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Cancian M Bortolati M Fagiolo U 《Annali italiani di medicina interna : organo ufficiale della Società italiana di medicina interna》2003,18(1):16-23
Urticaria is a common complaint characterized by the eruption of cutaneous wheals, accompanied by redness and itching and in which mast cells are thought to play a central role. Wheals range from a few millimeters to several centimeters in diameter and are usually short lasting, except in case of urticarial vasculitis in which they last longer than 24 hours. Urticaria may occur alone or be associated with angioedema, that can be defined as a deep dermal and subcutaneous edema typically affecting the lips, face, hands, feet, penis or scrotum. Angioedema may also involve the submucosal tissue, and when the swellings occur in the oropharynx they can be alarming and occasionally life-threatening. In many cases the cause of acute urticaria or angioedema may be determined, whilst the pathogenetic and diagnostic aspects of the chronic forms are more complex and variable. The clinical features of, as well as the diagnostic and therapeutic approaches to the different forms of urticaria and angioedema are here reviewed, focusing on chronic idiopathic urticaria. 相似文献
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Stefano Rausei M.D. Gianlorenzo Dionigi M.D. F.A.C.S. Francesco Frattini M.D. Patrizia Castano M.D. Andrea Leotta M.D. Francesca Rovera M.D. Luigi Boni M.D. F.A.C.S. Luigi Bartalena M.D. Renzo Dionigi M.D. F.A.C.S. F.R.C.S. 《American journal of surgery》2011,(4):525-530
Background
To investigate the relationship between nodule size and malignancy and the correlation between the dimensional parameter and fine-needle aspiration biopsy (FNAB) in patients with a nodular goiter.Methods
Histological data of 415 patients who underwent thyroidectomy were used to estimate the actual nodule size and the difference between the diameter of the nodular lesion and the included tumor (intranodular peritumoral tissue [IPT]). FNAB was performed in 338 patients, and its predictive role was evaluated in comparison with histology.Results
The histology revealed 207 cases of thyroid malignancy. The mean nodule size was significantly larger in benign disease compared with malignant. Only age and FNAB malignant category were independently associated with malignancy. The IPT showed a trend toward a statistically significant association with FNAB malignant category.Conclusions
Nodule size does not appear to be a reliable parameter to improve the clinical management of a nodular goiter because of a high variability between size of nodular area and tumor diameter. 相似文献100.
Neuromonitoring and video-assisted thyroidectomy: a prospective, randomized case-control evaluation 总被引:1,自引:0,他引:1
Introduction This study evaluates the role of intraoperative neuromonitoring (IONM) in video-assisted thyroidectomy (VAT) with emphasis
given to the identification of recurrent laryngeal nerve (RLN) and external branch of superior laryngeal nerve (EBSLN).
Methods The study was based on a prospectively randomized series comprising 72 standard VAT gasless approaches. In the control group
(N = 36), the laryngeal nerves were identified by 30° 5-mm endoscope magnification solely. The standard technique of the IONM
group (N = 36) consisted of localizing and monitoring EBSLN, both vagus and RLNs, before and after thyroid resection to prove nerve
integrity. Surgical outcomes were mean operative time, nerve representation, incision length, and morbidity.
Results All procedures were performed successfully. There were no instances of equipment malfunction or interference. No permanent
complications occurred in either group. The incidences of temporary RLN injury were 2.7% (1 patient) and 8.3% (3 patients)
in the IONM and control group, respectively. The EBSLN was identified better in the IONM group: 83.6% versus 42% (p < 0.05). In the IONM group, a negative electromyography (EMG) response indicated an altered function of RLN and stage thyroidectomy
was scheduled.
Conclusions This is the first VAT series with a standardized IONM technique. The technical feasibility and safety of IONM in selected
patients seem acceptable. Neuromonitoring during VAT is effective in providing identification and function of laryngeal nerves.
IONM enables surgeons to feel more comfortable with their approach to VAT. A reduction of rates for postoperative complications
could not be demonstrated in the present study. Larger series are needed for further evaluation. 相似文献