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101.
Isolated pure dislocations of the fifth carpo-metacarpal joint are extremely rare injuries. The dorsal form was described
in mere 12 cases. The diagnosis can be easily missed. The lesion is also often overlooked in the routine diagnostic X-ray.
Lateral and oblique views are important for the recognition of the true extent of the lesion. Treatment of these injures is
still controversial and both closed reduction with percutaneous pinning or open reduction with internal fixation are advocated.
The goal of treatment is early reduction and fixation of the metacarpal. Early diagnosis is the key to success. The aim of
this paper is to review literature and present two new cases. 相似文献
102.
R. I. Mustafin A. A. Protasova G. Van den Mooter V. A. Kemenova 《Pharmaceutical Chemistry Journal》2005,39(12):663-666
With a view to the development of new controlled drug delivery systems, the formation of an interpolyelectrolyte complex (IPEC)
between chitosan (CTS) and Eudragit L100 (L-100) has been studied. The structure of this IPEC is such that two maxima are
observed in the curves of IPEC swelling in the media with different pH values. The release of a model drug (ibuprofen) from
IPEC-based tablets is significantly retarded, and this delay can be controlled by changing the molecular weight of CTS in
the IPEC composition.
__________
Translated from Khimiko-Farmatsevticheskii Zhurnal, Vol. 39, No. 12, pp. 44–46, December, 2005. 相似文献
103.
Riccardo Torta Carlotta Berra Luca Binaschi Roberto Borio 《Supportive care in cancer》2007,15(5):539-546
Introduction Amisulpride is a substituted benzamide that, at low doses, selectively blocks D2 and D3 presynaptic dopamine receptors, enhancing
dopaminergic transmission in frontal cortex and limbic areas. Many clinical studies versus placebo, tricyclic antidepressants
and selective serotonin reuptake inhibitors showed amisulpride antidepressant effect, supporting its safety and rapid onset
of action. In oncological population, depression is quite frequent and difficult to treat because of the particular sensitivity
of cancer patients to the antidepressants’ side effects.
Goals of work The aims of this study were to evaluate efficacy, safety and tolerability of low doses of amisulpride (50 mg) in oncological,
depressed patients during chemotheraphy.
Materials and methods One hundred six consecutive cancer outpatients with depressive symptoms were treated in a prospective, intention to treat,
4-week study, and were evaluated in single-blind with Montgomery Asberg rating scale for depression (MADRS), clinical global
impression (CGI) and dosage record treatment emergent symptom scale (DOTES) to assess side effects of treatment.
Main results After 4 weeks of treatment, scores of MADRS and CGI significantly improved (p < 0.002; p < 0.001, respectively), with a reduction of depressive symptoms concerning both emotional (such as apparent sadness, reported
sadness, inner tension, etc.) and physical cluster (such as lack of appetite, reduction in weight, tiredness and insomnia)
with good tolerability (only two patients dropped out).
Conclusions This study is the first trial on the use of amisulpride in a cohort of oncological, depressed patients during chemotherapy.
Amisulpride demonstrated high efficacy and safety. Controlled studies are needed to confirm these preliminary data. 相似文献
104.
105.
Donna K. McNeese-Smith Mary E. Wickman Marie Earvolino-Ramirez Mel Moncrieff Scott Robertson 《Journal of addictions nursing》2006,17(2):105-113
This article reports the results of semi-structured interviews with substance abuse treatment (SAT) program directors (PDs) regarding the ways SAT is being influenced by managed care (MC), plans for future SAT, and strategies for decreasing costs of care. It compares findings to an earlier survey of 50 SAT PDs.
Interviews were conducted in 20 SAT programs to gather information about treatment delivery since the advent of MC, including PD responsibilities, funding source, treatment intensity, location, duration, and methods of treatment. Open-ended responses were used to gather information about current and future plans in providing SAT, and awareness of new types of treatment being planned by organizations impacted by MC.
PDs reported changes in SAT secondary to MC such as decreased treatment length, limiting of inpatient and outpatient services, and delayed treatment secondary to benefit determination. Political and economic constraints were seen as barriers to providing adequate and effective services. SAT being subsumed by mental health was viewed as problematic along with an emerging split between alcohol abuse and drug treatment. A positive emerging treatment trend was the development of targeted programs for special need groups.
PDs revealed a variety of strategies that have promoted necessary adaptations to economic and political influences within the structure of managed behavioral care. Strategies such as varying treatment length, modality, and subspecialty care reflected necessary adaptations to diverse market needs.
Managed care continues to have a tremendous impact on the delivery of SAT services. While MC has helped to contain costs, negative outcomes are decreased availability of appropriate care and overtaxing of units that have survived MC cut backs. However, special need programs have allowed SAT programs to specialize, expand, and even flourish in today's competitive SAT market. Interviews with PDs reinforced the need for maintaining quality and diversified SAT services in today's MC environment. 相似文献
Interviews were conducted in 20 SAT programs to gather information about treatment delivery since the advent of MC, including PD responsibilities, funding source, treatment intensity, location, duration, and methods of treatment. Open-ended responses were used to gather information about current and future plans in providing SAT, and awareness of new types of treatment being planned by organizations impacted by MC.
PDs reported changes in SAT secondary to MC such as decreased treatment length, limiting of inpatient and outpatient services, and delayed treatment secondary to benefit determination. Political and economic constraints were seen as barriers to providing adequate and effective services. SAT being subsumed by mental health was viewed as problematic along with an emerging split between alcohol abuse and drug treatment. A positive emerging treatment trend was the development of targeted programs for special need groups.
PDs revealed a variety of strategies that have promoted necessary adaptations to economic and political influences within the structure of managed behavioral care. Strategies such as varying treatment length, modality, and subspecialty care reflected necessary adaptations to diverse market needs.
Managed care continues to have a tremendous impact on the delivery of SAT services. While MC has helped to contain costs, negative outcomes are decreased availability of appropriate care and overtaxing of units that have survived MC cut backs. However, special need programs have allowed SAT programs to specialize, expand, and even flourish in today's competitive SAT market. Interviews with PDs reinforced the need for maintaining quality and diversified SAT services in today's MC environment. 相似文献
106.
Yukinori Sakao Toru Sakuragi Yuji Takeda Masafumi Natsuaki Tsuyoshi Itoh 《General thoracic and cardiovascular surgery》2003,51(10):537-540
We experienced a rare case of giant cell tumor (GCT) arising in the 5th rib involving the 5th vertebral body and transverse process. A 57-year-old man presented with a well-defined mass in the left thoracic cavity on chest x ray examination. Chest computed tomography showed a heterogeneous 7cm-diameter mass originating in the posterior segment of the left 5th rib. The tumor had spread to the 5th thoracic vertebra destroying the left half of the body and transverse process. Magnetic resonance imaging showed a heterogeneous-intensity mass involving the 4th to 6th ribs. A radical excision of the tumor followed by a 50 Gy radiotherapy was performed after embolization of the feeding arteries. The pathological diagnosis was a GCT. The patient remains well without evidence of recurrence for 6 years following surgery. The present case is only the 14th case of GCT arising in the rib to have been reported in Japan. 相似文献
107.
Zhao-Jin Chen Mamun Al-Mahtab Salimar Rahman Ngiap-Chuan Tan Nan Luo Bee-Choo Tai 《Quality of life research》2010,19(9):1343-1348
Purpose
Hepatitis B virus (HBV) is endemic in Bangladesh, and the quality of life (QoL) of these patients remains unknown as there is no instrument available in the native language. In this study, we translated the 56-item Hepatitis Quality of Life Questionnaire (HQLQ) into Bengali and evaluated its validity and reliability. 相似文献108.
Healthcare information systems (HISs) are often implemented to enhance the quality of care and the degree to which it is patient-centered,
as well as to improve the efficiency and safety of services. However, the outcomes of HIS implementations have not met expectations.
We set out to organize the knowledge gained in qualitative studies performed in association with HIS implementations and to
use this knowledge to outline an updated structure for implementation planning. A multi-disciplinary team performed the analyses
in order to cover as many aspects of the primary studies as possible. We found that merely implementing an HIS will not automatically
increase organizational efficiency. Strategic, tactical, and operational actions have to be taken into consideration, including
management involvement, integration in healthcare workflow, establishing compatibility between software and hardware and,
most importantly, user involvement, education and training. The results should be interpreted as a high-order scheme, and
not a predictive theory. 相似文献
109.
Ian F. Dunn Pankaj K. Agarwalla Alexander M. Papanastassiou William E. Butler Edward R. Smith 《Child's nervous system》2007,23(10):1191-1194
Objective Approximately 10% of patients with neurofibromatosis I (NFI) patients will have central nervous system (CNS) tumors. The most
common of these are hypothalamic–optic gliomas, followed by brainstem and cerebellar pilocytic astrocytomas. While isolated
pilocytic astrocytomas in NFI are well described, the appearance of multiple pilocytic astrocytomas in an individual patient
is less common. The most frequent combination in NFI patients with more than one pilocytic astrocytoma is optic tract/hypothalamic
and brainstem. Other combinations are exceedingly rare; multiple pilocytic astrocytomas have only been reported once in the
cerebral hemispheres in a patient with NFI. This report presents the first documented case, to our knowledge, of multiple
pilocytic astrocytomas in the cerebellum of a patient with NF1.
Methods Case report.
Conclusion The finding of multiple cerebellar pilocytic astrocytomas in a patient with NF1 is important because it expands the spectrum
of presentations for patients with NF1 and also highlights specific diagnostic and therapeutic challenges faced by the treating
physicians. The genetic and molecular basis of NF1 is reviewed. Strategies of diagnosis and treatment outlined here are relevant
to both patients with NF1 and all patients with multiple posterior fossa tumors. 相似文献
110.
Isabelle Mermet MD ; Nathalie Pottier MSc ; Jean Marie Sainthillier MSc ; Carole Malugani MSc ; Sandrive Cairey-Remonnay MD ; Stéphane Maddens PhD ; Didier Riethmuller MD PhD ; Pierre Tiberghien MD PhD ; Philippe Humbert MD PhD ; François Aubin MD PhD 《Wound repair and regeneration》2007,15(4):459-464
Amniotic membrane (AM), the most internal placental membrane, has unique properties including antiadhesive effects, bacteriostatic, wound protection and pain-reduction properties, as well as epithelialization initialization capacities. Furthermore, AM is widely available and less costly than other bioengineered skin substitutes. In a prospective pilot study, we evaluated the safety, feasibility, and the effects on healing of AM graft in 15 patients with chronic venous leg ulcers. AM grafts were prepared from placentas harvested during cesarean section. All grafted AM had adhered to the wound bed 7 days after being applied with a 100% engraftment rate. The percentage of granulation tissue increased significantly (from 17% on day 0 to 69% on day 14, p<0.0001), along with a significant decrease of fibrinous slough (from 36% at day 0 to 16% at day 14, p<0.001). A significant clinical response occurred in 12 patients (80%) including complete healing (20%) in three during the 3-month follow-up period. The ulcer surface area decreased significantly from a mean value (+/- standard deviation) of 4.59 +/- 2.49 cm(2) at baseline to 2.91+/-2.01 cm(2) on day 30 (p<0.001). All patients experienced a significant reduction of ulcer-related pain rapidly after AM transplantation. No adverse events were recorded. AM transplantation seems to function as a safe substrate, promoting proper epithelialization while suppressing excessive fibrosis. Further advantages of biotherapy with AM are its easy and low-cost production, and that it can be applied as an ambulatory treatment without immobilization. AM transplantation may thus be considered to be an alternative method for treating chronic leg ulcers. 相似文献