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排序方式: 共有1226条查询结果,搜索用时 15 毫秒
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Geoffrey P. J. Mullan Christos Georgalas Asit Arora Anthony Narula 《European archives of oto-rhino-laryngology》2007,264(6):685-688
Tracheal rupture represents a rare but serious complication of intubation. We discuss a case of a major post-intubation rupture.
After investigation with CT scan tracheoscopy and bronchoscopy a low tracheostomy was formed protecting the rupture from pressure
changes associated with ventilation. The patient was managed with minimal surgical intervention, low tracheostomy with antibiotic
cover and monitoring in the intensive care unit for 24 h before being woken and moved to a ward after 48 h. The patient made
a full and uncomplicated recovery and was discharged 2 weeks after the original injury. Most of the literature on the subject
is made up of review of case reports that conclude management of such a major tear must be with surgical repair. This however
confers significant morbidity and an associated high mortality. We suggest an alternative management protocol. 相似文献
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Ilias I Mastorakos G Mavrikakis M Papazoglou S Karamitsos D Ntantis P Mantzos E Mantzos I Koutras DA 《Acta medica Austriaca》1999,26(1):26-28
The objective of this study was to screen for thyroidopathies in patients with rheumatoid arthritis (RA). Screening for thyroid disorders is advocated in patients with autoimmune diseases, and rheumatoid arthritis has been linked to thyroid autoimmune disorders, more particularly Hashimoto's thyroiditis and sometimes Graves' disease. We performed thyroid disease screening in 69 patients with RA free of medication for at least a 2 weeks period, not in remission, and in 65 patients with osteoarthritis (OA). The latter were studied as a control group of non-autoimmune arthritis patients. Basal levels of thyrotrophin (TSH) were measured using a sensitive chemiluminescence serum TSH assay. Serum antithyroperoxidase and antithyroglobulin (anti-Tg) autoantibodies were measured as well. If TSH values were found to be outside the normal limits, serum total thyroxine, total triiodothyronine (T3), resin T3 uptake, the free thyroxine index (FT4I) and free triiodothyronine index (FT3I) were evaluated. Rheumatoid arthritis patients exhibited statistically significant lower mean TSH values as compared to OA patients. However, RA patients with low TSH values did not have elevated FT4I. Previous use of corticosteroids in some of the RA patients may be responsible for these results. The autoantibodies levels did not differ between the two groups. We conclude that thyroid function screening with sensitive TSH assays is not sufficient for assessment of early stages of autoimmune thyroidopathies in patients with RA. Thyroid hormones should also be estimated. 相似文献
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Rapid tracheal intubation with vecuronium: the priming principle 总被引:4,自引:0,他引:4
Following the administration of a single 0.1 mg/kg dose of vecuronium bromide, satisfactory conditions for tracheal intubation developed in 156 +/- 12 s (mean +/- SEM), and the clinical duration of the initial dose was 36 +/- 2 min. When the initial dose of vecuronium was administered in two increments, a 0.015 mg/kg "priming" dose, followed 6 min later by a 0.050 mg/kg "intubating" dose, intubation time decreased to 61 +/- 3 s and clinical duration to 21 +/- 1 min. The priming dose that had no unpleasant effect on premedicated, awake patients could be administered 3-4 min before, and the intubating dose 2 to 3 min after induction of anesthesia. With the described technique, comparable intubating conditions could be obtained just as rapidly with vecuronium as with succinylcholine chloride, without subjecting the patients to the side effects of and the complications occasionally encountered with succinylcholine. An added advantage of the use of a priming dose is that it will reveal undiagnosed, pathologic, or idiopathic increase of sensitivity to nondepolarizing muscle relaxants. 相似文献
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Isabella Stelle Lorraine K. McDonagh Ilias Hossain Anastasia Z. Kalea Dora I. A. Pereira 《Nutrients》2021,13(4)
Introduction: In most sub-Saharan African countries iron deficiency anaemia remains highly prevalent in children and this has not changed in the last 25 years. Supplementation with iron hydroxide adipate tartrate (IHAT) was being investigated in anaemic children in a phase two clinical trial (termed IHAT-GUT), conducted at the Medical Research Council Unit the Gambia at the London School of Hygiene and Tropical Medicine (LSHTM) (abbreviated as MRCG hereof). This qualitative study aimed to explore the personal perceptions of the trial staff in relation to conducting a clinical trial in such settings in order to highlight the health system specific needs and strengths in the rural, resource-poor setting of the Upper River Region in the Gambia. Methods: Individual interviews (n = 17) were conducted with local trial staff of the IHAT-GUT trial. Data were analysed using inductive thematic analysis. Results: Potential barriers and facilitators to conducting this clinical trial were identified at the patient, staff, and trial management levels. Several challenges, such as the rural location and cultural context, were identified but noted as not being long-term inhibitors. Participants believed the facilitators and benefits outnumbered the barriers, and included the impact on education and healthcare, the ambitious and knowledgeable locally recruited staff, and the local partnership. Conclusions: While facilitators and barriers were identified to conducting this clinical trial in a rural, resource-poor setting, the overall impact was perceived as beneficial, and this study is a useful example of community involvement and partnership for further health improvement programs. To effectively implement a nutrition intervention, the local health systems and context must be carefully considered through qualitative research beforehand. 相似文献
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? Proton pump inhibitors are currently used widely for the treatment of laryngopharyngeal reflux. ? This systematic review assessed the efficacy of proton pump inhibitors in the treatment of symptoms of laryngopharyngeal reflux. ? Outcome measures used to assess efficacy of proton pump inhibitors included endoscopic laryngeal signs and pH recordings. ? Only two small randomized‐controlled trials included patients with objective evidence of reflux in the 24‐h ambulatory oesophageal pH monitoring. ? Pooled analysis of these two randomized‐controlled trials failed to show any effect in favour of treatment with proton pump inhibitors. ? Further randomized‐controlled trials are required to ascertain the role of proton pump inhibitors in the treatment of laryngopharyngeal reflux. 相似文献