共查询到20条相似文献,搜索用时 15 毫秒
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Abdulghafour Halawani Kyo Chul Koo Alex G. Kavanagh Victor K.F. Wong Ben H. Chew 《BJU international》2023,132(2):149-153
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《Burns : journal of the International Society for Burn Injuries》2020,46(1):207-212
BackgroundBurn injuries are the third leading cause of preventable death in children worldwide, resulting in over 100 000 annual hospitalisations. In the paediatric population, scalds are the commonest mechanism and burn injuries of greater than 40% total burn surface area (TBSA) are associated with a high mortality and morbidity rate.AimsThe aim of this study was to review mortality in paediatric burns in a tertiary burns centre over a 60-year period, providing an understanding of local causes of mortality and directing future clinical research.MethodsWe reviewed data collected prospectively from patients treated for burn injuries at the WCH from 1960 to 2017. Data of age, gender, mechanism of injury and TBSA were collected. TBSA of 40% and greater were included in the study.ResultsAll patients with total burn surface area (TBSA) less than 40% survived. There were a total of 75 patients who sustained burns of or greater than 40% TBSA. Overall mortality was 34% (26 of 75) of which 24 occurred in the 1960s. Of the 21 patients who died of flame burn injuries, 12 of them were described as clothes catching alight from being in close proximity to the source of flame. Average length of stay for patients who did not survive was 7 days (1–26).ConclusionMortality has since declined and the prognosis for survival good, even in TBSA of greater than 90%. The investigations in fabric flammability led by Dr Thomas Pressley and Mr Murray Clarke prompted the rewriting of Australian standards for production of children’s clothing. This, in combination with advances in paediatric resuscitation, surgical techniques as well as wound care has improved survival rates and outcomes in extensive burn injuries. Future studies focus to see not only better survival rates, but also better aesthetic and functional outcomes in burn survivors. 相似文献
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Mathew D. Sorensen Thomas Chi Nawar M. Shara Hong Wang Ryan S. Hsi Tonya Orchard Arnold J. Kahn Rebecca D. Jackson Joe Miller Alex P. Reiner Marshall L. Stoller 《Journal of the American Society of Nephrology : JASN》2014,25(2):362-369
Obesity is a strong risk factor for nephrolithiasis, but the role of physical activity and caloric intake remains poorly understood. We evaluated this relationship in 84,225 women with no history of stones as part of the Women’s Health Initiative Observational Study, a longitudinal, prospective cohort of postmenopausal women enrolled from 1993 to 1998 with 8 years’ median follow-up. The independent association of physical activity (metabolic equivalents [METs]/wk), calibrated dietary energy intake, and body mass index (BMI) with incident kidney stone development was evaluated after adjustment for nephrolithiasis risk factors. Activity intensity was evaluated in stratified analyses. Compared with the risk in inactive women, the risk of incident stones decreased by 16% in women with the lowest physical activity level (adjusted hazard ratio [aHR], 0.84; 95% confidence interval [95% CI], 0.74 to 0.97). As activity increased, the risk of incident stones continued to decline until plateauing at a decrease of approximately 31% for activity levels ≥10 METs/wk (aHR, 0.69; 95% CI, 0.60 to 0.79). Intensity of activity was not associated with stone formation. As dietary energy intake increased, the risk of incident stones increased by up to 42% (aHR, 1.42; 95% CI, 1.02 to 1.98). However, intake <1800 kcal/d did not protect against stone formation. Higher BMI category was associated with increased risk of incident stones. In summary, physical activity may reduce the risk of incident kidney stones in postmenopausal women independent of caloric intake and BMI, primarily because of the amount of activity rather than exercise intensity. Higher caloric intake further increases the risk of incident stones.The prevalence of kidney stones is 8.8%, or 1 in 11 people, in the United States, and during the last 15 years the prevalence has increased by almost 70%.1 The increased prevalence is especially pronounced among women and may be due to increased rates of obesity, weight gain, and metabolic syndrome.1–3 Most visits for kidney stones occur in the outpatient setting. From 1992 to 2000, physician office visits primarily for kidney stones increased 43%, representing up to 1,825,000 annual visits.4 This represents a significant burden of disease, and additional efforts are needed to help with prevention.The increase in the prevalence of kidney stones has paralleled epidemic rates of obesity.5 In multiple prior studies, obesity has been recognized as a strong and consistent risk factor for kidney stones.2,6–9 The cause of this increased risk is not well understood. Although obesity and higher body mass index (BMI) are associated with changes in urinary pH and electrolytes, the link with nephrolithiasis probably involves more than an increased solute load due to excess nutrient intake.6–8,10–12 It has been hypothesized that the proinflammatory state is associated with obesity and that metabolic syndrome may lead to stone formation.13,14Several dietary factors have been linked to an increased risk of kidney stones.9,15–18 For example, in clinical practice we recommend increased fluid intake, low sodium and low animal-protein intake, and normal calcium intake because these have all been shown to reduce stone recurrence.19–21 Patients are often interested in dietary modification to prevent stone recurrence.22A person’s present-day BMI reflects their historic balance between energy intake and energy expenditure. A restriction in dietary energy intake or increase in energy expenditure might partially offset the risk of stone formation imparted by BMI. The purpose of this study was to evaluate the independent relationship between physical activity, dietary energy intake, and BMI and the risk of incident kidney stone formation. 相似文献
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Takayasu’s arteritis (TA) is a rare inflammatory disease affecting the aorta and its major branches. In patients with TA, middle aortic syndrome with aortic and renal artery involvement causes severe hypertension that does not respond well to medical therapy. Currently, the optimal therapeutic options have not been established, and the reported results of different treatments vary widely. We herein present a case of middle aortic syndrome with renovascular hypertension caused by TA in a 12-year-old male treated by an aortic stent and renal autotransplantation as a two-staged procedure. 相似文献
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Daniel Pérez Fentes 《BJU international》2021,127(5):520-523
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Pedro Acién Maribel Acién Jesús Romero-Maroto 《International urogynecology journal》2010,21(3):365-369
Genital anomalies associated with unilateral renal agenesis are generally due to agenesis or hypoplasia of the entire urogenital
ridge or distal mesonephric aberrations. However, renal adysplasia could also occur in association with anomalies of the ventral
urogenital sinus. The patient presented didelphys uterus in the superior uterine segment, a septate cervix, and a simple vagina.
After transvaginal puncture and injection of a contrast agent into the bulge observed in the right vaginal wall, a filled
sac or cavity was detected, possibly a hemibladder. This structure continued upward with a possible dilated tortuous ureter
that filled retrogradely. Magnetic resonance imaging also showed the presence of the right blind paravaginal sac. Right hemitrigone
and ureteral orifice were absent in the cystourethroscopy. No right kidney was found, despite the use of multiple imaging
techniques. Blind hemibladder, ectopic ureterocele, and Gartner’s duct cyst seem to be a possible diagnosis associated to
Müllerian malformations and supposed unilateral renal agenesis. Therefore, Müllerian anomalies without combined mesonephric
alteration could be associated with conditions of the ventral urogenital sinus, including blind hemibladder or ectopic ureterocele
with secondary renal dysplasia. 相似文献
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We report the case of a patient already submitted to bilateral deep-brain stimulation (DBS) of the subthalamic nucleus (STN)
who started to develop gait impairment, postural imbalance and frequent falls in the course of the disease and who subsequently
underwent DBS of the right pedunculopontine nucleus (PPN) at our institute. An immediate clinical benefit in hand dexterity
was observed with acute external stimulation and maintained after the definitive implant of the internal pulse generator (IPG)
at 6 months’ follow-up. The benefit on hand dexterity seemed to be related to the interactions between the PPN low-frequency
stimulation and the bilateral STN high-frequency stimulation. 相似文献
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Panagiotis Korovessis 《European spine journal》2015,24(7):1368-1369
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Amelia?Pietropaolo Silvia?Proietti Rob?Geraghty Andreas?Skolarikos Athanasios?Papatsoris Evangelos?Liatsikos Bhaskar?K.?Somani