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71.
B. Herron Phd H.J. Willison J. Veitch D. Roelcke L.S. Illis and F.E. Boulton 《Vox sanguinis》1994,67(1):58-63
A patient with a demyelinating sensory motor polyneuropathy secondary to IgM paraproteinaemia is reported. The paraprotein binds to the gangliosides GD1b, GT1b, GQ1b and GD3, all of which contain disialosyl groups with the sequence NeuAcα2–8NeuAcα2–3Gal. The paraprotein also acts as a cold agglutinin recognising the sialic-acid-dependent Pr1d antigenic determinant of the red cell membrane glycophorins. In this and in similar cases that have been reported, the coexistence of anti-Pr cold agglutinins and peripheral neuropathy suggest that they might be the causative agents of the disease. 相似文献
72.
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74.
Shun‐wu Fan MD Zhi‐jun Hu Phd Xiang‐qian Fang MD Feng‐dong Zhao MD Yue Huang MD He‐jun Yu MD 《Orthopaedic Surgery》2010,2(3):194-200
Objective: To determine differences in paraspinal muscle injury between a modified minimally invasive approach (MMIA) and a traditional operative approach (TOPA) for one‐level instrumented posterior lumbar inter‐body fusion (PLIF). Methods: From March 2006 to May 2008, a consecutive series of 91 patients who underwent a one‐level instrumented PLIF procedure using one of two different approaches (MMIA in 41 patients and TOPA in 50), and who were operated on by one group of surgeons at a single institution, was studied. The following data were compared between the two groups: surgical time, blood loss, and changes in postoperative serum concentration of creatinine kinase (CK). More than 1 year post operation, low back pain was evaluated by a visual analog scale (VAS) and the Oswestry disability index (ODI). Some patients were also evaluated by MRI to allow comparison of the preoperative and postoperative cross sectional area (CSA) and fat degeneration grades at the operative level. Results: There was no statistically significant difference in surgical time, but blood loss, serum concentration of CK, and scores of the VAS and ODI were markedly less in the MMIA group compared with the TOPA group. In the TOPA group, the postoperative CSA of the multifidus muscles was significantly smaller than it was pre‐operatively. In contrast, there was no significant difference between the pre‐ and post‐operative CSA of the multifidus muscles in the MMIA group. There was more fatty infiltration postoperatively than preoperatively in both the TOPA and MMIA groups, the increase in fatty infiltration being greater in the TOPA than in the MMIA group. Conclusion: Compared with TOPA, MMIA can significantly lessen paraspinal muscle injury, and reduce the incidence of low back pain. 相似文献
75.
This study reports findings from focus group discussions with aging service providers and family caregivers about low-income ambulatory or homebound older adults' depressive symptoms and barriers to seeking treatment. It also reports the participants' suggestions about interventions for depression that can be integrated into existing aging service settings or implemented in older adults' homes, as well as the type of training the aging service providers need if they are to provide services for depression. Participants identified social isolation, loneliness, and loss and grief as major correlates of depression in older adults. Barriers to seeking treatment included older adults' denial of or lack of understanding about depression, a sense of stigma, financial worries, and lack of mobility. Suggested depression treatments included brief cognitive behavioral interventions, friendly visitors, and physical exercise. Bachelor's-level service providers expressed their need and desire for training in mental health assessment and brief psychotherapy. 相似文献
76.
The “understandability phenomenon” (Blanchard, 1992) asserts that older people believe depression to be a normal consequence of old age. However, there is limited empirical evidence to support this concept. A measure was developed with community dwelling depressed and nondepressed older people that examined their belief in this concept. The “understandability phenomenon” was not related to depression but was related to older peoples' beliefs about their own aging. Depressed and nondepressed older people shared the belief that depression is an inevitable consequence of old age. The understandabilty phenomenon was endorsed by the oldest-old and particularly those living alone. 相似文献
77.
By itself, glucagon-like peptide-1(GLP-1) appears to be an excellent drug for appetite control and the treatment of obesity.
Unfortunately, few enzymes, such as IV dipeptidyl peptidase and renal excretin, degrade and render GLP-1 inactive within minutes.
A receptor agonist, exendin-4, with a longer biological half-life than GLP-1, has been tried. Subcutaneous injection of exendin-4
or continuous IV injection of GLP-1 warrants further research and investigation. 相似文献
78.
79.
Shabbir M. H. Alibhai MD MSc Marc Leach MA Mark D. Minden MD Phd Joseph Brandwein MD 《Cancer》2009,115(13):2903-2911
BACKGROUND:
Acute myeloid leukemia (AML) is associated with a poor prognosis, particularly in older patients. To the authors' knowledge, few population‐based studies of AML treatment patterns and outcomes exist to date.METHODS:
The authors used the Ontario Cancer Registry to identify all patients diagnosed with AML between 1965 and 2003. Referral to specialized cancer centers (SCCs) and receipt of chemotherapy were examined as quality of care indicators. Survival outcomes were examined using logistic regression at 30 days, 1 year, and 3 years.RESULTS:
A total of 9365 patients (mean age, 58.1 years; range, 0 to 103 years) developed AML between 1965 and 2003. Overall, 75.1%, 32.9%, and 17.3% of patients survived to 30 days, 1 year, and 3 years, respectively. Although survival improved over time among patients aged 19 to 59 years, similar improvements were not seen among older patients. The proportion of patients receiving chemotherapy declined with age (59.0% vs 29.3% among patients ages 19‐59 vs ≥60 years). Fewer patients aged ≥60 years were referred to a SCC compared with younger patients (20.8% vs 29.9%). Younger age, less comorbidity, later year of diagnosis, receipt of chemotherapy, and being referred to a SCC were associated with better 30‐day and long‐term survival in multivariate models.CONCLUSIONS:
Although the prognosis has improved over time among younger adults, it remains poor among those aged ≥60 years. Fewer older patients were referred to SCCs or treated with chemotherapy compared with younger patients, whereas both factors were associated with improved survival. Opportunities may exist to improve the quality of care and outcomes among older adults with AML. Cancer 2009. © 2009 American Cancer Society. 相似文献80.
A 27-year-old woman underwent laparoscopic Roux-en-Y gastric bypass. A retrocolic-retrogastric herniation of most of the small
bowel and later a gastric perforation due to internal hernia at the mesenteric defect of the jejuno-jejunostomy occurred.
These unusual, but not rare, complications are directly related to the neoanatomy that follows gastric bypass and can lead
to rapidly progressing and life-threatening situations. Proper evaluation of clinical signs and symptoms, early abdominal
CT scan, and urgent operative intervention are mandatory to achieve a successful outcome. 相似文献