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41.
We reviewed ninety-three patients who had one hundred and seven complete fractures of the femur between them and were treated over a twenty-five year period in Western Australia and South Australia. Operative surgical management of complete fractures in the middle and distal thirds was usually successful. In contrast, fractures proximal to the middle third were regularly associated with non-union, implant failure and requirement for revision surgery. In view of this significant difference in outcome after fracture of the pagetic femur in different sites, a comprehensive surgical management strategy is recommended in order to avoid complications. 相似文献
42.
G Bradley T J Ward J C White J Coleman A Taylor K F Rhodes 《Journal of medicinal chemistry》1992,35(9):1515-1520
A series of benzoylureas derived from bicycle amines were prepared and evaluated for 5-HT3 antagonist activity on the rat isolated vagus nerve. From among these compounds, those analogues which were ortho substituted by an alkoxy group on the benzoyl function were shown to be potent 5-HT3 antagonists with similar or greater potency than the standard agent ondansetron. NMR and X-ray crystallography studies showed these o-alkoxy compounds to exist as a planar, hydrogen-bonded, tricyclic ring system. In molecular modeling studies on endo-N-[[(8-methyl-8-azabicyclo[3.2.1]octan-3-yl-amino] carbonyl]-2-(cyclopropylmethoxy)benzamide (30) the central hydrogen-bonded ring was able to mimic an aromatic ring present in previously reported 5-HT3 antagonists. 相似文献
43.
Clare Bradley Rosalind Plowright John Stewart John Valentine Elke Witthaus 《Health and quality of life outcomes》2007,5(1):57
Background
The results of using status measures to identify any changes in treatment satisfaction strongly suggest a need for specific change instruments designed to overcome the ceiling effects frequently observed at baseline. Status measures may leave little room to show improvement in situations where baseline ceiling effects are observed. A change version of the DTSQ (DTSQc) is compared here with the original status (now called DTSQs) version to test the instruments' comparative ability to demonstrate change. 相似文献44.
Management of pressure ulcers. 总被引:2,自引:0,他引:2
Bradley C Cannon Joan P Cannon 《American journal of health-system pharmacy》2004,61(18):1895-905; quiz 1906-7
PURPOSE: Wound healing, the epidemiology and staging of pressure ulcers, and pressure ulcer prevention and treatment are discussed. SUMMARY: The principal event leading to the formation of pressure ulcers appears to be a consistent interruption in blood supply to the skin. Several known risk factors exist and can be attributed to patient-specific variables and wound-specific conditions. Initial management should include removal of the source of pressure, a comprehensive assessment of the patient, and proper staging of the ulcer. Preparation of the wound for treatment is essential and can have a significant impact on healing. While the patient's nutritional status is thought to affect wound healing, only an increased protein content in the diet has been demonstrated to have a benefit. Specialized wound dressings are available for pressure ulcers of all stages and drainage characteristics. With wide variation in cost and in application regimens, a direct cost-effectiveness comparison of commercially available dressing products is difficult. Many of the growth factors commonly present in healing wounds have been synthesized and evaluated as treatments. Although topical platelet-derived growth factor has demonstrated benefit in some studies, its use remains controversial. To date, no topical growth factors carry FDA-approved labeling for use in the treatment of pressure ulcers. Human skin equivalents mark the latest advancement in therapy. Certain species of bacteria have been associated with poorly healing ulcers and may warrant intervention with either local or systemic antibiotic therapy. CONCLUSION: No pharmacologic intervention has been conclusively shown to be effective for pressure ulcers. The cornerstones of therapy remain elimination of the source of pressure or friction and appropriate wound care. usa. 相似文献
45.
Efficacy and safety of xaliproden in amyotrophic lateral sclerosis: results of two phase III trials.
Vincent Meininger Gilbert Bensimon Walter R Bradley Benjamin Brooks Patrice Douillet Andrew A Eisen Lucette Lacomblez P Nigel Leigh Wim Robberecht 《Amyotrophic lateral sclerosis and other motor neuron disorders》2004,5(2):107-117
Amyotrophic lateral sclerosis (ALS) is a relentlessly progressive and fatal motor neuron disease. We carried out two randomized, double-blind, placebo-controlled, multi-centre, multi-national studies with xaliproden (a drug with neurotrophic effect) to assess drug efficacy and safety at two doses. Patients with clinically probable or definite ALS of more than 6 months and less than 5 years duration were randomly assigned to placebo, 1 mg or 2 mg xaliproden orally once daily as monotherapy in Study 1 (n=867); or to the same regimen with addition of riluzole 50 mg bid background therapy in Study 2 (n=1210 patients). The two primary endpoints were defined as: 1. Time to death, tracheostomy, or permanent assisted ventilation (DTP), and 2. Time to vital capacity (VC)<50% or DTP before (log-rank test) and after adjustment using a Cox proportional hazard model for prespecified prognostic factors. Secondary endpoints were rates of change of various functional measures. In Study 1, primary outcome measures did not reach statistical significance. For the 2 mg group, for time to VC<50% analysis (without DTP) a significant 30% RRR was obtained (95% confidence interval [CI]: 8.46, P=0.009). In Study 2, no significant results were obtained. However, there was a trend in favour of add-on 1 mg dose xaliproden vs. placebo (RRR 15% [-6.31, ns] for time to VC<50%; RRR 12% [CI: -6.27, ns] for time to VC<50% or DTP). Adjusted RR ratios were consistently more favourable for the xaliproden groups. Tolerability was good, and dose-dependent side effects were largely associated with the serotonergic properties of xaliproden. An effect of xaliproden on functional parameters, especially VC, was noted. Although this effect did not reach statistical significance, xaliproden had a small effect on clinically noteworthy aspects of disease progression in ALS. 相似文献
46.
W J Wilson K L Bailey C L Balke C L D'Arbe B R Hoddinott A P Bradley P C Mills 《Clinical neurophysiology》2006,117(10):2211-2220
OBJECTIVE: To use the over-complete discrete wavelet transform (OCDWT) to further examine the dual structure of auditory brainstem response (ABR) in the dog. METHODS: ABR waveforms recorded from 20 adult dogs at supra-threshold (90 and 70dBnHL) and threshold (0-15dBSL) levels were decomposed using a six level OCDWT and reconstructed at individual scales (frequency ranges) A6 (0-391Hz), D6 (391-781Hz), and D5 (781-1563Hz). RESULTS: At supra-threshold stimulus levels, the A6 scale (0-391Hz) showed a large amplitude waveform with its prominent wave corresponding in latency with ABR waves II/III; the D6 scale (391-781Hz) showed a small amplitude waveform with its first four waves corresponding in latency to ABR waves I, II/III, V, and VI; and the D5 scale (781-1563Hz) showed a large amplitude, multiple peaked waveform with its first six waves corresponding in latency to ABR waves I, II, III, IV, V, and VI. At threshold stimulus levels (0-15dBSL), the A6 scale (0-391Hz) continued to show a relatively large amplitude waveform, but both the D6 and D5 scales (391-781 and 781-1563Hz, respectively) now showed relatively small amplitude waveforms. CONCLUSIONS: A dual structure exists within the ABR of the dog, but its relative structure changes with stimulus level. SIGNIFICANCE: The ABR in the dog differs from that in the human both in the relative contributions made by its different frequency components, and the way these components change with stimulus level. 相似文献
47.
Bradley R Pieters Johan N B van der Grient Leo E C M Blank Kees Koedooder Maarten C C M Hulshof Theo M de Reijke 《Radiotherapy and oncology》2006,80(1):69-72
Catheters were developed that can be fixed in the prostate gland by self-expanding parts for use in PDR brachytherapy. Daily CT-scans were made to investigate the magnitude of catheter displacement. The mean absolute displacement during the 3 day treatment was 1.2 mm. The resulting minor alterations in dose-volume parameters were of no clinical importance. 相似文献
48.
49.
Remotely inserted venous occlusion catheters for the control of venous haemorrhage. 总被引:1,自引:1,他引:0
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S. R. Smith A. O. Mansfield J. P. Bradley 《Annals of the Royal College of Surgeons of England》1988,70(3):161-162
This paper describes the use of venous occlusion catheters inserted via the long saphenous vein or its tribularies for control of major retroperitoneal venous haemorrhage. The technique has been applied successfully in 10 cases of trauma and aortocaval fistula. Exposure and insertion are simple and quick and a measure of control is obtained before exposure of the injury which can then be completely repaired before deflation of the balloon and withdrawal of the catheter. 相似文献
50.
A case is reported in which entrapped polymethylmethacrylate following traumatic dislocation of a total hip replacement prevented complete reduction. A combined arthroscopic and fluoroscopic technique was used to remove the entrapped polymethylmethacrylate. Manipulation of the total hip prosthesis was done after removal of polymethylmethacrylate to minimize mechanical abrasion. This technique allows direct visual assessment of the articulating surfaces as well as the mechanical stability of the prosthesis. The morbidity related to the procedure is minimal and a short rehabilitation period is the major advantage. 相似文献