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51.
BACKGROUND: Omeprazole is an inhibitor of the parietal cell enzyme H+/K+ adenosine triphosphatase. Immediate-type hypersensitivity reactions, such as urticaria, angioedema, and hypotension, induced by omeprazole and other proton pump inhibitors are rare. OBJECTIVES: To confirm the immediate-type mechanism of recurrent anaphylactic reactions to the repeated administration of omeprazole using skin testing and to enable safe administration of the drug after successful oral desensitization. METHODS: Intradermal skin tests were performed with omeprazole (0.04 and 0.4 mg/mL) prepared from the oral and intravenous commercial preparations and with pantoprazole (0.02 and 0.2 mg/mL) prepared from the oral commercial preparation. Skin tests were repeated after completion of the desensitization. Oral desensitization was applied at a starting dose of 0.001 mg of omeprazole, and a full dose of 16 mg was achieved after 5.6 hours (cumulative dose of 32.6 mg). RESULTS: Intradermal skin test results were positive to omeprazole and pantoprazole at all tested concentrations. After successful desensitization, omeprazole was administered in the full dose uneventfully. The wheal size of the intradermal skin tests performed after completion of the desensitization was significantly reduced. CONCLUSION: When indicated, this newly designed desensitization protocol may be used in patients with omeprazole-induced anaphylaxis. 相似文献
52.
Psychosocial factors at work and perceived health among agricultural meat industry workers in France
Christine Cohidon Patrick Morisseau Francis Derriennic Marcel Goldberg Ellen Imbernon 《International archives of occupational and environmental health》2009,82(7):807-818
Objective The objective of this study was to describe the perceived health status of the meat industry employees—i.e., working in the
slaughtering, cutting, and boning of large animals and poultry—and its relation to their organisational and psychosocial constraints
at work.
Methods This postal survey included all 3,000 employees of the meat industry (beef, pork and poultry) in four districts in Brittany,
France, whose companies were affiliated with the agricultural branch of the national health insurance fund. The questionnaire
asked for social and demographic data and information describing their job and the organisation of their work. The psychosocial
factors at work were described according to Karasek’s questionnaire (demand, latitude and social support at work). Perceived
health was measured with the Nottingham Health Profile perceived health indicator.
Results This study shows the high prevalence of poor health reported by the workers in this industry. This poor perceived health was
worse in women and increased regularly with age. Among the psychosocial factors studied, high quantitative and qualitative
demand at work, inadequate resources for good work and to a lesser extent, inadequate prospects for promotion appear especially
associated with poor perceived health. Other factors often associated with poor perceived health included young age at the
first job and work hours that disrupt sleep rhythms (especially for women).
Conclusion Our results show that this population of workers is especially vulnerable from the point of view of perceived physical and
psychological health and is exposed to strong physical, organisational and psychosocial constraints at work. They also demonstrate
that poor perceived health is associated with some psychosocial (such as high psychological demand and insufficient resources)
and organisational factors at work. These results, in conjunction with those from other disciplines involved in studying this
industry, may help the companies to develop preventive activities. 相似文献
53.
Nieca Goldberg MD 《Current cardiovascular risk reports》2007,1(2):137-136
54.
The increased awareness of the incidence and risk of coronary heart disease (CHD) has increased the efforts of physicians to identify women with CHD as early as possible. Exercise electrocardiogram (ECG) testing and imaging have been used in this manner for men and women but represent unique challenges with regard to women. Exercise ECG testing, which determines the presence of coronary artery disease by the provocation of ST depression and chest pain, has a lower positive predictive value in women than in men of the same age. This is explained by a lower prevalence of CHD in female patients with symptoms and (to a lesser extent) by the reported lower sensitivity and specificity of the test in women as compared with men. Exercise nuclear isotope myocardial perfusion imaging and exercise echocardiography have higher reported specificity and sensitivity, and new imaging agents, contrast echo agents, and acquisition protocols have reduced the limitations of these studies in selected women. The value of the exercise ECG examination with regard to CHD event risk assessment is equal in men and women and should be incorporated into the clinical evaluation of appropriate women patients. 相似文献
55.
Qiang Fu Karestan C Koenen Mark W Miller Andrew C Heath Kathleen K Bucholz Michael J Lyons Seth A Eisen William R True Jack Goldberg Ming T Tsuang 《Neuropsychopharmacology》2007,62(10):1088-1094
BACKGROUND: Epidemiologic studies reveal that posttraumatic stress disorder (PTSD) is highly comorbid with both conduct disorder and major depression in men. The genetic and environmental etiology of this comorbidity has not been examined. METHODS: Data were analyzed from 6744 middle-aged male-male monozygotic and dizygotic twins from the Vietnam Era Twin Registry. Conduct disorder, major depression, and PTSD were assessed via telephone interview using the Diagnostic Interview Schedule for the DSM-III-R in 1992. Structural equation modeling was used to estimate additive genetic, shared environmental, and individual-specific environmental effects common and specific to conduct disorder, major depression, and PTSD. RESULTS: The association between conduct disorder and PTSD was explained primarily by common shared environmental influences; these explained 10% (95% confidence interval: 6%-17%) of the variance in PTSD. The association between major depression and PTSD was largely explained by common genetic influences; these explained 19% (95% confidence interval: 11%-26%) of the variance in PTSD. CONCLUSIONS: Our findings suggest that different etiologic mechanisms explain the association of conduct disorder and major depression with PTSD in male veterans. If replicated in other populations, results suggest research aimed at identifying specific genetic and environmental factors that influence PTSD may benefit from starting with those that have been more consistently and strongly associated with major depression and conduct disorder. 相似文献
56.
Biological and physical properties of autogenous vascularized fibular grafts in dogs 总被引:3,自引:0,他引:3
V M Goldberg S Stevenson J W Shaffer D Davy L Klein J Zika G Field 《The Journal of bone and joint surgery. American volume》1990,72(6):801-810
The biological and biomechanical properties of normal fibulae, fibulae that had had a sham operation, and both vascularized and non-vascularized autogenous grafts were studied in dogs at three months after the operation. The study was designed to quantify and correlate changes in these properties in orthotopic, stably fixed, weight-bearing grafts and to provide a baseline for additional studies of allografts. The grafts were eight centimeters long and internally fixed. The mechanical properties of the grafts were studied by torsional testing. Metabolic turnover of the grafts was evaluated by preoperative labeling of the dogs with 3H-tetracycline for resorption of bone mineral and with 3H-proline for turnover of collagen. Cortical bone area and porosity were measured. Postoperative formation of bone was evaluated by sequential labeling with fluorochrome. The vascularized grafts resembled the fibulae that had had a sham operation and those that had not had an operation with regard to the total number of osteons and the remodeling process, as measured both morphometrically and metabolically. The vascularized grafts were stronger and stiffer than the non-vascularized grafts and were not different from the bones that had had a sham operation. In contrast, the non-vascularized grafts were smaller, weaker, less stiff, and more porotic, had fewer osteons, and demonstrated increased turnover and resorption compared with the vascularized grafts, the bones that had had a sham operation, and the bones that had not been operated on. 相似文献
57.
W. E. Lieb D. A. Merton J. A. Shields S. M. Cohen D. D. Mitchell B. B. Goldberg 《The British journal of ophthalmology》1990,74(5):305-308
Colour Doppler imaging (CDI) is a recent development in ultrasonography. It allows simultaneous two-dimensional structural imaging and Doppler evaluation of blood flow. Quantitative information on flow velocity is obtained by pulsed Doppler spectral analysis, the colour information being used to choose the vessel of interest. Using this technique the authors examined a patient with an orbital varix previously diagnosed by clinical findings and computed tomography. Dynamic evaluation with real-time direct imaging of flow facilitated the diagnosis of this orbital disorder without the need for any contrast material. This technique may prove to be a useful adjunct to computed tomography for the evaluation of suspected vascular lesions of the orbit. 相似文献
58.
Alexander Goldberg Ursula Schlötzer-Schrehardt Theo Seiler 《International ophthalmology》1997,21(3):117-120
We report the first case of a unilateral microcysticMeesmann‘s epithelial dystrophy, observed in the left cornea of a 43-year-old
patient. The diagnosis was verified histologically by the unilateral occurrence of a ’peculiar substance‘ within epithelial
cysts and within the cytoplasm of the corneal epithelial cells. In an attempt to resolve thepatient‘s frequent corneal erosions,
we performed an autologous stem cell transplantation from the non-involved right eye. The results are, so far, satisfactory.
This revised version was published online in August 2006 with corrections to the Cover Date. 相似文献
59.
Nocturnal pains of the leg were the only complaint of a 2 1/2-year-old girl with recurrent dislocations of the left hip. Unusual movement during sleep probably caused the dislocations. This case represents a benign entity characterized by spontaneous or voluntary posterior dislocations of the femoral head in young children without other significant connective tissue abnormalities. 相似文献
60.
We have reported a case of severe erythema multiforme caused by outbreaks of recurrent HSV-2 infection. The EM was debilitating and responded to the treatment of HSV with oral acyclovir. On stopping the oral acyclovir, the HSV and the EM both recurred. We recommend a trial of oral acyclovir in cases of severe EM caused by recurrent HSV. 相似文献