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991.
992.
Kalapatapu VR Murray BW Palm-Cruz K Ali AT Moursi MM Eidt JF 《Vascular and endovascular surgery》2009,43(1):46-50
The diagnosis of median arcuate ligament (MAL) syndrome and its correlation with symptoms has been controversial since the disease entity was described. The authors describe a technique that will identify patients who will benefit from intervention. Eight patients with isolated celiac artery compression from MAL were identified by the authors. Their technique involved selective cannulation of the superior mesenteric artery (SMA) and injection of a vasodilator during angiography. Symptom reproduction and loss of collateral filling of the celiac territory represented a positive test: 4 of the 8 patients had a positive test and underwent successful surgical treatment of the condition; 3 of them remained asymptomatic at follow-up; 1 patient continues to have mild abdominal discomfort. Of the 4 patients with a negative test, 2 were found to have other conditions causing their symptoms. Vasodilator injection into the SMA is a useful diagnostic test to identify patients with symptomatic MAL syndrome. 相似文献
993.
Coping With a Diagnosis of Breast Cancer-Literature Review and Implications for Developing Countries
Mohammed Al-Azri MD MRCGP MMedSc PhD Huda Al-Awisi BSc MSc Mansour Al-Moundhri BSc MRCPUK FRACP MD 《The breast journal》2009,15(6):615-622
Abstract: Breast cancer is the most common cancer affecting women worldwide. Women are at an increased risk of developing both physical and psychological morbidity after diagnosis; however, many use different strategies to cope with the disease. The aim of this article is to review the available literature on the impact of breast cancer diagnoses and the strategies used by women to cope with this disease. The implications of these emerging findings are extrapolated within the context of health services provided in developing countries. Electronic databases were used to search the relevant literature. The findings showed that women who were diagnosed with breast cancer are at risk of developing several psychological morbidities such as depression, anxiety, fatigue, negative thoughts, suicidal thoughts, fear of dying, sense of aloneness, sexual and body images problems, as well as an overall decrease in the quality of life. Several strategies are used by women with breast cancer to cope with the disease, including positive cognitive restructuring, wishful thinking, emotional expression, disease acceptance, increased religious practice, family and social support, and yoga and exercise. Breast cancer diagnoses have been associated with several devastating psychological consequences; however, many women have used different coping strategies to adjust their lives accordingly. Healthcare professionals in developing countries, who work with women with breast cancer, should be aware of the different coping mechanisms that women use when diagnosed with cancer. Integrating a coping strategy into the treatment regimen would constitute an important milestone in the palliative care of patients with breast cancer. 相似文献
994.
Shabir Ahmed Dhar Murtaza Fazal Ali Tahir Ahmed Dar Asif Sultan Mohammed Farooq Butt Altaf Ahmed Kawoosa Mohammed Ramzan Mir 《Journal of children's orthopaedics》2009,3(6):473-477
Purpose
To determine the impact of a substantial delay in providing surgical treatment on the final outcome in transcervical femoral neck fractures in children. 相似文献995.
Florescu DF Iwen PC Hill LA Dumitru I Quader MA Kalil AC Freifeld AG 《Clinical transplantation》2009,23(1):116-120
Abstract: This report describes the first case of cerebral aspergillosis in a heart transplantation patient caused by Aspergillus ustus and reviews 15 previously reported cases of invasive aspergillosis in immunocompromised hosts caused by this mold. The utility of molecular analysis for the identification of unusual fungal pathogens is also described. The refractory nature of A. ustus to treatment is similar to other Aspergillus species and treatment options are reviewed. 相似文献
996.
Sulieman Haddadin M.D. Aldo D. Milano M.D. Ph.D. Giuseppe Faggian M.D. Mohammed Morjan M.D. Fabio Patelli M.D. Giorgio Golia M.D. † Pierluigi Franchi M.D. ‡ Alessandro Mazzucco M.D. 《Journal of cardiac surgery》2009,24(6):624-631
Abstract Background: Left ventricular free wall rupture (LVFWR) is still one of the often fatal complications of acute myocardial infarction. Surgical repair is mandatory even with high operative mortality. The optimal surgical technique is controversial since the results depend on type of rupture. We present our mid‐term surgical experience according to the status of the left ventricular tear and type of surgical repair. Methods: From January 1997 to December 2007, 19 consecutive patients with LVFWR were treated at our institution. The mean age was 72 ± 8 ranging from 53 to 81 years; there were eight males and 11 females. According to the intraoperative findings, patients were divided into two groups: group 1 (eight patients), where no macroscopic tear of the LVFW could be detected with blood oozing from infarcted zone (Oozing type LVFWR); and group 2 (11 patients), where a macroscopic defect of the epicardium, with free communication between left ventricular cavity and pericardial space, was identified (Blow‐out type LVFWR). The patch covering and glue technique was applied for group 1 patients, while closure of the ventricular tear either by direct suture or by patch repair was used for group 2 patients. Results: The interval between diagnosis of LVFWR and surgery was 2.9 ± 1.1 hours. However, reevaluation of echocardiographic studies showed an early missed diagnosis of LVFWR in three patients of group 1 and in eight of group 2. Thus, the mean interval between initial signs of rupture and surgery was 9 ± 8 hours and 21 ± 15 hours, respectively, for oozing and blow‐out type rupture. On arrival in the operating room, four patients were on cardiopulmonary resuscitation, while four were in cardiogenic shock. The hospital mortality was 12% (one death) in group 1 and 36% (four deaths) in group 2 mainly due to multiorgan failure. Fourteen patients were discharged with a mean follow‐up of 3.8 ± 3.5 years. During follow‐up, one patient in group 1 died after 7.5 years. No recurrence of free wall rupture or aneurysm formation was demonstrated in all cases. At last follow‐up, all survivors showed excellent clinical results with a preserved left ventricular function. Patients with oozing type LVFWR and patch covering technique repair showed an absence of left ventricular‐restricted motion at the echocardiographic study. Conclusion: In patients with LVFWR, early diagnosis and surgical treatment are crucial for successful outcome when excellent results can be achieved with a simple glued patch covering technique. 相似文献
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1000.
Jan MM 《Neurosciences (Riyadh, Saudi Arabia)》2009,14(1):3-9
Unsteady gait is a relatively common presentation to the pediatric emergency and neurology services. Unsteadiness can be due to a wide variety of causes, however, the primary concern on initial assessment is to exclude serious disorders such as meningitis, encephalitis, or brain tumors. Recognizing benign and non-neurological causes of unsteady gait is essential to avoid unnecessary investigations and hospital admission. In this review, a clinical approach to the unsteady child is presented with discussion of diagnostic considerations, approach to investigation, treatment, and prognosis. Ataxia can be cerebellar or sensory. Cerebellar ataxia can be acute, chronic, progressive, or episodic. It may result from trauma, infections, metabolic, degenerative disease, space occupying lesions, or congenital anomalies. Sensory ataxia is due to peripheral neuropathy involving large myelinated fibers that carry vibration and position sense, or due to posterior spinal column dysfunction. Accurate assessment depends on detailed history, examination, and then formulation of a differential diagnosis list to guide laboratory investigations. 相似文献