前列腺的彩色多普勒血流图

前列腺是男性沁尿系统的重要组成部分,前列腺增生随年龄增大发生率上升。前列腺癌肿与增生的鉴别有一定难度,为提高前列腺病变超声诊断率,我们用彩色多普勒血流图(CDFI)检查前列腺血管与血流动力资料,为前列腺病变诊断提供血流动力依据。 资料与方法 30例男性,其中25例无泌尿系统的病史,排尿正常的健康人,年龄14～68岁,50岁以上5例,平均60.8±6岁,20～49岁17例,平均36.5±8岁,20岁以下3例,平均13.3±6岁;5例前列腺肥大,年龄     

彩色直方图估测前列腺血流的价值

目的：本文利用彩色直方图对正常和异常前列腺彩色血流给出定量参考值并探讨其对前列腺疾病诊断的价值。方法：分别用端射式和双平面二种控头对经穿刺活检证实的前列腺增生症的前列腺癌各25例用彩色直方图软件测得前列腺内彩色血流面积占前列腺面积的百分比（BCR）,并有22例正常对照。结果：正常组、前列腺增生症组、前列腺癌组之间BRC的均值在统计学上有显著意义（端射式P＜0.05;双平面P＜0.01）,二种探头之间无统计学意义（P＞0.05）。但对个体而言各组间存在一定交叉,其交叉范围为17％－26％,不交叉范围为74％－83％。结论：彩色直方图测定前列腺血流中作为前列腺疾病诊断中客观的参考依据。     

彩色多普勒能量图与彩色多普勒血流图检测肿瘤内血流的对…

应用彩色多普劳动力血流图（ＣＤＦＩ）多普勒能量图（ＣＤＰＩ）结合脉冲多普勒观测４８例（６８个病灶）盆腹腔器官肿块内血流情况，结果显示：ＣＤＰＩ肿块内血流显示率及显示质量优于ＣＤＦＩ：ＣＤＰＩ显示下取样脉冲多普勒频谱质量优良率及血流参数可信度也明显高于ＣＦＩ显示下取样，我们认为ＣＤＰＩ是一种更敏感的彩色血流显像技术，具有一定的实用价值，值得推广应用。     

彩色多普勒血流图检测移植肾的应用

用二维彩色多普勒血流图（ＣＤＩ）对６５例移植肾进行了详细观察，从移植肾１～４级肾动脉血流动力学与肾形态学，比较了功能正常的移植肾与排异或轻度肾动脉狭窄的ＣＤＩ不同。并提出肾排异时除ＲＩ与ＰＩ升高Ｄ／Ｓ比值下降外，移植肾血流速度减慢，血流量减低。这些指标结合临床表现对排异诊断有一定价值。     

彩色多普勒能量图与彩色多普勒血流图检测肿瘤内血流的对照研究

应用彩色多普勒血流图（ＣＤＦＩ）、多普勒能量图（ＣＤＰＩ）结合脉冲多普勒观测４８例（６８个病灶）盆腹腔器官肿块内血流情况。结果显示：ＣＤＰＩ肿块内血流显示率及显示质量优于ＣＤＦＩ；ＣＤＰＩ显示下取样脉冲多普勒频谱质量优良率及血流参数可信度也明显高于ＣＤＦＩ显示下取样。我们认为ＣＤＰＩ是一种更敏感的彩色血流显像技术，具有一定的实用价值，值得推广应用。     

经直肠彩色多普勒血流显像评价良性前列腺增生症临床治疗效果

目的 :探讨前列腺大小及内腺动脉血流动力学参数对良性前列腺增生症 (BPH)疗效评估的意义。方法 :2 48例 BPH患者随机分为 A、B两组 ,分别应用保列治和益气通淋冲剂进行治疗 ,采用经直肠彩色多普勒血流显像技术对治疗前、后的前列腺进行观察。结果 :A、B两组前列腺厚径及上下径于治疗前、后均无明显差异 ,P>0 .0 5 ;每组中的内腺动脉血流收缩期峰值速度 (Vs)、舒张期血流速度 (Vd)、阻力指数 (RI)、血管内径 (D)于治疗后均有显著下降(P<0 .0 5 ,P<0 .0 0 1)。结论 :前列腺内腺动脉血流动力学主要参数可用于 BPH临床疗效的评估 ,而前列腺大小不能作为疗效观察指标 ,益气通淋冲剂治疗 BPH,其疗效与保列治相似 ,适用于临床推广应用。     

正常前列腺的彩色多普勒超声研究

探讨正常前列腺的血流信号分布、频谱多普勒特点和各血流参数的正常测值 ,以及青壮年各年龄组间有无差异和变化 ,为临床提供正常参考值。资料与方法正常青壮年 10 7例 ,年龄最小 2 0岁 ,最大 49岁 ,平均( 33.90± 8.12 )岁。分为Ａ组 :2 0～ 2 9岁 ,37例 ;Ｂ组 :30～ 39岁 ,39例 ;Ｃ组 :40～ 49岁 ,31例。均无任何泌尿系临床症状 ,常规前列腺检查均在正常值范围内。采用Ａｃｕｓｏｎ 12 8ＸＰ型多功能彩超仪 ,配备端扫式腔内探头及多普勒计算软件 ,频率 5～ 7ＭＨｚ ,固定彩色量程在 0 .0 6ｍ /ｓ ,频谱多普勒取样线与血流方向夹角 <6 0°。…     

彩色多普勒能量图与彩色多普勒血流显像检测脑血管疾病血流的对比研究

本文应用CDE和CDFI对40例正常人脑血管及125例脑血管疾病进行了检测。结果:CDE对脑动脉显示率高于CDFI,尤其是脑动脉硬化病人,显示更为清楚。CDE和CDFI对大脑前动脉(ACA)的显示率分别为95%和88%,P＜0.01;大脑后动脉(PCA)为94%和84.8%,P＜0.01;大脑中动脉(MCA)为96.8%和94%;P＞0.05;椎动脉(VA)为98%和90%,P＜0.05。CDE技术对脑动脉硬化和高度狭窄低速血流检测有较高临床价值。     

彩色多普勒能量图与彩色多普勒血流显像检测脑血管疾病血流的？…

本文应用ＣＤＥ和ＣＤＦＩ对４０例正常人脑血管及１２５例脑血管疾病的进行了检测。结果：ＣＤＥ对脑动脉显示率高于ＣＤＦＩ,尤其是脑动脉硬化病,人显示为清楚。ＣＤＥ和ＥＤＦＩ对大脑前动脉的显示率分别为９５％和８８％,Ｐ〈０．０１,大脑后动脉９４％和８４．８％,Ｐ〈０．０１,大脑中动脉为９６．８％和９４％;Ｐ〉０．０５;椎动脉为９８和９０％,Ｐ〈０．０５。ＣＤＥ技术对脑动脉化和高度狭窄低速血流检测有较高临     

彩色多普勒能量图与彩色多普勒血流图在肾肿瘤诊断中的作用

目的 :比较 CDE和 CDFI在肾肿瘤诊断中的作用。方法 :分别用 CDE和 CDFI显像各种肾肿瘤 5 1例 ,分析不同肿瘤的血流供应特征 ,并比较 CDE和 CDFI的显像优劣性。结果 :CDE显示 97.2 %的肾细胞癌血流丰富 ,其中 级血流占 80 .5 % ,且 5 0 %出现异常血流形态。而肾盂癌和肾良性肿瘤血流分级均为 0～ 级 ,血流形态单一 ,与肾细胞癌明显不同 (P<0 .0 1)。 5 2 .9%的肿瘤血流显示 CDE>CDFI,47.1% CDE=CDFI,无 1例 CDE相似文献   

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

Prospects for the control of neglected tropical diseases by mass drug administration

The prospects for the control of neglected tropical diseases, including soil-transmitted helminthiasis, shistosomiasis, lymphatic filariasis, onchocerciasis and trachoma, through mass drug administration, are exemplified by the elimination of the trachoma as a public-health problem in Morocco. In spite of this and other striking successes, mass drug administration programs are faced with major challenges resulting from suboptimal coverage and lack of efficacy. At current suboptimal coverage rates, programs may need prolongation for an extended period, increasing costs and undermining sustainability. Community participation through health education and information appears to be crucial to improve coverage and to achieve sustainability. Implementation of complementary measures, such as vector control, improved hygiene and environmental sanitation, are important to further control transmission and to prevent re-emergence of the infection and, again, may only be achieved effectively through community-based initiatives. To reduce costs and to relieve pressure on the health system, combining neglected tropical disease programs in areas where diseases coexist and integration with existing control programs for malaria, tuberculosis and HIV/AIDS is advocated. The risk of developing drug resistance is of particular concern in view of the lack of alternative drugs, and reduced treatment efficacy due to emerging resistance is evident for the soil-transmitted helminths and onchocerciasis. Given the risk for the development of drug resistance and the need for a high degree of participation, close attention should be paid to the monitoring of the coverage and efficacy of the different program components.     

Prise en charge des entorses externes de cheville : étude clinique préliminaire sur l’efficacité du dispositif Myolux™

Ankle sprains are the most common injury of the musculoskeletal system and are associated with significant societal and economic impacts. It has been proven that classical therapeutic strategies may not be effective in preventing recurrent injuries: the recurrence rates reported in the literature can reach 73%. In order to provide an effective rehabilitation solution, a destabilizing orthosis was developed. This device is equipped with a mechanical articulator reproducing the subtalar mechanics and placed under the heel. In this paper, we present the main results of a preliminary clinical study conducted between 2004 and 2007. All subjects included in this study were treated with the abovementioned orthosis during 10 rehabilitation sessions of 30 minutes each. Data show a relatively low recurrence rate of 12% for the overall population. Moreover, it's of primary importance to note that this satisfactory ratio is largely reduced (3% of recurrence rate) for the 29 patients who performed one training session per month after the 10th initial rehabilitation sessions. Hence, the destabilizing orthosis appears to be an effective solution to prevent recurrent ankle sprains. However, joint protection requires long-term and regular training sessions. This result has motivated the development of a similar device allowing patients to perform training sessions at home. Finally, data obtained in this study are promising awaiting the final results of the comparative, multicentric and independent clinical trials currently managed by the Hospices Civils de Lyon.     

Bacterial meningitis: an update of new treatment options

The outcome of bacterial meningitis critically depends on the rapid initiation of bactericidal antibiotic therapy and adequate management of septic shock. In community-acquired meningitis, the choice of an optimum initial empirical antibiotic regimen depends on the regional resistance patterns. Pathogens resistant to antibacterials prevail in nosocomial bacterial meningitis. Dexamethasone is recommended as adjunctive therapy for community-acquired meningitis in developed countries. In comatose patients, aggressive measures to lower intracranial pressure <20 mmHg (in particular, external ventriculostomy, osmotherapy and temporary hyperventilation) were effective in a case–control study. Although many experimental approaches were protective in animal models, none of them has been proven effective in patients. Antibiotics, which are bactericidal but do not lyse bacteria, and inhibitors of matrix metalloproteinases or complement factor C5 appear the most promising therapeutic options. At present, vaccination is the most efficient method to reduce disease burden. Palmitoylethanolamide appears promising to enhance the resistance of the brain to infections.