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91.
Dale W Stovall Andrea S Fernandez Stephen A Cohen 《JSLS, Journal of the Society of Laparoendoscopic Surgeons》2006,10(1):11-15
OBJECTIVES: To assess laparoscopic training curriculums in US Obstetrics and Gynecology residency programs. METHODS: A list of E-mail addresses was obtained for the accredited Obstetrics and Gynecology residency programs in the US from the CREOG Directory of Obstetric-Gynecologic Residency Programs and Directors. An E-mail survey containing 8 questions regarding laparoscopy training was sent to all residency directors with current E-mail addresses. RESULTS: Seventy-four residency directors responded to the survey for a response rate of 41%. Residency programs from all sections of the US were included in the study. Results of the survey indicate that 69% of residency programs had implemented a formal laparoscopy training program. At least half of the program directors surveyed stated that lack of faculty time and funds were the main barriers to laparoscopic surgery training. Seventy-two percent of those surveyed thought that in the future the health-care industry would demand proof of competency in laparoscopy as standard of care. CONCLUSIONS: Most US Obstetrics and Gynecology residency programs have implemented a formal laparoscopy training curriculum, use more than one method to train their residents, and involve almost half of their faculty on average in training residents to perform laparoscopic surgery. 相似文献
92.
Giovanni Battista Grossi Carlo Maiorana Rocco Alberto Garramone Andrea Borgonovo Luca Creminelli Franco Santoro 《Journal of oral and maxillofacial surgery》2007,65(5):901-917
PURPOSE: The purpose of this study was to identify the risk factors for severe discomfort after mandibular third molar surgery and to assess the validity of the Postoperative Symptom Severity (PoSSe) scale. PATIENTS AND METHODS: In a 2-year prospective study, a total of 255 unilateral impacted mandibular third molar teeth were surgically removed under local anesthesia by 3 surgeons. Standardized surgical and analgesic protocols were followed. At the review appointment, 1 week after surgery, all patients returned a completed follow-up questionnaire (PoSSe scale) and were evaluated clinically for postoperative pain (number of painkillers taken) and trismus (differences in mouth opening). Sixteen predictive variables were evaluated using stepwise logistic regression analysis to identify the risk factors associated with severe discomfort. RESULTS: Severe postoperative discomfort was predicted by these independent variables: gender, tobacco use, ramus relationship/space available, and antibiotic prophylaxis. Oral contraceptive use and operation time were not identified as risk factors. The patients' perceptions of the severity of symptoms (PoSSe scale score) was strongly correlated with clinical assessment of trismus (r = 0.54) and pain (r = 0.42). CONCLUSION: The PoSSe scale resulted in a valid and responsive measure of the severity of symptoms after surgical extraction of lower third molars and reflected the clinical severity of the postoperative discomfort. From a patient's perspective, operative factors had little bearing on the quality of life after removal of mandibular third molars. 相似文献
93.
Paola Sarchielli Andrea Alberti Beatrice Gallai Francesca Coppola Antonio Baldi Ardesio Floridi Virgilio Gallai 《The journal of headache and pain》2002,3(3):129-135
Little has been done to investigate the biochemical basis of chronic daily headache (CDH). Our group has recently demonstrated
an increase in the cerebrospinal fluid (CSF) levels of nerve growth factor (NGF) in CDH patients, supporting the involvement
of this growth factor in the abnormal processing of head pain in this pathological condition. Other members of the neurotrophin
family, especially brain-derived neurotrophic factor (BDNF), have been hypothesized as being involved in the development of
chronic head pain in patients affected by CDH, but so far no data are available on this subject. BDNF, NGF and glutamate levels
were determined in the CSF of 25 patients affected by CDH with a previous history of migraine. These levels were compared
with those of a group of 20 control subjects, for whom the CSF examination and other instrumental investigations excluded
diseases of the central and peripheral nervous systems. Significantly higher levels of BDNF, NGF and glutamate were found
in CDH patients compared with control subjects (p<0.0001, p<0.0002 and p<0.001, respectively). A significant positive correlation emerged between CSF values of BDNF and those of NGF (r=0.61, p<0.001) and glutamate (r=0.44, p<0.025) in CDH patients. No significant differences were detected in BDNF, NGF and glutamate levels between CDH patients with
analgesic overuse and those without. These results support the involvement of BDNF in CDH through the potentiation of glutamatergic
transmission involved in the processing of head pain. The significant correlation between BDNF and NGF levels suggests that
NGF-mediated up-regulation of BDNF in central sites involved in long-term sensitization plays a key role in persistent head
pain in CDH patients.
Correspondence to P. Sarchielli 相似文献
94.
95.
96.
BACKGROUND: Worldwide, fire-related burns are a major cause of unintentional injury, morbidity and mortality, with the majority of deaths occurring in developing countries. In the US, as in other countries, most fatal fires occur in the home. Effective prevention strategies for residential fires are, however, currently underutilized. The news media is one available communication channel to promote such strategies, and analyzing current news coverage is a first step towards incorporating media advocacy into injury prevention efforts related to residential fires. METHODS: Four daily newspapers circulating widely in Maryland were monitored for 1 year. Articles describing residential fires were coded for measures of prominence, content and frame. Analysis focused on measures of issue newsworthiness, reporting of causation and consequences of fires, and inclusion of public health context and conveyance of prevention messages. RESULTS: The data indicate that fires are newsworthy, with 374 relevant news articles in a 1-year period, 32% of which appear on the first page of a section. Coverage generally concerned recent local fire events. Most articles discussed the consequences of fires (88%), and identified a causal factor (58%). Only 36%, however, included prevention information, and less than one-quarter set residential fires in a public health context. CONCLUSION: The newsworthiness of residential fires provides a clear opportunity for widespread communication around injury prevention. Improving media advocacy will entail framing discussion of recent fire events in such a way as to support inclusion of prevention strategies and a public health context in news coverage. 相似文献
97.
Antonio Fea Andrea Grosso Marilena Rabbione Federico Grignolo 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2007,245(2):315-317
Background Optic disc anomalies are frequently associated with Alagille syndrome. We report here the first case of a patient with Alagille
syndrome combined with optic pit and serous macular detachment.
Methods A male patient with Alagille syndrome was referred from the pediatric hepatology department for investigation of visual loss
in the right eye. Anterior segment examination showed evidence of posterior embryotoxon, confirmed by gonioscopic evaluation.
Dilated fundus examination revealed serous macular detachment and optic pit.
Results OCT 3 scans confirmed the clinical findings.
Conclusions Optic pit is uncommon and should prompt a search for genetic disorders or development abnormalities. The association between
the two syndromes in this patient might be due to failure of correct neuroectodermal development, for which a common genetic
pathway is likely. 相似文献
98.
R. Grant Steen Wilburn E. Reddick Raymond K. Mulhern James W. Langston Robert J. Ogg Andrea A. Bieberich Peter B. Kingsley Winfred C. Wang 《Journal of magnetic resonance imaging : JMRI》1998,8(3):535-543
Conventional MRI (cMRI) has shown that brain abnormalities without clinical stroke can manifest in patients with sickle cell disease (SCD). We used quantitative MRI (qMRI) and psychometric testing to determine whether brain abnormalities can also be present in patients with SCD who appear normal on cMRI. Patients 4 years of age and older with no clinical evidence of stroke were stratified by cMRI as normal (n = 17) or abnormal (n = 13). Spin-lattice relaxation time (T1) of gray and white matter structures was measured by the precise and accurate inversion recovery (PAIR) qMRI method. Patient cognitive ability was assessed with a standard psychometric instrument (WISC-III or WISC-R). In all 30 patients with SCD, qMRI T1 was lower than in 24 age- and race-matched controls, in cortical gray matter (P < .0006) and caudate (P < .0009), as well as in the ratio of gray-to-white matter T1 (P < .008). In the 17 patients who were shown to be normal by cMRI, qMRI T1 was still lower than in controls, in both cortical gray matter (P < .02) and caudate (P < .004). Histograms of voxel T1 show that the proportion of voxels with T1 values intermediate between gray and white matter (ie, consistent with encephalomalacia) was 9% higher than controls in patients shown to be normal by cMRI (P < .05) and 15% higher than controls in patients shown to be abnormal by cMRI (P < .0005). The full scale intelligence quotient (FSIQ) of all patients with SCD was 75, compared to the FSIQ of 88 in a historical control group of patient siblings (P < .001). The FSIQ of patients shown to be normal by cMRI was 79, significantly lower than the FSIQ of patient siblings (P < .04). The FSIQ of 71 in patients shown to be abnormal by cMRI was significantly lower than both the patient siblings (P < .005) and the patients shown to be normal by cMRI (P < .04). Patients shown to be abnormal by cMRI scored lower than patients shown to be normal by cMRI, specifically on the subtests of vocabulary (P = .003) and information (P = .03). Cognitive impairment is thus significant, even in patients with SCD who were shown to be normal by cMRI, suggesting that cMRI may be insensitive to subtle neurologic damage that can be detected by qMRI. Because cognitive impairment can occur in children normal by cMRI, our findings imply that prophylactic therapy may be needed earlier in the course of SCD to mitigate neurologic damage. 相似文献
99.
Antonella d’Arminio Monforte Paola Cinque Luca Vago Aleandro Rocca Antonella Castagna Cristina Gervasoni Maria Rosa Terreni Roberto Novati Andrea Gori Adriano Lazzarin Mauro Moroni 《Journal of neurology》1996,244(1):35-39
Twenty patients with AIDS who had intracranial lesions underwent both brain biopsy and cerebro-spinal fluid (CSF) examination
to compare histological diagnosis with the polymerase chain reaction (CSF-PCR) for the identification of infectious agents.
CSF-PCR was performed for herpes simplex virus, varicella zoster virus, cytomegalovirus (CMV), JC virus (JCV), Epstein-Barr
virus (EBV), Toxoplasma gondii and Mycobacterium tuberculosis. A definitive diagnosis was obtained by brain biopsy in 14 patients (2 with astrocytoma, 12 with brain infection). CSF-PCR
was positive for EBV DNA in 3 of 3 cases of primary cerebral lymphoma, positive for JCV DNA in 6 of 7 biopsy-proven (and one
autopsy-proven) cases of progressive multifocal leukoencephalopathy (PML). CSF-PCR was positive for CMV DNA in one biopsy-proven
and one autopsy-proven case of CMV encephalitis (the former also had PML) and positive for M. tuberculosis DNA in one case of tuberculous encephalitis. None of the five toxoplasmic encephalitis cases (one definite, four presumptive)
were T. gondii DNA positive. There was close correlation between histology and CSF-PCR for CMV encephalitis, PML and PCL. Antitoxoplasma
therapy affected the sensitivity of both histological and CSF-PCR methods.
Received: 8 November 1995 Received in revised form: 9 July 1996 Accepted: 19 July 1996 相似文献
100.
The spatial and temporal pattern of expression of the protein products of immediate early genes (IEGs) c-fos, fos B, and egr-1 were mapped in medial preoptic area (MPOA) and ventral bed nucleus of stria terminalis (VBST) during maternal behavior in rats. Immunocytochemical analysis indicated significant increases in the number of cells expressing c-Fos after 2 h of pup exposure, while Fos B levels showed a delayed response, reaching maximal levels after 6 h. 相似文献