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21.
Risk of death from acute pancreatitis 总被引:5,自引:0,他引:5
Giorgio Talamini Claudio Bassi Massimo Falconi Nora Sartori Luca Frulloni Vincenzo Di Francesco Sergio Vesentini Paolo Pederzoli Giorgio Cavallini 《Journal of gastrointestinal cancer》1996,19(1):15-24
Summary
Conclusions
The analysis of all the data available in 192 patients at 24 h from admission shows that only serum glucose above 250 mg/dL
(13.88 mmol/L) and serum creatinine above 2 mg/dL (176.8 μmol/L) are prognostic factors of death (P<0.0001). When, however, pathological chest X-rays are also considered in a subset of 149 patients, these and serum creatinine
are prognostic factors of death with odds ratios of 2.9 (95% CL 1.3–6.3) and 9.4 (95% CL 2.2–40.7), respectively (P<0.0001).
Background In patients suffering from acute pancreatitis, neither Ranson scores nor Glasgow criteria evaluation at 24 h yield a sufficiently
reliable prognosis of the risk of death from the first acute attack.
Methods After excluding posttraumatic, postsurgical, and post-ERCP acute pancreatitis, we selected 192 consecutive patients admitted
in the first instance to our center for a first attack, distinguishing between patients who died and patients who survived.
We used Cox's model to analyze the prognostic weight of variables available within 24 h of admission (sex, age, alcohol intake,
smoking habits, 17 biochemical tests, body mass index, chest X-rays, body temperature, and shock status).
Results Seventeen (8.8%) patients died; mortality showed a decreasing trend over the period of years considered and was correlated,
among other things, with necrotizing type of pancreatitis, idiopathic etiology, and shock status on admission. 相似文献
22.
23.
P S Houts J M Yasko M A Simmonds S B Kahn G W Schelzel K M Marconi M J Bartholomew 《Journal of clinical epidemiology》1988,41(9):875-881
Problem reporting rates of 180 persons with cancer (PWC) were compared with those of their closest in age same sex cancer-free siblings living outside their households for the same time periods. PWC had significantly higher reporting rates for physical, activities of daily living, nutrition, and emotional problems and a significantly lower rate for family problems. Sibling problem reporting rates, which indicate the likelihood that PWC would have experienced similar problems without a diagnosis of cancer, were highest for physical, emotional, employment, and family problems suggesting that noncancer factors are especially likely to play a role in those types of problems. Regression analyses showed that female and younger PWCs tended to report more problems than their siblings suggesting that they were more affected by cancer and its treatments than were other types of PWC. 相似文献
24.
Fernanda Coutinho Luiz Claudio de Santa Maria 《Macromolecular chemistry and physics.》1992,193(7):1739-1744
The effect of ethyl benzoate (EB), diisobutyl phthalate (DIBP), dibutyl ether (DBE) and triethoxy(phenyl)silane (EPS) as third components on the propene polymerization with the catalyst systems δ-TiCl3/AlCl(C2H5)2 and δ-TiCl3/Al(C2H5)3 was investigated. The influence of external donors on the isotacticity, catalyst activity and average molecular weight (M v) was tested. If external donors are employed, M v decreases, the insoluble fraction in boiling isooctane increases and the catalyst activity is strongly influenced by the mole ratio external donor/TiCl3. The results indicate that all external donors employed have the same qualitative effect on catalytic active centers. 相似文献
25.
26.
Aureo L DePaula Antonio L V Macedo Claudio R Cernea Vladimir Schraibman Jacques Pinus José R Milanez José E Succi Flávio C Hojaij Dorival de Carlucci Sunao Nishio 《Otolaryngology--head and neck surgery》2006,135(5):710-713
BACKGROUND: Gastric pull-up is a useful method for reconstruction of the upper digestive tract, with considerable morbidity/mortality, especially in esophageal cancers (EC). OBJECTIVE: To analyze the experience of a multidisciplinary team with a laparoscopic gastric pull-up (LGPU) method, with or without thoracoscopy, in a series of 120 patients with EC. STUDY DESIGN: Retrospective. PATIENTS AND METHODS: From 1992 to 2004, 120 EC [cervical/cervicothoracic (3.0%), middle third (15.0%), and inferior third (82.0%)]. Most were squamous cell carcinomas (47.0%) and adenocarcinomas (34.0%). Stomach was dissected and mobilized exclusively by laparoscopy. Occasionally, laparoscopic approach was extended cranially, until connecting with cervical dissection. In other cases, dissection of thoracic esophagus was accomplished through a thoracoscopic approach. RESULTS: Eighty-one patients (68.0%) had LGPU; 39 (32.0%) needed thoracoscopy. Mortality was 5.9%. Complications were fistula (10.0%) and pneumonia (10.0%). All fistulae closed spontaneously; 89.2% of patients could swallow a normal oral diet. CONCLUSION: Low morbidity/mortality of LGPU for EC compared favorably with conventional techniques. 相似文献
27.
Imad Sheiban M. D. Dino Casarotto Giampaolo Trevi Paolo Benussi Alberto Marini Roberto Accardi Antonio Motta Massimo Brunelli Claudio Muneretto Alessandro Tenuti Ludovico Antonio Scuro 《Cardiovascular and interventional radiology》1987,10(3):157-161
The accuracy of two-dimensional echocardiography in the detection of intracardiac masses was verified in 334 patients who
underwent cardiac catheterization in our laboratory over 21 consecutive months. A complete two-dimensional echocardiographic
(2DE) examination was performed a day before catheterization. The presence or absence of a mass was verified at surgery in
77 patients who successively underwent mitral or aortic valve replacement (51), left ventricular aneurysmectomy with or without
myocardial revascularization (25), and resection of atrial myxoma (2). In 32 patients 2DE revealed the presence of a mass-left
or right atrial thrombi in 12, left atrial myxoma in 2, left ventricular thrombi in 16, and endocardial vegetations in 2.
The other 45 patients were free of intracardiac masses on 2DE. Anatomic verification at surgery revealed the presence of an
intracardiac mass in 34 patients. In 30 (true positives) of these, 2DE revealed the mass as well, and in 4 (false negatives)
the presence of a mass had not been identified by 2DE. In 2 patients (false positives) the predicted mass was not found at
surgery. Absence of a mass was correctly predicted by 2DE in 41 patients (true negatives). Thus 2DE detected intracardiac
masses with sensitivity of 88.2% and a specificity of 95.3%. We recommend that 2DE be performed in all patients prior to hemodynamic
study and/or cardiac surgery to enable safer management of patients with intracardiac masses during cardiac catheterization
and/or cardiac surgery. 相似文献
28.
Simona Cabib Claudio Castellano Vincenzo Cestari Umberto Filibeck Stefano Puglisi-Allegra 《Psychopharmacology》1991,105(3):335-339
Pretreament with small, per se ineffective doses of the selective D1 antagonist SCH 23390 inhibited hyperactivity induced by cocaine. On the other hand, the classic neuroleptic haloperidol and the selective D2 antagonist metoclopramide prevented the stimulatory effects of cocaine on locomotion only at hypokinetic doses, while the atypical neuroleptic (–)-sulpiride, a selective D2 antagonist, did not produce significant effects when administered at the hypokinetic dose of 12 mg/kg. Finally, at low doses (–)-sulpiride dose-dependently potentiated the locomotor-stimulating effects of cocaine, an effect that is not shared either with haloperidol or with metoclopramide. These results are discussed in terms of different roles of DA receptor subtypes in the modulation of the stimulant effects of cocaine on locomotion. 相似文献
29.
Giorgio Nanni Federica Majorani Anna Maria Bassi Claudio Canepa Giuseppe Maloberti Anna Casu 《Experimental and toxicologic pathology》2002,54(1):43-50
The content of dolichol, an isoprenoid present in all biological membranes, was determined in isolated sinusoidal liver cells after treatment of rats for 2 and 4 months with a low dosage of the hepatotoxin thioacetamide. The significant decrease in dolichol observed in hepatocytes after 2 months might be explained by peroxidation of the isoprenoid. At the same time point, retinol was retained, and decreased only after 4 months of treatment. After 4 months of treatment therefore both lipids decreased. In a subfraction of hepatic stellate cells, Ito-1 cells, the main storage site of vitamin A, dolichol decreased significantly only after 4 months. A remarkable difference from hepatocytes is that in Ito-1 cells retinol content significantly decreased after 2 months of treatment. In another subfraction, Ito-2 cells, the content of the two isoprenoids decreased in parallel. This heterogeneous subfraction might represent those transitional hepatic stellate cells that, while losing retinol, are in the process of differentiating into myofibroblasts secreting extracellular matrix components. In Kupffer cells and sinusoidal endothelial cells, impairment of dolichol might be observed later, only after 4 months of treatment, while retinol decreases uniformly over time. Starting after two months of treatment, the decrease of dolichol and the increase of retinol in hepatocytes, at the same time as retinol decreases in hepatic stellate cells, might be taken as an early index of incipient liver injury due to thioacetamide. This hypothesis is discussed with regard to a role of dolichol in the modulation of membrane fluidity for intracellular and intercellular retinol transport. 相似文献
30.
Adriano Rizzi Gaetano Rocco Mario Robustellini Gerolamo Rossi Claudio Della Pona Giuseppe Vertemati 《World journal of surgery》1997,21(5):488-491
n
= 8), multidrug resistance
or noncompliance to the medical treatment (
n
= 11),
parenchymal sequelae (
n
= 3), suspected cancer
(
n
= 5), and for the correction of postpneumonectomy
bronchopleural fistula and empyema (
n
= 1). On
admission, eight patients presented with sputum positivity (28.6%).
Similar to previous series, tubercular predilection for upper lobes was
confirmed (21/28, 75%); accordingly, upper lobectomy through an
extrapleural approach was the most common procedure (16/28, 57.1%).
Atypical segmental resections or segmentectomies were performed in
seven patients (25%), whereas a bilobectomy was necessary in another
three patients (10.7%) and a completion pneumonectomy in one (3.6%).
Additional procedures were an open-window thoracostomy with
transpericardial closure of the main bronchus and a tailored
thoracoplasty. No operative mortality was reported. Healing was
achieved in 26 patients (93%). Bleeding, either from the chest wall or
hilar dissection, was the only reported intraoperative complication.
Median blood loss, inclusive of early postoperative collections from
chest tubes, reached 1330 ml (range 100–3700 ml). Major postoperative
complications included recurrent disease (2/28, 7%) in sputum-positive
patients and segmental pulmonary embolism (3.5%). Causes of minor
morbidity were air leaks resulting in residual space undergoing
spontaneous resolution (18%), wound breakdown (14%), and, fever
(11%). This limited series confirms the therapeutic value of the
surgical treatment of postprimary tuberculosis, provided that correct
indications, adequate pre- and postoperative medical coverage, and
meticulous technique are applied. 相似文献