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101.
102.
Figueiredo AA Lucon AM Júnior RF Ikejiri DS Nahas WC Srougi M 《International urology and nephrology》2009,41(2):327-333
Objective Compare the clinicoradiological presentation of urogenital tuberculosis (UGT) between immunocompromised and nonimmunocompromised
patients.
Patients and methods Eighty patients diagnosed with UGT were divided into two groups: eight immunocompromised patients (four with acquired immunodeficiency
syndrome [AIDS], and four renal transplant patients on immunosuppressive therapy) and 72 nonimmunocompromised patients. The
groups were compared as for age, signs and symptoms, diagnostic approach, pattern of urogenital organ involvement, and early
specific mortality (within 6 months from diagnosis).
Results AIDS patients were younger (median age 26 years, range 16–38 years), and renal transplant patients were older (median age
51.5 years, range 45–57 years), compared with the nonimmunocompromised subjects (median age 35 years, range 12–75 years).
Immunocompromised patients had greater frequency of fever (87.5% versus 43.1%, P = 0.024), lower frequency of storage symptoms (37.5% versus 76.4%, P = 0.033), shorter length of disease (<6 months: 87.5% versus 2.8%, P < 0.001), and larger frequency of disseminated tuberculosis (62.5% versus 18.1%, P = 0.012). Predominantly parenchymatous renal involvement was more frequent in immunocompromised patients (87.5% versus 6.2%,
P < 0.001), who also had lower frequency of stenosis of the collecting system (12.5% versus 93.8%, P < 0.001) and contracted bladder (12.5% versus 65.3%, P = 0.001).
Conclusions UGT has a different clinicoradiological presentation in immunocompromised patients, with predominance of systemic symptoms,
disseminated tuberculosis, multiple parenchymatous renal foci, and lower frequency of lesions of the collecting system. In
the context of immunosuppression, UGT behaves as a severe bacterial infection, with bacteremia and visceral metastatic foci. 相似文献
103.
Risch SC Horner MD McGurk SR Palecko S Markowitz JS Nahas Z DeVane CL 《Schizophrenia Research》2007,93(1-3):131-135
Thirteen outpatients with chronic but stable schizophrenia received donepezil and placebo augmentation of their maintenance antipsychotic medication regimen. Each subject received in a randomized, counterbalanced order 1) donepezil 5 mg for 6 weeks then donepezil 10 mg for six weeks and 2) placebo donepezil for 12 weeks. Serial ratings of the Positive and Negative Symptom Scale (PANSS) [Kay, S.R., Fiszbein, A., Opler, L.A., 1987. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin 13(2): 261-276] were performed by a trained rater blind to the donepezil order and condition: at baseline, 12 weeks and 24 weeks. On donepezil as compared to baseline or placebo, there was a significant improvement in PANSS negative scores (p=.018, n=13). These results are discussed with respect to other studies using cholinesterase inhibitors as an augmentation strategy in schizophrenia. 相似文献
104.
George MS Nahas Z Borckardt JJ Anderson B Foust MJ Burns C Kose S Short EB 《Current opinion in psychiatry》2007,20(3):250-4; discussion 247-9
105.
106.
Nahas CS Akhurst T Yeung H Leibold T Riedel E Markowitz AJ Minsky BD Paty PB Weiser MR Temple LK Wong WD Larson SM Guillem JG 《Annals of surgical oncology》2008,15(3):704-711
Background Patients with locally advanced rectal cancer may present with synchronous distant metastases. Choice of optimal treatment—neoadjuvant
chemoradiation versus systemic chemotherapy alone—depends on accurate assessment of distant disease. We prospectively evaluated
the ability of [18F]fluorodeoxyglucose ([18F]FDG) positron emission tomography (PET) to detect distant disease in patients with locally advanced rectal cancer who were
otherwise eligible for combined modality therapy (CMT).
Methods Ninety-three patients with locally advanced rectal cancer underwent whole-body [18F]FDG PET scanning 2–3 weeks before starting CMT. Sites other than the rectum, mesorectum, or the area along the inferior
mesenteric artery were considered distant and were divided into nine groups: neck, lung, mediastinal lymph node (LN), abdomen,
liver, colon, pelvis, peripheral LN, and soft tissue. Two nuclear medicine physicians blinded to clinical information used
PET images and a five-point scale (0–4) to determine certainty of disease. A score greater than 3 was considered malignant.
Confirmation was based on tissue diagnosis, surgical exploration, and subsequent imaging.
Results At a median follow-up of 34 months, the overall accuracy, sensitivity, and specificity of PET in detecting distant disease
were 93.7%, 77.8%, and 98.7% respectively. Greatest accuracy was demonstrated in detection of liver (accuracy = 99.9%, sensitivity = 100%,
specificity = 98.8%) and lung (accuracy = 99.9%, sensitivity = 80%, specificity = 100%) disease; PET detected 11/12 confirmed
malignant sites in liver and lung. A total of 10 patients were confirmed to have M1 stage disease. All 10 were correctly staged
by pre-CMT PET; abdominopelvic computed tomography (CT) scans accurately detected nine of them.
Conclusion Baseline PET in patients with locally advanced rectal cancer reliably detects metastatic disease in liver and lung. PET may
play a significant role in defining extent of distant disease in selected cases, thus impacting the choice of neoadjuvant
therapy.
An erratum to this article can be found at 相似文献
107.
Laparoscopic pyeloplasty: a prospective randomized comparison between the transperitoneal approach and retroperitoneoscopy 总被引:3,自引:0,他引:3
PURPOSE: A prospective randomized study was performed to compare the results of laparoscopic dismembered pyeloplasty using transperitoneal and retroperitoneal approaches. MATERIALS AND METHODS: A total of 40 patients with primary ureteropelvic junction obstruction were included in the study. The patients were prospectively randomized between transperitoneal (20 patients, group 1) and retroperitoneal (20 patients, group 2) laparoscopic Anderson-Hynes pyeloplasty. All the patients were assessed preoperatively by excretory urography, diuretic isotope renography and computerized tomography angiography. The patients were followed at 3 and 6 months postoperatively, and then every 6 months. Evaluation was performed by excretory urography and diuretic renography. Both approaches were compared regarding operative time, morbidity, hospital stay, convalescence and functional outcome. The preoperative demographic data of the patients and radiological and operative findings were statistically correlated to the operative time. RESULTS: The preoperative data of both groups were comparable. All the procedures were successfully completed with laparoscopy. Mean operative times were 149 and 189 minutes for the transperitoneal approach and retroperitoneoscopy, respectively (p = 0.02). In groups 1 and 2 there were complications in 3 and 5 patients, respectively. Morbidity, hospital stay, convalescence and success rate had no significant differences between the groups. None of the patient parameters apart from the approach had a significant impact on operative time. CONCLUSIONS: Laparoscopic dismembered Anderson-Hynes pyeloplasty has a satisfactory functional outcome and low morbidity regardless of the approach. Nevertheless, with early experience retroperitoneoscopy is associated with a longer operative time. 相似文献
108.
109.
110.
Nathália Nahas Grijó Ricardo Carneiro Borra Vera Lucia Sdepanian 《Digestive diseases and sciences》2010,55(9):2498-2504