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61.
62.
Child maltreatment and the responsibility of heath care professionals to assist in prevention and diagnosis is currently center stage in the United Kingdom. This subject has a very large literature base. Anesthetists were one of the first groups to have specific guidance on this subject, and key competencies are now part of the core curriculum for our trainees. This article seeks to briefly define maltreatment and provide statistics that outline the scale of the problem, and includes discussion of risk factors and recognition. We have focused on physical abuse and have provided a separate section on abusive head trauma, which is of particular importance to anesthetists. We also discuss the process of management, with some detail around Child Death Review procedures. 相似文献
63.
64.
A microcapillary method utilizing phthalate esters or an ultracentrifuge method are both capable of separating autologous from homologous erythrocytes in polytransfused patients. The microcapillary technique which is readily adaptable to blood bank laboratories provides a previously unavailable method for defining blood group antigen typings in transfused patients. Such typings are of vital importance in the laboratory evaluation of transfused patients with multiple or weak blood group antibodies. 相似文献
65.
Total radical trapping antioxidant potential (TRAP) and exercise 总被引:1,自引:0,他引:1
Sharpe PC; Duly EB; MacAuley D; McCrum EE; Mulholland C; Stott G; Boreham CA; Kennedy G; Evans AE; Trinick TR 《QJM : monthly journal of the Association of Physicians》1996,89(3):223-228
The relationship between physical activity, physical fitness and total
radical trapping antioxidant potential (TRAP) was examined in the Northern
Ireland Health and Activity Survey. This was a cross-sectional population
study (n = 1600) using a two-stage probability sample of the population.
TRAP was calculated using the sum of the individual serum antioxidant
concentrations (urate, protein thiols, ascorbate, alpha tocopherol and
bilirubin) multiplied by their respective stoichiometric values. Physical
fitness was determined by estimation of VO2max by extrapolation from
submaximal oxygen uptake, and physical activity was recorded by
computer-assisted interview. Mean serum TRAP concentrations were
significantly higher in males (653 +/- 8.2 mumol/l, mean +/- SEM) compared
to females (564 +/- 8.0 mumol/l) (p < 0.0001). Both male and female
smokers had significantly lower TRAP values than non-smokers (males p <
0.0001, females p = 0.02). In females, there was a positive relationship of
TRAP with age (p < 0.001) and body mass index (p < 0.001) but a
negative relationship with physical fitness (p < 0.05). The known
beneficial effects of exercise and activity do not appear to be directly
mediated through increased antioxidant status.
相似文献
66.
HE Connor W Feniuk DT Beattie PC North AW Oxford DA Saynor PPA Humphrey 《Cephalalgia : an international journal of headache》1997,17(3):145-152
The biological profile of naratriptan (N-methyl-3-(1-methyl-4-piperidinyl)-1H-indole-5-ethane-sulphona-mide), a novel 5HT1B/1D receptor agonist, was investigated in a variety of experimental models of relevance to migraine. Naratriptan has high affinity for human recombinant 5HT1B and 5HT1D receptors (pKi = 8.70.03 and 8.30.1, respectively) and causes contractions of dog isolated basilar and middle cerebral artery (EC50 values of 0.11 and 0.07 M, respectively). Naratriptan causes small contractions of human isolated coronary arteries (EC50 value of 0.17 M; maximum contraction equivalent to 33% of 5HT maximum). In anaesthetized dogs, naratriptan causes selective vasoconstriction of the carotid arterial bed (CD50 dose = 193 g kg−1 ) and, in anaesthetized rats, naratriptan selectively inhibits neurogenic plasma protein extravasation in the dura (ID50 = 4.1 g kg−1 ). In a variety of antinociceptive tests, naratriptan has no effect even at high doses. In conscious rats and dogs, naratriptan has high oral bioavailability (71% and 95%, respectively). The data show that naratriptan is a selective agonist at 5HT1B/1D receptors, with a pharmacological profile very similar to that of sumatriptan, albeit 2-3 fold more potent. These observations, coupled with high oral bioavailability in animals, suggest that naratriptan has the profile of an orally effective anti-migraine drug. 相似文献
67.
Fradet Y Grossman HB Gomella L Lerner S Cookson M Albala D Droller MJ;PC B/ Study Group 《The Journal of urology》2007,178(1):68-73; discussion 73
PURPOSE: We compared hexaminolevulinate (Hexvix) fluorescence cystoscopy with white light cystoscopy for detecting carcinoma in situ. MATERIALS AND METHODS: In this multicenter study 298 patients with known or suspected bladder cancer underwent bladder instillation with 50 ml 8 mM hexaminolevulinate for 1 hour. Cystoscopy was then performed, first using standard white light and then hexaminolevulinate fluorescence cystoscopy. Lesions or suspicious areas identified under the 2 illumination conditions were mapped and biopsied for histological examination. In addition, 1 directed biopsy was obtained from an area appearing to be normal. RESULTS: Of 196 evaluable patients 29.6% (58 of 196) had carcinoma in situ, including 18 with carcinoma in situ alone, and 35 with carcinoma in situ and concomitant papillary disease, which was only detected on random biopsy in 5. Of the 18 patients with no concomitant papillary disease carcinoma in situ was detected only by hexaminolevulinate fluorescence in 4 and only by white light in 4. In the group with concomitant papillary disease carcinoma in situ was found only by hexaminolevulinate fluorescence in 5 patients and only by white light in 3. The proportion of patients in whom 1 or more carcinoma in situ lesions were found only by hexaminolevulinate cystoscopy was greater than the hypothesized 5% (p=0.0022). Overall more carcinoma in situ lesions were found by hexaminolevulinate than by white light cystoscopy in 22 of 58 patients (41.5%), while the converse occurred in 8 of 58 (15.1%). Biopsy results confirmed cystoscopy findings. Of a total of 113 carcinoma in situ lesions in 58 patients 104 (92%) were detected by hexaminolevulinate cystoscopy and 77 (68%) were detected by white light cystoscopy, while 5 were detected only on directed visually normal mucosal biopsy. Hexaminolevulinate instillation was well tolerated with no local or systemic side effects. CONCLUSIONS: In patients with bladder cancer hexaminolevulinate fluorescence cystoscopy with blue light can diagnose carcinoma in situ that may be missed with white light cystoscopy. Hexaminolevulinate fluorescence cystoscopy can be used in conjunction with white light cystoscopy to aid in the diagnosis of this form of bladder cancer. 相似文献
68.
SUMMARY.— Pasteurella pseudotuberculosis is a widely distributed coccobacillary infection of birds and animals. Infections in man may present as mesenteric adenitis, lymphadenopathy, upper respiratory infections or pharyngitis: a septicaemic form occurs.
Erythema nodosum has been reported, particularly in France, as a complication of such infections in children and young adult females.
In an epidemiological survey of erythema nodosum in one region of England, two cases of erythema nodosum were found in children in which evidence of infection by P. pseudotuberculosis was obtained by agglutination and intradermal antigen tests.
The diagnostic criteria are examined. A series of intradermal antigen tests and agglutination titres carried out on other patients with erythema nodosum and controls does not suggest that this infection is common in the area studied or is a frequent cause of erythema nodosum. But it is one that may easily be overlooked. 相似文献
Erythema nodosum has been reported, particularly in France, as a complication of such infections in children and young adult females.
In an epidemiological survey of erythema nodosum in one region of England, two cases of erythema nodosum were found in children in which evidence of infection by P. pseudotuberculosis was obtained by agglutination and intradermal antigen tests.
The diagnostic criteria are examined. A series of intradermal antigen tests and agglutination titres carried out on other patients with erythema nodosum and controls does not suggest that this infection is common in the area studied or is a frequent cause of erythema nodosum. But it is one that may easily be overlooked. 相似文献
69.
S.M. WILKINSON J.S.C. ENGLISH N.P. SMITH E. WILSON-JONES R.K. WINKELMANN 《Clinical and experimental dermatology》1992,17(2):87-93
Erythema elevatum diutinum is a syndrome of vasculitis in which lesions, typically over the extensor surfaces, showed a mixed inflammatory infiltrate on biopsy. We describe a series of 13 patients. The most common association in our series was with hypergammaglobulinemia; both mono and polyclonal. Chronic infection, not streptococcal, was a less frequent finding although two of three patients had a positive reaction to the intradermal injection of streptococcal antigen. Dapsone remains the initial treatment of choice. 相似文献
70.
Excessive dorsiflexion (dorsal tilting) of the lunate on a lateral wrist radiograph can be an important sign of carpal injury. Lunate dorsiflexion is a well-recognized sign of an intercarpal ligamentous injury pattern known as dorsal intercalated segment instability (DISI). It is less well recognized that excessive dorsal tilting of the lunate (DISI configuration) can also be produced by displacement of a scaphoid waist fracture. Since the management and prognosis of displaced scaphoid fractures may be quite different from those for nondisplaced fractures, radiologists can make an important contribution by recognizing dorsal tilting of the lunate and appreciating that it may be an important, indirect sign of scaphoid fracture displacement, which may not be directly visualized with standard wrist radiography. In this setting, computed tomography or complex motion tomography may be helpful for further evaluation of the scaphoid fracture. 相似文献