Job Accommodations,Return to Work and Job Retention of People with Physical Disabilities: A Systematic Review

Journal of Occupational Rehabilitation - Purpose We aimed to identify job accommodations that help persons with physical disabilities maintain or return to work and explore the barriers and...     

Teaching Case Ciliated Renal Tubular Cells in Crescentic Glomerulonephritis

Numerous cilia were found in the proximal convoluted tubules from a case of crescentic glomerulonephritis. The cilia exhibited the 9 + 2 pattern of organization characteristic of motile cilia. Microvilli were scanty or absent in heavily ciliated cells. The significance of renal cilia is discussed.     

Optimization of uretero-intestinal anastomosis in urinary diversion: an experimental study in dogs

Summary A new antireflux uretero-ileal reimplantation technique suitable for use with bladder substitutes is presented. This procedure entails creation of a serouslined extramural tunnel. Following detubularization of the bowel segment, the adjacent flaps are approximated by continuous 4/0 non-absorbable sutures 1.5 cm from the cut edges. The ureters are laid in the trough thus fashioned. Button-holes are created in the bowel flaps and a mucosa-to-mucosa uretero-ileal anastomosis is carried out. The mucosal edges of the flaps are then approximated by one layer of continuous 4/0 (PGA) suture resulting in closure of this artificial tunnel. The feasibility and functional outcome of this technique were experimentally investigated in 8 dogs. Follow-up was carried out up to 30 weeks. Assessment by intravenous urography and ascending studies showed that the procedure is an efficient method of providing an unobstructed unidirectional flow of urine.     

Aneurysms complicating pulmonary autograft procedure for aortic valve replacement

Aneurysm formation in the left ventricular outflow tract related to the proximal end of the pulmonary autograft after the Ross procedure was present in 2 patients. Both occurred late after operation and were associated with prolapse of a leaflet of the autograft and significant regurgitation. Both were repaired with no immediate complications. There was no evidence of infection at time of operation. The probable mechanisms underlying this complication and the possibilities of avoiding it are discussed.     

Correlation between fungi isolated from burn wounds and burn care units

A comparison was made prospectively between fungal isolates from patients and burn care units. Aspergillus niger was the most frequent isolate in both patients and burn care units whereas Ulocladium was the commonest isolate in the control group. Aspergillus terreus, Penicillium and Zygomycetes, which were recovered from burned patients, were also found more frequently in the burn care units than in the control group (other areas in the hospital). These findings indicate a potential risk of fungal infection which can be acquired from the immediate surroundings of patients in burn care units. Periodical burn ward decontamination is therefore recommended.     

Allied studies on the effect of Rosmarinus officinalis L. on experimental hepatotoxicity and mutagenesis

The hepatoprotective and antimutagenic effects of the rosemary essential oil and the ethanolic extract were investigated using carbon tetrachloride and cyclophosphamide as hepatotoxic and mutagenic compounds, respectively. Our results revealed that i.g. administration of the rosemary ethanolic extract (0.15 g/100 g BW) to rats for 3 weeks produced the most pronounced hepatoprotective effect compared to silymarin (reference compound) due to the amelioration of most of the studied serum and liver parameters and confirmed by histopathological examination of the liver tissue. Pretreatment of mice for 7 days with the rosemary essential oil (1.1 mg/g BW) followed by i.p. injection with cyclophosphamide reduced significantly the induced mitodepression in the bone marrow cells of the animals. The potential hepatoprotective and antimutagenic activities of the rosemary ethanolic extract and essential oil, respectively, are attributed to the presence of a relatively high percentage of phenolic compounds with high antioxidant activity (according to our chemical studies).     

Prospective randomized study of transurethral vaporization resection of the prostate using the thick loop and standard transurethral prostatectomy

Objectives. Transurethral vaporization resection of the prostate (TUVRP) is a recent modification of the standard transurethral prostatectomy (TURP). The procedure uses one of the novel, thick resection loops coupled to augmented electrocutting energy. We evaluated the safety and efficacy of TUVRP in comparison with TURP.Methods. Sixty-eight patients with prostatic outflow obstruction were prospectively randomized between equal TUVRP and TURP treatment groups. Safety parameters evaluated included changes in serum hemoglobin, hematocrit, and sodium 1 and 24 hours after resection. Operative time, catheterization time, and incidence of complications were noted. Efficacy parameters included evaluation by the International Prostate Symptom Score and maximum flow rate.Results. Patients of both groups were balanced for the different baseline variables. One hour after TURP, patients had significantly lower levels of hemoglobin, hematocrit, and sodium (P = 0.03, 0.03, and 0.01, respectively). The prostate resection weight was similar in both groups; however, the difference in the mean operative time was significant (TUVRP group 42.4 minutes and TURP group 35.9 minutes, P = 0.02). The postoperative catheterization time was significantly shorter for the TUVRP group (23.1 ± 10.3 versus 36 ± 17.3 hours, P <0.0001). All patients were followed up for an average of 9 months. The International Prostate Symptom Score was 4 ± 3.4 and 5.6 ± 3.1 and the maximum flow rate was 19 ± 6.5 and 15.2 ± 10 mL/s for the TUVRP and TURP groups, respectively; these differences were statistically significant (P = 0.03 and 0.01, respectively). Complications included urethral strictures (6 patients) and delayed hemorrhage with clot retention (2 patients); no differences in the incidence of complications were noted between the two groups.Conclusions. The results of the present study have demonstrated that TUVRP is as safe and efficacious as TURP in the treatment of men with prostatic outflow obstruction. The shorter catheterization time observed after TUVRP may be clinically significant, considering the demand for lower morbidity profiles by patients. The longer operative time in TUVRP was related to the slower motion of the Wing electrode needed to add the advantages of electrovaporization.     

Combined sciatic-paravertebral nerve block vs. general anaesthesia for fractured hip of the elderly

Sixty elderly patients scheduled for surgical hip fracture repair were given the choice of either general isoflurane anaesthesia (n = 30) or a nerve stimulator guided combined sciatic-paravertebral nerve block (n = 30). The incidence of intraoperative hypotension and the need for postoperative admission to the intensive care unit/high dependency unit (ICU/HDU) within 48 hours postoperatively were recorded. No differences in patient characteristics, ASA class or concomitant disease status were detected between the two study groups. Both the incidence of intraoperative hypotension (0/30 vs. 11/30, p < 0.001) and the postoperative need for ICU/HDU admission (0/30 vs. 11/30, p < 0.001) was significantly reduced in patients treated with a combined sciatic-paravertebral nerve block compared to patient receiving general anaesthesia. The length of hospital stay was also found to be shorter for patient in the regional anaesthesia group [mean 6.7 days (SD 2.3) vs. 13.6 days (SD 6.1)]. The described technique appears to be an attractive alternative method to handle proximal fractures of the femur in the elderly, especially in a situation with limited ICU/HDU availability.     

伊朗传统医学治疗牙周疾病

目的:牙周疾病非常普遍,尽管有各种特定的治疗方法,但我们始终面临治疗方法有限的问题。考虑到世界组织十分关注传统医学在医疗服务中的发展和应用,我们在一直考察研究伊朗传统医学中药物对牙周疾病的治疗作用。方法:此项研究是一个对有关方面书籍的综合论述,伊朗传统医学内容是经过对重量级作者如Avicenna和Alzahrawy所著的有价值的书籍修订,收集了各医学院校馆藏图书和医药公司的有关信息编辑而成,因为在伊朗传统医学中牙周疾病分成不同目类,对有关药物的研究也被分成8个大组63个题目。(1)缓解牙龈肿胀药物(2)治疗牙龈恶化药物(3)治疗口疮腐烂药物(4)治疗牙龈肥大药物(5)利于伤口康复药物(6)利于牙龈加固的药物(7)阻止牙龈出血的药物(8)防止牙齿松动药物。结果结论:伊朗传统医学在准确的观察和实践的基础上来描述和治疗牙周疾病的。在制药学、有效治疗方面、科学研究手段等领域,伊朗传统医学在以下几个方面可作为现代制药研究的重要资源:(1)纯天然资源(2)容易获得(3)相对比较安全。