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141.
Gonzalez G Feingold A Oliveto A Gonsai K Kosten TR 《The American journal of drug and alcohol abuse》2003,29(3):497-514
Depression is common among patients who abuse both opiates and cocaine, and its treatment has had mixed success. This study compares buprenorphine-maintained patients with lifetime major depressive disorder (MDD, N = 53) with those never depressed (ND, N = 96) on cocaine and opiate-free urines during a 12-week outpatient double-blind, placebo-controlled, randomized clinical trial. The 149 subjects were assigned to four groups: 1) desipramine (DMI) + contingency management (CM); 2) DMI + noncontingency management (NCM); 3) placebo + CM; and 4) placebo + NCM. Depression assessments included Hamilton Depression Rating Scale, Center for Epidemiological Studies Depression Inventory, and Structured Clinical Interview for DSM-IV interview for diagnosis of lifetime MDD. Urine toxicologies were performed thrice weekly and the CES-D was performed monthly. The MDD group had a larger proportion of females (45% vs 21%, P = 0.02) and were more likely to be married (13.2% vs 7.3%, P = 0.02) than the ND group. Treatment retention did not vary by depression status. Hierarchical Linear Modeling found that depressive symptoms decreased comparably across the four treatment groups. Although participation in CM improved drug-free urines more for patients with MDD than for the ND group (Z = 2.44, P = 0.01), treatment with DMI was significantly more efficacious for the ND group than for the MDD group (Z = -2.89, P = 0.003). These results suggest that patients with MDD may respond better to behavioral treatments such as CM than to desipramine plus buprenorphine. The ND cocaine-abusing, opiate-dependent patients may be more responsive to the anticraving effects of DMI. 相似文献
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144.
Leah Kleinman Anne Kilburg Gerardo Machnicki Randall Faull Rowan Walker Ramesh Prasad Patrice Ambuehl Udo Bahner Mary Kay Margolis 《Quality of life research》2006,15(7):1223-1232
Introduction: Gastrointestinal (GI) side-effects occur frequently as a result of immunosuppressant regimens used in renal transplant patients.
Little effort has been made to quantify the impact of these side-effects on patients’ health-related quality of life and symptom
severity. Objective: To assess the psychometric characteristics of two GI-specific outcome instruments (the Gastrointestinal Rating Scale (GSRS)
and the Gastrointestinal Quality of Life Index (GIQLI)) for use in post-renal transplant patients. Methods: Cross-sectional study conducted at 5 clinical centers in 4 countries. Patients were required to be on mycophenolate mofetil
and a calcineurin inhibitor. Patients completed the GSRS, GIQLI and two generic instruments (the Psychological General Well-Being
Index and the EQ-5D) at one timepoint. Reliability, construct and known groups validity were assessed. Results: In general the GSRS and the GIQLI demonstrated Cronbach’s alphas higher than 0.70. The GIQLI was moderately to highly correlated
with the PGWB and EQ-5D. Correlations among the GSRS and generic instruments were slightly lower. The GSRS and GIQLI both
distinguished between patients with and without GI complaints (all p<0.05). Conclusions: The GSRS and the GIQLI are appropriate for use in a post-renal transplant population. Scores on both instruments demonstrated
significant differences between renal transplant patients with GI complications and without GI complications. 相似文献
145.
Hsu MI Barroso G Mayer J Lanzendorf S Gibbons WE Muasher S Oehninger S 《Journal of assisted reproduction and genetics》2000,17(1):34-38
Purpose: Our purpose was to examine the timing ofimplantation and early embryo development following uterinetransfer of oocytes/embryos previously subjected to zonapellucida micromanipulation.
Methods: A total of 68 singleton pregnancies resulting fromIVF and embryo transfer with/without micromanipulation.Patients were divided into four groups according to the typeof micromanipulation technique: assisted hatching, embryobiopsy, intracytoplasmic sperm injection, and nomicromanipulation (control group). Serial serum -hCG levels weremeasured between 10 and 25 days after fertilization andlog-transformed. Linear regression analyses were performedand extrapolated to hCG = 10 mIU/ml (hCG10) to estimatedetectable implantation. The slopes of the regression lineswere used to estimate the rising speed of hCG, an indirectsign of embryo development.
Results: There were no significant differences among groupswith respect to hCG10, the slopes or intercepts of theregression lines.
Conclusions: Various oocyte/embryo microsurgicalprocedures used in ART involving zona pellucida manipulationdo not appear to affect the timing of implantation or earlyembryo development. 相似文献
146.
147.
Arnaldo Dossena Gerardo Palla Rosangela Marchelli Tiziana Lodi 《Chemical biology & drug design》1984,23(2):198-202
Nα-protected amino acid methylthiomethyl esters (MTM) were obtained in good yields under mild conditions using the «ButBr/Me2SO» reagent. Selective removal of the N-protecting group was achieved in HCl/anhydrous ethyl ether and the MTM ester hydrochlorides were successfully used in the synthesis of dipeptides. 相似文献
148.
A. Germanò Sergio Baldari Gerardo Caruso Mariella Caffo Gaspare Montemagno Emanuele Cardia Francesco Tomasello 《Child's nervous system》1998,14(3):114-119
Mutism is an infrequent and transitory complication observed following posterior fossa surgery. Patients become mute in the
immediate postoperative period, with restoration of speech within a few weeks in the absence of additional neurological alterations.
The anatomical structures thought to be involved are the connections between the cerebellar dentate nucleus, the ventrolateral
nucleus of the contralateral thalamus and the supplementary motor area. In an attempt to understand the pathophysiology of
this syndrome, and to depict the perfusion of different brain areas semiquantitatively, in two children who had become mute
after posterior fossa surgery we performed a Tc99M-HM-PAO SPECT study during the period of mutism and again when normal speech
had returned. In one patient, who had a left cerebellar astrocytoma, the SPECT study showed a marked reduction of cerebral
perfusion in the right fronto-parietal region, and in the other, who had a medulloblastoma, a left fronto-temporo-parietal
perfusion alteration was observed. When the patients regained normal speech, the follow-up SPECT studies revealed normalization
of the cerebral perfusion. This study demonstrates the occurrence of a focal dysfunction of cerebral perfusion in children
with cerebellar mutism after posterior fossa surgery. These observations are useful in extending our understanding of the
pathophysiology of this postoperative clinical syndrome.
Received: 12 September 1997 Revised: 17 November 1997 相似文献
149.
Presentation, treatment, and multivariate analysis of risk factors for obstructive and perforative colorectal carcinoma 总被引:8,自引:0,他引:8
Alvarez JA Baldonedo RF Bear IG Truán N Pire G Alvarez P 《American journal of surgery》2005,190(3):376-382
BACKGROUND: It is known that emergency surgery for colorectal cancer is associated with high morbidity and mortality. The aim of this study was to assess the presentation, treatment, and outcome of patients with complicated colorectal cancer. Risk factors for morbidity and mortality were also evaluated. METHODS: From 1991 to 2002, the medical records of 107 consecutive patients undergoing emergency surgery for obstructing or perforating colorectal carcinoma were retrospectively reviewed. Information regarding patient and tumor characteristics, treatment, and outcome was recorded. Risk factors were assessed by multivariate analysis. RESULTS: Eighty-three patients (78%) had complete obstruction and 24 (22%) had perforation. Overall and major complications occurred in 70% and 34%, respectively. The mortality rate was 15%. Independent risk factors for major morbidity were perioperative blood transfusion and high American Society of Anesthesiologists (ASA) class, whereas those for mortality were older age and high Acute Physiology and Chronic Health Evaluation II (APACHE II) score. CONCLUSIONS: Emergency surgery for complicated colorectal carcinoma carries high rates of morbidity and mortality. To achieve improvements in outcome, intensive treatment after surgery in patients with risk factors is recommended. 相似文献
150.
BACKGROUND: Glomerular filtration rate (GFR) in humans and animals might be determined with precision by measuring the clearance of an ideal marker, such as inulin. However, the use of inutest, an inulin analog, is limited by its cost and accessibility. The present study tested whether low calorie commercial sugar (LC sugar) can be used to measure GFR during normal and renal dysfunction. METHODS: Two groups of 6 male Wistar rats weighing 300 to 350 g were included. One group was treated with a daily dose of cyclosporine (CsA) 30 mg/kg subcutaneously for 7 days and the other group was formed by nontreated control rats. In one half of each group, GFR was evaluated by using inutest and in the other half by using LC sugar. GFR was also evaluated by using a wide LC sugar plasma concentration range in an additional group. RESULTS: In nontreated rats, the mean GFR evaluated with LC sugar was 2.2 +/- 0.1 mL/min. This value is equal to that obtained with inutest: 2.3 +/- 0.1 mL/min. CsA administration produced a significant reduction of renal blood flow and renal function. The GFR reduction induced by CsA was similarly determined by both LC sugar and inutest to be at 1.0 +/- 0.2 and 1.1 +/- 0.2 mL/min (P= NS), respectively. In addition, GFR did not change when LC sugar plasma concentration gradually increased. CONCLUSION: Our results show that in both normal and pathophysiologic conditions, LC sugar is a good marker of GFR similar to the gold standard inutest. 相似文献