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21.
We report the case of a 49-year-old patient, with recent onset of fatigue, who was diagnosed with atrial fibrillation, which was cardioverted electrically. A diagnosis of right atrial aneurysm, with no other cardiac pathology, was made. An aneurysmectomy was performed. Both surgery and postoperative recovery were uneventful. 相似文献
22.
César Marques Salgado Claudio C Conti Paulo H B Becker 《Applied radiation and isotopes》2006,64(6):700-705
The Monte Carlo method was used to calculate the efficiency, escape and Compton curves of a planar high-purity germanium detector (HPGe) in the 20-150 keV energy. These curves were used for the determination of photons spectra produced by an X-ray machine in order to allow a precise characterization of photon beams applied to medical diagnosis. The detector was modeled with the MCNP5 computer code and validated by comparison with experimental data. The air kerma calculated after the spectra stripping was compared with ionization chamber measurements. 相似文献
23.
Andr ia Kist Fernandes Felipe Mallmann Ana Maria Pasquali Steinhorst Fernando Lopes Nogueira Eduardo Mü ller vila Dumitriu Zunino Saucedo Francisco Juchem Machado Marcelo Greg rio Raymundi S rgio Saldanha Menna Barreto Paulo de Tarso Roth Dalcin 《The Journal of asthma》2003,40(6):683-690
Asthma patients that depend on emergency department (ED) services are generally considered to have extremely poor disease control and prognosis. It is important to identify characteristics related to poor disease control and frequent visits to the ED to apply appropriate clinical management. This study comprised a cross-sectional survey of consecutive patients with asthma exacerbation (age ≥12 years) presenting at the adult ED of a large, tertiary care, university-affiliated hospital over a 2-month period. The frequent visitors (FV) were defined by ≥3 visits to the ED in the preceding year, and the occasional visitors (OV) by ≤2 visits. Eighty-six patients (61 females and 25 males) were included in the study (mean age 38 ± 18 years). Of these patients, 51.2% were FV and 48.8% were OV. Sixty-nine percent had annual income lower than A$3000 and 66.3% had ≤8 years of the formal education. Only 18.6% had used inhaled corticosteroids, 79.1% identified the asthma attack severity, 70.9% increased or initiated inhaled β-agonist, 20.9% increased or initiated steroid therapy, and 55.8% had an asthma action plan for attack. The number of hospital admissions in past year (OR 4.3, P = .02), use of home nebulizer (OR 3.6, P = .05) and the lack of a written asthma action plan (OR 3.3, P = .03) were independently associated with frequent visits to the ED. We conclude that a substantial proportion of the patients that visit the ED are FV. These patients are more likely to have hospital admission in the past year, to use a home nebulizer, and to lack a written asthma action plan. They should be considered the most important target for asthma education. 相似文献
24.
Nelson Wolosker Guilherme Yazbek José Ribas Milanez de Campos Paulo Kauffman Augusto Ishy Pedro Puech-Leão 《Clinical autonomic research》2007,17(3):172-176
Background Sympathectomy is the treatment of choice for primary hyperhidrosis. One curious occurrence that is difficult to explain from
an anatomophysiological point of view in cases of video-assisted thoracoscopic sympathectomy (VATS) for the treatment of palmar
hyperhidrosis (PH) is the observed improvement in plantar hyperhidrosis (PLH). Nevertheless, current reports on VATS rarely
describe the effect on PLH or just give superficial data. The aim of this study was to prospectively investigate, how surgery
affects PLH in patients with PH and PLH over one-year period.
Methods From May 2003 to January 2004, 70 consecutive patients with combined PH and PLH underwent VATS at the T2, T3, or T4 ganglion
level (47 women and 23 men, with mean age of 23 years).
Results Immediately after the operation, all the patients said they were free from PH episodes, except for two patients (2.8%) who
suffered from continued PH. Compensatory hyperhidrosis (CH) of various degrees was observed in 58 (90.6%) patients after one
year. Only 13 (20.3%) suffered from severe CH. There was a great initial improvement in PLH in 50% of the cases, followed
by progressive regression, such that only 23.4% still presented that improvement after one year. The number of cases without
overall improvement increased progressively (from 17.1% to 37.5%) and the numbers with slight improvement remained stable
(32.9–39.1%). Of the 24 patients with no improvement after one year, 6 patients graded plantar sweating worse.
Conclusion Patients with PH and PLH who undergo VATS to treat their PH present a good initial improvement in PLH that reduces to a lower
level of improvement after the one-year period. 相似文献
25.
Therapy of post-renal transplantation hyperlipidaemia: comparative study with simvastatin and fish oil 总被引:1,自引:0,他引:1
Castro R; Queiros J; Fonseca I; Pimentel J; Henriques A; Sarmento A; Guimaraes S; Pereira M 《Nephrology, dialysis, transplantation》1997,12(10):2140-2143
Background: Recipients of renal transplantation (RT)
exhibit disturbances of serum lipids and apoproteins that may contribute to
their cardiovascular morbidity and mortality. In our renal transplant
department the hypercholesterolaemia prevalence at the first and fifth year
of RT is 70.0% and 81.2%, respectively. Lipid-lowering therapy has been
utilized in many Transplant Units. The aim of our study was to evaluate
post-RT hyperlipidaemia control with simvastatin or fish oil.
Method: Forty-three RT patients (26 men and 17 women)
with persistent hypercholesterolaemia and stable graft function which were
resistant to a lipid-lowering diet (American Heart Association Step Two)
were randomized into two groups and treated for 3 months with simvastatin
(S) (10 mg/day; n=25) and fish oil (F) (6 g/day; n=18). Total cholesterol
(TC), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C), lipoprotein a
(Lp(a)), apolipoprotein A1 (Apo A1), and apolipoprotein B (Apo B) were
monitored and at the study baseline they were similar between the two
groups. Results: No side effects were detected after 3
months of therapy. In group S, the concentrations of TC (271±46
mg% vs 228±49mg%; P <0.001), TG (180±78 vs
134±45; P<0.01), LDL-C (177& plusmn;40 vs
144±43; P <0.01) and Apo B (96±18 vs
82±16; P <0.001) were significantly reduced, and Apo A1
concentration had increased (135±24 vs 149±30; P
<0.01). In group F, the concentrations of TC (266±25 vs
240±31; P <0.001), TG (203±105 vs
156±72; P=0.02) and HDL-C (63±15 vs 53±12;
P <0.01) were significantly reduced.
Conclusion: We concluded that low-dose simvastatin and
fish oil are both effective and safe in correcting post-RT hyperlipidaemia.
Further prospective studies with larger follow-up are needed to clarify
whether this therapy has an impact on cardiovascular morbidity and
mortality in RT patients. 相似文献
26.
27.
Paulo Rogério Ferreti Bonan Estela Kaminagakura Fábio Ramoa Pires Pablo Agustin Vargas Oslei Paes de Almeida 《Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics》2006,101(2):205-211
OBJECTIVE: The aim of this work was to study cytokeratin (Ck) expression in initial radiation-induced oral mucositis. STUDY DESIGN: Eleven cases of initial radiomucositis of the buccal mucosa and 9 normal specimens were immunostained for Ck 1, 5, 6, 7, 8, 10, 14, 16, 18, and 19 by immunoperoxidase method. RESULTS: Expression of Ck 1, 6, 10, and 16 was stronger in mucositis than in normal mucosa. Ck 7, 8, and 18 were negative for both control and study groups. Ck 5, 13, and 14 were positive for both groups, nevertheless suprabasal staining for Ck 14 was more evident in mucositis than in the control group. Sporadic staining for Ck 19 was observed in 1 case of mucositis and in 2 controls. CONCLUSIONS: Increased Ck expression can be associated with the reactive proliferation of the epithelium and increasing resistance of the oral mucosa during the initial phases of radiotherapy. 相似文献
28.
29.
Camila Oliveira Rodini Flávia Sirotheau Corrêa Pontes Hélder Ant?nio Rebelo Pontes Paulo Sérgio da Silva Santos Marina Gallottini Magalh?es Décio Santos Pinto 《Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics》2007,104(4):e50-e55
Leiomyosarcoma of the oral cavity is a very rare tumor associated with aggressive clinical behavior and low survival. In this paper, we report 2 cases of leiomyosarcoma, affecting the gingival mucosa of a 54-year-old female and the maxillary bone of a 63-year-old male. Histologically, the tumors were composed of variably oriented fascicles of spindle-shaped cells with cigar-shaped nuclei and eosinophilic cytoplasm. The lesions were treated by surgical resection. Immunoreactivity to anti-vimentin, anti-smooth muscle actin, anti-desmin, anti-laminin, and anti-muscle-specific actin antibodies were found; conversely, the tumor cells were negative for anti-S100 and AE1/AE3 proteins. This report emphasizes the role of immunohistochemical study for correct diagnosis of leiomyosarcoma. 相似文献
30.
Everson L. A. Artifon Airton Z. Rodrigues Sergio Marques Bhawna Halwan Paulo Sakai Claudio Bresciani Atul Kumar 《Journal of gastrointestinal surgery》2007,11(12):1686-1691
Background Exploratory laparoscopy is commonly undertaken in patients with highly suspicious biliary and pancreatic lesions to facilitate
diagnosis and staging cancer is present. If an unresectable tumor is identified, a second endoscopic procedure may be required
do deploy a self-expandable metal stent (SEMS) for palliation. As endoscopic retrograde cholangio pancreatography (ERCP) may
be unsuccessful in up to 20% of patients, we evaluated the feasibility and safety of deployment of self-expandable metal stents
at the same time as the initial laparoscopy.
Patients and Methods A total of 23 eligible patients (8 male and 15 female) with malignant obstruction of the common bile duct underwent deployment
of SEMS at laparoscopy. Primary outcome measure was the successful laparoscopic deployment of stent and secondary outcome
measure was complications rates.
Results Indications for stent deployment were unresectable pancreatic cancer in 18, cholangiocarcinoma in two, neuroendocrine tumor
in one and ampullary adenocarcinoma in two patients. The median age was 73 years (range 49–93). Twenty-two of 23 stents were
deployed successfully: 17 stents were deployed transcystically and five via a choledochotomy. Median times for laparoscopic
exploration and SEMS deployment were 165 min (range 105–230) and 20 min (range 10–50), respectively. Pre- and post-procedures
median total bilirubin were 9.4 mg/dl (range 5.4–17.5) and 4.0 (range 2.6–7.1). The median size of the pancreatic mass was
3 cm (range 2–5 cm) and that of the common bile duct (CBD) from 9.2 mm (range 7.2–17.4). The mean duration of laparoscopy
was 170 min (range 120–230 min) and that for stent deployment 23 min (range 10–50 min). Complications included bleeding, obstruction,
and wound infection. Bleeding occurred on day 7 in two patients and on day 30 in one patient; bleeding occurred at the gastrojejunal
anastomosis site and was successfully treated with endoscopic hemostasis. A total of three stent obstructions were identified:
one each at 60, 90, and 120 days follow-up. All complications were successfully managed endoscopically. There were a total
of seven deaths, six as a result of progressive cancer and one of surgical wound infection and ensuing complications.
Conclusion This study demonstrates that laparoscopic deployment of self-expandable metal bile duct stents is feasible and safe. This
option appears to be a reasonable option in patients with inoperable malignant obstruction of the distal common bile duct. 相似文献