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91.
Red cell loss following orthopedic surgery: the case against postoperative blood salvage 总被引:3,自引:0,他引:3
J Umlas ; RR Foster ; SA Dalal ; SM O'Leary ; L Garcia ; MS Kruskall 《Transfusion》1994,34(5):402-406
BACKGROUND: Expensive devices have been developed for the collection and transfusion of blood salvaged after hip or knee arthroplasty. STUDY DESIGN AND METHODS: The volume of salvaged red cells was measured for the first 6 hours after operation. This volume was compared to total red cell loss during hospitalization and to the volume of allogeneic red cells transfused. RESULTS: Mean postoperative red cell loss in 31 patients following hip replacement was 55 +/− 29 mL and that in 20 patients following knee replacement was 121 +/− 50 mL. The 6-hour wound drainage represented 8.7 and 16.8 percent of overall red cell loss during hospitalization for hip and knee replacement, respectively. The transfusion of postoperatively salvaged red cells would have supplanted transfusion of less than one-third of a unit of allogenic blood after hip replacement and two-thirds of a unit after knee replacement. Only three patients (5.9%) lost red cell volume in the drainage equivalent to or in excess of 1 unit of red cells (180 mL). The volume of red cells salvaged postoperatively bore no relationship to perioperative red cell losses as a whole. CONCLUSION: The relatively small red cell loss in the postoperative period in most arthroplasty patients does not appear to justify the routine use of this technique for the recovery of autologous blood. 相似文献
92.
SA Dr. R. Lechner G. Achatz T. Hauer H.-G. Palm A. Lieber C. Willy 《Der Unfallchirurg》2010,113(2):106-113
Epidemiological analyses of injury patterns and mechanisms help to identify the expertise military surgeons need in a combat setting and accordingly help to adjust infrastructure and training requirements. Therefore, a MEDLINE search (1949–2009), World Wide Web search (keywords “combat, casualties, war, military, wounded and neurosurgery”) and an analysis of deaths among allied war casualties in Afghanistan and Iraq were performed. Up to 10th December 2009 there had been 4,688 allied military deaths in Iraq and 1,538 in Afghanistan. Of these 22% died in non-hostile action, 33% in direct combat situations and the majority of 45% in indirect combat actions. The leading causes of injury were explosive devices (70%) and gunshot wounds. Chest or abdominal injuries (40%) and traumatic brain injuries (35%) were the main causes of death for soldiers killed in action. The case fatality rate in Iraq is approximately half that of the Vietnam War, whereas the killed-in-action rate in Afghanistan (18.7%) is similar to the Vietnam War (20%); however, the amputation rate is twice as high in modern conflicts. Approximately 8–15% of the fatal injuries seem to be potentially survivable. Military surgeons must have an excellent expertise in a wide variety of surgical specialties. Life saving emergency care, especially in the fields of thoracic, visceral and vascular surgery as well as practical skills in the fields of neurosurgery and oral and maxillofacial surgery are required. Additionally, it is of vital importance to ensure the availability of sufficient tactical and strategic medical evacuation capabilities for the wounded. 相似文献
93.
S Ghezzi F Pacciarini S Nozza S Racca SA Mariani E Vicenzi A Lazzarin F Veglia G Tambussi G Poli 《HIV medicine》2010,11(5):349-352
Objective
To investigate the impact of intermittent interleukin‐2 (IL‐2) plus combination antiretroviral therapy (cART) on HIV‐1 entry co‐receptor use.Methods
Primary HIV‐1 isolates were obtained from 54 HIV‐1‐positive individuals at baseline and after 12 months using co‐cultivation of peripheral blood mononuclear cells (PBMC) with activated PBMC of HIV‐negative healthy donors. HIV‐1 co‐receptor use was determined on U87‐CD4 cells.Results
Fourteen out of the 21 (67%) IL‐2‐treated individuals harbouring a primary CCR5‐dependent (R5) HIV‐1 isolate at baseline confirmed an R5 virus isolation after 12 months in contrast to 3 out of 7 (43%) of those receiving cART only. After 12 months, only 1 R5X4 HIV‐1 isolate was obtained from 21 cART+IL‐2‐treated individuals infected with an R5 virus at entry (5%) vs. 2/7 (29%) patients receiving cART alone, as confirmed by a 5‐year follow‐up on some individuals.Conclusions
Intermittent IL‐2 administration plus cART may prevent evolution towards CXCR4 usage in individuals infected with R5 HIV‐1.94.
目的对实验动物皮肤病原真菌2种培养方法进行了比较。方法将采集到的3只皮肤真菌感染病兔样品经由沙氏平皿法和沙氏试管斜面培养法分别进行培养。结果在3只真菌感染病兔中应用试管斜面法我们只检测到1例皮肤病原真菌阳性,而采用沙氏平皿法3例阳性全部检出。结论结合临床检测经验,我们认为本研究的沙氏平皿法优于沙氏试管斜面法,在实验动物皮肤病原真菌常规检测中具有推广应用价值。 相似文献
95.
目的 建立大鼠血浆中栀蒡热毒平方有效组分中栀子苷、牛蒡子苷和黄芩苷的HPLC血药浓度测定方法.方法 血浆样品采用甲醇-乙腈(1∶ 1)沉淀蛋白,HPLC测定血药浓度.色谱柱为Diamonsil C18柱(4.6 mm×150 mm, 5 μm),流动相乙腈-0.2%磷酸水梯度洗脱,流速1.0 mL/min,检测波长238 nm和278 nm.结果 各成分的最低检测浓度(S/N>3)在0.23~0.32 mg/L,平均回收率均在85%以上,日内、日间精密度及稳定性的RSD均小于10%.结论 该方法简便、准确,可作为栀蒡热毒平方血药浓度定量分析方法. 相似文献
96.
Clinical Impact of Tumour Involvement of the Anastomotic Doughnut in Oesophagogastric Cancer Surgery
K Sillah EA Griffiths SA Pritchard R Swindell CM West R Page IM Welch 《Annals of the Royal College of Surgeons of England》2009,91(3):195-200
INTRODUCTION
Published colorectal cancer surgery data suggest no role for the analysis of the anastomotic doughnuts following anterior resection. The usefulness of routine histological analysis of the upper gastrointestinal doughnut is not clear. Our study assessed the impact of cancer involvement of the doughnut on clinical practice. Factors associated with doughnut involvement and the effect on patients'' survival were also analysed.PATIENTS AND METHODS
The clinicopathological details of 462 patients who underwent potentially curative oesophagogastrectomy for cancer with a stapled anastomosis between 1994 and 2006 in two specialist centres were retrospectively analysed. Univariate, multivariate and survival analyses were carried out.RESULTS
Approximately 5% of doughnuts (22 of 462) were histologically involved with cancer. Microscopic involvement of the proximal resection margin, local lymph node metastasis and lymphatic invasion within the main resected specimen were independently associated with doughnut involvement (all P < 0.05). However, these three factors taken together failed to predict doughnut involvement. Doughnut involvement was an independent adverse prognostic factor for overall survival (P = 0.0013).CONCLUSIONS
In contrast to findings in colorectal surgery, doughnut involvement with cancer appears to have useful prognostic information following oesophagogastrectomy. Routine histological analysis of upper gastrointestinal doughnuts is justified. Doughnut involvement could potentially strengthen the indications for adjuvant therapy in the future. 相似文献97.
V Venkatramani S Pillai S Marathe SA Rege JV Hardikar 《Annals of the Royal College of Surgeons of England》2009,91(5):W13-W14
Introduction
Breast gangrene has been reported as a complication following puerperal sepsis, breast surgery, nipple piercings, warfarin toxicity, etc. We report a case of primary breast gangrene in an HIV-positive individual which, to the best of our knowledge, is the first of its kind.Case report
A 40-year-old previously healthy woman presented with fulminating left breast gangrene. She was detected to be HIV positive. Mastectomy was performed. The detailed management of the condition is discussed.Conclusion
Severe necrotising infections may be initial manifestations of HIV infection and patients with such infections should be screened for HIV. 相似文献98.
子宫结合带(JZ)是MRI上显示的子宫壁正常结构,JZ在MRI上呈低信号。妊娠期以外的子宫结合带是依赖雌激素的周期性调控来控制子宫的收缩运动的,除此之外,许多生物因子都参与了JZ的调节,如CX43、干扰素因子IFNγ、细胞活素和生长因子等。JZ与子宫肌瘤、子宫内膜异位症、子宫腺肌症、妊娠期并发症、不孕、胚胎植入等的发生均有关,其相关研究现在主要聚集在MRI方面的研究,本文综述了子宫结合带的调节因素及相关疾病。 相似文献
99.
Background
Within the last decade there has been a growth in the call-centre industry in the UK, with a growing awareness of the voice as an important tool for successful communication. Occupational voice problems such as occupational dysphonia, in a business which relies on healthy, effective voice as the primary professional communication tool, may threaten working ability and occupational health and safety of workers. While previous studies of telephone call-agents have reported a range of voice symptoms and functional vocal health problems, there have been no studies investigating the use and impact of vocal performance in the communication industry within the UK. This study aims to address a significant gap in the evidence-base of occupational health and safety research. The objectives of the study are: 1. to investigate the work context and vocal communication demands for call-agents; 2. to evaluate call-agents' vocal health, awareness and performance; and 3. to identify key risks and training needs for employees and employers within call-centres. 相似文献100.