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1.
Vascular tumours of the stomach are rare, representing 0.9%-3.3% of all gastric neoplasms. A 58 year old man was admitted as an emergency with a one day history of haematemesis and melaena. He underwent an emergency laparotomy for a tumour in the lesser curve of the stomach. The tumour showed the characteristic histological and immunohistochemical features of epithelioid haemangioendothelioma. Surgery in the form of wide excision seems to be the treatment of choice for this rare neoplasm. This case highlights the difficulty in diagnosing this rare tumour preoperatively and emphasises the need for long term follow up in view of its uncertain metastatic potential. 相似文献
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Sahana Shetty Julie Hephzibah Bidyut Borah Deepak Burad Vishnu Chandrakumar Mazhuvanchary Jacob Paul Nihal Thomas 《The Australasian medical journal》2014,7(8):345-349
Paraneoplastic polyarthritis is a rare manifestation described in association with various solid tumours. We describe the clinical presentation, diagnostic evaluation, differential diagnosis, and management of a 28-year-old woman who presented with fever, weight loss, and symmetrical polyarthritis, subsequently diagnosed to have a metastatic neuroendocrine tumour of the adrenal gland with paraneoplastic polyarthritis. Paraneoplastic polyarthritis must be considered in polyarthritis unexplained by common aetiologies. The unusual presentation of this case, alerts us about the atypical presentation of these tumours. To the best of our knowledge, this is the first case study of a neuroendocrine tumour presenting as paraneoplastic polyarthritis. 相似文献
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Jakov Gather 《Medicine studies》2011,3(1):19-27
The extra-therapeutic use of psychotropic drugs to improve cognition and to enhance mood has been the subject of controversial
discussion in bioethics, in medicine but also in public for many years. Concerns over a liberal dealing with pharmacological
enhancers are raised not only from a biomedical–pharmacological perspective, but particularly from an ethical one. Within
these ethical concerns, there is one objection about the normative differentiation between “natural” and “artificial” enhancers,
which is theoretically indeed widely discredited in bioethics, which has, however, entrenched itself in such a persistent
way in everyday moral consciousness that it keeps a crucial influence on the assessment of pharmacological enhancers made
by the public and medical professionals. This paper tries to first show why a normative differentiation between “natural”
and “artificial” enhancers is highly problematic. In a second step, the resulting implications for our current dealing with
pharmacological enhancers shall be examined. In a specific comparison of synthetic pharmaceuticals (modafinil, SSRIs) with
phytopharmaceuticals (ginkgo biloba, St. John’s wort) and other already established enhancers (alcohol, caffeine), argumentative
inconsistencies are pointed out which, at least partly, result from a rationally untenable preference for the “natural” over
the “artificial”. Therefore, it is conclusively argued the case for an unprejudiced assessment of pharmacological enhancers
beyond a “natural”–“artificial” dichotomy, which equally takes into account biomedical and ethical aspects. The goal is to
reach a coherent dealing with pharmacological enhancement in the long run. 相似文献
5.
B. D. Kelly 《Irish journal of medical science》2009,178(1):73-77
Background Syphilis presented substantial challenges to nineteenth-century medical and psychiatric services.
Aims To illustrate the clinical course and diagnostic challenges associated with neurosyphilis in nineteenth-century Ireland.
Method This paper uses original archival material from the Central Criminal Lunatic Asylum, Dublin to present clinical cases and
inform a discussion of related issues.
Results Mr A, a 34-year-old banker convicted of “felonious entry”, demonstrated many psychiatric and neurological features of neurosyphilis
(“general paralysis of the insane”); he soon became “feeble”, “paralytic” and “demented”, and died within 2 years. The case
of Mr B, a 38-year-old game-keeper convicted of “attempting to upset trains”, illustrates diagnostic dilemmas associated with
neurosyphilis, especially when complicated by evidence of tuberculosis (“scrofulous diathesis”).
Conclusions The clinical and diagnostic challenges presented by syphilis have changed over the past century, but these cases, combined
with recent evidence of syphilis outbreaks, highlight ongoing needs for clinical and epidemiological vigilance. 相似文献
6.
Wiseman N 《中国结合医学杂志》2006,12(3):225-228
This paper strongly rejects the notion that the use of biomedical terms to represent traditional Chinese medical concepts is helpful to the internationalization of Chinese medicine. It further argues that this practice destroys the integrity and independence of Chinese medical concepts. Taking the term 风火眼 fěng huǒ yǎn as an example, it shows that the biomedical term "acute conjunctivitis" often suggested as the translation for this term is unsatisfactory, because ( 1 ) the clinical reference is not identical, (2) it introduces the concepts of "conjunctiva" and "inflammation", which are not Chinese medical concepts, and (3) destroys the Chinese medical concepts "wind" and "fire" expressed in the Chinese, which reflect the way the disease is traditionally diagnosed and treated. While for English readers not familiar with Chinese medicine, "acute conjunctivitis" may be immediately intelligible, for those seeking a deep understanding of the subject, the literal translation (loan translation) "wind-fire eye" is much more helpful. This paper supports these arguments with numerous other examples. 相似文献
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Parotid gland carcinosarcoma with follicular dendritic cell sarcoma as mesenchymal component: a case report 总被引:3,自引:0,他引:3
The WHO has classified malignant mixed tumours of salivary glands into noninvasive carcinoma in pleomorphic adenoma, invasive carcinoma in pleomorphic adenoma, carcinosarcoma and metastasizing mixed tumour.Carcinosarcoma, or true malignant mixed tumour, is a tumour composed of both carcinomatous and sarcomatous elements. 相似文献
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Anders Ottosson 《Medicine studies》2011,3(2):83-116
More than one single professional group deals with therapeutic manipulations of the spine and the joints. Osteopaths, Chiropractors,
Naprapaths, Physical Therapists (and a contingent Physicians) all share this interest. Each profession is also very clear
about where its bulk of knowledge stems from. The disciplines that are reckoned as the oldest are from the USA. A number of
“inventors” are to be found, all without a formal university degree in Medicine. Andrew Taylor Still (1828–1917) came up with
his system of Osteopathy in 1874. Daniel D. Palmer (1845–1913), the man behind Chiropractic, founded his system in 1894, and
Palmer’s colleague and former student, Oakley Smith (1880–1967), developed Naprapathy in 1906/1907. Physical Therapists working
with what is called Orthopaedic Manual Physical Therapy are on the other hand not claiming American ancestry, nor do their
body of knowledge and clinical skills originate from outside the medical profession. It is an offspring of Orthopaedic Medicine
(OM) which was an invention by Physicians. Date and place of birth is said to be 1929 in England. This article turns the above-mentioned
chronology on its head. It will show that Orthopaedic Medicine likely is the oldest system. It will also unearth OM’s sturdy
roots in a strong but forgotten, and even hidden, discourse of Mechanical Medicine found in 19th century Europe, which was
ruled by Physical Therapists. Why “we” do not know about this “history” is analysed and explained from a variety of perspectives. 相似文献
10.
Background
Wilms’ tumour is a very rare adult malignancy representing 1% of adult renal tumours. It is however the most common renal tumour of childhood, and adult patients are treated in accordance with paediatric protocols. 相似文献11.
As their populations age, many countries are facing the increasing economic pressure of providing healthcare to their people.
In Taiwan, this problem is exacerbated by an increasing rate of obesity and obesity-related conditions. Encouraging the adoption
of personal health management services is one way to maintain current levels of personal health and to efficiently manage
the distribution of healthcare resources. This study introduces Mobile Health Management Services (MHMS) and employs the Technology
Acceptance Model (TAM) to explore the intention of students in Executive Master of Business Management programs to adopt mobile
health management technology. Partial least squares (PLS) was used to analyze the collected data, and the results revealed
that “perceived usefulness” and “attitude” significantly affected the behavioral intention of adopting MHMS. Both “perceived
ease of use” and “perceived usefulness,” significantly affected “attitude,” and “perceived ease of use” significantly affected
“perceived usefulness” as well. The results also show that the determinants of intention toward MHMS differed with age; young
adults had higher intention to adopt MHMS to manage their personal health. Therefore, relevant governmental agencies may profitably
promote the management of personal health among this population. Successful promotion of personal health management will contribute
to increases in both the level of general health and the efficient management of healthcare resources. 相似文献
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Summary Application of conventional ultrasonography in the diagnosis of rectal cancer is in itself very difficult. The authors have
designed a new device called “Water Ballon-Aided Ultrasonography”. With the aid of the echofree zone and “acoustic window”
effect formed by the water ballon, complete knowledge of the location, size and extension of the rectal cancer can be acquired,
and the distance of the tumor from the the lower margin of the anus and the possibility of any infiltration to the adjacent
organs can be detected, thereby enabling the surgeon to estimate the resectability of the tumor accurately and select suitable
surgical approach. In this respect the water ballon-aided ultrasonography is much superior to other conventional examinations. 相似文献
14.
The recreational use of the so-called “legal-highs” has been in both the medical and political arena over the last year as
a result of the appearance of “head shops” in many towns in Ireland. These shops specialized in selling new psychotropic compounds
that circumvented established drug legislation. Little is known about the potentially harmful effects of these substances
but case reports suggest a plethora of harmful psychological and physical effects. Our case describes for the first time acute
liver failure associated with the ingestion of two of these amphetamine type compounds. 相似文献
15.
Dahlgren E Gull B Willén R Sundler F Rosén T Jansson PA 《Upsala journal of medical sciences》2005,110(3):233-236
Sertoli-Leydig cell tumours are rare sex stromal tumours with an incidence of < 0.5% of all ovarian tumours. Most frequently this tumour occurs in young women with a history of amenorrhoea, hirsutism and lowered pitch. Here, we report on a woman with IRS, postmenopausal virilization and increased testosterone levels due to a Sertoli-Leydig cell tumour. This is the first case to suggest an association between IRS and Sertoli-Leydig cell tumours. Furthermore, we highlight the difficulties in detecting this ovarian tumour with sonography. 相似文献
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Connolly SS O'Brien MF Kunni IM Phelan E Conroy R Thornhill JA Grainger R 《Irish journal of medical science》2011,180(1):177-179
Background
The Oxford English dictionary defines the term “simple” as “easily done” and “uncomplicated”. We tested the validity of this terminology in relation to open nephrectomy surgery. 相似文献17.
In our experiments, a “tendon bridge” or a “tendon tunnel” was used as a conduit to repair the defect of a peripheral nerve
in rabbits. A gap of about 1 cm was made on the deep peroneal nerve in each animal. In group 1, the tendon of anterior tibial
muscle was isolated near the severed nerve, and a segment of half cross section of tendon was removed in ladder-shaped reversed
fashion. The proximal and distal nerve stump were sutured respectively to the tendon by 11/0 atraumatic sutures under surgical
microscope. In group 2, the nerve stumps were sutured to the tendon of anterior tibial muscle without cutting the tendon,
but the tendon was dissected free and turned to form a tunnel wrapping the gap in between the nerve stumps.
The results showed that a gap of 1 cm of the deep peroneal nerve might be repaired by both methods, but the results of using
“tendon tunnel” in group 2 were much better than those of using “tendon bridge” in group 1. 相似文献
18.
Rada R 《Journal of medical systems》2006,30(3):153-157
The objective is to determine the extent to which information systems (IS) for cancer are unique and necessary. Via an analysis
of Medical Subject Headings used to index relevant literature and other bibliometric techniques, cancer IS are compared and
contrasted with IS of other specialties. Cancer IS are relatively little discussed and primarily connect radiation equipment
with the radiation oncology staff. By contrast, clinical laboratory and radiology IS are frequently discussed and connect
specialized equipment to the hospital. A “Specialty Need” model accounts for these patterns and says that the “need for a
specialty IS” is proportional to the “uniqueness of the specialty tools” plus the “degree to which the information from those
tools is needed throughout the particular health care entity.” 相似文献
19.
Since its introduction in 1983, the Greek NHS is under an almost constant reform, aiming improvement on the efficiency and
the quality of provided services. The national program of psychiatric reform “Psychargos” introduced new models of therapeutic
approach to the care of the mentally ill, that required expansion of the existing roles and development of new roles of the
healthcare staff. Consequently, the efficient management of the healthcare workforce in Greek mental facilities was identified
as a primary determinant of the successful implementation of the program. Primary objective of this study was the development
of a research framework for the assessment of job satisfaction in Greek Mental Health Hospitals. Among the objectives was
the evaluation of the capacity of the underlying motivators and hygiene factors and the identification of potential correlations
of the global job satisfaction and the motivation and retention factors with the demographic, social and occupational characteristics
of the employees. A custom questionnaire was developed, based on Herzberg two-factor theory, after a systematic review of
the relevant literature. The instrument was constructed by two parts and 37 items. Ten items addressed the sociodemographic
characteristics of the subjects, while the remaining 27 items were distributed in 11 subscales which addressed the global
satisfaction index and the “retention” and the “motivation” variables. The instrument was validated by means of the Cronbach
alpha for each subscale and by confirmatory factor analysis. The study was conducted at the Public Mental Hospital of Chania
(PMHC). From the 300 employees of the PMHC, 133 subjects successfully responded to the questionnaire (response rate, 44.3%).
In accordance to former surveys, subjects presented average scores in the global satisfaction index (GSI). The professional
category of the employee was identified as the primary determinant of the GSI. Nurses presented statistically significant
lower scores in comparison to the rest of the employees. Strong Pearson correlations were detected between GSI and “working
conditions”, “interpersonal relations”, “organization”, “salary” and “supervision” factors. The retention factors presented
stronger impact on GSI in comparison to the motivation ones. The results of the study indicate that the proposed instrument
presents satisfactory validity and reliability for the assessment of job satisfaction in Greek mental NHS hospitals. 相似文献
20.
Luigi Sacco (1769–1863) was the main protagonist of early vaccination campaign in Italy. He found a native source of vaccine
lymph: with that, he personally vaccinated more than 500,000 people and furnished all Italy and some Middle East countries
too. Starting from the pictures of his books, Sacco proposed to create wax models of “real” and “spurious” smallpox pustules
in human, cow, sheep and horse; just to permit, not only to doctors, but also to all other health operators, the identification
of the right pustules from where to extract active lymph for vaccination. In the Museum of Pathological Anatomy of the Padua
University Medical School, we have four anatomical waxes which corresponded exactly to the explicative pictures in 1809 Sacco’s
treatise on Vaccine. We have found the same models also at the University of Milan, Pavia and Bologna—the main cities of “Cisalpine
Republic”, the state of North Italy formed at the epoch of Sacco following the Napoleon conquest. The history of the diffusion
of these models presented in this text will be a starting point to develop wider questions. In particular, this history could
be useful to improve our understanding of the birth of scientific and experimental medicine through XIX and XX Century. 相似文献