Triple simultaneous primary gynecological malignancies in a 56-year-old patient

The occurrence of double simultaneous primary cancers is common. However, the occurrence of synchronous primary triple gynecological malignancies is an extremely rare event. In this report, the clinical and pathologic findings of a 56-year-old female patient with synchronous triple primary gynecological cancers including well-differentiated ovarian mucinous cystadenocarcinoma, well-differentiated endometrial endometrioid adenocarcinoma, and uterine leiomyosarcoma were presented. Synchronous primary, well-differentiated endometrial endometrioid adenocarcinoma and leiomyosarcoma of uterus without any ovarian neoplasm has only been once described in the English literature. To our knowledge, the presented patient is the first case in aspect of accompanying ovarian mucinous adenocarcinoma to endometrial endometrioid adenocarcinoma and leiomyosarcoma of uterus.     

Surveillance of HIV and syphilis infections among antenatal clinic attendees in Tanzania-2003/2004

Background

SPARCLE is a nine-centre European epidemiological research study examining the relationship of participation and quality of life to impairment and environment (physical, social and attitudinal) in 8–12 year old children with cerebral palsy. Concepts are adopted from the International Classification of Functioning, Disability and Health which bridges the medical and social models of disability.

Methods/Design

A cross sectional study of children with cerebral palsy sampled from total population databases in 9 European regions. Children were visited by research associates in each country who had been trained together. The main instruments used were KIDSCREEN, Life-H, Strength and Difficulties Questionnaire, Parenting Stress Index. A measure of environment was developed within the study. All instruments were translated according to international guidelines. The potential for bias due to non response and missing data will be examined. After initial analysis using multivariate regression of how the data captured by each instrument relate to impairment and socio-economic characteristics, relationships between the latent traits captured by the instruments will then be analysed using structural equation modelling.

Discussion

This study is original in its methods by directly engaging children themselves, ensuring those with learning or communication difficulty are not excluded, and by studying in quantitative terms the crucial outcomes of participation and quality of life. Specification and publication of this protocol prior to analysis, which is not common in epidemiology but well established for randomised controlled trials and systematic reviews, should avoid the pitfalls of data dredging and post hoc analyses.     

女性青少年的安全套使用情况、性行为以及患性传播性疾病与生殖器人乳头状瘤病毒感染持续时间的关系

目的:调查女性青少年中潜在的可改变因素如安全套使用、性行为和并发的性传播性疾病与生殖器人乳头状瘤病毒(H PV)感染持续时间的关系。设计:纵向观察研究。机构:在印第安纳州的印第安纳波利斯的3所诊所进行的研究。入选者:49名H PV阳性青少年对H PV感染进行经常性测试并提供性行为日记。主要调查内容:安全套使用情况、性行为、性伴侣人数和伴发的淋病奈瑟菌、沙眼衣原体和阴道毛滴虫感染。主要观察指标:对特定类型H PV感染从发生到清除的时间应用比例风险模型进行分析,应用校正后的危险比(AH Rs)来评价危险因素对H PV感染时程的影…     

Neutrophil chemotaxis in acutely infected and clinically stable cystic fibrosis patients*

Abstract Purpose : The aim of the present study was to evaluate the role of neutrophil chemotaxis in cystic fibrosis (CF) and to also determine whether an acute bacterial infection and the nutritional status of a child can affect neutrophil chemotaxis.
Methods : Twelve acutely infected and 12 clinically stable CF patients and 10 healthy age-matched controls were studied. Neutrophil chemotaxis and random migration were investigated in vitro in the peripheral blood of subjects by the Boyden chamber method and the results were expressed as chemotactic index (CI). The nutritional status of the cases was evaluated as body mass index (BMI).
Results : The CI values in the acutely infected group were found to be significantly lower than the clinically stable and healthy control groups ( P <0.05 and P <0.005, respectively). There was no significant difference between the clinically stable CF group and the healthy control group ( P >0.1). No significant correlation was detected between the CI and BMI of the two groups of CF patients ( P >0.05).
Conclusions : The present study confirms that neutrophil chemotaxis and random migration are normal in clinically stable CF patients. The decreased CI in the acutely infected patients indicates the possible role of infection itself on neutrophil chemotaxis.     

规范应用颈腰椎脊柱融合术

<正>脊柱融合术是以病椎为中心,从上位到下位正常脊椎间行植骨术,使病椎与周围节段形成骨性融合成为力学整体的手术,是和神经减压、内植物固定并列的三大必不可少的脊柱外科技术。从1911年Hibbs和Albee介绍脊柱融合术起,经过100多年发展,随着手术理念的改进和移植物、手术器械的更新,脊柱融合术的术式推陈出新,并广泛用于治疗各种脊柱疾病。国内各大医院都开展了该项技术,甚至不少并未真正掌握该技术的基层医院     

后腹腔镜肾输尿管全切加腹膜后肾周区域淋巴结清扫与开放手术治疗UUT-TCC疗效比较

目的:探讨后腹腔镜技术与开放手术治疗上尿路移行细胞癌(upper urinary tract transitional cell carcinoma,UUT-TCC)的效果及优势。方法:回顾性分析2009年11月~2012年12月间,我院采用后腹腔镜下肾输尿管根治性切除术加腹膜后肾周区域淋巴结清扫术治疗肾盂输尿管癌患者23例(腹腔镜组),并与同期14例行传统开放性肾输尿管切除术患者(开放术组)的手术时间、出血量、肿瘤学预后等指标进行比较。结果:腹腔镜组患者经术后病理检查,肾盂癌24例,输尿管癌10例,输尿管癌伴膀胱癌3例,其中腹腔镜组和开放组淋巴结转移各1例。同时研究发现:①腹腔镜组与开放术组比较,手术时间缩短,出血量明显减少,术后肠胃功能恢复快,术后住院时间短,差异有统计学意义(P0.05);②两种术式肿瘤学预后在远处转移方面,腹腔镜组更少,差异有统计学意义(P0.05)。结论:后腹腔镜下肾输尿管全长切除加经尿道膀胱袖状切除并腹膜后肾周区域淋巴结清扫治疗UUT-TCC具有创伤小、痛苦少、术后恢复快等优点,可能有更好的肿瘤学预后。     

回肠代膀胱扩大术治疗氯胺酮导致膀胱挛缩患者围手术期的护理

目的探讨回肠代膀胱扩大术治疗氯胺酮导致膀胱挛缩患者围手术期的护理要点。方法选取行回肠代膀胱扩大术治疗的因服用氯胺酮导致膀胱挛缩的患者6例,从术前、术后、并发症的处理及出院指导4个方面总结该类患者的护理要点。结果患者均手术顺利,肝肾功能恢复正常,经过精心护理,患者均治愈出院,临床疗效满意。结论回肠代膀胱扩大术是治疗氯胺酮导致膀胱挛缩的有效手段,精心的护理是患者手术成功及术后恢复的必要手段。     

Aetiology and outcome of acute renal failure secondary to war related trauma and infectious disease in Croatia

Summary: The aim of our study was to explore the aetiology and the outcome of acute renal failure (ARF) during the war in Croatia. of the 2132 patients admitted to our hospital between April 1990 and November 1992 due to war related trauma, 11 (0.5%) developed ARF. We believe that the development of ARF in these patients was secondary to an overwhelming septic process. Most of our patients suffered from multiple organ failure. of the 11 patients suffering from ARF due to war related trauma only four recovered (63.6% had died). We attribute the lethal outcome to the progression of the septic process. Patients who developed ARF due to infectious diseases unrelated to trauma had a different prognosis. Acute renal failure caused by the Hantan virus ran a benign course, in both its oliguric and non-oliguric form. Patients who developed ARF as a complication of leptospirosis also had a good prognosis. Although ARF is usually of a multifactorial genesis, our study aimed to emphasize the importance of disseminated septic processes as a cause of ARF.