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71.
72.
Roberto Rivera-Luna Marta Zapata-Tarrés Aurora Medina-Sansón Enrique López-Aguilar Ana Niembro-Zúñiga J. Amador Zarco Alfonso Marhx-Bracho Fernando Rueda-Franco Leticia Bornstein-Quevedo 《Child's nervous system》2007,23(5):543-547
Objective The purpose of this study is to analyze clinical aspects and disease-free survival (DFS) in children less than 3 years of
age diagnosed with low-grade astrocytoma.
Methods In a period of 24 years (1980–2004), a total of 43 (5.4%) children were registered with these characteristics. Twenty-three
patients had pilocytic astrocytoma, 18 diffused, and 2 mixed. Thirty-one (72.1%) children had incomplete surgical tumor resection
and 12 (27.9%) had a complete tumor resection. Twelve (27.9%) patients had cranial radiotherapy and 17 (39.5%) received chemotherapy.
Overall survival was recorded in 23 (53%). DFS was 50% at 250 months of follow-up for the whole group. DFS for the supratentorial
group was 60% at 250 months, whereas, for the infratentorial, it was 22% at 120 months (p = 0.008).
Conclusion The only favorable prognostic pattern was the supratentorial presentation. Radiotherapy and chemotherapy did not alter the
outcome. 相似文献
73.
S.L. CHARLES NGU PETER DUVAL CATHRYN COLLINS 《Journal of Medical Imaging and Radiation Oncology》1992,36(4):321-322
Management of breast cancer during pregnancy is complicated by the high risks of abortion and foetal malformation from the use of radio therapy and chemotherapy. A case of breast cancer during pregnancy, treated with radiotherapy, and the estimated foetal dose is reported. 相似文献
74.
Carcinoma of the urinary bladder presenting during pregnancy is rare. We report two such cases presenting with gross hematuria,
both of which were managed by transurethral electroresection of the tumor; there was no adverse effect on the pregnancies.
Transurethral resection thus appears to be the procedure of choice in the management of this condition, and carries minimal
morbidity even when performed during pregnancy.
EDITORIAL COMMENT: As these authors point out, bladder tumors are rare in pregnancy and frequently present as gross hematuria
that is mistaken for vaginal bleeding due to the pregnancy. Ultrasound is very helpful in distinguishing the causes of bleeding,
and will show the bladder filled with clots and frequently the tumor as well. Standard transurethral resection is effective
when performed during pregnancy, bearing in mind the need to heed to the anesthetic risks inherent in any operative procedure
during pregnancy. 相似文献
75.
上海市闵行区流动人口中的孕产妇保健状况 总被引:3,自引:0,他引:3
通过对上海市闵行区580名外来孕产妇及580名作为对照的本地孕产妇的孕产期保健现况调查分析,表明外来孕产妇缺乏必要的孕产期保健措施,有47.6%的外来孕产妇从未做产前检查,产后保健则完全没有,并由此而造成外来产妇在急产、死产、甚至孕产妇死亡等方面令人忧虑的现状。为适应和促进当前经济发展的新形势,改善流动人口的孕产妇保健状况,应对流动人口中孕产妇保健状况深入研究,并采取相应的措施。 相似文献
76.
米索前列醇用于正常足月妊娠计划分娩临床效果分析 总被引:2,自引:0,他引:2
武雄飞 《中国计划生育学杂志》2003,11(10):617-619
目的:研究米索前列醇促宫颈成熟、诱发临产的效果及用药量。方法:将200例正常足月孕妇随机分为催产素组(对照组)100例和米索前列醇组(观察组)100例。结果:①引产有效率观察组明显高于对照组;②米索前列醇用药1天有效率为91%,用药量为100.54±25.27μg;2天有效率为97%,用药量为108.76±63.53μg;③孕妇产后出血及剖宫产率两组无显著差异;④羊水混浊发生率,观察组高于对照组差异有显著性;新生儿窒息率,两组相同,差异无显著性。结论:米索前列醇促宫颈成熟及诱发临产效果明显好于催产素,用于正常足月妊娠进行计划分娩是一种安全、有效、方便的方法,值得推广。 相似文献
77.
78.
U. Lehmann G. Regel B. Ellendorf E. Rickels M. Lorenz H. Becker H. Tscherne 《Der Unfallchirurg》1997,100(9):705-710
Summary
A total of 208 multiple trauma patients with head injury (HI) were investigated who had been treated in the period from 1990
to 1995. The average age was 35.2 ± 17.7 years; the injury severity according to ISS was 30.2 ± 8.6 points; 20.5 % died as
a result of the HI; the mortality of all patients was 26.5 %. The Glasgow Coma Scale (GCS) was determined at an average of
22 min after trauma (8.0 ± 4.3 points) at the scene of accident. The patients were classified according to GCS into minor
HI (group 1: 14–15 points), moderate HI (group 2: 9–13 points) and severe HI (group 3: 3–8 points). Patient outcome was assessed
by the Glasgow Outcome Scale (GOS) and was classified as good (GOS 4 and 5) and poor (GOS 1, 2 and 3) outcome. At the latest,
2 h after trauma, a CT scan of the head (CCT) was done. The HI groups are compared regarding frequency of types of injury.
In all HI groups the fractures of the bony face occurred at the same frequency (36.0–38.9 %). The frequency of calotte fractures
(Kal-Fx) increased from group 1 (8.0 %) to 2 (19.2 %) and 3 (25.6 %); fractures of the skull base significantly differed between
group 1 (16.0 %), 2 (7.8 %) and 3 (33.4 %). Epidural hemorrhage (EDB) appeared only in group 2 (7.8 %) and 3 (6.7); subdural
hemorrhage was found in group 1 (2.7 %), 2 (7.8 %) and 3 (10.0 %). Subarachnoid hemorrhage (SAB) was significantly more frequently
seen, dependent on HI severity, in group 3 (26.7 %) compared to group 2 (11.7 %) and 1 (8.0 %). Intracerebral contusion (ICK)
significantly increased from group 1 (12.0 %) to 2 (27.3) and 3 (45.6 %). Brain swelling (BS) also significantly increased
from group 1 (8.0 %) to 2 (19.5 %) and 3 (49.0 %) and lesions of ventricles (VL) from group 1 (2.7 %) to 2 (11.7 %) and 3
(20.0 %). Midline shift (13.4 %) and signs of herniation (4.5 %) only occurred in group 3. The analysis of correlation/regression
and receiver operating characteristics was able to predict 79 % of patients' outcome accurately using GCS (r 0.54; P < 0.0001) alone, using CCT (r 0.65; P < 0.0001) 87 % were correctly predicted with significant variables Cal-Fx, EDB, SAB and BS. CCT with GCS (r 0.74; P < 0.0001) were able to predict 88 % accurately with significant variables Cal-Fx, EDB, BS and GCS. The combination of CCT
with GCS, age and ISS (r 0.78; P < 0.0001) was able to predict only 87 % correctly, although the r value was the highest; significant variables were Kal-Fx, EDB, BS, VL, GCS, age and ISS.
相似文献
79.
William R. Reinus M.D. Franz J. Wippold II M.D. Kavita K. Erickson M.D. 《Emergency radiology》1994,1(2):81-84
We studied clinical predictors of cranial computed tomography (CT) abnormalities in patients with acute or acutely worsened
headache. Data were collected from chart review of 333 consecutive patients presenting to an emergency department and who
were clinically selected for cranial CT. Patients with a positive neurologic examination were at 10.7 times greater risk for
a positive CT than the rest of the sample (p<1.5 – 10−10). Using only neurologic examination to select patients for CT would have missed 30.3% of the positive scans. The amnesia,
depressed sensorium, and hypertension variables had CT yields approximating 10% or greater even in the presence of a negative
neurologic examination. Together with a positive neurologic examination, these variables detected 87.9% of the patients in
this sample with positive scans; their absence had a negative predictive value of 98.0%. Of the four patients with positive
scans who would have been missed using this strategy, one was discharged directly from the emergency department anyway and
the other three developed positive neurologic examinations within 24 hours. One died of causes unrelated to the intracranial
pathology. Positive neurologic examination, hypertension, history of amnesia, or a depressed sensorium provide reasonable
initial guidelines to select for CT patients with an acute headache. 相似文献
80.
Summary Intracranial haemorrhage due to rupture of an arteriovenous malformation (AVM) during pregnancy is a rare but serious condition that warrants prompt recognition. Once the diagnosis is made, the management is primarily based on neurosurgical rather than obstetric considerations. Due to its rarity, no definitive guidelines exist, and the best time to perform elective surgery (i.e., at presentation or at completion of the pregnancy) is ill-defined. This report describes three patients recently treated at our institution who had AVMs that ruptured during pregnancy. These cases well summarize the difficulties encountered in treating such patients. The diagnostic as well as the therapeutic implications of this condition are discussed. 相似文献