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11.
Roberto Manfredi Sergio Sabbatani Leonardo Calza 《The Brazilian journal of infectious diseases》2007,11(6):605-609
A patient with HIV infection developed the first episode of AIDS-defining opportunism (severe Candida albicans esophagitis) with an underlying CD4+ lymphocyte count of 1,025 cells/microL. After treatment with a highly active antiretroviral therapy (HAART), taken with insufficient compliance and leaving a residual viral load, our patient suffered from two relapses of esophageal candidiasis, which occurred three months and seven years later, when his CD4+ lymphocyte count was 930 and 439 cells/microL, respectively, and a viral load slightly above 10(4) copies/mL was still present. Also in the HAART era, Candida esophagitis remains one of the most common AIDS-defining diseases, but a presentation with a concurrent CD4+ count above 1,000 cells/microL remains a rare exception, as well as the two isolated, subsequent relapses, occurred with a CD4+ count ranging from 439 to 930 cells/microL, and a residual HIV viremia due to insufficient adherence to the prescribed HAART regimens. Our case report represents the opportunity to revisit the epidemiology and, especially, the pathogenesis of this opportunistic fungal complication in HIV-infected patients and in other subjects at risk, on the ground of an extensive literature review, and to explore possible alternative supporting factors other than the crude absolute CD4+ lymphocyte count, with emphasis on the possible role of a persisting HIV viremia, and other potential contributing factors. Clinicians engaged with immunocompromised patients and subjects with HIV disease, should be aware that a Candida esophagitis may occur and relapse also when the cell-mediated immunity, as measured by a simple CD4+ cell count, do not show relevant abnormalities. 相似文献
12.
13.
Osvaldo Chiara Stefania Cimbanassi Alessio Pitidis Sergio Vesconi 《World journal of emergency surgery : WJES》2006,1(1):12-7
Preventable trauma deaths are defined as deaths which could be avoided if optimal care has been delivered. Studies on preventable
trauma deaths have been accomplished initially with panel reviews of pre-hospital and hospital charts. However, several investigators
questioned the reliability and validity of this method because of low reproducibility of implicit judgments when they are
made by different experts. Nevertheless, number of studies were published all around the world and ultimately gained some
credibility, particularly in regions where comparisons were made before and after trauma system implementation with a resultant
fall in mortality. During the last decade of century the method of comparing observed survival with probability of survival
calculated from large trauma registries has obtained popularity. Preventable trauma deaths were identified as deaths occurred
notwithstanding a high calculated probability of survival. In recent years, preventable trauma deaths studies have been replaced
by population-based studies, which use databases representative of overall population, therefore with high epidemiologic value.
These databases contain readily available information which carry out the advantage of objectivity and large numbers. Nowadays,
population-based researches provide the strongest evidence regarding the effectiveness of trauma systems and trauma centers
on patient outcomes. 相似文献
14.
Sergio Barroilhet Adrián Cano-Prous Salvador Cervera-Enguix Maria João Forjaz Francisco Guillén-Grima 《Social psychiatry and psychiatric epidemiology》2009,44(12):1051-1065
Introduction
This paper presents the results of a study on the psychometric properties of an authorized Spanish version of the McMaster Family Assessment Device, a self-report measure of family functioning. 相似文献15.
16.
Carlos Alberto Herrero de Morais Norberti Bernardineli Roberto B Garcia Marco A H Duarte Danilo M Z Guerisoli 《Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics》2006,102(3):417-421
OBJECTIVE: The aim of this study was to evaluate the biocompatibility of Portland cement with the addition of iodoform, compared to MTA (ProRoot). STUDY DESIGN: Eighteen Wistar albino rats were divided into 3 groups of 6 animals each. Polyethylene tubes were filled either with freshly mixed MTA or Portland cement mixed with iodoform (20% wt/wt) and implanted subcutaneously. An empty tube served as control. After 7, 30, or 60 days, the implants together with the surrounding tissues were removed in blocks. Sections were evaluated for the presence and thickness of a fibrous capsule, presence of granulation tissue, and the severity of inflammatory response. Data were submitted to nonparametric statistical analysis with individual comparisons between groups at a significance level of P < 0.05. RESULTS: There were no differences between inflammatory responses at 7 and 30 days. After 60 days from surgical removal, there was significantly more tissue reaction to the MTA and Portland cement compared to the control group. CONCLUSION: There were no significant differences regarding inflammatory responses between MTA and Portland cement with iodoform after 7, 30, or 60 days. After 60 days, the fibrous capsule around the Portland cement appeared more organized than tissue surrounding MTA implants. After 60 days, there was still a significantly increased tissue reaction to the 2 cements compared to the empty polyethylene tubes. 相似文献
17.
目的评估十二指肠-空肠导管(Endoluminal Duodeno-Jejunal Tube,EDJT)在活体猪实验动物模型中减缓体重增加的可行性,及其在中短期生存中的安全性。方法本项研究共用8只45kg重的Yorkshire猪,其中3只置入180emEDJT,1只置入360cm EDJT,另4只猪作为对照组。切开十二指肠,将EDJT导管缝合固定在十二指肠近Vater壶腹起始处。结果评估全部猪的不适反应和体重,每日一次,共7周,未发现严重并发症发生。术后7周3组动物的平均体重变化百分率:对照组、180cm组和360cm组分别是22.5%,6%和-2.8%。EDJT组(180cm组、360cm组)体重增加明显减慢,与对照组相比,有统计学意义(P=0.05)。结论EDJT可以安全使用,无肠梗阻、肠套叠或胰腺炎等并发症发生。EDJT可明显减缓体重增加。 相似文献
18.
Giuseppe D'Ancona Giuseppe Mamone Gianluca Marrone Francesco Pirone Gianluca Santise Sergio Sciacca Michele Pilato 《European journal of cardio-thoracic surgery》2007,32(3):475-480
Ischemic mitral valve regurgitation (IMVR) refers to mitral regurgitation in patients with ischemic heart disease (IHD) in the presence of a structurally normal mitral valve. IMVR contributes significantly to morbidity and mortality in patients with IHD. The thresholds for clinical management, surgical intervention, and the choice of surgical procedure continue to evolve and independent determinants for surgical success in the pre- and post-operative evaluation of IMVR are still controversial. Although echocardiography has been valued as the gold standard in the evaluation of IMVR, new technologies such as magnetic resonance imaging (MRI) may be seen as applicable to the investigation of this complex pathology. MRI may allow for detection of parameters that could help clinicians and surgeons to better assess IMVR and eventually guide appropriate treatment whenever necessary. The present article discusses the main parameters that should be routinely investigated while adopting MRI technology to assess patients with IMVR. The review is the result of a multidisciplinary approach to this complex etiopathogenic entity and involves expertise spanning from radiology, cardiology, to cardiac surgery. 相似文献
19.
Factors affecting aseptic loosening of 4750 total hip arthroplasties: multivariate survival analysis
Barbara Bordini Susanna Stea Manuela De Clerico Sergio Strazzari Antonio Sasdelli Aldo Toni 《BMC musculoskeletal disorders》2007,8(1):69
Background
Total hip arthroplasty is a successful surgery, that fails at a rate of approximately 10% at ten years from surgery. Causes for failure are mainly aseptic loosening of one or both components partially due to wear of articular surfaces and partially to design. The present analysis aimed to identify risk factors and quantify their effects on aseptic failure. 相似文献20.
David Jiménez Castro Gema Díaz David Martí Carlos Escobar Javier Ortega Sergio García-Rull Joaquin Picher Antonio Sueiro 《Blood coagulation & fibrinolysis》2007,18(2):173-177
This study aimed to determine whether a weight-adjusted dose of subcutaneous enoxaparin is as effective and safe as oral acenocoumarol for the secondary prophylaxis of pulmonary embolism. Three hundred and eighty consecutive noncancer outpatients hospitalized with an episode of symptomatic pulmonary embolism selected treatment with acenocoumarol or enoxaparin at a dose of 1 mg/kg once daily after being informed of the type of administration and expected frequency of laboratory monitoring for both medicinal products. Endpoints were symptomatic recurrent thromboembolic events evaluated by standard objective testing, and a composite endpoint of recurrent venous thromboembolism, major bleeding, and death from any cause. One hundred and ninety-nine patients (52%) chose acenocoumarol therapy and 181 chose enoxaparin monotherapy. Four patients in the enoxaparin group (2.2%) and six patients in the acenocoumarol group (3%) had an objective thromboembolic recurrence (hazard ratio, 1.35; 95% confidence interval, 0.38-4.79; P = 0.64). Nine patients in the enoxaparin group (5.0%) had a hemorrhagic complication compared with 11 in the acenocoumarol group (5.5%) (P = 0.81). The hospital length of stay was shorter with enoxaparin compared with acenocoumarol (11 versus 16 days, P = 0.0001). Enoxaparin is as effective and safe as acenocoumarol in the secondary prevention of recurrent thromboembolic disease and is associated with shorter hospitalization. 相似文献