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Douglas Holdstock MSc MD FRCP 《Medicine, conflict, and survival》2013,29(1):43-50
The distinguished surgeon Wilfred Trotter (1872–1939), in his book Instincts of the Herd in Peace and War, can be regarded as a pioneer of biosociology and its application to the phenomenon of war. In this paper some of Trotter's ideas are discussed and their relevance to the problems of the present day are considered. 相似文献
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Until recently, axillary node clearance had long been the standard of care in patients with axillary node-positive disease. One stop nucleic acid sampling (OSNA) has been used to guide intraoperative decision-making regarding suitability for axillary node clearance (ANC). The aim of this study is to evaluate the use of OSNA following neoadjuvant chemotherapy (NACT) and whether it can predict lymph node burden in ANC. A single center, prospective cohort study was performed on 297 patients having OSNA between 2016 and 2019. Patients were sub-classified according to node positivity at diagnosis and those treated with NACT and outcomes included copy number and lymph node harvest. Axillary complete pathological response was observed in 24/36 patients (67%) following NACT. 14/16 patients (87%) having axillary node clearance had axillary node disease limited to 4 nodes. OSNA copy numbers were significantly higher in patients showing disease progression following NACT. Overall, 73% of patients with lymph node positivity at diagnosis could be successfully treated with a combination of NACT and lymph node excision of four nodes. De-escalating axillary surgical treatment to resection of four nodes following NACT may be effective in balancing oncological resection and limiting treatment morbidity. ONSA can correctly identify patients experiencing disease progression who would benefit from traditional three-level ANC. 相似文献
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Al-Bahry SN Al-Mashani BM Al-Ansari AS Elshafie AE Mahmoud IY 《Asian Pacific journal of tropical medicine》2013,6(9):718-722
ObjectiveTo screen for Escherichia coli (E. coli) resistant to tetracycline, followed by identification of tet efflux genes by polymerase chain reaction (PCR). In addition, detection of tetracycline residues in chicken livers and kidneys were conducted using high performance liquid chromatography-tandem quadrupole mass spectrometry (HPLC-MS-MS).MethodsStrains of E. coli were isolated from samples of chicken colon and screened for tetracycline resistance. Tetracycline genes conferring resistance (Tcr) were detected by polymerase chain reaction (PCR). Most of the isolates were resistant to tetracycline (97.9%).ResultsPCR analysis indicated that Tcr E. coli R-plasmids contained tet(A), tet(B) and a combination of both efflux genes. None of the isolates contained other efflux tet genes tet (C, D, E and Y). High performance liquid chromatography-tandem quadrupole mass spectrometry (HPLC-MS-MS), a sensitive technique, was used to detect residues of chlortetracycline (CTC), oxytetracycline (OTC), doxycycline (DC) in chicken livers and kidneys. The samples containing tetracycline residues were at 0.13-0.65 pg/μL levels.ConclusionsTetracycline and other antibiotics are commonly used in the poultry and meat production industry for prevention of microbial infections. Multiple antibiotic resistant bacteria in Oman have increased to alarming levels, threatening public health, domestic and may have adverse effect on environment. 相似文献
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Böhme J Wenz H Al-Zghloul M A Alonso Groden C Förster A 《Journal of neuroradiology. Journal de neuroradiologie》2019,46(1):3-8
Purpose
Aim of this study was to evaluate the collateral blood flow between more distal branches of the middle cerebral artery (MCA) in the case of peripheral MCA branch occlusion on dynamic 4D angiograms. We sought to individually predict the finally resulting infarction volume with regard to the extent of collateral blood flow.Methods
Overall, 35 acute ischemic stroke patients with peripheral MCA branch occlusion were included. Volumes of the ischemic infarctions and perfusion deficits were measured on diffusion-weighted images DWI and time-to-peak TTP (>?4?s). Collateral flow on 4D MR angiograms were classified as previously specified.Results
On DWI, the ischemic lesions had a mean volume of 3.4?±?15.1?mL while the mean volume on TTP (>?4?s) was significantly larger 22.0?±?18.1?mL (P?<?0.001). On dynamic 4D angiograms we observed grade 1 in 8 (22.9%), grade 2 in 4 (11.4%), grade 3 in 10 (28.6%), and grade 4 in 13 (37.1%) patients. In comparison to patients with better collateralization (grade 3–4) patients with less sufficient collateralization (grade 0–2) demonstrated larger infarction volumes on initial (11.1?mL (IQR 2.9–35.5) vs. 2.1?mL (IQR 0.5–4.5), P?=?0.03) and follow-up DWI (15.5?mL (IQR 12.6–23.3) vs. 1.9?mL (IQR 0.5–4.5), P?=?0.03) with prominent infarction growth (7.4?mL (IQR 2.6–10.1) vs. 0.9?mL (IQR 0.2–2.6), P?=?0.08).Conclusions
In the majority of cases with distal MCA branch occlusion a good collateral blood flow has been observed. Nevertheless, in approximately one quarter of patients an insufficient collateral blood flow has been detected that was associated with substantial infarction growth. 相似文献68.
Wearable monitors for patients following discharge from an intensive care unit: practical lessons learnt from an observational study 下载免费PDF全文
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