significant risk factor, was PAD (p = 0.035). Five patients underwent successful renal transplantation within the follow-up period. Conclusion Although 30-day mortality in this high-risk patient population was increased, midterm survival rates were comparable to the results described in the literature. Cause of death within midterm follow-up period was mostly noncardiac related. Given the limited number of patients, predictors for enhanced 30-day mortality, such as preoperative myocardial infarction, prolonged extracorporeal circulation, operation time, and diabetes mellitus, did not have an influence on midterm survival.

  2. Hepaticojejunostomy for the management of sump syndrome arising from choledochoduodenostomy in a patient who underwent bariatric Roux-en-Y gastric bypass: A case report

    Science.gov (United States)

    Alqahtani, Mohammed S.; Alshammary, Shadi A.; Alqahtani, Enas M.; Bojal, Shoukat A.; Alaidh, Amal; Osian, Gelu

    2016-01-01

    Introduction Rapid weight loss following bariatric surgery is associated with high incidence of gallstones and complications that may need bilioenteric diversion. This presents a specific challenge in the management of this group of patients. Case presentation A 37 years old female underwent a Roux-en-Y gastric bypass (RYGB) in 2008 for morbid obesity. In 2009 she presented with obstructive jaundice and was diagnosed with choledocholithiasis successfully managed by open cholecystectomy and choledochoduodenostomy. In the following years, she developed recurrent attacks of fever, chills, jaundice, and right upper quadrant pain and her weight loss was not satisfactory. Imaging of the liver showed multiple cholangitic abscesses. Reflux at the choledochoduodenostomy site was suggestive of sump syndrome as a cause of her recurrent cholangitis and a definitive surgical treatment was indicated. Intraoperative findings confirmed sump at the choledochoduodenostomy site and also revealed the presence of a large superficial accessory duct arising from segment four of the liver with separate drainage into the duodenum distal to the choledochoduodenostomy site. A formal hepaticojejunostomy was done after ductoplasty. The Roux limb was created by transecting the jejunum 40 cm distal to the foot anastomosis of the RYGB. The gastric limb was lengthened as part of this procedure which afforded the patient the additional benefit of weight loss. Conclusion Choledochoduodenostomy should be avoided in patients with RYGB due to the risk of sump syndrome which requires conversion to a formal hepaticojejunostomy. PMID:26921534

  3. Evaluation of long-term results and quality of life in patients who underwent rib fixation with titanium devices after trauma.

    Science.gov (United States)

    Billè, Andrea; Okiror, Lawrence; Campbell, Aideen; Simons, Jason; Routledge, Tom

    2013-06-01

    To describe the long-term results, quality of life and chronic pain after chest wall fixation for traumatic rib fracture using a quality of life (QOL) score and a numeric pain score. Retrospective analysis of 10 consecutive patients who underwent surgery for rib fractures after trauma and reconstruction between October 2010 and March 2012. Chest rib fractures were fixed with titanium clips and bars or titanium plates and screws through a posterolateral thoracotomy. Pain was assessed with a numeric pain scale 0-10 and quality of life (QOL) with the EORTC questionnaire QLQ-C30. There were 5 males and 5 females. The median age was 58 years (range 21-80). There were no postoperative deaths. The only postoperative complication observed was a contralateral pleural effusion requiring drainage. Median length of stay of the drain and median length of hospital stay were 2 days (range 0-8) and 4 days (range 1-42 days), respectively. The average follow-up period of operatively managed patients was 14 months (range 8-23.5 months). Seven patients scored the pain as 0, one as 1 (mild), one as 4 (moderate) and one as 8 (severe). Only two patients are taking occasionally pain killers. Only one patient presents severe limitation in his life scoring his QOL as poor. Titanium devices (clips and bars; screws and plates) are effective and safe for repair of rib fractures and showed good long-term results in terms of pain and quality of life after the operation.

  4. Traços psicológicos dos pacientes submetidos a angioplastia transluminal coronária Psychological profile of patients that underwent coronary angioplasty

    Directory of Open Access Journals (Sweden)

    Lourdes Helena de Campos

    1990-12-01

    Full Text Available Este trabalho teve por objetivo a identificação de traços psicológicos e características emocionais comuns aos pacientes que foram, pela primeira vez, submetidos a angioplastia transluminal coronária (ATC, no Instituto Dante Pazzanese de Cardiologia. Foram analisados 84 pacientes, de ambros os sexos, com idade média de 55 anos. Foram realizadas, pela equipe de psicólogos, duas entrevistas semidirigidas, durante cada uma das quais foram aplicados o Inventário de Ansiedade Traço - Estado (IDATE e a Escala de Hamilton. Essas entrevistas foram realizadas imediatamente anterior à ATC e um dia após o procedimento, na alta dos pacientes. Os resultados permitiram-nos concluir que a grande maioria apresentou padrão comportamental tipo A, próprio do coronariano, alto estresse constitucional e ambiental e ansiedade - traço acima da média. Obtiveram alta porcentagem, também, as variáveis tensão, depressão, grau de competitividade e labilidade de humor.This paper presents psychological and emotional characteristics that were found common to patients that underwent a first coronary angioplasty at Instituto Dante Pazzanese de Cardiologia. We studied 84 patients of both sexes, with mean age of 55 years. Two semi-directed interviews were conducted by the psychology team, and during each of them the State-Trait - Anxiety Inventory STAI and the Hamilton Scale were applied. Such interviews were conducted immediately before PTCA and repeated one day after it, at patient's discharge. We concluded that most patients had a type A personality, typical of patients with coronary artey disease, high constitutional stress and anxiety-trace higher than the average population. There was also a high incidence of tension, depression, competitivity and humor lability.

  5. 'Where of is mad al mankynde' : an edition of and introduction to the twenty-four poems in Oxford, Bodleian Library, MS Digby 102

    NARCIS (Netherlands)

    Verheij, Louis Johan Philip

    2009-01-01

    'Where of is Mad al Mankynde' represents a new critical edition of the collection of twenty-four late-medieval anonymous poems contained, among other pieces, in Oxford, Bodleian Library, MS Digby 102. Each poem is introduced with a brief summary and closes with line-for-line explanatory comments. Th

  6. Analysis of incidence of keratoconus in relatives of patients who underwent corneal transplant due to advanced keratoconus using the Orbscan II topographic graphs

    Science.gov (United States)

    López Olazagasti, Estela; Hernández y del Callejo, César E.; Ibarra-Galitzia, Jorge; Ramírez-Zavaleta, Gustavo; Tepichín, Eduardo

    2011-10-01

    Keratoconus is a corneal disease in which the cornea assumes a conical shape due to an irregular alteration of the internal structure of the corneal tissue and sometimes is progressive, especially in young people. Anatomically, the main signs of keratoconus are thinning of the cornea in its central or paracentral region, usually accompanied by an increase in this part of a high irregular astigmatism, with a consequent loss of vision. Its diagnosis requires a thorough study including the family history, a complete ophthalmologic examination and imaging studies. This diagnosis allows classifying the type of keratoconus, which allow determining options of management, with what it is possible to establish a visual prognosis of each eye. One of the indicators that help in the diagnosis of keratoconus is an inherited familiar propensity. The literature reports an incidence of keratoconus of 11%1 in first-degree relatives of patients with keratoconus. Results suggest an ethnic dependence, which implies that the knowledge of the tendency of keratoconus in the Mexican population is important. In this work, we present the preliminary results of the study realized to a group of relatives of patients who underwent corneal transplant by advanced keratoconus using Orbscan II topographic diagnosis, to determine the predisposition to Keratoconus in this group.e

  7. The results of surgical treatment of 14 patients underwent repeated tricuspid valve operations%三尖瓣再次手术14例

    Institute of Scientific and Technical Information of China (English)

    周明阳; 张健群; 孟旭; 李温斌; 孔晴宇

    2008-01-01

    目的 总结三尖瓣再次手术的治疗效果及经验.方法 2002年至2006年,收治14例三尖瓣再次手术病人,其中三尖瓣成形术后再次出现关闭不全12例,三尖瓣置换术后人工瓣膜功能障碍2例.结果 再次实施三尖瓣成形术5例,三尖瓣置换术9例.死亡2例,余者治愈出院.10例随访2~40个月,1例心功能Ⅲ级,余者均为Ⅰ~Ⅱ级.结论 再次三尖瓣手术治疗效果确切,手术死亡与手术方式的选择以及围术期心、肾功能衰竭有关.%Objective To evaluate the results and surgical treatment of the repeated tricuspid valve operations. Methods The hospital records was reviewed for 14 patients who underwent repeated tricuspid valve operations between 2003 and 2006, including 12 patients with tricuspid regurgitation received first tricuspid valve repair and 2 patients, with prosthetic valve dysfunction. Results Reoperations of tricuspid valve included 5 tricuspid valve repair and 9 tricuspid valve replacement. There were two postoperative deaths. Post-operative heart function (NYHA) was improved significantly, 1 case in Ⅲ and 9 in Ⅰ-Ⅱ. Ten survivors were followed up for 2 - 40 months. Conclusion Tricuspid valve reoperations may be performed with acceptable operative mortality. Perioperative death was associated with surgical methods and heart or renal function failure.

  8. Gender-linked impact of epicardial adipose tissue volume in patients who underwent coronary artery bypass graft surgery or non-coronary valve surgery.

    Science.gov (United States)

    Maimaituxun, Gulinu; Shimabukuro, Michio; Salim, Hotimah Masdan; Tabata, Minoru; Yuji, Daisuke; Morimoto, Yoshihisa; Akasaka, Takeshi; Matsuura, Tomomi; Yagi, Shusuke; Fukuda, Daiju; Yamada, Hirotsugu; Soeki, Takeshi; Sugimoto, Takaki; Tanaka, Masashi; Takanashi, Shuichiro; Sata, Masataka

    2017-01-01

    Traditional and non-traditional risk factors for atherosclerotic cardiovascular disease (ASCVD) are different between men and women. Gender-linked impact of epicardial adipose tissue volume (EATV) in patients undergoing coronary artery bypass grafting (CABG) remains unknown. Gender-linked impact of EATV, abdominal fat distribution and other traditional ASCVD risk factors were compared in 172 patients (men: 115; women: 57) who underwent CABG or non-coronary valvular surgery (non-CABG). In men, EATV, EATV index (EATV/body surface area) and the markers of adiposity such as body mass index, waist circumference and visceral fat area were higher in the CABG group than in the non-CABG group. Traditional ASCVD risk factors were also prevalent in the CABG group. In women, EATV and EATV index were higher in the CABG group, but other adiposity markers were comparable between CABG and non-CABG groups. Multivariate logistic regression analysis showed that in men, CABG was determined by EATV Index and other ASCVD risk factors including hypertension, dyslipidemia, adiponectin, high sensitive C-reactive protein (hsCRP) and type 2 diabetes mellitus (Corrected R2 = 0.262, p < 0.0001), while in women, type 2 diabetes mellitus is a single strong predictor for CABG, excluding EATV Index (Corrected R2 = 0.266, p = 0.005). Our study found that multiple risk factors, including epicardial adipose tissue volume and traditional ASCVD factors are determinants for CABG in men, but type 2 diabetes mellitus was the sole determinant in women. Gender-specific disparities in risk factors of CABG prompt us to evaluate new diagnostic and treatment strategies and to seek underlying mechanisms.

  9. Eating behavior and nutritional status in patients who underwent coronary angioplasty La conducta alimentaria y estado nutricional en pacientes sometidos a angioplastia coronaria

    Directory of Open Access Journals (Sweden)

    L. Proença Vieira

    2012-02-01

    Full Text Available Introduction: The identification of stages of dietary change and the factors affecting food choices can direct more effective nutritional intervention against coronary heart disease progression. Objective: Identify the stages of change of eating behavior and its relation with nutritional status, food consumption and previous cardiovascular events in patients who underwent coronary angioplasty. Methods: A cross-sectional study with 200 hospitalized patients from a specialized cardiology hospital, after elective coronary angioplasty. They were applied an algorithm that identifies the provision of change of eating habits for a healthier pattern. Variables measured were stages of change of eating behavior, nutritional status, food consumption and cardiovascular events (previous myocardial infarction or angioplasty. It was realized comparison of averages by analysis of variance or Student´s test and Chi-square test for qualitative variables. Value of significance was taken at 5%. Results: The patients were classified in the following stages: 36% maintenance, 26% preparation, 17% precontemplation, 12% action and 9% contemplation. It was observed higher cardiovascular events in maintenance/action group (p = 0.04, higher consumption of calories (p = 0.04, meat/eggs (p = 0.01 and sweets (p = 0.03 in preparation stage, comparing to maintenance group, and no association between nutritional status and stages of change (p = 0.13, although 62% of the individuals in maintenance stage were overweight. Conclusions: This work contributed to identifying the stages of change and conditions that favor changes in eating pattern. Even patients that classified themselves into the maintenance stage need to adjust their eating habits in order to reach a healthy weight.Introducción: La identificación de las etapas de cambio en la dieta y los factores que afectan la elección de alimentos puede dirigir una intervención nutricional más eficaz contra la progresión de

  10. Twenty-four-hour urine constituents in stone formers: A study from the northeast part of Peninsular Malaysia

    OpenAIRE

    N S Hussein; S M Sadiq; M D Kamaliah; A W NorAkmal; M N Gohar

    2013-01-01

    Urolithiasis is a common disease with increasing incidence and prevalence world-wide, probably more common in industrialized countries. The metabolic evaluation of 24-h urine collection has been considered as part of the management of urinary stone patients. The aim of this study was to evaluate the 24-h urine constituents in stone formers and its relation to demographic data in the northeast part of Peninsular Malaysia. One hundred and six patients were recruited in this study from two hospi...

  11. Twenty-four-hour urine constituents in stone formers: A study from the northeast part of Peninsular Malaysia

    Directory of Open Access Journals (Sweden)

    N S Hussein

    2013-01-01

    Full Text Available Urolithiasis is a common disease with increasing incidence and prevalence world-wide, probably more common in industrialized countries. The metabolic evaluation of 24-h urine collection has been considered as part of the management of urinary stone patients. The aim of this study was to evaluate the 24-h urine constituents in stone formers and its relation to demographic data in the northeast part of Peninsular Malaysia. One hundred and six patients were recruited in this study from two hospitals in the same geographical region; 96 patients fulfilled the inclusion criteria and an informed consent was obtained from all subjects. The 24-h urine was collected in sterile bottles with a preservative agent and calcium, oxalate, citrate, uric acid, magnesium and phosphate were tested using commercial kits on a Roche Hitachi 912 chemistry analyzer. The age (mean ± SD of 96 patients was 56.45 ± 13.43 years and 82.3% of the patients were male while 17.7% were female. The 24-h urine abnormalities were hypercalciuria (14.5%, hyperoxaluria (61.4%, hypocitraturia (57.2%, hyperuricouria (19.7%, hypomagnesuria (59.3% and hyperphosphaturia (12.5%. Hyperoxaluria (61.4% was the most common abnormality detected during the analysis of 24-h urine constituents in contradiction to industrial countries, where hypercalciuria was the most common finding. The high frequencies of hypomagnesuria and hypocitraturia reflect the important role of magnesium and citrate in stone formation and their prophylactic role in the treatment of urinary stone disease in the given population.

  12. Twenty-four-hour urine constituents in stone formers: a study from the northeast part of Peninsular Malaysia.

    Science.gov (United States)

    Hussein, N S; Sadiq, S M; Kamaliah, M D; Norakmal, A W; Gohar, M N

    2013-05-01

    Urolithiasis is a common disease with increasing incidence and prevalence world-wide, probably more common in industrialized countries. The metabolic evaluation of 24-h urine collection has been considered as part of the management of urinary stone patients. The aim of this study was to evaluate the 24-h urine constituents in stone formers and its relation to demographic data in the northeast part of Peninsular Malaysia. One hundred and six patients were recruited in this study from two hospitals in the same geographical region; 96 patients fulfilled the inclusion criteria and an informed consent was obtained from all subjects. The 24-h urine was collected in sterile bottles with a preservative agent and calcium, oxalate, citrate, uric acid, magnesium and phosphate were tested using commercial kits on a Roche Hitachi 912 chemistry analyzer. The age (mean ± SD) of 96 patients was 56.45 ± 13.43 years and 82.3% of the patients were male while 17.7% were female. The 24-h urine abnormalities were hypercalciuria (14.5%), hyperoxaluria (61.4%), hypocitraturia (57.2%), hyperuricouria (19.7%), hypomagnesuria (59.3%) and hyperphosphaturia (12.5%). Hyperoxaluria (61.4%) was the most common abnormality detected during the analysis of 24-h urine constituents in contradiction to industrial countries, where hypercalciuria was the most common finding. The high frequencies of hypomagnesuria and hypocitraturia reflect the important role of magnesium and citrate in stone formation and their prophylactic role in the treatment of urinary stone disease in the given population.

  13. Prevalence of type 1 brugada electrocardiographic pattern evaluated by twelve-lead twenty-four-hour holter monitoring.

    Science.gov (United States)

    Cerrato, Natascia; Giustetto, Carla; Gribaudo, Elena; Richiardi, Elena; Barbonaglia, Lorella; Scrocco, Chiara; Zema, Domenica; Gaita, Fiorenzo

    2015-01-01

    Patients with drug-induced type 1 Brugada electrocardiograms (BrECGs) are considered to have good prognosis. Spontaneous type 1 is, instead, considered a risk factor; however, it is probably underestimated because of the BrECG fluctuations. The aim of this study was to analyze, in a large population of patients with Br, the real prevalence of type 1 BrECG using 12-lead 24-hour Holter monitoring (12L-Holter) and its correlation with the time of the day. We recorded 303 12L-Holter in 251 patients. Seventy-five (30%) patients exhibited spontaneous type 1 BrECG at 12-lead ECG (group 1) and 176 (70%) had only drug-induced type 1 (group 2). Type 1 BrECG was defined as "persistent" (>85% of the recording), "intermittent" (Holter, 57% intermittent type 1%, and 31% never had type 1; in group 2, none had persistent type 1, 20% had intermittent type 1%, and 80% never showed type 1. To evaluate the circadian fluctuations of BrECG, 4 periods in the day were considered. Type 1 BrECG was more frequent between 12-noon and 6 p.m. (52%, p Holter than with conventional follow-up with periodic ECGs and this has important implications in the risk stratification. 12L-Holter recording might avoid 20% of the pharmacological challenges with sodium channel blockers, which are not without risks, and should thus be considered as the first screening test, particularly in children or in presence of borderline diagnostic basal ECG.

  14. Twenty-four hours or 10 days? A prospective randomised controlled trial in children comparing head bandages following pinnaplasty.

    Science.gov (United States)

    Ramkumar, S; Narayanan, V; Laing, J H E

    2006-01-01

    The perceived benefits of bandaging for 10 days following pinnaplasty have been questioned by previous studies. The problems arising from these dressings are many [Powell BWEM. The value of head dressings in the postoperative management of the prominent ear. Br J Plast Surg 1989;42:692-4. Bartley J. How long should ears be bandaged after otoplasty? J Laryngol Otol 1998;112:531-2. Wong MC, Sylaidis P. Head dressings for pinnaplasty: a tradition not supported by evidence. Br J Plast Surg 2001;54:81-2], including their slippage [Powell BWEM. The value of head dressings in the postoperative management of the prominent ear. Br J Plast Surg 1989;42:692-4. Bradbury ET, Hewison J, Timmons MJ. Psychological and social outcome of prominent ear correction in children. Br J Plast Surg 1992;45:97-100. Jeffery SLA. Complications following correction of prominent ears: an audit review of 122 cases. Br J Plast Surg 1999;52:588-90]. Eighty children were recruited into a prospective randomised controlled trial comparing the use of a head bandage for only 24 h with a standard practise of a 10-day head bandage. A preoperative measurement of the lateral ear projection (LEP) was made. The outcome measures recorded during the two planned postoperative visits at 10 days (visit 1) and 2 months (visit 2) were: patient satisfaction score, LEP, complications and any unscheduled hospital visits associated with the surgery. There was no significant difference in LEP and patient satisfaction between the two groups at both the scheduled postoperative visits. Differences between the groups in the number of unscheduled visits (p=0.21) did not reach statistical significance. The findings indicate that it is safe and effective to use head bandage for only 24 h following surgical correction of prominent ears. This study shows no benefit from the application of a formal head bandage for any longer than 1 day.

  15. Diurnal and twenty-four hour patterning of human diseases: acute and chronic common and uncommon medical conditions.

    Science.gov (United States)

    Smolensky, Michael H; Portaluppi, Francesco; Manfredini, Roberto; Hermida, Ramon C; Tiseo, Ruana; Sackett-Lundeen, Linda L; Haus, Erhard L

    2015-06-01

    The symptom intensity and mortality of human diseases, conditions, and syndromes exhibit diurnal or 24 h patterning, e.g., skin: atopic dermatitis, urticaria, psoriasis, and palmar hyperhidrosis; gastrointestinal: esophageal reflux, peptic ulcer (including perforation and hemorrhage), cyclic vomiting syndrome, biliary colic, hepatic variceal hemorrhage, and proctalgia fugax; infection: susceptibility, fever, and mortality; neural: frontal, parietal, temporal, and occipital lobe seizures, Parkinson's and Alzheimer's disease, hereditary progressive dystonia, and pain (cancer, post-surgical, diabetic neuropathic and foot ulcer, tooth caries, burning mouth and temporomandibular syndromes, fibromyalgia, sciatica, intervertebral vacuum phenomenon, multiple sclerosis muscle spasm, and migraine, tension, cluster, hypnic, and paroxysmal hemicranial headache); renal: colic and nocturnal enuresis and polyuria; ocular: bulbar conjunctival redness, keratoconjunctivitis sicca, intraocular pressure and anterior ischemic optic neuropathy, and recurrent corneal erosion syndrome; psychiatric/behavioral: major and seasonal affective depressive disorders, bipolar disorder, parasuicide and suicide, dementia-associated agitation, and addictive alcohol, tobacco, and heroin cravings and withdrawal phenomena; plus autoimmune and musculoskeletal: rheumatoid arthritis, osteoarthritis, axial spondylarthritis, gout, Sjögren's syndrome, and systemic lupus erythematosus. Knowledge of these and other 24 h patterns of human pathophysiology informs research of their underlying circadian and other endogenous mechanisms, external temporal triggers, and more effective patient care entailing clinical chronopreventive and chronotherapeutic strategies.

  16. Diurnal and twenty-four hour patterning of human diseases: cardiac, vascular, and respiratory diseases, conditions, and syndromes.

    Science.gov (United States)

    Smolensky, Michael H; Portaluppi, Francesco; Manfredini, Roberto; Hermida, Ramon C; Tiseo, Ruana; Sackett-Lundeen, Linda L; Haus, Erhard L

    2015-06-01

    Various medical conditions, disorders, and syndromes exhibit predictable-in-time diurnal and 24 h patterning in the signs, symptoms, and grave nonfatal and fatal events, e.g., respiratory ones of viral and allergic rhinorrhea, reversible (asthma) and non-reversible (bronchitis and emphysema) chronic obstructive pulmonary disease, cystic fibrosis, high altitude pulmonary edema, and decompression sickness; cardiac ones of atrial premature beats and tachycardia, paroxysmal atrial fibrillation, 3rd degree atrial-ventricular block, paroxysmal supraventricular tachycardia, ventricular premature beats, ventricular tachyarrhythmia, symptomatic and non-symptomatic angina pectoris, Prinzmetal vasospastic variant angina, acute (non-fatal and fatal) incidents of myocardial infarction, sudden cardiac arrest, in-bed sudden death syndrome of type-1 diabetes, acute cardiogenic pulmonary edema, and heart failure; vascular and circulatory system ones of hypertension, acute orthostatic postprandial, micturition, and defecation hypotension/syncope, intermittent claudication, venous insufficiency, standing occupation leg edema, arterial and venous branch occlusion of the eye, menopausal hot flash, sickle cell syndrome, abdominal, aortic, and thoracic dissections, pulmonary thromboembolism, and deep venous thrombosis, and cerebrovascular transient ischemic attack and hemorrhagic and ischemic stroke. Knowledge of these temporal patterns not only helps guide patient care but research of their underlying endogenous mechanisms, i.e., circadian and others, and external triggers plus informs the development and application of effective chronopreventive and chronotherapeutic strategies.

  17. The biological activity of propolis-containing toothpaste on oral health environment in patients who underwent implant-supported prosthodontic rehabilitation.

    Science.gov (United States)

    Morawiec, Tadeusz; Dziedzic, Arkadiusz; Niedzielska, Iwona; Mertas, Anna; Tanasiewicz, Marta; Skaba, Dariusz; Kasperski, Jacek; Machorowska-Pieniążek, Agnieszka; Kucharzewski, Marek; Szaniawska, Karolina; Więckiewicz, Włodzimierz; Więckiewicz, Mieszko

    2013-01-01

    The soft and periodontal tissues surrounding dental implants are particularly susceptible to bacteria invasion and inflammatory reactions due to complex histological structures. This study was carried out to investigate the influence of a propolis-containing hygienic agent on selected oral health parameters, oral microflora, and the condition of periodontal health. Sixteen subjects who underwent an oral rehabilitation with dental implants were selected and randomly assigned into two groups, which received a newly formulated propolis-containing toothpaste (3% (CA)) or a negative control without an active ingredient (CC). Approximal plaque index (API), oral hygiene index (OHI, debris component), and sulcus bleeding index (SBI) were assessed in three subsequent stages. During the first and last examinations, the swabs were employed for microbiological inoculation. Propolis-containing toothpaste was found to be distinctively effective in improving oral health and the occurrence of gingivitis triggered by dental plaque. The qualitative and quantitative changes in oral bacteria spectrum were observed. Antibacterial measures containing propolis might be used as a natural adjuvant to other active substances in individuals with a high risk of periodontal problems against pathogenic oral microflora.

  18. The Biological Activity of Propolis-Containing Toothpaste on Oral Health Environment in Patients Who Underwent Implant-Supported Prosthodontic Rehabilitation

    Directory of Open Access Journals (Sweden)

    Tadeusz Morawiec

    2013-01-01

    Full Text Available The soft and periodontal tissues surrounding dental implants are particularly susceptible to bacteria invasion and inflammatory reactions due to complex histological structures. This study was carried out to investigate the influence of a propolis-containing hygienic agent on selected oral health parameters, oral microflora, and the condition of periodontal health. Sixteen subjects who underwent an oral rehabilitation with dental implants were selected and randomly assigned into two groups, which received a newly formulated propolis-containing toothpaste (3% (CA or a negative control without an active ingredient (CC. Approximal plaque index (API, oral hygiene index (OHI, debris component, and sulcus bleeding index (SBI were assessed in three subsequent stages. During the first and last examinations, the swabs were employed for microbiological inoculation. Propolis-containing toothpaste was found to be distinctively effective in improving oral health and the occurrence of gingivitis triggered by dental plaque. The qualitative and quantitative changes in oral bacteria spectrum were observed. Antibacterial measures containing propolis might be used as a natural adjuvant to other active substances in individuals with a high risk of periodontal problems against pathogenic oral microflora.

  19. Three years later: report on the state of well-being of patients with chronic tinnitus who underwent modified tinnitus retraining therapy.

    Science.gov (United States)

    Seydel, Claudia; Haupt, Heidemarie; Szczepek, Agnieszka J; Hartmann, Anne; Rose, Matthias; Mazurek, Birgit

    2015-01-01

    Successful management of patients with chronic tinnitus is an important health issue. One of the tinnitus management strategies used at our Tinnitus Center is a combination of tinnitus retraining therapy (TRT) with physiotherapy and psychological management [called modified TRT (MTRT)]. We have used this type of management for over a decade and have described the protocol in detail elsewhere. In the present study, we wanted to determine the effect of MTRT on the well-being of tinnitus patients 3 years after treatment onset. One hundred and thirty patients with chronic tinnitus were assessed using psychometric instruments immediately before 7-day MTRT, immediately after the therapy and 3 years later. Patients with very severe tinnitus-related distress associated with major depression and a risk of suicide were excluded from this study. MTRT resulted in a sustained reduction of tinnitus-related distress. Moreover, the quality of life of patients had increased, as assessed by a separate questionnaire. The effect of MTRT was influenced by the degree of tinnitus-related distress and by the patients' age, the latter being gender dependent. Hearing loss and tinnitus duration had only a minor influence on the therapeutic effect. Taken together, we report a positive change in the state of well-being of patients with chronic tinnitus measurable with various psychometric instruments 3 years after the onset of MTRT.

  20. The Prevalence of Risk Factors of Coronary Artery Disease in the Patients who Underwent Coronary Artery Bypass Graft, Shiraz, Iran: Suggesting a Model

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Ostovan

    2014-12-01

    Full Text Available Background: Cardiovascular diseases are the main cause of 40% of deaths in Iran annually. Many patients undergoing coronary artery bypass graft surgery have previous cardiovascular risk factors which could be prevented. Objectives: The present study aimed to assess the prevalence of cardiovascular risk factors in the patients undergoing coronary artery bypass graft surgery. Materials and Methods: In this cross-sectional (descriptive – analytical study, a data collecting form was used. A total of 246 patients were selected from six hospitals of Shiraz using random stratification. Descriptive statistics were presented through figures and tables and t-test was used to analyze the continuous variables. All the statistical analyses were performed using the SPSS statistical software (version 15.0. Besides, P < 0.05 was considered as statistically significant. Results: Among the study patients, only 11.67% had no risk factors and 88.33% had one or more risk factors. The most common risk factors observed in the patients were hypertension, obesity and overweight, hyperlipidemia, and diabetes mellitus. The results showed a significant difference between males and females regarding the prevalence of hypertension (P = 0.001, diabetes (P = 0.028, hypercholesterolemia (P = 0.020, and cigarette smoking (P = 0.001. In addition, the patients' mean levels of cholesterol, LDL, triglyceride, and fasting blood sugar were higher than the acceptable level, while that of HDL was lower than the accepted level. Conclusions:: These patients are recommended to be trained regarding lifestyle changes. Also, prevention strategies can play an important role in reducing patient morbidity and mortality.

  1. Clinical outcomes for T1-2N0-1 oral tongue cancer patients underwent surgery with and without postoperative radiotherapy

    Directory of Open Access Journals (Sweden)

    Choi Eun

    2010-05-01

    Full Text Available Abstract Background The aim of this study was to assess the results of curative surgery with and without radiotherapy in patients with T1-2N0-1 oral tongue squamous cell carcinoma (OSCC and to evaluate survival and prognostic factors. Methods Retrospective analysis of 86 patients with T1-2N0-1 OSCC who received surgery between January 2000 and December 2006. Fourteen patients (16.3% received postoperative radiotherapy (PORT. Patient characteristics, tumor characteristics, treatment modality, failure patterns, and survival rates were analyzed. Results The median follow-up was 45 months. The five-year overall survival (OS and disease-free survival (DFS rates were 80.8% and 80.2%, respectively. Higher tumor grade and invasion depth ≥ 0.5 cm were the significant prognostic factors affecting five-year OS and DFS (OS rate; 65% vs. 91%, p = 0.001 for grade; 66% vs. 92%, p = 0.01 for invasion depth: DFS rate; 69% vs. 88%, p = 0.005 for grade; 66% vs. 92%, p = 0.013 for invasion depth. In the risk group, there was no local failure in patients with postoperative radiotherapy. Conclusions In T1-2N0-1 OSCC, factors that affected prognosis after primary surgery were higher tumor grade and deep invasion depth over 0.5 cm. Postoperative radiotherapy should be considered in early oral tongue cancer patients with these high-risk pathologic features.

  2. CLINICAL CASE OF PERFORMING A TWO-ST AGE LOVER RESECTION BY TYPE ALPPS IN PATIENT WHO PREVIOUSLY UNDERWENT ANATOMIC RESECTION OF THE RIGHT LOBE OF THE LIVER

    Directory of Open Access Journals (Sweden)

    D. V. Sidorov

    2015-01-01

    Full Text Available Abstract:One of the variants for the surgical treatment of patients with bilobal liver metastases is to perform two-stage anatomic resections. Thus, at least in a quarter of the patients it is impossible to perform the second stage of intervention because of absence of hypertrophy of the remaining liver parenchyma or progression of disease during standby. The most modern and promising way of overcoming this obstacle is to perform the so-called ALPPS (Associating Liver Partition and Portal vein Ligation for Staged hepatectomy or «in situ slit» liver resections. In this article we present a clinical case of performing a two-stage hepatectomy by type ALPPS in patients with metastatic colorectal cancer liver, who previously undergone the anatomic bisegmentectomy SVI-SVII. The present observation is the first in the available literature, evidence of justification perform repeated liver resections in patients with metastatic colorectal cancer and demonstrates the possibility of ALPPS techniques when performing extensive anatomical liver resections in patients who have undergone previous removal of the parenchyma of the right lobe.

  3. Impact of Additional Transthoracic Electrical Cardioversion on Cardiac Function and Atrial Fibrillation Recurrence in Patients with Persistent Atrial Fibrillation Who Underwent Radiofrequency Catheter Ablation

    Directory of Open Access Journals (Sweden)

    Deguo Wang

    2016-01-01

    Full Text Available Backgrounds and Objective. During the procession of radiofrequency catheter ablation (RFCA in persistent atrial fibrillation (AF, transthoracic electrical cardioversion (ECV is required to terminate AF. The purpose of this study was to determine the impact of additional ECV on cardiac function and recurrence of AF. Methods and Results. Persistent AF patients received extensive encircling pulmonary vein isolation (PVI and additional line ablation. Patients were divided into two groups based on whether they need transthoracic electrical cardioversion to terminate AF: electrical cardioversion (ECV group and nonelectrical cardioversion (NECV group. Among 111 subjects, 35 patients were returned to sinus rhythm after ablation by ECV (ECV group and 76 patients had AF termination after the ablation processions (NECV group. During the 12-month follow-ups, the recurrence ratio of patients was comparable in ECV group (15/35 and NECV group (34/76 (44.14% versus 44.74%, P=0.853. Although left atrial diameters (LAD decreased significantly in both groups, there were no significant differences in LAD and left ventricular cardiac function between ECV group and NECV group. Conclusions. This study revealed that ECV has no significant impact on the maintenance of SR and the recovery of cardiac function. Therefore, ECV could be applied safely to recover SR during the procedure of catheter ablation of persistent atrial fibrillation.

  4. Predictive value of preoperative tests in estimating difficult intubation in patients who underwent direct laryngoscopy in ear, nose, and throat surgery

    Directory of Open Access Journals (Sweden)

    Osman Karakus

    2015-04-01

    Full Text Available BACKGROUND AND OBJECTIVES: Predictive value of preoperative tests in estimating difficult intubation may differ in the laryngeal pathologies. Patients who had undergone direct laryngoscopy (DL were reviewed, and predictive value of preoperative tests in estimating difficult intubation was investigated. METHODS: Preoperative, and intraoperative anesthesia record forms, and computerized system of the hospital were screened. RESULTS: A total of 2611 patients were assessed. In 7.4% of the patients, difficult intubations were detected. Difficult intubations were encountered in some of the patients with Mallampati scoring (MS system Class 4 (50%, Cormack-Lehane classification (CLS Grade 4 (95.7%, previous knowledge of difficult airway (86.2%, restricted neck movements (cervical ROM (75.8%, short thyromental distance (TMD (81.6%, vocal cord mass (49.5% as indicated in parentheses (p < 0.0001. MS had a low sensitivity, while restricted cervical ROM, presence of a vocal cord mass, short thyromental distance, and MS each had a relatively higher positive predictive value. Incidence of difficult intubations increased 6.159 and 1.736-fold with each level of increase in CLS grade and MS class, respectively. When all tests were considered in combination difficult intubation could be classified accurately in 96.3% of the cases. CONCLUSION: Test results predicting difficult intubations in cases with DL had observedly overlapped with the results provided in the literature for the patient populations in general. Differences in some test results when compared with those of the general population might stem from the concomitant underlying laryngeal pathological conditions in patient populations with difficult intubation.

  5. [Predictive value of preoperative tests in estimating difficult intubation in patients who underwent direct laryngoscopy in ear, nose, and throat surgery].

    Science.gov (United States)

    Karakus, Osman; Kaya, Cengiz; Ustun, Faik Emre; Koksal, Ersin; Ustun, Yasemin Burcu

    2015-01-01

    Predictive value of preoperative tests in estimating difficult intubation may differ in the laryngeal pathologies. Patients who had undergone direct laryngoscopy (DL) were reviewed, and predictive value of preoperative tests in estimating difficult intubation was investigated. Preoperative, and intraoperative anesthesia record forms, and computerized system of the hospital were screened. A total of 2611 patients were assessed. In 7.4% of the patients, difficult intubations were detected. Difficult intubations were encountered in some of the patients with Mallampati scoring (MS) system Class 4 (50%), Cormack-Lehane classification (CLS) Grade 4 (95.7%), previous knowledge of difficult airway (86.2%), restricted neck movements (cervical ROM) (75.8%), short thyromental distance (TMD) (81.6%), vocal cord mass (49.5%) as indicated in parentheses (p<0.0001). MS had a low sensitivity, while restricted cervical ROM, presence of a vocal cord mass, short thyromental distance, and MS each had a relatively higher positive predictive value. Incidence of difficult intubations increased 6.159 and 1.736-fold with each level of increase in CLS grade and MS class, respectively. When all tests were considered in combination difficult intubation could be classified accurately in 96.3% of the cases. Test results predicting difficult intubations in cases with DL had observedly overlapped with the results provided in the literature for the patient populations in general. Differences in some test results when compared with those of the general population might stem from the concomitant underlying laryngeal pathological conditions in patient populations with difficult intubation. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  6. Evaluation of Sociodemographic Characteristics and the Relationship Between Initial Complaints and Histopathological Diagnosis of Patients Who Underwent Kidney Biopsy Procedure Between 2007-2011

    Directory of Open Access Journals (Sweden)

    Servet YÜKSEL

    2013-09-01

    Full Text Available OBJECTIVE: The aim of this study is to evaluate the relationship between patients’ age, gender, body mass index, family history, initial complaints and histopathological diagnosis and progression to end stage renal failure. MATERIAL and METHODS: 268 patients, who had renal biopsy in GATA Nephrology Department between 2007 and 2011, included to the study. All of the patients had native renal biopsy. The patients’ clinical and pathological findings were compared with age, gender and other sociodemographic features. RESULTS: The mean age was 34±15 years among men and 47±17 years among women. The most common histopathological diagnosis was FSGS with the rate of 20.9% (n=56 and the second was IgA nephropathy with the rate of %18.7 (n=50. The rate for completely asymptomatic patients without any complaints or abnormal test results or patients who were determined during routine examination before the operation found to be 25,7% (n=69. Face and leg edema found to be the most common complaint. CONCLUSION: Fighting against risk factors (hypertension, diabetes, smoking, obesity, etc. even before the disease presents, which actually is the basis of preventive medicine; will slow down the progression of CKD, decrease mortality and morbidity, and thus will contribute to the country’s economy.

  7. Changes in neurotic personality profile associated with reduction of suicidal ideation in patients who underwent psychotherapy in the day hospital for the treatment of neurotic and behavioral disorders

    Directory of Open Access Journals (Sweden)

    Paweł Rodziński

    2015-12-01

    The results confirm effectiveness of intensive psychotherapy as a treatment method that leads to comprehensive improvement encompassing reduction of neurotic personality disorders (neuroticism and of majority of neurotic personality traits, as well as SI reduction. The revealed associations weigh in favor of hypothesis on neuroticism as SI predisposing factor in patients with neurotic, behavioral and personality disorders.

  8. Autoimmune hemolytic anemia after allogeneic hematopoietic stem cell transplantation: analysis of 533 adult patients who underwent transplantation at King's College Hospital.

    Science.gov (United States)

    Wang, Meng; Wang, Wenjia; Abeywardane, Ayesha; Adikarama, Malinthi; McLornan, Donal; Raj, Kavita; de Lavallade, Hugues; Devereux, Stephen; Mufti, Ghulam J; Pagliuca, Antonio; Potter, Victoria T; Mijovic, Aleksandar

    2015-01-01

    Autoimmune hemolytic anemia (AIHA) is a recognized complication of hematopoietic stem cell transplantation (HSCT); it is often refractory to treatment and carries a high mortality. To improve understanding of the incidence, risk factors, and clinical outcome of post-transplantation AIHA, we analyzed 533 patients who received allogeneic HSCT, and we identified 19 cases of AIHA after HSCT (overall incidence, 3.6%). The median time to onset, from HSCT to AIHA, was 202 days. AIHA was associated with HSCT from unrelated donors (hazard ratio [HR], 5.28; 95% confidence interval [CI], 1.22 to 22.9; P = .026). In the majority (14 of 19; 74%) of AIHA patients, multiple agents for treatment were required, with only 9 of 19 (47%) patients achieving complete resolution of AIHA. Patients with post-transplantation AIHA had a higher overall mortality (HR, 2.48; 95% CI, 1.33 to 4.63; P = .004), with 36% (4 of 11 cases) of deaths attributable to AIHA.

  9. Clinical and echocardiographic characteristics of pericardial effusion in patients who underwent echocardiographically guided pericardiocentesis: Yonsei Cardiovascular Center experience, 1993-2003.

    Science.gov (United States)

    Cho, Byoung Chul; Kang, Seok Min; Kim, Dae Hyuck; Ko, Young Guk; Choi, Donghoon; Ha, Jong Won; Rim, Se Joong; Jang, Yangsoo; Chung, Namsik; Shim, Won Heum; Cho, Seung Yun; Kim, Sung Soon

    2004-06-30

    Percutaneous pericardiocentesis guided by two-dimensional echocardiography was introduced in 1983 as an alternative to electrocardiographically or fluoroscopically guided puncture for the management of pericardial effusion. The objective of this study was to investigate echocardiographically (echo)- guided pericardiocenteses performed at Yonsei Cardiovascular Center from January 1, 1993 to December 31, 2003, and also to determine whether patient profiles, etiology, and practice patterns have changed over this 11-year period. The medical records of 272 patients were examined and a follow-up survey was conducted. Patient clinical profiles, etiology, echocardiographic findings, and procedural details were determined for 2 periods: January, 1993 through December, 1997 (period 1); and January 1998 through December, 2003 (period 2). During the 11-year study period, 291 therapeutic, echo-guided pericardiocenteses with pericardial catheter drainage were performed in 272 patients. The number of pericardiocentesis in period 2 was increased compared with period 1 (191 cases vs. 100 cases). The mean age at pericardiocentesis increased from 49 +/- 17 years in period 1 to 55 +/- 16 years in period 2 (p < 0.05). The procedural success rate was 99% overall with a major complication rate of 0.7% (2 cases of right ventricular free wall perforation which required emergency operation). Only one procedure-related mortality (< 30 days) was noted. Malignancy was the leading cause of a pericardial effusion requiring pericardiocentesis (45.6%). The incidence of pericardial effusion following cardiothoracic surgery and percutaneous coronary intervention procedures accounted for nearly 20% of all pericardiocenteses performed. Echo-guided pericardiocentesis has become a safe, standard practice for clinically significant pericardial effusion, in line with the changes of patients profiles over the 11 years of the study.

  10. Study on Patients Who Underwent Suspected Diagnosis of Allergy to Amide-Type Local Anesthetic Agents by the Leukocyte Migration Test

    Directory of Open Access Journals (Sweden)

    Mikio Saito

    2014-01-01

    Conclusions:: There is a high possibility that these adverse reactions were caused by pseudoallergy to drug. Even by allergic reactions, it was assumed that 80% of them might be caused by antiseptic agents such as paraben. In addition, it was suggested that ALAs, especially lidocaine hydrochloride preparations have high antigenicity (sensitizing property. Furthermore, it was considered that patients with past history of drug or food allergies have a high potential for manifestation of the reactions.

  11. Lack of an Association between Neutrophil-to-Lymphocyte Ratio and PSA Failure of Prostate Cancer Patients Who Underwent Radical Prostatectomy

    Directory of Open Access Journals (Sweden)

    Yoko Maeda

    2016-01-01

    Full Text Available Introduction. The neutrophil-to-lymphocyte ratio (NLR, which can be easily calculated from routine complete blood counts of the peripheral blood, has been suggested to serve as a prognostic factor for some solid malignancies. In the present study, we aimed to determine the relationship between NLR in prostate cancer patients undergoing radical prostatectomy (RP and their prognosis. Materials and Methods. We assessed NLR in 73 men (patients who received RP for their prostate cancer. We also performed immunohistochemistry for CD8 and CD66b in a separate set of RP specimens. Results. The median NLR in the 73 patients was 1.85. There were no significant correlations of NLR with tumor grade (p=0.834, pathological T stage (p=0.082, lymph node metastasis (p=0.062, or resection margin status (p=0.772. Based on the area under the receiver operator characteristic curve (AUROC to predict biochemical recurrence after RP, potential NLR cut-off point was determined to be 2.88 or 3.88. However, both of these cut-off points did not precisely predict the prognosis. There were no statistically significant differences in the number of CD66b-positive neutrophils or CD8-positive lymphocytes between stromal tissues adjacent to cancer glands and stromal tissues away from cancer glands and between different grades or stages of tumors. Conclusions. There was no association between NLR and biochemical failure after prostatectomy.

  12. Manejo da osteorradionecrose em pacientes submetidos à radioterapia de cabeça e pescoço =Osteoradionecrosis management in patients underwent head and neck radiotherapy

    Directory of Open Access Journals (Sweden)

    Vier, Fabiana Vieira et al.

    2005-01-01

    Full Text Available Os efeitos colaterais da radioterapia instituída para tratamento de pacientes com câncer da região de cabeça e pescoço interferem significativamente na qualidade de vida desses indivíduos. Entre esses efeitos, podem-se citar mucosite, hipossialia, ageusia, cáries por radiação, trismo e osteorradionecrose (ORN. Esta última constitui uma complicação grave e de difícil tratamento. A presente revisão da literatura objetiva enfatizar aspectos da osteorradionecrose, abordando fatores etiológicos, características clínicas e radiográficas, prevalência, tratamento e prognóstico da enfermidade. O cumprimento de medidas protocolares antes, durante e após a radioterapia de cabeça e pescoço previne e minimiza a ocorrência de complicações como a ORN. As consultas de controle após o término da radioterapia são imprescindíveis e devem ser garantidas pela conscientização do paciente sobre a importância das mediadas preventivas. Radiotherapy appointed for the treatment of patients with head and neck cancer presents side effects which interfere significantly with the patients’ quality of life. Mucous inflammation, hyposialia, loss of taste, radiation caries, trismus, and osteoradionecrosis (ORN are among these side effects. ORN represents a serious complication of difficult treatment. The present literature review aims to emphasize aspects of ORN approaching the pathology’s etiologic factors, clinical and radiographic characteristics, prevalence, treatment and prognosis. Compliance with protocol procedures both prevents and reduces the development of complications such as ORN. After finishing radiotherapy, follow-up consultations are indispensable and to assure them the patient should be aware of the importance of preventive procedures.

  13. Avaliação das atividades da vida diária dos pacientes com doença de Parkinson submetidos a cirurgia estereotáxica Daily living activities in Parkinson's disease patients underwent to stereotactic surgery

    Directory of Open Access Journals (Sweden)

    Roberta Arb Saba Rodrigues Pinto

    2002-06-01

    Full Text Available OBJETIVO: Avaliar o impacto da cirurgia estereotáxica sobre a realização das atividades da vida diária dos paciente com doença de Parkinson (DP. MÉTODO: Foram avaliados 30 pacientes com DP forma idiopática submetidos a cirurgia estereotáxica nos períodos pré-operatório, 1º, 3º, 6º e 12º mês pós-operatório, segundo as escala UPDRS - Item II (escala unificada para DP, Schwab & England e Hoehn & Yahr. Destes, nove pacientes foram também avaliados no 24º mês pós-operatório. RESULTADOS: Foram realizadas nove palidotomias póstero-ventrais (PPV, sendo duas à esquerda e sete à direita; duas PPV bilaterais no mesmo tempo cirúrgico; 17 talamotomias ventro-laterais (TVL, sendo 12 à esquerda e cinco à direita; duas TVL à esquerda com PPV à direita no mesmo tempo cirúrgico. Os escores médios, na fase off, das escalas utilizadas foram: 65,6 no pré-operatório,74 no 1º mês, 76,6 no 3º mês, 75,6 no 6º mês e 72,3 no 12º mês pós-operatório (Schwab & England; 21 no pré-operatório, 12,3 no 1º mês, 14,7 no 3º mês, 15,27 no 6º mês e 17,1 no 12º mês pós-operatório (UPDRS; 3,1 no pré-operatório, 2,8 no 1º mês, 2,7 no 3º mês, 2,8 no 6º mês e 2,85 no 12º mês pós-operatório (Hoehn & Yarh. CONCLUSÃO: A TVL e a PPV são procedimentos capazes de melhorar a independência dos pacientes para realização das atividades cotidianas, sendo constatado benefício maior nos seis primeiros meses de pós-operatório.OBJECTIVE: To evaluate the impact of stereotactic surgery on daily activities of Parkinson's disease (PD patients. METHOD: Thirty patients with idiopathic PD were evaluated before surgery and one, three, six and twelve months after surgery. Patients were evaluated with the UPDRS - part II (Unified Parkinson's Disease Rating Scale and the Schwab & England scales. Nine of the patients had also been evaluated after twenty four months. RESULTS: We performed nine posteroventral pallidotomies (PVP, two on the

  14. What are the intensities and line-shapes of the twenty four polarization terms in coherent anti-Stokes Raman spectroscopy?

    Directory of Open Access Journals (Sweden)

    Kai Niu

    2015-12-01

    Full Text Available Coherent anti-Stokes Raman spectroscopy (CARS is conventionally described by just one diagram/term where the three electric field interactions act on the ket side in a Feynman dual time-line diagram in a specific time order of pump, Stokes and probe pulses. In theory, however, any third-order nonlinear spectroscopy with three different electric fields interacting with a molecule can be described by forty eight diagrams/terms. They reduce to just 24 diagrams/terms if we treat the time ordering of the electric field interactions on the ket independently of those on the bra, i.e. the ket and bra wave packets evolve independently. The twenty four polarization terms can be calculated in the multidimensional, separable harmonic oscillator model to obtain the intensities and line-shapes. It is shown that in fs/ps CARS, for the two cases of off-resonance CARS in toluene and resonance CARS in rhodamine 6G, where we use a fs pump pulse, a fs Stokes pulse and a ps probe pulse, we obtain sharp vibrational lines in four of the polarization terms where the pump and Stokes pulses can create a vibrational coherence on the ground electronic state, while the spectral line-shapes of the other twenty terms are broad and featureless. The conventional CARS term with sharp vibrational lines is the dominant term, with intensity at least one order of magnitude larger than the other terms.

  15. What are the intensities and line-shapes of the twenty four polarization terms in coherent anti-Stokes Raman spectroscopy?

    Energy Technology Data Exchange (ETDEWEB)

    Niu, Kai [School of Science, Tianjin University of Technology and Education, Tianjin, 300222 (China); Lee, Soo-Y., E-mail: sooying@ntu.edu.sg [Division of Physics & Applied Physics, and Division of Chemistry & Biological Chemistry, School of Physical & Mathematical Sciences, Nanyang Technological University, Singapore 637371 (Singapore)

    2015-12-15

    Coherent anti-Stokes Raman spectroscopy (CARS) is conventionally described by just one diagram/term where the three electric field interactions act on the ket side in a Feynman dual time-line diagram in a specific time order of pump, Stokes and probe pulses. In theory, however, any third-order nonlinear spectroscopy with three different electric fields interacting with a molecule can be described by forty eight diagrams/terms. They reduce to just 24 diagrams/terms if we treat the time ordering of the electric field interactions on the ket independently of those on the bra, i.e. the ket and bra wave packets evolve independently. The twenty four polarization terms can be calculated in the multidimensional, separable harmonic oscillator model to obtain the intensities and line-shapes. It is shown that in fs/ps CARS, for the two cases of off-resonance CARS in toluene and resonance CARS in rhodamine 6G, where we use a fs pump pulse, a fs Stokes pulse and a ps probe pulse, we obtain sharp vibrational lines in four of the polarization terms where the pump and Stokes pulses can create a vibrational coherence on the ground electronic state, while the spectral line-shapes of the other twenty terms are broad and featureless. The conventional CARS term with sharp vibrational lines is the dominant term, with intensity at least one order of magnitude larger than the other terms.

  16. Effect of Programmatic Emergency Care on the Patients Underwent Cheat Trauma in ICU%ICU胸外伤患者实施程序化急救护理的效果观察

    Institute of Scientific and Technical Information of China (English)

    钟衬珠; 钟玉娱; 钟爱娟; 温冬娣

    2014-01-01

    目的:观察ICU胸外伤患者实施程序化急救护理的效果。方法:选择笔者所在医院ICU收治的47例胸部外伤患者,制定和采用相应的程序化急救护理措施,观察患者的预后情况。结果:44例患者抢救成功,3例患者死亡。结论:程序化急救护理可提高患者抢救成功率。%Objective:To observe the effect of programmatic emergency care on the patients underwent cheat trauma in ICU.Method:47cases of patients underwent cheat trauma were chose.Programmatic emergency care measure were established and carried out .The prognosis of the patients was observed. Result:44 patients were rescued successfully. 3patients died. Conclusion:Programmatic emergency care can increase the rescue success rate of the patients.

  17. 53例结肠造口病人适应状况及相关因素调查%Survey of adaptation and related factors of 53 cases of patients underwent colostomy

    Institute of Scientific and Technical Information of China (English)

    宋秋香; 赵晓艳; 李婧婧; 孙慧卿; 丰艳; 李敏; 靳璐璐

    2016-01-01

    Objective:To know about the adaptive condition of 53 cases of patients underwent colostomy,and an-alyze its related factors.Methods:A total of 53 cases of patients underwent colostomy in 3 third grade A hospi-tals in Taiyuan city received questionnaire by using general data questionnaire,colostomy adaptive scale and co-lostomy related self efficacy questionnaire.Results:The score of adaptive level of patients underwent colostomy was(127.40±18.95);the adaptive condition of patients underwent colostomy was different who were in differ-ent ages,culture levels,colostomy time and self care situation (P <0.05 or P <0.01);regression analysis re-sults showed that the factors influencing adaptive condition of patients underwent colostomy were self effica-cy,colostomy time,cultural degree and age.Conclusion:Adaptive level of patients underwent colostomy was at the medium level and needed to be further improved.The self efficacy of patients underwent colostomy was closely related to adaptive level.The patient's self efficacy could be improved,so as to promote adaption of colon colostomy and improve their quality of life.%[目的]了解结肠造口病人适应状况,分析其影响因素。[方法]采用一般资料问卷、造口适应量表和造口相关自我效能问卷对太原市3所三级甲等医院53例结肠造口病人进行问卷调查。[结果]结肠造口病人适应水平为(127.40±18.95)分;②不同年龄、文化程度、造口时间和自理情况的结肠造口病人适应状况不同(P <0.05或 P <0.01);回归分析结果显示,影响结肠造口病人适应状况的因素为自我效能、造口时间、文化程度、年龄。[结论]结肠造口病人适应水平处于中等水平,有待于进一步提高,结肠造口病人的自我效能与适应水平密切相关,可通过提升病人自我效能促进其适应造口生活,提高生活质量。

  18. Minimal percentage of dose received by 90% of the urethra (%UD90 is the most significant predictor of PSA bounce in patients who underwent low-dose-rate brachytherapy (LDR-brachytherapy for prostate cancer

    Directory of Open Access Journals (Sweden)

    Tanaka Nobumichi

    2012-09-01

    Full Text Available Abstract Background To clarify the significant clinicopathological and postdosimetric parameters to predict PSA bounce in patients who underwent low-dose-rate brachytherapy (LDR-brachytherapy for prostate cancer. Methods We studied 200 consecutive patients who received LDR-brachytherapy between July 2004 and November 2008. Of them, 137 patients did not receive neoadjuvant or adjuvant androgen deprivation therapy. One hundred and forty-two patients were treated with LDR-brachytherapy alone, and 58 were treated with LDR-brachytherapy in combination with external beam radiation therapy. The cut-off value of PSA bounce was 0.1 ng/mL. The incidence, time, height, and duration of PSA bounce were investigated. Clinicopathological and postdosimetric parameters were evaluated to elucidate independent factors to predict PSA bounce in hormone-naïve patients who underwent LDR-brachytherapy alone. Results Fifty patients (25% showed PSA bounce and 10 patients (5% showed PSA failure. The median time, height, and duration of PSA bounce were 17 months, 0.29 ng/mL, and 7.0 months, respectively. In 103 hormone-naïve patients treated with LDR-brachytherapy alone, and univariate Cox proportional regression hazard model indicated that age and minimal percentage of the dose received by 30% and 90% of the urethra were independent predictors of PSA bounce. With a multivariate Cox proportional regression hazard model, minimal percentage of the dose received by 90% of the urethra was the most significant parameter of PSA bounce. Conclusions Minimal percentage of the dose received by 90% of the urethra was the most significant predictor of PSA bounce in hormone-naïve patients treated with LDR-brachytherapy alone.

  19. On the Idyllic Realm in the Twenty-four Poetic Genres%论«二十四诗品»的休闲境界

    Institute of Scientific and Technical Information of China (English)

    孙敏明

    2016-01-01

    «二十四诗品»不仅是司空图论诗歌艺术风格类型的文学理论作品,也是优美的诗歌作品。综观«二十四诗品»,最重要的是通过对纯洁本性的累积、回归、体悟而达到对“真”“中”“虚”的葆有。«二十四诗品»为我们展示了诗意栖居的生活,也体现了古人内外双修,体验式的生活方式,从而能启示活在当下、顺任自然的诗意人生,启示我们思考如何更聪明地休闲,追求与道同体的永恒境界。%The Twenty-four Poetic Genres written by Si kongtu is not only a theoretic book on the po-etic genres,but also a poetic work itself.Overview the whole book,the essence is to maintain the"true""intrinsic"and"virtual"quality through the accumulation,regression and comprehension of pure nature. It revealed the idyllic settings of our ancestors with the poetic life to inspire us to take relaxation naturally and cleverly for the pursuit of eternal realm of life.

  20. The usefulness of twenty-four molecular markers in predicting treatment outcome with combination therapy of amodiaquine plus sulphadoxine-pyrimethamine against falciparum malaria in Papua New Guinea

    Directory of Open Access Journals (Sweden)

    Reeder John C

    2008-04-01

    Full Text Available Abstract Background In Papua New Guinea (PNG, combination therapy with amodiaquine (AQ or chloroquine (CQ plus sulphadoxine-pyrimethamine (SP was introduced as first-line treatment against uncomplicated malaria in 2000. Methods We assessed in vivo treatment failure rates with AQ+SP in two different areas in PNG and twenty-four molecular drug resistance markers of Plasmodium falciparum were characterized in pre-treatment samples. The aim of the study was to investigate the association between infecting genotype and treatment response in order to identify useful predictors of treatment failure with AQ+SP. Results In 2004, Day-28 treatment failure rates for AQ+SP were 29% in the Karimui and 19% in the South Wosera area, respectively. The strongest independent predictors for treatment failure with AQ+SP were pfmdr1 N86Y (OR = 7.87, p pfdhps A437G (OR = 3.44, p pfcrt K76T, A220S, N326D, and I356L did not help to increase the predictive value, the most likely reason being that these mutations reached almost fixed levels. Though mutations in SP related markers pfdhfr S108N and C59R were not associated with treatment failure, they increased the predictive value of pfdhps A437G. The difference in treatment failure rate in the two sites was reflected in the corresponding genetic profile of the parasite populations, with significant differences seen in the allele frequencies of mutant pfmdr1 N86Y, pfmdr1 Y184F, pfcrt A220S, and pfdhps A437G. Conclusion The study provides evidence for high levels of resistance to the combination regimen of AQ+SP in PNG and indicates which of the many molecular markers analysed are useful for the monitoring of parasite resistance to combinations with AQ+SP.

  1. Twenty four hour insulin infusion impairs the ability of plasma from healthy subjects and Type 2 diabetic patients to promote cellular cholesterol efflux

    NARCIS (Netherlands)

    Dullaart, RPF; van Tol, A

    Removal of cholesterol from peripheral cells by high density lipoproteins (HDL) is regarded as an important defence mechanism against atherosclerosis development. PLTP is involved in the generation of pre beta -HDL that can act as initial accepters of cellular cholesterol. Exogenous

  2. Low-Level Laser and Light-Emitting Diode Therapy for Pain Control in Hyperglycemic and Normoglycemic Patients Who Underwent Coronary Bypass Surgery with Internal Mammary Artery Grafts: A Randomized, Double-Blind Study with Follow-Up.

    Science.gov (United States)

    Lima, Andréa Conceição Gomes; Fernandes, Gilderlene Alves; Gonzaga, Isabel Clarisse; de Barros Araújo, Raimundo; de Oliveira, Rauirys Alencar; Nicolau, Renata Amadei

    2016-06-01

    This study aimed to evaluate the efficacy of low-level laser therapy (LLLT) and light-emitting diodes (LEDs) for reducing pain in hyperglycemic and normoglycemic patients who underwent coronary artery bypass surgery with internal mammary artery grafts. This study was conducted on 120 volunteers who underwent elective coronary artery bypass graft (CABG) surgery. The volunteers were randomly allocated to four different groups of equal size (n = 30): control, placebo, LLLT [λ = 640 nm and spatial average energy fluence (SAEF) = 1.06 J/cm(2)], and LED (λ = 660 ± 20 nm and SAEF = 0.24 J/cm(2)). Participants were also divided into hyperglycemic and normoglycemic subgroups, according to their fasting blood glucose test result before surgery. The outcome assessed was pain during coughing by a visual analog scale (VAS) and the McGill Pain Questionnaire. The patients were followed for 1 month after the surgery. The LLLT and LED groups showed a greater decrease in pain, with similar results, as indicated by both the VAS and the McGill questionnaire (p ≤ 0.05), on the 6th and 8th postoperative day compared with the placebo and control groups. The outcomes were also similar between hyperglycemic and normoglycemic patients. One month after the surgery, almost no individual reported pain during coughing. LLLT and LED had similar analgesic effects in hyperglycemic and normoglycemic patients, better than placebo and control groups.

  3. Risk factors of depression in coronary heart disease patients who underwent revascularization therapy%冠心病再血管化治疗后发生抑郁的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    解存; 丛洪良; 李曦铭; 张茹艳

    2015-01-01

    Objective To explore the incidence and risk factors of depression in coronary heart disease patients who underwent revascularization therapy. Methods A total of 493 patients who were admitted in Tianjin chest hospital from April 2012 to February 2013 were enrolled, among whom 258 patients acceptted coronary artery bypass grafting (CABG) and the rest 235 patients underwent percutaneous coronary intervention (PCI). Self-rating depression scale (SDS) was employed to assess the state of patients at both1 day before and 7 days after the operations. According to the postopera⁃tive scores, CABG group was divided into the depression group (n=90) and non-depression group (n=168) while PCI group was also divided into depression group (n=54) and non-depression group (n=181). Basic clinical datum of patients were col⁃lected and analyzed and independent risk factors of depression was analyzed though logistic multi-variant regression. Results The incidence of postoperative depression among CABG patients was significantly higher than that in PCI patients (P<0.05).(1)In the CABG group, age, ratio of female gender, alcohol intake, rate of past depression, length of anaesthesia, length of staying in ICU and incidence of postoperative cognitive dysfunction(POCD)were all higher in depression subgroup than those in non-depression subgroup. Female and preoperative depression were both independent risk factors for postoper⁃ative depression in patients underwent CABG.(2)In PCI group, ratio of female gender, blood pressure, incidence of Diabe⁃tes Mellitus, the rate of past Myocardiac infaction (MI), length of intervention therapy and the number of planted stents were all higher in depression subgroup than non-depression subgroup. Female, past MI and length of intervention therapy are all independent factors of post-operative depression in patients underwent PCI. Conclusion Incidence of depression in pa⁃tients underwent revascularization is high. Female is the dependent risk

  4. Assessment of peri- and postoperative complications and Karnofsky-performance status in head and neck cancer patients after radiation or chemoradiation that underwent surgery with regional or free-flap reconstruction for salvage, palliation, or to improve function

    Directory of Open Access Journals (Sweden)

    Sertel Serkan

    2011-09-01

    Full Text Available Abstract Background Surgery after (chemoradiation (RCTX/RTX is felt to be plagued with a high incidence of wound healing complications reported to be as high as 70%. The additional use of vascularized flaps may help to decrease this high rate of complications. Therefore, we examined within a retrospective single-institutional study the peri--and postoperative complications in patients who underwent surgery for salvage, palliation or functional rehabilitation after (chemoradiation with regional and free flaps. As a second study end point the Karnofsky performance status (KPS was determined preoperatively and 3 months postoperatively to assess the impact of such extensive procedures on the overall performance status of this heavily pretreated patient population. Findings 21 patients were treated between 2005 and 2010 in a single institution (17 male, 4 female for salvage (10/21, palliation (4/21, or functional rehabilitation (7/21. Overall 23 flaps were performed of which 8 were free flaps. Major recipient site complications were observed in only 4 pts. (19% (1 postoperative haemorrhage, 1 partial flap loss, 2 fistulas and major donor site complications in 1 pt (wound dehiscence. Also 2 minor donor site complications were observed. The overall complication rate was 33%. There was no free flap loss. Assessment of pre- and postoperative KPS revealed improvement in 13 out of 21 patients (62%. A decline of KPS was noted in only one patient. Conclusions We conclude that within this (chemoradiated patient population surgical interventions for salvage, palliation or improve function can be safely performed once vascularised grafts are used.

  5. 术中给予艾塞那肽对心脑血管的保护作用研究%Protective effects of Exenatide on cardiovascular function of patients underwent cardiac surgery

    Institute of Scientific and Technical Information of China (English)

    冯丽娜

    2014-01-01

    Objective To study the protective effect of exenatide on cardiovascular function of patients underwent cardiac surgery. Methods From March 2012 to August 2013,168 patients enrolled in our hospital were randomly divided into 2 groups including 80 cases of control group and 88 cases of exenatide group. Results Compared with the control group,exenatide group has lower blood sugar after surgery (P0. 05).Conclusion For cardiac surgery patients,exenatide could reduce cardiovascular disease complications caused by surgery by protecting effect on heart and brain.%目的:探讨术中给予艾塞那肽对心脑血管的保护作用。方法收集2012年3月-2013年8月我院择期心脏外科手术患者168例,随机分为对照组80例和艾塞那肽组88例。结果2组手术后血糖比较差异有统计学意义(P0.05)。结论艾塞那肽对心脏外科手术患者具有保护心脑血管的作用,可以减少手术引起的心脑血管疾病并发症,值得推广。

  6. 苏芬太尼联合地佐辛对开胸手术患者胰岛素抵抗的影响%The effect of sufentanil plus dezocine on insulin resistance of patients underwent thoracotomy

    Institute of Scientific and Technical Information of China (English)

    韩念平

    2013-01-01

    Objective To study the effect of sufentanil plus dezocine on insulin resistance of patients underwent thoracotomy.Methods 80 patients underwent thoracotomy were randomly divided into the observation group (n =40 cases) and the control group (n =40 cases).The patients in the control group were anesthetized through sufentanil,while the patients in the observation group were anesthetized through sufentanil plus dezocine.The analgesic effect and insulin resistance index were compared.Results There wasn't significant difference between two groups in VAS,Ramsay and BCS 2,12 and 24 hours after operation (all P > 0.05).Insulin resistance index in both two groups was increased after operation and it in the control group was higher than that in the observation group(t =5.0233,P<0.05).Conclusion The analgesic.effect of sufentanil plus zuoxin is the same as sufentanil alone,but can reduce insulin resistance.%目的 探讨苏芬太尼联合地佐辛对开胸手术患者胰岛素抵抗的影响.方法 将80例开胸手术患者采用随机数字表法分为观察组、对照组各40例,对照组采用苏芬太尼,观察组采用苏芬太尼联合地佐辛镇痛.观察两组镇痛效果和测定胰岛素抵抗指数.结果 两组术后2、12、24 h VAS、Ramsay和BCS评分差异均无统计学意义(均P>0.05).两组术后胰岛素抵抗均有明显升高,但对照组较观察组升高更明显(t=5.0233,P<0.05).结论 苏芬太尼联合地佐辛与单用苏芬太尼镇痛效果相当,但可以减轻胰岛素抵抗.

  7. 抗凝管理服务在心房颤动导管消融术后患者中的应用评价%Evaluation of anticoagulation management service in patients who underwent catheter ablation for atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    田颖; 刘兴鹏; 齐淑媛; 卢晓英; 陈汝明; 尹先东; 周旭; 石亮; 王彦江; 杨新春

    2012-01-01

    Objective To evaluate the effectiveness of anticoagulation management service (AMS) in patients who underwent catheter ablation for atrial fibrillation (AF).Methods Two hundreds and forty-five consecutive patients [134 males; age (64 ± 11) years] with AF were enrolled.All patients received warfarin therapy for 3 ~ 6 months after catheter ablation for AF.Patients adjusted their warfarin doses either by visiting the outpatient clinic (the former 116 patients,non-AMS group) or under the guidance of one well-trained nurse (the latter 129 patients,AMS group).The percentage of patients in whom the international normalized ratio (INR) value achieved therapeutic anticoagulation range (2.0 ~ 3.0),the effective anticoagulation rate that defined as more than 70% of INR values were between 2.0 ~ 3.0 after titration period,and the INR fluctuation index after titration period were compared between the 2 groups.Results Warfarin therapy rendered 119 patients (92.2%) in AMS group and 93 patients (80.2%) in non-AMS group achieved therapeutic anticoagulation range (P=0.008).The effective anticoagulation rate in AMS group (59.8%) was significantly higher than that in non-AMS group (42.7%,P =0.027),while the INR fluctuation index in AMS group were significantly less than that in non-AMS group(0.64±0.74 vs 1.01±1.03,P=0.004).Conclusion This study demonstrates that the application of AMS in patients who underwent catheter ablation of AF is helpful in achieving higher effective anticoagulation rate while keeping therapeutic INR value more stable.%目的 评价抗凝管理服务(AMS)在心房颤动(房颤)导管消融术后患者中的应用价值.方法 连续245例[男134例,年龄(64±11)岁]接受导管消融治疗的房颤患者,所有患者术后均接受口服华法林抗凝治疗3~6个月.其中,前116例随机就诊于心内科门诊并接受华法林剂量调整(非AMS组),后129例接受经过培训的专业护士指导下的华法林剂量调整(AMS组).

  8. Biotype identification and epidemiological analysis of twenty-four Brucella strains%24株布鲁菌的种型鉴定和流行病学分析

    Institute of Scientific and Technical Information of China (English)

    张磊; 屈平华; 吴尚为; 陈经雕

    2016-01-01

    Objective To identify the biotype and analyze the epidemiological characteristics of twentyfour Brurella strains from the primary hospitals in Guangdong Province.Methods The twenty-four Brucella strains,collected from Oct.2009 to Oct.2015,were identified by routine biochemical methods,VITEK 2 COMPACT automatic microbial identification analyzer,16S rRNA gene sequencing and biology phenotype based on serological and bacteriophages lysis test.The etiology was analyzed based on clinical data,biotypes of the isolates and other clinical information.Results All of the twenty-four strains were Gram-negative coccobacilli,including two strains of Brucella suis biotype Ⅱ,four strains of Brucella melitensis biotype Ⅰ and eighteen strains of Brucella melitensis biotype Ⅲ.By GN card of VITEK 2 COMPACT automatic microbial identification analyzer,one strain was mistaken as Bordetella bronchiseptica and two strains were mistaken as Ochrobaetrum anthropi.The 16S rRNA gene sequencing showed they were high homology to Ochrobactrum intermedium and Ochrobaetrum anthropi,which completely excluded the possibility of Bordetella bronchiseptica.Tbe clinical data showed that all of the twenty-four patients were adults with an average age of 49.0 years old,men and women were twelve people respectively,with no significant gender differences and no occupational exposure,which presenting a wide and diverse range of nonspecific clinical signs and symptoms,but brucellosis was not aware of by the physician.Conclusion Brucella melitensis biotype Ⅲ is the main pathogen of brucellosis,with the characteristics of sporadic outbreak and occult infection in the primary hospitals in Guangdong Province.%目的 对广东省基层地区24株布鲁菌进行种型鉴定和流行病学分析.方法 对24株来自于2009年10月至2015年10月广东省基层医院血培养阳性的布鲁菌进行传统生化鉴定、VITEK 2仪器鉴定、16S rRNA基因测序、血清学试验和噬菌体试验,比较不

  9. 腹腔镜直肠癌根治术对病人生活质量影响的分析%Quality-of-life analyses for patients with rectal cancer underwent radical laparoscopic surgery

    Institute of Scientific and Technical Information of China (English)

    许菡; 胡艳艳; 金艳; 奚蓓华; 施晓群; 吴蓓雯

    2012-01-01

    目的:比较腹腔镜直肠癌根治术与传统开腹手术对病人术后生活质量(quality of life,QOL)的影响.方法:对照研究25例腹腔镜直肠癌根治术(腹腔镜组)和29例开腹直肠癌根治术(开腹组),采用欧洲癌症研究与治疗组织的癌症病人QOL评价量表QLQ-C30,评价和比较手术前后QOL的变化特征.结果:两组病人在年龄、性别、肿瘤与肛缘距离、TNM分期方面差异均无统计学意义.两组病人术后早期除情绪功能和认知功能以外的QOL总体评价较术前均明显下降,术后3~6个月,各项功能分值呈逐渐恢复趋势,腹腔镜组恢复显著早于开腹组(P<0.05).总体健康状况量表的评价结果显示,腹腔镜组病人QOL恢复到中等以上水平的时间也显著早于开腹组.结论:腹腔镜直肠癌根治术不但创伤小、痛苦少、恢复快,且病人术后QOL恢复较开腹手术佳.%Objective To compare the impacts of radical laparoscopic surgery and conventional laparotomy on the quality of life (QOL) in patients with rectal cancer. Methods Quality of life questionnaire module, European Organisation for Research and Treatment of Cancer QLQ-C30, was used to evaluate the quality of life for all enrolled rectal cancer patients peri-operatively. Results No significant difference was observed in terms of age, gender, tumor location, as well as TNM staging between the groups. Overall QOL early after operation decreased significantly in both groups of patients comparing with preoperative data, except for emotional function and cognitive function. The trend of QOL recovery was observed in both groups 3—6 months after operation. Furthermore, the QOL recovery was earlier in laparoscopic group than in open group (P<0.05). Overall rating scales of health condition showed that recovery was earlier for patients underwent laparoscopic surgery than for patients underwent conventional open laparotomy. Conclusions Laparoscopic rectal surgery is safe

  10. Diagnostic Accuracy of Detecting Hashimoto's Thyroiditis in Thyroid Cancer Patients Who Underwent Thyroid Surgery: Comparison of Ultrasonography, Positron Emission Tomography/CT, Contrast Enhanced CT, and Anti-Thyroid Antibody

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Gyun; Lee, Tae Hyun; Park, Dong Hee; Nam, Sang Been [Dept. of Radiology, Korea Cancer Center Hospital, Seoul (Korea, Republic of)

    2012-11-15

    To compare the diagnostic accuracy of ultrasonography (US), F18-fluorodeoxyglucose positron emission tomography/CT (PET/CT), contrast enhanced CT (CECT), serum anti-thyroid antibody for detecting Hashimoto's thyroiditis in thyroid cancer patients who underwent neck surgery. A total of 150 patients with suspicious for thyroid cancer, who had previously undergone US guided needle aspiration of thyroid, were evaluated with the use of US, PET/CT, CECT and serum anti-thyroid antibody. The four studies were performed within two months before neck surgery. Hashimoto's thyroiditis was confirmed by histopathological results. The diagnostic accuracy of US, PET/CT, CECT and serum anti-thyroid antibody were calculated statistically. Hashimoto's thyroiditis was diagnosed in 51 out of the 150 patients, following neck surgery. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of US were 76.5%, 92.9%, 84.8%, 88.5%, and 87.3%, respectively. The corresponding values of PET/CT were 37.3%, 96.0%, 82.6%, 74.8%, and 76.0%, and CECT were 62.7%, 89.9%, 76.2%, 82.4%, and 80.7%, and serum anti-thyroid antibody level were 90.2%, 93.9%, 88.5%, 94.9%, and 92.7%, respectively. McNemar test revealed significant difference among PET/CT and others, but no significant differences among US, CECT and serum anti-thyroid antibody. Overall, serum anti-thyroid antibody showed most accurate diagnostic performance. In detecting Hashimoto's thyroiditis, serum anti-thyroid antibody showed higher diagnostic accuracy than others. US also showed relatively high diagnostic accuracy.

  11. 妇科肿瘤患者术后切口感染的综合防治措施%The Prevention and Control Measures of Postoperative Wound Infections in Patients Underwent Gynecological Tumor Resection Surgery

    Institute of Scientific and Technical Information of China (English)

    葛莉娜

    2012-01-01

    Objective To analyze the postoperative wound infections in patients underwent gynecological tumor resection surgery,and develop prevention and control measures. Methods Totally 310 gynecologic tumor patients were recruited as experimental group,in which integrated nursing measures were carried out. Meanwhile,298 gynecologic tumor cases were selected as control group and regular nursing measures were performed. The infection rate and healing status of wound were assessed. Results The infection rate of experiment group is significantly lower than control group (control group: 10 infection cases,3.36%;experimental group:3 infection case,0.96% ;P < 0.05).The patients with wound infection were cured after systemic treatment and nursing care. Conclusion Systemic prevention and treatment measures can reduce wound infection rate and accelerate infection healing.%目的 分析妇科肿瘤术后切口感染情况及防治措施.方法 对接受手术治疗的妇科肿瘤患者术后分别采用防治感染的综合护理措施(实验组,n =310)和常规护理措施(对照组,n=298).比较2组感染率的差异和感染创口的愈合情况.结果 对照组感染10例,感染率3.36%.实验组感染3例,感染率0.96%.实验组术后感染率显著低于对照组(P<0.05).结论 个体化的综合防治措施明显降低妇科肿瘤患者术后切口感染发生率,且使切口感染均在短期内顺利治愈.

  12. 规范化疼痛管理在上腹部术后患者应用中的效果评价∗%The Efficacy of Standardlized Pain Management in the Patients underwent Upper Abdominal Surgery

    Institute of Scientific and Technical Information of China (English)

    王静; 唐小丽; 顾琼; 陈晓琴; 姜淑

    2014-01-01

    目的:评价规范化疼痛管理在上腹部术后患者临床应用中的效果。方法:将160例患者随机分为对照组和观察组,对照组采用传统的术后疼痛干预,观察组实施规范化疼痛管理,比较对两组患者手术镇痛认知度的影响、术后3d疼痛控制效果、术后生理功能恢复方面的指标。结果:观察组对疼痛知识的认知程度明显高于对照组,术后3d疼痛分值明显低于对照组,睡眠时间多于对照组,肛门排气时间、下床活动时间、住院时间及并发症发生率均明显少于对照组,两组比较差异均有统计学意义(P<0.05)。结论:规范化疼痛管理改变了患者错误的疼痛认知,有效提高开腹术后的镇痛效果,促进患者康复。%Objective: To evaluate the efficacy of standardlized pain management in the patients who had accepted upper abdominal surgery. Methods:One hundred and sixty patients were randomly allocated into the control group and ob-servation group. Patients in the control group underwent the conventional postoperative pain management, whereas patients in the observation group accepted the standardized postoperative pain management. The awareness of analgesia, pain control effect on 3 days after surgery and status of physiological function recovery were compared between these two groups. Re-sults:Compared with the control group, awareness of analgesia in the observation group was significantly higher, however, pain scores were significantly lower. In addition, patients in the observation group had longer sleep time, shorter time to flatus and out-of-bed activity, lower incidence of complication and shorter hospitalization time than those in the control group. The differences were statistically significant (P<0. 05). Conclusion:Standardized pain management can alter pa-tients’ awareness of analgesia, effectively improve the analgesic effect after abdominal surgery, and promote the rehabilita-tion of

  13. 负压吸引在低位肛周脓肿根治术后引流效果的临床观察%Negative pressure drainage in patients underwent primary radical surgical procedure for low perianal abscess

    Institute of Scientific and Technical Information of China (English)

    岳中文; 张建余

    2011-01-01

    目的 探讨负压吸引装置在低位肛周脓肿根治术后的应用效果.方法 将60例低位肛周脓肿患者随机分为两组,治疗组30例,采用负压吸引装置引流;对照组30例,采用生理盐水纱条引流,就一次治愈率、愈合时间及住院天数进行对比分析.结果 肛周脓肿根治术后应用负压吸引装置提高了愈合率,加快切口愈合,缩短住院时间.结论 负压吸引装置操作简便,安全可靠,是低位肛周脓肿根治术后引流有效的方法之一.%Objective To evaluate the effect of negative pressure drainage in patients underwent primary radical surgical procedure for low perianal abscess. Methods Sixty patients with low perianal abscess were divided randomly into the treatment group (30 cases) and the control group (30 cases). After primary radical surgical procedure, the treatment group was treated by negative pressure drainage, and the control group drained by normal saline gauze. Results The treatment group had a higher cure rate, shorter wound healing time and hospital stay than those of the control group. Conclusion Negative pressure drainage is a simple, safe and effective method for low perianal abscess after primary radical surgical procedure.

  14. Twenty-four mini-pool HCV RNA screening in a routine clinical virology laboratory setting: a six-year prospective study.

    Science.gov (United States)

    Seme, Katja; Mocilnik, Tina; Poljak, Mario

    2011-01-01

    The usefulness of combined anti-HCV and 24 mini-pool HCV RNA screening strategy was re-evaluated after a six-year continuous routine use in a clinical virology laboratory, at which more than half of newly diagnosed hepatitis C patients are intravenous drug users. Pools of 24 samples were prepared from 20,448 anti-HCV negative serum samples and tested using an automated commercial PCR assay with a lower limit of detection of 50 IU/ml. After detection of anti-HCV negative/HCV RNA positive patients, responsible physicians provided follow-up samples. Thirty-eight (0.19%) anti-HCV negative/HCV RNA positive samples from 30 patients (28 intravenous drug users) were detected. Follow-up samples were available for 27/30 patients. Twenty, six and one patient seroconverted in the second, third and fourth available samples, respectively. The interval between the first HCV RNA positive and the first available anti-HCV positive sample was 17-517 days. The costs of detecting a single anti-HCV negative/HCV RNA positive patient were 1227 Euros. Combined anti-HCV and 24 mini-pool HCV RNA screening is a useful and cost effective strategy, not only in blood-transfusion settings but also in a routine clinical virology laboratory, at which a significant proportion of the tested population belongs to a high-risk population. Copyright © 2010 Elsevier B.V. All rights reserved.

  15. Multiple biomarkers including cardiac troponins T and I measured by high-sensitivity assays, as predictors of long-term mortality in patients with chronic renal failure who underwent dialysis.

    Science.gov (United States)

    Hickman, Peter E; McGill, Darryl; Potter, Julia M; Koerbin, Gus; Apple, Fred S; Talaulikar, Girish

    2015-06-01

    There is a high cardiac mortality in patients on long-term renal dialysis. No studies have reported long-term outcomes relating to both high-sensitivity cardiac troponin T (hs-cTnT) and high-sensitivity cardiac troponin I (hs-cTnI) in these patients. Patients who underwent long-term dialysis at the Canberra Hospital had blood samples collected for both cardiac and other biomarkers. Samples were stored at -80°C until analysis. Mortality data were collected at 5 years, and univariate and multivariate analyses were performed to identify which biomarkers were predictive of mortality at 5 years. After multivariate analysis, albumin, C-reactive protein (CRP), and hs-cTnT remained independently predictive of all-cause mortality, with hs-cTnT having the highest hazard ratio. If hs-cTnT was excluded from the analysis, then hs-cTnI was independently predictive of mortality. For hs-cTnT, for both genders, the ninety-ninth percentile, derived from a population with subjects with subclinical disease excluded, served as an excellent partition between survivors and nonsurvivors. Receiver-operating characteristic curve analysis for hs-cTnT had area under the curve of 0.798 and for hs-cTnI of 0.774. Kaplan-Meier curves for the aggregation of albumin, CRP, and hs-cTnT showed a stronger predictive power with receiver-operating characteristic area under the curve of 0.805. The addition of echocardiographic data in an analysis of all patients who had an echocardiogram for clinical reasons (n = 105) did not alter the final observations in this subgroup. In conclusion, hs-cTnT retains a superior predictive power in a dialysis-dependent population for identifying those at risk for death and when aggregated with albumin and CRP also has substantial additive value for identifying mortality risk in a renal-dialysis population.

  16. SF-12量表评价全髋关节置换术患者生存质量%Evaluation of quality of life in patients who underwent total hip arthroplasty by SF - 12 health survey

    Institute of Scientific and Technical Information of China (English)

    陈城; 陈继营; 张国强; 柴伟; 苟文隆; 耿磊

    2012-01-01

    [目的]评估SF - 12量表用于评价全髋关节置换术后患者生存质量的适用性.[方法]Harris髋关节功能评分量表(Harris hip score,HHS)、SF - 12生存质量量表(MOS 12 -item Short Form Health Survey,SF - 12)评估接受全髋关节置换术治疗的患者283例381髋,采用内部一致性信度(Cronbach's alpha系数)评估SF - 12量表的信度;采用集合效度、区分效度和结构效度评估SF - 12量表的效度;Pearson相关分析评估HHS与生理总分、心理总分关联度;单因素方差分析评估生理及心理总分分级的组间差异性.[结果] SF-12量表总的Cronbach's alpha系数为0.879,各维度Cronbach's alpha系数均>0.8;集合效度及区分效度定标实验均为100%;结构效度因子分析产生两个公因子生理及心理总分,累积解释72.229%的总方差,8个维度因子负荷与理论假设基本符合;HHS与生理总分、心理总分均为强相关(r1=0.745,r2=0.703,P<0.01);组间差异F1=85.282,F2=61.377,P<0.01.[结论]SF-12量表具有良好的信度和效度,适用于评价全髋关节置换术后患者的生存质量,评估效果良好.%[Objective] To access the applicability of the SF - 12 health survey on measuring quality of life in patients who underwent total hip arthroplasy (THA). [ Methods] Totally 283 patients were measured by Chinese - version 12 - item short -form health survey (SF - 12) and Harris hip score ( HHS). Reliability of the SF - 12 was evaluated by internal consistency reliability. Validity of the SF - 12 was evaluated by discriminant validity, convergent validity and structure validity. Pearson correlation coefficient was used to evaluate the correlation of HHS with physical component summary (PCS) and mental component summary (MCS). One - way analysis of variance (ANOVA) was used to analyze the variance of PCS grading and MCS grading. [ Results] The internal consistency Cronbachs alpha coefficient was 0. 879. The Cronbachs alpha of all

  17. 纤维支气管镜术后痰细胞学检查在肺癌诊断中的意义%Value of Sputum Cytology for Postoperative Patients Underwent Fiberoptic Bronchoscopy in Diagnosis of Lung Cancer

    Institute of Scientific and Technical Information of China (English)

    马家兰; 黄晓霞; 肖卫; 许菊秀; 陈振平; 李芬

    2012-01-01

    Objective To explore the value of sputum cytology in the diagnosis of lung cancer for postoperative patients who underwent fiberoptic bronchoscopy. Methods 120 patients accepted 2-3 sputum cytological examinations before fiberoptic bronchoscopy and 1 -4 days after fiberoptic bronchoscopy. Results Among the 120 cases 79 cases were diagnosed as lung cancer ,75 cases were confirmed by different examinations including sputum cytology before fiberoptic bronchoscopy, brush cytology, biopsy, liquid washing and postoperative sputum cytology- 23 cases of cancer were found in p/eoperative sputum cytology. the positive rale was 29. 1% ,the cytotyping accuracy was 63. 6% in squamous carcinoma,60. 0% in adenocarcinoma and 66. 7% in small cell carcinoma. 42 cases of cancer were found in postoperative sputum cytology,the positive rate was 53. 2% ,the cytotyping accuracy was 87.5% in squamous carcinoma,88.2% in adenocarcinoma and 83.3% in small cell carcinoma. Conclusion Sputum cytology for postoperative patients who underwent fiberoptic bronchoscopy can increase the detectable rate of lung cancer. The positive rate and accuracy of postoperative sputum cytology are better than that of preoperative sputum cytology. The postoperative sputum cytology is noninvasive, safe and repeatable, it is worthy of clinical application.%目的 观察纤维支气管镜术后痰细胞学检查对肺癌的诊断价值.方法 对120例行纤维支气管镜患者术前送2~3次痰细胞学,术后第1~4天送2~3次痰细胞学检查.结果 120例有79例确诊为肺癌,其中75例通过术前痰检,纤支镜刷检、活检、冲洗液及术后痰检联合检查确诊肺癌,术前痰细胞学检出癌23例,阳性率29.1%,其细胞学分类与组织学活检分类符合率鳞癌63.6%、腺癌60.0%、小细胞癌66.7%.术后痰细胞学检出癌42例,阳性率53.20%,术后痰检与组织活检符合率鳞癌87.5%、腺癌88.2%、小细胞癌83.3%%.结论 纤维支气管镜检结

  18. Clinical Observation of Intraoperative Local Chemotherapy with Lobaplatin for Breast Cancer Patients Underwent Modified Radical Mastectomy%乳腺癌改良根治术中局部应用洛铂的疗效观察

    Institute of Scientific and Technical Information of China (English)

    陈伟贤; 李建; 恽文; 于丹丹; 赵建华; 秦建伟; 唐金海

    2016-01-01

    目的:评价乳腺癌改良根治术中局部应用洛铂的临床疗效。方法选择早期乳腺癌患者50例,随机分为观察组和对照组各25例,均行乳腺癌改良根治术。术中观察组用溶有50 mg洛铂的生理盐水冲洗并浸泡创面,15 min后吸出冲洗液。皮瓣缝合前,再将50 mg洛铂多点喷洒于瘤床、腋窝淋巴结清扫区及其他可疑残余癌细胞区域。对照组仅用等量生理盐水处理。对药物安全性、近期及远期疗效进行追踪和对比研究。结果两组术后的不良反应包括骨髓抑制(白细胞和血小板计数)、肝肾功能(血肌酐和谷丙转氨酶)、局部疼痛和胃肠道反应(恶心、呕吐和腹泻),以及Ⅰ期愈合时间等方面比较无显著差异(P>0.05)。观察组引流液脱落癌细胞检查阳性率和局部复发率均低于对照组,差异有统计学意义(P<0.05),而远处转移率和2年生存率比较无统计学意义(P>0.05)。结论乳腺癌患者改良根治术中应用洛铂安全有效,可显著降低局部复发,值得临床进一步推广。%Objective To evaluate the clinical efficacy of intraoperative local chemotherapy with lobaplatin for breast cancer patients underwent modified radical mastectomy .Methods 50 cases of breast cancer patients treated with modified radical mastectomy were randomly divided into 2 groups,25 cases in each group .In the observation group ,operation wound was washed and steeped by physiological saline containing 50 mg lobaplatin for 15min.After sucking out the washing fluid ,another 50 mg lobaplatin was multi-point sprayed in tumor bed ,axillary lymph node dissection area ,and any other potential area of residual canc-er cells before flap suture.The control group only received a treatment of same amount of physiological saline .Then,drug safety, short-term effects and long-term results were tracked and compared .Results Postoperative adverse effects

  19. Performance characteristics of prostate-specific antigen density and biopsy core details to predict oncological outcome in patients with intermediate to high-risk prostate cancer underwent robot-assisted radical prostatectomy.

    Science.gov (United States)

    Yashi, Masahiro; Nukui, Akinori; Tokura, Yuumi; Takei, Kohei; Suzuki, Issei; Sakamoto, Kazumasa; Yuki, Hideo; Kambara, Tsunehito; Betsunoh, Hironori; Abe, Hideyuki; Fukabori, Yoshitatsu; Nakazato, Yoshimasa; Kaji, Yasushi; Kamai, Takao

    2017-06-23

    Many urologic surgeons refer to biopsy core details for decision making in cases of localized prostate cancer (PCa) to determine whether an extended resection and/or lymph node dissection should be performed. Furthermore, recent reports emphasize the predictive value of prostate-specific antigen density (PSAD) for further risk stratification, not only for low-risk PCa, but also for intermediate- and high-risk PCa. This study focused on these parameters and compared respective predictive impact on oncologic outcomes in Japanese PCa patients. Two-hundred and fifty patients with intermediate- and high-risk PCa according to the National Comprehensive Cancer Network (NCCN) classification, that underwent robot-assisted radical prostatectomy at a single institution, and with observation periods of longer than 6 months were enrolled. None of the patients received hormonal treatments including antiandrogens, luteinizing hormone-releasing hormone analogues, or 5-alpha reductase inhibitors preoperatively. PSAD and biopsy core details, including the percentage of positive cores and the maximum percentage of cancer extent in each positive core, were analyzed in association with unfavorable pathologic results of prostatectomy specimens, and further with biochemical recurrence. The cut-off values of potential predictive factors were set through receiver-operating characteristic curve analyses. In the entire cohort, a higher PSAD, the percentage of positive cores, and maximum percentage of cancer extent in each positive core were independently associated with advanced tumor stage ≥ pT3 and an increased index tumor volume > 0.718 ml. NCCN classification showed an association with a tumor stage ≥ pT3 and a Gleason score ≥8, and the attribution of biochemical recurrence was also sustained. In each NCCN risk group, these preoperative factors showed various associations with unfavorable pathological results. In the intermediate-risk group, the percentage of positive cores showed

  20. Risk factors for patients with hepatocellular carcinoma and liver cirrhosis who underwent major hepatectomy%肝癌合并肝硬化大块肝切除的手术风险性

    Institute of Scientific and Technical Information of China (English)

    何强; 彭宝岗; 梁力建

    2006-01-01

    目的分析肝癌合并肝硬化大块肝切除的风险.方法回顾性分析近8年我院90例肝癌合并肝硬化大块切除病例.结果乙肝感染率81%,肝功能A级55.6%,B级40%,C级4.4%.轻度肝硬化44.4%,中度46.7%,重度8.9%.肝癌大小(8.5±4.0)cm,手术时间为(188±89)min,失血量(1 281±1 831)mL,输血量(1109±1 213)mL.术后总并发症为24%,严重并发症17.8%,肝功能衰竭及肝功不全发生率8.9%.手术死亡率为6.7%.单变量分析示术前AST、肝功能、手术时间及失血量为肝功能衰竭发生的独立因素,多变量分析提示手术时间及肝功能为肝功能衰竭发生的独立危险因素(P<0.01,P<0.05).结论术前肝功C级应避免手术切除.术中缩短手术时间对预防肝功能衰竭起关键作用.%[Objective] To evaluate risk factors for patients with hepatocellular carcinoma (HCC) and liver cirrhosis who underwent major hepatectomy. [Methods] 90 HCC patients with liver cirrhosis who underwent major hepatectomy in recent years were reviewed, retrospectively. [Results] The hepatitis B infection was found in 81% (73/90) of cases. Liver function tests showed that Child A, Child B and Child C were found in 55.6% (50/90), 40% (36/90) and 4.4% (4/90) of cases, respectively. Cases of slight, moderate and severe cirrhosis were found in 44.4% (40/90), 46.7% (42/90) and 8.9% (8/90) of cases, respectively. The tumor size was (8.5±4.0) cm in diameter. The operation duration was (188±89) min with blood loss of (1281±1831) mL and blood transfusion of (1109±1213) mL.The overall morbidity was 24.4% (22/90), compared with 21% (31/181) in local resection group (P =0.537). The severe complications incidence was 18% (18/90), significantly higher than 6.1% (12/181) in local resection group (P <0.01). The liver failure incidence was 8.9% (12/90), compared with 4.9% (9/181) in local resection group (P =0.286).The operative mortality was 6.7% (6/90), compared with 1.1% (2/181) in local resection group (P =0

  1. Twenty-Four-Hour Blood Pressure Monitoring to Predict and Assess Impact of Renal Denervation: The DENERHTN Study (Renal Denervation for Hypertension).

    Science.gov (United States)

    Gosse, Philippe; Cremer, Antoine; Pereira, Helena; Bobrie, Guillaume; Chatellier, Gilles; Chamontin, Bernard; Courand, Pierre-Yves; Delsart, Pascal; Denolle, Thierry; Dourmap, Caroline; Ferrari, Emile; Girerd, Xavier; Michel Halimi, Jean; Herpin, Daniel; Lantelme, Pierre; Monge, Matthieu; Mounier-Vehier, Claire; Mourad, Jean-Jacques; Ormezzano, Olivier; Ribstein, Jean; Rossignol, Patrick; Sapoval, Marc; Vaïsse, Bernard; Zannad, Faiez; Azizi, Michel

    2017-03-01

    The DENERHTN trial (Renal Denervation for Hypertension) confirmed the blood pressure (BP) lowering efficacy of renal denervation added to a standardized stepped-care antihypertensive treatment for resistant hypertension at 6 months. We report here the effect of denervation on 24-hour BP and its variability and look for parameters that predicted the BP response. Patients with resistant hypertension were randomly assigned to denervation plus stepped-care treatment or treatment alone (control). Average and standard deviation of 24-hour, daytime, and nighttime BP and the smoothness index were calculated on recordings performed at randomization and 6 months. Responders were defined as a 6-month 24-hour systolic BP reduction ≥20 mm Hg. Analyses were performed on the per-protocol population. The significantly greater BP reduction in the denervation group was associated with a higher smoothness index (P=0.02). Variability of 24-hour, daytime, and nighttime BP did not change significantly from baseline to 6 months in both groups. The number of responders was greater in the denervation (20/44, 44.5%) than in the control group (11/53, 20.8%; P=0.01). In the discriminant analysis, baseline average nighttime systolic BP and standard deviation were significant predictors of the systolic BP response in the denervation group only, allowing adequate responder classification of 70% of the patients. Our results show that denervation lowers ambulatory BP homogeneously over 24 hours in patients with resistant hypertension and suggest that nighttime systolic BP and variability are predictors of the BP response to denervation. URL: https://www.clinicaltrials.gov. Unique identifier: NCT01570777. © 2017 American Heart Association, Inc.

  2. Twenty-four-hour central blood pressure is not better associated with hypertensive target organ damage than 24-h peripheral blood pressure.

    Science.gov (United States)

    de la Sierra, Alejandro; Pareja, Julia; Fernández-Llama, Patricia; Armario, Pedro; Yun, Sergi; Acosta, Eva; Calero, Francesca; Vázquez, Susana; Blanch, Pedro; Sierra, Cristina; Oliveras, Anna

    2017-10-01

    Central blood pressure (BP) is increasingly considered as a better estimator of hypertension associated risks. We aimed to evaluate the association of 24-h central BP, in comparison with 24-h peripheral BP, with the presence of target organ damage (TOD). Cross-sectional study of 208 hypertensive patients, aged 57 ± 12 years, 34% women. Office (mean of 4 measurements) and 24-h central and peripheral BP were measured by the oscillometric Mobil-O-Graph device. TOD was assessed at cardiac (left ventricular hypertrophy by echocardiography), renal (reduction of glomerular filtration rate and/or microalbuminuria), and arterial (increased aortic pulse wave velocity) levels. A total of 107 patients (51.4%) had TOD (77, 35% patients left ventricular hypertrophy; 54, 25.9% renal abnormalities; and 40, 19.2% arterial stiffness). All SBP and pulse BP estimates (office, 24-h, daytime, and night-time) were associated with the presence of TOD, after adjustment for age, sex, and antihypertensive treatment, with higher odds ratios for ambulatory-derived values. Odds ratios for central and peripheral BP were similar for all office, 24-h, daytime, and night-time BP. After simultaneous adjustment, peripheral, but not central, 24-h and night-time SBP and pulse pressures were associated with the presence of TOD. TOD in hypertension is associated with BP elevation, independently of the type of measurement (office or ambulatory, central or peripheral). Central BP, even monitored during 24 h, is not better associated with TOD than peripheral BP. These results do not support a routine measurement of 24-h central BP.

  3. Anatomia patológica da sinóvia de pacientes submetidos à liberação do túnel do carpo Pathological study of the synovial tissue of patients who underwent open carpal tunnel release

    Directory of Open Access Journals (Sweden)

    Pedro José Pires Neto

    2010-01-01

    Full Text Available OBJETIVO: Verificar se a biópsia da sinóvia do túnel do carpo é capaz de identificar patologias sistêmicas que não foram diagnosticadas clinicamente ou por exames laboratoriais. MÉTODO: 46 exames anatomopatológicos da sinóvia dos tendões flexores no túnel do carpo de pacientes submetidos à liberação aberta para o tratamento desta síndrome compressiva foram, retrospectivamente, analisados. Os autores propuseram uma nova classificação para a lesão de acordo com a intensidade do processo inflamatório. RESULTADOS: O exame anatomopatológico mostrou que 56,6% das lâminas foram classificadas como grau I (sem alterações inflamatórias, 32,6%, grau II (infiltrado leucocitário e fibrose discretos, além de hialinose, 4,3%, grau III (infiltrado leucocitário e fibrose intensos, presença de fibrina e neoformação vascular e 6,5%, grau IV (as alterações acima descritas associadas à presença de calcificação local e células gigantes. Dois pacientes com amiloidose foram classificados como graus I e II e não foram encontrados depósitos de material amilóide em suas lâminas. Dois pacientes portadores de hiperparatireoidismo e outro com insuficiência renal crônica foram classificados como grau IV. CONCLUSÃO: A realização da biópsia da sinóvia do túnel do carpo, além de agregar custos adicionais ao procedimento, não possibilitou o diagnóstico precoce de doenças sistêmicas em pacientes portadores de síndrome do túnel do carpo.OBJECTIVE: To determine whether a biopsy of the synovia of the carpal tunnel is able to identify systemic diseases that were not diagnosed by clinical examination and laboratory tests. METHODS: Anatomical pathology P examinations of synovial tissue were performed in 46 patients that underwent open carpal tunnel release. Anatomical pathology examination with hematoxylin-eosin staining determined the intensity of the inflammatory process and the authors proposed a new classification of the injury

  4. 右美托咪定在胆囊微创手术老年患者中的全麻维持效果研究%Effect of dexmedetomidine on elderly patients underwent laparoscopic cholecystectomy under general anesthesia

    Institute of Scientific and Technical Information of China (English)

    李峥

    2015-01-01

    Objective To investigate the effect of dexmedetomidine on elderly patients underwent laparoscopic cholecystectomy under general anesthesia. Methods One hundrad patients underwent laparoscopic cholecystectomy in Central Hospital of Nanyang from January 2011 to December 2013 were selected and randomly divided into control group (propofol combined with remifentanil)and the study group(dexmedetomidine combined with remifentanil),with 50 pa-tients in each group. The control group was not treated with any preoperative medication,while study group was treated with loading dose of 0. 5 μg/ kg dexmedetomidine intravenously completed within 10 minutes. Induction of anesthesia were same in both groups. Maintenance of anesthesia in control group treated with propofol 2. 0 ~ 3. 0 μg/ ml + 4. 5 ~ 5. 5 ng/ ml TCI, Maintenance of anesthesia in study group treated with dexmedetomidine 0. 25 μg/(kg·h) + remifentanil 4. 5 ~ 5. 5 ng/ ml (TCI). HR,SBP,DBP,BIS values,and Steward awakening scores and OAA/ S rating were recorded at different time points. Results No significant difference was found between BIS value of two groups at different time points. Compared with control group,HR at different time in study group were significantly lower,SBP,DBP were significantly decreased (P ﹤ 0. 05). There was no significant difference in Steward awakening score and modified OAA/ S score at recovery and ex-tubation time between the two groups. Conclusions Compared with propofol given in minimally invasive laparoscopic gall-bladder surgery in elderly patients maintain anesthesia effect,dexmedetomidine is more secure,more efficient and more sta-ble hemodynamics. Therefore,it is worthy of clinical application.%目的:探讨右美托咪定在腹腔镜胆囊微创手术老年患者中全麻维持效果。方法2011年1月至2013年12月在南阳市中心医院行腹腔镜胆囊切除术的患者共100例,随机分为对照组(丙泊酚+瑞芬太尼麻醉)和研究组(右美托咪定

  5. Twenty-Four-Hour Real-Time Continuous Monitoring of Cerebral Edema in Rabbits Based on a Noninvasive and Noncontact System of Magnetic Induction

    Directory of Open Access Journals (Sweden)

    Gen Li

    2017-03-01

    Full Text Available Cerebral edema is a common disease, secondary to craniocerebral injury, and real-time continuous monitoring of cerebral edema is crucial for treating patients after traumatic brain injury. This work established a noninvasive and noncontact system by monitoring the magnetic induction phase shift (MIPS which is associated with brain tissue conductivity. Sixteen rabbits (experimental group n = 10, control group, n = 6 were used to perform a 24 h MIPS and intracranial pressure (ICP simultaneously monitored experimental study. For the experimental group, after the establishment of epidural freeze-induced cerebral edema models, the MIPS presented a downward trend within 24 h, with a change magnitude of −13.1121 ± 2.3953°; the ICP presented an upward trend within 24 h, with a change magnitude of 12–41 mmHg. The ICP was negatively correlated with the MIPS. In the control group, the MIPS change amplitude was −0.87795 ± 1.5146 without obvious changes; the ICP fluctuated only slightly at the initial value of 12 mmHg. MIPS had a more sensitive performance than ICP in the early stage of cerebral edema. These results showed that this system is basically capable of monitoring gradual increases in the cerebral edema solution volume. To some extent, the MIPS has the potential to reflect the ICP changes.

  6. Meta Analysis of Robotic Nissen Fundoplication for Patients Underwent Gynecological Surgery%达芬奇手术机器人在妇科手术中应用疗效的荟萃分析

    Institute of Scientific and Technical Information of China (English)

    周凡; 陈香

    2015-01-01

    Objective To evaluate the efifcacy and feasibility of robotic Nissen fundoplication for the patients underwent gynecological surgery through Meta-analysis.Methods We searched the electronic bibliographic databases, including The Cochrane Library, PubMed, EMbase, CBM, CNKI, VIP database and Wanfang database to assemble the randomized controlled trials of thoracoscopic surgery for advanced lung cancer with malignant pleural effusion. The deadline of the retrieval time was June 2014. Data were extracted and evaluated by two reviewers independently with a designed extraction. The RevMan 5.0 software was used for meta-analysis on homogeneous studies.Results Fore studies met the criteria ifnally, which included 299 patients. Meta analysis showed: except the operative time and cost, statistical differences were not observed in the other outcomes between conventional laparoscopic group and robotic Nissen fundoplication group, including blood loss, conversions, hospital stay, intraoperative and postoperative complications (P>0.05).Conclusion Robotic Nissen fundoplication is not superior to the traditional laparoscopic surgery for patients underwent gynecological surgery. Therefore, we should select the indications carefully.%目的:探讨达芬奇手术机器人在妇科手术中应用的临床疗效和安全性。方法计算机检索Cochrane图书馆(2014年第3期)、PubMed、EMBASE、CBM、CNKI、VIP、万方(截至2014年6月)。收集达芬奇手术机器人对比腹腔镜在妇科手术中应用的随机对照试验,采用Cochrane系统评价的方法,提取数据并由2名评价者独立评价并交叉核对纳入研究的质量,对同质研究采用RevMan5.0软件进行Meta分析。结果共纳入4个RCT包括299例患者。Meta分析结果显示:①手术时间:两组间差异有统计学意义[WMD=43.78,95%CI(23.32,64.23)],提示达芬奇手术机器人的妇科手术时间明显长于腹腔镜手术组。②术中出血量:达芬奇手

  7. Nursing measures and retention time of central venous catheter in esophageal cancer patients underwent radical operation%食管癌术后中心静脉导管留置时间与护理

    Institute of Scientific and Technical Information of China (English)

    姜萍; 林玉琴; 刘新

    2010-01-01

    Objective To explore nursing measures and retention time of central venous catheter in esophageal cancer patients underwent radical operation. Methods According to retention time of central venous catheters, a total of 90 cases of esophageal carcinoma patients were randomly divided into three groups: 31 cases with 5 days retention time in group Ⅰ , 29 cases with 7 days retention time in group Ⅱ; 30 cases with 10 days retention time. Complications of central venous catheter including swelling and pain in punition site, fever,extravasation, extrusion and block of catheter and the bacterial culture of central venous catheter were compared among three groups. Results Incidence of complications in group Ⅰ,group Ⅱ and group Ⅲ were 3.2%,20.6% and 46.7% respectively. The differences were significant( P < 0.01 ). As for the positive of bacteria culture, differences among three groups were significant too, with no case in group Ⅰ , one case in group Ⅱ and 4cases in group Ⅲ. Conclusions Retention time of central venous catheter should under 7 days. Retention time depends on the quality of nursing care.%目的 探讨食管癌术后中心静脉导管留置时间与护理方法.方法 择期食管癌根治术患者90例,按中心静脉导管留置时间随机分为3组,留置5 d组(n=31),留置7 d组(n=29)和留置10 d组(n=30).观察中心静脉导管留置期间的局部红肿、疼痛、发热、液体外渗以及导管脱出、堵塞等一般并发症.观察期结束后拔除中心静脉导管,用无菌剪刀剪下尖端5 cm,放置于无菌容器内,送细菌培养.结果 一般并发症发生率留置5 d组为3.2%,留置7 d组为20.6%,留置10 d组为46.7%,差异有统计学意义(P<0.01).静脉导管尖端细菌培养结果留置5 d组均为阴性,留置7 d组有1例阳性,留置10 d组有4例阳性,导管相关性感染的发生率比较,差异有统计学意义(P<0.05).结论 食管癌根治术后中心静脉导管留置时间一般不应超过7 d,

  8. Terminal ileum of patients who underwent colonoscopy: endoscopic, histologic and clinical aspects Íleo terminal de pacientes submetidos a colonoscopia: aspectos endoscópicos, histológicos e clínicos

    Directory of Open Access Journals (Sweden)

    Marcelo Maia Caixeta de Melo

    2009-06-01

    Full Text Available CONTEXT: For the diagnosis of the diseases which affect the terminal ileum, the colonoscopy allows macroscopic evaluation and the performing of biopsies. Studies with criteria for the endoscopic and histological characterization of this segment are scarce and there are still some doubts about the need of biopsies in patients with normal ileoscopy. OBJECTIVE: Study the terminal ileum of patients who underwent colonoscopy considering: endoscopic and histological correlation; agreement between results of the initial histological evaluation and slides review, and the chance of subjects with normal ileoscopy with abdominal pain and/or chronic diarrhea to show histological alterations. METHODS: In a prospective study, 111 patients who presented smooth mucosa without enanthema in the endoscopic exam of the terminal ileum were selected. Biopsies of the ileal mucosa of such patients were performed, being the slides routinely examined and reviewed afterwards. RESULTS: The correlation between patients with normal ileoscopy and ileum with preserved histological architecture was of 99.1%. The agreement between initial histological evaluation and slides review calculated by the Kappa test was 0.21. In patients with abdominal pain and/or chronic diarrhea, the chance of showing histological alterations was 2.5 times higher than the others. CONCLUSIONS: The correlation between endoscopic and histological findings was high. The agreement between the initial histologic evaluation and slides review was not satisfactory. The chance of subjects with normal ileoscopy with abdominal pain and/or chronic diarrhea, showing histological alterations was higher in relation to the asymptomatic ones or with other symptoms, although the clinical importance of this datum was not evaluated.CONTEXTO: Para o diagnóstico de doenças que afetam o íleo terminal, a colonoscopia permite avaliação macroscópica e realização de biopsias. Estudos com critérios para caracteriza

  9. 论《二十四诗品》虚拟人物背后的“五然”理想人格%"Five Good" ldeal Personalities of the Virtual Characters of "Twenty-four Poems"

    Institute of Scientific and Technical Information of China (English)

    张猛刚

    2014-01-01

    "Taste of poetry reflects taste of life and style shows personality in the opposite way." In this sense, "Twenty-four Poems" do absolutely not mean to teach how to write poems and how to cultivate the couplet but to develop human nature to promote personality. It is the aloof personality, light life consciousness, self perfection and the acceptance of natural realization that are prominently revealed in the twenty-four kinds of mood behind the virtual figures. Those spirits have got considerable inspiration for the modern people in self-cultivation.%“诗品映衬人品,风格返现人格。”从这个意义上来说,《二十四诗品》绝对不是教我们如何作诗,如何对句,而是陶冶人的性情,求得人格上的提升。其实在二十四种意境之中,在虚拟人物背后,突出表现的是超然的人格理想、淡然的生命意识和自我完善、自然实现的精神。这对今人在修身养性方面有着极大的启示作用。

  10. 右美托咪定对老年人髋部手术后认知功能障碍的影响%Dexmedetomidine on cognitive function of elderly patients who underwent hip orthopedic surgery

    Institute of Scientific and Technical Information of China (English)

    张云飞; 高伟忠; 马世颖; 刘金碧

    2015-01-01

    目的:观察硬膜外麻醉复合不同剂量右美托咪定对老年人髋部手术后循环和认知功能障碍(POCD)的影响。方法选择2013年6月—2014年9月,65岁以上髋部手术患者120例,行硬膜外麻醉联合右美托咪定静脉泵注,按右美托咪定的泵注量不同,分为A组0.2μg·h-1·kg-1,B组0.4μg·h-1·kg-1和C组0.6μg·h-1·kg-1,每组40例。观察并记录3组患者入室时(T0)、用药后10 min(T1)、用药后20 min(T2)、停药即刻(T3)、停药后10 min(T4)以及手术完毕时(T5)的心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO2)。应用简易智力状态量表(MMSE)测试3组患者术前24 h(t1)、术后12 h(t2)、术后24 h(t3)及术后72 h(t4)认知功能。结果3组患者在T0时MAP、HR及SpO2比较差异无统计学意义;C组T2、T3时HR和MAP均较A组、B组明显下降(均P0. 05).A significant decrease in MAP and HR were ob⁃served in Group C at T2 and T3 time points compared to those in Group A or Group B (P 0.05). However, compared to that in group A or group C, MMSE increased significantly at time point T2, T3 in group B (P<0.05). In addition, compared to group A or group C, the pa⁃tients in group B exhibited lower incidence of postoperative cognitive function disorder (P < 0.05). Conclusion Continu⁃ous intravenous infusion of Dexmedetomidine can be used in elderly patient who underwent hip orthopedic surgery at the dose of 0.4μg·h-1·kg-1 safely with little interference to circulatory and cognitive function in perioperative period.

  11. On the Beauty of Twenty-four Poetry Style%美感体验中的三维透视--论《二十四诗品》朦胧美

    Institute of Scientific and Technical Information of China (English)

    吕甜

    2016-01-01

    A lot of researches have been done about the aesthetics of the Twenty-four Poetry Style for several years. The highly theoretical aesthetic researches which include framing aesthetics, thought aesthetics, ecological esthetics, poetic aesthetics and ideal aesthetics make this book more attractive. But on the other hand, some expansion exists in the aesthetic value of this book because the researchers add their aesthetic theories to the theoretic distillation of the book. In this article, the directly perceived dim beauty and the burden of dim beauty have been analyzed from the experience of the aesthetic perception, which will clearly display the beauty of the Twenty-four Poetry Style.%历年来关于《二十四诗品》的美学研究是层出不穷的,从架构美学到思想美学到生态美学到诗歌美学到理想美学等等,这种高度理论性的美学研究使得整部著作更加具有魅力性。但是这种提炼浓缩后的理论升华在无形中也附加上了论者们的美学理想,使得《二十四诗品》美学价值或多或少地存在着“膨胀”的现象。文章将从美感体验出发,旨在挖掘分析能被直接感知的朦胧美和美的朦胧负担,让《二十四诗品》的美变得更加有迹可循。

  12. Fatal Renal Failure in a Spinal Cord Injury Patient with Vesicoureteric Reflux Who Underwent Repeated Ureteric Reimplantations Unsuccessfully: Treatment Should Focus on Abolition of High Intravesical Pressures rather than Surgical Correction of Reflux

    Directory of Open Access Journals (Sweden)

    Subramanian Vaidyanathan

    2012-01-01

    Full Text Available A 29-year-old man developed paraplegia at T-10 level due to road traffic accident in 1972. Both kidneys were normal and showed good function on intravenous urography. Division of external urethral sphincter was performed in 1973. In 1974, cystogram showed retrograde filling of left renal tract, which was hydronephrotic. Left ureteric reimplantation was performed. Following surgery, cystogram revealed marked retrograde filling of left renal tract as before. Penile sheath drainage was continued. In 1981, intravenous urography revealed bilateral severe hydronephrosis. Left ureteric reimplantation was performed again in 1983. Blood pressure was 220/140 mm Hg; this patient was prescribed atenolol. Cystogram showed gross left vesicoureteral reflux. Intermittent catheterisation was commenced in 2001. In 2007, proteinuria was 860 mg/day. This patient developed progressive renal failure and expired in 2012. In a spinal cord injury patient with vesicoureteral reflux, the treatment should focus on abolition of high intravesical pressures rather than surgical correction of vesicoureteric reflux. Detrusor hyperactivity and high intravesical pressures are the basic causes for vesicoureteral reflux in spinal cord injury patients. Therefore, it is important to manage spinal cord injury patients with neuropathic bladder by intermittent catheterisations along with antimuscarinic drug therapy in order to abolish high detrusor pressures and prevent vesicoureteral reflux. Angiotensin-converting enzyme inhibitors or angiotensin-receptor-blocking agents should be prescribed even in the absence of hypertension when a spinal cord injury patient develops vesicoureteral reflux and proteinuria.

  13. The clinical application and nursing experience of adjustable shunt valve in treatment for patients with normal pressure hydrocephalus

    Directory of Open Access Journals (Sweden)

    YANG Li-rong

    2012-02-01

    Full Text Available Objective To introduce the application of adjustable shunt valve in treatment for patients with normal pressure hydrocephalus. Methods Twenty-four patients with normal pressure hydrocephalus implanted adjustable shunt valve underwent ventriculo-peritoneal shunt surgery and nursing care. Results After operation, cerebrospinal pressure was regulated for 0-6 (1.88 ± 1.52 times. Clinical symptoms were improved, especially in gait disturbance. Conclusion Treatment of normal pressure hydrocephalus with adjustable shunt valve can alleviate symptoms of hydrocephalus. It is especially suitable for patients with short course and secondary normal hydrocephalus patients.

  14. Improvement of quality of life in serous cavity inflammation patients underwent pigtail tube drainage%猪尾导管心包引流治疗浆膜腔炎患者改善生存质量的观察

    Institute of Scientific and Technical Information of China (English)

    傅恩清; 金发光; 何勇; 刘同刚; 谢永宏; 曹义战

    2002-01-01

    Objective To observe the effect of drainage of pericardium with pigtail tube associated with drainage tube or puncture of pleural cavity. Method Saving cardiac tamponade and treating serious multiple serous cavity inflammation through percutaneous catheterization with pigtail tube infra- xiphoid associating with percutaneous drainage tube or puncture and chemotherapy. Resutls The 4 cases of patients with serous poly serous cavity inflammation were all cured on the whole. They were all not only lived fro 4- 6 months longer, but also got better existing mass and they could live on themselves. Conclusion It is a good way to cure patients with serious poly serous cavity inflammation of percutaneous catheterizatin with pigtail tube infra- xiphoid associating with percutaneous drainage tube or puncture and chemotherapy. It can also save pericardiac tamponade patients.It is worth application in clinic. ``

  15. Characteristics of flexed knee gait and functional outcome of a patient who underwent knee reconstruction with a hingeless prosthesis for bone tumor resection: a case report with gait analysis and comparison with healthy subjects.

    Science.gov (United States)

    Okita, Y; Tatematsu, N; Nagai, K; Nakayama, T; Nakamata, T; Okamoto, T; Toguchida, J; Ichihashi, N; Tsuboyama, T

    2013-12-01

    We report on a patient after knee reconstruction for osteosarcoma in the distal femur using a hingeless prosthesis K-MAX KNEE system K-5 who walked without ipsilateral knee extension in the latter half of the stance phase (flexed knee gait). We evaluated the patient using three-dimensional gait analysis and isokinetic knee strength measurement, and compared the patient with five healthy subjects. The Musculoskeletal Tumor Society (MSTS) score was also used for evaluation. The patient kept his operated knee flexed during mid stance. The maximal ankle plantarflexion internal moment was lower on the ipsilateral side than on the contralateral side, and lower than in the healthy subjects. The negative ankle power during the stance phase was generally stronger on the ipsilateral side than on the contralateral side, and also in the healthy subjects. Unusual contralateral hip flexion occurred after the initial contact, indicating increased joint load on the ipsilateral ankle and the contralateral hip. The ratios of the peak knee extension/flexion torque were 0.7 on the ipsilateral side, 1.9 on the contralateral side, and 1.7 in the healthy subjects. The MSTS score of the patient was 23/30 (76.6%). Flexed knee gait might account for the reduction of ipsilateral hip flexion and ankle plantarflexion moment during the late stance phase. These results suggest the importance of focusing more on the ipsilateral ankle joint and the contralateral hip joint to maintain the function of the entire limb joints of the patients with flexed knee gait.

  16. Relevant factors of nosocomial infection in cervical cancer patients underwent radical surgery%宫颈癌根治术患者医院感染相关因素分析

    Institute of Scientific and Technical Information of China (English)

    祝英杰; 王毅; 魏向群

    2011-01-01

    目的 分析宫颈癌根治术后患者医院感染的状况、特点、病原菌分布及其耐药性,探究其预防措施.方法 对2009年10月-2010年9月在医院行宫颈癌根治术患者120例进行医院感染相关因素调查分析.结果 120例宫颈癌根治术患者发生医院感染40例次,例次感染率为33.3%;手术部位感染最多见,占52.5%,其次为消化道感染,占27.5%;检出病原菌24株,以真菌(12株)占首位,其次为大肠埃希菌(9株);大肠埃希菌对亚胺培南的耐药率为0,对头孢他啶、头孢吡肟、阿米卡星耐药率分别为12.5%、12.5%、12.5%.结论 为减少医院感染的发生,除应严格无菌技术操作及加强术后切口的引流外,合理使用抗菌药物是预防医院感染的重要环节.%OBJECTIVE To analyze the status, characteristics, pathogenic distribution and drug resistance of nosocomial infection (NI) in cervical cancer patients after'surgical procedures and explore preventive measures. METHODS Relevant factors of nosocomial infections in 120 patients with cervical cancer after radical hysterectomy and pelvic lymphadenectomy from Oct. 2009 to Sep. 2010 were investigated. RESULTS In the 120 patients with cervical cancer after radical surgery, there were 40 cases of nosocomial infections, with the infection rate of 30. 0%( the main infection site was surgical site infection (SSI) (52. 5%), followed by gastrointestinal infection (27.5%). Among the 24 strains of pathogenic microbes, the predominant microorganisms were fungi (12 strains) .followed by Escherichia coli (9 strains). E. Coli showed the lowest resistance rate to imipenem, followed by ceftazidime, cefepime and amikacin. The drug resistance rates were 0, 12. 5%, 12. 5% and 12. 5% respectively. CONCLUSION It is vital to prevent and control surgical nosocomial infections by strict application of aseptic technique, enhancing incision drain and rational use of antimicrobial agents. OBJECTIVE To analyze the

  17. Cochlear implant patients underwent successful MRI examination after local bandaging:a case report%电子耳蜗植入术患者局部包扎后行MRI检查成功1例

    Institute of Scientific and Technical Information of China (English)

    保国华; 曹克利

    2012-01-01

    Summary A female patient, now 6 years old. received cochlear implant in the right ear at the age of 2(February .2006). In August 16. 2010. a cervical spine MR1 examination was required due to the cervical spine injury in order to confirm the diagnosis. Considering the cochlea coil may interfere with the MKI examination results, a local bandaging around the ear was given to isolate cochlear magnetic field. The results of cervical spine MR1 ex aminations showed no obvious disturbance, which suggests that we could further explore this method clinically.

  18. 化疗对肺癌患者生活质量及焦虑情绪的影响及分析%Changes in Quality of Life and Anxiety of Lung Cancer Patients Underwent Chemotherapy

    Institute of Scientific and Technical Information of China (English)

    李淑芳; 王燕; 辛士珍; 曹建存

    2012-01-01

    背景与目的 通过观察肺癌患者化疗前后生活质量及焦虑情绪的改变,探讨化疗对肺癌患者生活质量及焦虑情绪的影响.方法 随机抽取住院化疗的肺癌患者58例,分别于化疗前、化疗后2周期1星期内、化疗后4周期1星期内评估临床疗效,并进行肺癌患者生活质量量表(QLQ-C30)和ZUNG焦虑自评量表(SAS)评分.结果 化疗前,生活质量功能领域、疲乏、呼吸困难条目得分较高,有焦虑情绪的占56%,SAS得分为49.54±5.64;焦虑症状与失眠轻度相关(P<0.05);化疗后2周期,呼吸困难得分下降,失眠、食欲丧失得分上升,较化疗前相比差异有统计学意义(P<0.05);有焦虑情绪的占80%,SAS得分为52.48±6.10,较化疗前相比差异有统计学意义(P<0.05);有基础病患者SAS得分高于无基础病患者,差异有统计学意义(P<0.05);焦虑症状与疲乏、呼吸困难轻度相关(p<0.05).化疗后4周期,躯体、角色、情绪、社会功能得分下降明显,恶心呕心、食欲不振、便秘、经济困难条目得分上升,较化疗后2周期相比差异有统计学意义(P<0.05);有焦虑情绪的占72%,SAS得分为54.82±6.55,较化疗后2周期相比无统计学差异;SAS得分与KPS呈负相关(P<0.05);焦虑症状与疲乏、失眠相关(P<0.01),与便秘轻度相关(P<0.05).结论 化疗过程中,部分肺癌患者躯体症状得到缓解,焦虑情绪明显增加,生活质量有所下降,医务工作者应及时评价患者生活质量及情绪改变,提高患者生活质量,积极地对患者进行心理疏导治疗.%Background and objective This study aims to observe the changes in quality of life as well as the anxiety among lung cancer patients before and after chemotherapy. This work also aims to explore the effect of chemotherapy on quality of life and anxiety. Methods Fifty-eight lung cancer patients were evaluated based on clinical outcomes, EORTC QLQ-C30, and on SAS

  19. 拉米夫定在乳腺癌化疗期间对肝功能的作用%Protective effect of lamivudine with the preventive application on liver function in patients underwent breast cancer chemotherapy

    Institute of Scientific and Technical Information of China (English)

    王波; 张彤; 王群

    2014-01-01

    目的:观察拉米定夫在乳腺癌化疗期间对肝功能的作用。方法2013年3月—2014年9月收治且诊断为乳腺癌患者共100例,随机分为观察组和对照组各50例,所有患者化疗前检测乙肝表面抗原( HBsAg )、乙型肝炎病毒DNA( HBV-DNA)均显示阴性;观察组患者化疗前采用预防性拉米夫定治疗,对照组采用标准的化疗方案。以WHO标准对患者的肝脏毒性反应进行对比分析。结果化疗后2组患者的TB和ALT、AST水平均显著高于治疗前(P <0¥.05, P <0.01),而观察组显著低于对照组[(20.3±7.4)μmol/L vs.(59.1±35.1)μmol/L, t =3.725, P =0.021;(60.1±20.8)U/L vs.(417.3±185.1)U/L, t =4.627, P <0.001;(372.6±94.7)U/L vs.(126.4±55.6)U/L, P =0.023];出现肝脏损害的比例显著低于对照组(14.0%vs.42.0%,χ2=2.934, P =0.032),且肝脏损害以0~II级为主,对照组的肝脏损害以III~IV级为主,差异均有统计学意义( P <0.05);HBV-DNA定量平均水平显著低于对照组[(0.21±0.01)×109拷贝/ml vs.(0.73±0.04)×109拷贝/ml, t =3.241, P =0.024],乙肝阳性率显著低于对照组(4.0%vs.10.0%,χ2=4.206, P <0.05)。结论预防性应用拉米定夫可以较为显著地减少乳腺癌化疗后肝脏损害的发生,减轻肝脏损害的程度,降低乙肝的阳性率。%Objective To observe the effect of lamivudine on liver function during chemotherapy in patients with breast cancer. Methods From 2013 March to 2014 September , a total of 100 cases of patients who were analyzed and diag-nosed with breast cancer were randomly divided into observation group and control group with 50 cases in each group , hepatitis B surface antigen (HBsAg), hepatitis B virus DNA (HBV-DNA) were detected in all patients before

  20. 经导管肝动脉化疗栓塞术患者围术期抗菌药物应用方案探讨%Disscusion on Antibiotics Program for Patient Underwent Transcatheter Arterial Chemoembolization during Perioperative Period

    Institute of Scientific and Technical Information of China (English)

    戎佩佩

    2016-01-01

    OBJECTIVE:To provide reference for rational use of antibiotics during perioperative period of transcatheter arterial chemoembolization(TACE). METHODS:After full evaluation of 1 cases of primary liver cancerpatient’s conditions,the optimal clinical evidences were retrieved and evaluated,which were related to antibiotics regimen during perioperative period of TACE. Us-ing“hepatocellular carcinoma”“antibiotic prophylaxis”“hepatic cancer”“TACE”as subjects,the evidence were retrieved from Co-chrane Library(issue 4,2015),Medline(1980 to 2015)and CJFD(1990 to 2015)and then evaluated. RESULTS:1 meta-analy-sis or systematic review,10 RCTs and 2 practice guidelines were identified. This patient didn’t need to use antibiotics to prevent in-fection according to literature analysis. CONCLUSIONS:The rational treatment plan according to evidence-based medicine methods for patients can not only promote the rational use of antibiotics,reduce bacterial drug resistence and treatment cost,but also guide both doctors and patients to take the indeterminate risk of medicine.%目的:为经导管肝动脉化疗栓塞术(TACE)围术期合理使用抗菌药物提供参考。方法:临床药师在充分评估1例原发性肝癌患者的病情后,查找并评价当前与TACE围术期抗菌药物给药方案相关的最佳临床证据。以“hepatocellular carcinoma”“antibiotic prophylaxis”“肝癌”“经导管肝动脉化疗栓塞术”等为主题词,计算机检索Cochrane Library(2015年4期)、Medline (1980-2015年)、中国期刊全文数据库(1990-2015年),并对所获证据进行评价分析。结果:共筛选出与临床问题密切相关的1个系统评价/Meta分析,10个随机对照试验和2个临床指南。通过文献分析认为该患者不需要预防性使用抗菌药物。结论:采用循证医学方法,为该患者制订合理的用药方案,不仅可以促进抗菌药物的合理使用,减少细菌

  1. Optimal time-points for minimal residual disease monitoring change on the basis of the method used in patients with acute myeloid leukemia who underwent allogeneic stem cell transplantation: a comparison between multiparameter flow cytometry and Wilms' tumor 1 expression.

    Science.gov (United States)

    Rossi, Giovanni; Carella, Angelo Michele; Minervini, Maria Marta; di Nardo, Francesco; Waure, Chiara de; Greco, Michele Mario; Merla, Emanuela; Cillis, Giovanni Pio de; Di Renzo, Nicola; Melpignano, Angela; Capalbo, Silvana; Palumbo, Gaetano; Pisapia, Giovanni; Cascavilla, Nicola

    2015-02-01

    Minimal residual disease (MRD) of 30 adult AML patients was monitored by multiparameter flow cytometry (MFC) and WT1 expression before and after allogeneic stem cell transplantation (allo-SCT). Diagnostic performance of pre-transplant MRD measured by MFC was higher than that obtained by WT1 expression. Comparable results were displayed at day +30 post-transplant, while better values by WT1 compared to MFC were found at day +90. Positive MRD by MFC predicted a shorter disease free survival (DFS) before and 1 month after transplant (p=0.006 and p=0.005), while only high WT1 levels at 1 month from the transplant significantly impacted on DFS (p=0.010). Our results support the idea that MRD monitoring by MFC should be suggested before and 30 days after the transplant, while WT1 expression should be preferred after this procedure. The assessment of MRD at day +30 from allo-SCT is recommended as post transplant check-point for the predictive role displayed, independently of the method used.

  2. Nursing of 62 patients with osteosarcoma around the knee underwent artificial tumor prosthesis replacement%62例膝关节周围骨肉瘤人工肿瘤型假体置换术的护理

    Institute of Scientific and Technical Information of China (English)

    楼燕凤; 曹爽; 王蔚雯

    2011-01-01

    Objective Using artificial tumor prosthesis replacement to treat osteosarcoma around the knee is a combined surgical therapy mainly for limb salvage. which is different from the simple method of amputation. Whereas, for this surgery, studies related to nursing are relatively rare. In this study, the nursing and the clinical effects of using artificial tumor prosthesis replacement to treat osteosarcoma around the knee has been discussed. Methods 62 cases of osteosarcoma around the knee were extensively resected. Pre-operative care of intervention, the skin preparation and the psychological care were done before the operation. Nursing of drainage , prevention and care of complications were done after the operation. The patients were given early functional exercise guide and their knee functions were followed-up regularly. Results The 62 cases were followed-up for 6 months to 103 months, 4 cases had recurrence and 3 cases had complications. The flexed motion range of articulation was 90 -98° and straight up to 180°, the Mus culoskeletal Tumor Society ( MSTS) rate of good and excellent was 85. 4% . Conclusion Using artificial tumor prosthesis replacement to treat osteosarcoma around the knee is the mainstream of surgical treatment, Good nursing and careful observarion is the key of success for the operation and the recovery of knee function.%目的 膝关节周围骨肉瘤人工肿瘤型假体置换术是以保肢治疗为主的综合外科治疗方法,文中探讨此手术的护理及临床疗效.方法 对62例膝关节周围骨肉瘤进行安全边界切除,术前做好介入护理和皮肤准备,施行心理护理,术后做好引流管的护理,并发症的预防和护理,早期有序的功能锻炼指导.并对膝关节功能锻炼情况定期随访.结果 62例患者随访6~103个月,4例出现肿瘤复发,3例出现并发症.膝关节屈曲90~98°,伸直达180°,骨与软组织肿瘤协会(the Musculoskeletal Tumor Society,MSTS)保肢评分系统对保

  3. Clinical effect analysis of twenty-four cases with laparoscopic hiatal hernia repair%补片修补食管裂孔疝24例疗效分析

    Institute of Scientific and Technical Information of China (English)

    阿依都·阿不都热依木; 张辅江; 朱学鹏; 姜伟; 郭文江; 克力木; 张成

    2015-01-01

    Objective To investigate the superiority and applicability of patch repair in hiatal hernia surgery. Methods A retrospective analysis from April 2009 to January 2015 in Bazhou People′s Hospital was performed,24 cases were hiatal hernia, the patients underwent patch repair for hiatal hernia, Nissen fundoplication was in 12 cases, Toupet fundoplication in eight cases, Dor fundoplication in four cases. Results 24 patients were operated successfully completely, the operation time were 60 to 200 minutes, average were 120 minutes, blood loss were 20 to 100 ml, mean postoperative hospital stay were 6. 1 days, started to feed in 2 days after operation, drainage tubes were pulled out within 2 days after operation. Followed-up 7 to 46 months,subcutaneous and mediastinal emphysema was 1 case,4 cases were with Nissen fundoplication,swallowed hard in one year after the operation, after one year relieved. Conclusion Patch repair for hiatal hernia surgery is safe, reliable, with shorter operative time, less wound, less short-term relapse,less postoperative complications. For hiatal hernia,patch repair is a safe,effective treatment.%目的:探讨补片修补食管裂孔疝术的应用经验。方法回顾性分析2009年4月至2015年1月,新疆巴州人民医院收治的24例食管裂孔疝患者的临床资料,患者均行补片修补食管裂孔疝,其中Nissen胃底折叠术12例,Toupet胃底折叠术8例,Dor胃底折叠术4例。结果24例患者手术均顺利完成,手术时间60~200 min,平均120 min,失血量20~100 ml,术后平均住院6.1 d,术后2 d内进食,引流管在术后2 d内拔出。随访7~46个月,术后皮下纵隔气肿1例,其中4例行Nissen胃底折叠术,术后1年内有明显吞咽因难,1年后吞咽困难症状逐渐缓解。结论补片修补食管裂孔疝术具有安全可靠、手术时间短、创伤小、短期复发少、术后并发症少等优点。对于食管裂孔疝,补片修补食管裂孔疝术是一种安全、有效的治疗方法。

  4. 主动脉瓣及二尖瓣机械瓣联合置换术后瓣膜不匹配现象的临床研究%Study of valve prosthesis-patient mismatch in patients underwent combined mitral and aortic valve replacement with mechanical valve

    Institute of Scientific and Technical Information of China (English)

    王律; 白一帆; 刘小刚; 张锡武; 张米; 徐志云

    2013-01-01

    目的:探讨主动脉瓣及二尖瓣机械瓣联合置换术后人工心脏瓣膜-患者不匹配(VP-PM)现象的发生率及其与术前患者情况及预后的关系.方法:比较患者术后瓣膜有效开口面积指数(EOAi)与血流速度的关系.明确不同VP-PM状态患者一般情况及预后有无差异.结果:本研究共纳入729例患者,主动脉瓣中重度VP-PM发生率高于二尖瓣(20.94% vs 2.74%).双瓣均为重度VP-PM患者的身高、体重及体表面积均大于单瓣VP-PM或无VP-PM患者.双瓣均为中重度VP-PM组患者住院期间肾功能衰竭发生率、死亡率显著高于单瓣中重度VP-PM及无VP-PM患者.结论:(1)双瓣置换术后易出现主动脉瓣VP-PM;(2)双瓣均出现VP-PM患者体重及体表面积较大;(3)术后双瓣均为中重度VP-PM患者的死亡率及肾功能衰竭发生率高.%Objective To evaluate the incidence of valve prosthesis-patient mismatch (VP-PM) in patients underwent combined AVR and MVR,and explore the relationship between VP-PM and patient's baseline characteristic,hospital mortality and risk of acute renal dysfunction.Methods Evaluated the baseline in different patients according the degree of VP-PM,and analyzed the effect of VP-PM on hospital mortality and risk of acute renal dysfunction.Results A total of 729 patients were retrospectively evaluated.The number of patients with moderate to severe aortic VP-PM are more than that with mitral valve VP-PM (20.94% vs 2.74%).Patients with moderate to severe VP-PM in both aortic and mitral valve had more height,body weight and body surface area than that of others.Patients with severe VP-PM of both aortic and mitral valve had higher hospital mortality and more risk of acute renal dysfunction (18.2%) than that of the other patients.Conclusions (1) The incidence of aortic VP-PM is higher than that of mitral VP-PM in patients with combined AVR and MVR.(2) Except for body weight and body surface area,patients with combined aortic and

  5. Evaluation of “J”-shaped Uterine Incision during Caesarean Section in Patients with Placenta Previa:A Retrospective Study

    Institute of Scientific and Technical Information of China (English)

    邹丽; 钟少平; 赵茵; 朱剑文; 陈莉娟

    2010-01-01

    This study evaluated the efficacy and safety of "J"-shaped uterine incision for caesarean section for patients diagnosed with placenta previa.A total of 55 consecutive cases of placenta previa treated in Union Hospital were retrospectively analyzed over a period of two years and 10 months.The subjects were divided into two groups with respect to the uterine incision.Twenty-four pregnant women with placenta previa who were indicated for caesarean section underwent the procedure using a new "J"-shaped uterine...

  6. Relationship of abdominal compartment syndrome and multiple organs failure in patients underwent abdominal surgery%腹部手术患者并发腹腔间室综合征与多脏器功能衰竭的关系

    Institute of Scientific and Technical Information of China (English)

    王林; 李丰

    2011-01-01

    Objective To analyze the correlation between abdominal compartment syndrome and multiple organ failure in the patients underwent abdominal surgery. Methods Data of 344 patients underwent abdominal surgery were analyzed retrospectively,who were divided into 2 groups of A(66 cases,with abdominal compartment syndrome) and B(278 cases, without abdominal compartment syndrome). The correlation between abdominal compartment syndrome and multiple organ failure was analyzed. Results Of 66 patients in group A,40 cases were complicated with abdominal compartment syndrome with the incidence rate of 60.61% ,which was significantly higher than 23. 02%(64/278) in group B(P<0.01). The incidence of abdominal compartment syndrome was positively correlated with multiple organ failure (r=0.322, P<0.01). Conclusion The incidence of abdominal compartment syndrome is closely related with multiple organ failure in the patients underwent abdominal surgery.%目的 分析腹部手术患者并发腹腔间室综合征与多脏器功能衰竭的相关性.方法 回顾性分析344例腹部手术患者资料,其中,并发腹腔间室综合征66例(A组),无腹腔间室综合征278例(B组).比较两组患者并发多脏器功能衰竭的发生情况.结果 A组患者有40例发生多脏器功能衰竭,发生率为60.61%(40/66),明显高于B组的23.02%(64/278)(P<0.01).Spearman相关分析显示,腹部手术患者并发腹腔间室综合征与多脏器功能衰竭具正相关(r=0.322,P<0.01).结论 腹部手术患者并发腹腔间室综合征患者容易发生多脏器功能衰竭.

  7. The application of oral enteralnutrition support for senior abdominal aortic aneurysm patients who underwent endovascular aortic repair%口服肠内营养支持在局麻下高龄腹主动脉瘤腔内覆膜支架置入术后的应用

    Institute of Scientific and Technical Information of China (English)

    曾国军; 赵纪春; 马玉奎; 黄斌; 杨轶; 袁丁; 熊飞; 陈熹阳; 吴洲鹏

    2014-01-01

    Objective To investigate the clinical value of oral enteralnutrition support (ENSURE) for senior (> 60 years) abdominal aortic aneurysm (AAA) patients who underwent endovascular aortic repair (EVAR).Methods The data of 30 senior AAA patients who underwent EVAR was restrictively reviewed.The patients were divided into two groups:Group A =15,with postoperative ENSURE,50 g,tid; Group B =15,with postoperative common food.The postoperative data were compared between two groups,including the hospital stay,infection of operative incision rate,and nutritional state in the third and seventh day after operation.Results The postoperative hospital stay and infection rate had no significant difference between two groups.The plasma albumin in group A in the third day and the seventh day were higher (P < 0.05).Conclusions ENSURE improved the nutritional status of AAA patients who underwent EVAR,and shorten postoperative hospital stays.%目的 探讨口服肠内营养支持在局麻下高龄(>60岁)腹主动脉瘤(AAA)腔内覆膜支架置入术后的应用.方法 本院2010年1月至2011年10月经腔内覆膜支架置入术治疗的高龄腹主动脉瘤患者中选取30例,分为2组,每组15例,A组术后8h给予口服肠内营养支持(安素,50 g,3次/d),B组术后8h普食.对比术后切口感染率、血浆白蛋白、术后住院时间.结果 A组患者术后第3、7天白蛋白水平高于B组(P<0.05),两组感染率及术后住院时间比较差异无统计学意义(P>0.05).结论 口服肠内营养支持可促进局麻下经腔内覆膜支架置入术治疗的高龄腹主动脉瘤患者术后恢复,提高营养状态,有利于患者恢复.

  8. Clinical study on nosocomial multidrug-resistant acinetobacter baumanii infections in the patients underwent cardiac surgeries%心脏外科术后患者多药耐药鲍氏不动杆菌医院感染临床研究

    Institute of Scientific and Technical Information of China (English)

    周晔; 张健群; 杨毅; 邵涓涓; 贾明; 万久贺; 贾士杰

    2011-01-01

    OBJECTIVE To investigate the clinical distribution and antibiotics resistance and pronosis of nosocomial multidrug-resistant Acinetobacter baumanii (MDR-AB) infection in the patients underwent cardiac surgeries. METHODS The clinical data of the nosocomial A. baumanii infection patients underwent cardiac surgeries in our hospital between Jul 2007 and Jun 2010 were retrospectively analyzed. RESULTS There were 105 nosocomial A. baumanii infection cases in patients underwent cardiac surgeries and MDR-AB cases accounted for 65.7% (69 cases). Results of susceptibility test showed that cefoperazone/sulbactam (34. 8%) and minocycline (46. 4%) were the most active antibiotics for MDR-AB and MDR-AB presented highly resistant to other antibiotics including the carbapenems antibiotics with the resistant rates more than 70. 0%. There were no significantly different between the mortality between the nosocomial MDR-AB infection patients and the non-MDR A. baumanii cases. CONCLUSION A. baumannii is one of the most common pathogens in the patients underwent cardiac surgeries in our hospital. The prevalence of MDR-AB strains in cardiac surgical settings creates demand on rational selecting the antibiotics the and implementation of strict screening and contact precautions. Curing the primary disease and improving the patients'general status are also important to refine prognosis.%目的 调查医院心脏手术后多药耐药鲍氏不动杆菌(MDRAB)医院感染状况和耐药性及预后.方法 回顾性分析2007年7月-2010年6月医院心脏外科手术后医院感染鲍氏不动杆菌患者的临床资料.结果 共发生鲍氏不动杆菌医院感染105例,其中MDRAB医院感染69例,占65.7%;MDRAB对头孢哌酮/舒巴坦的耐药率为34.8%,米诺环素的耐药率为46.4%,其他包括碳青霉烯类抗菌药物,耐药率均>70.0%;而心外术后非多药耐药鲍氏不动杆菌医院感染患者和MDRAB医院感染患者院内死亡率统计学分析差

  9. Influence of family support and personality characteristics on quality of patients" life who underwent total laryngectomy%家庭支持与个性特征对全喉切除术后患者生存质量的影响

    Institute of Scientific and Technical Information of China (English)

    陆关珍; 沈旭慧; 沈玲珠; 杨丽

    2008-01-01

    目的 探讨家庭支持与个性特征对全喉切除术后患者生存质量的影响.方法 采用苏氏生活质量量表、胡氏家庭支持量表、龚氏个性特征测验问卷,对68例全喉切除术后患者进行问卷调查,并进行统计分析.结果 2组家庭支持与生存质量评分进行t检验,身体机能、心理状态均P<0.05;生活能力、社会关系、气管造口均P<0.01.个性特征与生存质量单因素分析,心理状态与4个维度有明显相关性.2组家庭支持与个性特征评分进行t检验,E内外向质P<0.05;P精神质、N神经质均P<0.01.结论 家庭支持与个性特征作为内外环境因素直接影响着全喉切除术后患者的生存质量,三开放四指导五干预的综合护理对策能全面提高其生存质量.%Objective To investigate the influence of family support and personality characteristics on quality of patients' life who underwent total laryngectomy. Methods Patients (68 eases)who underwent total laryngectomy were surveyed with Su life of quality scale,Hu family support scale, Gong personality test and the results were sent for statistical analysis. Results Scores of two family groups in family support and quality of life underwent t test, physical function and psychological state were statistically different (P<0.05), living ability,social relations, tracheal stoma were statistically different(P<0.01). Persona lity and quality of life were subjected to single-factor analysis, psychological states were obviously related with four dimensions.Family support and personality characteristics score of two family groups underwent t test, E(internal and external quality),P(spiritual quality),N(nerval quality)were statistically significant (P <0.01 ). Condusions Family support and personality characteristics as the internal and external environmental factors directly affected patients who underwent total laryngectomy. Three-openfour-guiding-five-integrated-care-intervention measures can overall

  10. 放松训练辅助聆听音乐对介入治疗的颅内动脉瘤患者睡眠质量影响的效果评价%Effect of relaxation training in combination with listening to music on sleep quality of patients with intracranial aneurysm who underwent endovascular interventional therapy

    Institute of Scientific and Technical Information of China (English)

    谢春雷; 李春霞; 李爱文; 黄维明; 钟丽丽

    2008-01-01

    Objective To improve the sleep quality of patients by evaluating the effect of relaxation training in combination with listening to music on sleep quality of patients with intracranial aneurysm who underwent endovascular interventional therapy. Methods 55 patients who reached the entrance standard were divided into the observation group (28 cases)and the control group(27 cases).The control group received routine nursing measures. The observation group were given relaxation training in combination with listening to music based on routine nursing measures. The sleep quality was appraised by Pittsburgh Sleep Quality Index (PSQI) and patients subjective feeling was investigated by self-designed questionnaires. Results The relaxation training in combination with listening to music ameliorated the sleep quality in the observation group compared with that of the control group(P<0.01).Conclusion The relaxation training in combination with listening to music could improved the sleep quality of patients with intracranial aneurysm who underwent endovascular interventional therapy.%目的 评价放松训练配合聆听音乐对颅内动脉瘤患者介入治疗前后睡眠质量的影响,以期提高患者的睡眠质量.方法 收集符合纳入标准的55例颅内动脉瘤患者,随机分为观察组28例和对照组27例,对照组患者按照颅内动脉瘤常规护理进行护理,观察组在常规护理的基础上让患者坚持放松训练配合聆听音乐,以匹兹堡睡眠质量指数作为评定工具评价2组患者睡眠质量情况,自制问卷评价患者主观感受.结果 放松训练配合聆听音乐改善了患者的睡眠质量,2组比较,差异有统计学意义(P<0.01).结论 放松训练配合聆听音乐可提高介入治疗的颅内动脉瘤患者睡眠质量.

  11. 不同喉环状软骨上部分切除术式术后误咽发生情况分析%Extent of post-operative deglutition disorder in patients underwent different modalities of supracricoid partial laryngectomy

    Institute of Scientific and Technical Information of China (English)

    林刃舆; 陈建福; 彭建华; 郭志强; 贾明辉

    2011-01-01

    Objective To compare the extent of deglutition disorder in patients with laryngeal carcinoma underwent different modalities of supracricoid partial laryngectomy.Methods Thirty eight patients with laryngeal carcinoma underwent supracricoid partial laryngectomy with cricohyoidoepiglottopexy (SCPL- CHEP) and 28 patients underwent supracricoid partial laryngectomy- cricohyoidopexy (SCPL-CHP) from 2005 to 2009.The extent of post- operative deglutition disorder in both groups was evaluated by Ridit analysis; and its relationship with age of patients was analyzed by Pearson correlation.Results There was significant difference in the extent of deglutition disorder between the two groups (U=25.685,P<0.01); the correlation coefficient was 0.932 (P<0.01) in SCPL- CHEP group and 0.850 (P<0.01) in SCPL- CHP group respectively.There was a positive correlation between age and extent of deglutition disorder.The occurrence of deglutition disorder was 2.6% (1/38)in SCPL- CHEP group and 25% (7/28)in SCPL- CHP group 8 weeks after operation (P <0.01).Conclusion SCPL- CHEP is a safe and effective operational modality for laryngeal carcinoma with less incidence of post- operational deglutition disorder.The extent of deglutition disorder in both groups increases with the age of patients, particularly for those aged over 70.%目的 探讨喉环状软骨上部分切除(SCPL)的不同术式对喉癌患者术后误咽发生及其程度的可能影响.方法 2005至2009年38例喉癌患者采用喉环状软骨上部分切除-环舌骨会厌吻合术(SCPL-CHEP),28例喉癌患者采用喉环状软骨上部分切除-环舌骨吻合术(SCPL-CHP),对两组患者术后误咽的发生率和程度进行评估与比较,并对误咽程度与年龄之间的关系进行分析.结果 两组患者术后误咽程度的差异有统计学意义(P<0.01),SCPL-CHP组患者误咽程度更为明显.术后误咽程度与年龄之间呈正相关关系(P<0.01),年龄是两组患者术后发生误咽

  12. "Doctor-nurse integration"management in the prevention of Deep Vein Thrombosis in patients underwent artificial total hip replacement%医护一体化管理降低人工髋关节置换术患者深静脉血栓发生率的实践

    Institute of Scientific and Technical Information of China (English)

    姜香云; 吴佳倩; 张亚珥; 冯志仙

    2014-01-01

    目的:探讨医护一体化管理降低人工髋关节置换术后深静脉血栓(DVT)发生率的成效。方法:成立医护一体化专项管理小组,制定医护一体化管理流程,分析人工髋关节置换术所致深静脉血栓发生原因并提出对策,医护人员共同参与培训学习,明确责任,共同监督、协作、反馈、持续改进。对比分析实施医护一体化管理前后人工髋关节置换术患者DV T的发生率。结果:实施前髋关节置换术患者DVT发生率为42.1%,经两轮持续质量改进,DVT发生率降低至17.3%,实施前后比较差异有统计学意义(P<0.01)。结论:医护一体化管理可降低人工髋关节置换术患者DVT的发生率,从而提升医疗护理质量。%Objective:To assess the efficacy of"doctor-nurse integration"management in the prevention of Deep Vein Thrombosis (DVT) in patients underwent total hip replacement (THA) surgery. Methods:A"doctor-nurse integration"team was established to investigate the incidence rate of DVT, the proper use of administration of anti-clotting drug, and the rate of intermittent pneumatic compression pump (IPCP) application in patients who underwent THA between January and March in 2013. The team analyzed possible causes of DVT to develop a standard process for the prevention of DVT after THA. The nurses and physicians were trained together to specify their own responsibilities, with substantial interactions, such as co-supervision, co-operation, and in time feedbacks. The pattern of"doctor-nurse integration"was carried out together with physical therapists. The incidence rate of DVT was measured before and after the application of"doctor-nurse integration"management for analysis. Results:After two-round improvements, the incidence rate of DVT in patients underwent THA decreased from 42.1%to 17.3%(P<0.01). Conclusion:The pattern of"doctor-nurse integration"could signiifcantly decrease the incidence of DVT in patients who had

  13. Facial lipohypertrophy in HIV-infected subjects who underwent autologous fat tissue transplantation.

    Science.gov (United States)

    Guaraldi, Giovanni; De Fazio, Domenico; Orlando, Gabriella; Murri, Rita; Wu, Albert; Guaraldi, Pietro; Esposito, Roberto

    2005-01-15

    Of 41 HIV-infected patients with facial lipoatrophy who underwent autologous fat transplantation, disfiguring facial lipohypertrophy at the graft site occurred at the same time as recurrent fat accumulation at the tissue harvest site in 4 patients who had had fat transferred from the dorsocervical fat pad or from subcutaneous abdominal tissue.

  14. Avaliação da qualidade de vida em pacientes submetidos à ressecção colorretal por via laparoscópica ou aberta em período pós-operatório inicial Evaluation of quality of life in patients underwent laparoscopic or open colorectal resection in the early postoperative period

    Directory of Open Access Journals (Sweden)

    Teon Augusto Noronha de Oliveira

    2010-03-01

    laparoscópica apresentaram melhor qualidade de vida ao final do primeiro mês de pós-operatório, quando comparados com os pacientes submetidos à cirurgia aberta.INTRODUCTION: Several studies, including meta-analysis, have demonstrated the safety, effectiveness and oncologic equivalence of laparoscopic resections when compared to open procedures leading minimally invasive colorectal surgery to be adopted in crescent number of services around the world. This study aims to evaluate the quality of life of patients underwent laparoscopic and open colorectal resections in the early postoperative period. METHODS: this is a prospective study which evaluated 42 patients underwent laparoscopic and open colorectal resection between May to November 2008 followed up until 60th postoperative day. Questionnaires of quality of life were applied in 3th, 7th and 30th postoperative days. Statistical analysis consisted of descriptive analysis of global healthy status scores, functional scores and symptoms of EORTC/QLQ 30. Shapiro-Wilk, Mann-Whitney e t de Student statistical tests were used to check the data, with level of significance in 0.05. RESULTS: Most of patients were females (57.1% with mean age of 61.5 years. It was observed significant difference of "global health status" score on the 30th postoperative between groups, with values of 75.0 and 58.3 for patients underwent laparoscopic and open procedures respectively (p = 0.005. There were no differences in terms of physical function and others as, accomplishment, emotional, cognitive and social functions. In relation to symptoms (fatigue, nausea, pain, dyspnea, insomnia, loss of appetite and constipation and financial difficulties, there were also no differences between groups. CONCLUSION: Our results have demonstrated that patients underwent laparoscopic colorectal resections have better quality of life at the end of first postoperative month when compared to patients underwent to open colorectal resections.

  15. Effects of Nursing Intervention on Quality of Life of Patient with Ureteral Stones Underwent Holmium: YAG Laser Ureteroscopic Lithotripsy%护理干预对输尿管镜钬激光碎石术患者生活质量的影响

    Institute of Scientific and Technical Information of China (English)

    钱彦; 瞿青云; 沈敏; 张涛; 吴宗林

    2012-01-01

    目的:探讨护理干预对输尿管镜钬激光碎石术患者生活质量的影响.方法:采取前瞻性随机对照的方法,从2008年5月到2010年12月,共有123例接受榆尿管镜钬激光碎石术的输尿管结石患者被随机分成对照组和护理干预组.使用世界卫生组织生存质量测定量表简表评价输尿管镜钬激光碎石术对患者生活质量的影响.结果:非护理干预组和护理干预组的世界卫生组织生存质量测定量表简表的生活质量评分手术后比手术前有明显改善(P<0.05).输尿管镜钬激光碎石术后,护理干预组患者的生活质量优于非护理干预组.结论:护理干预能明显改善输尿管镜钬激光碎石术患者的生活质量.%Objective: To investigate the effects of nursing intervention on quality of life of patient with ureteral stones underwent holmium: YAG laser ureteroscopic lithotripsy. Methods: From May in 2008 to December in 2010, a total of 123 consecutive patients admitted from a waiting list for surgery for ureteral stones were prospectively randomized to either nursing intervention or non-nursing intervention. Pre-and postoperative WHOQOL-BREF outcome data were obtained. Results; The WHOQOL-BREF in non-nursing intervention and nursing intervention group had significantly improved at post-operation compared to pre-operation. There was significant difference on WHOQOL-BREF scores in two groups at post-operation. Conclusions: Nursing intervention can improve the quality of life of patients with ureteral stones underwent holmium: YAG laser ureteroscopic lithotripsy. Improving the nursing after the procedure makes good prognosis.

  16. Factors Analysis of Fatigue Syndrome of Patients with Primary Gastric Cancer Underwent Radi-cal Surgiery%原发性胃癌外科根治术患者术后疲劳综合征的影响因素分析

    Institute of Scientific and Technical Information of China (English)

    周良弼; 吴定泉; 朱长康; 赵永亮

    2015-01-01

    [Objective]To study the risk and protective factors of POFS of patients with primary gastric cancer underwent radical surgiery.[Methods]60 cases of primary gastric cancer patients underwent radical treatment were selected in our hospital from August 2012 to August 2014.The visual analogue scale (VAS) fatigue and Pittsburgh sleep quality index (PSQI)on the patients were used for postoperative observation to study the effect of patients POFS influenced by the factors like sex,tumor stage,operation method and nutri-tion conditions.[Results]Those related to male,later tumor staging and older age get higher scores in VAS、PSQI,while their postoperative recovery index tended to be lower,the difference had statistical significance (P <0.05).The POFS symptoms of patients with laparoscopic gastric cancer radical therapy are lighter than those underwnt open operation.The POFS symptoms of patients in the SE group is lighter than patients in the EN group,the difference had statistical significance (P <0.05).[Conclusion]Female,early cancer stage,lap-aroscopic surgery,nutrition intervention and younger age compose the protective factors,while male,later tumor stage,open operation and senior age make the risk factors .%【目的】探讨原发性胃癌外科根治手术患者术后疲劳综合征(POFS)的影响因素。【方法】选取2012年8月至2014年8月在本院接受外科手术根治手术治疗的原发性胃癌患者60例。应用视觉模拟疲劳尺(VAS)和匹兹堡睡眠质量指数(PSQI)等指标对患者进行术后评估,并分析性别、年龄、肿瘤分期、手术方式、营养方式等对患者 POFS 的影响。【结果】男性患者、肿瘤分期越晚、年龄越大的患者其 VAS、PSQI 得分越高,术后康复指标越差,差异具有统计学意义(P <0.05)。腹腔镜胃癌根治术患者的 POFS 症状比开腹手术患者的症状轻,SE 组患者比 EN 组患者的 POFS 症状轻,差异具有统计学意义(P <0.05)。【结论】女性、

  17. Perioperative Period Treatments for Patients Underwent One-stage Coronary Artery bypass Grafting and Artificial Heart Valve Repair or Replacement%冠心病合并心脏瓣膜疾病同期手术治疗的围手术期处理要点

    Institute of Scientific and Technical Information of China (English)

    黎昱江; 刘学刚

    2013-01-01

    目的:探讨同期行冠脉旁路移植术和瓣膜置换或瓣膜成形术的围手术期的处理要点和注意事项,以期降低该类手术围手术期的死亡率.方法:通过Pubmed、万方数据库、中国知网等检索近几年国内外关于同期行冠脉旁路移植术和瓣膜置换或瓣膜成形术研究的相关文献,总结其围手术期的处理要点和注意事项.结果:同期行冠脉旁路移植术和瓣膜置换或瓣膜成形术,术前应注意患者各脏器功能情况,积极处理合并症;严格掌握手术适应证,制定合理的手术方式、手术流程;术中需掌握各种手术技巧,注意加强心肌保护;术后积极处理各种并发症.结论:同期行冠脉旁路移植术和瓣膜置换或瓣膜成形术,重视并掌握围手术期的处理要点和注意事项,在提高该类手术病人的生存率上起关键作用,能有效提高病人术后生存质量、降低其死亡率.%Objective:To investigate the perioperative period treatments for patients underwent one-stage coronary artery bypass grafting and artificial heart valve repair or replacement in order to reduce the surgical perioperative morbidity and mortality.Methods:To search the related literature in the database of PubMed,Wanfang Data and CNKI in recent years,to sum up the appropriate perioperative treatments.Results:In the perioperative period treatments for patients underwent one-stage coronary artery bypass grafting and artificial heart valve repair or replacement,it has many critical factors,including organs' condition before operation,correct assessment for operative indications,rational operative plan,operative skills,myocardial preservation in operation and prophylaxis and treatment for operation complications.Conclusions:The operation effect of patients underwent one-stage coronary artery bypass grafting and artificial heart valve repair or replacement will be increased remarkably if we pay attention to above-mentioned perioperative period

  18. Observational Study on the Effect of Evidence-based Nursing for Patients with HBP and DM Underwent Electro-prostatectomy During the Periopera-tive Period%循证护理在合并HBP、DM患者前列腺电切围手术期护理效果的观察研究

    Institute of Scientific and Technical Information of China (English)

    陈惠洪; 詹陈菊; 林立姮; 林争艳; 郑燕华

    2015-01-01

    Objective To study the effect of evidence-based nursing for patients with high blood pressure(HBP) and diabetes melli-tus(DM) underwent electro-prostatectomy during the perioperative period. Methods 60 cases with HBP and DM underwent elec-tro-prostatectomy in our hospital from March 2012 to March 2014 were selected and randomly divided into the control group and the observation group with 30 cases in each. The control group was treated by the traditional nursing mode, while the observation group was treated by the evidence-based nursing mode. The patient satisfaction, length of stay, recovery of spontaneous urination time, total cost of hospitalization, incidence of complications, quality of life (QOL) scores before and after nursing, International Prostate Symptom Score (IPSS) and control of HBP and DM were compared between the two groups. Results The study found the difference in the incidence of complications was not statistically significant between two groups, P>0.05. After intervention, com-pared with the control group, the observation group had shorter length of stay, P0.05. Conclusion For patients with HBP and DM underwent electro-prostatectomy, evidence-based nursing has bet-ter effect, which can significantly control the HBP and DM, improve the quality of life, so it is worthy of wide application.%目的:探讨循证护理在合并高血压(High Blood Pressure, HBP)、糖尿病(Diabetes Mellitus, DM)患者前列腺电切围手术期的护理效果。方法随机选取2012年3月-2014年3月该院经行前列腺电切术治疗且合并有HBP、DM的患者60例,将其随机分成对照组及观察组各30例,分别采用传统护理模式及循证护理模式经行护理,后将两组患者的满意率、住院时间、恢复自主排尿时间、住院总费用、并发症发生率以及护理前后生活质量评分(QOL)及前列腺症状评分(IPSS)和HBP、DM的控制情况进行比较。结果研究发现虽然两组并发症发生

  19. 糖尿病肾病与慢性肾小球肾炎血液透析患者血钙、磷及甲状旁腺激素水平比较%Comparison of calcium, phosphorus, and PTH levels in patients with diabetic nephropathy and chronic glomerulo-nephritis underwent hemodialysis

    Institute of Scientific and Technical Information of China (English)

    潘锐

    2015-01-01

    目的:评估并分析糖尿病肾病及慢性肾小球肾炎血液透析患者血钙、血磷及甲状旁腺激素水平。方法选择2012年2月至2014年6月于洛阳市第一中医院进行血液透析治疗的患者90例,其中糖尿病肾病患者39例,慢性肾小球肾炎患者51例,分别观察分析其血钙、血磷、甲状旁腺素水平及甲状旁腺素达标率。结果糖尿病肾病患者与慢性肾小球肾炎患者血钙水平比较差异未见统计学意义(P >0.05);糖尿病患者血磷水平低于慢性肾小球肾炎患者,甲状旁腺激素水平低于慢性肾小球肾炎,甲状旁腺素水平达标率高于慢性肾小球肾炎,差异均有统计学意义(P 0. 05); The serum phosphorus and PTH levels in patients with diabetes were lower than those of patients with chronic glomerulonephritis (P < 0. 05), and the PTH standard-reaching rate was higher in patients with diabetic nephropathy, all of the differences were significant (P < 0. 05). Conclusions The serum phosphor-us and PTH levels are lower and PTH standard-reaching rate is higher in patients with diabetic nephropathy than that of pa-tients with chronic glomerulonephritis, and therefore individualized treatment should be adopted according to different cau-ses to patients underwent hemodialysis, and closely monitoring their electrolytes and related hormone levels.

  20. Resultado funcional e índice macular em portadores de buraco macular submetidos à cirurgia com remoção da membrana limitante interna Functional outcome and macular index in macular hole patients who underwent surgery with internal limiting membrane removal

    Directory of Open Access Journals (Sweden)

    José Ricardo Diniz

    2008-04-01

    Full Text Available OBJETIVOS: Avaliar o resultado funcional e o índice macular dos portadores de buraco macular submetidos à cirurgia com remoção da membrana limitante interna. MÉTODOS: Quinze olhos de 15 pacientes com buraco macular estágios 2, 3 e 4 foram incluídos no estudo. Todos foram submetidos à cirurgia de buraco macular convencional com remoção da membrana limitante interna corada pelo azul de tripan. Melhor acuidade visual com correção e cortes transversais medidos por tomografia de coerência óptica (OCT foram avaliados no pré- e pós-operatório. O índice macular (razão entre a altura e base do buraco macular foi calculado e correlacionado com o diâmetro mínimo do buraco macular e o ganho de acuidade visual pós-operatória. RESULTADOS: Obteve-se fechamento do buraco macular em todos pacientes operados. Em 86,7%, houve ganho de pelo menos três linhas de visão. O índice macular demonstrou correlação negativa significante com o diâmetro mínimo (r=0,811. Não foi observada correlação significante entre o índice macular e o ganho de acuidade visual pós-operatória (r=0,351. CONCLUSÃO: Os resultados funcionais na cirurgia do buraco macular com remoção da membrana limitante interna foram bons neste grupo de pacientes. O índice macular demonstrou ser compatível com a configuração espacial do buraco macular, porém não foi preditor de resultados visuais.PURPOSE: To evaluate the functional outcome and macular index in patients with macular hole who underwent surgery with internal limiting membrane removal. METHODS: Fifteen eyes of 15 patients with idiopathic macular hole stages 2, 3 or 4 were enrolled in this study. All patients underwent conventional macular hole surgery with trypan blue staining to remove the internal limiting membrane. The best-corrected visual acuity and cross-sectional images of macular hole measured by optical coherence tomography (OCT were evaluated pre- and postoperatively. The macular hole index

  1. Análise da evolução tardia de 291 pacientes submetidos a substituição valvar por próteses metálicas Late follow-up of 291 patients who underwent heart valve replacement with mechanical valves

    Directory of Open Access Journals (Sweden)

    Carlos M. A Brandão

    1995-03-01

    Full Text Available No período de janeiro de 1980 a dezembro de 1993, 291 pacientes foram submetidos a substituição valvar por próteses metálicas, no Instituto do Coração do HCFMUSP. Cento e oitenta e sete (64,3% pacientes eram do sexo masculino, com idade variando de 2 meses a 78 anos (média de 38,3 +/-18,5. A etiologia das lesões foi reumática em 132 (45,4% pacientes. Foram realizadas 201 substituições da valva aórtica, 77 da valva mitral, 15 duplas substituições mitro-aórticas, 2 substituições da valva tricúspide, 1 dupla substituição mitro-tricuspídea e 1 tríplice substituição mitro-aórtico-tricuspídea, totalizando 315 substituições valvares. Cirurgias associadas foram realizadas em 164 (56,4% pacientes, sendo a mais freqüente a correção de aneurisma de aorta ascendente em 49 (16,8% pacientes Cento e quarenta e um (48,4% pacientes foram submetidos anteriormente a cirurgias valvares. Os pacientes foram avaliados clinicamente no pós-operatório tardio, segundo a classe funcional (NYHA e o aparecimento de complicações relacionadas às próteses e à anticoagulação. A mortalidade imediata foi de 36 (12,4% pacientes. Foram estudados 159 pacientes no pós-operatório tardio, com um tempo médio de evolução de 40,6 meses (10078 meses/paciente. As taxas linearizadas para tromboembolismo, hemorragia relacionada à anticoagulação, óbito tardio, endocardite, escape paravalvar e hemólise no pós-operatório tardio foram, respectivamente, 1,33%, 0,95%, 1,9%, 0,19%, 0,57% e 0,57% pacientes/ano. A curva actuarial de sobrevida em 14 anos é de 63,8%. Oitenta e dois porcento dos pacientes encontram-se em classe funcional I no pós-operatório tardio. Podemos concluir que os nossos resultados foram bastante satisfatórios com a utilização de próteses metálicas.Between January 1980 and December 1993, 291 patients underwent valve replacement with mechanical valves in the Heart Institute of HCFMUSP. One hundred and eighty seven (64

  2. 前列腺穿刺活检患者血清高敏C反应蛋白与Gleason评分的相关性%Relationship of serum high sensitive C-reactive protein and Gleason score in patients underwent prostate biopsy

    Institute of Scientific and Technical Information of China (English)

    莫晓东; 李纲; 孙军; 张学锋; 唐敬; 浦金贤; 侯建全; 温端改

    2013-01-01

    目的 探讨前列腺癌(PCa)和前列腺增生(BPH)患者血清高敏C反应蛋白(hs-CRP)与Gleason评分的关系.方法 分析261例经直肠前列腺穿刺活检患者病理诊断为PCa和BPH患者血清hs-CRP的差异,比较PCa患者hs-CRP增高和正常者高危性(Gleason评分≥7分)PCa患病率,运用Logistic回归分析hs-CRP、前列腺特异性抗原(tPSA)、前列腺特异性抗原密度(PSAD)、前列腺总体积(TPV)和年龄等因素对高危性PCa患病率的影响.结果 PCa患者血清hs-CRP的中位数为3.57 mg/L,明显高于BPH患者的1.20 mg/L(P<0.05).在高危性PCa中hs-CRP为5.05mg/L,明显高于低危性PCa中的0.75 mg/L(P<0.05).PCa患者hs-CRP>3 mg/L组高危性PCa患病率为94.23% (49/52),明显高于hs-CRP≤3 mg/L组高危性PCa患病率59.45% (22/37)(P<0.05).hs-CRP影响高危性PCa患病率的优势比(OR)为1.618(P<0.05).结论 hs-CRP升高明显增加前列腺穿刺活检患者高危性PCa检出率;hs-CRP是影响高危性PCa患病率的独立因素.%Objective To investigate the correlation between serum high sensitive C-reactive protein(hs-CRP) and Gleason score of prostate cancer (PCa) in patients undewent prostate biopsy. Methods A total of 261 consecutive patients underwent prostate biopsy. The difference of serum hs-CRP between the patients with pathologically diagnosed prostate cancer(PCa) and those with benign prostate hyperplasia (BPH) were analyzed. In the patients with PCa, the morbidity of PCa was compared between the patients with high hs-CRP and those with normal hs-CRP but Gleason score≥ 7. The effects of factors such as hs-CRP, tPSA, prostate volume and age on the morbidity of PCa were analyzed. Results The mean serum hs-CRP was higher in PCa patients than that in BPH cases(3. 57 mg/L vs. 1. 20 mg/L)(P3 mg/L, which was higher than 59. 45% in those with nomal hs-CRP(≤3 mg/L)(P<0. 05). The odds ratio of hs-CRP in diagnosing Gleason score≥7 was 1. 618(P<0. 05). Conclusions An elevated serum

  3. Epidural anesthesia combined with remifentanil and propofol intravenous injection in 15 patients underwent Da Vinci robotic radical resection of esophageal cancer%硬膜外阻滞复合全身静脉麻醉应用于15例达芬奇手术机器人食管癌根治术的麻醉体会

    Institute of Scientific and Technical Information of China (English)

    陈浩飞; 李伟彦

    2012-01-01

    Objective: To summarize the epidural anesthesia combined with remifentanil and propofol intravenous injection, in the Da Vinci surgical robot assisted radical resection of esophageal cancer. Methods : Fifteen patients underwent selective robotic radical resection of esophageal cancer. All the patients were generally anesthetized using epidural anesthesia combined with remifentanil and propofol intravenous injection. The patients were intubated with double lumen endobronchial tube after anesthesia induction following epidural puncture, and underwent one-lung ventilation during intrathoracic operation. The blood gas, respiratory and hemodynamics parameters were monitored throughout the whole procedure. Results : All the 15 patients passed through the robotic surgery, and there was no conversion of thoracotomy occurred. The mean PaO2 and PaCO2 after anesthesia induction were (202.4±55.3) mmHg and (37.8±4.1) mmHg, and the mean PaO2 and PaCO2 30 minutes after one lung ventilation were (113.2±33.3) mmHg and (44.4±3.1) mmHg respectively. The anesthesia, operative and carbon dioxide pneumothorax duration were (245.4±40.7) min, (228.3±41.1) min and (210.3±33.1) min respectively. All the patients had (28.1±7.7) mmHg of blood pressure drop when the thorax was inflated with carbon dioxide, which was rectified by fast colloid injection and vasoactive agents. The patient-controlled epidural analgesia was applied and the patients were then transferred to PACU with single lumen intubation. Conclusion: Except that fast-track anesthesia can maintain adequately deep anesthesia and stable hemodynamics, and thus lessen surgical related stress and palliate postoperative pain, fast-track anesthesia can accelerate postoperative consciousness and muscular tension recovery, which may facilitate early extubation. As an important component of fast tract surgery, fast-track anesthesia is safe and reliable during the procedure the robotic surgery.%目的:总结硬膜外阻滞复合全

  4. 前列腺素E1降低心脏瓣膜置换术患者心肌细胞NF-κB活性及血浆TNF-α水平%Effects of prostaglandin E1 on the levels of myocardium NF-κB and plasma TNF-α in patients underwent heart valve replacement

    Institute of Scientific and Technical Information of China (English)

    张文斌; 朱成均; 石泉; 赵振海

    2015-01-01

    目的:评价前列腺素E1(PGE1)对心脏瓣膜置换术患者心肌细胞核转录因子κB(NF‐κB)活性和血浆肿瘤坏死因子α(T N F‐α)水平的影响。方法择期行体外循环下心脏瓣膜置换术的患者40例,年龄32~67岁,体质量指数17~28 kg/m2,美国麻醉师协会(ASA)分级Ⅱ或Ⅲ级,纽约心脏病协会(NYHA)分级Ⅱ或Ⅲ级。采用随机数字表法,将患者分为2组(n=20):对照组(C组)和PGE1组(P组)。麻醉诱导后P组静脉输注PGE120 ng · kg -1· min-1,至手术结束,C组给予等容量生理盐水。于体外循环前(T0,基础值)、体外循环开始后30 min(T1)、体外循环结束时(T2)、体外循环结束后12 h(T3)、体外循环结束后24 h(T4)抽取动脉血,检测血浆TNF‐α水平;于T0和T2时取右心耳组织,观察组织病理学变化,并用蛋白免疫印迹法(Western blot)检测NF‐κB活性。结果与C组比较,P组T1~T4时血浆 TNF‐α水平下降(P<0.05),T2时心肌病理学损伤明显减轻,心肌细胞NF‐κB活性下降(P<0.05)。结论 PGE1可减轻心脏瓣膜置换术患者心肌损伤,其机制与抑制心肌细胞NF‐κB活性,减少血浆TNF‐α水平有关。%Objective To investigate the effects of prostaglandin E1 (PGE1) on the levels of myocardium nuclear factor‐κB (NF‐κB) and plasma tumor necrosis factor‐α (TNF‐α) in patients underwent heart valve replacement .Methods Forty ASA Ⅱ orⅢ degree patients (NYHA Ⅱ or Ⅲ degree) ,aged 32 to 67 years with body mass index of 17 to 28 kg/m2 ,underwent heart valve replacement ,were randomly divided into 2 groups (n=20):control group (group C) and PGE1 group (group P) .After induction of anesthesia ,PGE1 20 ng · kg -1 · min-1 was infused intravenously in group P ,while the equivalent volume of normal saline was giv‐en in group C ,and the infusion was completed at the end of

  5. Preoperative embolization of the splenic artery in patients that underwent splenectomy for immune thrombocytopenic purpura Embolização pré-operatória da artéria esplênica em pacientes submetidos à esplenectomia por púrpura trombocitopênica immune

    Directory of Open Access Journals (Sweden)

    PlínioCarlos Baú

    2007-12-01

    Full Text Available Transfusion of platelets, red blood cells, or both is usually necessary immediately after splenic artery ligature in patients with immune thrombocytopenic purpura who undergo splenectomy. PURPOSE: To investigate whether preoperative embolization of the splenic artery reduced the need for transfusion of platelets, red blood cells, or both. METHODS: Twenty- seven consecutive patients that underwent splenectomy for purpura between October 1999 and March 2006 performed by the same surgical team were enrolled. The first 17 patients did not undergo embolization and were compared with the next 10 patients, who composed the embolization group. RESULTS: The platelet count in the embolization group rose from a mean 7000 u/µl before to 75000 u/µl after the procedure. There was no need for platelet or red blood cell transfusion in the embolization group; in the group without preoperative embolization, 11 patients (p=0.001 required platelet transfusion and 8 (p=0.01, red blood cell transfusion. CONCLUSION: Embolization of the splenic artery before splenectomy is a safe method to avoid blood transfusions in patients with ITP.A transfusão de plaquetas e ou hemácias geralmente é realizada em pacientes submetidos a esplenectomia por Purpura Trombocitopênia Imune (PTI. OBJETIVO: Investigar se a embolização pré-operatória da artéria esplênica é eficaz na redução da necessidade de transfusão de hemácias ou plaquetas. MÉTODOS: Vinte e sete pacientes foram submetidos a esplenectomia por PTI de Outubro de 1999 a Março de 2006 pela mesma equipe cirúrgica. Os primeiros 17 pacientes não foram submetidos a embolização e foram comparados com os outros 10 individuos nos quais a embolização foi realizada. RESULTADOS: A contagem de plaquetas no grupo em que a embolização foi realizada subiu de uma média de 7000u/µl antes do procedimento, para 75000 u/µl após. Não foi necessário transfundir plaquetas ou glóbulos vermelhos no grupo submetido a

  6. Effect of Glutaimne on Immunologic Function and Gastrointestinal Reactions in Advanced Gastric Cancer Patients Underwent Chemotherapy%谷氨酰胺对晚期胃癌患者化疗期间免疫功能及胃肠道反应的影响

    Institute of Scientific and Technical Information of China (English)

    王晓青; 王大中

    2014-01-01

    目的:观察添加谷氨酰胺对晚期胃癌患者化疗期间免疫功能的影响及胃肠道不良反应的预防效果。方法选取51例晚期胃癌患者为研究对象,按照随机数字法分为观察组( n=25)和对照组( n=26)。2组患者均接受奥沙利铂+卡培他滨( XELOX)方案化疗,并给予肠外营养。观察组在肠外营养中添加谷氨酰胺。比较2组患者临床疗效,化疗期间免疫功能的变化、化疗计划完成率及不良反应发生率。结果计划化疗周期完成率对照组为76.9%(20/26);观察组为96.0%(24/25),2组差异有统计学意义(P<0.05)。观察组CR、PR稍高于对照组,但无明显差异(P>0.05)。2组患者肠外营养前 IgG、IgM、IgA 无显著差异,营养7 d后,观察组IgG、IgM、IgA 高于对照组,具有统计学意义( P<0.05)。观察组Ⅲ、Ⅳ级口腔黏膜炎、恶心呕吐、腹痛腹泻发生率显著低于对照组(P<0.05)。结论胃癌晚期患者化疗期间在肠外营养中添加谷氨酰胺,可降低胃肠道反应、改善免疫功能,提高化疗完成率。%Objective To observe the effect of Glutaimne ( Gln) on immunologic function and gastrointestinal reactions in advanced gastric cancer patients underwent chemotherapy .Methods 51 patients with locally advanced gastric cancer were se-lected and divided into the observation group (n=25) and the control group (n=26)randomly.All patients received XELOX chemotherapy .The control group received routine parenteral nutrition and the observation group received parenteral nutrition sup -plemented with Gln .The short-term efficacy ,life quality and side effects were observed during treatment .Results Chemotherapy completion rates of the observation group and the control group were 96.0%and 76.9%,respectively,and the difference had sta-tistical significance(P0.05).The level of IgG,IgM,IgA in the observation group were higher than those

  7. ClassicTM喉罩用于老年患者腰-硬联合阻滞术中镇静的临床研究%CLINICAL RESEARCH ON THE APPLICATION OF LARYNGEAL MASK IN ELDERLY PATIENTS UNDERWENT EPIDURAL-SPINAL ANESTHESIA FOR INTRAOPERATIVE SEDATION

    Institute of Scientific and Technical Information of China (English)

    黄泽波; 罗文报

    2011-01-01

    [目的]评估ClassicTM喉罩(LMA)用于老年患者腰-硬联合阻滞未中镇静的临床效果与可行性.[方法]选择在腰-硬联合阻滞下行下腹部或下肢手术的老年患者40例,年龄60~80岁,其中男22例,女18例,随机分为2组.两组患者蛛网膜下腔均给以0.5%布比卡因重比重混合液2.5 ml.首次静脉注射丙泊酚l mg,kg-1后以10 μg·kg-1,min-1速度持续泵注镇静.面罩组(M组)使用密闭面罩吸氧;喉罩组(LMA组)使用ClassicTM LMA连接麻醉机开放模式吸氧.监测并记录两组患者未前、术中呼吸,循环及动脉血气情况.[结果]LMA组术中SpO2均值为(99.3±1.1)%,出现SpO2< 95%共计2例,面M组相应分别为(97.7±1.6)%,13例,差异有统计学意义(P<0.05).LMA组辅助通气次数以及术中舌后坠例数与M组差异有统计学意义(P<0.05).术中lMA组的pH,PO2,PC02与M组差异有统计学意义(P<0.05).[结论]ClassicTM喉罩用于老年患者腰-硬联合阻滞下术中镇静,利于保持呼吸循环平稳,且安全可行.%[Objective] To evaluate the effect of laryngeal mask in elderly patients underwent epidural-spinal anesthesia for intraoperative sedation. [Methods] 40 ASA II-III patients undergoing selected bythus or lower extremity surgery were divided into 2 groups randomly. After the infusion of 0.5% bupivacaine mixture of heavy specific gravity of 2.5 ml were injected into subarachnoid space. Patients of group facemask (Group M,) inspired oxygen 3L·min-1) through facemasks of anaesthesia apparatuses, after propofol lmg·kg-1 were injected and assisted ventilati·n for 1 min, continuous infusion rate of propofol was l0μg·kg-1·min-1. Patients in group Laryngeal Mask Airway (Croup LMA,) were inserted Classic LMA in digital technique after propofol lmg·kg-1 were injected, and inspired oxygen (3L·mkr-1) through LMA that connected anaesthesia apparatuses. Group LMA were assisted ventilation for 1 min, and continuous infusion rate of

  8. Twenty-Four Tuba Harmonics Using a Single Pipe Length

    Science.gov (United States)

    Holmes, Bud; Ruiz, Michael J.

    2017-01-01

    Harmonics arise naturally from the resonances in strings and pipes. A video demonstration (Ruiz 2016 "YouTube: Tuba Harmonics" (https://youtu.be/souhEzOP9c4)) is provided where a tubist (coauthor Holmes) produces a phenomenal 24 harmonics using a single tuba pipe length by controlling the buzz of his lips. The frequencies of the…

  9. Twenty-four tuba harmonics using a single pipe length

    Science.gov (United States)

    Holmes, Bud; Ruiz, Michael J.

    2017-03-01

    Harmonics arise naturally from the resonances in strings and pipes. A video demonstration (Ruiz 2016 YouTube: Tuba Harmonics (https://youtu.be/souhEzOP9c4)) is provided where a tubist (coauthor Holmes) produces a phenomenal 24 harmonics using a single tuba pipe length by controlling the buzz of his lips. The frequencies of the harmonics, measured with the free software program Audacity, fall excellently on a linear fit using a spreadsheet. The skillful musical production of so many harmonics with a fixed pipe length is an extraordinary illustration of physics.

  10. Twenty four Hours Circadian Cortisol Profile in Shift Work Nurses

    Directory of Open Access Journals (Sweden)

    H Kakooei

    2009-04-01

    Full Text Available ABSTRACT: Introduction & Objective: It is well established that adrenal hormone cortisol has long been used in human psychobiological studies as a biological marker of circadian rhythm, stress, and anxiety. There is little information, however, about the interrelationships of night work, plasma cortisol levels in females’ nurses of the developing countries. The aim of the present study was to compare circadian cortisol profile between two groups of nurses with shift and permanent work in a Hospital affiliated to Shiraz University of Medical Sciences, Iran, between January 2006 to September 2008. Materials & Methods: In this experimental study, we examined the reproducibility of plasma cortisol levels during one month period in 34 shift work nurses and 10 permanent day shift works. We evaluated potential associations between night work and hormone levels, using current and shift work information for the health care shift workers. Results: The results clearly revealed that shift work significantly increased nighttime cortisol levels (34.93 μg/dl during night shift and decreased the peak levels of cortisol in the morning (39.03 μg/dl. During the work shift the plasma cortisol presented a decreased concentration in the morning and increasing levels (44.93 μg/dl by the end of the evening. In contrast , the permanent day work nurses, who had never worked at night shifts, showed a lowest secretion of cortisol during the first half of night time sleep (10.02 μg/dl , and a peak value of the cortisol after awakening at 07:00 h ( 59.75 μg/ml. We also observed a significant association between night work and increased levels of cortisol over the remaining of the day. Conclusion: It can be concluded that nurses with night shift work have an abnormal cortisol secretion profile. Shift work nurses on rotating night shifts seem to experience changes in hormones levels that may be associated with increased of circadian disorders risk observed among night – shift workers.

  11. Efecto de la localización del electrodo ventricular derecho (tracto de salida vs. ápex sobre la sincronía ventricular mecánica, en pacientes sometidos a terapia de implante de marcapaso cardiaco Effect of right ventricular electrode location (outflow tract vs. apex on mechanical ventricular synchrony in patients that underwent pacemaker implant therapy

    Directory of Open Access Journals (Sweden)

    Oscar S Rincón

    2008-12-01

    Full Text Available Objetivo: evaluar a profundidad el efecto de la estimulación ventricular desde el tracto de salida del ventrículo derecho y el ápex, sobre la sincronía ventricular mecánica. Materiales y métodos: estudio analítico de cohorte, en el que se realizó ecocardiograma transtorácico pre y post implante de marcapaso a 20 pacientes (diez por cada grupo con indicación de marcapaso definitivo, con implante del electrodo en el tracto de salida del ventrículo derecho y el ápex, sin cardiopatía estructural, fracción de eyección > 50%; QRS y conducción aurículo-ventricular normal, con el fin de evaluar la asincronía ventricular mecánica (modo M y Doppler tisular y los parámetros de implante y programación del dispositivo. Análisis estadístico: los resultados se presentan como promedios, desviación estándar o porcentajes. Las variables continuas se compararon utilizando prueba Chi cuadrado y ANOVA. Se consideró como estadísticamente significativa una p Objective: to assess in depth the effect of ventricular stimulation from the right ventricular outflow tract and the apex on mechanical ventricular synchrony. Materials and Methods: cohort analytical study. 20 patients with indication of definitive pacemaker indication underwent transthoracic echocardiogram before and after pacemaker implant with electrode implantation in the right ventricular outflow tract and in the apex (10 patients in each group. There was no structural cardiopathy, ejection fraction was > 50%, QRS and AV conduction were normal. Mechanical ventricular asynchrony (M mode and tissue doppler and implant and device parameters were evaluated. Statistical Analysis: results are given as mean values, standard deviation or percentages. Continuous variables were compared using Chi-square test and ANOVA. A p <0.05 value was considered statistically significant. Results: in five patients (25% a pre-implant ventricular asynchrony was found; in seven (70% ventricular asynchrony

  12. 慢性阻塞性肺疾病急性加重期伴呼衰患者有创机械通气撤机拔管的影响因素%Influence Factors of Withdraw Machine and Extubation in AECOPD and Serious Respiratory Failure Patients Who Underwent Invasive Mechanical Ventilation

    Institute of Scientific and Technical Information of China (English)

    陈红菊

    2016-01-01

    目的:探讨慢性阻塞性肺疾病急性加重期(AECOPD)伴重度呼吸衰竭(呼衰)患者有创机械通气成功撤机拔管的影响因素。方法:回顾性分析2013年1月-2015年6月本院ICU收治的100例接受有创机械通气的AECOPD伴重度呼吸衰竭患者的临床资料,其中成功撤机拔管患者作为有效组,撤机拔管失败和死亡患者作为无效组。对成功撤机拔管影响因素进行单因素分析,采用多因素Logistic回归分析进行独立影响因素分析。结果:单因素分析结果显示:有效组年龄,插管前血红蛋白,插管后血浆白细胞计数、中性粒细胞比率、血红蛋白、白蛋白、C反应蛋白水平,通气时间及器官功能障碍综合征方面均优于无效组,比较差异均有统计学意义(P<0.05);多因素Logistic回归分析结果显示:年龄、插管前HGB、插管后中性粒细胞比率及白蛋白水平、多脏器功能衰竭、机械通气时间为成功撤机拔管的独立影响因素(P<0.05)。结论:机械通气是AECOPD伴严重呼衰的有效救治措施,成功撤机拔管的影响因素较多,积极干预影响因素对提高撤机拔管率具有重要临床意义。%Objective:To investigate the influence factors of successful withdraw machine and extubation in acute exacerbation of chronic obstructive pulmonary disease(AECOPD) and serious respiratory failure patients who underwent invasive mechanical ventilation.Method:The clinical data of 100 cases of AECOPD and serious respiratory failure patients who underwent invasive mechanical ventilation in our hospital from January 2013 to June 2015 were retrospectively analyzed.Patients who successful withdrew machine and extubation were selected as the effective group,patients who were failure to withdraw machine and extubation and death were selected as the invalid group.The single factor analysis was used to analyze the influencing factors of successful withdraw

  13. Effects of the different temperatures rinse solution on rehabilitation of patients underwent transurethral resection of prostate%不同温度冲洗液对经尿道前列腺汽化电切病人的康复影响

    Institute of Scientific and Technical Information of China (English)

    彭顺秀; 郑洁; 欧红桃; 李莉; 马晓华

    2009-01-01

    目的 探讨术后不同温度冲洗液对经尿道前列腺汽化电切病人康复的影响,选择最佳的术后冲洗液温度.方法 将150例病人随机分为5组,每组30例,每组冲洗液温度分别为25℃、28℃、31℃、34℃、37℃.对各组病人体温、膀胱痉挛发生的频率、冲洗前后血红蛋白浓度、病人术后平均住院时间进行对比.结果 随着冲洗液温度的升高,低体温、膀胱痉挛发生率逐渐下降;34℃组平均住院时间短于25 ℃、28 ℃、31 ℃组,差异有统计学意义(P<0.05);34 ℃组冲洗前后血红蛋白浓度差值与其他各组相比有统计学意义(P<0.05).结论 经尿道前列腺汽化电切术后应用34 ℃膀胱冲洗液是最佳选择.%Objective To analyze effects of different temperatures of postoperative rinse solution on rehabilitation of patients underwent transurethral resection of prostate (TURP), and to select the optimal temperature of postoperative rinse solution. Methods A total of 150 cases were divided into 5 groups at random,30 cases per group. Temperatures of postoperative rinse solution of each group were 25 ℃, 28 ℃, 31 ℃, 34 ℃, 37 ℃ separately, then body temperature, incidence rate of cyst spasm , the difference of HB concentration between pre-rinse and post-rinse,and average stay postoperatively of each group were contrasted. Results Incidence rate of low body temperature and cyst spasm fall off gradually with increase of temperature of rinse solution; average stay of the group( 34 ℃ ) was shorter than the groups( 25 ℃ ,28 ℃ ,31 ℃ ), which had statistical significance( P < 0.05 ) ; Compared with the other groups, the difference of HB concentration between pre-rinse and post-rinse of the group (34 ℃ ) had statistical significance( P < 0.05 ). Conclusions The optimal temperature of postoperative rinse solution is 34 ℃.

  14. Efficacy Observation and Pharmacokinetic Study of Dexmedetomidine Combined with Propofol for Sepsis In-fection Deliration in Patients Underwent Continuous Intravenous Blood Replacement%右美托咪啶联合丙泊酚治疗连续静脉血液置换患者脓毒症感染谵妄的效果观察及药动学研究

    Institute of Scientific and Technical Information of China (English)

    李根区; 李东; 郭学军

    2015-01-01

    目的:观察右美托咪啶联合丙泊酚用于连续静脉血液置换患者脓毒症感染谵妄的效果,并进行药动学研究.方法:选择连续静脉血液置换脓毒症感染谵妄患者60例,随机分为观察组和对照组各30例.对照组患者给予丙泊酚0.5 mg/kg,观察组患者给予右美托咪啶+丙泊酚.对比分析两组患者的疗效,并研究丙泊酚的药动学参数.结果:观察组丙泊酚的药动学参数消除半衰期(t1/2β)、缓慢分布半衰期(t1/2α)等均短于文献参考值,差异具有统计学意义(P0.05).治疗后两组患者谵妄症评分表(ICDSC)评分较治疗前明显下降,差异有统计学意义(P0.05);观察组患者平均住院时间明显短于对照组,差异具有统计学意义(χ2=6.263 4,P=0.000);对照组患者的不良事件发生率显著高于观察组,差异具有统计学意义(P0.05). After treatment,ICDSC score of 2 groups were decreased significantly,with statistical significance(P0.05);the average hospital stay of observation group was significantly shorter than that of control group,with statistical signifi-cance(χ2=6.263 4,P=0.000);the incidence of ADR in control group was significantly higher than the observation group,with statistical significance(P<0.05). CONCLUSIONS:Dexmedetomidine combined with propofol have good effect on sepsis infec-tion deliration in patients underwent continuous intravenous blood replacement,and can reduce the length of hospital stay and the incidence of ADR.

  15. 营养护理对血液透析治疗终末期肾病患者营养不良及生活质量的影响%Effect of Nutritional Care on the Quality of Life in Patients with End-stage Renal Disease and Malnutrition Underwent Hemodialysis

    Institute of Scientific and Technical Information of China (English)

    李玉辉

    2015-01-01

    Objective To study the clinical effect of nutritional care on patients with end-stage renal disease underwent hemodialysis. Methods A study was carried out in 88 cases with end-stage renal disease admitted in our hospital. The patients were randomly divided into the observation group and the control group with 44 cases in each. The control group were treated by the usual care, and the observation group were given the nutritional care intervention based on the usual care. And the changes in nutritional status and quality of life after intervention were compared between the two groups. Results Two groups were given different nursing regimen. Compared with the control group, the observation group had better improvement in malnutrition, higher scores of physiological function, emotional function, cognitive function, social function, mental health and role function and the grand average, with statistically significant difference (P<0.05). Conclusion For end-stage renal disease patients, nutritional care can effectively improve the malnutrition and reduce the infection rate and enhance the prognosis and quality of life.%目的探讨终末期肾病行血液透析治疗患者给予营养护理措施的临床效果。方法整群选取该院收治的88例终末期肾病患者展开研究,随机将其分为观察组和对照组,每组44例;对照组行常规护理措施,观察组在常规护理基础上行营养护理干预措施,观察观察组与对照组预后的营养状况及生活质量变化情况。结果两组患者给予不同的护理方案,观察组营养不良改善效果优于对照组,且观察组患者的生理职能评分、情绪职能评分、认知职能评分、社会职能评分、心理健康评分、角色职能评分及总评均比对照组高,差异有统计学意义(P<0.05)。结论终末期肾病患者行营养护理措施能有效改善患者存在的营养不良情况,降低感染率,从而提升患者预后生活质量。

  16. High-flux dialysis vs low-flux dialysis in the treatment of restless legs syndrome in uremic patients underwent maintenance hemodialysis%高通量透析与低通量透析治疗尿毒症患者不安腿症状的疗效比较

    Institute of Scientific and Technical Information of China (English)

    张宇; 龙刚; 张敏; 周玟

    2013-01-01

    目的 观察高通量透析与低通量透析方法改善接受维持性血液透析治疗者不安腿症状的疗效.方法 纳入于2011年1月至2011年12月在我院门诊规律接受接受维持性血液透析且伴有不安腿症状的72例尿毒症患者,采用数字表法随机分为高通量透析组及低通量透析组,各36例,分别接受高通量透析及低通量透析,共1年.比较透析前后血尿素氮、肌酐、钙、磷、β2微球蛋白及甲状旁腺素变化,计算溶质清除率和尿素清除指数(Kt/V比值),通过问卷调查评估不安腿症状缓解率.结果 透析后,高通量透析组和低通量透析组血尿素氮、肌酐、Kt/V比值差异无统计学意义(均P>0.05);高通量透析组甲状旁腺素显著低于低通量透析组[(26±19)vs(45±20)pmol/L,P<0.05],不安腿症状缓解率明显高于低通量透析组[75.0% vs 16.7%,P<0.05].结论 高通量透析在清除中大分子毒素、纠正钙磷代谢紊乱、减轻不安腿症状、改善患者营养状态方面明显优于低通量透析.%Objective To compare the effects of high-flux dialysis vs low-flux dialysis on restless leg syndrome among patients underwent maintenance hemodialysis.Methods Seventy-two uremic patients with restless legs syndrome were randomly assigned to the high-flux dialysis (HFD) group and the conventional hemodialysis (CHD) group.All the patients were follow-up for 1 year.Blood urea nitrogen (BUN),creatinine,calcium,phosphate,β2-microglobulin and parathyroid hormone (PTH) were tested,and solute clearance rate and Kt/V value were calculated.Results There was no significant difference between the two groups in the decrease of BUN and creatinine (P > 0.05).The decrease of phosphate in the HFD group was higher than that in the CHD group (31.50% ± 12.95% vs 21.48% ± 9.57%,P < 0.05).The decreases of β2-microglobulin in the HFD group were higher than that in the CHD group (34.25% ± 15.17% vs 1.58% ± 4.36

  17. Effect of Kidney-qi-tonifying Pills on the Endometriosis Patients with Infertility Who Underwent Laparoscopy%金匮肾气丸对子宫内膜异位症患者术后的促孕效果评价

    Institute of Scientific and Technical Information of China (English)

    邝爱华

    2015-01-01

    Objective To evaluate the effect of kidney‐qi‐tonifying pills on the endometriosis patients with in‐fertility who underwent laparoscopy.Methods Seventy endometriosis cases with infertility were randomly divided into observation group and control group.Both groups were given common treatment and the observation group was added kidney‐qi‐tonifying pills orally.Dysmenorrhea visual pain score (VAS) ,natural killer (NK) cells and macrophages (MF) and CA125 level of two groups were evaluated before and after the treatment.The pregnancy rate after treatment was compared between two groups.Results After treatment ,VAS and CA125 in two groups decreased significantly when compared with those before treatment (P<0.05).After treatment ,VAS and CA125 of observation group was significantly lower than that of control group (P<0.05).NK and MF in the two groups after treatment increased significantly when compared with those before treatment (P<0.05).NK and MF in ob‐servation group were significantly higher than those in control group (P< 0.05).After treatment ,there were 26 and 22 pregnant cases in observation group and control group with in 1 years ,accounted for 74.29% and 62.86% , respectively ,with significantly higher pregnancy rate in observation group than in control group (χ2 =9.657 ,P=9.657).Above pregnant 26 and 22 patients had 20 and 15 cases of full term birth ,with 76.92% and 68.18% term labor rate ,respectively ,and significantly higher term labor rate in observation group than in control group (χ2 =10.083 ,P=0.001).Conclusion Kidney‐qi‐tonifying pills can modulate immunity of infertile EM T patients with kidney Yang deficiency and has a certain effect on promoting gestation.%目的:评价金匮肾气丸联合腹腔镜治疗子宫内膜异位症(endometriosis,EMT)致不孕的肾阳虚患者的促孕效果。方法搜集EMT患者70例,随机分为观察组和对照组,2组均给予常规治疗,观察组加用

  18. [Clinical anatomy: anthropometry for nutritional assessment of 367 adults who underwent endoscopic gastrostomy].

    Science.gov (United States)

    Fonseca, Jorge; Santos, Carla Adriana

    2013-01-01

    Patients suffering from long standing dysphagia need tube feeding through gastrostomy. Nutritional assessment of these patients is challenging and must be supported on objective data, including anthropometric evaluation. The aim of this study was the evaluation of the usefulness of anthropometry for identifying and grading malnutrition, as part of the initial assessment of patients that underwent endoscopic gastrostomy. From the files of consecutive adults underwent gastrostomy we selected patients with anthropometric data obtained before the procedure: Body Mass Index, Mid Upper Arm Circumference, Triceps Skinfold Thickness and Mid Arm Muscle Circumference. Nutritional status was classified according with World Health Organization criteria for Body Mass Index, and for Mid Upper Arm Circumference, Triceps Skinfold Thickness and Mid Arm Muscle Circumference using comparison with Frisancho reference-tables. Were selected 367 patients (median of ages: 74.1 years): neurological disease: 172; head and neck cancer: 176; other diseases: 19. Body Mass Index identified 136 underweight and 231 eutrophic or overweight patients. Mid Upper Arm Circumference identified 310 malnourished and 57 eutrophic or overweight patients. Triceps Skinfold Thickness identified 301 malnourished and 66 eutrophic or overweight patients. Mid Arm Muscle Circumference identified 269 malnourished, 97 eutrophic and one with MAMC above normal. Anthropometry identified the malnourished endoscopic gastrostomy-patients, contributed for malnutrition grading and demonstrated the impact on muscle and fat reserves. Mid Upper Arm Circumference, Triceps Skinfold Thickness and Mid Arm Muscle Circumference identified malnutrition in nearly 80% of the patients, most clearly with fat tissue wasting than muscle. Easily accessible e inexpensive, anthropometry allowed personalized nutritional therapy. Anthropometry must be recognized as a fundamental tool for enteral feeding teams.

  19. The Incidence of Concomitant Precancerous Lesions in Cases Who Underwent Hysterectomy for Prolapse

    Directory of Open Access Journals (Sweden)

    Serdar Aydin

    2016-09-01

    Full Text Available Aim: The aim of the study was is to assess the incidence of unexpected gynecological cancers and pre-cancerous lesions following hysterectomy for pelvic organ prolapse to better understand the risks of uterine sparing surgery. Material and Method: This was a retrospective analysis of histopathology findings after hysterectomy for uterine prolapse surgery who underwent preoperative diagnostic work including cervical cytology, transvaginal ultrasonography and endometrial histopathological examination for a high risk group (Postmenopausal women with an endometrial thickness of %u22655 mm and premenopausal women with abnormal bleeding. Patients with a history of endometrial, cervical and/or adnexal precancerous or cancerous pathological conditions and with incomplete medical records were excluded.Results: Results were taken from 106 women who underwent hysterectomy. The abdominal route was used in 22 cases (21.7 %, the vaginal route in 82 patients (77.4 % and laparoscopic-assisted vaginal route in two (1.9 % women. Oophorectomy was performed in 35 (33 % cases. None of the patients had malignant histopathology specimens from hysterectomy. Total premalignant pathology incidence was 7.5 % (8/106. Six (5.7% patients had simple endometrial hyperplasia and 2 patients (1.9 % had cervical intraepithelial neoplasia. Discussion: The incidence of unexpected endometrial, cervical or ovarian malignancy among women who underwent hysterectomy after preoperative diagnostic workup including transvaginal ultrasonograhy, endometrial pathological examination to high risk cases was negligible. The inclusion of low risk endometrial and cervical precancerous lesions increased the incidences. Our results could provide precious data to extrapolate to similar populations with uterine prolapse who desire surgical correction sparing uterus.

  20. Analyze the effectiveness of modified maze procedure by irrigated radiofrequency ablation in the 144 patients with valvular heart disease and atrial fibrillation who underwent surgical operation%144例心脏瓣膜病合并心房颤动外科手术同期行单极冲洗射频消融改良迷宫术的疗效

    Institute of Scientific and Technical Information of China (English)

    王嬿; 胡大清

    2012-01-01

    目的 分析本院心脏瓣膜病伴发心房颤动(简称房颤)的患者外科手术同期行单极冲洗射频消融改良迷宫术MazeⅢ型手术疗效.方法 调查2007年11月至2010年8月收治的心脏瓣膜病合并房颤患者在心内直视手术下同期行单极冲洗射频消融改良迷宫术MazeⅢ型手术,观察随访6个月时的心律情况,根据节律分为窦性心律(简称窦律)组和非窦律组,分析影响术后转律的原因.结果 144例入选,2例安置永久起搏器,1例因瓣周漏而行二次手术.出院时窦律88例(61.11%),房颤39例(27.08%),随访6个月窦律88例(61.11%),房颤25例(17.36%).窦律组左房小于非窦律组,房颤时间短于非窦律组.左房内径≥6.5 cm者,可达龙的转复率高于非可达龙组(53.8% vs 28.6%,P<0.05).结论 心脏病伴发房颤的病人,在心脏外科手术中同期行单极冲洗射频消融改良迷宫术,对窦律的恢复仍不失为一种安全有效的方法.术前左房内径大小及房颤持续时间是房颤转复的主要危险因素,可达龙在一定程度上可提高大左房(≥6.5 cm)的转复成功率.%Objective To analyze the effectiveness of modified maze procedure by irrigated radiofrequeney ablation in the patients of valvular heart diseases with atriai fibrillation ( AF) who underwent open-heart surgery. Methods All the cases of valvular heart diseases with AF undergoing modified maze procedure by irrigated radioirequency ablation with concomitant open-heart surgery during November 2007 to August 2010 were investigated. All the patients were followed up for 6 months and divided into two groups:sinus-rhythm group and non-sinus-rhythm group according to the rhythm. Analyze the influencing factors of the rhythm. Results One hundred and forty-four cases were collected,2 cases were implanted permanent pacemakers,1 case was re-operated because of paravalvulur leak,88 cases were recorded sinus rhythm and 39 remained in AF when discharged from

  1. Clinical and pathological investigation of adnexal masses in adolescents who underwent surgery in a tertiary center

    Directory of Open Access Journals (Sweden)

    Hediye Dağdeviren

    2015-06-01

    Full Text Available Objective: Adnexal masses are the most common reason for gynecologic surgery in adolescent patients. Early detection and adequate management of adnexal lesions are very important for saving lives and preserving fertility. In this study, we analyzed the clinical characteristics of 106 Turkish adolescent women who underwent surgery for adnexal masses. Methods: The study included 106 patients aged ≤20 years that underwent surgery for adnexal masses at our hospital between January 2008 and December 2013. Clinical profiles were retrospectively collected from the hospital medical records. The records were analyzed for demographic profiles, initial symptoms, preoperative radiologic findings, operative approach, surgical procedure, pathology findings, and the maximum diameter of the adnexal mass. Results: The age of the patients ranged from 12 to 20 years (median, 18.8 years. The most common initial symptom in these patients was abdominal pain (56.6%. Non-neoplastic ovarian lesions in the patients included 7 (6.6% corpora hemorrhagica, 10 (9.4% corpus luteal cysts, 4 (3.8% paratubal cysts, and 7 (6.6% simple cysts. Benign neoplastic tumors included 20 (18.9% mature cystic teratomas (i.e., dermoid tumors, 10 (9.4% serous cystadenomas, 1 (0.9% mucinous cystadenomas, and 7 (6.6% endometriomas. The most common surgical approach and procedure were laparoscopy (67.0% and cystectomy (60.4%, respectively. Conclusion: Laparoscopy can be performed in many adolescent patients and conservative, adnexal-sparing surgery should be encouraged for all patients. Ovarian-preserving techniques should be a priority when surgery is performed for benign masses in order to optimize future fertility potential. J Clin Exp Invest 2015; 6 (2: 96-101

  2. Meralgia paresthetica affecting parturient women who underwent cesarean section -A case report-.

    Science.gov (United States)

    Chung, Kum Hee; Lee, Jong Yeon; Ko, Tong Kyun; Park, Chung Hyun; Chun, Duk Hee; Yang, Hyeon Jeong; Gill, Hyun Jue; Kim, Min Ku

    2010-12-01

    Meralgia paresthetica is commonly caused by a focal entrapment of lateral femoral cuteneous nerve while it passes the inguinal ligament. Common symptoms are paresthesias and numbness of the upper lateral thigh area. Pregnancy, tight cloths, obesity, position of surgery and the tumor in the retroperitoneal space could be causes of meralgia paresthetica. A 29-year-old female patient underwent an emergency cesarean section under spinal anesthesia without any problems. But two days after surgery, the patient complained numbness and paresthesia in anterolateral thigh area. Various neurological examinations and L-spine MRI images were all normal, but the symptoms persisted for a few days. Then, electromyogram and nerve conduction velocity test of the trunk and both legs were performed. Test results showed left lateral cutaneous nerve injury and meralgia paresthetica was diagnosed. Conservative treatment was implemented and the patient was free of symptoms after 1 month follow-up.

  3. Role of colonoscopy in patients with persistent acute diverticulitis

    Institute of Scientific and Technical Information of China (English)

    Adi Lahat; Henit Yanai; Emad Sakhnini; Yoram Menachem; Simon Bar-Meir

    2008-01-01

    AIM:To identify patients with persistent acute diverticulitis who might benefit from an early colonoscopy during their first hospitalization.METHODS:All patients hospitalized between July 2000 and December 2006 for acute diverticulitis who underwent colonoscopy were included in the study.Patients were followed during hospitalization and after discharge.Patients were considered to have a persistent course of acute diverticulitis if symptoms continued after 1 wk of conventional treatment with IV antibiotics,or if symptoms recurred within 2 mo after discharge.Patients were considered to benefit from an early colonoscopy if the colonoscopy was therapeutic or if it changed a patient's outcome.RESULTS:Three hundred and six patients were hospitalized between July 2000 and December 2006 with the diagnosis of acute diverticulitis.Two hundred and twenty four of these were included in the study group.Twenty three patients (10.3%) fulfilled the criteria for a persistent course of acute diverticulitis.Of them,four patients (17.4%) clearly benefited from an early colonoscopy;these patients' clinical course is described.None of the patients with a regular non-persistent course demonstrated any benefit from colonoscopy.CONCLUSION:Early colonoscopy detected other significant pathology,which accounted for the clinical presentation in 17% of patients with persistent acute diverticulitis.Therefore,we believe an early colonoscopy should be considered in all patients with a persistent clinical course.

  4. Incidence, Predictors, and Clinical Outcomes of Postoperative Cardiac Tamponade in Patients Undergoing Heart Valve Surgery.

    Science.gov (United States)

    You, Seng Chan; Shim, Chi Young; Hong, Geu-Ru; Kim, Darae; Cho, In Jeong; Lee, Sak; Chang, Hyuck-Jae; Ha, Jong-Won; Chang, Byung-Chul; Chung, Namsik

    2016-01-01

    This study aimed to investigate the incidence, predictors, and clinical outcomes of cardiac tamponade after heart valve surgery. A total of 556 patients who underwent heart valve surgery in a single tertiary center between January 2010 and March 2012 were studied. All patients underwent transthoracic echocardiography (TTE) about 5 days after surgery and TTE was repeated regularly. Patients with suspected acute pericardial hemorrhage were excluded. Cardiac tamponade occurred in twenty-four (4.3%) patients and all underwent surgical or percutaneous pericardial drainage. The median time of pericardial drainage after surgery was 17 (interquartile range, IQR, 13-30) days. Infective endocarditis, mechanical valve replacement of aortic or mitral valve, and any amount of pericardial effusion (PE) on the first postoperative TTE were related to the occurrence of cardiac tamponade (all ptamponade was associated with any amount of PE on the first postoperative TTE (hazard ratio, HR, 14.00, ptamponade was higher than those without (34.9 vs. 13.5, p = 0.031). After pericardial drainage, there was no echocardiographic recurrence of significant PE during a median of 34.8 (IQR 14.9-43.7) months after surgery. Cardiac tamponade after heart valve surgery is not uncommon. Patients with any amount of PE at the first postoperative TTE or mechanical valve replacement should receive higher attention with regard to the occurrence of cardiac tamponade. Although it prolongs hospital stay, cardiac tamponade exhibits a benign clinical course without recurrence after timely intervention.

  5. Ultimate treatment for a patient with severe traumatic brain injury without intake for 192 hours after Wenchuan massive earthquake

    Institute of Scientific and Technical Information of China (English)

    GU Jian-wen; ZHOU Hu-tian; YANG Tao; CHENG Jing-min; QU Yan; LI Cui-ying; LI Qing-jie; L(U) Ji-yun; CHENG Shou-long; LIU Jian-jun; KUANG Yong-qin; HUANG Hai-dong; YANG Li-bin; HE Wei-qi; ZHAO Kai; SONG Li-xin; ZHENG Xiao-dong; LIU Shu-xin; SUN Yan; HE Hong-lian; WU Jiang; LIU Xu-sheng; LU Min

    2009-01-01

    @@ At 14:28 (2:28 pm) on May 12, 2008, a magnitude 8 earthquake, which was a rare event, occurred in Sichuan Province of China and led to deaths of thousands of people. In the Longmen Mountain fault zone, which is located 40 miles from the earthquake center at Wenchuan, the Chinese military used a variety of treatment methods to rescue the injured and successfully treated a victim with severe traumatic brain injury (TBI) who survived without food or water intake for 192 hours. Two hundred and twenty-four hours after the earthquake, the patient underwent craniotomy and removal of an intracerebral hematoma. The injury to the patient was severe and the rescue time was the longest for this earthquake. Detailed information is provided in this report.

  6. The Results of Open-Label, Multicenter, Non-Randomized Study on the Efficacy and Safety of Insulins: Insuman Basal®, Insuman Comb 25®, Insuman Rapid® in Patients with Diabetes Mellitus Type 2 Who Underwent Basic Training in Diabetes Schools (SPIRIT

    Directory of Open Access Journals (Sweden)

    A.S. Larin

    2015-06-01

    Conclusions. Treatment with Insuman® insulins of patients with DM-2, who were not compensated while taking OADs, was associated with improved glycemic control without an increase in the incidence of severe hypoglycemia. There was no statistically significant increase in the effectiveness of therapy in patients, who have successfully completed a training program at diabetes school, compared with evaluation of overall efficiency. The state of young studied population of patients with inadequate control at baseline, and those who had developed cardiovascular complications associated with DM, improved in most cases in terms of glycemic control, and, at that, episodes of severe hypoglycemia were not detected. This may be due to the positive influence of training in diabetes school.

  7. Cystoid Macular Edema during Treatment with Paclitaxel and Bevacizumab in a Patient with Metastatic Breast Cancer: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Takamichi Yokoe

    2017-07-01

    Full Text Available We present a case of a metastatic breast cancer patient with cystoid macular edema (CME occurring during treatment with paclitaxel and bevacizumab. She had a history of neoadjuvant chemotherapy and partial mastectomy plus axillary lymph node dissection for stage IIB left-breast cancer. Twenty-four months later, she was diagnosed with multiple bone metastases and underwent chemotherapy with paclitaxel and bevacizumab. Thirty-three months after the initiation of the chemotherapy, she noticed bilateral blurred vision. The retinal thickening with macular edema was observed by optical coherence tomography, resulting in a diagnosis of CME. With cessation of paclitaxel and administrating ocular instillation of a nonsteroidal anti-inflammatory drug, her macular edema gradually reduced and disappeared in a month. While CME caused by chemotherapy is very rare, taxane may cause ocular adverse events such as CME. It is important to urge patients to consult an ophthalmologist promptly when they have visual complaints during taxane chemotherapy.

  8. Avaliação da lordose da coluna cervical nos pacientes com escoliose do tipo Lenke I submetidos ao tratamento cirúrgico Evaluación de la lordosis de la columna cervical en los pacientes con escoliosis del tipo Lenke I sometidos al tratamiento quirúrgico Evaluation of cervical behavior in patients with scoliosis Lenke who underwent surgery

    Directory of Open Access Journals (Sweden)

    José Lucas Batista Junior

    2011-01-01

    Full Text Available OBJETIVO: Avaliar a angulação da lordose cervical nos pacientes portadores de Escoliose Idiopática do Adolescente (EIA do tipo Lenke I, no período pré- e pós-operatório. MÉTODO: Estudo prospectivo e descritivo em que foram avaliados pacientes com EIA, sendo documentadas medidas antropométricas. Foram avaliadas as angulações das radiografias (posição ortostática em perfil cervical de C3 a C7 no período pré- e pós-operatório, estabelecendo como normal a lordose cervical entre 10 e 30 graus. RESULTADOS: Participaram 26 pacientes com EIA, sendo a maioria do sexo feminino (73%, com média de idade de 14,3 anos. Observamos que no período pré-operatório 80,9% dos pacientes apresentavam angulação cervical não fisiológica, sendo que 42,3% dos pacientes apresentavam diminuição da lordose cervical (OBJETIVO: Evaluar el ángulo de la lordosis cervical en pacientes con Escoliosis Idiopática del Adolescente (EIA, clasificados en Lenke I en el pre y posoperatorio. MÉTODOS: Estudio prospectivo y descriptivo, en el que se evaluó a pacientes con EIA y se documentaron mediciones antropométricas. Se evaluó la angulación de las radiografías (posición ortostásica de perfil de columna cervical de C3 a C7, en el entorno de pre y posoperatorias, estableciéndose como normal la lordosis cervical entre 10 y 30 grados. RESULTADOS: Un total de 26 pacientes fue evaluado, en su mayoría mujeres (73% con edad promedio de 14,3 años. Observamos que, en el período preoperatorio, 80,9% de los pacientes presentaban angulación cervical no fisiológica, siendo que 42,3% de los pacientes habían reducido la lordosis cervical (OBJECTIVE: This study was to evaluate the angle of cervical lordosis in patients with Adolescent Idiopathic Scoliosis (AIS ranked in Lenke I pre- and postoperatively. METHODS: Prospective and descriptive study, which evaluated patients with AIS and documented anthropometric measures. We assessed the angulations of the

  9. Avaliação dos níveis basais de FSH em pacientes inférteis com endometriose profunda de ovário tratadas cirurgicamente Evaluation of basal FSH serum levels in infertile patients with deep ovarian endometriosis who underwent surgery

    Directory of Open Access Journals (Sweden)

    Sandra Frankfurt

    2009-07-01

    Full Text Available OBJETIVO: avaliar a reserva ovariana de pacientes inférteis portadoras de endometriose profunda de ovário, submetidas à cirurgia excisional dos endometriomas, atendidas entre os meses de Fevereiro e Novembro de 2008. MÉTODOS: estudo prospectivo que incluiu 30 pacientes portadoras de endometriose graus III e IV com comprometimento profundo de ovário submetidas à cirurgia excisional dos endometriomas e 30 pacientes portadoras de endometriose graus I e II que foram alocadas como Grupo Controle. A reserva ovariana foi avaliada indiretamente a partir do valor do hormônio folículo estimulante (FSH basal (U/L, entre o terceiro e quinto dias do ciclo, após um período de 12 meses da cirurgia. O índice de massa corpórea (IMC foi calculado conforme a fórmula de Quetelet [peso (kg/estatura (cm²]. Para a comparação das variáveis "idade", "IMC" e "valores de FSH basal" entre os grupos, foi utilizado o teste não paramétrico U de Mann-Whitney. RESULTADOS: não foi encontrada diferença significativa entre os grupos em relação à idade e ao IMC. Em relação ao FSH basal, observou-se que, no grupo das pacientes com endometriose profunda, o valor médio foi de 7,0 U/L, enquanto que, no Grupo Controle, foi de 5,6 U/L (p=0,3, o que demonstra que a diferença no valor médio de FSH encontrado nos dois grupos não foi significativa. CONCLUSÕES: a cirurgia não influenciou de forma deletéria a reserva ovariana das pacientes com endometriose profunda de ovário.PURPOSE: to evaluate the ovarian reserve of infertile patients with severe ovarian endrometriosis, submitted to excisional surgery of endometriomas and attended from February to November, 2008. METHODS: prospective study, including 30 patients with endometriosis grades III and IV, with severe ovarian impairment, submitted to excisional surgery of the endometriomas, and 30 patients with endometriosis grades I and II, allocated as a Control Group. The ovarian reserve was indirectly assessed

  10. Pediatric patients on ketogenic diet undergoing general anesthesia-a medical record review.

    Science.gov (United States)

    Soysal, Elif; Gries, Heike; Wray, Carter

    2016-12-01

    To identify guidelines for anesthesia management and determine whether general anesthesia is safe for pediatric patients on ketogenic diet (KD). Retrospective medical record review. Postoperative recovery area. All pediatric patients who underwent general anesthesia while on KD between 2009 and 2014 were reviewed. We identified 24 patients who underwent a total of 33 procedures. All children were on KD due to intractable epilepsy. The age of patients ranged from 1 to 15 years. General anesthesia for the scheduled procedures. Patients' demographics, seizure history, type of procedure; perioperative blood chemistry, medications including the anesthesia administered, and postoperative complications. Twenty-four patients underwent a total of 33 procedures. The duration of KD treatment at the time of general anesthesia ranged from 4 days to 8 years. Among the 33 procedures, 3 patients had complications that could be attributable to KD and general anesthesia. A 9-year-old patient experienced increased seizures on postoperative day 0. An 8-year-old patient with hydropcephalus developed metabolic acidosis on postoperative day 1, and a 7-year-old patient's procedure was complicated by respiratory distress and increased seizure activity in the postanesthesia care unit. This study showed that it is relatively safe for children on KD to undergo general anesthesia. The 3 complications attributable to general anesthesia were mild, and the increased seizure frequencies in 2 patients returned back to baseline in 24 hours. Although normal saline is considered more beneficial than lactated Ringer's solution in patients on KD, normal saline should also be administered carefully because of the risk of exacerbating patients' metabolic acidosis. One should be aware of the potential change of the ketogenic status due to drugs given intraoperatively. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Effect of intraoperative care on deep vein thrombosis in patients under-went hip-joint replacement surgery%术中护理对髋关节置换手术患者下肢深静脉血栓形成的影响

    Institute of Scientific and Technical Information of China (English)

    钟敏兰; 向福胜

    2015-01-01

    目的:探讨术中护理对髋关节置换手术患者下肢深静脉血栓形成的影响。方法选择2013年6月~2014年12月湖北省鄂州市中心医院收治的157例髋关节置换手术患者,按住院号单双分为观察组83例,对照组74例。对照组采用常规术中护理,观察组采用改进术中护理。比较两组手术前后血液流变学和凝血功能变化及下肢深静脉血栓形成情况。结果观察组出血量、术中输血量明显少于对照组(P0.05). In the control group, 1 d after surgery, high shear whole blood viscosity, low shear viscosity of whole blood, plasma viscosity, erythrocyte aggregation index, prothrombin time, fibrinogen had no significantly different with 1 d before surgery (P > 0.05). After surgery, 2 cases (2.41%) in the observation group and 8 cases (10.81%) in the control group had deep vein thrombosis, with statistically significant difference (P<0.05). Conclusion Improved intraoperative care can improve high blood coagulation state in patients with hip joint replacement, reduce the incidence of postoperative deep venous thrombosis.

  12. Estudo da função pulmonar em pacientes submetidos a revascularização do miocárdio sem circulação extracorpórea com derivação intraluminal Pulmonary function study in patients who underwent myocardial revascularization without cardiopulmonary bypass with an intraluminal shunt

    Directory of Open Access Journals (Sweden)

    Ana Maria Rocha Pinto

    1998-12-01

    Full Text Available As alterações da função pulmonar nos pacientes submetidos a cirurgias com auxílio da Circulação Extracorpórea (CEC têm sido relatadas na literatura. O objetivo do presente estudo foi analisar a função pulmonar de um grupo de pacientes submetidos a cirurgia de revascularização do miocárdio sem o uso da CEC. Foram estudados de maneira prospectiva 23 pacientes portadores de insuficiência coronariana e submetidos a cirurgia de revascularização do miocárdio sem CEC. A idade variou de 36 a 69 anos, sendo 16 pacientes do sexo masculino e sete do sexo feminino. A avaliação da função pulmonar foi feita através de espirometria e prova alvéolo-respiratória, realizadas no período pré-operatório, no quarto dia (PO4 e no décimo dia (PO10> pós-operatório. A análise dos dados revelou redução da Capacidade Vital (CV em 37,84% (pPulmonary complications are a major cause of postoperative morbidity and mortality in those patients undergoing operations utilizing cardiopulmonary bypass. The purpose of this study was to evaluate the pulmonary function after myocardial revascularization without cardiopulmonary bypass using a intraluminal shunt. Twenty-three patients with coronary disease were submitted to surgery by this technique and pulmonary function testing was conducted consecutively. The surgeries were performed via a median sternotomy with a reversed saphenous vein and/or an internal mammary artery graft. The age ranged from 36 to 69 years (mean 56,3 years. The group was comprised by 16 men and seven women. The pulmonary function tests consisted of spirometric investigations and blood gases measurements with evaluation of intrapulmonary shunt degree, both analyzed during the preoperative period, at the 4th (PO4 and at the 10th (PO10 postoperative day. In spirometry were determinated the vital capacity (VC, forced vital capacity (FVC, forced expiratory volume at one second (FEV, forced expiratory flow over middle half of FVC (FEF

  13. Air Temperature Variation and Mutation Analysis of the Twenty-Four Solar Terms in Xi'an over 60 Years%近60年西安市24节气气温变化特征及突变分析

    Institute of Scientific and Technical Information of China (English)

    沈姣姣; 徐虹; 李建科; 王靖; 高红燕; 杨新

    2013-01-01

    Based on daily air temperature from 1951-2010, mean air temperature (MAT) and the beginning-day air temperature (BAT), variation characteristics of the twenty-four solar terms in Xi'an were examined. MAT and BAT of phenological solar terms (Waking of Insects, Pure Brightness, Lesser Fullness of Grain and Grain in Beard) were used. We found that MAT of Lesser Heat and Greater Heat was higher than other solar terms, Lesser Cold was the coldest in all. Ending-day air temperature (EAT) was higher than BAT in each solar term from Greater Cold to Lesser Heat, and was lower than BAT in each solar term from Greater Heat to Lesser Cold. Curve of MAT variation of contiguous solar terms showed a single peak at Pure Brightness which was 3.4℃ higher than the Spring Equinox and single valley at the Beginning of Winter which was 3.9℃ lower than Frost's Descent. Daily MAT of seasonal solar terms varied as follows: spring (+0.190℃/ d) > autumn (-0.180℃/d) > winter (-0.105℃/d) > summer (+0.086℃/d). Daily MAT during the Beginning of Winter(-0.303℃/d), Waking of Insects (+0.233℃/d), Lesser Snow(-0.220℃/d) and Spring Equinox(+0.219℃/d) varied violently. MAT and BAT of most twenty-four solar terms showed a significant rising trend in the 1990s or 2000s, but BAT of autumn and winter solar terms did not change significantly in decadal temperature from 1951 to 2010. In 2000s, MAT of the Beginning of Spring, Greater Heat, the Beginning of Autumn, the End of Heat and the Winter Solstice dropped instead of rise. BAT and MAT of Waking of Insects rose in 1998 and 2008 at the 0.05 significant level, then in 2001 and 2010 at the 0.01 significant level. Pure Brightness and Lesser Fullness of Grain suddenly wanned in the 1990s (1999 and 1993), with 0.05 significant level at the beginning of 2000s (2004 and 2003) and 0.01 significant level in the mid-2000s (2006 and 2006). MAT and BAT of Grain in Beard showed a periodic rising and dropping trend, when it suddenly dropped at the

  14. Intraocular lens power estimation by accurate ray tracing for eyes underwent previous refractive surgeries

    Science.gov (United States)

    Yang, Que; Wang, Shanshan; Wang, Kai; Zhang, Chunyu; Zhang, Lu; Meng, Qingyu; Zhu, Qiudong

    2015-08-01

    For normal eyes without history of any ocular surgery, traditional equations for calculating intraocular lens (IOL) power, such as SRK-T, Holladay, Higis, SRK-II, et al., all were relativley accurate. However, for eyes underwent refractive surgeries, such as LASIK, or eyes diagnosed as keratoconus, these equations may cause significant postoperative refractive error, which may cause poor satisfaction after cataract surgery. Although some methods have been carried out to solve this problem, such as Hagis-L equation[1], or using preoperative data (data before LASIK) to estimate K value[2], no precise equations were available for these eyes. Here, we introduced a novel intraocular lens power estimation method by accurate ray tracing with optical design software ZEMAX. Instead of using traditional regression formula, we adopted the exact measured corneal elevation distribution, central corneal thickness, anterior chamber depth, axial length, and estimated effective lens plane as the input parameters. The calculation of intraocular lens power for a patient with keratoconus and another LASIK postoperative patient met very well with their visual capacity after cataract surgery.

  15. Nitric oxide monocyte production levels in patients with the hepatosplenic form of Scistosoma mansoni infection who underwent splenectomy, ligature of the left gastric vein and auto implantation of spleen tissue in the major omentum Níveis de óxido nítrico produzidos por monócitos em portadores de esquistossomose hepatoesplênica que se submeteram a esplenectomia, ligadura da veia gástrica esquerda e auto-implante de tecido esplênico no omento maior

    Directory of Open Access Journals (Sweden)

    Carlos Teixeira Brandt

    2006-10-01

    Full Text Available PURPOSE: To measure the levels of NO production by monocytes in patients with the hepatosplenic form of schistosomiasis mansoni who underwent splenectomy, ligature of the left gastric vein and auto implantation of spleen tissue in the major omentum. METHODS: Four groups of volunteers were enrolled in the investigation: G1 - 12 patients with S. mansoni infection in its hepatosplenic form without any kind of treatment (SMH; G2 - 13 SMH patients who underwent medical treatment and portal hypertension decompression splenectomy and ligature of the left gastric vein (SMH/SLGV; G3 - 19 patients similar to the later group, but additionally received auto implantation of spleen morsels in the major omentum (SMH/SLGV/AI; and G4 - 15 individuals with no S. mansoni infection coming from the same geographical area and presenting similar socio economical status (CG. Nitrite production by monocytes was determined by a standard Griess reaction adapted to microplates. The results were presented by mean ± SD for each group. Significant differences in NO production by monocytes were determined by Tukey-Kramer multicomparisons test. Probability values of 0.05 were considered significant. RESULTS: Patients from G1 (SMH showed lower level of NO production by monocytes (5.28 ± 1.28µmol/ml. Patients from G2 (SMH/SLGV showed similar results (6.67 ± 0.44µmol/ml - q = 2.681 p > 0.05. Individuals of G4 (CG showed higher level of NO production by monocytes (8.19 ± 2.74µmol/ml. Patients from G3 (SMH/SGLV/AI showed similar NO production by PBMC as compared to individuals of G4 (CG - (7.41 ± 1.65µmol/ml - q = 1.615 p > 0.05. The volunteers from G4 (CG and G3 (SMH/SLGV/AI showed significantly greater levels of NO production by monocytes as compared to those from G1 (SMH - (q = 5.837 p OBJETIVO: Mensurar os níveis de produção de ON por monócitos do sangue periférico (MSP em portadores de esquistossomose na forma hepatoesplênica que tinham se submetido a

  16. 接受直接经皮冠状动脉介入治疗的ST段抬高型急性心肌梗死患者血小板体积的变化及与冠状动脉影像的关系%Platelet volume and its association with coronary angiograms in patients with ST-segment elevation acute myocardial infarction underwent primary percutaneous coronary intervention

    Institute of Scientific and Technical Information of China (English)

    许文亮; 王旭; 邵一兵; 惠波; 武越; 要英杰; 张纯全

    2012-01-01

    Objective To assess the platelet volume in patients with ST-segment elevation acute myocardial infarction ( STEMI) underwent primary percutaneous coronary intervention ( PPCI) and its association with coronary angiograms flow. Methods Total 163 patients with STEMI who underwent PPCI were enrolled. Mean platelet volume ( MPV) and platelet large cell ratio (P-LCR) and other biochemical parameters were measured on admission. The TIMI flow for the infarct-related artery (IRA) were evaluated before and after PPCI, and the IRA's corrected Thrombolysis In Myocardial Infarction frame count (CTFC) were also calculated. One hundred and seven in-hospital patients with stable angina pectoris were taken as control. Results MPV and P-LCR were increased significantly in STEMI patients compared to patients with stable angina pectoris [(10.30 ±0. 82) fl vs. (9. 89 ± 0. 98) fl,t = 3. 656,P = 0. 000; (27.24 ±6.43)% vs. (24. 51 ±5. 88)% ,t =3. 524,P =0. 000]. Patients with multiple coronary lesions showed much higher MPV and P-LCR than patients with single coronary lesions [ (10. 40 ± 0. 85) fl vs. (10. 04 ± 0. 69) fl, t =-2.558, P=0. 011; (27.96 ±6.64)% vs. (25. 40 ±5. 52)% ,t = - 2. 319,P = 0. 022]. Compared to those with left circumflex artery as IRA, patients with anterior descending coronary artery as IRA had markedly increased MPV and P-LCR [ (10. 42 ± 0. 86) fl vs. (9. 98 ± 0. 62) fl, P < 0. 05; (28. 07 ± 6. 63) % vs. (24. 48 ± 4. 76) % , P < 0. 05 ]. If the IRA' s coronary flow was TIMI grade 1 to 3 before PPCI, it was defined as spontaneous reperfusion. Patients without spontaneous reperfusion had markedly increased MPV and P-LCR than those with spontaneous reperfusion [ ( 10. 39 ± 0. 84) fl vs. ( 10. 04 ± 0. 69 ) fl, t = - 2. 460, P = 0.015; (27.83 ±6.61)% vs. (25. 64 ± 5. 70)% ,t = - 2. 082,P = 0. 040]. After PPCI, patients whose IRAs TIMI flow was less than grade 3 had significantly elevated MPV and P-LCR than patient with TIMI flow grade 3 [ (10. 68 ± 1

  17. Serum Zn levels in dysphagic patients who underwent endoscopic gastrostomy for long term enteral nutrition.

    Science.gov (United States)

    Santos, Carla Adriana; Fonseca, Jorge; Brito, José; Fernandes, Tânia; Gonçalves, Luísa; Sousa Guerreiro, António

    2014-02-01

    Objetivos: Pacientes con disfagia sometidos a Gastrostomía Endoscópica (PEG) presentan malnutrición calórico- proteica, mas poco se conoce acerca da malnutrición en micronutrientes. El objetivo del presente trabajo fue el estudio del zinc sérico en pacientes portadores de PEG y su relación con proteínas séricas, zinc de sangre total y enfermedades de base. Métodos: De los pacientes portadores de PEG se ha obtenido antes del procedimiento. La determinación del zinc del suero y total se ha obtenido por lo método Wavelength Dispersive X-ray Fluorescence Spectroscopy. Fueron consideradas la albumina y la transferrina. Se estudiaron pacientes como un todo y se dividieron en: cáncer de cabeza y cuello (CCC) y enfermedad neurológica (EN). Resultados: 32 pacientes (22 hombres), 43-88 años: CCC = 15, EN = 17. La mayoría (30/32) presento lo zinc en suero bajo. Solo dos, con lesión cerebral traumática, tenían valores normales de zinc. En la sangre total, 17/32 estaban dentro del rango normal. Sin diferencias entre los grupos CCC-EN. Sin asociación entre lo zinc sérico y la albumina o transferrina. Sin asociación entre lo zinc en suero y total. Conclusiones: los enfermos presentaran zinc sérico bajo no momento de la PEG, relacionado con el ayuno prolongado y no con la enfermedad subyacente. La reducción del zinc sérico no está relacionada con las proteínas. Lo zinc sérico fue más sensible para la identificación de reducción de la ingesta. Los grupos que se ocupan de enfermos con PEG deben incluir la determinación del zinc en la evaluación o incluir el suministro de zinc.

  18. Evaluation of surgery risk factor associated to antithrombotic therapy in patients who underwent colorectal surgery.

    Science.gov (United States)

    Del Rio, Paolo; Sozzi, Francesco; Bertocchi, Elisa; Dell'Abate, Paolo; Perrone, Gennaro; Arcuri, Maria Francesca; Sianesi, Mario

    2016-01-01

    I trattamenti antipiastrinici sono comuni nel mondo occidentale ed il rischio di sanguinamento correlato a procedure chirurgiche o comunque invasive è di conseguenza elevato e pertanto abbiamo volute analizzare la correlazione tra la chirurgia del colon.retto ,la terapia antipiastrinica e le complicanze chirurgiche postoperatorie. Sono stati studiati 176 pazienti operati per tumori del colon-retto considerando i seguenti dati:tipo di intervento xchirurgico,l’indice di massa corporea (BMI), il valore dell’emoglobina (Hb); PT preoperatorio e le trasfusioni di sangue pre epost-operatorie e durante lo stesso intervento chirurgico. L’analisi si è concentrata su due gruppi :pazienti sottoposti a trattamento antipiastrinico (ATterapia antiaggregante) e pazienti non trattati ( NAT: non terapia antiaggregante piastrinica). Nei gruppi di pazienti sottoposti a emicolectomia destra, i valori di emoglobina erano più bassi neri pazienti che hanno ricevuto la terapia antitrombotica rispetto ai pazienti che non hanno ricevuto questa terapia, con una significatività statistica (p terapia antiaggregante avevano valori più bassi di emoglobina senza significatività statistica (valore di p non significativo). I pazienti in sovrappeso sottoposti a trattamento antiaggregante hanno presentato valori di Hb inferiori a quelli non trattati (p terapia antiaggregante rispetto al secondo grippo indipendentemente dal peso. In conclusione, la terapia antiaggregante in pazienti sottoposti ad interventi chirurgici invasivi cambia l’incidenza di alcuni fattori di rischio, cone il sanguinamento e le complicanze post-operatorie.Questo risultato sottolinea l’importanza di una corretta manipolazione e preparazione nei pazienti trattai con agenti antitreombotici che devono subire un intervento chirurgico invasivo.

  19. [Waist-hip ratio and perioperative bleeding in patients who underwent radical prostatectomy].

    Science.gov (United States)

    León-Ramírez, Víctor; Santiago-López, Janaí; Reyes-Rivera, Juan Gabriel; Miguel-Soto, Edgar

    2016-01-01

    Introducción: la prostatectomía radical se asocia con sangrado perioperatorio y múltiples transfusiones. La obesidad abdominal representa un factor de riesgo perioperatorio. Sugerimos un efecto protector del adipocito en pacientes oncológicos sometidos a prostatectomía radical. El objetivo fue evaluar el efecto del índice cintura-cadera (ICC) sobre la magnitud del sangrado y los requerimientos perioperatorios de transfusiones en pacientes oncológicos sometidos a prostatectomía radical. Métodos: estudio de cohorte en 156 pacientes. Se integraron dos grupos: el control (ICC  0.95); se registraron la magnitud del sangrado y las fracciones transfundidas durante la cirugía y en el postoperatorio. Se utilizaron medidas de tendencia central y dispersión, así como chi cuadrada, t de Student, U de Mann-Whitney y ANOVA. Una p < 0.05 fue significativa. Resultados: encontramos diferencias significativas en el peso, índice de masa corporal, cintura, índice cintura-cadera, sangrado perioperatorio, fracciones transfundidas, permanencia de la sonda y días de hospitalización. Conclusión: los pacientes sometidos a prostatectomía radical con ICC ≥ 0.95 tuvieron un sangrado y requerimientos transfusionales perioperatorios menores que aquellos con un ICC < 0.95.

  20. Prevalence of restless legs syndrome in patients with irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    Patrick Basu; N James Shah; Nithya Krishnaswamy; Tommy Pacana

    2011-01-01

    AIM: To determine the prevalence of restless legs syndrome (RLS) in patients with irritable bowel syndrome (IBS).METHODS: Patients with diarrhea-predominant IBS (n = 30), constipation-predominant IBS (n = 30), or mixed-symptom IBS (n = 30) were recruited from the community between March 2008 and February 2009. Rifaximin 200 mg three times daily was administered empirically to alleviate small intestinal bowel overgrowth in all patients. The presence of RLS was assessed via an RLS questionnaire and polysomnography. RESULTS: Twenty-six patients with IBS (29%) were diagnosed with RLS using the RLS questionnaire. Twenty-four of the 26 patients (92%) underwent polysomnog Pacanaraphy, and all had confirmation of RLS. A greater percentage of patients with RLS had diarrhea-predominant IBS (62%) compared with patients with constipation-predominant IBS (4%) or mixed-symptom IBS (33%). CONCLUSION: Restless legs syndrome is prevalent in patients with IBS, especially those with diarrheal symptoms. Assessment of concomitant disorders may improve diagnosis and expand relevant treatment options for patients.

  1. Analysis of corneal esthesia in patients undergoing photorefractive keratectomy

    Directory of Open Access Journals (Sweden)

    Elmar Torres Neto

    2015-12-01

    Full Text Available ABSTRACT Purpose: To quantitatively analyze corneal esthesia in patients undergoing photorefractive keratectomy (PRK surgery. Methods: Forty-five patients selected for PRK in one eye underwent corneal esthesia using a Cochet-Bonnet esthesiometer preoperatively and 30 and 90 days postoperatively. Patients with a refractive diopter error of 4 or greater received intraoperative 0.02% mitomycin C for 20 s. Results: Twenty-four (53.3% of the 45 eyes received intraoperative 0.02% mitomycin. Decreased sensitivity was observed on postoperative day 30. By postoperative day 90, corneal esthesia had normalized but remained 14.9% lower than preoperative levels. In the mitomycin group, no recovery of corneal esthesia to normal sensitivity levels was observed. The mean esthesiometer level was 39.2 mm on postoperative day 90 (P<0.001. Conclusions: The results of the present study demonstrate recovery of corneal esthesia to normal levels at 90 days postoperatively in patients who did not receive mitomycin C. In patients administered mitomycin C, a 23.59% reduction in the corneal touch threshold was observed compared with preoperative levels indicating a failure of recovery to normal levels.

  2. Long-term outcomes in primary spinal osteochondroma: a multicenter study of 27 patients

    Science.gov (United States)

    Sciubba, Daniel M.; Macki, Mohamed; Bydon, Mohamad; Germscheid, Niccole M.; Wolinsky, Jean-Paul; Boriani, Stefano; Bettegowda, Chetan; Chou, Dean; Luzzati, Alessandro; Reynolds, Jeremy J.; Szövérfi, Zsolt; Zadnik, Patti; Rhines, Laurence D.; Gokaslan, Ziya L.; Fisher, Charles G.; Varga, Peter Paul

    2016-01-01

    OBJECT Clinical outcomes in patients with primary spinal osteochondromas are limited to small series and sporadic case reports. The authors present data on the first long-term investigation of spinal osteochondroma cases. METHODS An international, multicenter ambispective study on primary spinal osteochondroma was performed. Patients were included if they were diagnosed with an osteochondroma of the spine and received surgical treatment between October 1996 and June 2012 with at least 1 follow-up. Perioperative prognostic variables, including patient age, tumor size, spinal level, and resection, were analyzed in reference to long-term local recurrence and survival. Tumor resections were compared using Enneking appropriate (EA) or Enneking inappropriate surgical margins. RESULTS Osteochondromas were diagnosed in 27 patients at an average age of 37 years. Twenty-two lesions were found in the mobile spine (cervical, thoracic, or lumbar) and 5 in the fixed spine (sacrum). Twenty-three cases (88%) were benign tumors (Enneking tumor Stages 1–3), whereas 3 (12%) exhibited malignant changes (Enneking tumor Stages IA–IIB). Sixteen patients (62%) underwent en bloc treatment—that is, wide or marginal resection—and 10 (38%) underwent intralesional resection. Twenty-four operations (92%) followed EA margins. No one received adjuvant therapy. Two patients (8%) experienced recurrences: one in the fixed spine and one in the mobile spine. Both recurrences occurred in latent Stage 1 tumors following en bloc resection. No osteochondroma-related deaths were observed. CONCLUSIONS In the present study, most patients underwent en bloc resection and were treated as EA cases. Both recurrences occurred in the Stage 1 tumor cohort. Therefore, although benign in character, osteochondromas still require careful management and thorough follow-up. PMID:25793467

  3. A comparison of lightwand and laryngoscopic intubation techniques in patients undergoing laparoscopic cholecystectomy

    Institute of Scientific and Technical Information of China (English)

    Chenglan Xie; Congjin Ju; Jiawen Cheng; Xuejun Yan; Dengquan Guo

    2009-01-01

    Objective:To assess the effects of lightwand and laryngoscopic intubation techniques in patients undergoing laparoscopic cholecystectomy (LC). Methods: 300 ASA physical status Ⅰ and Ⅱ patients, undergoing LC, were randomly assigned to two groups, with 150 cases in each group. Patients in the LS group underwent endotracheal intubation using a standard direct-suspension laryngoscopic technique. Patients in the LW group were intubated by using transillumination with a lightwand. Mean arterial pressure and heart rate were recorded before induction, and at 1, 3 and 5 min after intubation. The incidence and of sore throat, hoarseness, and dysphagia was assessed twenty-four hours after surgery. Results: This study demonstrated no clinically significant difference in cardiovascular variables between the two techniques. Patients had a significantly lower incidence of sore throat, hoarseness, and dysphagia when the lightwand was used for intubation. Conclusion: This study suggests that lightwand intubation may decrease the incidence of postoperative sore throat, hoarseness,and dysphagia, thereby potentially increasing satisfaction in surgical patients. Therefore, more frequent use of the lightwand is recommended for endotracheal intubation.

  4. Autotransplantation of spleen tissue in children with mansonic schistosomiasis who underwent splenectomy: Evaluation of splenic residual functions

    Directory of Open Access Journals (Sweden)

    Brandt Carlos Teixeira

    1998-01-01

    Full Text Available Autotransplantation of spleen tissue is an attempt for maintenance of splenic functions when splenectomy is indicated in children. It minimizes the risks of overwhelming postsplenectomy infection and it has been done in children with severe portal hypertension due to hepatosplenic mansonic schistosomiasis that underwent splenectomy. The purposes of this investigation were to study the morphology of the residual splenic tissue; to evaluate the residual filtration function of this splenosis; and to assess the immune response to polyvalent pneumococcal vaccine of these patients. Twenty-three children with portal hypertension from mansonic schistosomiasis who underwent splenectomy, ligature of the left gastric vein, autotransplantation of spleen tissue into an omental pouch were evaluated for residual splenic parenchyma and functions. Tc-99m sulfur colloid liver-spleen scans were used for detection of splenic nodules. The search for Howell Jolly bodies were used for assessing the filtration function and Enzyme-linked immunosorbent assay was used for measuring the relative rise in titter of specific pneumococcal antibodies. Splenosis was evident in all children; however, in two there were less than five splenic nodules in the greater omentum, which was considered insufficient. Howell-Jolly bodies were found in the peripheral blood only in these two patients with less evident splenosis. The immune response was adequate in 15 patients; it was intermediate in 4 patients and inadequate in 4 patients. Autotransplantation of spleen tissue into an omental pouch is efficient in maintaining the filtration splenic function in more than 90% of the cases and the immune response to pneumococcal vaccination in approximately 65% of the children.

  5. Minimally Invasive Posterior Stabilization Improved Ambulation and Pain Scores in Patients with Plasmacytomas and/or Metastases of the Spine

    Directory of Open Access Journals (Sweden)

    Joseph H. Schwab

    2011-01-01

    Full Text Available Background. The incidence of spine metastasis is expected to increase as the population ages, and so is the number of palliative spinal procedures. Minimally invasive procedures are attractive options in that they offer the theoretical advantage of less morbidity. Purpose. The purpose of our study was to evaluate whether minimally invasive posterior spinal instrumentation provided significant pain relief and improved function. Study Design. We compared pre- and postoperative pain scores as well as ambulatory status in a population of patients suffering from oncologic conditions in the spine. Patient Sample. A consecutive series of patients with spine tumors treated minimally invasively with stabilization were reviewed. Outcome Measures. Visual analog pain scale as well as pre- and postoperative ambulatory status were used as outcome measures. Methods. Twenty-four patients who underwent minimally invasive posterior spinal instrumentation for metastasis were retrospectively reviewed. Results. Seven (29% patients were unable to ambulate secondary to pain and instability prior to surgery. All patients were ambulating within 2 to 3 days after having surgery (=0.01. The mean visual analog scale value for the preoperative patients was 2.8, and the mean postoperative value was 1.0 (=0.001. Conclusion. Minimally invasive posterior spinal instrumentation significantly improved pain and ambulatory status in this series.

  6. A Case of Type 2 Amiodarone-Induced Thyrotoxicosis That Underwent Total Thyroidectomy under High-Dose Steroid Administration

    Directory of Open Access Journals (Sweden)

    Koshi Hashimoto

    2015-01-01

    Full Text Available Amiodarone is used commonly and effectively in the treatment of arrhythmia; however, it may cause thyrotoxicosis categorized into two types: iodine-induced hyperthyroidism (type 1 amiodarone-induced thyrotoxicosis (AIT and destructive thyroiditis (type 2 AIT. We experienced a case of type 2 AIT, in which high-dose steroid was administered intravenously, and we finally decided to perform total thyroidectomy, resulting in a complete cure of the AIT. Even though steroid had been administered to the patient (maximum 80 mg of prednisolone, the operation was performed safely and no acute adrenal crisis as steroid withdrawal syndrome was found after the operation. Few cases of type 2 AIT that underwent total thyroidectomy with high-dose steroid administration have been reported. The current case suggests that total thyroidectomy should be taken into consideration for patients with AIT who cannot be controlled by medical treatment and even in those under high-dose steroid administration.

  7. Actual Situations and Problems of Postoperative Nursing Care for the Elderly who Underwent Neurosurgical Operation

    OpenAIRE

    2014-01-01

    The objective of the study is to identify nursing care and related problems involved in extending the daily life and supporting self-care of the elderly who underwent neurosurgical operation, and to determine the direction of nursing care. Subjects were six nurses who had been working in anacute-phase department for five years or longer. Collected data was analyzed by the qualitative synthesis method (KJ method). The results clarified [nursing care to enhance the treatment effect of neurosurg...

  8. Sarcopenia predicts 1-year mortality in elderly patients undergoing curative gastrectomy for gastric cancer: a prospective study.

    Science.gov (United States)

    Huang, Dong-Dong; Chen, Xiao-Xi; Chen, Xi-Yi; Wang, Su-Lin; Shen, Xian; Chen, Xiao-Lei; Yu, Zhen; Zhuang, Cheng-Le

    2016-11-01

    One-year mortality is vital for elderly oncologic patients undergoing surgery. Recent studies have demonstrated that sarcopenia can predict outcomes after major abdominal surgeries, but the association of sarcopenia and 1-year mortality has never been investigated in a prospective study. We conducted a prospective study of elderly patients (≥65 years) who underwent curative gastrectomy for gastric cancer from July 2014 to July 2015. Sarcopenia was determined by the measurements of muscle mass, handgrip strength, and gait speed. Univariate and multivariate analyses were used to identify the risk factors associated with 1-year mortality. A total of 173 patients were included, in which 52 (30.1 %) patients were identified as having sarcopenia. Twenty-four (13.9 %) patients died within 1 year of surgery. Multivariate analysis showed that sarcopenia was an independent risk factor for 1-year mortality. Area under the receiver operating characteristic curve demonstrated an increased predictive power for 1-year mortality with the inclusion of sarcopenia, from 0.835 to 0.868. Solely low muscle mass was not predictive of 1-year mortality in the multivariate analysis. Sarcopenia is predictive of 1-year mortality in elderly patients undergoing gastric cancer surgery. The measurement of muscle function is important for sarcopenia as a preoperative assessment tool.

  9. Impact of Triple-Negative Phenotype on Prognosis of Patients With Breast Cancer Brain Metastases

    Energy Technology Data Exchange (ETDEWEB)

    Xu Zhiyuan [Department of Neurosurgery, University of Virginia, Charlottesville, Virginia (United States); Schlesinger, David [Department of Radiation Oncology, University of Virginia, Charlottesville, Virginia (United States); Toulmin, Sushila [Department of Neurosurgery, University of Virginia, Charlottesville, Virginia (United States); Rich, Tyvin [Department of Radiation Oncology, University of Virginia, Charlottesville, Virginia (United States); Sheehan, Jason, E-mail: jps2f@virginia.edu [Department of Neurosurgery, University of Virginia, Charlottesville, Virginia (United States)

    2012-11-01

    Purpose: To elucidate survival times and identify potential prognostic factors in patients with triple-negative (TN) phenotype who harbored brain metastases arising from breast cancer and who underwent stereotactic radiosurgery (SRS). Methods and Materials: A total of 103 breast cancer patients with brain metastases were treated with SRS and then studied retrospectively. Twenty-four patients (23.3%) were TN. Survival times were estimated using the Kaplan-Meier method, with a log-rank test computing the survival time difference between groups. Univariate and multivariate analyses to predict potential prognostic factors were performed using a Cox proportional hazard regression model. Results: The presence of TN phenotype was associated with worse survival times, including overall survival after the diagnosis of primary breast cancer (43 months vs. 82 months), neurologic survival after the diagnosis of intracranial metastases, and radiosurgical survival after SRS, with median survival times being 13 months vs. 25 months and 6 months vs. 16 months, respectively (p < 0.002 in all three comparisons). On multivariate analysis, radiosurgical survival benefit was associated with non-TN status and lower recursive partitioning analysis class at the initial SRS. Conclusion: The TN phenotype represents a significant adverse prognostic factor with respect to overall survival, neurologic survival, and radiosurgical survival in breast cancer patients with intracranial metastasis. Recursive partitioning analysis class also served as an important and independent prognostic factor.

  10. Oxidative status imbalance in patients with metabolic syndrome: role of the myeloperoxidase/hydrogen peroxide axis.

    Science.gov (United States)

    da Fonseca, Lucas José Sá; Nunes-Souza, Valéria; Guedes, Glaucevane da Silva; Schettino-Silva, Glauber; Mota-Gomes, Marco Antônio; Rabelo, Luíza Antas

    2014-01-01

    The present study evaluated the cardiometabolic and redox balance profiles in patients with Metabolic Syndrome compared to apparently healthy individuals, and the participation of the myeloperoxidase/hydrogen peroxide axis in systemic lipid peroxidation. Twenty-four patients with Metabolic Syndrome and eighteen controls underwent a full clinical assessment. Venous blood samples were collected for general biochemical dosages, as well as for the oxidative stress analyses (superoxide dismutase, catalase, and arginase activities; and lipid peroxidation, myeloperoxidase activity, nitrite, and hydrogen peroxide concentrations in plasma). Arterial stiffness was assessed by radial artery applanation tonometry. Plasma lipid peroxidation, erythrocyte superoxide dismutase activity, myeloperoxidase activity, and hydrogen peroxide concentrations were shown to be increased in Metabolic Syndrome patients, without significant differences for the other enzymes, plasma nitrite concentrations, and arterial stiffness. Linear regression analysis revealed a positive and significant correlation between lipid peroxidation and myeloperoxidase and also between this enzyme and hydrogen peroxide. In contrast, such correlation was not observed between lipid peroxidation and hydrogen peroxide. In summary, Metabolic Syndrome patients exhibited evident systemic redox imbalance compared to controls, with the possible participation of the myeloperoxidase/hydrogen peroxide axis as a contributor in lipid peroxidation.

  11. Thermodynamic correction of particle concentrations measured by underwing probes on fast-flying aircraft

    Science.gov (United States)

    Weigel, Ralf; Spichtinger, Peter; Mahnke, Christoph; Klingebiel, Marcus; Afchine, Armin; Petzold, Andreas; Krämer, Martina; Costa, Anja; Molleker, Sergej; Reutter, Philipp; Szakáll, Miklós; Port, Max; Grulich, Lucas; Jurkat, Tina; Minikin, Andreas; Borrmann, Stephan

    2016-10-01

    Particle concentration measurements with underwing probes on aircraft are impacted by air compression upstream of the instrument body as a function of flight velocity. In particular, for fast-flying aircraft the necessity arises to account for compression of the air sample volume. Hence, a correction procedure is needed to invert measured particle number concentrations to ambient conditions that is commonly applicable to different instruments to gain comparable results. In the compression region where the detection of particles occurs (i.e. under factual measurement conditions), pressure and temperature of the air sample are increased compared to ambient (undisturbed) conditions in certain distance away from the aircraft. Conventional procedures for scaling the measured number densities to ambient conditions presume that the air volume probed per time interval is determined by the aircraft speed (true air speed, TAS). However, particle imaging instruments equipped with pitot tubes measuring the probe air speed (PAS) of each underwing probe reveal PAS values systematically below those of the TAS. We conclude that the deviation between PAS and TAS is mainly caused by the compression of the probed air sample. From measurements during two missions in 2014 with the German Gulfstream G-550 (HALO - High Altitude LOng range) research aircraft we develop a procedure to correct the measured particle concentration to ambient conditions using a thermodynamic approach. With the provided equation, the corresponding concentration correction factor ξ is applicable to the high-frequency measurements of the underwing probes, each of which is equipped with its own air speed sensor (e.g. a pitot tube). ξ values of 1 to 0.85 are calculated for air speeds (i.e. TAS) between 60 and 250 m s-1. For different instruments at individual wing position the calculated ξ values exhibit strong consistency, which allows for a parameterisation of ξ as a function of TAS for the current HALO

  12. Long-term follow-up of children who underwent severe hypospadias repair using an online survey with validated questionnaires.

    Science.gov (United States)

    Fraumann, Sarah A; Stephany, Heidi A; Clayton, Douglass B; Thomas, John C; Pope, John C; Adams, Mark C; Brock, John W; Tanaka, Stacy T

    2014-06-01

    Few studies of hypospadias repair in childhood have used validated questionnaires to investigate outcomes of cosmesis, urinary function, and sexual function in adulthood. We sought to investigate long-term outcomes in adult patients who had undergone severe hypospadias repair as children using an existing web-based application available to multiple institutions in order to develop an online patient survey of previously validated questionnaires. Patients aged 18 years or older who underwent severe hypospadias repair between 1992 and 1997 at our institution were contacted to complete an online survey. Through medical chart reviews, we analyzed the location of meatus, type of repair, and complications. The online survey included questions about penile appearance, and validated questionnaires to assess urinary and sexual function. Of 58 patients who met the inclusion criteria, we contacted 19, and 13 completed the survey. Fifty-nine percent had complications, with an average of 2.2 procedures per patient. Most (85.0%) were satisfied with penile appearance, although 38.0% had residual penile curvature. Hypospadias patients had mean lower orgasmic function than normal controls. Mean scores for urinary function and other domains of sexual function were similar to normal controls. Although the majority of adult patients were satisfied with the outcomes of penile appearance, urinary function, and sexual function, our online survey suggests decreased lower orgasmic function as measured by validated questionnaire. An online survey accessible to multiple institutions with validated questionnaires may facilitate assessment of long-term hypospadias results. Copyright © 2014 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  13. Endovascular Iliocaval Stent Reconstruction for Inferior Vena Cava Filter-Associated Iliocaval Thrombosis: Approach, Technical Success, Safety, and Two-Year Outcomes in 120 Patients.

    Science.gov (United States)

    Chick, Jeffrey Forris Beecham; Jo, Alexandria; Meadows, J Matthew; Abramowitz, Steven D; Khaja, Minhaj S; Cooper, Kyle J; Williams, David M

    2017-07-01

    To report technical success, outcomes, and patency of iliocaval stent reconstruction for inferior vena cava (IVC) filter-bearing iliocaval thrombosis. A total of 120 patients with 123 IVC filters and symptomatic iliocaval thrombosis underwent stent reconstruction. Mean patient age was 55 years (range, 19-88 y). Filters included 70 (57%) retrievable and 53 (43%) permanent filters. Symptoms included lower extremity swelling or pain (n = 93), ulcers (n = 8), phlegmasia (n = 7), back pain (n = 5), shortness of breath (n = 4), worsening renal function (n = 2), and stenosis identified during translumbar catheter placement (n = 1). Clinical success was defined as decrease in clinical, etiology, anatomy, and pathophysiology (CEAP) score of at least 1; resolution of presenting symptoms; or normalization of renal function in patients with juxtarenal or suprarenal thrombosis on presentation. Technical aspects of reconstruction, technical success, complications, 6-month clinical response, and 6-, 12-, and 24-month primary, primary-assisted, and secondary stent patency rates were recorded. Stent reconstruction was technically successful in all 120 patients, 63 of whom (53%) underwent thrombolysis. Thirty filters (24%) were retrieved, and 93 (76%) were excluded with stent placement across the indwelling filter. Six minor and 2 major complications occurred. Clinical success was achieved in 115 patients (96%) at 6 months. Six-, 12-, and 24-month primary iliocaval stent patency rates were 96.4%, 94.8%, and 87.2%, respectively. Twenty-four month primary-assisted and secondary patency rates were 90.3% and 94.2%, respectively. Iliocaval stent reconstruction is an effective treatment for filter-associated thrombosis with 100% technical success and 96% clinical success at 6 months. Technical and clinical outcomes in patients who underwent filter retrieval versus filter exclusion were similar. Copyright © 2017 SIR. Published by Elsevier Inc. All rights reserved.

  14. 帕米膦酸二钠治疗累及股骨近端多发性纤维结构不良的24例报告%Pamidronate disodium for polyostotic fibrous dysplasia in the proximal femur:twenty-four cases report

    Institute of Scientific and Technical Information of China (English)

    徐明; 许宋锋; 于秀淳

    2014-01-01

    疗组:末次随访Harris评分(79.58±5.2)大于治疗前Harris评分(43.67±31.8);单纯药物治疗组:末次随访Harris评分(79.17±8.4)大于治疗前Harris评分(69.75±7.9),差异均有统计学意义(P=0.002)。除5例在首次静滴帕米膦酸二钠后次日发热外,24例均未见其它不良反应。结论帕米膦酸二钠治疗累及股骨近端多发性纤维结构不良疗效确切,能减少溶骨性破坏、预防骨折风险、缓解疼痛、改善髋关节功能,不良反应轻微、短暂。对无症状的PFD、MAS无须手术治疗,可直接应用帕米膦酸二钠治疗;对病变范围局限、溶骨性破坏者须行刮除植骨内固定术,对于股骨近端病变范围大、骨强度不佳者可单纯内固定,二者术后均须应用帕米膦酸二钠治疗,以防止植骨吸收及病情恶化。%Objective To investigate the therapeutic methods and clinical effects of pamidronate disodium for polyostotic ifbrous dysplasia in the proximal femur in different degrees. Methods From June 2009 to January 2012, 24 patients with polyostotic ifbrous dysplasia in the proximal femur were adopted and treated. There were 14 males and 10 females, whose average age was 24 years old ( range;8-61 years ). A combination of surgery and postoperative pamidronate disodium was performed on 11 patients, curettage, bone graft and internal ifxation on 8 patients, simple internal fixation on 3 patients and only pamidronate disodium on 13 patients. Pamidronate disodium was taken every 3 months after the operation or after the ifrst treatment, and the duration was 2 years. Before the treatment or before pamidronate disodium injection, bone metabolic markers were detected and the imaging examination was performed in all the patients, including osteocalcin ( OC ) and C-terminal telopeptides of type I collagen ( CTX-I ).The Visual Analogue Scale ( VAS ) was used to evaluate the preoperative and postoperative pain. The hip function was systematically assessed based on the Harris

  15. HLA-G regulatory haplotypes and implantation outcome in couples who underwent assisted reproduction treatment.

    Science.gov (United States)

    Costa, Cynthia Hernandes; Gelmini, Georgia Fernanda; Wowk, Pryscilla Fanini; Mattar, Sibelle Botogosque; Vargas, Rafael Gustavo; Roxo, Valéria Maria Munhoz Sperandio; Schuffner, Alessandro; Bicalho, Maria da Graça

    2012-09-01

    The role of HLA-G in several clinical conditions related to reproduction has been investigated. Important polymorphisms have been found within the 5'URR and 3'UTR regions of the HLA-G promoter. The aim of the present study was to investigate 16 SNPs in the 5'URR and 14-bp insertion/deletion (ins/del) polymorphism located in the 3'UTR region of the HLA-G gene and its possible association with the implantation outcome in couples who underwent assisted reproduction treatments (ART). The case group was composed of 25 ART couples. Ninety-four couples with two or more term pregnancies composed the control group. Polymorphism haplotype frequencies of the HLA-G were determined for both groups. The Haplotype 5, Haplotype 8 and Haplotype 11 were absolute absence in ART couples. The HLA-G*01:01:02a, HLA-G*01:01:02b alleles and the 14-bp ins polymorphism, Haplotype 2, showed an increased frequency in case women and similar distribution between case and control men. However, this susceptibility haplotype is significantly presented in case women and in couple with failure implantation after treatment, which led us to suggest a maternal effect, associated with this haplotype, once their presence in women is related to a higher number of couples who underwent ART.

  16. Circulating S100B and Adiponectin in Children Who Underwent Open Heart Surgery and Cardiopulmonary Bypass

    Directory of Open Access Journals (Sweden)

    Alessandro Varrica

    2015-01-01

    Full Text Available Background. S100B protein, previously proposed as a consolidated marker of brain damage in congenital heart disease (CHD newborns who underwent cardiac surgery and cardiopulmonary bypass (CPB, has been progressively abandoned due to S100B CNS extra-source such as adipose tissue. The present study investigated CHD newborns, if adipose tissue contributes significantly to S100B serum levels. Methods. We conducted a prospective study in 26 CHD infants, without preexisting neurological disorders, who underwent cardiac surgery and CPB in whom blood samples for S100B and adiponectin (ADN measurement were drawn at five perioperative time-points. Results. S100B showed a significant increase from hospital admission up to 24 h after procedure reaching its maximum peak (P0.05 have been found all along perioperative monitoring. ADN/S100B ratio pattern was identical to S100B alone with the higher peak at the end of CPB and remained higher up to 24 h from surgery. Conclusions. The present study provides evidence that, in CHD infants, S100B protein is not affected by an extra-source adipose tissue release as suggested by no changes in circulating ADN concentrations.

  17. Fast relapse and high drop out rate of 48 weeks daily interferon monotherapy in HIV-infected patients with chronic hepatitis C

    Directory of Open Access Journals (Sweden)

    Patruno Savino FA

    2002-08-01

    Full Text Available Abstract Background The standard of care for HCV Hepatitis is the combination of interferon (IFN plus Ribavirin. In HIV patients the use of this combination therapy may induce drug interactions, and reduces the adherence to HAART. The aim of this study is to evaluate safety and efficacy of a 48 weeks daily dose IFN schedule. Methods We evaluated 50 coinfected patients; alpha IFN 2a was administered at a dose of 3 MU daily. The baseline values were the following : CD4+ 515 cells/mmc (mean; HIV-RNA Results At 48 weeks, 10 patients (20% achieved a biochemical and virological response according to an intention to treat analysis. Twenty four patients (48% underwent a drop-out mainly by side effects related to overlapping toxicity of interferon and antiretroviral therapy. All the patients, who responded to the treatment, showed a fast relapse one month after the end of treatment. Conclusion Although our results demonstrated a very poor outcome and a bad tolerance to interferon monotherapy, this approach should not be dropped out, mainly in patients at high risk for side effects and in those with cirrhosis who do not tolerate or are at increased risk for the use of ribavirin.

  18. Assessment of Gastric Accommodation in Patients with Functional Dyspepsia by 99mTc-Pertechtenate Single Photon Emission Computed Tomography Imaging: Practical but not Widely Accepted

    Directory of Open Access Journals (Sweden)

    Taghi Amiriani

    2015-10-01

    Full Text Available Objective: Impaired gastric accommodation is one of the main symptoms in patients with functional dyspepsia. The aim of the present study was to assess gastric accommodation in patients with functional dyspepsia using single photon emission computed tomography (SPECT imaging. Methods: Twenty-four patients with functional dyspepsia and 50 healthy volunteers as control group were enrolled in this study. All participants were given 5 mCi 99mTc-pertechtenate intravenously, served with a low fat meal, and underwent SPECT scanning 20 minutes after the meal. Results: Based on the scintigraphic data, gastric volumes were found to be significantly increased after food ingestion in both patient and control groups. We also found that while there was no significant difference between patient and control groups in terms of fasting gastric volumes, postprandial gastric volume was significantly lower in patients as compared to healthy individuals (p<0.05. Conclusion: Measuring gastric volume by using SPECT can be a valuable method in the detection of functional dyspepsia and in differentiation of this entity from other organic disorders.

  19. Right Lower Quadrant Abdominal Pain in a Patient with Prior Ventriculoperitoneal Shunting: Consider the Tip!

    Directory of Open Access Journals (Sweden)

    Petros Charalampoudis

    2012-01-01

    Full Text Available Introduction. Ventriculoperitoneal (VP shunting is the treatment of choice for nonobstructive hydrocephalus. In patients with such a device, right lower quadrant abdominal pain can puzzle the surgeon, posing a differential diagnostic problem among appendicitis, nonsurgical colicky pain, and primary shunt catheter tip infection. Treatment is different in either case. Presentation of Case. We hereby present a case of a young woman with prior ventriculoperitoneal shunt positioning who presented to our department with right lower quadrant abdominal pain. The patient underwent a 24-hour observation including a neurosurgery consult in order to exclude acute appendicitis and VP shunt tip infection. Twenty four hours later, the patient’s symptomatology improved, and she was discharged with the diagnosis of atypical colicky abdominal pain seeking a gastroenterologist consult. Discussion. This case supports that when a patient with prior VP shunting presents with right lower quadrant abdominal pain, differential diagnosis can be tricky for the surgeon. Conclusion. Apart from acute appendicitis, primary or secondary VP catheter tip infection must be considered because the latter can be disastrous.

  20. Future singularities if the universe underwent Starobinsky inflation in the past

    CERN Document Server

    Carlson, Eric D; Einhorn, John R; Hicks, Bradley; Lundeen, Andrew J

    2016-01-01

    The effects which quantum fields and an $R^2$ term in the gravitational Lagrangian have on future singularities are investigated in the case that the universe underwent Starobinsky inflation in the past. The dark energy is modeled as a perfect fluid, and the focus is on type I-IV singularities and little rips which result when the classical Einstein equations are solved with various types of dark energy as a source. First, evidence is provided that the energy densities of massive conformally coupled scalar fields approach that of the conformally invariant scalar field as a type III singularity is approached. Then, solutions to the semiclassical backreaction equations are investigated when conformally invariant fields and an $R^2$ term in the gravitational Lagrangian are present. General proofs regarding the behaviors of the solutions in cases where the dark energy results in classical singularities of the above types are given. These indicate that backreaction effects always make little rips, where the scale ...

  1. Effect of Acupuncture on Pain and Quality of Life in Patients with Lumbar Spinal Stenosis: A Case Series Study.

    Science.gov (United States)

    Hadianfard, Mohammad J; Aminlari, Ali; Daneshian, Arghavan; Safarpour, Ali R

    2016-08-01

    Lumbar spinal stenosis (LSS) is a major cause of debilitation in adults, and acupuncture is a recommended treatment. We assessed the effect of acupuncture on pain and quality of life in patients with LSS. Twenty-four patients with LSS who had symptoms of neurogenic claudication were randomly selected and underwent 10 sessions of acupuncture. Pain and quality of life were evaluated before and immediately after the intervention and 6 weeks later using a visual analogue scale and Short Form-36 Health Survey. Paired t tests and repeated measure tests were used to analyze the data. The mean age of the patients was 48.2 ± 10.8 years. The mean visual analogue scale scores before and immediately after intervention (7.9 ± 1.3 and 4.3 ± 2.1) were statistically different (p acupuncture (p pain, and physical well-being. Therefore, acupuncture had a significant short-term effect on pain and quality of life in patients with LSS.

  2. Differential anti-ischaemic effects of muscarinic receptor blockade in patients with obstructive coronary artery disease - impaired vs normal left ventricular function

    NARCIS (Netherlands)

    van den Heuvel, AFM; van Veldhuisen, DJ; Bartels, GL; van der Ent, M; Remme, WJ

    1999-01-01

    Aims In patients with coronary artery disease acetylcholine (a muscarinic agonist) causes vasoconstriction. The effect of atropine (a muscarinic antagonist) on coronary vasotone in patients with normal or impaired left ventricular function is unknown. Methods and Results Twenty-four patients who req

  3. [Predict value of time to peak of systolic velocity derived from velocity vector imaging on cardiac resynchronization therapy response in refractory heart failure patients].

    Science.gov (United States)

    Guo, Jianping; Wang, Yutang; Zhi, Guang; Zhang, Xiaojuan; Shan, Zhaoliang; Shi, Xiangmin; Lin, Kun

    2015-09-01

    To investigate the impact of cardiac resynchronization therapy (CRT) on left ventricular systolic function evaluated by velocity vector imaging (VVI) in refractory heart failure patients and the predictive value of VVI on CRT responses. This study included 38 patients with medically refractory heart failure (HF) patients underwent CRT in our department from May 2007 to April 2011. Left ventricular long axis dyssynchrony indexes including time to peak of systolic velocity (Ts max-min), standard deviation of the time to peak of systolic velocity (Ts-SD) before and at 3-6 months post CRT. CRT response was defined as 15% decrease in left ventricular end-systolic volume. ROC curve and the area under the curve (AUC) were calculated. Twenty-four patients were defined as responder. No significant difference was observed between responders and non-responders in medical therapy. When using Ts max-min to predict response, the AUC of ROC curves was 0.76 ± 0.07. The sensitivity and specifity was 70.8% and 77.8% respectively with Ts max-min ≥ 124.0 ms. When using Ts-SD to predict response, the AUC of ROC curves was 0.82 ± 0.07. The sensitivity and specifity was 79.2% and 71.2% respectively with Ts-SD ≥ 40.5. Ts-SD is a useful index to predict CRT response in refractory HF patients.

  4. Association between Seminal Vesicle Invasion and Prostate Cancer Detection Location after Transrectal Systemic Biopsy among Men Who Underwent Radical Prostatectomy.

    Directory of Open Access Journals (Sweden)

    Young Ik Lee

    Full Text Available Our hypothesis is that the location of the seminal vesicles near the base of the prostate, the more positive cores are detected in the base, the greater the risk of seminal vesicle invasion. Therefore we investigate the clinical outcomes of base dominant prostate cancer (BDPC in transrectal ultrasound (TRUS -guided biopsies compared with anteromiddle dominant prostate cancer (AMPC.From November 2003 to June 2014, a total of 990 intermediate and high risk prostate cancer (PCa patients who underwent radical prostatectomy (RP were enrolled and stratified into two groups according to proportion of positive cores-BDPC group had ≥ 33.3% ratio of positive cores from the prostate base among all positive cores and AMPC group < 33.3% in systemic biopsy. Between two groups, we compared the rate of pathologic outcomes and biochemical recurrence (BCR. We performed multivariate logistic regression model to confirm the significance of BDPC to seminal vesicle invasion (SVI and Cox proportional hazard analysis to BCR.Among these 990 PCa patients, the 487 patients in BDPC group had more advanced clinical stage (p<0.001, a higher biopsy GS (p = 0.002, and a higher rate of extracapsular extension (ECE, SVI and BCR (all p<0.001 than AMPC group. The patients in BDPC group had poor BCR free survival rate via Kaplan-meier analysis (p<0.001. The ratio of the base positive cores was a significant predictor to SVI in multivariate analysis (p < 0.001 and significant predictor of BCR in multivariate Cox proportional analysis (hazard ratio: 1.466, p = 0.004.BDPC in TRUS-guided prostate biopsies was significantly associated with SVI and BCR after adjusting for other clinical factors. Therefore, BDPC should be considered to be a more aggressive tumor despite an otherwise similar cancer profile.

  5. RECURRENCE OF PAROXYSMAL ATRIAL-FIBRILLATION OR FLUTTER AFTER SUCCESSFUL CARDIOVERSION IN PATIENTS WITH NORMAL LEFT-VENTRICULAR FUNCTION

    NARCIS (Netherlands)

    SUTTORP, MJ; KINGMA, JH; KOOMEN, EM; VANTHOF, A; TIJSSEN, JGP; LIE, KI

    1993-01-01

    One hundred twenty-four consecutive patients (85%) with paroxysmal atrial fibrillation (AF) and 21 (15%) with atrial flutter (AFI) were studied immediately after pharmacologic or electrical cardioversion to sinus rhythm. Mean age was 59 +/- 13 years (range 23 to 79). Patients with reduced left ventr

  6. Safety and Efficacy of Liraglutide in Patients With Type 2 Diabetes and End-Stage Renal Disease

    DEFF Research Database (Denmark)

    Idorn, Thomas; Knop, Filip K; Jørgensen, Morten B;

    2016-01-01

    OBJECTIVE: To evaluate parameters related to safety and efficacy of liraglutide in patients with type 2 diabetes and dialysis-dependent end-stage renal disease (ESRD). RESEARCH DESIGN AND METHODS: Twenty-four patients with type 2 diabetes and ESRD and 23 control subjects with type 2 diabetes...

  7. Adverse effect of excess body weight on survival in cervical cancer patients after surgery and radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Yunseon; Ahn, Ki Jung; Park, Sung Kwang; Cho, Heung Lae; Lee, Ji Young [Inje University Busan Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

    2017-03-15

    This study aimed to assess the effects of body mass index (BMI) on survival in cervical cancer patients who had undergone surgery and radiotherapy (RT). We retrospectively reviewed the medical records of 70 cervical cancer patients who underwent surgery and RT from 2007 to 2012. Among them, 40 patients (57.1%) had pelvic lymph node metastases at the time of diagnosis. Sixty-seven patients (95.7%) had received chemotherapy. All patients had undergone surgery and postoperative RT. Median BMI of patients was 22.8 kg/m2 (range, 17.7 to 35.9 kg/m2). The median duration of follow-up was 52.3 months (range, 16 to 107 months). Twenty-four patients (34.3%) showed recurrence. Local failure, regional lymph nodal failure, and distant failure occurred in 4 (5.7%), 6 (8.6%), and 17 (24.3%) patients, respectively. The 5-year actuarial pelvic control rate was 83.4%. The 5-year cancer-specific survival (CSS) and disease-free survival (DFS) rates were 85.1% and 65.0%, respectively. The presence of pelvic lymph node metastases (n = 30) and being overweight or obese (n = 34, BMI ≥ 23 kg/m2) were poor prognostic factors for CSS (p = 0.003 and p = 0.045, respectively). Of these, pelvic lymph node metastasis was an independent prognostic factor (p = 0.030) for CSS. Overweight or obese cervical cancer patients showed poorer survival outcomes than normal weight or underweight patients. Weight control seems to be important in cervical cancer patients to improve clinical outcomes.

  8. Adverse effect of excess body weight on survival in cervical cancer patients after surgery and radiotherapy.

    Science.gov (United States)

    Choi, Yunseon; Ahn, Ki Jung; Park, Sung Kwang; Cho, Heunglae; Lee, Ji Young

    2017-03-01

    This study aimed to assess the effects of body mass index (BMI) on survival in cervical cancer patients who had undergone surgery and radiotherapy (RT). We retrospectively reviewed the medical records of 70 cervical cancer patients who underwent surgery and RT from 2007 to 2012. Among them, 40 patients (57.1%) had pelvic lymph node metastases at the time of diagnosis. Sixty-seven patients (95.7%) had received chemotherapy. All patients had undergone surgery and postoperative RT. Median BMI of patients was 22.8 kg/m(2) (range, 17.7 to 35.9 kg/m(2)). The median duration of follow-up was 52.3 months (range, 16 to 107 months). Twenty-four patients (34.3%) showed recurrence. Local failure, regional lymph nodal failure, and distant failure occurred in 4 (5.7%), 6 (8.6%), and 17 (24.3%) patients, respectively. The 5-year actuarial pelvic control rate was 83.4%. The 5-year cancer-specific survival (CSS) and disease-free survival (DFS) rates were 85.1% and 65.0%, respectively. The presence of pelvic lymph node metastases (n = 30) and being overweight or obese (n = 34, BMI ≥ 23 kg/m(2)) were poor prognostic factors for CSS (p = 0.003 and p = 0.045, respectively). Of these, pelvic lymph node metastasis was an independent prognostic factor (p = 0.030) for CSS. Overweight or obese cervical cancer patients showed poorer survival outcomes than normal weight or underweight patients. Weight control seems to be important in cervical cancer patients to improve clinical outcomes.

  9. Twenty-Four-Hour Urine Osmolality as a Physiological Index of Adequate Water Intake

    Directory of Open Access Journals (Sweden)

    Erica T. Perrier

    2015-01-01

    Full Text Available While associations exist between water, hydration, and disease risk, research quantifying the dose-response effect of water on health is limited. Thus, the water intake necessary to maintain optimal hydration from a physiological and health standpoint remains unclear. The aim of this analysis was to derive a 24 h urine osmolality (UOsm threshold that would provide an index of “optimal hydration,” sufficient to compensate water losses and also be biologically significant relative to the risk of disease. Ninety-five adults (31.5 ± 4.3 years, 23.2 ± 2.7 kg·m−2 collected 24 h urine, provided morning blood samples, and completed food and fluid intake diaries over 3 consecutive weekdays. A UOsm threshold was derived using 3 approaches, taking into account European dietary reference values for water; total fluid intake, and urine volumes associated with reduced risk for lithiasis and chronic kidney disease and plasma vasopressin concentration. The aggregate of these approaches suggest that a 24 h urine osmolality ≤500 mOsm·kg−1 may be a simple indicator of optimal hydration, representing a total daily fluid intake adequate to compensate for daily losses, ensure urinary output sufficient to reduce the risk of urolithiasis and renal function decline, and avoid elevated plasma vasopressin concentrations mediating the increased antidiuretic effort.

  10. Twenty-four near-instabilities of Caspar-Klug viruses

    Science.gov (United States)

    Englert, François; Peeters, Kasper; Taormina, Anne

    2008-09-01

    Group theoretical arguments combined with normal mode analysis techniques are applied to a coarse-grained approximation of icosahedral viral capsids which incorporates areas of variable flexibility. This highlights a remarkable structure of the low-frequency spectrum in this approximation, namely, the existence of a plateau of 24 near zero modes with universal group theory content.

  11. LECTURES ON ACUPUNCTURE Part Ⅰ Clinical Acupuncture Lecture Twenty-Four "XIONGBI" (CHEST PAIN) SYNDROME

    Institute of Scientific and Technical Information of China (English)

    Dong Hongying; Guo Ling; Shang Xiukui

    2001-01-01

    @@ "Xiongbi" chest (or precordial) pain with stuffiness, or chest pain syndrome is referred to choking pain in the chest due to stagnation of chest -yang, failure of qi and blood in warming and nourishing the local meridians. It is usually caused by stagnation of dampness and phlegm in the interior, or by insufficiency of qi and blood stasis, leading to impeded flow of qi and blood in the heart vessels. Its pathological characteristics are deficiency (chest-yang) in origin and excess (i. e., qi stagnation) in superficiality. The therapeutic principles are promoting blood circulation to remove blood stasis, getting rid of blockage and dredging the passages of yang-qi.

  12. Twenty-four hour urinary urea excretion and 9-year risk of hypertension: The PREVEND study

    NARCIS (Netherlands)

    Tielemans, S.M.A.J.; Geleijnse, J.M.; Baak, M.A. van; Engberink, M.F.; Brink, E.J.; Jong, P.E. de; Gansevoort, R.T.; Bakker, S.J.L.

    2013-01-01

    OBJECTIVES: It is not yet clear whether dietary protein could help maintaining a healthy blood pressure (BP). We investigated the association between total protein intake, estimated from 24-h urinary urea excretion, and incident hypertension in Dutch men and women. METHODS: We analyzed data of 3997

  13. Autistic children grow up: an eight to twenty-four year follow-up study.

    Science.gov (United States)

    Wolf, L; Goldberg, B

    1986-08-01

    Eighty questionnaires were sent to parents and/or caregivers of autistic persons diagnosed between 1960-73 at CPRI, a regional assessment and treatment centre. The objective was to determine their present place of residence, functioning ability, language development, program involvement, and seizure activity. The results of this study support evidence that more than 50 percent require long-term institutional care; almost one-third suffer epileptic seizures; there is a persistence of symptoms and difficulty in gaining useful speech; few live independently or are capable of employment.

  14. Total antioxidant and antiproliferative activities of twenty-four Vitis vinifera grapes

    Science.gov (United States)

    The phytochemical profiles of 24 Vitis vinifera grape cultivars, including total phenolics, total flavonoids, total antioxidant activity and antiproliferative activity, were determined. Total phenolic contents in the cultivars ranged from 95.3 to 686.5 mg of gallic acid equivalents/100 g FW, and to...

  15. Twenty four year time trends in fats and cholesterol intake by adolescents. Warsaw Adolescents Study

    Directory of Open Access Journals (Sweden)

    Charzewska Jadwiga

    2015-06-01

    Full Text Available The objective of this study was to determine time trends (1982–2006 in total fat intake and changes in fatty acid structure intake in adolescents from Warsaw in view of increasing prevalence of obesity. Data come from four successive surveys randomly selected samples of adolescents (aged 11–15 years old, from Warsaw region. In total 9747 pupils have been examined, with response rate varying from 55% to 87% depending on year. Surveys were done always in the spring season of the year. Food intake was assessed by using 24 hours recall method of consumption by the pupils all products, including enriched, dishes and beverages as well as diet supplements, in the last 24 hours preceding the examination. The content of energy and nutrients was calculated by means of own computer softwares (DIET 2 and 4, taking into account successive revisions of the tables of food composition and nutritional values, as well as current Polish DRI. A significant decreasing trend was found in intake of total fat, of saturated fatty acids (SFA and cholesterol. The percentage of energy from total fat, also decreased both in boys (to 35,1% and girls (to 33,7%, what failed to reach the desired level below 30% of energy from fat which is recommended. Also significant decrease of SFA consumption was not satisfactory enough to approach the values <10% of energy recommended as was from 13% to 15%. Decreasing trends in fat intake was not in accordance with the trend in obesity prevalence in the adolescents as average BMI is going up. To stabilize the health-oriented changes especially in the diets of adolescents, further activity is desired from professionals working with prevention of adolescents obesity.

  16. Twenty-four hour urinary urea excretion and 9-year risk of hypertension : the PREVEND study

    NARCIS (Netherlands)

    Tielemans, Susanne M. A. J.; Geleijnse, Johanna M.; van Baak, Marleen A.; Engberink, Marielle F.; Brink, Elizabeth J.; de Jong, Paul E.; Gansevoort, Ronald T.; Bakker, Stephan J. L.

    2013-01-01

    Objectives:It is not yet clear whether dietary protein could help maintaining a healthy blood pressure (BP). We investigated the association between total protein intake, estimated from 24-h urinary urea excretion, and incident hypertension in Dutch men and women.Methods:We analyzed data of 3997 men

  17. Twenty-four hour urinary urea excretion and 9-year risk of hypertension: the PREVEND study

    NARCIS (Netherlands)

    Tielemans, S.M.A.J.; Geleijnse, J.M.; Baak, van M.A.; Engberink, M.F.; Brink, E.J.; Jong, P.E.; Gansevoort, R.T.; Bakker, S.J.A.

    2013-01-01

    OBJECTIVES:: It is not yet clear whether dietary protein could help maintaining a healthy blood pressure (BP). We investigated the association between total protein intake, estimated from 24-h urinary urea excretion, and incident hypertension in Dutch men and women. METHODS:: We analyzed data of 399

  18. Twenty-Four Veterinary Anatomic Fibs, Half-Truths, and Misleading Statements.

    Science.gov (United States)

    Shively, Michael Jay

    1979-01-01

    A number of statements about well-established information in veterinary anatomy are debated and refuted: (1) sesamoid bones change the direction of tendons, (2) tendons are composed of collagenous connective tissue, (3) anal glands are synonymous with anal sacs, (4) reciprocal apparatus is part of stay apparatus, etc. (Author/MLW)

  19. Twenty-four-hour ambulatory blood pressure in children with sleep-disordered breathing.

    Science.gov (United States)

    Amin, Raouf S; Carroll, John L; Jeffries, Jenny L; Grone, Charles; Bean, Judy A; Chini, Barbara; Bokulic, Ronald; Daniels, Stephen R

    2004-04-15

    Obstructive sleep apnea causes intermittent elevation of systemic blood pressure (BP) during sleep. To determine whether obstructive apnea in children has a tonic effect on diurnal BP, 24-hour ambulatory blood pressure was obtained from 60 children with mean age of 10.8 +/- 3.5 years. Thirty-nine children had obstructive apnea and 21 had primary snoring. Children with obstructive apnea had significantly greater mean BP variability during wakefulness and sleep, a higher night-to-day systolic BP, and a smaller nocturnal dipping of mean BP. Variability of mean arterial pressure during wakefulness was predicted by the desaturation, body mass, and arousal indices, whereas variability during sleep was predicted by apnea-hypopnea and body mass indices. Nocturnal BP dipping was predicted by the desaturation index. There were no significant differences in systolic, diastolic, or mean arterial BP during sleep between the groups. Diastolic BP during wakefulness was significantly different between the groups and correlated negatively with apnea-hypopnea index. We conclude that obstructive apnea in children is associated with 24-hour BP dysregulation and that, independent of obesity, the frequency of obstructive apnea, oxygen desaturation, and arousal contributes to abnormal BP control.

  20. Community Energy Systems and the Law of Public Utilities. Volume Twenty-four. Michigan

    Energy Technology Data Exchange (ETDEWEB)

    Feurer, D.A.; Weaver, C.L.

    1981-01-01

    A detailed description of the laws and programs of the State of Michigan governing the regulation of public energy facilities, the municipal franchising of public energy utilities, and the prescription of rates to be charged by utilities including attendant problems of cost allocations, rate base and operating expense determinations, and rate of return allowances. These laws and programs are analyzed to identify impediments which they may present to the implementation of Integrated Community Energy Systems (ICES). This report is one of fifty-one separate volumes which describe such regulatory programs at the Federal level and in each state as background to the report entitled Community Energy Systems and the Law of Public Utilities - Volume One: An Overview. This report also contains a summary of a strategy described in Volume One - An Overview for overcoming these impediments by working within the existing regulatory framework and by making changes in the regulatory programs to enhance the likelihood of ICES implementation.

  1. 77 FR 47631 - Agency Information Collection Activities: Request for Comments on Twenty-Four Proposed...

    Science.gov (United States)

    2012-08-09

    ...: NSPS for Synthetic Fiber Production Facilities (40 CFR Part 60, Subpart HHH). ICR Numbers: EPA ICR..., 2012. (9) NSPS for Synthetic Fiber Production Facilities (40 CFR Part 60, Subpart HHH); Learia Williams... Part 60, Subpart HHH); Docket ID Number EPA-HQ-OECA-2012-0528; EPA ICR Number 1156.12; OMB...

  2. A Twenty-Four-Year-Old Woman with Left Flank Lipoma-Like Hibernoma

    Directory of Open Access Journals (Sweden)

    R.E. Shackelford

    2017-05-01

    Full Text Available A 24-year-old woman presented with a 5-month history of a left flank mass that was painful on palpation. Magnetic resonance imaging revealed a 10.0 × 6.0 × 2.5 cm mass consistent with lipoma. A fatty lobulated mass was excised and subjected to H&E staining and immunohistochemical analyses. The specimen consisted of mature univacuolated adipocytic cells, with intermixed multivacuolated eosinophilic granular cells. No atypia or hyperchromasia was identified. Most of the cells were S100 positive and Ki-67 immunonegative. A diagnosis of a lipoma-like hibernoma was rendered. Hibernomas are rare benign lipomatous tumors that show differentiation toward brown fat. The lipoma-like hibernoma subtype is rare and can be misdiagnosed as atypical lipoma or well-differentiated liposarcoma. Here we describe an example of this rare tumor.

  3. Twenty-four years of follow-up for a Hanford plutonium wound case.

    Science.gov (United States)

    Carbaugh, Eugene H; Lynch, Timothy P; Antonio, Cheryl L; Medina-Del Valle, Fernando

    2010-10-01

    A 1985 plutonium puncture wound resulted in the initial deposition of 48 kBq of transuranic alpha activity, primarily 239+240Pu and 241Am, in a worker's right index finger. Surgical excisions in the week following reduced the long-term residual wound activity to 5.4 kBq, and 164 DTPA chelation therapy administrations over 17 mo resulted in urinary excretion of about 7 kBq. The case was published in 1988, but now 24 y of follow-up data are available. Annual bioassays have included in-vivo measurements of 241Am in the wound, skeleton, liver, lung, and axillary lymph nodes, and urinalyses for plutonium and 241Am. These measurements have shown relatively stable levels of 241Am at the wound site, with gradually increasing amounts of 241Am detected in the skeleton. Liver measurements have shown erratic detection of 241Am, and the lung measurements indicate Am but as interference from activity in the axillary lymph nodes and skeleton rather than activity in the lung. Urine excretion of Pu since termination of chelation therapy has typically ranged from 10 to 20 mBq d, with Am excretion about 10% of that for 239+240Pu. Annual routine medical exams have not identified any adverse health effects associated with the intake.

  4. Low-dose rate prostate brachytherapy is well tolerated in patients with a history of inflammatory bowel disease.

    Science.gov (United States)

    Peters, Christopher A; Cesaretti, Jamie A; Stone, Nelson N; Stock, Richard G

    2006-10-01

    We report on the follow-up of 24 patients with a prior history of inflammatory bowel disease (IBD) treated with brachytherapy for early-stage prostate cancer. Twenty-four patients with a history of inflammatory bowel disease (17 with ulcerative colitis (UC), 7 with Crohn's disease [CD]) underwent prostate brachytherapy between 1992 and 2004. Fifteen patients were treated with I-125 implantation and 6 patients were treated with Pd-103 alone or in combination with 45 Gy external beam radiation. Charts were reviewed for all patients, and all living patients were contacted by phone. National Cancer Institute common toxicity scores for proctitis were assigned to all patients. Actuarial risk of late toxicity was calculated by the Kaplan-Meier method. Statistical analysis was performed using SPSS software. Follow-up ranged from 3 to 126 months (median, 48.5 months; mean, 56.8 months). None of the patients experienced Grade 3 or 4 rectal toxicity. Four patients experienced Grade 2 late rectal toxicity. The 5-year actuarial freedom from developing late Grade 2 rectal toxicity was 81%. At a median follow-up of 48.5 months, 23 patients were alive and had no evidence of disease with a median prostate-specific antigen for the sample of 0.1 ng/mL (range, <0.05-0.88 ng/mL). One patient died of other causes unrelated to his prostate cancer. Prostate brachytherapy is well tolerated in patients with a history of controlled IBD. Therefore, brachytherapy should be considered a viable therapeutic option in this patient population.

  5. Renal versus splenic maximum slope based perfusion CT modelling in patients with portal-hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, Michael A. [University Hospital Zurich, Department of Diagnostic and Interventional Radiology, Zurich (Switzerland); Karolinska Institutet, Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology (CLINTEC), Stockholm (Sweden); Brehmer, Katharina [Karolinska University Hospital Huddinge, Department of Radiology, Stockholm (Sweden); Svensson, Anders; Aspelin, Peter; Brismar, Torkel B. [Karolinska Institutet, Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology (CLINTEC), Stockholm (Sweden); Karolinska University Hospital Huddinge, Department of Radiology, Stockholm (Sweden)

    2016-11-15

    To assess liver perfusion-CT (P-CT) parameters derived from peak-splenic (PSE) versus peak-renal enhancement (PRE) maximum slope-based modelling in different levels of portal-venous hypertension (PVH). Twenty-four patients (16 men; mean age 68 ± 10 years) who underwent dynamic P-CT for detection of hepatocellular carcinoma (HCC) were retrospectively divided into three groups: (1) without PVH (n = 8), (2) with PVH (n = 8), (3) with PVH and thrombosis (n = 8). Time to PSE and PRE and arterial liver perfusion (ALP), portal-venous liver perfusion (PLP) and hepatic perfusion-index (HPI) of the liver and HCC derived from PSE- versus PRE-based modelling were compared between the groups. Time to PSE was significantly longer in PVH groups 2 and 3 (P = 0.02), whereas PRE was similar in groups 1, 2 and 3 (P > 0.05). In group 1, liver and HCC perfusion parameters were similar for PSE- and PRE-based modelling (all P > 0.05), whereas significant differences were seen for PLP and HPI (liver only) in group 2 and ALP in group 3 (all P < 0.05). PSE is delayed in patients with PVH, resulting in a miscalculation of PSE-based P-CT parameters. Maximum slope-based P-CT might be improved by replacing PSE with PRE-modelling, whereas the difference between PSE and PRE might serve as a non-invasive biomarker of PVH. (orig.)

  6. Learning effect of humphrey matrix frequency doubling technology perimetry in patients with ocular hypertension.

    Science.gov (United States)

    Centofanti, Marco; Fogagnolo, Paolo; Oddone, Francesco; Orzalesi, Nicola; Vetrugno, Michele; Manni, Gianluca; Rossetti, Luca

    2008-09-01

    To evaluate the learning effect of Frequency Doubling Technology (FDT) perimetry using the Humphrey Matrix-FDT perimetry (Matrix) 24-2 full-threshold program on patients with ocular hypertension experienced with standard automated perimetry. Twenty-four patients with ocular hypertension underwent 5 full-threshold Matrix tests at intervals of 5+/-2 days. Learning effect was defined as an improvement at results for duration, perimetric indices, foveal sensitivity, Glaucoma Hemifield Test, and the number of points with a Plearning effect. Test-retest variability was also calculated for each repetition as the mean of the point-to-point interindividual standard deviations. A learning effect was demonstrated for mean defect (P=0.031, analysis of variance) and foveal sensitivity (P=0.009) and it only affected the first test for both parameters. All the other parameters did not show any significant learning effect. The effect was independent from eccentricity and quadrant or hemifield sensitivities. The results of this study demonstrate that the learning effect for Matrix-FDT is mild and it may affect only the first test. Caution is needed in the analysis of the first Matrix-FDT examination and retest may be advisable in the presence of low mean defect.

  7. Saphenous vein graft thrombus findings by scanning electron microscopy in a patient with acute myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Borges, Marcela Dias; Aguillera, André Haraguti [Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP (Brazil); Brilhante, José Joaquim; Caixeta, Adriano [Hospital Israelita Albert Einstein, São Paulo, SP (Brazil)

    2013-07-01

    An eighty-year-old male patient with a history of prior (19 years) coronary artery bypass graft surgery was admitted to the hospital with non ST-segment elevation myocardial infarction (NSTEMI). During the hospital stay he was taking acetylsalicylic acid 100mg per day, a loading dose of 600mg clopidogrel, and low molecular weight heparin 1mg/kg twice a day. Twenty-four hours later the patient underwent coronary angiography, which showed a 90% obstruction in the mid portion of the saphenous vein graft to obtuse marginal with signs of degeneration and local thrombus (Figure 1). Thrombus aspiration was performed with a 6-Fr Export{sup ™} catheter (Medtronic, Santa Rosa, CA, USA), which removed small reddish colored fragments. They were fixed in 2,5% glutaraldehyde in a 0.1M sodium cacodilate buffer. The material was processed following the GOTO protocol in which the fragments were washed with osmium tetroxide and titanic acid, after which they were dried in a critical-point device and a golden bath. Scanning electron microscopy and high definition photos (3,000 to 27,221x magnification) were obtained by the FEI Quanta{sup ™} FEG SEM device (FEI Company, Hillsboro, OR, USA). The images showed that the thrombus was rich in activated platelets, with few erythrocytes or inflammatory cells. Many cholesterol crystals were observed (Figures 2 to). The fibrin networks were sparse and thin, which is compatible with a short ischemic time and recent thrombus formation.

  8. Supragingival biofilm control and systemic inflammation in patients with type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Hilana Paula Carillo ARTESE

    2015-01-01

    Full Text Available The objective of this study was to evaluate the effect of strict supragingival biofilm control on serum inflammatory markers and on periodontal clinical parameters in type 2 diabetes mellitus (T2DM patients with chronic severe periodontitis. Twenty-four individuals with T2DM and periodontitis were randomly allocated to two treatment groups. The supragingival therapy group (ST, n = 12 received supragingival scaling, whereas the intensive therapy group (IT, n = 12 underwent supra- and subgingival scaling, as well as root planing. Patients from both groups received professional oral hygiene instructions every month. Data regarding visible plaque index (VPI, gingival bleeding index (GBI, bleeding on probing (BOP, probing pocket depth (PPD, clinical attachment level (CAL, serum levels of interleukin (IL-6, IL-17A, IL-8, tumor necrosis factor α (TNF-α, monocyte chemoattractant protein (MCP-1 enzyme-linked immunosorbent assay (ELISA, and glycated hemoglobin (HbA1c levels were obtained at baseline and at 6 months post-therapy. Both therapies resulted in the improvement of almost all clinical periodontal parameters (p 0.05, between the two periods. However, MCP-1 levels were significantly reduced in both the ST (p = 0.034 and the IT (p = 0.016 groups, whereas the serum IL-6 levels were significantly reduced only in the IT group (p = 0.001. Strict control of supragingival biofilm has a limited effect on systemic inflammatory markers, and a moderate effect on periodontal clinical parameters.

  9. Repeated otilonium bromide administration prevents neurotransmitter changes in colon of rats underwent to wrap restraint stress.

    Science.gov (United States)

    Traini, Chiara; Evangelista, Stefano; Girod, Vincent; Faussone-Pellegrini, Maria Simonetta; Vannucchi, Maria Giuliana

    2017-04-01

    Otilonium bromide (OB) is a spasmolytic drug successfully used for the treatment of irritable bowel syndrome (IBS). Its efficacy has been attributed to the block of L- and T-type Ca(2+) channels and muscarinic and tachykinin receptors in the smooth muscle. Furthermore, in healthy rats, repeated OB administration modified neurotransmitter expression and function suggesting other mechanisms of action. On this basis, we investigated whether repeated OB treatment prevented the functional and neurochemical changes observed in the colon of rats underwent to wrap restrain stress (WRS) a psychosocial stressor considered suitable to reproduce the main IBS signs and symptoms. In control, WRS and OB/WRS rats functional parameters were measured in vivo and morphological investigations were done ex vivo in the colon. The results showed that OB counteracts most of the neurotransmitters changes caused by WRS. In particular, the drug prevents the decrease in SP-, NK1r-, nNOS-, VIP-, and S100β-immunoreactivity (IR) and the increase in CGRP-, and CRF1r-IR. On the contrary, OB does not affect the increase in CRF2r-IR neurons observed in WRS rats and does not interfere with the mild mucosal inflammation due to WRS. Finally, OB per se increases the Mr2 expression in the muscle wall and decreases the number of the myenteric ChAT-IR neurons. Functional findings show a significantly reduction in the number of spontaneous abdominal contraction in OB treated rats. The ability of OB to block L-type Ca(2+) channels, also expressed by enteric neurons, might represent a possible mechanism through which OB exerts its actions. © 2016 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.

  10. Vitellogenin underwent subfunctionalization to acquire caste and behavioral specific expression in the harvester ant Pogonomyrmex barbatus.

    Science.gov (United States)

    Corona, Miguel; Libbrecht, Romain; Wurm, Yannick; Riba-Grognuz, Oksana; Studer, Romain A; Keller, Laurent

    2013-01-01

    The reproductive ground plan hypothesis (RGPH) proposes that the physiological pathways regulating reproduction were co-opted to regulate worker division of labor. Support for this hypothesis in honeybees is provided by studies demonstrating that the reproductive potential of workers, assessed by the levels of vitellogenin (Vg), is linked to task performance. Interestingly, contrary to honeybees that have a single Vg ortholog and potentially fertile nurses, the genome of the harvester ant Pogonomyrmex barbatus harbors two Vg genes (Pb_Vg1 and Pb_Vg2) and nurses produce infertile trophic eggs. P. barbatus, thus, provides a unique model to investigate whether Vg duplication in ants was followed by subfunctionalization to acquire reproductive and non-reproductive functions and whether Vg reproductive function was co-opted to regulate behavior in sterile workers. To investigate these questions, we compared the expression patterns of P. barbatus Vg genes and analyzed the phylogenetic relationships and molecular evolution of Vg genes in ants. qRT-PCRs revealed that Pb_Vg1 is more highly expressed in queens compared to workers and in nurses compared to foragers. By contrast, the level of expression of Pb_Vg2 was higher in foragers than in nurses and queens. Phylogenetic analyses show that a first duplication of the ancestral Vg gene occurred after the divergence between the poneroid and formicoid clades and subsequent duplications occurred in the lineages leading to Solenopsis invicta, Linepithema humile and Acromyrmex echinatior. The initial duplication resulted in two Vg gene subfamilies preferentially expressed in queens and nurses (subfamily A) or in foraging workers (subfamily B). Finally, molecular evolution analyses show that the subfamily A experienced positive selection, while the subfamily B showed overall relaxation of purifying selection. Our results suggest that in P. barbatus the Vg gene underwent subfunctionalization after duplication to acquire caste- and

  11. Vitellogenin underwent subfunctionalization to acquire caste and behavioral specific expression in the harvester ant Pogonomyrmex barbatus.

    Directory of Open Access Journals (Sweden)

    Miguel Corona

    Full Text Available The reproductive ground plan hypothesis (RGPH proposes that the physiological pathways regulating reproduction were co-opted to regulate worker division of labor. Support for this hypothesis in honeybees is provided by studies demonstrating that the reproductive potential of workers, assessed by the levels of vitellogenin (Vg, is linked to task performance. Interestingly, contrary to honeybees that have a single Vg ortholog and potentially fertile nurses, the genome of the harvester ant Pogonomyrmex barbatus harbors two Vg genes (Pb_Vg1 and Pb_Vg2 and nurses produce infertile trophic eggs. P. barbatus, thus, provides a unique model to investigate whether Vg duplication in ants was followed by subfunctionalization to acquire reproductive and non-reproductive functions and whether Vg reproductive function was co-opted to regulate behavior in sterile workers. To investigate these questions, we compared the expression patterns of P. barbatus Vg genes and analyzed the phylogenetic relationships and molecular evolution of Vg genes in ants. qRT-PCRs revealed that Pb_Vg1 is more highly expressed in queens compared to workers and in nurses compared to foragers. By contrast, the level of expression of Pb_Vg2 was higher in foragers than in nurses and queens. Phylogenetic analyses show that a first duplication of the ancestral Vg gene occurred after the divergence between the poneroid and formicoid clades and subsequent duplications occurred in the lineages leading to Solenopsis invicta, Linepithema humile and Acromyrmex echinatior. The initial duplication resulted in two Vg gene subfamilies preferentially expressed in queens and nurses (subfamily A or in foraging workers (subfamily B. Finally, molecular evolution analyses show that the subfamily A experienced positive selection, while the subfamily B showed overall relaxation of purifying selection. Our results suggest that in P. barbatus the Vg gene underwent subfunctionalization after duplication to

  12. Vitellogenin Underwent Subfunctionalization to Acquire Caste and Behavioral Specific Expression in the Harvester Ant Pogonomyrmex barbatus

    Science.gov (United States)

    Wurm, Yannick; Riba-Grognuz, Oksana; Studer, Romain A.; Keller, Laurent

    2013-01-01

    The reproductive ground plan hypothesis (RGPH) proposes that the physiological pathways regulating reproduction were co-opted to regulate worker division of labor. Support for this hypothesis in honeybees is provided by studies demonstrating that the reproductive potential of workers, assessed by the levels of vitellogenin (Vg), is linked to task performance. Interestingly, contrary to honeybees that have a single Vg ortholog and potentially fertile nurses, the genome of the harvester ant Pogonomyrmex barbatus harbors two Vg genes (Pb_Vg1 and Pb_Vg2) and nurses produce infertile trophic eggs. P. barbatus, thus, provides a unique model to investigate whether Vg duplication in ants was followed by subfunctionalization to acquire reproductive and non-reproductive functions and whether Vg reproductive function was co-opted to regulate behavior in sterile workers. To investigate these questions, we compared the expression patterns of P. barbatus Vg genes and analyzed the phylogenetic relationships and molecular evolution of Vg genes in ants. qRT-PCRs revealed that Pb_Vg1 is more highly expressed in queens compared to workers and in nurses compared to foragers. By contrast, the level of expression of Pb_Vg2 was higher in foragers than in nurses and queens. Phylogenetic analyses show that a first duplication of the ancestral Vg gene occurred after the divergence between the poneroid and formicoid clades and subsequent duplications occurred in the lineages leading to Solenopsis invicta, Linepithema humile and Acromyrmex echinatior. The initial duplication resulted in two Vg gene subfamilies preferentially expressed in queens and nurses (subfamily A) or in foraging workers (subfamily B). Finally, molecular evolution analyses show that the subfamily A experienced positive selection, while the subfamily B showed overall relaxation of purifying selection. Our results suggest that in P. barbatus the Vg gene underwent subfunctionalization after duplication to acquire caste- and

  13. Relation Between Quality-of-Care Indicators for Diabetes and Patient Outcomes : A Systematic Literature Review

    NARCIS (Netherlands)

    Sidorenkov, Grigory; Haaijer-Ruskamp, Flora M.; de Zeeuw, Dick; Bilo, Henk; Denig, Petra

    The authors conducted a systematic literature review to assess whether quality indicators for diabetes care are related to patient outcomes. Twenty-four studies were included that formally tested this relationship. Quality indicators focusing on structure or processes of care were included.

  14. Relation Between Quality-of-Care Indicators for Diabetes and Patient Outcomes : A Systematic Literature Review

    NARCIS (Netherlands)

    Sidorenkov, Grigory; Haaijer-Ruskamp, Flora M.; de Zeeuw, Dick; Bilo, Henk; Denig, Petra

    2011-01-01

    The authors conducted a systematic literature review to assess whether quality indicators for diabetes care are related to patient outcomes. Twenty-four studies were included that formally tested this relationship. Quality indicators focusing on structure or processes of care were included. Descript

  15. Everyday Cognitive Failures and Memory Problems in Parkinson's Patients without Dementia

    Science.gov (United States)

    Poliakoff, Ellen; Smith-Spark, James H.

    2008-01-01

    There is growing evidence that Parkinson's disease patients without dementia exhibit cognitive deficits in some executive, memory and selective attention tasks. However, the impact of these deficits on their everyday cognitive functioning remains largely unknown. This issue was explored using self-report questionnaires. Twenty-four Parkinson's…

  16. Turner Syndrome with 45,X/46,XY mosaicism underwent gonadectomy: Report of 3 cases

    OpenAIRE

    Tokmak, Aytekin; Akselim, Burak; Yeşilyurt, Hüseyin

    2015-01-01

    Turner syndrome (TS) classically is characterized by complete or partial absence of one X chromosome. A Y chromosome can be detected in some of the TS patients called mosaicism. In this study we report three cases of TS with a female phenotype and a 45,X/46,XY karyotype. All of the cases were referred or applied to our hospital for gonadectomy at third decade of their lives. They had many of the stigmata of TS. We performed gonadectomy to our patients. In one of them histopathology was sugges...

  17. Physical activity in the elderly who underwent joint replacement surgery in the course of rheumatic diseases

    Science.gov (United States)

    Komorowski, Arkadiusz; Przepióra, Wiktor; Księżopolska-Orłowska, Krystyna

    2016-01-01

    According to the forecasts of the Central Statistical Office of Poland, in 2030 people at the age of 65 and older will account for 23.8%, i.e. their number will amount to approx. 8.5 m people. Geriatric rheumatic patients more often decide to undergo surgical joint replacement. According to the National Health Fund, the number of joint replacement services provided in 2014 increased by 93%, as compared to 2005. Improving the physical performance of this constantly expanding group of patients requires taking into account many factors to raise their functional status, reduce the risk of falling, teach rules of proper functioning with an artificial joint and encourage unassisted physical activity. Restoring fitness and independence is a difficult but necessary task due to an increasing number of seniors with replaced joint. PMID:27504021

  18. Physical activity in the elderly who underwent joint replacement surgery in the course of rheumatic diseases.

    Science.gov (United States)

    Prusinowska, Agnieszka; Komorowski, Arkadiusz; Przepióra, Wiktor; Księżopolska-Orłowska, Krystyna

    2016-01-01

    According to the forecasts of the Central Statistical Office of Poland, in 2030 people at the age of 65 and older will account for 23.8%, i.e. their number will amount to approx. 8.5 m people. Geriatric rheumatic patients more often decide to undergo surgical joint replacement. According to the National Health Fund, the number of joint replacement services provided in 2014 increased by 93%, as compared to 2005. Improving the physical performance of this constantly expanding group of patients requires taking into account many factors to raise their functional status, reduce the risk of falling, teach rules of proper functioning with an artificial joint and encourage unassisted physical activity. Restoring fitness and independence is a difficult but necessary task due to an increasing number of seniors with replaced joint.

  19. Prognostic factors for perioperative myocardial infarction and immediate mortality in patients who underwent coronary artery bypass graft surgery

    Directory of Open Access Journals (Sweden)

    Mirtha López Ramírez

    2016-03-01

    Conclusions: Older age and higher body mass index were protective prognostic factors for perioperative acute myocardial infarction events. Prolonged surgical time and complications were independently associated with perioperative infarction and mortality after coronary artery bypass graft surgery. Low preoperative glomerular filtration rate was also associated with mortality.

  20. Enzalutamide treatment in patients with metastatic castration-resistant prostate cancer progressing after chemotherapy and abiraterone acetate

    DEFF Research Database (Denmark)

    Thomsen, Frederik Birkebaek; Røder, Martin Andreas; Rathenborg, Per

    2013-01-01

    -chemotherapy setting. MATERIAL AND METHODS: Twenty-four mCRPC patients with progression after abiraterone treatment following primary docetaxel therapy received enzalutamide 160 mg/day. The percentage PSA response was recorded following first line docetaxel, abiraterone and enzalutamide treatment. Fischer's exact test...

  1. Dural ectasia and FBN1 mutation screening of 40 patients with Marfan syndrome and related disorders: role of dural ectasia for the diagnosis.

    Science.gov (United States)

    Attanasio, Monica; Pratelli, Elisa; Porciani, Maria Cristina; Evangelisti, Lucia; Torricelli, Elena; Pellicanò, Giannantonio; Abbate, Rosanna; Gensini, Gian Franco; Pepe, Guglielmina

    2013-07-01

    Marfan syndrome is an autosomal dominant disorder of connective tissue caused by mutations in the gene encoding fibrillin-1 (FBN1), a matrix component of microfibrils. Dural ectasia, i.e. enlargement of the neural canal mainly located in the lower lumbar and sacral region, frequently occurs in Marfan patients. The aim of our study was to investigate the role of dural ectasia in raising the diagnosis of Marfan syndrome and its association with FBN1 mutations. We studied 40 unrelated patients suspected for MFS, who underwent magnetic resonance imaging searching for dural ectasia. In all of them FBN1 gene analysis was also performed. Thirty-seven patients resulted affected by Marfan syndrome according to the '96 Ghent criteria; in 30 of them the diagnosis was confirmed when revaluated by the recently revised criteria (2010). Thirty-six patients resulted positive for dural ectasia. The degree of dural ectasia was grade 1 in 19 patients, grade 2 in 11 patients, and grade 3 in 6 patients. In 7 (24%) patients, the presence of dural ectasia allowed to reach a positive score for systemic feature criterion. Twenty-four patients carried an FBN1 mutation, that were represented by 13 missense (54%), and 11 (46%) mutations generating a premature termination codon (PTC, frameshifts and stop codons). No mutation was detected in the remaining 16 (6 patients with MFS and 10 with related disorders according to revised Ghent criteria). The prevalence of severe (grade 2 and grade 3) involvement of dura mater was higher in patients harbouring premature termination codon (PTC) mutations than those carrying missense-mutations (8/11 vs 2/13, P = 0.0111). Our data emphasizes the importance of dural ectasia screening to reach the diagnosis of Marfan syndrome especially when it is uncertain and indicates an association between PTC mutations and severe dural ectasia in Marfan patients.

  2. Variability of postural orthostatic tachycardia in patients with myalgic encephalomyelitis and orthostatic intolerance.

    Science.gov (United States)

    Miwa, Kunihisa

    2016-09-01

    Central nervous system dysfunction with myalgic encephalomyelitis (ME) has been suggested as the main cause of chronic fatigue syndrome. Fluctuation of the symptom severity and hierarchy is a characteristic feature in ME patients. The characteristics of the sympathetic activation may differ between the "good days" and "bad days" in them. Twenty-four ME patients with orthostatic intolerance underwent a conventional 10-min active standing test and echocardiography both on a "good day" and a "bad day", defined according to the severity of their symptoms. The mean heart rate at rest was significantly higher on the "bad days" than on the "good days". During the standing test on a "bad day", 5 patients (21 %) failed to maintain an upright posture for 10 min, whereas on a "good day" all the 24 patients maintained it. Postural orthostatic tachycardia (POT) (increase in heart rate ≥30 beats/min) or severe POT (heart rate ≥120 beats/min) was observed on the "bad days" in 10 patients (43 %) who did not suffer from the severe tachycardia on the "good days", suggesting the exaggerated sympathetic nervous activation. In contrast, POT did not occur or severe POT was attenuated on the "bad days" in 5 patients (21 %) who developed POT or severe POT on the "good days", suggesting the impaired sympathetic activation. Echocardiography revealed significantly lower mean values of both the left ventricular end-diastolic diameter and stroke volume index on the "bad days" compared with the "good days". In conclusion, in ME patients with orthostatic intolerance, the exaggerated activation of the sympathetic nervous system while standing appears to switch to the impaired sympathetic activation after the system is loaded with the additional accentuated stimuli associated with the preload reduction.

  3. Heyde syndrome in a 71-year-old man who underwent chest radiotherapy at young age

    Directory of Open Access Journals (Sweden)

    V.M. Santos

    2013-08-01

    Full Text Available We report the case of a 71-year-old man with diagnosis of aortic valve stenosis for ten years, who came to hospital because of breathlessness during the previous two months and recent low intestinal hemorrhage. On admission, laboratory tests and upper gastrointestinal endoscopy and colonoscopy revealed anemia and bleeding cecal angiodysplasia. The echocardiography study showed a severe aortic stenosis. Classical Heyde syndrome is described as the association of aortic stenosis, bleeding gastrointestinal angiodysplasia and secondary anemia. The antecedent of mediastinal radiotherapy for treatment of Hodgkin´s disease during his youth, and eventual late cardiac adverse effects that may include aortic or mitral valve disturbances are highlighted. Electrocoagulation with argonium was performed on the sites of active bleeding during the colonoscopy. In sequence, surgical replacement by bioprothesis was done on the aortic valve. The patient remains asymptomatic, under long-term outpatient surveillance, with normal control evaluations. The aim of this case study is to emphasize difficulties related to diagnosis, and to highlight the role of endoscopy and imaging studies to confirm a hypothesis of this underestimated condition.

  4. Insulin-like growth factors and insulin-like growth factor-binding proteins in relation to disease status and incidence of hypoglycaemia in patients with a gastrointestinal stromal tumour

    NARCIS (Netherlands)

    Rikhof, B.; van Doorn, J.; Suurmeijer, A. J. H.; Rautenberg, M. W.; Groenen, P. J. T. A.; Verdijk, M. A. J.; Jager, P. L.; de Jong, S.; Gietema, J. A.; van der Graaf, W. T. A.

    Patients and methods: Twenty-four patients were included. Plasma samples were collected before 1 week and median 5 months after start of treatment with imatinib, and levels of IGF-I, total IGF-II, pro-IGF-IIE[68-88], insulin-like growth factor-binding protein (IGFBP)-2, -3 and -6 were determined.

  5. Risk of malignancy in women who underwent hysterectomy for uterine prolapse.

    Science.gov (United States)

    Wan, Osanna Y K; Cheung, Rachel Y K; Chan, Symphorosa S C; Chung, Tony K H

    2013-04-01

    To evaluate the risk of missing a malignancy in surgical specimens following hysterectomy for uterine prolapse if routine pathological examination is not performed. Additionally, information on the risk of missing an hitherto unsuspected malignancy if uterine preservation is the preferred management option will be provided. A retrospective study was performed on all cases of surgery performed for uterine prolapse in a tertiary referral institution from 2003 to 2011. Those with confirmed malignancy before operation were excluded. The study subjects had their clinical history, investigations, the type of operations and histopathology report analysed. They were classified into symptomatic or asymptomatic, depending on whether they reported symptoms that were suggestive of uterine malignancy. A total of 640 women were studied. Three cases of hitherto unsuspected uterine malignancy were found, giving an incidence of 0.47%. Among the 456 asymptomatic women, both pre- and postmenopausal, the risk of incidental malignancy was 0.22%. Within the postmenopausal group, risk of incidental malignancy was 0.26%. Another 3 cases of uterine premalignant conditions were identified, giving an overall risk of premalignant and malignant uterine condition of 0.94%. Five cases of cervical intra-epithelial neoplasia were found, contributing to a risk of 0.78%. The risk of missing an uterine malignancy in patients with uterine prolapse is low if appropriate investigations are carried out prior to surgery. If hysterectomy is to be performed, we recommend that all surgical specimens be subjected to histopathological examination. © 2013 The Authors ANZJOG © 2013 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  6. {sup 18}F-FDG PET/CT for early detection of embolism and metastatic infection in patients with infective endocarditis

    Energy Technology Data Exchange (ETDEWEB)

    Riet, Jelle van; Gheysens, Olivier; Mortelmans, Luc [University Hospital KU Leuven, Department of Nuclear Medicine, Leuven (Belgium); Hill, Evelyn E.; Herregods, Marie-Christine [University Hospital KU Leuven, Department of Cardiology, Leuven (Belgium); Dymarkowski, Steven [University Hospital KU Leuven, Department of Radiology, Leuven (Belgium); Herijgers, Paul [University Hospital KU Leuven, Department of Cardiac Surgery, Leuven (Belgium); Peetermans, Willy E. [University Hospital KU Leuven, Department of Internal Medicine, Leuven (Belgium)

    2010-06-15

    In the acute setting of endocarditis it is very important to assess both the vegetation itself, as well as potential life-threatening complications, in order to decide whether antibiotic therapy will be sufficient or urgent surgery is indicated. A single whole-body scan investigating inflammatory changes could be very helpful to achieve a swift and efficient assessment. In this study we assessed whether {sup 18}F-FDG can be used to detect and localize peripheral embolism or distant infection. Twenty-four patients with 25 episodes of endocarditis, enrolled between March 2006 and February 2008, underwent {sup 18}F-FDG PET/CT imaging on a dedicated PET/CT scanner. PET/CT imaging revealed a focus of peripheral embolization and/or metastatic infection in 11 episodes (44%). One episode had a positive PET/CT scan result for both embolism and metastatic infection. PET/CT detected seven positive cases (28%) in which there was no clinical suspicion. Valve involvement of endocarditis was seen only in three patients (12%). PET/CT may be an important diagnostic tool for tracing peripheral embolism and metastatic infection in the acute setting of infective endocarditis, since a PET/CT scan detected a clinically occult focus in nearly one third of episodes. (orig.)

  7. 可调压式分流管治疗正常压力脑积水的临床应用及护理体会%The clinical application and nursing experience of adjustable shunt valve in treatment for patients with normal pressure hydrocephalus

    Institute of Scientific and Technical Information of China (English)

    杨利容; 索鹏; 王晶; 姚远; 李德珍

    2012-01-01

    Objective To introduce the application of adjustable shunt valve in treatment for patients with normal pressure hydrocephalus. Methods Twenty - four patients with normal pressure hydrocephalus implanted adjustable shunt valve underwent ventriculo-peritoneal shunt surgery and nursing care. Results After operation, cerebrospinal pressure was regulated for 0-6 (1.88 ± 1.52) times. Clinical symptoms were improved, especially in gait disturbance. Conclusion Treatment of normal pressure hydrocephalus with adjustable shunt valve can alleviate symptoms of hydrocephalus. It is especially suitable for patients with short course and secondary normal hydrocephalus patients.%采用可调压式分流管治疗24例正常压力脑积水患者,根据影像学检查结果 和临床症状.术后分别调压0~6次,平均(1.88±1.52)次,患者临床症状得到明显改善,尤以步态障碍为首发症状者效果最佳.证明可调压式分流管能够缓解正常压力脑积水患者临床症状,尤其适用于病程短之继发性正常压力脑积水.

  8. Increased serum nitric oxide and malondialdehyde levels in patients with acute intestinal amebiasis.

    Science.gov (United States)

    Namıduru, E S; Tarakçıoğlu, M; Namıduru, M; Kocabaş, R; Erbağcı, B; Meram, I; Karaoğlan, I; Yılmaz, N; Cekmen, M

    2011-12-01

    To determine the level of oxygen-nitrogen stress parameters in the pathogenesis of amebiasis. Twenty-four acute intestinal amebiasis patients and 20 healthy controls were enrolled in the present study. Serum malondialdehyde and nitric oxide levels were determined spectrophotometrically. Serum malondialdehyde and nitric oxide levels were significantly higher in acute intestinal amebiasis patients than healthy controls (Pamebiasis patients. Also these parameters can be used to supplement the conventional microscopic method for reliable diagnosis of intestinal amebiasis.

  9. Metabolic syndrome in patients with severe mental illness undergoing psychiatric rehabilitation receiving high dose antipsychotic medication

    Directory of Open Access Journals (Sweden)

    Bapu V Ravindranath

    2012-01-01

    Full Text Available Background: To review evidence of chronic antipsychotic medication and the association with metabolic syndrome in mentally ill patients. This evidence was used to analyse a cohort of patients with severe mental illness and to deduce a correlation between the prevalence of metabolic syndrome and their dose regimens. Materials and Methods: Twenty-four male patients undergoing Psychiatric rehabilitation underwent a review of current medication and assessment of risk factors for metabolic syndrome. Assessment criteria was based upon National Cholesterol Education Programme expert panel on detection, evaluation and treatment of high blood cholesterol in adults (Adult Treatment Panel III (NCEP ATP III criteria, incorporating waist circumference, raised triglycerides, reduced high density lipoprotein, raised blood pressure and fasting blood glucose. PubMed, Nature and Science Direct databases have been used to compile the medical and scientific background on metabolic syndrome and antipsychotic medication and the effect on patients particularly on high dose. Results: Out of 24 patients, 10 patients (41.7% were receiving high dose antipsychotics (HDA and four were on maximum dosage limits of 100%. 8.3% (2/24 patients were receiving only one first generation antipsychotics (FGA, 37.5% (9/24 patients were receiving only one second generation antipsychotic (SGA, 45.8% patients (11/24 were receiving two or more SGA only, and only one patient was receiving two or more FGA. One patient was receiving a combination of FGA and SGA. PRN ("as needed" therapy was not included in this study as their usage was limited. Clozapine was mostly prescribed in these patients (10/24, 41.6%. Four out of the 24 patients refused blood tests therefore were excluded from the following results. In the patients evaluated, 55% (11/20 had confirmed metabolic syndrome. In these patients with metabolic syndrome, 45.4% (5/11 were on HDA and 27.3% (3/11 were on maximum British National

  10. Functional connectivity-based signatures of schizophrenia revealed by multiclass pattern analysis of resting-state fMRI from schizophrenic patients and their healthy siblings

    Directory of Open Access Journals (Sweden)

    Yu Yang

    2013-02-01

    Full Text Available Abstract Background Recently, a growing number of neuroimaging studies have begun to investigate the brains of schizophrenic patients and their healthy siblings to identify heritable biomarkers of this complex disorder. The objective of this study was to use multiclass pattern analysis to investigate the inheritable characters of schizophrenia at the individual level, by comparing whole-brain resting-state functional connectivity of patients with schizophrenia to their healthy siblings. Methods Twenty-four schizophrenic patients, twenty-five healthy siblings and twenty-two matched healthy controls underwent the resting-state functional Magnetic Resonance Imaging (rs-fMRI scanning. A linear support vector machine along with principal component analysis was used to solve the multi-classification problem. By reconstructing the functional connectivities with high discriminative power, three types of functional connectivity-based signatures were identified: (i state connectivity patterns, which characterize the nature of disruption in the brain network of patients with schizophrenia; (ii trait connectivity patterns, reflecting shared connectivities of dysfunction in patients with schizophrenia and their healthy siblings, thereby providing a possible neuroendophenotype and revealing the genetic vulnerability to develop schizophrenia; and (iii compensatory connectivity patterns, which underlie special brain connectivities by which healthy siblings might compensate for an increased genetic risk for developing schizophrenia. Results Our multiclass pattern analysis achieved 62.0% accuracy via leave-one-out cross-validation (p  Conclusions Based on our experimental results, we saw some indication of differences in functional connectivity patterns in the healthy siblings of schizophrenic patients compared to other healthy individuals who have no relations with the patients. Our preliminary investigation suggested that the use of resting-state functional

  11. Multidetector CT Assessment of Lymph Node Size for Nodal Staging in Patients with Potentially Operable Squamous Esophageal Cancer and the 18F-FDG Positron Emission Tomography CT Correlation

    Energy Technology Data Exchange (ETDEWEB)

    Yoom, Soo Kyung; Jung, Jung Im; Ahn, Myeong Im; Park, Jae Gil; Yoo, Ie Ryung; Park, Seog Hee [Catholic University Seoul St. Mary' s Hospital, Seoul (Korea, Republic of); Park, Mi Jung [Gyeongsang National University Hospital, Junju (Korea, Republic of); Park, Hyun Jin [Catholic University St. Vincent Hospital, Suwon (Korea, Republic of)

    2010-03-15

    To investigate the size criteria of multidetector computed tomography (MDCT) for the evaluation metastatic lymph nodes (LNs) for potentially operable squamous esophageal cancer, and to compare this information with the results of positron emission tomography-CT (PET-CT). Twenty-four patients who underwent radical esophagectomy for esophageal cancer were studied. All patients had preoperative MDCT and PET-CT. The MDCT findings were compared with those of PET-CT and were correlated with the surgical records. The receiver operating characteristic (ROC) curve method was used to determine the appropriate cut-off value to distinguish benign from metastatic LNs. The size of metastatic LNs (9.35 {+-} 3.41 mm) was significantly larger than that of benign LNs (5.74 {+-} 1.64 mm) (p<0.001). The best cut-off value was 7 mm (81.8% sensitivity, 80.8% specificity). PET-CT detected all metastatic LNs except for four in the peritumoral region. The sensitivity and specificity of metastatic LN evaluation on PET-CT were 82.6% and 99.4%, respectively. Only one LN without metastasis showed increased fluoro-2-deoxy-D-glucose uptake on PET-CT. Size of metastatic LNs can typically be < 10 mm. For MDCT, the short diameter of 7 mm may be the optimal criterion. PET-CT is very accurate for the assessment of metastatic LNs except for those in the peritumoral region.

  12. Robot-assisted arm assessments in spinal cord injured patients: a consideration of concept study.

    Directory of Open Access Journals (Sweden)

    Urs Keller

    Full Text Available Robotic assistance is increasingly used in neurological rehabilitation for enhanced training. Furthermore, therapy robots have the potential for accurate assessment of motor function in order to diagnose the patient status, to measure therapy progress or to feedback the movement performance to the patient and therapist in real time. We investigated whether a set of robot-based assessments that encompasses kinematic, kinetic and timing metrics is applicable, safe, reliable and comparable to clinical metrics for measurement of arm motor function. Twenty-four healthy subjects and five patients after spinal cord injury underwent robot-based assessments using the exoskeleton robot ARMin. Five different tasks were performed with aid of a visual display. Ten kinematic, kinetic and timing assessment parameters were extracted on joint- and end-effector level (active and passive range of motion, cubic reaching volume, movement time, distance-path ratio, precision, smoothness, reaction time, joint torques and joint stiffness. For cubic volume, joint torques and the range of motion for most joints, good inter- and intra-rater reliability were found whereas precision, movement time, distance-path ratio and smoothness showed weak to moderate reliability. A comparison with clinical scores revealed good correlations between robot-based joint torques and the Manual Muscle Test. Reaction time and distance-path ratio showed good correlation with the "Graded and Redefined Assessment of Strength, Sensibility and Prehension" (GRASSP and the Van Lieshout Test (VLT for movements towards a predefined position in the center of the frontal plane. In conclusion, the therapy robot ARMin provides a comprehensive set of assessments that are applicable and safe. The first results with spinal cord injured patients and healthy subjects suggest that the measurements are widely reliable and comparable to clinical scales for arm motor function. The methods applied and results can

  13. The Predictability of Preoperative Pilocarpine-Induced Lens Shift on the Outcomes of Accommodating Intraocular Lenses Implanted in Senile Cataract Patients

    Science.gov (United States)

    Li, Jin; Chen, Qi; Lin, Zhibo; Leng, Lin; Huang, Fang

    2016-01-01

    Purpose. To evaluate the predictability of lens shift induced by pilocarpine (LSPilo) on the outcomes of accommodating intraocular lens (Acc-IOL) implantation. Methods. Twenty-four eyes of 24 senile cataract patients who underwent phacoemulsification and Acc-IOL implantation were enrolled. LSPilo was evaluated with anterior segment optical coherence tomography (AS-OCT). At 3 months postoperatively, the best corrected distance visual acuities (BCDVA), distance-corrected near visual acuities (DCNVA), and subjective and objective accommodations were measured. IOL shifts under accommodation stimulus (IOLSAcc) were evaluated with AS-OCT. Results. The mean LSPilo was 112.29 ± 30.72 µm. LSPilo was not associated with any preoperative parameters. The mean IOLSAcc was 130.46 ± 42.71 µm. The mean subjective and objective accommodation were 1.54 ± 0.39 D and 1.27 ± 0.41 D, respectively. The mean postoperative BCDVA and DCNVA (log MAR value) were 0.22 ± 0.11 and 0.24 ± 0.12, respectively. LSPilo positively correlated with IOLSAcc (r = 0.541; P = 0.006), subjective accommodation (r = 0.412; P = 0.022), and objective accommodation (r = 0.466; P = 0.045), respectively. Conclusion. LSPilo is an independent preoperative parameter associated with the postoperative Acc-IOL mobility and pseudophakic accommodation. It may offer valuable information for ophthalmologists in determining the suitable candidates for Acc-IOL implantation. PMID:27516899

  14. Ultrasound-Guided 50% Ethyl Alcohol Injection for Patients With Malleolar and Olecranon Bursitis: A Prospective Pilot Study

    OpenAIRE

    2016-01-01

    Objective To evaluate the feasibility and effect of ultrasound-guided ethyl alcohol injection on malleolar and olecranon synovial proliferative bursitis. Methods Twenty-four patients received ultrasound-guided 50% diluted ethyl alcohol injection at the site of synovial proliferative bursitis after aspiration of the free fluid. Results Swelling and symptoms significantly decreased in 13 of the 24 patients without any complications. Eleven patients had partial improvement in swelling and sympto...

  15. An evaluation of quality of life in women with endometriosis who underwent primary surgery: a 6-month follow up in Sabah Women & Children Hospital, Sabah, Malaysia.

    Science.gov (United States)

    M F, Ahmad; Narwani, Hussin; Shuhaila, Ahmad

    2017-10-01

    Endometriosis is a complex disease primarily affecting women of reproductive age worldwide. The management goals are to improve the quality of life (QoL), alleviate the symptoms and prevent severe disease. This prospective cohort study was to assess the QoL in women with endometriosis that underwent primary surgery. A pre- and post-operative questionnaire via ED-5Q and general VAS score used for the evaluation for endometrial-like pain such as dysmenorrhoea and dyspareunia. A total of 280 patients underwent intervention; 224 laparoscopically and 56 via laparotomy mostly with stage II disease with ovarian endometriomas. Improvements in dysmenorrhoea pain scores from 5.7 to 4.15 and dyspareunia from 4.05 to 2.17 (p improved; 6.66-4.68 post-operatively (p intervention. There was no correlation between the stage of disease and endometrial pain; (p = .289), method of intervention (p = .290) and usage of post-operative hormonal therapy (p = .632). This study concluded that surgical treatment improved the QoL with added hormonal therapy post-intervention, despite not reaching statistical significance, showed a promising result. Impact statement Surgical intervention does improve the QoL for women with endometriosis however post interventional hormonal therapy is remain inconclusive.

  16. Common mental disorder underwent colostomy and the research progress of nursing intervention%结肠造口常见心理障碍及护理干预的研究进展

    Institute of Scientific and Technical Information of China (English)

    钮丽美; 滕卓艳; 王红艳

    2015-01-01

    Underwent colostomy is one of the common for the treatment of abdominal surgery. Is the necessary way for treatment of low rectal cancer underwent colostomy, the existence of underwent colostomy and colostomy surgery caused by physiological and pathological changes led to the patient's physical function, physical function, mental status changes, which affects the patient's quality of life. The underwent colostomy complications and bowel way, changes in body shape has a great influence to the patient's physical and psychological. Knot patients underwent colostomy should not only face the challenges of the cancer, and to undertake artificial anus bring physical and psychological pressure, which can produce fear, pessimism, low self-esteem and a series of psychological problems. In this paper, the psychological problems of patients underwent colostomy common and nursing intervention were reviewed, aimed at improving the quality of life of patients underwent colostomy.%结肠造口,是腹部外科常见的治疗措施之一。结肠造口是治疗低位直肠癌的必要手段,结肠造口的存在及造口手术引起的生理、病理变化导致了病人的躯体功能、生理功能、精神状态的改变,从而影响病人的生活质量。结肠造口的并发症及排便方式、身体外形的改变对患者的生理和心理有很大的影响。结结肠造口患者既要面对癌症的挑战,又要承担人工肛门带来的生理和心理上的巨大压力,由此可产生恐惧、悲观、自卑等一系列心理问题。本文就结肠造口患者常见的心理障碍问题及护理干预等进行综述,旨在提高结肠造口患者的生活质量。

  17. [Anesthetic Management of an Infant who Underwent Awake-intubation for Her Pharyngeal Injury Caused by a Toothbrush].

    Science.gov (United States)

    Nakano, Yoko; Suzuki, Hiroaki; Arai, Takero; Hashimoto, Yuichi; Okuda, Yasuhisa

    2016-04-01

    A 2-year-and-4-month-old female infant, 12 kg in weight and 90 cm in height fell off from a table, which was about 1 m height with a toothbrush in her mouth without her parents noticing. Urgent CT scan showed that it penetrated the left side of her oropharyngeal wall to the bifurcation of her right carotid artery. According to the initial assessment, carotid artery seemed intact and there seemed to be no sign of CNS involvement. She underwent general anesthesia for further investigation and operation. We could detect vocal code with ease by inserting Glidescope between her tongue and the toothbrush. After the intubation, we administered fentanyl 25 μg rocuronium 15 mg and sevoflulane 3-5% to her, and then she underwent arteriography. The neurosurgeon found no sign of major arterial injury nor traumatic aneurysm nor CNS involvement. She went to the ICU intubated after the removal of the toothbrush. She was extubated 5 days after operation. One of the benefits of the Glidescope is that we can share the visual image, and we chose it this time. When we expect a difficult airway during management for oropharyngeal trauma, we have to consider the way to manage the airway.

  18. Long-term followup of rheumatoid arthritis patients treated with total lymphoid irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Tanay, A.; Field, E.H.; Hoppe, R.T.; Strober, S.

    1987-01-01

    Total lymphoid irradiation was administered to 32 patients with intractable rheumatoid arthritis. Twenty-four patients showed at least a 25% improvement in 3 of 4 disease activity parameters, which persisted during the followup period of up to 48 months. Eight of the 32 patients required adjunctive immunosuppressive drug therapy to maintain improvement. Four patients died after total lymphoid irradiation; the causes of death were acute myocardial infarction (1 patient), pulmonary embolism (1 patient), and rheumatoid lung disease complicated by respiratory infection (2 patients). After therapy, patients exhibited a prolonged reduction in the number and function of circulating T helper cells.

  19. Allergenicity and safety of recombinant human C1 esterase inhibitor in patients with allergy to rabbit or cow's milk.

    Science.gov (United States)

    van den Elzen, Mignon T; van Os-Medendorp, Harmieke; Röckmann-Helmbach, Heike; van Hoffen, Els; Lebens, Ans F M; van Doorn, Helma; Klemans, Rob J B; Bruijnzeel-Koomen, Carla A F M; Hack, C Erik; Kaufman, Leonard; Relan, Anurag; Knulst, André C

    2016-08-01

    Recombinant human C1 inhibitor (rhC1INH) for on-demand treatment of hereditary angioedema is purified from milk of transgenic rabbits. It contains low amounts (<0.002%) of host-related impurities, which could trigger hypersensitivity reactions in patients with rabbit allergy (RA) and/or cow's milk allergy (CMA). This study is an assessment of allergenicity and safety of rhC1INH in patients with RA and/or CMA. Patients with CMA and/or RA underwent skin prick test (SPT), intracutaneous test (ICT), and, when results for both were negative, subcutaneous (SC) challenge with up to 2100U (14 mL) rhC1INH. The negative predictive value of the skin test protocol was calculated, defined as the ratio of patients without systemic symptoms of hypersensitivity following SC challenge, over the number of patients having tested negative for both the SPT and the ICT. Adverse events after exposure to rhC1INH were recorded. Twenty-six patients with RA and/or CMA were enrolled. Twenty-four had negative SPT and ICT results for rhC1INH, whereas 2 had negative SPT result but positive ICT result to rhC1INH (only the highest concentration). Twenty-two patients with negative SPT and ICT results underwent SC challenge. None developed allergic symptoms. Local treatment-emergent adverse events occurred in 7 patients (32%) after SC challenge. In 5 these were considered drug related. All were mild. None of the patients with negative SPT and ICT results for rhC1INH had allergic symptoms during rhC1INH challenge. The negative predictive value of the combination of SPT and ICT for the outcome of the SC challenge was 100% (95% CI, 84.6%-100%). SC administration of rhC1INH was well tolerated. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  20. One-Stage vs Two-Stage Laparoscopic Roux-en-Y Gastric Bypass in Obese Patients with Body Mass Index >55 Kg/m(2); 5-YEAR FOLLOW UP.

    Science.gov (United States)

    Díaz-Tobarra, María; Cassinello Fernández, Norberto; Jordá Gómez, Pablo; Nofal, Mohammad Nebih; Alfonso Ballester, Raquel; Ortega Serrano, Joaquín

    2017-04-01

    Surgical strategies in patients with BMI > 55 kg/m(2) are not well established. The objective of this study is to compare the long term results and complications of 1- vs. 2-stage laparoscopic "Roux-en-Y″ gastric bypass (LRYGB) for patients with BMI > 55 kg/m(2). Retrospective review of the complications and outcomes, between January 2007 and January 2010, for patients with a BMI > 55 kg/m(2) who underwent directly a LRYGB (1-stage) or a LRYGB as a 2nd stage of a laparoscopic sleeve gastrectomy (LSG). Twenty-four patients were enrolled (no patient was lost during the 5-year follow-up). In the 1-stage LRYGB group, two patients had grade II complications according to Clavien-Dindo classification. In the 2-stage LRYGB group, complications of the first and the second surgery were summed. There were no differences between the two groups despite being heterogenous (more men with a higher BMI in the 2-stage group). There was a statistically significant difference in the final BMI in 1-stage LRYGB group compared to the 2-stage LRYGB group (34.46 ± 6.29 vs. 40.40 ± 3.47; p = 0.01, respectively) and in percentage of excess of BMI loss (%EBMIL; 69.80 ± 19.96 vs. 54.54 ± 13.93; p = 0.04, respectively). In patients with a BMI > 55 kg/m(2), both 1- and 2-stage LRYGB give good long-term results. If feasible, a 1-stage LRYGB obtains a better percentage of excess of BMI loss but if not possible, the strategy of initially performing a laparoscopic sleeve gastrectomy followed by a LRYGB is safe and there were no differences in complications.

  1. The role of CAHPS/patient experiences in the Dutch health care system: developing a questionnaire for patients who underwent cataract surgery or total hip or knee arthroplasty.

    NARCIS (Netherlands)

    Brouwer, W.; Gelsema, T.; Delnoij, D.

    2005-01-01

    Background: In the Netherlands, there is a growing need for standardized disease specific instruments to measure performance to aid consumer choice, provider contracting and performance improvement. Initiated by the Netherlands Organisation for Health Research and Development a whole series of quest

  2. [Clinical factors and findings in knee arthroscopy of patients with knee arthrosis candidates for conversion to total replacement].

    Science.gov (United States)

    Figueroa, D; Calvo, R; Villalón, I; Tuca, M J; Vaisman, A; Valdés, M

    2013-01-01

    To identify those clinical characteristic and arthroscopic findings in patients with knee arthrosis that are associated with worsening of the disease and subsequent total knee arthroplasty (TKA). A retrospective, descriptive study was conducted on 78 consecutive patients (88 knees) who underwent knee arthroscopy for arthrosis. The study included 44 women and 34 men, with a mean age of 58.9 years (range: 37-78 years). After a mean follow-up of 50.4 months (range: 12-96 months), those patients who progressed towards TKA were identified. A logistic regression model was applied to recognise the factors associated with deterioration of the arthrosis, with consequent progression towards a TKA. Twenty-four out of the 88 knees progressed towards a TKA (27.3%) within a mean time of 13.5 months after arthroscopy (range: 13-29 months). The clinical characteristics that showed a significant association with poor progression of the arthrosis were: female gender (0.02) and Ahlbäck 2 (P=.04). Arthroscopic finding that proved significant correlation with worsening of the arthrosis towards TKA were: meniscal tears of the posterior horn (P=.02), meniscectomies above 60% (P=.03), and 2nd degree chondral lesions in loading areas of the medial femoral condyle (P=.02). The variables associated with a greater chance of progressing towards a TKA after a knee arthroscopy due to arthrosis in this study were, female gender, grade 2 radiographic arthrosis, posterior horn meniscal lesions, meniscectomies over 60%, and chondral lesions in loading area of the medial femoral condyle. Copyright © 2013 SECOT. Published by Elsevier Espana. All rights reserved.

  3. Chronic obstructive pulmonary disease in stage I non-small cell lung cancer that underwent anatomic resection: the role of a recurrence promoter.

    Science.gov (United States)

    Kuo, Chih-Hsi; Wu, Ching-Yang; Lee, Kang-Yun; Lin, Shu-Min; Chung, Fu-Tsai; Lo, Yu-Lun; Liu, Chien-Ying; Hsiung, Te-Chih; Yang, Cheng-Ta; Wu, Yi-Cheng

    2014-08-01

    Despite the use of anatomic resection, the post-surgical recurrence rate remains high in early-stage non-small cell lung cancer (NSCLC). Chronic inflammation plays a role in the mechanism that promotes tumor initiation. This study aimed to investigate the association between recurrence outcome and chronic inflammation-related co-morbidities in early-stage resected NSCLC. A review of medical records for recurrence outcome and co-morbidities, in terms of chronic obstructive pulmonary disease (COPD), DM, asthma and cardiovascular diseases, was performed with 181 patients with stage I NSCLC that underwent anatomic resection. Subjects with T descriptors as T2a disease (49.5 vs. 28.0%, p recurrence. Univariate analysis for recurrence-free survival showed T descriptor as T2a (21.5 months vs. NR, p recurrence-free survival in the Cox regression model. Patients with COPD were at higher risk of brain recurrence (OR: 7.88; 95% CI, 1.50-41.3, p recurrence in bone and liver (OR: 4.13; 95% CI, 1.08-15.8, p = 0.05). Subjects with COPD and T2a disease had a higher risk of recurrence. The role of COPD as a recurrence promoter merits further prospective investigation.

  4. A single FTO gene variant rs9939609 is associated with body weight evolution in a multiethnic extremely obese population that underwent bariatric surgery.

    Science.gov (United States)

    Rodrigues, Gisele K; Resende, Cristina M M; Durso, Danielle F; Rodrigues, Lorena A A; Silva, José Luiz P; Reis, Rodrigo C; Pereira, Solange S; Ferreira, Daniela C; Franco, Gloria R; Alvarez-Leite, Jacqueline

    2015-01-01

    The rs9939609 single nucleotide polymorphism (SNP) in the fat mass and obesity-associated (FTO) gene is involved in obesity. Few studies have been conducted on patients who underwent bariatric surgery. The aim of this study was to evaluate the influence of FTO SNPs on body weight, body composition, and weight regain during a 60-mo follow-up period after bariatric surgery. The rs9939609 was genotyped in 146 individuals using a real-time polymerase chain reaction TaqMan assay. Data for lifestyle, comorbidities, body weight, body mass index (BMI), excess weight loss (EWL), and body composition were obtained before and 6, 12, 18, 24, 36, 48, and 60 mo after surgery. Data were analyzed by comparing two groups of patients according to rs9939609 FTO gene polymorphism. Mixed-regression models were constructed to evaluate the dynamics of body weight, BMI, and EWL over time in female patients. No differences were observed between the groups during the first 24 mo after surgery. After 36, 48, and 60 mo, body weight, fat mass, and BMI were higher, whereas fat-free mass and EWL were lower in the FTO-SNP patient group. Weight regain was more frequent and occurred sooner in the FTO-SNP group. There is a different evolution of weight loss in obese carriers of the FTO gene variant rs9939609 after bariatric surgery. However, this pattern was evident at only 2 y postbariatric surgery, inducing a lower proportion of surgery success and a greater and earlier weight regain. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Phase II Trial of Hypofractionated IMRT With Temozolomide for Patients With Newly Diagnosed Glioblastoma Multiforme

    Energy Technology Data Exchange (ETDEWEB)

    Reddy, Krishna [Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado (United States); Damek, Denise [Department of Neurology, University of Colorado School of Medicine, Aurora, Colorado (United States); Gaspar, Laurie E. [Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado (United States); Ney, Douglas [Department of Neurology, University of Colorado School of Medicine, Aurora, Colorado (United States); Waziri, Allen; Lillehei, Kevin [Department of Neurosurgery, University of Colorado School of Medicine, Aurora, Colorado (United States); Stuhr, Kelly; Kavanagh, Brian D. [Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado (United States); Chen Changhu, E-mail: changhu.chen@ucdenver.edu [Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado (United States)

    2012-11-01

    Purpose: To report toxicity and overall survival (OS) in patients with newly diagnosed glioblastoma multiforme (GBM) treated with hypofractionated intensity-modulated radiotherapy (hypo-IMRT) with concurrent and adjuvant temozolomide (TMZ). Methods and Materials: Patients with newly diagnosed GBM after biopsy or resection and with adequate performance status and organ or bone marrow function were eligible for this study. Patients received postoperative hypo-IMRT to the surgical cavity and residual tumor seen on T1-weighted brain MRI with a 5-mm margin to a total dose of 60 Gy in 10 fractions (6 Gy/fraction) and to the T2 abnormality on T2-weighted MRI with 5-mm margin to 30 Gy in 10 fractions (3 Gy/fraction). Concurrent TMZ was given at 75 mg/m{sup 2}/day for 28 consecutive days. Adjuvant TMZ was given at 150 to 200 mg/m{sup 2}/day for 5 days every 28 days. Toxicities were defined using Common Terminology Criteria for Adverse Events version 3.0. Results: Twenty-four patients were treated, consisting of 14 men, 10 women; a median age of 60.5 years old (range, 27-77 years); and a median Karnofsky performance score of 80 (range, 60-90). All patients received hypo-IMRT and concurrent TMZ according to protocol, except for 2 patients who received only 14 days of concurrent TMZ. The median number of adjuvant TMZ cycles was 6.5 (range, 0-14).With a median follow-up of 14.8 months (range, 2.7-34.2 months) for all patients and a minimum follow-up of 20.6 months for living patients, no instances of grade 3 or higher nonhematologic toxicity were observed. The median OS was 16.6 months (range, 4.1-35.9 months). Six patients underwent repeated surgery for suspected tumor recurrence; necrosis was found in 50% to 100% of the resected specimens. Conclusion: In selected GBM patients, 60 Gy hypo-IMRT delivered in 6-Gy fractions over 2 weeks with concurrent and adjuvant TMZ is safe. OS in this small cohort of patients was comparable to that treated with current standard of care

  6. A Case of Gastrointestinal Stromal Tumor That Underwent Endoscopic Ultrasound-Guided Aspiration with a 25-Gauge Biopsy Needle

    Directory of Open Access Journals (Sweden)

    Minoru Tomizawa

    2016-05-01

    Full Text Available Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA is performed to obtain specimens for pathological analysis. For this procedure, 19-gauge (19G, 22-guage (22G, and 25-guage (25G needles are available. The needles are classified into aspiration type and biopsy type. A 56-year-old woman underwent upper gastrointestinal endoscopy that showed a 38-mm-diameter submucosal tumor. The elevated lesion was diagnosed as a submucosal tumor of the stomach. Contrast-enhanced computed tomography showed a low-density area on the luminal surface of the gastric wall, which was covered with a thin layer of gastric mucosa. EUS showed a hypoechoic lesion in the submucosal layer. Color Doppler image showed a pulsating vascular signal extending into the center of the hypoechoic lesion from the periphery. EUS-FNA was performed with a 25G biopsy needle. The specimen tissue consisted of spindle-shaped cells. The cells were positive for CD117 and CD34. The submucosal tumor was diagnosed as a gastrointestinal stromal tumor.

  7. A Case of Gastrointestinal Stromal Tumor That Underwent Endoscopic Ultrasound-Guided Aspiration with a 25-Gauge Biopsy Needle.

    Science.gov (United States)

    Tomizawa, Minoru; Shinozaki, Fuminobu; Motoyoshi, Yasufumi; Sugiyama, Takao; Yamamoto, Shigenori; Ishige, Naoki

    2016-01-01

    Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is performed to obtain specimens for pathological analysis. For this procedure, 19-gauge (19G), 22-guage (22G), and 25-guage (25G) needles are available. The needles are classified into aspiration type and biopsy type. A 56-year-old woman underwent upper gastrointestinal endoscopy that showed a 38-mm-diameter submucosal tumor. The elevated lesion was diagnosed as a submucosal tumor of the stomach. Contrast-enhanced computed tomography showed a low-density area on the luminal surface of the gastric wall, which was covered with a thin layer of gastric mucosa. EUS showed a hypoechoic lesion in the submucosal layer. Color Doppler image showed a pulsating vascular signal extending into the center of the hypoechoic lesion from the periphery. EUS-FNA was performed with a 25G biopsy needle. The specimen tissue consisted of spindle-shaped cells. The cells were positive for CD117 and CD34. The submucosal tumor was diagnosed as a gastrointestinal stromal tumor.

  8. Whole Lung Lavage Treatment of Chinese Patients with Autoimmune Pulmonary Alveolar Proteinosis:A Retrospective Long-term Follow-up Study

    Institute of Scientific and Technical Information of China (English)

    Yu-Yue Zhao; Hui Huang; Yong-Zhe Liu; Xin-Yu Song; Shan Li; Zuo-Jun Xu

    2015-01-01

    Background:Pulmonary alveolar proteinosis (PAP) is a rare lung disease,the most common type of which is autoimmune PAP.The gold standard therapy for PAP is whole lung lavage (WLL).Few studies have reported the optimal technique with which to evaluate the response to WLL.In this study,we aimed to identify parameters with which to assess the need for repeat WLL during a long-term 8-year follow-up.Methods:We conducted a retrospective analysis of 120 patients with autoimmune PAP with 80 of whom underwent WLL.Physiologic,serologic,and radiologic features of the patients were analyzed during an 8-year follow-up after the first WLL treatment.Results:Of the 40 patients without any intervention,39 patients either achieved remission or remained stable and only one died of pulmonary infection.Of the 56 patients who underwent WLL for 1 time,55 remained free from a second WLL and 1 patient died of cancer.Twenty-four required additional treatments after their first WLL.The baseline PaO2 (P =0.000),PA-aO2 (P =0.000),shunt fraction rate (P =0.00 1),percent of predicted normal diffusing capacity of the lung for carbon monoxide (DLCO%Pred) (P =0.016),6-min walk test (P =0.013),carcinoembryonic antigen (CEA) (P =0.007),and neuron-specific enolase (NSE) (P =0.003) showed significant differences among the three groups.The need for a second WLL was significantly associated with PaO2 (P=0.000),CEA (P =0.050),the 6-minute walk test (P =0.026),and DLCO%Pred (P =0.041).The DLCO%Pred on admission with a cut-offvalue of42.1% (P =0.001) may help to distinguish whether patients with PAP require a second WLL.Conclusions:WLL is the optimal treatment method for PAP and provides remarkable improvements for affected patients.The DLCO%Pred on admission with a cut-off value of 42.1% may distinguish whether patients with PAP require a second WLL.

  9. Mycophenolate mofetil and FK506 have different effects on kidney allograft fibrosis in rats that underwent chronic allograft nephropathy

    Directory of Open Access Journals (Sweden)

    Luo Lei

    2012-07-01

    Full Text Available Abstract Background Tacrolimus (FK506 is associated with renal fibrosis in long-term use. Mycophenolatemofetil (MMF can also inhibit or attenuate the progression of renal fibrosis. This study aimed to determine the different effects of FK506 and MMF on fibrosis-associated genes in the kidney in rats that underwent chronic allograft nephropathy (CAN. Methods Fisher (F344 kidneys were orthotopically transplanted into Lewis rat recipients. All recipients were given Cyclosporin A (CsA 10 mg/kg-1.d-1 × 10 day and were then randomly divided into three oral treatment groups (n = 9 in each group: (1 the vehicle group was given vehicle orally; (2 the FK506 group was given 0.15 mg/kg-1.d-1 FK506; and (3 the MMF group was given 20 mg/kg-1.d-1 MMF. At 4, 8, and 12 weeks post-transplantation, serum creatinine (SCr, collagen deposition, Connective tissue growth factor (CTGF, alpha smooth muscle actin (α-SMA and E-cadherin expressions were determined and hematoxylin-eosin (HE and Periodic acid-Schiff (PAS stains were performed. Results Renal function progressively deteriorated and showed typical CAN morphology in the vehicle and FK506 groups, while SCr and inflammatory infiltration (Banff score showed a significant decrease in the MMF group after 8 weeks post-transplantation compared with those in the other groups (p α-SMA in the MMF group were significantly reduced, and the down-regulated expression of E-cadherin was abated (p  Conclusions MMF showed favorable effects on renal interstitial fibrosis, thus efficiently retarding the progression of CAN.

  10. Clinical and radiological of acute ischemic stroke patients without angiographic occlusion on digital subtraction angiogram. A pooled analysis of case series

    Energy Technology Data Exchange (ETDEWEB)

    Shah, Qaisar A.; Memon Zeeshan, Muhammad; Vazquez, Gabriela; Suri, M. Fareed K.; Hussein, Haitham M.; Qureshi, Adnan I. [Zeenat Qureshi Stroke Research Center, Department of Neurology, University of Minnesota, Minneapolis, MN (United States); Mohammad, Yousef M. [Department of Neurology, Ohio State University, Columbus, OH (United States)

    2008-11-15

    Approximately 20-30% of the patients with acute ischemic stroke do not have any occlusion demonstrated on initial digital subtraction angiography (DSA). We sought to determine the risk and rates of cerebral infarction and favorable neurological outcome in this group of acute ischemic stroke patients. Patients were identified from a prospectively maintained stroke database and from literature search of MEDLINE, PubMed, and Cochrane databases. All patients had initial neurological assessment on National Institutes of Health Stroke Scale (NIHSS). Patients then underwent DSA after initial head computed tomography (CT) scans. Follow-up radiological assessment at 24-72 h was performed with CT and magnetic resonance imaging scans. Association of stroke risk factors with clinical and radiological outcomes was estimated. A total of 81 patients was analyzed (mean age 63 years; 28 were women). The median NIHSS score was 8 (range 2-25). None of the patients received either intravenous or intra-arterial thrombolytic. Cerebral infarction was detected in 62 (76%) of the 81 patients. Twenty-four to 48-h NIHSS was available for 51 patients only. Neurological improvement was observed in 22 (43%) of the 51 patients. Favorable outcome ascertained at 3-month follow-up was seen in 48 (59%) of the 81 patients. After adjusting for age, sex, and baseline NIHSS, male patients [odds ratio (OR) 4.5 (1.4-14.3), p value=0.01] and patients with age{>=} =65 [OR 4.3 (1.2-16.2), p value=0.03] have a higher risk of cerebral infarcts on the follow-up imaging. Similarly, patients who presented with <10 NIHSS had a better 3-month outcome than those with >10 NIHSS [OR 0.21 (0.08-0.61), p value=0.004]. Ischemic stroke patients without arterial occlusion on DSA have a higher risk of cerebral infarction and disability particularly in men, patients over 65 years of age and with NIHSS{>=}=10. The cause of infarction may have been arterial obstruction with spontaneous recanalization or small vessel occlusion

  11. Twenty-four hour predictions of the solar wind speed peaks by the probability distribution function model

    Science.gov (United States)

    Bussy-Virat, C. D.; Ridley, A. J.

    2016-10-01

    Abrupt transitions from slow to fast solar wind represent a concern for the space weather forecasting community. They may cause geomagnetic storms that can eventually affect systems in orbit and on the ground. Therefore, the probability distribution function (PDF) model was improved to predict enhancements in the solar wind speed. New probability distribution functions allow for the prediction of the peak amplitude and the time to the peak while providing an interval of uncertainty on the prediction. It was found that 60% of the positive predictions were correct, while 91% of the negative predictions were correct, and 20% to 33% of the peaks in the speed were found by the model. This represents a considerable improvement upon the first version of the PDF model. A direct comparison with the Wang-Sheeley-Arge model shows that the PDF model is quite similar, except that it leads to fewer false positive predictions and misses fewer events, especially when the peak reaches very high speeds.

  12. The Twenty-four Hour Workday: Proceedings of a Symposium on Variations in Work-Sleep Schedules

    Science.gov (United States)

    1980-10-01

    Md. Tray.: 1971, _j 393-395. .ndlauer,P., Carpentier,J., & Cazamian,P. (Eds.). Ergonomie du travail de nuit et des horaires alternants. Education...and between subjects and suggest that Gaillard’s conclusion may not -be true. 743 REM 0) 2 {3 i4 40[ REM E 0L ɘ U 730-Delta Hour !Igure :2. Comuter

  13. Prevalence of gastrointestinal parasites in captive non-human primates of twenty-four zoological gardens in China.

    Science.gov (United States)

    Li, Mei; Zhao, Bo; Li, Bo; Wang, Qiang; Niu, Lili; Deng, Jiabo; Gu, Xiaobin; Peng, Xuerong; Wang, Tao; Yang, Guangyou

    2015-06-01

    Captive primates are susceptible to gastrointestinal (GIT) parasitic infections, which are often zoonotic and can contribute to morbidity and mortality. Fecal samples were examined by the means of direct smear, fecal flotation, fecal sedimentation, and fecal cultures. Of 26.51% (317/1196) of the captive primates were diagnosed gastrointestinal parasitic infections. Trichuris spp. were the most predominant in the primates, while Entamoeba spp. were the most prevalent in Old World monkeys (P primates and the safety of animal keepers and visitors.

  14. Twenty-four years after theYellowstone Fires: Are postfire lodgepole pine stands converging in structure and function?

    Science.gov (United States)

    Turner, Monica G; Whitby, Timothy G; Tinker, Daniel B; Romme, William H

    2016-05-01

    Disturbance and succession have long been of interest in ecology, but how landscape patterns of ecosystem structure and function evolve following large disturbances is poorly understood. After nearly 25 years, lodgepole pine (Pinus contorta var. latifolia) forests that regenerated after the 1988 Yellowstone Fires (Wyoming, USA) offer a prime opportunity to track the fate of disturbance-created heterogeneity in stand structure and function in a wilderness setting. In 2012, we resampled 72 permanent plots to ask (1) How have postfire stand structure and function changed between 11 and 24 yr postfire, and what variables explain these patterns and changes? (2) How has landscape-level (among-stand) variability in postfire stand structure and function changed between 11 and 24 yr postfire? We expected to see evidence of convergence beginning to emerge, but also that initial postfire stem density would still determine trajectories of biomass accumulation. After 24 yr, postfire lodgepole pine density remained very high (mean = 21,738 stems/ha, range = 0-344,067 stems/ha). Stem density increased in most plots between 11 and 24 yr postfire, but declined sharply where 11-yr-postfire stem density was > 72,000 stems/ha. Stems were small in high-density stands, but stand-level lodgepole pine leaf area, foliage biomass, and live aboveground biomass increased over time and with increasing stem density. After 24 yr, mean annual lodgepole pine aboveground net primary production (ANPP) was high (mean = 5 Mg · ha⁻¹ · yr⁻¹, range = 0-16.5 Mg · ha⁻¹ · yr⁻¹). Among stands, lodgepole pine ANPP increased with stem density, which explained 69% of the variation; another 8% of the variation was explained by environmental covariates. Early patterns of postfire lodgepole pine regeneration, which were contingent on prefire serotiny and fire severity, remained the dominant driver of stand structure and function. We observed mechanisms that would lead to convergence in stem density (structure) over time, but it was landscape variation in functional variables that declined substantially. Stand structure and function have not converged across the burned landscape, but our evidence suggests function will converge sooner than structure.

  15. Evaluation of Parents’ Knowledges and Experiences about Infant Feeding in Children between Six-Twenty Four Months

    OpenAIRE

    Zeynep Kaya; Özgül Yiğit; Meltem Erol; Özlem Bostan Gayret

    2016-01-01

    Aim: Complementary feeding is important in early childhood. Therefore, raising awareness of families about complementary feeding is of importance. In this study, we aimed to evaluate the parents’ knowledge and experience of infant feeding. Methods: This study was made in the pediatric outpatient clinic at Bağcılar Training and Research Hospital between 25.09.2012 and 25.11.2012. A questionnaire including questions regarding infant feeding was administered to 417 parents (250 mothers, 167 f...

  16. A Seroprevalence Survey of Maedi-Visna Among Twenty-Four Ovine Floks from Twelve Regions of China

    Institute of Scientific and Technical Information of China (English)

    ZHANG Ke-shan; HE Ji-jun; LIU Yong-jie; SHANG You-jun; LIU Xiang-tao

    2013-01-01

    Maedi-visna virus (MVV) is an ovine lentivirus that is widespread in many countries worldwide. Both clinical and subclinical MVV infections cause substantial economic losses. MVV infection in live sheep is usually diagnosed serologically, with antibody-positive sheep being regarded as infected. There have been few reports of maedi-visna in China, with no detailed epidemic analysis of MVV infection in ovine herds. In order to investigate the seroprevalence and spatial distribution of maedi-visna among ovine lfocks in China, a total of 672 serum samples were collected from different ovine lfocks in 12 regions (provinces, autonomous regions or municipalities) of China in 2011, and serum antibody levels were determined using a commercial ELISA Kit. This study represents the ifrst investigation of the seroepidemiology of maedi-visna in China, indicating a circulation of MMV among sheep.

  17. Exploring the relationship between cyberbullying and unnatural child death: an ecological study of twenty-four European countries.

    Science.gov (United States)

    Fu, King-wa; Chan, Chung-hong; Ip, Patrick

    2014-07-30

    Internet risk has been recognised as a child safety problem, but evidence is insufficient to conclude that a child's online risk exposure can lead to physical harm. This study aims to explore the ecological relationship between Internet risk exposure and unnatural child death. Multiple secondary data sources were used: online exposure to content about self-harm, cyberbullying, and Internet addiction data (EU Kids Online survey, 2010); and mortality data (European Detailed Mortality Database, 2010 or the latest year if not available) of 24 European countries. Correlations were found using quasi-Poisson regression. Countries' prevalence rates of psychiatric problems (European Social Survey Round 3 and 6, 2006 and 2012) were used to test for possible spuriousness. This study finds that countries with higher rates of cyberbullying were more likely to have a higher incidence of unnatural child death. A 1 percent rise in the prevalence of cyberbullying translated into a 28% increase in risk of unnatural child death (95% CI: 2%-57%). No evidence was found to substantiate confounding effect of the national prevalence of depressive symptoms or traditional bullying. Explanations are given for the findings. We conclude that intervention programs designed to serve as precautionary measures for risk minimisation should be considered.

  18. Group of Twenty Four Countries and Three Tiers: An International Comparative Study on China’s Urbanization

    Institute of Scientific and Technical Information of China (English)

    Li; Hao; Li; Min

    2015-01-01

    It is of great signif icance to conduct an international comparative study on China’s and other countries’ urbanization by taking the concept of "scale" as a crucial study point. This paper puts forward that countries with an area over two million km2 or a GDP over 650 billion dollars are comparable with China. Accordingly, there are 24 such countries in the world leading the global socio-economic development. For consisting of almost all types of countries, they can be considered as basic references for international comparative studies on China’s urbanization. Based on the relationship between urbanization and economic levels, the 24 countries can be divided into three tiers. The fi rst tier countries are mainly developed countries at high urbanization and economic levels; the second tier countries are later starters yet urbanized at a rapid speed, thus have fallen into the "middle-income trap" because of an imbalanced urbanization and economic development; the third tier countries including China and India are still in the starting phase of urbanization, and the key to their future development is a steady economic growth and a balanced urbanization and economic development.

  19. Twenty-four-hour profiles of metabolic and stress hormones in sheep selected for a calm or nervous temperament.

    Science.gov (United States)

    Rietema, S E; Blackberry, M A; Maloney, S K; Martin, G B; Hawken, P A R; Blache, D

    2015-10-01

    Even in the absence of stressors, temperament is associated with changes in the concentration of stress-responsive hormones and, possibly because of such changes, temperament can affect metabolism. We tested whether, in sheep bred for temperament for 14 generations, "nervous" females have greater concentrations of stress-responsive hormones in the absence of stressors than "calm" females, and whether these differences are associated with changes in the concentrations of metabolic hormones. In resting "calm" (n = 8) and "nervous" (n = 8) sheep, concentrations of cortisol, prolactin, leptin, and insulin were measured in blood plasma sampled via jugular catheter every 20 min for 24 h. The animals were individually penned, habituated to their housing and human handling over 7 wk, and fed before sampling began. Diurnal variation was evident for all hormones, but a 24-h cortisol pattern was detected in only 7 individuals. There was no effect of temperament on any aspect of concentrations of cortisol or prolactin, but "calm" animals had greater concentrations of insulin in the early afternoon than "nervous" animals (14.5 ± 1.1 vs 10.0 ± 1.6 μU/mL; P = 0.038), and a similar tendency was seen for leptin (P = 0.092). We conclude that selection for temperament affects the concentration of metabolic hormones in the absence of stressors, but this effect is independent of stress-responsive hormones.

  20. Twenty-four hours hypothermia has temporary efficacy in reducing brain infarction and inflammation in aged rats

    DEFF Research Database (Denmark)

    Sandu, Raluca Elena; Buga, Ana Maria; Balseanu, Adrian Tudor

    2016-01-01

    inflammation and infarct size. However, after 1 week, the infarct size became even larger than in controls and after 2 weeks there was no beneficial effect on regenerative processes such as neurogenesis. Behaviorally, hypothermia also had a limited beneficial effect. Finally, after hydrogen sulfide...

  1. Twenty-four-hour exposure to altered blood flow modifies endothelial Ca2+-activated K+ channels in rat mesenteric arteries

    DEFF Research Database (Denmark)

    Hilgers, Rob H P; Janssen, Ger M J; Fazzi, Gregorio E

    2010-01-01

    ,5,12,16]tetraazacyclotricosine-5,13-diium dibromide (UCL 1684; inhibitor of SK3) or 1-[(2-chlorophenyl)diphenylmethyl]-1H-pyrazole (TRAM-34; inhibitor of IK1). In LF arteries, endothelium-dependent relaxation was markedly reduced, due to a reduction in the endothelium-derived hyperpolarizing factor (EDHF) response. In HF...

  2. Exploring the relationship between cyberbullying and unnatural child death: an ecological study of twenty-four European countries

    Science.gov (United States)

    2014-01-01

    Background Internet risk has been recognised as a child safety problem, but evidence is insufficient to conclude that a child’s online risk exposure can lead to physical harm. This study aims to explore the ecological relationship between Internet risk exposure and unnatural child death. Methods Multiple secondary data sources were used: online exposure to content about self-harm, cyberbullying, and Internet addiction data (EU Kids Online survey, 2010); and mortality data (European Detailed Mortality Database, 2010 or the latest year if not available) of 24 European countries. Correlations were found using quasi-Poisson regression. Countries’ prevalence rates of psychiatric problems (European Social Survey Round 3 and 6, 2006 and 2012) were used to test for possible spuriousness. Results This study finds that countries with higher rates of cyberbullying were more likely to have a higher incidence of unnatural child death. A 1 percent rise in the prevalence of cyberbullying translated into a 28% increase in risk of unnatural child death (95% CI: 2%-57%). No evidence was found to substantiate confounding effect of the national prevalence of depressive symptoms or traditional bullying. Conclusions Explanations are given for the findings. We conclude that intervention programs designed to serve as precautionary measures for risk minimisation should be considered. PMID:25079144

  3. Influence of erdosteine, a mucolytic agent, on amoxycillin penetration into sputum in patients with an infective exacerbation of chronic bronchitis.

    OpenAIRE

    Ricevuti, G; Mazzone, A.; Uccelli, E.; G. Gazzani; Fregnan, G. B.

    1988-01-01

    Twenty four patients with acute infective exacerbations of chronic bronchitis received amoxycillin alone or in combination with erdosteine (a mucolytic agent) for a week in a double blind, placebo controlled study. Clinical assessment scores, body temperature, serum and sputum amoxycillin concentrations, and sputum culture results were recorded in each group. Erdosteine significantly increased antibiotic concentrations in sputum but not in serum. The combined treatment also caused a more rapi...

  4. The effect of different information sources on the anxiety level of pregnant women who underwent invasive prenatal testing.

    Science.gov (United States)

    Çakar, Mehmet; Tari Kasnakoglu, Berna; Ökem, Zeynep Güldem; Okuducu, Ümmühan; Beksaç, M Sinan

    2016-12-01

    The goal is to explore the effects of age, education, obstetric history and information sources on the (Beck) anxiety levels of pregnant women attending invasive prenatal testing. Questionnaire results from 152 pregnant women are utilized. Results are analyzed through an independent samples t-test and a two-step cluster analysis attempting to categorize patients in terms of the chosen variables. t-Tests reveal that age, education and bad obstetric history do not significantly affect anxiety levels. Descriptive statistics indicate that almost 60% of patients feel anxious mostly because of the fear of receiving bad news, followed by the fear of miscarriage, the fear of pain and the fear of hurting the baby. According to the cluster analysis, patients who use doctors or nurses as information sources have significantly lower anxiety levels, while those who do not receive information from any source have the second lowest level of anxiety. Patients who receive information from personal sources (i.e. friends and family) have the highest level of anxiety. Anxiety levels do not change according to test type. Doctors and nurses should allocate enough time for providing information about prenatal diagnosis before the procedure. This will reduce the anxiety level as well as the felt necessity to search for information from other sources, such as personal or popular which will further increase the level of anxiety.

  5. Efeitos da latanoprosta sobre a espessura foveal em olhos submetidos à cirurgia de catarata Influence of topical latanoprost on foveal thickness in eyes that underwent uneventful cataract surgery

    Directory of Open Access Journals (Sweden)

    Enyr Saran Arcieri

    2008-10-01

    Full Text Available OBJETIVO: Avaliar prospectivamente com o uso da tomografia de coerência óptica se o uso tópico de latanoprosta induz alterações retinianas em pacientes submetidos à cirurgia de catarata. MÉTODOS: Estudo clínico randomizado, com observador mascarado e um mês de duração. Pacientes pseudofácicos foram tratados com latanoprosta (n=10 ou lubrificante ocular uma vez ao dia (grupo controle - placebo (n=10. Metade dos pacientes de cada grupo possuía capsulotomia posterior (Nd:YAG laser. Avaliamos o status da barreira hemato-retiniana pela medida da espessura retiniana na fóvea com a tomografia de coerência óptica. Exames de tomografia de coerência óptica e medida da acuidade visual foram realizados antes do início do estudo e com 15 e 30 dias de tratamento. RESULTADOS: Não foi observada alteração significante na média da espessura foveal do grupo controle (p>0,0610. Houve aumento significante na média da espessura foveal nos pacientes tratados com latanoprosta (pPURPOSE: To study prospectively using optical coherence tomography whether topical latanoprost induces retinal disorders in patients that underwent cataract surgery. METHODS: Randomized, masked-observer, one-month clinical trial. Pseudophakic patients were treated with latanoprost (n=10 or lubricant drop q.d. (control group (n=10. Half of the patients of each group presented ruptured posterior capsule (Nd:YAG laser. We evaluated the blood-retinal barrier status assessed by optical coherence tomography measurement of retinal thickness in the fovea. Before the beginning of the study and after 15 and 30 days of treatment, optical coherence tomography images were taken, and the visual acuity examination was performed. RESULTS: There was no statistically significant increase in mean foveal thickness when patients instilled placebo (P>0.0610. A statistically significant increase in retinal thickness in the fovea was observed when patients instilled latanoprost (P<0.0004. No

  6. Elderly patients have similar short term outcomes and five-year survival compared to younger patients after pancreaticoduodenectomy.

    Science.gov (United States)

    Shamali, Awad; De'Ath, Henry D; Jaber, Bashar; Abuawad, Mahmoud; Barbaro, Salvatore; Hamaday, Zaed; Abu Hilal, Mohammad

    2017-09-01

    Outcomes following pancreaticoduodenectomy (PD) in elderly patients in the United Kingdom (UK) remain uncertain. This study aimed to analyse peri-operative outcomes in the elderly, and investigate the impact of age on five-year survival following PD in a UK tertiary centre. All patients who underwent PD in a single Hepatobiliary and Pancreatic unit in the UK between January 2007 to December 2015 were analysed from a prospectively collected database. Individuals were divided into two groups (Group A years and Group B ≥ 75 years "elderly") and outcomes compared. Five hundred and twenty-four patients were included (Group A n = 422, Group B n = 102). Post-operative cardiac events and peri-operative mortality were higher in the elderly (10.8 vs 3.6%, p = 0.008 and 5.9 vs 1.9%, 0.037, respectively). Multivariate analysis revealed only ASA score (OR 0.279, 95% CI 0.063-1.130), post-pancreatectomy haemorrhage (OR 0.055, 95% CI 0.006-0.518) and pulmonary embolism (OR 0.03, 95% CI 0.00-0.148) as independent risk factors for peri-operative mortality. Age was not (OR 0.978, 95% CI 0.911-1.049). Median survival was 22 months in Group A and 19 months in Group B (p = 0.165). Predictors of five-year survival included vascular resection (OR 0.171, 95% CI 0.053-0.549), positive margin (OR 0.256, 95% CI 0.102-0.641), lympho-vascular invasion (OR 0.392, 95% CI 0.160-0.958) and lymph node ratio (OR 67.381, 95% CI 3.301-1375.586), but not age (OR 1.012, 95% CI 0.972-1.054). Older patients have similar peri-operative outcomes and five-year survival compared to younger counterparts after PD in a UK tertiary centre, and should be considered for surgical resection of pancreatic and periampullary cancers. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  7. Patient Discomfort Following Single-Tooth Implant Placement

    DEFF Research Database (Denmark)

    Spin-Neto, Rubens; Pontes, Ana Emília Farias; Wenzel, Ann

    2014-01-01

    Aims: Evaluate postoperative discomfort (pain, bleeding and swelling) in single-tooth implant patients submitted to immediate or conventional tooth restoration together with assessment of treatment time. Methods: Twenty-four patients who received single-tooth maxillary dental implants were randomly...... assigned to an IR (Immediate Restoration) or CR (Conventional Restoration) group. In IR, an implant was inserted and a provisional tooth crown was delivered within the same session, while in CR it was delivered three months after implantation. Pain (first three days), bleeding (first day) and swelling...

  8. TREATMENT OF UNSTABLE THORACOLUMBAR FRACTURES IN PEDIATRIC PATIENTS

    Directory of Open Access Journals (Sweden)

    Roberto Chapa Sosa

    2015-09-01

    Full Text Available Objective:To analyze the characteristics of unstable thoracolumbar fractures in the pediatric population.Methods:A retrospective cross-sectional study was conducted with pediatric patients (0 to 15 years who presented with unstable thoracolumbar fracture with or without neurological damage. Twenty-four operated patients were analyzed: 13 male and 11 female.Results:Falls from height are the most common cause, being the thoracolumbar junction the anatomical site most frequently injured.Conclusion:The thoracolumbar fractures are rare in the pediatric population, as well as post-surgical instrumentation structural deformities.

  9. Single cell morphology of muscle in patients with chronic muscle pain

    DEFF Research Database (Denmark)

    Jacobsen, Søren; Bartels, E M; Danneskiold-Samsøe, B

    1991-01-01

    including 5 with concomitant fibromyalgia. Twenty-four CMP patients and 48 fibromyalgia patients were randomly selected to match with regard to sex, age, smoking and drinking habits. "Rubber band" morphology was blindly graded on a biopsy score scale from 0 to 2. A statistically significant difference...... to the biopsy score. "Rubber band" morphology is seen more often in fibromyalgia patients than in CMP patients. The exact genesis of this phenomenon is still unknown but theories connected with the possible pathogenesis of the syndrome are presented....

  10. A Study of the Patients Admitted to the Clinical Decision Unit over One Year.

    Science.gov (United States)

    O'Shea, E; Cusack, S; O'Sullivan, I

    2016-06-10

    Clinical decision units (CDUs) are areas within an emergency department (ED) providing care for the patient who may benefit from an extended observation period, usually for a maximum of twenty-four hours. A retrospective patient record audit was performed to determine the characteristics of patients admitted to the Cork University Hospital (CUH) CDU over 12 months. The average length of stay of a patient in the CDU was 29 hours. The most common diagnoses admitted to the CDU were chest pain (9.5%) and headache (7.2%). The research implies that the CDU provided a means for CUH to save approximately €2 million annually.

  11. Evaluation of coma patients after cardiopulmonary resuscitation

    Institute of Scientific and Technical Information of China (English)

    SU Ying-ying; YANG Qing-lin; PANG Ying; LV Xiang-ping

    2005-01-01

    Background Coma after cardiopulmonary resuscitation (CPR) is commonly seen in daily clinical practice. How to objectively evaluate brain function after CPR is essential to the following treatment. Coma patients after CPR had been studied prospectively at the Neuro-Intensive Care Unit of Xuanwu Hospital since 2002. In this study, we focused on the topic of how to evaluate the severity of coma after CPR .Methods From April 2002 to November 2004, patients in coma 24 hours after CPR were monitored, the evaluation methods included Glasgow coma score (GCS),brain stem reflection, and spinal reflection. Laboratory evaluation included electroencephalography (EEG),brainstem auditory evoked potential (BAEP), short latency somatosensory evoked potential (SLSEP), and transcranial Doppler (TCD) .Results Twenty-four of 35 patients(68.57%)were in deep coma. The GCS was 3 except for 2 patients;EEG was evaluated not less than grade Ⅳ except for 4 patients, BAEP was evaluated as grade Ⅲ except for 3 patients, and SLSEP was evaluated as grade Ⅲ except for 1 patient.Twenty-four patients died within 1 month and 11 of them(45.83%)were determined as brain death. Glasgow outcome score (GOS) was evaluated as grade Ⅰ. Eleven of the 35 patients survived and their consciousness changed from deep coma to coma vigil. EEG was evaluated as gradeⅠin 5 patients, BAEP and SLSEP were evaluated as grade Ⅰ in 3 patients, and GOS was all evaluated as grade Ⅱ among the 11 patients.Two patients(18.18%)regained consciousness in 35 and 90 days after cardiopulmonary resuscitation and GOS was evaluated as grade Ⅳ and Ⅲ, respectively.Conclusion Combined or continuous evaluation of clinical examinations and laboratory tests can accurately and objectively determine brain function after CPR.

  12. Modulatory effect of acupuncture at Waiguan (TE5 on the functional connectivity of the central nervous system of patients with ischemic stroke in the left basal ganglia.

    Directory of Open Access Journals (Sweden)

    Junqi Chen

    Full Text Available To study the influence of acupuncture at Waiguan (TE5 on the functional connectivity of the central nervous system of patients with ischemic stroke.Twenty-four patients with ischemic stroke in the left basal ganglia were randomized based on gender to receive TE5 acupuncture (n = 12 or nonacupoint acupuncture (n = 12. Each group underwent sham acupuncture and then verum acupuncture while being scanned with functional magnetic resonance imaging. Six regions of interest (ROI were defined, including bilateral motor, somatosensory, and bilateral basal ganglia areas. The functional connectivity between these ROIs and all voxels of the brain was analyzed in Analysis of Functional NeuroImages (AFNI to explore the differences between verum acupuncture and sham acupuncture at TE5 and between TE5 acupuncture and nonacupoint acupuncture. The participants were blinded to the allocation.The effect of acupuncture on six seed-associated networks was explored. The result demonstrated that acupuncture at Waiguan (TE5 can regulate the sensorimotor network of the ipsilesional hemisphere, stimulate the contralesional sensorimotor network, increase cooperation of bilateral sensorimotor networks, and change the synchronization between the cerebellum and cerebrum. Furthermore, a lot of differences of effect existed between verum acupuncture and sham acupuncture at TE5, but there was little difference between TE5 acupuncture and nonacupoint acupuncture.The modulation of synchronizations between different regions within different brain networks might be the mechanism of acupuncture at Waiguan (TE5. Stimulation of the contralesional sensorimotor network and increase of cooperation of bilateral hemispheres imply a compensatory effect of the intact hemisphere, whereas changes in synchronization might influence the sensorimotor function of the affected side of the body.Chinese Clinical Trial Registry ChiCTR-ONRC-08000255.

  13. Long-term MRI cell tracking after intraventricular delivery in a patient with global cerebral ischemia and prospects for magnetic navigation of stem cells within the CSF.

    Directory of Open Access Journals (Sweden)

    Miroslaw Janowski

    Full Text Available BACKGROUND: The purpose of the study was to evaluate the long-term clinical tracking of magnetically labeled stem cells after intracerebroventricular transplantation as well as to investigate in vitro feasibility for magnetic guidance of cell therapy within large fluid compartments. METHOD: After approval by our Institutional Review Board, an 18-month-old patient, diagnosed as being in a vegetative state due to global cerebral ischemia, underwent cell transplantation to the frontal horn of the lateral ventricle, with umbilical cord blood-derived stem cells labeled with superparamagnetic iron oxide (SPIO contrast agent. The patient was followed over 33 months with clinical examinations and MRI. To evaluate the forces governing the distribution of cells within the fluid compartment of the ventricular system in vivo, a gravity-driven sedimentation assay and a magnetic field-driven cell attraction assay were developed in vitro. RESULTS: Twenty-four hours post-transplantation, MR imaging (MRI was able to detect hypointense cells in the occipital horn of the lateral ventricle. The signal gradually decreased over 4 months and became undetectable at 33 months. In vitro, no significant difference in cell sedimentation between SPIO-labeled and unlabeled cells was observed (p = NS. An external magnet was effective in attracting cells over distances comparable to the size of human lateral ventricles. CONCLUSIONS: MR imaging of SPIO-labeled cells allows monitoring of cells within lateral ventricles. While the initial biodistribution is governed by gravity-driven sedimentation, an external magnetic field may possibly be applied to further direct the distribution of labeled cells within large fluid compartments such as the ventricular system.

  14. Clinicopathological features for predicting central and lateral lymph node metastasis in papillary thyroid microcarcinoma: Analysis of 66 cases that underwent central and lateral lymph node dissection.

    Science.gov (United States)

    Tao, Yang; Wang, Chongjie; Li, Liye; Xing, Haijun; Bai, Yun; Han, Bing; Liu, Zhiyan; Yang, Xiangshan; Zhu, Shourong

    2017-01-01

    Currently the surgical approach for papillary thyroid microcarcinoma (PTMC), particularly the range of lymph node dissection, remains controversial. The present study aims to evaluate the risk factors for central and lateral lymph node metastasis (CLNM and LLNM) for appropriate clinical decision of neck lymph node dissection in PTMC. A total of 66 cases of PTMC that underwent unilateral or bilateral lobectomy plus prophylactic cervical lymph node dissection were collected for clinicopathological evaluation, including age, gender, tumor size, subtypes, extrathyroidal invasion, multifocality, calcifications, loss of cellular polarity/cohesiveness (LOP/C) in the invasive front, CLNM and LLNM, and retrospectively analysis. Univariate analysis revealed that LOP/C was significantly associated with CLNM (P=0.001) and LLNM (P0.5 cm and multifocality were high-risk factors of LLNM (P=0.022, 0.044 and 0.005, respectively). Multivariable analysis revealed that LOP/C was significantly associated with CLNM [P=0.007, odds ratio (OR)=7.765, 95% confidence interval (CI)=1.773-33.996] and LLNM [P=0.029, OR=5.717, 95% CI=1.190-27.470]. Both multivariable analysis and χ(2) test revealed that CLNM was another important high-risk factor of LLNM (P=0.021, OR=5.444, 95% CI=1.290-22.969, χ(2)=17.867, PLOP/C and CLNM, which can be performed by intraoperative frozen section pathological examination. This must be considered discreetly in the case of patients with age 0.5 cm and multifocal lesions.

  15. Risk of postoperative complications in chronic obstructive lung diseases patients considered fit for lung cancer surgery: beyond oxygen consumption.

    Science.gov (United States)

    Shafiek, Hanaa; Valera, Jose Luis; Togores, Bernat; Torrecilla, Juan Antonio; Sauleda, Jaume; Cosío, Borja G

    2016-10-01

    Patients with poor lung function usually undergo cardiopulmonary exercise testing (CPET) and those with a predicted postoperative maximal oxygen consumption (VO2 max) of >10 ml/kg/min undergo lung resection surgery and still some complications are observed. We aimed to determine other parameters beyond VO2 able to predict postoperative complications in patients undergoing lung resection surgery. This is an observational study with longitudinal follow-up. Patients with forced expiratory volume in 1 second (FEV1) or diffusing capacity for carbon monoxide of VO2 max of >10 ml/kg/min were considered fit for surgery. Patients were followed up prospectively for 12 months and postoperative complications and survival were recorded. Physiological parameters obtained during CPET and pulmonary function tests were analysed. Eighty-three chronic obstructive pulmonary disease (COPD) patients were evaluated for surgery between 2010 and 2015. Twenty-four patients were considered unfit for surgery and received an alternative therapy. Fifty-five patients had a VO2 max of >10 ml/kg/min and underwent lung surgery. Among them, 4% died and 41% developed complications postoperatively. Baseline minute ventilation to carbon dioxide output (VE/VCO2) slope was significantly higher among those who developed postoperative complications or died (P = 0.047). Furthermore, VE/VCO2 slope of >35 (at maximal exercise) was the single parameter most strongly associated with the probability of mortality and postoperative complications (hazard ratio 5.14) with a survival probability of 40% after 1 year of follow-up. In a multivariable model, VO2, VE/VCO2 slope of >35 and work load were independently associated with the probability of having an event. VO2 is not the unique parameter to consider when CPET is performed to evaluate the postoperative risk of lung cancer surgery in COPD patients. The signs of ventilatory inefficiency such as VE/VCO2 slope predict complications better than VO2 does. © The

  16. Efects of Trimetazidine On-pump Coronary Artery Bypass Grarting in Patients with IL-6, IL-8%曲美他嗪对非体外循环冠脉搭桥术患者IL-6、IL-8的影响

    Institute of Scientific and Technical Information of China (English)

    宋书田; 张彬; 张楠; 杨明; 白传明; 周继梧

    2011-01-01

    目的:观察曲美他嗪对非体外循环冠状动脉(冠脉)旁路移植术(of-pump coronary artery bypass,OPCAB)患者白介素6(interleukin-6,IL-6)和白介素8(interleukin-8,IL-8)浓度的影响.方法:将103例于我院择期行OPCAB的冠心病患者随机分为曲美他嗪组(52例)和对照组(51例).分别于术前、吻合旁路血管开放后6h、12h、24h、48h抽取静脉血,采用放免法检测血清IL-6和IL-8浓度.结果:2组患者临床特征及手术桥血管情况无统计学意义.曲美他嗪组IL-6浓度在术后6h[(225±16)、(515±81)ng/L]和术后12h[(172±5)、(285±11)ng/L]明显低于对照组(P<0.05).曲美他嗪组的IL-8浓度在术后12h[(638±30)、(893±59)ng/L]和24h[(497±16)、(589±26)ng/L]显著低于对照组(P<0.01).结论:曲美他嗪可降低OPCAB患者IL-6和IL-8的释放.%Objective:To observe the effects of trimetazidine on serum of the patients ,interleukin-6 and interleukin-8 underwent offpump coronary artery bypass.Methods:One hundred and three patients who underwent off-pump coronary artery bypass randomly divided into trimetazidine group(52 cases) and control group(51 cases).To draw vein blood preoperative,postoperative six hours,postoperative twelve hours,postoperative twenty-four hours and postoperative forty-eight hours for analyze interleukin-6 and interleukin-8.Results:There was no significant difference between two groups of clinical characterizes and grafts.The serum interleukin-6 of trimetazidine group was lower than control group after surgery six hours and twelve hours, respectively(P<0.05).The serum interleukin-8 of trimetazidine group was lower than control group after surgery twelve hours and twenty-four hours, respectively(P<0.01).Conclusion:Trimetazidine may reduce the release of the serum level of interleukin-6 and interleukin-8 the patients underwent off-pump coronary artery bypass.

  17. 二尖瓣再次手术患者临床特征分析%Clinical Analysis on the Characteristic Underwent Mitral Valve Reoperation

    Institute of Scientific and Technical Information of China (English)

    周维正; 颜涛; 邹良建

    2011-01-01

    Objective:To study the risk factors and treatment methods of the re-valve surgery after mitral valve operation.Methods: From January 2006 to December 2009, a total of 28 patients underwent the second mitral valve replacement after their first mitral valve repair or replacement surgery. Among the patients who received mitral valve replacement for the first time, 7 patients had perivalvular leakage,6 patients happened the degeneration of the artificial hiovalves, 5 patients were valve stenosis.Among these patients, 4 were complicate with artificial valve endocarditis, with 3 positive of the blood culture,and 1 negative.One patient have infravalve stenosis of the artificial valve was because of thrombogenesis. Ten patients received the mitral valve replacement operation because of the degeneration of mitra valve after valve repair surgery. Results:Two patients were dead after operation, and the fatality rate was 7.14%, both were complicated with artificial valve endocarditis. The follow up was 5 months to 5 years. Two patient had severe atrioventricular block, and both received permanent pacemaker implantation in our hospital. All patients received cardioultrasonogragh, and the results showed the artificial valves worked well, and their cardiac function had been from Ⅰ to Ⅱ degree of the New York Heart Association (NYHA) functional cbassification. Conclusions:The degeneration of mitra valve after valve repair surgery has been gradually become the major cause of reoperation of the mitral valve, to restrict the indication of repair surgery can decrease the risk of reoperation. Prosthetic valve endocarditis is a severe complication with high mortality, we should discover it earlier, treat it earlier, to save enough time for the operation.%目的:探讨二尖瓣手术后再次行瓣膜手术的病因和治疗方式.方法:分析2006年1月-2009年12月28例接受再次二尖瓣置换术患者的临床资料.再次手术的病因:二尖瓣成

  18. MENTAL HEALTH IN PATIENTS UNDERWENT ORTHODONTIC TREATMENT FOR PERIODONTAL DISEASE%牙周病正畸病人心理健康状况的调查

    Institute of Scientific and Technical Information of China (English)

    高杨; 李作平; 于艳玲

    2015-01-01

    目的 探讨牙周病正畸病人的心理健康状况,为临床正畸治疗提供参考依据.方法 选择2012年2月-2013年2月来我院正畸治疗的牙周病病人45例(实验组),无正畸需求的牙周病病人46例(对照组),采用症状自评量表、焦虑自评量表(SAS)和抑郁自评量表(SDS)进行心理测定.结果 两组人际关系敏感、抑郁、焦虑、偏执因子得分高于全国成人常模(t=3.59~9.05,P<0.05).实验组抑郁、焦虑因子得分明显高于对照组(t=2.26、2.99,P<0.05).实验组SAS和SDS得分与对照组比较,差异有显著性(t=3.96、4.59,P<0.05).结论 伴牙周病的正畸病人有一定的心理健康问题,在临床治疗过程中应及时加以心理辅导,以便达到最佳治疗效果.

  19. 造血干细胞移植病人口腔并发症护理%Nursing Care in Patients Underwent Hematopoietic Stem Cell Transplantation Developed Oral Complications

    Institute of Scientific and Technical Information of China (English)

    李蓉萍; 荣惠英; 李巧凤; 昝文娟; 马秀琴; 张燕

    2003-01-01

    目的:观察30例造血干细胞移植病人口腔并发症发生的规律,探讨有效科学的护理措施.方法:移植前拟定好口腔护理常规,认真逐一完成;采用自行配制的漱口液,每日交替漱口;用2%碘甘油、肾上腺素稀释液或云南白药防治口腔出血.结果:30例接受造血干细胞移植病人中,口腔黏膜炎发生率为43.3%,发生部位主要在两颊部,发生与白细胞下降的程度以及持续的时间无关;口腔出血发生率为52.3%.结论:造血干细胞移植过程中,有效的口腔护理可预防和减少口腔并发症的发生,达到预防感染、提高疗效的目的.

  20. Manejo da osteorradionecrose em pacientes submetidos à radioterapia de cabeça e pescoço = Osteoradionecrosis management in patients underwent head and neck radiotherapy

    OpenAIRE

    Vier, Fabiana Vieira; Cherubini, Karen; Figueiredo,Maria Antonia Zancanaro de; Yurgel,Liliane Soares

    2005-01-01

    Os efeitos colaterais da radioterapia instituída para o tratamento de pacientes com câncer da região de cabeça e pescoço interferem significativamente na qualidade de vida desses indivíduos. Entre esses efeitos, podem-se citar mucosite, hipossialia, ageusia, cáries por radiação, trismo e osteorradionecrose (ORN). Esta última constitui uma complicação grave e de difícil tratamento. A presente revisão da literatura objetiva enfatizar aspectos da osteorradionecrose, abordando fatores etiológicos...

  1. Manejo da osteorradionecrose em pacientes submetidos à radioterapia de cabeça e pescoço =Osteoradionecrosis management in patients underwent head and neck radiotherapy

    OpenAIRE

    Vier, Fabiana Vieira et al.

    2005-01-01

    Os efeitos colaterais da radioterapia instituída para tratamento de pacientes com câncer da região de cabeça e pescoço interferem significativamente na qualidade de vida desses indivíduos. Entre esses efeitos, podem-se citar mucosite, hipossialia, ageusia, cáries por radiação, trismo e osteorradionecrose (ORN). Esta última constitui uma complicação grave e de difícil tratamento. A presente revisão da literatura objetiva enfatizar aspectos da osteorradionecrose, abordando fatores etiológicos, ...

  2. Ultrasound-Guided 50% Ethyl Alcohol Injection for Patients With Malleolar and Olecranon Bursitis: A Prospective Pilot Study

    Science.gov (United States)

    Hong, Ji Seong; Lee, Jin Hyung

    2016-01-01

    Objective To evaluate the feasibility and effect of ultrasound-guided ethyl alcohol injection on malleolar and olecranon synovial proliferative bursitis. Methods Twenty-four patients received ultrasound-guided 50% diluted ethyl alcohol injection at the site of synovial proliferative bursitis after aspiration of the free fluid. Results Swelling and symptoms significantly decreased in 13 of the 24 patients without any complications. Eleven patients had partial improvement in swelling and symptoms. Conclusion Ultrasound-guided alcohol injection could be an alternative therapeutic option before surgery in patients with chronic intractable malleolar and olecranon synovial proliferative bursitis. PMID:27152282

  3. Effects of Kinesio Tape application to quadriceps muscles on isokinetic muscle strength, gait, and functional parameters in patients with stroke.

    Science.gov (United States)

    Ekiz, Timur; Aslan, Meryem Doğan; Özgirgin, Neşe

    2015-01-01

    The aim of this study was to evaluate the effects of Kinesio Tape (KT) application to quadriceps muscles on isokinetic muscle strength, gait, and functional parameters in patients with stroke. Twenty-four patients were allocated into KT and control groups. All patients participated in the same conventional rehabilitation program 5 times/wk for 4 wk. In addition, KT was applied to quadriceps muscles bilaterally to the patients in the KT group. Compared with baseline, peak torque levels increased significantly in both groups (all p 0.05). KT application to quadriceps muscles in addition to conventional exercises for 4 wk is effective on isokinetic but not functional parameters.

  4. Computed tomography assessment of bone lesions in patients with POEMS syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Glazebrook, K.; Johnson, Adam; Leng, S.; Dispenzieri, A. [Mayo Clinic, Rochester, MN (United States); Guerra Bonilla, Francis L. [Hospital Regional Rafael Hernandez, Hematology Division, David, Chiriqui (Panama)

    2014-09-25

    To describe the imaging findings on computed tomography (CT) and skeletal survey (SS) in patients with POEMS syndrome. We retrospectively reviewed, with institutional review board approval, the dysproteinemia database at our institution for patients with new diagnosis of POEMS syndrome between January 1998 and December 2008. Twenty-four patients were identified with PET/CT or CT and had skeletal survey (SS) available for review. Twenty-four patients were included in the study group with median age of 47 years. All CTs demonstrated at least one sclerotic lesion. The most common pattern was multiple small lesions, with 18 patients (75 %) having at least 5 lesions less than 1 cm. The larger lesions had a central lytic component and were FDG avid. SS had a false negative rate of 36 % (8 patients). Serial CT after treatment showed a decrease in size and number of sclerotic lesions in 53 % of cases (13 patients), the majority showing increased sclerosis. Two patients had complete resolution of sclerotic lesions. CT identified sclerotic lesions in all study patients with POEMS syndrome, the majority being less than 1 cm in size, which were not identified radiographically. CT may demonstrate increased sclerosis or even resolution of sclerotic lesions corresponding to treatment response. (orig.)

  5. Orbital Wall Reconstruction with Titanium Mesh: Retrospective Study of 24 Patients

    OpenAIRE

    Gabrielli, Mario Francisco; Monnazzi, Marcelo Silva; Passeri, Luis Augusto; Carvalho, Waldner Ricardo; Gabrielli, Marisa; Hochuli-vieira, Eduardo [UNESP

    2011-01-01

    The aim of this study was to evaluate the efficacy and safety of traumatic orbital defect reconstruction with titanium mesh. A retrospective study was made. Evaluations were made after a minimum postoperative follow-up of 12 months, looking for the main complications. Twenty-four patients were included in this evaluation; 19 were male (79.1%) and 5 (20.8%) were female. The main injury etiology was vehicle accidents (50%) followed by other causes. Fourteen patients (58.3%) presented orbital fl...

  6. Comparison of in-and outpatients protocols for providence night time only bracing in AIS patients -- compliance and satisfaction

    DEFF Research Database (Denmark)

    Al-Aubaidi, Zaid Tj; Tropp, Hans; Pedersen, Niels W

    2013-01-01

    BACKGROUND: Skeletally immature patients diagnosed with adolescent idiopathic scoliosis (AIS) and a Cobb angle above 25degrees is usually treated with a brace. Standard protocols in many centers include hospitalisation for a few days for the purpose of brace adaptation and fitting. The aim...... of this study is to compare compliance and satisfaction in hospitalization and out patient clinic protocols, at the initiation phase of brace treatment.Materials and methodsTwenty-four consecutive patients with AIS were initiated with the Providence night time only brace at our department between October 2008...

  7. Ahmed阀平坦部植入联合MMC治疗眼外伤玻切术后难治性青光眼%AGV pars planna implantation combined with MMC in treating traumatic glaucoma underwent pars plana vitrectomy

    Institute of Scientific and Technical Information of China (English)

    吴敏; 肖丽波; 胡竹林

    2012-01-01

    Objective To evaluate the effect of Ahmed glaucoma valve pars plana implantation combined with MMC in treating ocular traumatic glaucoma patients who underwent pars plana vitrectomy.Methods 17 cases of traumatic glaucoma who underwent pars plana vitrectomy were treated by Ahmed glaucoma valve pars planna implantation combined with MMC from January 2007 to January 2010.Results Follow-up durations were 10 ~ 32 months and the average follow-up time was(14.5 ± 2.3)months.the success rate of the procedure was 82.4%,in which 76.5% was completely successful.Post-operatvie visual acuity was stable or improved in 88.2% of the patients.Surgical complications were mild vitreous hemorrhage(2cases)and early-stage low tension(3 cases).Conclusion Ahmed glaucoma valve pars planna implantation combined with MMC was effective in treating ocular traumatic glaucoma patients who underwent pars plana vitrectomy.%目的 观察Ahmed引流阀平坦部植入术联合MMC对眼外伤玻切术后难治性青光眼的治疗效果.方法 回顾性分析采用Ahmed引流阀平坦部植入术联合MMC治疗的17例眼外伤玻切术后难治性青光眼.结果 随访时间10~32个月,平均(14.5±2.3)个月.手术成功率为82.4%,其中完全成功率76.5%,视力保持不变和提高者88.2%,并发症为2例少量玻璃体积血,3例早期低眼压.结论 AGV平坦部植入联合MMC治疗眼外伤玻璃体切除术后无晶状体的难治性青光眼患者是一种有效的方法.

  8. The Australasian Hepatology Association consensus guidelines for the provision of adherence support to patients with hepatitis C on direct acting antivirals

    Directory of Open Access Journals (Sweden)

    Richmond JA

    2016-12-01

    : Twenty-four guidelines emerged from the evidence synthesis and expert panel discussion. The guidelines focus on the pretreatment assessment and education, assessment of treatment readiness, and monitoring of medication adherence. The guidelines are embedded in a patient-centered approach which highlights that all patients are at risk of nonadherence. The guidelines recommend implementing interventions focused on identifying patients’ memory triggers and hooks; use of nonconfrontational and nonjudgmental language by health professionals; and objectively monitoring adherence. Conclusion: These are the first guidelines to support patients and health professionals in the delivery of clinical care by identifying practical adherence support interventions for patients taking DAAs. Keywords: nursing, adherence, best practice, nursing support, hepatitis C treatment

  9. Preload dependence of new Doppler techniques limits their utility for left ventricular diastolic function assessment in hemodialysis patients.

    Science.gov (United States)

    Ie, Eric H Y; Vletter, Wim B; ten Cate, Folkert J; Nette, Robert W; Weimar, Willem; Roelandt, Jos R T C; Zietse, Robert

    2003-07-01

    Left ventricular (LV) hypertrophy leads to diastolic dysfunction. Standard Doppler transmitral and pulmonary vein (PV) flow velocity measurements are preload dependent. New techniques such as mitral annulus velocity by Doppler tissue imaging (DTI) and LV inflow propagation velocity measured from color M-mode have been proposed as relatively preload-independent measurements of diastolic function. These parameters were studied before and after hemodialysis (HD) with ultrafiltration to test their potential advantage for LV diastolic function assessment in HD patients. Ten patients (seven with LV hypertrophy) underwent Doppler echocardiography 1 h before, 1 h after, and 1 d after HD. Early (E) and atrial (A) peak transmitral flow velocities, peak PV systolic (s) and diastolic (d) flow velocities, peak e and a mitral annulus velocities in DTI, and early diastolic LV flow propagation velocity (V(p)) were measured. In all patients, the E/A ratio after HD (0.54; 0.37 to 1.02) was lower (P < 0.01) than before HD (0.77; 0.60 to 1.34). E decreased (P < 0.01), whereas A did not. PV s/d after HD (2.15; 1.08 to 3.90) was higher (P < 0.01) than before HD (1.80; 1.25 to 2.68). Tissue e/a after HD (0.40; 0.26 to 0.96) was lower (P < 0.01) than before HD (0.56; 0.40 to 1.05). Tissue e decreased (P < 0.02), whereas a did not. V(p) after HD (30 cm/s; 16 to 47 cm/s) was lower (P < 0.01) than before HD (45 cm/s; 32 to 60 cm/s). Twenty-four hours after the initial measurements values for E/A (0.59; 0.37 to 1.23), PV s/d (1.85; 1.07 to 3.38), e/a (0.41; 0.27 to 1.06), and V(p) (28 cm/s; 23 to 33 cm/s) were similar as those taken 1 h after HD. It is concluded that, even when using the newer Doppler techniques DTI and color M-mode, pseudonormalization, which was due to volume overload before HD, resulted in underestimation of the degree of diastolic dysfunction. Therefore, the advantage of these techniques over conventional parameters for the assessment of LV diastolic function in HD

  10. Anxiety and quality of life in phobic dental patients.

    Science.gov (United States)

    Crofts-Barnes, N P; Brough, E; Wilson, K E; Beddis, A J; Girdler, N M

    2010-03-01

    Little is known about the anxiety patients experience before attending for dental treatment. The aim of this study was to determine, in dentally phobic patients, the temporal relationship of pre-operative anxiety levels, and the disruption to daily life caused by this. Twenty-four phobic and 19 comparison (non-phobic) dental patients were recruited. Four validated questionnaires were used to assess anxiety and quality of life, which each patient completed for 5 days prior to, and on the day of, treatment. Those in the experimental group were found to have significantly greater levels of dental and general anxiety, and a significantly lower quality of life compared with those in the comparison group. Significant temporal relationships were found with all of the questionnaires. Dental and general anxiety scores were significantly correlated with quality-of-life measures. This study suggests that phobic dental patients are experiencing significant increased anxiety, and significant negative quality-of-life effects, in this period.

  11. Prognostic Factors and a New Prognostic Index Model for Children and Adolescents with Hodgkin’s Lymphoma Who Underwent Autologous Hematopoietic Stem Cell Transplantation: A Multicenter Study of the Turkish Pediatric Bone Marrow Transplantation Study

    Directory of Open Access Journals (Sweden)

    Vural Kesik

    2016-12-01

    Full Text Available Objective: The prognostic factors and a new childhood prognostic index after autologous hematopoietic stem cell transplantation (AHSCT in patients with relapsed/refractory Hodgkin’s lymphoma (HL were evaluated. Materials and Methods: The prognostic factors of 61 patients who underwent AHSCT between January 1990 and December 2014 were evaluated. In addition, the Age-Adjusted International Prognostic Index and the Childhood International Prognostic Index (CIPI were evaluated for their impact on prognosis. Results: The median age of the 61 patients was 14.8 years (minimummaximum: 5-20 years at the time of AHSCT. There were single relapses in 28 patients, ≥2 relapses in eight patients, and refractory disease in 25 patients. The chemosensitivity/chemorefractory ratio was 36/25. No pretransplant radiotherapy, no remission at the time of transplantation, posttransplant white blood cell count over 10x103/ μL, posttransplant positron emission tomography positivity at day 100, and serum albumin of <2.5 g/dL at diagnosis were correlated with progression-free survival. No remission at the time of transplantation, bone marrow positivity at diagnosis, and relapse after AHSCT were significant parameters for overall survival. Conclusion: The major factors affecting the progression-free and overall survival were clearly demonstrated. A CIPI that uses a lactate dehydrogenase level of 500 IU/L worked well for estimating the prognosis. We recommend AHSCT at first complete remission for relapsed cases, and it should also be taken into consideration for patients with high prognostic scores at diagnosis.

  12. Nurses experience of aromatherapy use with dementia patients experiencing disturbed sleep patterns. An action research project.

    Science.gov (United States)

    Johannessen, Berit

    2013-11-01

    The purpose of this study was to gain an insight into nurses' experiences of incorporating aromatherapy into the care of residents suffering from dementia, anxiety and disturbed sleep patterns. Twenty-four residents and twelve nurses from four nursing homes participated in an action research study. The use of lavender augustofolia essential oil diffused nightly was perceived as an effective care modality reducing insomnia and anxiety in this patient cohort. Nurses experienced some negative attitudes among colleagues because they considered aromatherapy as not evidence based. Nurses require greater access to evidence based use of Aromatherapy. Further research is needed to study how smell can enhance dementia care.

  13. Prevalence of Pancreatic Cystic Lesions Is Associated With Diabetes Mellitus and Obesity: An Analysis of 5296 Individuals Who Underwent a Preventive Medical Examination.

    Science.gov (United States)

    Mizuno, Suguru; Isayama, Hiroyuki; Nakai, Yousuke; Yoshikawa, Takeharu; Ishigaki, Kazunaga; Matsubara, Saburo; Yamamoto, Natsuyo; Ijichi, Hideaki; Tateishi, Keisuke; Tada, Minoru; Hayashi, Naoto; Koike, Kazuhiko

    2017-07-01

    Pancreatic cystic lesions (PCLs) are considered precursors of pancreatic cancer. Diabetes mellitus (DM) and obesity are known as risk factors for pancreatic cancer. We investigated the prevalence of PCLs in the general population and the relationship between PCLs and DM/obesity. This cross-sectional analysis included 5296 individuals who underwent a preventive medical examination between October 2006 and June 2013 at our institution. Magnetic resonance imaging, including magnetic resonance cholangiopancreatography, was performed using a 3.0-T system as part of a comprehensive health screening program. We investigated the prevalence and risk factors of PCLs. The prevalence of PCLs was 13.7%, which was increased according to age. Individuals with PCLs were more prone to obesity (body mass index, 24.0 vs 23.7 kg/m [P = 0.015]; waist circumference, 87.4 vs 85.5 cm [P Pancreatic cystic lesions were significantly associated with DM and obesity.

  14. HO-1 gene overexpression enhances the beneficial effects of superparamagnetic iron oxide labeled bone marrow stromal cells transplantation in swine hearts underwent ischemia/reperfusion: an MRI study.

    Science.gov (United States)

    Jiang, Yibo; Chen, Lijuan; Tang, Yaoliang; Ma, Genshan; Shen, Chengxing; Qi, Chunmei; Zhu, Qi; Yao, Yuyu; Liu, Naifeng

    2010-05-01

    To determine the effect of intracoronary transfer of superparamagnetic iron oxide (SPIO) labeled heme oxygenase-1 (HO-1) overexpressed bone marrow stromal cells (BMSCs) in a porcine myocardial ischemia/reperfusion model. Cell apoptosis was assayed and supernatant cytokine concentrations were measured in BMSCs that underwent hypoxia/reoxygen in vitro. Female mini-swines that underwent 1 h LAD occlusion followed by 1 h reperfusion were randomly allocated to receive intracoronary saline (control), 1 x 10(7) SPIO-labeled BMSCs transfected with pcDNA3.1-Lacz plasmid (Lacz-BMSCs), pcDNA3.1-human HO-1 (HO-1-BMSCs), pcDNA3.1-hHO-1 pretreated with a HO inhibitor, tin protoporphyrin (SnPP, n = 10 each). MRI and postmortem histological analysis were made at 1 week or 3 months thereafter. Post hypoxia/reoxygen in vitro, apoptosis was significantly reduced, supernatant VEGF significantly increased while TNF-alpha and IL-6 significantly reduced in HO-1-BMSCs group compared with Lacz-BMSCs group (all p < 0.05). Myocardial expression of VEGF was significantly higher in HO-1-BMSCs than in Lacz-BMSCs group at 1 week post transplantation (all p < 0.05). Signal voids induced by the SPIO were detected in the peri-infarction region in all BMSC groups at 1 week but not at 3 months post transplantation and the extent of the hypointense signal was the highest in HO-1-BMSCs group, and histological analysis showed that signal voids represented cardiac macrophages that engulfed the SPIO-labeled BMSCs. Pretreatment with SnPP significantly attenuated the beneficial effects of HO-1-BMSCs. Transplantation of HO-1-overexpressed BMSCs significantly enhanced the beneficial effects of BMSCs on improving cardiac function in this model.

  15. Post-traumatic avascular necrosis of the femoral head predicted by preoperative technetium-99m antimony-colloid scan: an experimental and clinical study. [Rabbits; patients

    Energy Technology Data Exchange (ETDEWEB)

    Turner, J.H.

    1983-07-01

    Technetium-99m antimony colloid was used to visualize the bone marrow of the head of the femur within twenty-four hours after interruption of the blood supply by subcapital osteotomy and section of the ligamentum teres in thirteen rabbits and within twenty-four hours after a subcapital fracture in thirty patients. Of the rabbits, all showed loss of marrow radioactivity over the affected femoral head. Bone-imaging with technetium-99m methylene diphosphonate, in contrast, failed to demonstrate any abnormality in the avascular head of the femur for as long as forty-eight hours after osteotomy. This difference between the marrow scan and the bone scan was attributed to earlier loss of function in the marrow cells than in the osteocytes. The thirty patients who had a preoperative scan within twenty-four hours after sustaining a subcapital fracture were treated by internal fixation with a Richards screw and plate and were followed for as long as two years, or until the patient died or radiographs showed evidence of avascular necrosis. The preoperative technetium-99m antimony-colloid activity in the head of the fractured femur was normal in sixteen patients and absent in fourteen; two of the fourteen had no activity in either hip, which precluded assessment of the fractured hip in these patients. In fifteen of the sixteen hips, preservation of the uptake in the marrow of the head of the fractured femur preoperatively predicted normal healing. Late segmental collapse developed in the remaining hip. In eleven of the twelve patients who had loss of marrow activity in the femoral head preoperatively, avascular necrosis developed within two years.

  16. Effect of systematic relaxation techniques on anxiety and pain in older patients undergoing abdominal surgery.

    Science.gov (United States)

    Rejeh, Nahid; Heravi-Karimooi, Majideh; Vaismoradi, Mojtaba; Jasper, Melanie

    2013-10-01

    Inadequate pain control in older patients who have undergone abdominal surgery can lead to many complications. This study investigates the effect of systematic relaxation techniques on pain and anxiety in older patients undergoing abdominal surgery. One hundred twenty-four patients were randomly assigned into the experimental and control groups. The systematic relaxation techniques consisted of older patients in the experimental group slowly reading relaxing sentences during recovery in ambulation after the surgery. Patients' satisfaction with pain and anxiety relief was recorded, as was their use of opioid analgesia. Statistically significant differences in pain and anxiety, and in analgesic use, were reported between the patients in experimental and control groups after the intervention. These relaxation techniques can be incorporated into the care plan to reduce pain and anxiety after surgery as well as offering a measure for increasing the patients' independence in pain management control. © 2013 Wiley Publishing Asia Pty Ltd.

  17. Views on Induced Abortion in Those Unmarried Women Underwent Abortion%从未婚人工流产女性视角看人工流产

    Institute of Scientific and Technical Information of China (English)

    崔念; 陈颖; 田爱平

    2015-01-01

    目的:从未婚人工流产女性视角分析未婚妊娠原因,了解她们对未婚人工流产的认识。方法:对成都市不同等级妇幼保健机构/医院接受过人工流产术的19名未婚女性进行个人深入访谈。结果:避孕知识缺乏、发生性行为时心存侥幸心理、未采取避孕措施和避孕措施不当为未婚妊娠的主要原因;对未婚人工流产对健康影响有一定的认识,最为担心的是怕影响以后的再生育。结论:对未婚人群加强生殖健康知识教育、尤其是避孕措施的咨询和服务非常重要,需要政府牵头、家庭-学校-社会多部门协同合作,并不断探索适宜、有效的教育方式方法以及服务模式,以促进未婚人群的生殖健康。%Objective: To analyze the reason of unintended pregnancy in those unmarried women underwent induced abortion, so as to understand their views on induced abortion. Methods: An in-depth interview was conducted among 19 unmarried women underwent induced abortion in Maternity and Child Care Institution/Hospital, Chengdu, China. Results: The main reasons of unintended pregnancy were lack of contraceptive knowledge, not use or misuse contraceptives during sex intercourse. Those unmarried women had some knowledge on the induced abortion which affects health. The most worried thing was the possible effect on their future fertility. Conclusions: It is very important to provide comprehensive reproductive health information, and particularly the good-quality of contraceptive counseling and services for unmarried youth. It is also necessary to explore the appropriate and effective model of education and health care service so as to promote the reproductive health of unmarried population by the leadership of government and multi-sectoral collaboration among family, school and community.

  18. The Mouse-colored Tyrannulet (Phaeomyias murina) is a species complex that includes the Cocos Flycatcher (Nesotriccus ridgwayi), an island form that underwent a population bottleneck.

    Science.gov (United States)

    Zucker, Marc R; Harvey, Michael G; Oswald, Jessica A; Cuervo, Andrés; Derryberry, Elizabeth; Brumfield, Robb T

    2016-08-01

    Simultaneous examination of evolutionary history in island forms and closely related mainland relatives can provide reciprocal insight into the evolution of island and mainland faunas. The Cocos Flycatcher (Nesotriccus ridgwayi) is a small tyrant flycatcher (Tyrannidae) endemic to Cocos Island, an oceanic island in the eastern Pacific Ocean. We first established its close relationship to the mainland species Mouse-colored Tyrannulet (Phaeomyias murina) using a phylogeny from genome-wide ultraconserved elements and exons. We then used mitochondrial DNA to explore the relationships between Nesotriccus and Phaeomyias populations from across its distribution in Central and South America. We found that Nesotriccus is nested within the Phaeomyias evolutionary tree, and that Phaeomyias represents a complex of at least four evolutionarily distinct species that differ in plumage, voice, and habitat association. Nesotriccus underwent a population bottleneck subsequent to its divergence from Central American and northern South American Phaeomyias populations in the middle Pleistocene. The 46 UCE loci containing alleles that are fixed between the two species are widely distributed across the genome, which suggests that selective or neutral processes responsible for divergence have occurred genome-wide. Overall, our simultaneous examination of Phaeomyias and Nesotriccus revealed divergent levels of genetic diversity and evolutionary histories between island and mainland forms.

  19. Atrial fibrillation, ischaemic heart disease, and the risk of death in patients with heart failure

    DEFF Research Database (Denmark)

    Pedersen, Ole Dyg; Søndergaard, Peter; Nielsen, Tonny

    2006-01-01

    AIMS: Atrial fibrillation (AF) is a risk factor for death in patients with a myocardial infarction, but highly variable results are reported in patients with heart failure. We studied the prognostic impact of AF in heart failure patients with and without ischaemic heart disease. METHODS AND RESULTS......: During a period of 2 years, 3587 patients admitted to hospital because of heart failure were included in this study. All patients were examined by echocardiography and the presence of AF was recorded. Follow-up was available for 8 years. Twenty four percent of those discharged alive from hospital had AF......), 1.02-1.23, P=0.018]. There was a significant interaction between the importance of AF and the presence of ischaemic heart disease (P=0.034). In patients with AF at the time of discharge and ischaemic heart disease, HR was 1.25 (95% CI: 1.09-1.42) and P

  20. Patient-Treatment Matching Improves Compliance of Alcoholics in Outpatient Treatment

    DEFF Research Database (Denmark)

    Nielsen, Anette Søgaard; Nielsen, Bent; Wraae, Olaf

    1998-01-01

    In chronic medical disorders, patient compliance is very poor and often less than 50%. The purpose of this investigation was to determine whether the proper matching of patient, treatment, and therapist would improve patient compliance in the outpatient treatment of alcoholics. We randomly placed...... curves. The consequence of compliance for long-term prognosis was described by means of the Addiction Severity Index. The form of treatment in itself had no importance for compliance. However, correct matching of a patient and a treatment structure resulted in a compliance rate of 63% as opposed to 38......% compliance among mismatched patients. Twenty-four months after the initiation of treatment, patients in the compliance group had a significantly higher level of function than those in the noncompliance group. Our investigation of alcoholics involved in outpatient treatment shows that the correct matching...

  1. Deliberate ingestion of foreign bodies by institutionalised psychiatric hospital patients and prison inmates.

    LENUS (Irish Health Repository)

    O'Sullivan, S T

    2012-02-03

    Deliberate and recurrent foreign body ingestion is a common problem among institutionalised patients. We review our experience with 36 cases of deliberate foreign body ingestion by prisoners or psychiatric patients, thirty of whom were institutionalised at the time of ingestion. Symptoms were frequently severe in the prison inmate group but, in contrast, psychiatric patients presented with few, if any, symptoms. A majority of objects pass spontaneously or remain in situ without complication. Twenty-four patients were discharged following initial evaluation and without specific treatment. Eight of these were reviewed electively and discharged within one week. Twelve patients were admitted for observation, seven of whom were discharged within 48 hrs. Upper gastrointestinal endoscopy was performed in four patients and an intragastric foreign body identified in two cases. Laparotomy was performed in two cases for unresolving mechanical intestinal obstruction. Management should be conservative when possible, with surgery indicated only for complications.

  2. Incidence of Y-chromosome microdeletions in children whose fathers underwent vasectomy reversal or in vitro fertilization with epididymal sperm aspiration: a case-control study.

    Science.gov (United States)

    Ghirelli-Filho, Milton; Marchi, Patricia Leme de; Mafra, Fernanda Abani; Cavalcanti, Viviane; Christofolini, Denise Maria; Barbosa, Caio Parente; Bianco, Bianca; Glina, Sidney

    2016-01-01

    To evaluate the incidence of Y-chromosome microdeletions in individuals born from vasectomized fathers who underwent vasectomy reversal or in vitro fertilization with sperm retrieval by epididymal aspiration (percutaneous epididymal sperm aspiration). A case-control study comprising male children of couples in which the man had been previously vasectomized and chose vasectomy reversal (n=31) or in vitro fertilization with sperm retrieval by percutaneous epididymal sperm aspiration (n=30) to conceive new children, and a Control Group of male children of fertile men who had programmed vasectomies (n=60). Y-chromosome microdeletions research was performed by polymerase chain reaction on fathers and children, evaluating 20 regions of the chromosome. The results showed no Y-chromosome microdeletions in any of the studied subjects. The incidence of Y-chromosome microdeletions in individuals born from vasectomized fathers who underwent vasectomy reversal or in vitro fertilization with spermatozoa recovered by percutaneous epididymal sperm aspiration did not differ between the groups, and there was no difference between control subjects born from natural pregnancies or population incidence in fertile men. We found no association considering microdeletions in the azoospermia factor region of the Y chromosome and assisted reproduction. We also found no correlation between these Y-chromosome microdeletions and vasectomies, which suggests that the assisted reproduction techniques do not increase the incidence of Y-chromosome microdeletions. Avaliar a incidência de microdeleções do cromossomo Y em indivíduos nascidos de pais vasectomizados submetidos à reversão de vasectomia ou fertilização in vitro com recuperação de espermatozoides por aspiração do epidídimo (aspiração percutânea de espermatozoides do epidídimo). Estudo caso-controle que compreende crianças do sexo masculino de casais em que o homem havia sido previamente vasectomizado e escolheu revers

  3. FACTORES DE RIESGO CARDIOVASCULAR Y CALIDAD DE VIDA EN MUJERES REVASCULARIZADAS CON STENT CORONARIOS / Cardiovascular risk factors and quality of life in women who under-went revascularization with coronary stenting

    Directory of Open Access Journals (Sweden)

    José C. Castillo Núñez

    2013-10-01

    descriptive, longitudinal prospective study was conducted in women (n=62 who underwent revascularization with PTCA and stent implantation from January to June 2011. Clinical follow-up was performed for 180 days through medical consultations. Results: The mean age was 52.8 years and the most frequent cardiovascular risk factor was hypertension (66.1 %; diabetes (24.2 % was the least prevalent. One-vessel atherosclerotic coronary artery disease was the most common (87.1%, and three-vessel disease (1.6% was the least frequent one. Only one stent was implanted in 75.8 % of patients, and only one patient required the implantation of three stents; 83.9% of patients expressed that their quality of life was good, 14.5 % considered it was acceptable and one patient estimated it was poor. During clinical follow-up, no cardiovascular events was reported in 93.5 % of patients. Diabetes and poor quality of life showed a statistically significant association with the extent of atherosclerotic coronary artery disease, the number of stents used and cardiovascular events. Conclusions: Women with atherosclerotic coronary artery disease who underwent revascularization with coronary stents show a high frequency of risk factors, and have a favorable clinical course with a prevalence of positive perceptions concerning their quality of life.

  4. Effects of self-relaxation methods and visual imagery on IOP in patients with open-angle glaucoma.

    Science.gov (United States)

    Kaluza, G; Strempel, I

    1995-01-01

    In this study, the effects of a training in relaxation and visual imagery on the intra-ocular pressure (IOP) of patients with primary open-angle glaucoma were investigated. Twenty-three patients, aged 24-69 years, were assigned either to a training group or to a waiting-list control group. The intervention included a basic programme (BP) of standard autogenic relaxation exercises and an advanced programme (AP) in which special exercises in ocular relaxation and imagination of aqueous humour drainage were conducted. IOP was measured before and after each training session. Twenty-four-hour IOP profiles were ascertained, and the water drinking test to provoke maximum IOP levels was performed during clinical assessments prior to the training, between the BP and the AP and after termination of the training. Results indicate only slight short-term changes of IOP levels immediately after each training session. However, during the course of the BP as well as of the AP a relevant decrease in IOP could be measured. Twenty-four-hour IOP profiles as well as the water drinking test also showed significant reductions of IOP during time. Medication could be reduced for 56% of the initially treated patients. The findings suggest that relaxation and visual imagery techniques can be beneficial in reducing elevated IOP levels in patients with open-angle glaucoma though the conclusiveness of the data is limited due to methodological shortcomings.

  5. Intravitreal bevacizumab (Avastin) for neovascular age-related macular degeneration in treatment-naive patients

    DEFF Research Database (Denmark)

    Pedersen, Karen Bjerg; Sjølie, Anne Katrin; Møller, Flemming

    2008-01-01

    , pilot study of 26 eyes of 26 patients, all previously treatment-naive to photodynamic therapy, argon laser or anti-vascular endothelial growth factor (VEGF), were treated with one or more intravitreal injections of 1.25 mg bevacizumab. Of the 26 patients, 15 (57.7%) had occult choroidal...... neovascularization (CNV), 6 (23.1%) had predominantly classic CNV and 5 (19.2%) had minimally classic CNV. Ophthalmic outcome measures included changes in standardized Early Treatment Diabetic Research Study (ETDRS) VA, contrast sensitivity and OCT. The patients were examined at baseline and 1 week, 6 weeks, 3...... months and 6 months after the first injection. Re-treatment was given on an 'as needed' basis. Results: Twenty-four eyes of 24 patients completed 6 months of follow-up. Two patients chose to discontinue the study. Mean ETDRS VA score improved from 55 letters at baseline to 60 letters at 1 week (P

  6. Perforated duodenal ulcer in high risk patients: Is percutaneous drainage justified?

    Directory of Open Access Journals (Sweden)

    Aly Saber

    2012-01-01

    Full Text Available Background: Conservative treatment was recommended as the treatment of choice in perforated acute peptic ulcer. Here, we adjunct percutaneous peritoneal drainage with nonoperative conservative treatment in high risk elderly patients with perforated duodenal ulcer. Aim: The work was to study the efficacy of percutaneous peritoneal drainage under local anesthesia supported by conservative measures in high risk elderly patients, according to the American Society of Anesthesiologists grading, with perforated duodenal ulcer. Patients and Methods: Twenty four high risk patients with age >65 years having associated medical illness with evidence of perforated duodenal ulcer. Results: The overall morbidity and mortality were comparable with those treated by conservative measures alone. Conclusion: In high risk patients with perforated peptic ulcer and established peritonitis, percutaneous peritoneal drainage under local anesthesia seems to be effective with least operative trauma and mortality rate.

  7. Prevalence ofHIV seropositivity among patients with squamous cell carcinoma of the conjunctiva

    Institute of Scientific and Technical Information of China (English)

    Adesuwa I Osahon; Catherine U Ukponmwan; Odarosa M Uhunmwangho

    2011-01-01

    Objective:To determine the prevalence ofHIV seropositivity among patients with squamous cell carcinoma of the conjunctiva.Methods:All patients with clinical and histopathological confirmation of squamous cell carcinoma seen during a ten year period (July1999 to June2009) were tested for HIV (Human Immunodeficiency Virus). The number of patients with squamous cell carcinoma of the conjunctiva who areHIV positive were counted.Results:A total of thirty-three(33) eyes in thirty-two(32) patients were confirmed histopathologically to have conjunctival squamous cell carcinoma. Their ages ranged from22 years to66 years with a mean age of (38.6±11.8) years (SD). The male to female ratio was1:1.5. Twenty four (75%) of these patients wereHIV positive.Conclusions: Squamous cell carcinoma is associated with the human immunodeficiency virus and is thus a marker for the disease in Benin City, Nigeria.

  8. Effects of Ramadan Fasting on Ambulatory Blood Pressure in Hypertensive Patients

    Directory of Open Access Journals (Sweden)

    Maryam Alinezhad Namaghi

    2014-03-01

    Full Text Available Background: Previous studies have indicated that Ramadan fasting has beneficial effects on cardiovascular risk factors, specially blood pressure and heart rate (1. In the present study, the effect of Ramadan fasting on 24-hour ambulatory blood pressure and heart rate has been investigated. Materials and Methods: This prospective observational study was conducted on two groups of individuals. Six patients under hypertension treatment were allocated to the case group and 12 healthy individuals were selected as the control group. Twenty-four-hour blood pressure monitoring was carried out during four periods: prior to Ramadan, during the first ten days and the last ten days of Ramadan, and one month after it. All patients continued their medication, which was administered twice per day. Twenty-four-hour mean blood pressure, weight, body mass index (BMI, and waist circumference were compared among the groups. Results: In the case group, there was a significant reduction in subjects’ weight during the third period of the experiment; also, a significant improvement was observed in the heart rate during the second and third periods in the case group (P<0.05, t-test. Conclusion: This study indicated a significant improvement in the subjects’ heart rate over second and third periods of measurements; also, no high-risk variations in blood pressure or heart rate were observed among the subjects.

  9. Effects of Ramadan fasting on ambulatory blood pressure in hypertensive patients

    Directory of Open Access Journals (Sweden)

    Maryam Alinezhad Namaghi

    2014-02-01

    Full Text Available Background: Previous studies have indicated that Ramadan fasting has beneficial effects on cardiovascular risk factors, specially blood pressure and heart rate (1. In the present study, the effect of Ramadan fasting on 24-hour ambulatory blood pressure and heart rate has been investigated. Materials and Methods: This prospective observational study was conducted on two groups of individuals. Six patients under hypertension treatment were allocated to the case group and 12 healthy individuals were selected as the control group. Twenty-four-hour blood pressure monitoring was carried out during four periods: prior to Ramadan, during the first ten days and the last ten days of Ramadan, and one month after it. All patients continued their medication, which was administered twice per day. Twenty-four-hour mean blood pressure, weight, body mass index (BMI, and waist circumference were compared among the groups. Results: In the case group, there was a significant reduction in subjects’ weight during the third period of the experiment; also, a significant improvement was observed in the heart rate during the second and third periods in the case group (P

  10. A case of false median cleft of upper lip with IV-A holoprosencephaly that underwent cheiloplasty at 2.5 years of age.

    Science.gov (United States)

    Kobayashi, J; Arai, N; Kiyosaki, I; Uzawa, N; Ishii, J; Yoshimasu, H; Amagasa, T

    2000-11-01

    Holoprosencephaly results from the incomplete development of midline structures within the cerebrum and encompasses a series of abnormalities of mid-facial development. Here, we report a case of male holoprosencephaly associated with false median cleft of upper lip. This patient belonged clinically to the DeMyer's group IV holoprosencephaly, semilobar type. An infant with this type of holoprosencephaly has been thought to die generally within 1 to 2 years after birth and to rarely benefit from an operation. In this case, the patient had cheiloplasty at the age of 2.5 years at the request of his parents and he lives currently, being 3 years and 2 months old.

  11. [Twenty-four hour time and frequency domain variability of systolic blood pressure and heart rate in an experimental model of arterial hypertension plus obesity].

    Science.gov (United States)

    Pelat, M; Verwaerde, P; Lazartiques, E; Cabrol, P; Galitzky, J; Berlan, M; Montastruc, J L; Senard, J M

    1998-08-01

    Modifications of heart rate (HR) and systolic blood pressure (SBP) variabilities (V) have been reported in the human syndrome arterial hypertension plus insulin-resistance. The aim of this study was to characterize the 24 h SBPV and HRV in both time and frequency domains during weight increase in dogs fed ad libitum with a high fat diet. Implantable transmitter units for measurement of blood pressure and heart rate were surgically implanted in five beagle male dogs. BP and HR were continuously recorded using telemetric measurements during 24 hours, before and after 6 and 9 weeks of hypercaloric diet in quiet animals submitted to a 12h light-dark cycle. To study nychtemeral cycle of SBP and HR, two periods were chosen: day (from 6.00 h to 19.00 h) and night (from 23.00 h to 6.00 h). Spontaneous baroreflex efficiency was measured using the sequence method. Spectral variability of HR and SBP was analyzed using a fast Fourier transformation on 512 consecutive values and normalized units of low (LF: 50-150 mHz, reflecting sympathetic activity) and high (HF: respiratory rate +/- 50 mHz, reflecting parasympathetic activity) frequency bands were calculated. The energy of total spectrum (from 0.004 to 1 Hz) was also studied. Body weight (12.4 +/- 0.9 vs 14.9 +/- 0.9 kg, p < 0.05). SBP (132 +/- 1 vs 147 +/- 1 mmHg, p < 0.05) significantly increased after 9 weeks of hypercaloric diet. A nycthemeral HR rhythm was present at baseline (day: 79 +/- 1 vs night: 71 +/- 1 bpm) but not after 9 weeks (day: 91 +/- 4 bpm ; night: 86 +/- 2 bpm). Concomitantly, the efficiency of spontaneous baroreflex decreased at 6 weeks (36 +/- 1 vs 42 +/- 2 mmHg/ms, p < 0.05). A significant decrease in HF energy of HRV was found after 6 but not after 9 weeks. LF energy of SBPV was increased at 6 but not at 9 weeks (table). [table: see text] In conclusion, this study shows that an hyperlipidic and hypercaloric diet induces transient variations in autonomic nervous system activity which could be the physiopathological link between obesity, insulin-resistance and arterial hypertension.

  12. Twenty-four-hour plasma tryptophan concentrations and ratios are below normal in obese subjects and are not normalized by substantial weight reduction

    DEFF Research Database (Denmark)

    Breum, Leif; Rasmussen, Michael H; Hilsted, Jannik

    2003-01-01

    subjects. Blood samples were drawn frequently throughout the 24-h period. An insulin tolerance test was also used to determine whether weight loss altered the ability of insulin to modify plasma concentrations of tryptophan and of the other large neutral amino acids. RESULTS: Plasma tryptophan......BACKGROUND: Plasma tryptophan concentrations and the ratio of tryptophan to other large neutral amino acids (plasma tryptophan ratio) are reportedly low in obese subjects. The plasma tryptophan ratio predicts brain tryptophan uptake and serotonin production. If this ratio is low in obese subjects...... concentrations and ratios in obese subjects were low at all times; these effects persisted after weight reduction. Plasma concentrations of all the large neutral amino acids decreased during insulin infusion in all the groups. CONCLUSIONS: The low 24-h plasma tryptophan ratios in obese and formerly obese...

  13. Image, Imagery Thinking and the Twenty -four Poetry Style%意象、意象思维与《二十四诗品》

    Institute of Scientific and Technical Information of China (English)

    金路杰

    2012-01-01

    Imagery thinking is the unique ancient Chinese way of thinking, both in poetry writing and poetry review. The author uses images to express his mind. Sikong Tu's Twenty -Your Poetry Style in the Tang Dynasty is absolutely the aesthetic model in which there are intensive image groups constituted by the refining phrases in the text, in order to reflect the classical poetics. On the other hand, Sikong Tu is not only a theorist but also a poet; the book contains a profound meaning.%意象思维是中国古代特有一种思维方式,无论是诗歌创作还是诗学评论,即通过意象来表达作者的情思。唐代司空图的《二十四诗品》无疑就是其中的美学典范,文本中有着大量的精炼性词组构成的密集意象群,以此来体现古典文人的诗歌创作论和诗歌批评论。同时由于司空图的妙笔生花,《诗品》集诗学与诗歌一体的文本特殊性,又分析了《诗品》意象下所隐含的精神内涵。

  14. Moderate to severe injuries in football: a one-year prospective study of twenty-four female and male amateur teams.

    Science.gov (United States)

    Lion, Alexis; Theisen, Daniel; Windal, Thierry; Malisoux, Laurent; Nührenbörger, Christian; Huberty, Robert; Urhausen, Axel; Seil, Romain

    2014-01-01

    This study aimed to realize a prospective follow-up of the injuries occurring in female and male football players involved in the highest league in the Grand-Duchy of Luxembourg. Data concerning anthropometric characteristics and football activities were gathered in 125 female and 243 male football players via questionnaires at the beginning of the study. Then, a follow-up of moderate to severe injuries (> 15 days of interruption in football practice) was performed throughout the season 2013-2014. Sixteen injuries (injury incidence = 0.7 injuries/1000 h of exposure) were observed in 13 female football players (10.4%). These injuries concerned mainly the knee (n = 7; 43.7%), with capsules and ligaments being the most often concerned tissues (n = 7; 43.7%). In male football players, 41 severe injuries (injury incidence = 0.6 injuries/1000 h of exposure) were observed in 36 players (14.8%). These injuries concerned mainly the thighs (n = 12; 29.3%) and the muscles and tendons were the most often concerned tissues (n = 18; 43.9%). Injuries in football are predominantly located at the lower limbs, particularly the knees in female football players. The predominant muscle and tendon lesions of the thighs occurring in males could reveal that physical preparation is insufficient or inadequate for a number of players. Regarding these results, it is necessary to implement an injury prevention strategy. The "FIFA 11+" programme could be used as the basic method, but should be personalized according to sex. The injury collection methodology could be optimized with the use of an electronic database, such as the Training and Injury Prevention Platform for Sports (TIPPS). Beside the systematic recording of injury data (as well as the training load) by the players or the medical staff, this system allows to share of important information between stake