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81.
We report the case of an 8 week old infant with fulminant autoimmune haemolytic anaemia refractory to conventional immunomodulating treatment. Massive haemolysis resulted in cardiac decompensation and acute renal failure which necessitated mechanical ventilation and peritoneal dialysis. Rituximab, a chimeric anti-CD20 monoclonal antibody, halted progression of the haemolytic process, but the patient died of acute viral pneumonia and disseminated fungal infection. Earlier introduction of rituximab might have prevented the renal complications. Paediatricians should be aware of this useful therapeutic tool for treatment of refractory autoimmune haemolytic anaemia and balance its use against the risk of potential life threatening infection. 相似文献
82.
院内感染严重影响重症监护室(ICU)危重病人的治疗。目前5例院内感染病例中就有1例是发生在ICU病房。院内输血感染(blood stream injections,BSIs)使危重病人的监护面临重大挑战。虽然输血感染的死亡率还存在争议,但大量的报道已经证实ICU内菌血症的增多使病人住院时间及费用均有所上升。如一项研究证实患院内菌血症后患者ICU住院期增加〉7天,住院费用额外增加〉2万美元。耐药菌群的不断出现与ICU病人病情加重进一步增加了BSIs的治疗难度。 相似文献
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84.
Clip placement after stereotactic vacuum-assisted breast biopsy 总被引:3,自引:0,他引:3
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86.
Central giant cell granuloma (CGCG) is a benign lesion of unknown etiology that especially affects the jaws, usually appears in patients younger than 30 years and is more common in females than in males. Lesions generally occur in the anterior portion of the jaws and mandibular lesions frequently cross the midline. The conventional treatment of CGCG is surgical removal. According to clinical and radiological features, the extent of tissue removal ranges from simple curettage to an en bloc resection. We present an 8-year-old male patient, lack of any systemic disease or syndrome, complaining from painless swelling of the left posterior part of the mandible. In intraoral examination, a firm, expansive swelling with overlying intact mucosa, extending from mandibular primary canine to the distal portion of the left permanent first molar, was detected. A panoramic radiograph exhibited an ill-defined radiolucent lesion of 1.5 x 2 cm, extending from left permanent first molar to angulus mandibula and a well-defined, unilocular radiolucent lesion of 1 x 2 cm, extending from angulus to ramus mandibula on the asymptomatic right side. After the assessment of MRI, surgical removal was planned with the otorhinolaryngology department and lesions were totally removed under general anesthesia in two consecutive operation. Histopathologic examination revealed typical giant cell granuloma containing numerous multinucleated giant cells embedded in a fibrous stroma. In presenting this case we aimed to share occurrence of bilateral central giant cell granulomas of the mandible in the absence of hyperparathyroidism and associated syndromes, which is very rare in the literature. 相似文献
87.
Metallic hip implants: CT with multiplanar reconstruction 总被引:4,自引:0,他引:4
Thirty consecutive patients with metallic implants in the hip were evaluated with both standard transaxial computed tomography (CT) and multiplanar reconstruction (MPR) to assess the contribution of MPR. The metallic devices included total hip replacements (n = 6), one or more surgical plates with screws (n = 9), acetabular pins or screws (n = 9), and Knowles pins (n = 6). The metallic implants were on the side of interest in 25 hips and in the contralateral hip in five cases. One patient had bilateral hardware. MPR reformats axially acquired data into other planes. The reconstruction program weights the true signal over the randomly distributed artifacts by integrating adjacent axial images. Examination using standard transaxial imaging was graded as excellent in five cases, adequate in 15 cases, and inadequate in ten cases. After MPR, 19 studies were classified as excellent, 11 were classified as adequate, and none were classified as inadequate. It is concluded that MPR significantly reduced artifacts caused by metal present in transaxial images. 相似文献
88.
Background
Interest is increasing in the application of standardised outcome measures in clinical practice. Measures designed for use in research may not be sufficiently precise to be used in monitoring individual patients. However, little is known about how clinicians and in particular, multidisciplinary teams, score patients using these measures. This paper explores the challenges faced by multidisciplinary teams in allocating scores on standardised outcome measures in clinical practice. 相似文献89.
90.