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51.
52.
Poor nutritional status and inadequate dietary intake in intravenous drug misusers (IVDMs) is a well-recognized problem among those involved in their care. However, there are very few published studies to substantiate these observations. This paper provides a review of the current literature and outlines the aims of dietary advice for IVDMs. 相似文献
53.
Pedersen Bjφrn 《生殖与避孕(英文版)》2002,13(3):177-186
Recurrentmiscarriage (RM) isdefined as three ormoreconsecutivemiscarriagesand affects 0 .5~ 1 .0 % of all women.In less than 1 0 % of the couples a parentalchromosome abnormality ora significantuterine abnormality can be demonstrated ascauses.Some cases … 相似文献
54.
目的 评价腹部手术后患者静脉输注丁丙诺啡镇痛的可行性.方法 采用多中心、随机、开放、平行、阳性药物对照进行研究,择期全身麻醉下行腹部手术患者200例,年龄18~64岁,ASAⅠ级或Ⅱ级,性别不限,体重50~100 kg,随机分为丁丙诺啡组(B组)和芬太尼组(F组),每组100例.2组术后分别静脉输注丁丙诺啡0.3 μg·kg-1·h-1、芬太尼0.3 μg·kg-1·h-1.采用视觉模拟评分法(VAS评分)评价术后6、12、24、36和48 h的疼痛程度,于各时点行镇静评分及Prince-Henry评分,监测心率、呼吸频率(RR)和脉搏血氧饱和度(SpO2),记录不良反应的发生情况.结果 与F组比较,B组各时点VAS评分、镇静评分和Prince-Henry评分差异无统计学意义(P>0.05),恶心发生率较低(P<0.05);两组各时点RR和SpO2差异无统计学意义(P>0.05).结论 静脉输注丁丙喏啡0.3 μg·kg-1·h-1可有效缓解腹部手术后患者疼痛,且不良反应少. 相似文献
55.
Takeshi Kubota Kazuyoshi Hirota Noriaki Otomo Tadanobu Yasuda Akimasa Miyata Asahei Maeda Hironori Ishihara Akitomo Matsuki 《Journal of anesthesia》1998,12(1):17-20
Purpose As the middle-ear cavity is one of the noncompliant gas-filled cavities, an increase in middle-ear pressure (MEP) instead
of volume expansion is observed with inhalation of nitrous oxide (N2O). Changes in MEP cause many complications, such as ear pain, temporary hearing impairment, and postoperative emesis. Therefore,
we investigated changes in MEP during total intravenous anesthesia (TIVA) with propofol, fentanyl, and ketamine (PFK) and
inhalation of N2O.
Methods Twelve patients were anesthetized with PFK until 60 min after the induction of anesthesia, and then N2O (60%) inhalation was started. MEP was measured by impedance audiometry (ranging from −300 daPa to +200 daPa) at 10-min intervals
during PFK, and at 2-min intervals after the inhalation of N2O.
Results MEP gradually but significantly increased from the preanesthetic value of 16±8 to 34±12 (SEM) daPa 50 min after the induction
of PFK. However, MEP did not exceed the normal limit. The values of MEP in all patients were more than 200 daPa within 36
min after the start of inhalation of N2O in oxygen.
Conclusion PFK had a minimal effect on MEP, whereas addition of N2O to PFK increased MEP dramatically. Therefore, TIVA, or at least PFK, would be a better choice for patients with middle-ear
or upper-airway diseases. 相似文献
56.
Summary The pharmacokinetics of single intravenous and oral doses of L-carnitine 2 g and 6 g has been investigated in 6 healthy subjects on a low carnitine diet.Carnitine was more rapidly eliminated from plasma after the higher dose. Comparing the 2-g and 6-g doses, the t1/2 of the elimination phase () was 6.5 h vs 3.9 h, the elimination constant was 0.40 vs 0.50 h–1 and the plasma carnitine clearance was 5.4 vs 6.11 × h–1 (p<0.025), thus showing dose-related elimination.Saturable kinetics was not found in the range of doses given. The apparent volumes of distribution after the two doses were not significantly different and they were of the same order as the total body water. Urinary recoveries after the 2-g and 6-g doses were 70% and 82% during the first 24 h, respectively.Following the two oral dosing, there was no significant difference in AUCs of plasma carnitine. Urinary recoveries were 8% and 4% for the 2-g and 6-g doses during the first 24 h. The oral bioavailability of the 2-g dose was 16% and of the 6 h dose 5%. The results suggest that the mucosal absorption of carnitine is already saturated at the 2-g dose. 相似文献
57.
目的 基于Lasso回归和列线图构建并验证川崎病患儿对丙种球蛋白耐药的预测模型,以期为临床诊疗提供帮助。方法 回顾性收集2014年7月—2020年7月西南医科大学附属医院收治的474例川崎病患儿的临床资料,采用Lasso回归分析筛选重要的临床因素构建Nomogram模型,通过绘制受试者工作特征(ROC)曲线、Calibration校准曲线及DCA曲线验证模型的区分度、校准度及临床有效性。结果 共纳入474例患儿资料,其中339例作为训练集,135例作为验证集。Lasso回归分析显示,心脏表现、心外并发症、首剂静脉注射免疫球蛋白使用时间、中性粒细胞比例、红细胞分布宽度-标准差、血小板压积、白蛋白、系统性免疫-炎症指数及C反应蛋白/白蛋白是川崎病患儿丙种球蛋白耐药的预测因素。基于上述预测因素构建Nomogram模型,并分别在训练集与验证集人群中进行验证。训练集ROC曲线下面积(AUC)为0.784(95%CI:0.701,0.867),当最佳阈值取0.045时,相应的特异性和敏感性分别为0.490(95%CI:0.434,0.546)和0.935(95%CI:0.849,1.000);验证... 相似文献
58.
Shobha Malviya Frederick A. Burrows Albert E. Johnston Lee N. Benson 《Journal canadien d'anesthésie》1989,36(3):320-324
Anaesthetic and sedation techniques, complications and outcomes were reviewed in 176 children undergoing 184 interventional
cardiologic procedures. Techniques included sedation only, and ketamine, inhalational or narcotic anaesthesia. Ketamine infusion
was the technique most frequently used. Ketamine was associated with a higher incidence of respiratory complications (P <
0.05) than the other techniques. The higher incidence of hypercarbia (15.6 per cent), which did not affect outcome, may be
attributable to the use of supplemental sedatives. The incidence of upper airway obstruction (7.8 per cent) was similar to
that of previous studies. Vascular compromise resulted from the procedure in 33 patients, necessitating surgical correction
in 16. Cardiac perforation occurred in four cases, causing one death. Pulmonary valve stenosis was most amenable to balloon
dilatation and aortic valve stenosis least amenable. Ketamine was the anaesthetic agent preferred by cardiologists for use
in the catheterisation suite when general anaesthesia was required. Vigilant monitoring by anaesthetic staff is necessary
during the procedure, and avoidance of concomitant narcotics is recommended if a ketamine technique with spontaneous ventilation
is used.
Les techniques anesthésiques et de sédation ainsi que les complications et les issues ont été revues chez 176 enfants subissant
184 procedures cardiaques. Les techniques ont inctu soil la sédation seulement, soit l’anesthésie à la kétamine, aux agents
d’inhalation ou aux narcotiques. La perfusion de kétamine était la technique la plus fréquemment utilisée. La ketamine était
associée à une plus grande incidence de complication respiratoire (P < 0.05) comparativement aux autres techniques. La plus
grande incidence d’hypercarbie (15.6 pour cent), n’ayant pas affecté l’issue, pourrait être attribuée à l’utilisation additionnelle
de sédatifs. L’incidence d’obstruction des voies aériennes supérieures (7.8 pour cent) était similaire aux études préalables.
Un problème vasculaire suite à la procédure fut observé chez 33 patients dont 16 ont requis une correction chirurgicale. Une
perforation cardiaque est survenue dans quatre cas provoquant le décès d’un seul patient. La sténose de la valve pulmonaire
était la procédure la plus susceptible d’être dilatée et la sténose de la valve aortique la moins susceptible. La kétamine
était l’agent anesthésique préféré par les cardiologistes lors des cathétérisations quand une anesthésie générate était requise.
Une surveillance vigilante par une équipe anesthésique fut nécessaire durant la procedure. Il faut aussi éviter l’administration
de narcotiques si la kétamine est administrée en respiration spontanée.
Presented in part at the Canadian Anaesthetists’ Society annual meeting in Halifax, June 1988. 相似文献
Presented in part at the Canadian Anaesthetists’ Society annual meeting in Halifax, June 1988. 相似文献
59.
S M Flechner M I Lorber R H Kerman C T Van Buren C Wideman B D Kahan 《Human immunology》1985,14(3):305-313
The results of cadaveric retransplantation in 55 recipients immunosuppressed with cyclosporine and prednisone were compared to 156 recipients of primary renal allografts. By 3 yr posttransplant, there is no significant difference in patient survival, but the yearly graft survival for primary (79%, 72%, 72%) as compared to retransplant (69%, 58%, 58%) recipients was significantly (p less than 0.05) better. There was no significant difference in rejection episodes or mean +/- SD serum creatinine (mg/dl) at 2 yr between primary (32%, 2.14 +/- 1.1) and retransplant (33%, 2.08 +/- 1.4) patients, respectively. Donor source, third kidneys, human leukocyte antigen AB and Dr matching, percent reactive antibody levels, and cause of first graft loss do not have significant impact on cyclosporine-treated retransplant outcome. However, retransplant patients who have lost a previous graft in less than 3 months continue to be at high risk for subsequent early graft loss. These results suggest that the combination of cyclosporine and prednisone is the preferred regimen for cadaveric retransplantation. 相似文献
60.
Pemphigus vulgaris: the role of IL-1 and IL-1 receptor antagonist in pathogenesis and effects of intravenous immunoglobulin on their production 总被引:5,自引:0,他引:5
Intravenous immunoglobulin (IVIG) is increasingly being used for the treatment of autoimmune diseases. In the present report, the role of IVIG on in vivo and in vitro production of IL-1 and IL-1 receptor antagonist (Ra) was studied in patients with pemphigus vulgaris (PV). Serum samples from 20 untreated patients with active PV prior to initiation of systemic therapy, 20 patients receiving IVIG treatment, 20 patients in clinical remission after conventional therapy, and 20 normal human controls were studied to determine the serum levels of IL-1alpha, IL-1beta, and IL-1Ra. The in vitro production of these cytokines was measured in the culture supernatant of peripheral blood mononuclear cells (PBMC) from 10 PV patients immediately before and after IVIG therapy and from age and sex-matched 10 healthy donors simultaneously. Elevated levels of IL-1alpha and IL-1beta were detected (i) in the serum of untreated PV patients with active disease prior to systemic therapy and (ii) before IVIG infusions in patients receiving IVIG therapy. These increased levels are statistically significant when compared to the levels in healthy controls (P < 0.01). A marked reduction of IL-1alpha and IL-1beta was detected (i) in the serum of patients in prolonged clinical remission and (ii) immediately after IVIG infusion in those patients on IVIG therapy. Increased level of IL-1Ra was detected in PV patients in prolonged clinical remission and after IVIG infusion in those receiving IVIG therapy. These differences were statistically significant when compared to the levels in normal controls and to the levels in the sera of patients with active disease (P < 0.01) or just before the beginning of IVIG infusion (P < 0.01). Similar differences in the levels of IL-1alpha, IL-1beta, and IL-1Ra were found in the culture supernatant of PBMC isolated from the PV patients pre and post IVIG therapy. These observations suggests that, compared to normal controls, patients with active PV have reversed levels of IL-1alpha, IL-1beta, and IL-1Ra. IVIG therapy may down-regulate production of IL-1alpha and IL-1beta and enhance production of IL-1Ra, in vivo and in vitro. This might be one of the important mechanisms by which IVIG produces its early therapeutic effects in pemphigus vulgaris. 相似文献