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排序方式: 共有762条查询结果,搜索用时 15 毫秒
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ST Hornby FD McDermott M Coleman Z Ahmed J Bunni D Bunting M Elshaer V Evans A Kimble M Kostalas G Page J Singh L Szczebiot S Wienand-Barnett A Wilkins O Williams P Newell Severn Peninsula Audit Research Collaborative 《Annals of the Royal College of Surgeons of England》2015,97(2):115-119
Background
Laparoscopic hernia repair is used widely for the repair of incisional hernias. Few case studies have focussed on purely ‘incisional’ hernias. This multicentre series represents a collaborative effort and employed statistical analyses to provide insight into the factors predisposing to recurrence of incisional hernia after laparoscopic repair. A specific hypothesis (ie, laterality of hernias as well as proximity to the xyphoid process and pubic symphysis predisposes to recurrence) was also tested.Methods
This was a retrospective study of all laparoscopic incisional hernias undertaken in six centres from 1 January 2004 to 31 December 2010. It comprised a comprehensive review of case notes and a follow-up using a structured telephone questionnaire. Patient demographics, previous medical/surgical history, surgical procedure, postoperative recovery, and perceived effect on quality of life were recorded. Repairs undertaken for primary ventral hernias were excluded. A logistic regression analysis was then fitted with recurrence as the primary outcome.Results
A total of 186 cases (91 females) were identified. Median follow-up was 42 months. Telephone interviews were answered by 115/186 (62%) of subjects. Logistic regression analyses suggested that only female sex (odds ratio (OR) 3.53; 95% confidence interval (CI) 1.39–8.97) and diabetes mellitus (3.54; 1–12.56) significantly increased the risk of recurrence. Position of the defect had no statistical effect.Conclusions
These data suggest an increased risk of recurrence after laparoscopic incisional hernia repair in females and subjects with diabetes mellitus. These data will help inform surgeons and patients when considering laparoscopic management of incisional hernias. We recommend a centrally hosted, prospectively maintained national/international database to carry out additional research. 相似文献4.
Placebo controls play a critical role in the evaluation of any pharmacotherapy. This review surveys the placebo arm in 12 randomized controlled trials (RCTs) investigating burning mouth syndrome (BMS) and documents a positive placebo response in 6 of them. On average, treatment with placebos produced a response that was 72% as large as the response to active drugs. The lack of homogeneity in the use of placebos adds to the difficulty in comparing results and aggregating data. Future RCTs investigating BMS would benefit from larger sample sizes, adequate follow‐up periods, and use of a standard placebo. 相似文献
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S. K. BRÆKKAN E. B. MATHIESEN I. NJØLSTAD T. WILSGAARD J. STØRMER J. B. HANSEN 《Journal of thrombosis and haemostasis》2008,6(11):1851-1857
Summary. Background: Recent studies indicate that arterial cardiovascular diseases and venous thromboembolism (VTE) share common risk factors. A family history of myocardial infarction (MI) is a strong and independent risk factor for future MI. Objectives: The purpose of the present study was to determine the impact of cardiovascular risk factors, including family history of MI, on the incidence of VTE in a prospective, population‐based study. Patients and methods: Traditional cardiovascular risk factors and family history of MI were registered in 21 330 subjects, aged 25–96 years, enrolled in the Tromsø study in 1994–95. First‐lifetime VTE events during follow‐up were registered up to 1 September 2007. Results: There were 327 VTE events (1.40 per 1000 person‐years), 138 (42%) unprovoked, during a mean of 10.9 years of follow‐up. In age‐ and gender‐adjusted analysis, age [hazard ratio (HR) per decade, 1.97; 95% confidence interval (CI), 1.82–2.12], gender (men vs. women; HR, 1.25; 95% CI, 1.01–1.55), body mass index (BMI; HR per 3 kg m?2, 1.21; 95% CI, 1.13–1.31), and family history of MI (HR, 1.31; 95% CI, 1.04–1.65) were significantly associated with VTE. Family history of MI remained a significant risk factor for total VTE (HR, 1.27; 95% CI, 1.01–1.60) and unprovoked VTE (HR, 1.46; 95% CI, 1.03–2.07) in multivariable analysis. Blood pressure, total cholesterol, HDL‐cholesterol, triglycerides, and smoking were not independently associated with total VTE. Conclusions: Family history of MI is a risk factor for both MI and VTE, and provides further evidence of a link between venous and arterial thrombosis. 相似文献
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PHILIPPE MAURY M.D. EMILIE THOMSON M.D. ANNE ROLLIN M.D. MATHIEU BERRY M.D. THOMAS COGNET M.D. ALEXANDRE DUPARC M.D. PIERRE MONDOLY M.D. MATHIEU GAUTIER M.D. OLIVIER LAIREZ M.D. SIMON MÉJEAN M.D. PIERRE MASSABUAU M.D. CHRISTELLE CARDIN M.D. STÉPHANE COMBES M.D. JEAN‐PAUL ALBENQUE M.D. NICOLAS COMBES M.D. 《Pacing and clinical electrophysiology : PACE》2015,38(5):617-624
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Does the Golem Feel Pain? Moral Instincts and Ethical Dilemmas Concerning Suffering and the Brain 下载免费PDF全文
Pain has variously been used as a means of punishment, extracting information, or testing commitment, as a tool for education and social control, as a commodity for sacrifice, and as a draw for sport and entertainment. Attitudes concerning these uses have undergone major changes in the modern era. Normative convictions on what is right and wrong are generally attributed to religious tradition or to secular‐humanist reasoning. Here, we elaborate the perspective that ethical choices concerning pain have much earlier roots that are based on instincts and brain‐seated empathetic responses. They are fundamentally a function of brain circuitry shaped by processes of Darwinian evolution. Social convention and other environmental influences, with their idiosyncrasies, are a more recent, ever‐changing overlay. We close with an example in which details on the neurobiology of pain processing, specifically the question of where in the brain the experience of pain is generated, affect decision making in end‐of‐life situations. By separating innate biological substrates from culturally imposed attitudes (memes), we may arrive at a more reasoned approach to a morality of pain prevention. 相似文献
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Ritu R. Gill MD MPH Yifan Zheng MD Julianne S. Barlow BA Jagadeesan Jayender PhD Erin E. Girard PhD Philip M. Hartigan MD Lucian R. Chirieac MD Carol J. Belle‐King ST Kristen Murray BSN RN Christopher Sears BSN RN Jon O. Wee MD Michael T. Jaklitsch MD Yolonda L. Colson MD PhD Raphael Bueno MD 《Journal of surgical oncology》2015,112(1):18-25