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41.
The main goal of the present work was to longitudinally examine consequences of long‐term moderately elevated levels of stress for various health outcomes. To address this issue, data covering 10 years was used from the ongoing Swedish population‐based prospective Betula Study. Based on the ratings on a validated self‐reported stress scale, matched subsamples between 40 and 65 years of age were divided into a high (n = 137) and low (n = 211) stress group. The reported incidence of cardiovascular, diabetes, psychiatric, tumour and musculoskeletal diseases was assessed 5 and 10 years after baseline (baseline = 1993–1995) without contaminating effects of past health history. The incidence of diseases 5 years after baseline assessment showed no differences between the groups. After 10 years, there was a significantly higher incidence of psychiatric diseases, mainly depression in the high‐stress group as well as a significant effect for tumours, although the number of cases was low. Although moderately elevated stress level may have a possible impact on psychiatric diseases especially depression and some tumours, it seems that prolonged moderate stress does not appear to be harmful to other stress‐related diseases. Copyright © 2007 John Wiley & Sons, Ltd. 相似文献
42.
Jürgen Treckmann Andreas Paul Georgios C. Sotiropoulos Hauke Lang Arzu Özcelik Fuat Saner Christoph E. Broelsch 《Journal of gastrointestinal surgery》2008,12(2):313-318
Introduction Delayed massive hemorrhage induced by pancreatic fistula after pancreaticoduodenectomy is a rare but life-threatening complication.
The purpose of this study was to analyze the clinical course of patients with late hemorrhage, with or without sentinel bleeding,
to better define treatment options in the future.
Material and Methods From April 1998 to December 2006, 189 pancreaticoduodenectomies were performed. Eleven patients, including two patients referred
from other hospitals, were treated with delayed massive hemorrhage occurring 5 days or more after pancreaticoduodenectomy.
Sentinel bleeding was defined as minor blood loss via surgical drains or the gastrointestinal tract with an asymptomatic interval
until development of hemorrhagic shock. The clinical data of patients with bleeding episodes were analyzed retrospectively.
Results Eight of the 11 patients had sentinel bleeding, and seven of them had it at least 6 h before acute deterioration. Seven out
of 11 patients died, five out of eight with sentinel bleeding. No differences could be detected between patients with or without
sentinel bleeding before delayed massive hemorrhage. The only difference found was that non-surviving patients were significantly
older than surviving patients. Delayed massive hemorrhage is a common cause of death after pancreaticoduodenostomy complicated
by pancreatic fistula formation. The observation of sentinel bleeding should lead to emergency angiography and dependent from
the result to emergency relaparotomy to increase the likelihood of survival. 相似文献
43.
Mahmut Koç Ömer Yoldaş Yusuf Alper Kılıç Erdal Göçmen Tamer Ertan Hayrettin Dizen Mesut Tez 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》2007,392(5):581-585
Background and aims The aim of this study is to evaluate the predictive accuracy of different scoring systems on surgery for perforated peptic
ulcer referred to an academic department of general surgery in a tertiary reference center.
Patients and methods Seventy-five consecutive patients (Male/female ratio = 64:11; mean age, 44 years; range, 16–85) with perforated peptic ulcer
disease were investigated. Disease severity scores and mortality predictions were calculated using the collected data during
admission. Discrimination and calibration characteristics of each system, namely, the acute physiology and chronic health
evaluation II and III, the simplified acute physiology score II, and the mortality probability models (MPM) II, were determined
by using the area under receiver operating characteristics curve and the Hosmer–Lemeshow goodness-of-fit test, respectively.
Results Among the 75 patients included, there were eight (10.6%) mortalities. All systems had a reliable power of discrimination and
calibration. Among the systems tested, MPM II was the best performing as far as discrimination and calibration characteristics
were considered. The parameters of MPM II system that were related to systemic perfusion of the patient were significantly
positive in patients who died compared to those who survived.
Conclusions MPM II that predicted mortality at admission is better than the other systems in predicting mortality. Results also indicate
the importance of maintenance of systemic perfusion of the patient at the early phases of peptic ulcer perforation. 相似文献
44.
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47.
Detection of foot-and-mouth disease virus-infected cattle by assessment of antibody response in oropharyngeal fluids. 总被引:2,自引:0,他引:2
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The detection of foot-and-mouth disease virus (FMDV)-persistent carriers among convalescent ruminants is of paramount importance in the aftermath of a field outbreak. To this purpose, FMDV-specific antibody should be investigated first, since virus isolation procedures from such carriers are seriously constrained. The complexity of the overall picture may be compounded by possible emergency vaccinations in the affected areas at the beginning of the outbreak. In this case, it is suggested that mucosal rather than serum antibody be investigated. In fact, we showed that FMDV-infected cattle regularly mount an antibody response in oropharyngeal fluids, in contrast to vaccinated cattle. Antibody could be revealed by neutralization assays and/or an immunoglobulin A (IgA)-specific kinetic enzyme-linked immunosorbent assay (ELISA). Cattle vaccinated once seldom showed a mucosal antibody response, which could be only detected by a total immunoglobulin-specific kinetic ELISA. Very few, if any, cattle showed a mucosal IgA response after repeated vaccinations. Our kinetic, IgA-specific ELISA generally allowed an early detection of FMDV-infected cattle; in particular, it proved to be more sensitive than the usual indirect, antigen-trapping ELISA in experiments on saliva samples. 相似文献
48.
Kemal Gündüz Nazmİ Zengİn Süleyman Okudan Mehmet Okka Nİlgün Özbayrak 《Documenta ophthalmologica. Advances in ophthalmology》1995,91(2):155-164
We recorded pattern electroretinograms and visual evoked potentials in a group of selected patients with unilateral uncomplicated branch retinal vein occlusion. To document the effects of preexisting risk factors, patients were divided into three groups: diabetes mellitus, hypertension with hyperlipidemia and no systemic disease. The transient and steady-state pattern electroretinogram and visual evoked potential amplitudes were significantly reduced and visual evoked potential peak times were delayed relative to the fellow eyes and agematched normal subjects. There was a second amplitude reduction relative to the other patient groups in both the affected and fellow eyes of the diabetes mellitus group, which was indicative of an additive effect of diabetes mellitus.Abbreviations BRVO
branch retinal vein occlusion 相似文献
49.
Zusammenfassung In diesem Reviewartikel wird die sozial- und verhaltenswissenschaftliche Interventionsliteratur der letzten 20 Jahre im
deutschsprachigen Raum kritisch resümiert. Es werden nur kontrollierte Studien mit ad?quater Erhebungsmethodologie berücksichtigt.
Was Interventionen im kognitiven Bereich betrifft, so belegen die Arbeiten deutlich positive Trainingseffekte. Allerdings
zeigen Studien auch die Grenzen der kognitiven Plastizit?t in deutlicher Weise auf. Anhand eines weiten Bündels von Studien
zeigt sich die Potenz von Interventionen zur Bewahrung bzw. Wiedererlangung der Selbst?ndigkeit im Alltag, zur Erh?hung der
sozialen Aktivit?t und des subjektiven Wohlbefindens. Ebenso finden sich positive Effekte im Bereich des Selbstkonzepts, der
personalen Kontrolle und des Attributionsstils. Eine allgemeine Diskussion dieser Befunde mündet in Vorschl?ge für zukünftige
Forschungspriorit?en.
Eingegangen: 10. November 1997, Akzeptiert: 22. Januar 1998 相似文献
50.
Iatrogenic injuries to ureter, bladder and urethra during abdominal and pelvic operations 总被引:1,自引:0,他引:1
Ö Polat O. Gül Y. Aksoy I. Özbey A. Demirel Y. Bayraktar 《International urology and nephrology》1997,29(1):13-18
Abdominal and pelvic operations at Departments of Obstetrics and Gynaecology, and General Surgery play an important role in
ureteral, bladder and rarely urethral injuries.
Fifty-nine patients with iatrogenic ureteral, bladder and urethral injuries were treated at the Department of Urology, Atatürk
University Research Hospital, between 1985 and 1995. These injuries were urinary vaginal fistulas in 43 patients (vesicovaginal
33, ureterovaginal 7, urethrovaginal 2 and vesicovaginal plus urethrovaginal 1), ureteric ligation in 9, bladder laceration
in 7. These injuries were treated by different methods. All patients were followed up by intravenous urography (IVU) and urine
culture three months later.
It must be borne in mind that iatrogenic urinary tract injuries are not rare. Bladder and ureteral catheterization must be
performed to prevent these complications. 相似文献