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71.
Benjamin Poh Paul Cashin Kaye Bowers Travis Ackermann Yeng Kwang Tay Arun Dhir Daniel Croagh 《HPB : the official journal of the International Hepato Pancreato Biliary Association》2014,16(7):629-634
Introduction
Minimally-invasive options for the management of choledocholithiasis in patients undergoing laparoscopic cholecystectomy include laparoscopic and endoscopic approaches. This study reviews the effectiveness of both approaches in an emergency setting.Methods
A retrospective chart review was performed for a cohort of patients who underwent laparoscopic cholecystectomy. Outcomes assessed were duct clearance, the number of procedures performed (NPP), length of stay (LOS) and complication rate.Results
A total of 182 patients who underwent emergency laparoscopic cholecystectomies received intervention for choledocholithiasis. The duct clearance rate was lower in the laparoscopic group, 63% versus 86% (P = 0.001). However, the median NPP was also lesser in the laparoscopic group, 1 (interquartile range (IQR) 1–2) versus 2 (IQR 2–2) (P < 0.001), as was the median LOS, 5 days (IQR 3–8) versus 7 days (IQR 6–10) (P = 0.009). Forty-eight laparoscopic endobiliary stents were attempted; stent deployment was successful in 37 patients. A larger proportion of patients with laparoscopic endobiliary stents had duct clearance by endoscopic retrograde cholangiopancreatography (ERCP) compared with those without, although this was not statistically significant (P = 0.208).Conclusion
Laparoscopic clearance is not as effective as post-operative ERCP in an emergency cohort, but is associated with fewer procedures required and a shorter inpatient stay. Thus, laparoscopic clearance may still be an attractive option for surgeons especially where conditions are favourable during an emergency laparoscopic cholecystectomy. 相似文献72.
A Bahrami Y Rassi N Maleki MA Oshaghi M Mohebali MR Yagoobi-Ershadi S Rafizadeh 《亚太热带病杂志(英文版)》2014,4(2):110-114
Objective
To identify the vector(s), the parasite and the species composition of sand flies in the district during May-October 2012.Methods
For reaching our objectives we used polymerase chain reaction of kDNA, ITS1-rDNA, followed by restriction fragment length polymorphism.Results
Two species of Phlebotomus sergenti and Phlebotomus tobbi were the most prevalent among 8 species identified comprising 51.1% and 32.9% respectively. Among the 160 specimens of female sand flies tested by polymerase chain reaction of kDNA, ITS1-rDNA, followed by restriction fragment length polymorphisms, only 1 out of 80 Phlebotomus tobbi (1.25%) were positive to Leishmania infantum parasites.Conclusions
Our finding showed that Phlebotomus tobbi may play as a vector to circulate the parasite of Leishmania infantum among reservoir(s) and human. 相似文献73.
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76.
S. Heinrich T. Birkholz A. Irouschek A. Ackermann J. Schmidt 《Journal of anesthesia》2013,27(6):815-821
Background
Hypoxemia caused by difficulties in airway management presents a major cause for perioperative morbidity and mortality. The ability to predict difficult laryngoscopy more accurately would enable anesthesiologists to take specific precautions to reduce airway risks and prevent patient-threatening events.Methods
Over a 6-year period of time, all anesthesia records with a documented direct laryngoscopic view were retrieved from the electronic data management system and statistically processed. The Cormack–Lehane four-point scale of grading laryngoscopy was used to assess visibility of the vocal cords.Results
Of 102,306 cases, the overall rate of difficult laryngoscopy was 4.9 %. Male gender (6.5 %), Mallampati score III and IV (17.3 %), obesity with a BMI ≥35 kg/m2 (6.1 %), as well as physical status ASA III or IV (6.2 %), were identified as risk factors for difficult laryngoscopy. Patients undergoing surgery in the departments of oromaxillofacial (8.9 %), ear nose throat surgery (ENT) (7.4 %), and cardiac surgery (7.0 %) showed the highest rates of difficult laryngoscopy.Conclusions
The results indicate that the risk for difficult airway situations might substantially differ between surgical patient groups. In hospitals with departmental structures and spatially separated operating rooms, the deduction might be increased awareness and particular structural preparation for difficult airway situations in the respective subspecialties. 相似文献77.
Background: The syndrome of conduction aphasia is an umbrella term to label clinically heterogeneous language disorders that all include a deficit of repetition due to impaired immediate memory or, in some patients, impaired speech production. The present article reviews the currently available literature on conduction aphasia. It covers aspects of the history of conduction aphasia as a fascicular disconnection syndrome and the objections to this view and discusses the proposed subtypes of this syndrome and the underlying cortical and white matter lesions.Aims: The primary objectives of this article are to critically review the influence of historical concepts on recent approaches to optimise existing theoretical synergies. In addition, the article seeks to advance our understanding of the first steps of verbal auditory processing in individuals with normal and impaired language skills.Main Contribution: We present first indications for an involvement of the left hemisphere in both short- and long-term integration of auditory information derived by examining patients with (conduction) aphasia.Conclusions: Conduction aphasia may result from left hemisphere cortical lesions or from a disconnection of critical bundles of axons (fibre tract). The exact course of the fibre tract connections and the cortical regions involved in conduction aphasia remains controversial. 相似文献
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79.
Hermann Ackermann Ingo Hertrich Wolfram Ziegler Michael Bitzer Siegfried Bien 《Aphasiology》2013,27(4):409-417
Abstract The present study describes the acquired dysfluencies observed in a patient with transcortical motor aphasia (TCMA) following ischaemic infarction of the mesiofrontal cortex due to occlusion of the anterior cerebral artery. Prolongation of labial plosives and labiodental fricatives as well as hesitations concomitant with a few repetitions of syllables and sounds, respectively, were noted. The dorsolateral aspects of the frontal lobe of the dominant hemisphere have been considered the relevant site of lesion in instances of acquired stuttering concomitant with TCMA. The present case demonstrates that dysfluencies May-June be present with mesiofrontal lesions as well. The patient's stuttering was confined to production of complex sentences. Since transcortical motor aphasia is characterized by paucity of speech, consisting mostly in one- to two-word utterances, the dysfluencies of patients with this kind of disorder often might be masked. The observed stuttering-like behaviour differed in two respects from other reports on this disorder: the dysfluencies, first, were restricted to word-initial sounds and, secondly, did not occur during repetition tasks and reading aloud. Thus, acquired stuttering due to mesiofrontal lesions might represent a specific constellation of dysfluencies. 相似文献
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