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1.
围生期是子代大脑及中枢神经发育的关键时期,此期内发生的不同事件都会对子代大脑的发育进程有着深远影响。糖皮质激素、抗生素、硫酸镁、咖啡因、肺表面活性物质及亚低温治疗等是围生期的常见治疗药物及手段,与新生儿的神经发育预后有着密切关系。该文总结近年围生期治疗对新生儿神经发育影响的最新研究进展,为临床决策提供参考。  相似文献   
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《Cirugía espa?ola》2023,101(8):548-554
IntroductionPelvic fractures due to high energy trauma present a high risk of associated injuries that compromise the functional and vital prognosis of the patients. The objective of this study was to analyze the relationship between traumatic pelvic fractures and their associated injuries according to the Tile classification.MethodsRetrospective observational study of patients who suffered traumatic pelvic fractures (Type A, B or C of the Tile classification) with concomitant associated injuries, analyzing hemoglobin levels, between 6/2013 and 1/2016.ResultsA total of 42 patients were included; of those 69% (n = 29) were males, mean age was 48 years. 45% (n = 19) suffered traffic accidents and 26.2% (n = 11) falls. There was a different proportion in pelvic injuries: Tile A (n = 15, 35.7%), B (n = 20, 47.6%), and C (n = 7, 16.6%) of cases. 54.8% (n = 23) underwent surgery, 21.4% (n = 9) needed temporary or definitive external fixation. Significant differences were found between Tile A type and scapula fractures (P=.032), and Tile B with sacral fractures (P=.033) and visceral injuries (P=.049), while there is a tendency without a statistical significal between Tile C and costal fractures. 61.9% (n = 26) needed blood transfusion; 9.5% (n = 4) presented hypovolemic shock.ConclusionsTile A pelvic fractures were associated with scapular fractures, and Tile B with transforaminal fractures of the sacrum and with visceral injuries (lungs, liver and genitourinary). The small number of Tile C prevent us to confirm an association with any pathology, although they are the ones which presnt more hemodynamically instability and thoracic injuries.  相似文献   
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Even if the relationships between nutrition and inflammatory bowel disease (IBD) remain underexplored, the current literature is providing, day by day, much more evidence on the effects of various diets in both prevention and treatment of such illnesses. Wrong dietary habits, together with other environmental factors such as pollution, breastfeeding, smoke, and/or antibiotics, are among the theoretical pathogenetic causes of IBD, whose multifactorial aetiology has been already confirmed. While some of these risk factors are potentially reversible, some others cannot be avoided, and efficient treatments become necessary to prevent IBD spread or recurrence. Furthermore, the drugs currently available for treatment of such disease provide low-to-no effect against the symptoms, making the illnesses still strongly disabling. Whether nutrition and specific diets will prove to effectively interrupt the course of IBD has still to be clarified and, in this sense, further research concerning the applications of such dietary interventions is still needed.  相似文献   
4.
Heart failure (HF) has high event rates, mortality, and is challenging to manage in clinical practice. Clinical management is complicated by complex therapeutic strategies in a population with a high prevalence of comorbidity and general frailty. In the last four years, an abundance of research has become available to support multidisciplinary management of heart failure from within the hospital through to discharge and primary care as well as supporting diagnosis and comorbidity management. Within the hospital setting, recent evidence supports sacubitril-valsartan combination in frail, deteriorating or de novo patients with LVEF  40%. Furthermore, new strategies such as SGLT2 inhibitors and vericiguat provide further benefit for patients with decompensating HF. Studies with tafamidis report major clinical benefits specifically for patients with ATTR cardiac amyloidosis, a remaining underdiagnosed and undertreated disease. New evidence for medical interventions supports his bundle pacing to reduce QRS width and improve haemodynamics as well as ICD defibrillation for non-ischemic cardiomyopathy. The Mitraclip reduces hospitalisations and mortality in patients with symptomatic, secondary mitral regurgitation and ablation reduces mortality and hospitalisations in patients with paroxysmal and persistent atrial fibrillation. In end-stage HF, the 2018 French Heart Allocation policy should improve access to heart transplants for stable, ambulatory patients and, mechanical circulatory support should be considered to avoid deteriorating on the waiting list. In the community, new evidence supports that improving discharge education, treatment and patient support improves outcomes. The authors believe that this review fills the gap between the guidelines and clinical practice and provides practical recommendations to improve HF management.  相似文献   
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目的探讨外伤性硬脑膜外血肿患者采取微创引流术治疗的临床效果。方法选取沈阳市第一人民医院神经外科2019年6月-2020年12月收治的82例外伤性硬脑膜外血肿患者,依据治疗方案的不同分为观察组和对照组各41例。观察组行微创引流术治疗,对照组行传统开颅血肿清除术治疗。观察并比较两组手术相关指标、住院时间和并发症发生情况,以及治疗前后格拉斯哥昏迷量表评分情况。结果观察组的手术时间和住院时间均短于对照组,术中出血量少于对照组,差异均具有统计学意义(P<0.05)。治疗后两组格拉斯哥昏迷量表评分均较治疗前升高,且治疗后观察组格拉斯哥昏迷量表评分高于对照组,差异均具有统计学意义(P<0.05)。观察组并发症发生率低于对照组,差异具有统计学意义(P<0.05)。结论外伤性硬脑膜外血肿患者采取微创引流术治疗与传统开颅手术相比,二者具有同样的治疗效果,但微创引流术的并发症更少,更有利于患者的神经功能恢复,具有临床推广价值。  相似文献   
9.
BackgroundThe treatment of port-wine stains (PWS) becomes extremely difficult due to age-related malformation of the vasculature. In this study, we used alternative methods to treat hypertrophic PWS.MethodsA short-pulsed CO2 laser was applied to ablate the hypertrophic vasculature of PWS. The ablation was ended when the wound was on the same plane as normal skin. The long-pulsed neodymium-doped yttrium-aluminum-garnet (lpNd:YAG) laser was primarily applied to coagulate and subsequently liquefy the hypertrophic vasculature of the PWS. The therapeutic energy used in treating different lesions should be carefully regulated to significantly affect the treatment outcomes.ResultsThe two cases presented herein demonstrated substantial improvement in hypertrophic vasculature that was largely removed. The skin was resurfaced, although some scar formation and mild hypopigmentation occurred.ConclusionWe suggest the use of short-pulsed CO2 and lpNd:YAG lasers for treating certain cases of hypertrophic PWS. When using a short-pulsed CO2 laser, it is wise to judge the treatment endpoint and take appropriate precautions to avoid intraoperative bleeding. When using an lpNd:YAG laser, the therapeutic energy should be controlled according to the thickness of the lesion to reduce scar formation.  相似文献   
10.
青光眼是世界首位不可逆性致盲眼病, 中国作为原发性闭角型青光眼发病率最高国家, 重视和改进其治疗方法是降低致盲率的有效途径。随着微创青光眼手术(MIGS)技术的发展, 原发性闭角型青光眼的治疗方法更新迭代。本文汇总目前国内外相关文献, 总结MIGS在原发性闭角型青光眼联合手术治疗中的应用进展, 提示MIGS可能成为未来治疗原发性闭角型青光眼的优选联合方法, 为临床提高青光眼治疗水平提供参考。  相似文献   
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