Migraine without aura and migraine with aura are distinct clinical entities: a study of four hundred and eighty-four male and female migraineurs from the general population

The clinical characteristics of migraine without aura (MO) and migraine with aura (MA) were compared in 484 migraineurs from the general population. We used the criteria of the International Headache Society. The lifetime prevalence of MO was 14.7% with a M:F ratio of 1:2.2; that of MA was 7.9% with a M:F ratio of 1:1.5. The female preponderance was significant in both MO and MA. The female preponderance was present in all age groups in MA, but was first apparent after menarche in MO, suggesting that female hormones are an initiating factor in MO, but not likely so in MA. The age at onset of MO followed a normal distribution, whereas the age at onset of MA was bimodally distributed, which could be explained by a composition of two normal distributions. The estimated separation between the two groups of MA was at age 26 years among the females and age 31 years among the males. The observed number of persons with co-occurrence of MO and MA was not significantly different from the expected number. The specificity and importance of premonitory symptoms are questioned, but prospective studies are needed. Bright light was a precipitating factor in MA, but not in MO. Menstruation was a precipitating factor in MO, but not likely in MA. Both MO and MA improved during pregnancy. The clinical differences indicate that MO and MA are distinct entities.     

Is the Bishop–Koop procedure useful in severe jejunoileal atresia?

Purpose

The aim of this study was to report our experience using the Bishop–Koop procedure for the treatment of various surgical problems of jejunoileal atresia including luminal discrepancy, complex meconium peritonitis, type IIIb and type IV atresia which we defined as severe jejunoileal atresia.

维医治疗瘫痪病人75例临床总结

目的:本文简单介绍了对75例瘫痪病人临床治疗方法的探索过程。方法:对疾病本质采取措施,给于成熟剂、清除剂等恢复运动神经功能的内服方药及外用药结合治疗。结果:利用上述对75例瘫痪病人进行治疗后,痊愈39例(52%),有效28例(37.3%),无效8例(10.7%),总有效率达89.3%。结论:对瘫痪病人结合成熟剂、清除剂等及有营养神经功能的药物,针对病理性产物进行对症治疗,在使用恢复运动神经功能的内服方药的同时,结合外用药物及理疗能够达到治疗疾病的目的。     

Indication of lower neck irradiation in nasopharyngeal carcinoma without nodal metastasis: the potential impact of tumor volume

Background Elective radiation of lower neck is controversial for nasopharyngeal carcinoma (NPC) without lymph node metastasis (N0 disease).Tumor volume is an important prognostic indicator.The objectiv...     

The impact of familial environment on depression scores after genetic testing for cancer susceptibility

The associations between characteristics of family relationships and family trends in cancer worry and the psychological adjustment of recipients of genetic testing for cancer susceptibility were investigated. Data provided by 178 individuals from 24 families with Lynch syndrome who participated in a cohort study investigating psychological and behavioral outcomes of genetic testing were used. Responses from multiple family members were aggregated to construct family trends representing norms and departure from norms in cancer worry. Lower perceived family cohesion at baseline and decrease in this variable at 6 months after receipt of test results were associated with higher depression scores at 12 months. More variability in cancer worry among family members at baseline was also associated with higher depression scores at 12 months. Increase in family conflict was associated with decrease in depression scores among individuals from families with higher levels of cancer worry on average and less variability among the members. Family relationships and family trends in levels of cancer worry may play important roles in the psychological adjustment of genetic test recipients. The findings highlight the complexity of familial environment surrounding individuals that undergo genetic testing and suggest the benefits of considering these factors when providing genetic services.     

Renin,endothelial no synthase and endothelin gene expression in the 2Kidney-1clip goldblatt model of long-term renovascular hypertension

Objective

Numerous reports have shown the influence of renin, nitric oxide (NO) and the endothelin (ET) systems for regulation of blood pressure and renal function. Furthermore, interactions between these peptides have been reported. Aim of our study was to investigate the relative contribution of these compounds in long-term renovascular hypertension/renal ischemia.

Methods

Hypertension/left-sided renal ischemia was induced using the 2K1C-Goldblatt rat model. Renal renin, ET-1, ET-3 and endothelial NO synthase (eNOS) gene expression was measured by means of RNAse protection assay at different timepoints up to 10 weeks after induction of renal artery stenosis.

Results

Plasma renin activity and renal renin gene expression in the left kidney were increased in the clipped animals while eNOS expression was unchanged. Furthermore, an increase in ET-1 expression and a decrease of ET-3 expression was detected in early stenosis.

Conclusions

While renin is obviously involved in regulation of blood pressure and renal function in unilateral renal artery stenosis, ET-1, ET-3 and endothelium derived NO do not appear to play an important role in renal adaptation processes in long-term renal artery stenosis, although ET-1 and ET-3 might be involved in short-term adaptation processes.     

下肢严重开放性骨折的皮瓣覆盖

目的 观察以皮瓣覆盖下肢严重开放骨折的疗效，分析常见的并发症及手术时机。方法 自1999年12月～2004年4月间，41例患者，42侧下肢，共43个皮瓣。Ⅲb型骨折38个肢体，Ⅲc型骨折2个肢体，足的截肢性损伤2个肢体。男34例，女7例，年龄14～75岁，平均38．3岁。损伤部位33例在胫骨，10例位于足和踝。创面面积4～450cm^2(平均71cm^2)。本组病例受伤至皮瓣手术平均18．9d(3～43d)，游离皮瓣31例(游离股薄肌皮瓣14例，游离背阔肌皮瓣8例，游离背阔肌加肋骨2例，游离腹直肌皮瓣7例)，有蒂皮瓣12例(小腿外侧皮瓣9例，腓肠肌瓣2例，比目鱼肌肌瓣1例)。结果 1例游离背阔肌皮瓣失败，骨不愈合4例(9．52％)，26例患者术前创面细菌培养阳性，4例出现深部软组织感染(9．52％)。我们将术前细菌培养呈阳性的患者和术前细菌培养呈阴性患者的手术时间做了比较，两组患者受伤至皮瓣手术的平均时间分别为22．4d和8．33d，两者有显著性差异。结论 提倡合理使用抗菌素，早期覆盖创面及植骨。端-侧吻合是适用和安全的。     

AN INVESTIGATION INTO THE PRACTICE AND BENEFITS OF STATUTORY AFTERCARE IN AN INNER CITY PSYCHIATRIC SERVICE

The implementation of statutory aftercare for psychiatric inpatients, as outlined in Section 117 of the Mental Health Act 1983 (England and Wales), was studied by examining current practice in an inner city psychiatric service. Seventy-seven per cent of patients received Section 117 aftercare; 56% of patients did not have an identified key worker. A significant proportion of those receiving statutory aftercare did not have evidence of adequate forward planning. General practitioners did not attend any meetings. Patients who had Section 117 aftercare were compared with those who did not. Using the Cox regression model, it was found there was no significant difference between these two groups in terms of time between discharge and first readmission, readmission rate, and length of first readmission.