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61.
Nicholas H.L. Chua MBBS MMed FIPP DAAPM FAMS Kris C. Vissers MD PhD FIPP Oliver H. Wilder‐Smith MBChB MD PhD 《Pain practice》2011,11(5):439-445
Pulsed radiofrequency treatment has been described as a nonablative alternative to radiofrequency thermocoagulation for the management of certain chronic pain syndromes. We present our first three patients with long‐standing cluster headaches who were treated with pulsed radiofrequency to the sphenopalatine ganglion. All three patients have had cluster headaches for more than 10 years' duration and experienced minimal relief with conservative treatment. An excellent midterm effect was achieved in two of the three patients and a partial effect in one. No neurological side effects or complications were reported. Quantitative sensory testing consisting of allodynia testing, pressure–pain thresholds, electrical pain thresholds, and conditioned pain modulation (CPM) response testing were used to monitor their sensory processing changes before and after the procedure. From this case series, it might be that cluster headache patients with an impaired CPM response with or without signs of allodynia will respond less favorably to interventional treatment. Further studies are required to validate this hypothesis. 相似文献
62.
Gallbladder cancer 总被引:1,自引:0,他引:1
Opinion statement Gallbladder cancer (GBC) is the most common malignancy of the biliary tract and the fifth most common gastrointestinal (GI)
cancer. In addition to global inter-country variations in incidence, large racial and ethnic variations have been noted within
countries. High incidence rates of GBC have been described in North India, for example. Despite the fact that the precise
etiology of GBC is poorly understood, a strong association between GBC and cholelithiasis exists. Most GBC presents clinically
as advanced disease with unfavorable prognosis and poor response to treatment. A small but increasing proportion of cases
of incidental GBC detected during or after cholecystectomy is also being seen. Such patients are generally in an earlier stage
of disease and are potentially more curable by a completion radical cholecystectomy, which is especially indicated for patients
whose disease is stage pT1b or beyond. Radical surgery is the mainstay of curative intent treatment for GBC. When feasible,
extended or radical cholecystectomy is the standard treatment for resectable GBC. Patients with advanced stage III or IV disease
may undergo more complex, high-risk, and morbid extended resections such as hepatopancreaticoduodenectomy. We believe that
these procedures should be performed only in selected patients at centers specializing in these resections. Patients not fit
for such major resection or found unresectable on imaging or exploration are usually offered palliative treatment. This may
be in the form of surgical palliation (eg, palliative bypass for gastric outlet, bowel, or biliary tract obstruction), endoscopic
biliary stenting (for obstructive jaundice), or palliative chemotherapy. Chemotherapy for GBC is generally used in the palliative
setting. Gemcitabine, cisplatin, 5-fluorouracil, mitomycin, and capecitabine are some of the effective agents. We have reported
gratifying overall response rates of 55% with the combination of gemcitabine and cisplatin in patients with advanced GBC.
Patients with advanced GBC and jaundice who undergo stenting followed by chemotherapy show response and survival rates similar
to those who present without jaundice. 相似文献
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Childhood onset schizophrenia (COS) patients have marked neuropsychological deficits in areas of attention, working memory
and executive functions. Similar deficits have been found in studies on Adolescent onset (AdOS) and Adult onset schizophrenia
(AOS). In this study we compared the neuropsychological profile of COS with AdOS and AOS to test the hypothesis that earlier
the onset greater is the severity of illness and greater are the neuropsychological deficits. A sample of 15 patients of COS
was compared with 20 patients each of AdOS and AOS group. Assessment of neuropsychological profile was done using standard
neuropsychological battery for Indian population. Nahor Benson Test and Bender Visual Motor Gestalt Test were used to assess
perceptuomotor functioning. COS patients showed significantly greater deficits on scales of IQ, memory and perceptuomotor
skills as compared to AdOS that in turn had greater deficits than AOS. The persistence of differences across the three groups
inspite of controlling for education and age suggest that these deficits may have been present even before the onset of illness
and was not the result of poor academic achievements. These findings also point towards a brain damage in schizophrenia that
occurs on a continuum of severity with COS being the most virulent, AOS being the least and AdOS falling in between these
two extremes. 相似文献
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67.
U.N. Jindal MD G.I. Dhall FRCOG FACS FICOG K. Vasishta MD K. Dhall MD DGO P.L. Wahi MD FCCP FACS FAMS 《The Australian & New Zealand journal of obstetrics & gynaecology》1988,28(2):113-115
Perinatal outcome of 223 pregnancies complicated by maternal cardiac disease, over a 5-year period has been studied. Mean birth-weights of these babies were compared to the Institute's reference neonatal weight curves at different periods of gestation and found lower than the reference. The mean difference of 150 g was statistically significant. The incidence of prematurity, small for gestational age and perinatal mortality was analyzed according to the risk factors i.e. type, duration and severity of symptoms. The perinatal outcome was directly proportional to the severity of symptoms, irrespective of the type and duration of heart disease. 相似文献
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