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101.
102.
Santaro Noguchi Shunsuke Nakakura Asuka Noguchi Sayuri Nakama Yoko Tastukawa Tomoyuki Kashima Hitoshi Tabuchi 《Medicine》2021,100(4)
To evaluate the utility of low-concentration nitrous oxide (N2O) anesthesia in ptosis surgeryThis study was a retrospective consecutive case series that included 54 successive patients with blepharoptosis who underwent bilateral levator aponeurosis advancement and on whom skin resection performed by the same surgeon between August 2016 and July 2017. Among these patients, 27 were operated with a local anesthesia injection (air group) and 27 with a local anesthesia injection and low-concentration N2O anesthesia (N2O group). All N2O cases used a total of 6 L of gas comprising 70% oxygen and 30% N2O. Preoperative and postoperative blood pressure (BP) and heart rate (HR) and intraoperative pain, anxiety, nausea, and memory were measured immediately after surgery using visual analog scale score (VASS). Additionally, perioperative side effects were examined.There was no significant difference in age, sex, and preoperative and postoperative margin reflex distance (MRD) between the 2 groups (all P > .05). The intraoperative mean peripheral oxygen saturation was significantly higher (97.5% ± 1.6% vs 99.5% ± .6%, P < .001), intraoperative HR was significantly lower (78.2 ± 12.8 vs 70.7 ± 11.6 bpm, P = .02), and operation time was significantly shorter (33.1 ± 8.1 vs 29.4 ± 10.3 minutes, P = .03) in the N2O group than in the air group.Difference between intraoperative and preoperative systolic BP (BPs) (+15.8 ± 18.0 vs + 3.1 ± 21.7 mm Hg, P = .02), diastolic BP (BPd) (+7.0 ± 17.4 vs −2.3 ± 13.6 mm Hg, P = .04), and HR (3.2 ± 8.5 vs −3.9 ± 9.4 bpm, P = .01) was significantly lower in the N2O group than in the air group.VASS of intraoperative pain was significantly lower in the N2O group than in the air group (49.5 ± 24.7 vs 22.6 ± 14.9, P < .001), whereas intraoperative anxiety and memory did not present significant differences between the groups (P = .09 and P = .45, respectively). Intraoperative nausea score was 0 for all cases in both groups. There was no other side effect.Ptosis surgery with anesthesia using 30% N2O may effectively suppress intraoperative BP and HR along with pain and shorten the operation time without side effects such as nausea. 相似文献
103.
Isha Patel Rachel Rarus Xi Tan EK Lee Jason Guy Akram Ahmad Jongwha Chang 《Indian journal of pharmacology》2015,47(6):585-593
Comparative effectiveness research (CER) is an important branch of pharmacoeconomics that systematically studies and evaluates the cost-effectiveness of medical interventions. CER plays instrumental roles in guiding government public health policy programs and insurance. Countries throughout the world use different methods of CER to help make medical decisions based on providing optimal therapy at a reduced cost. Expenses to the healthcare system continue to rise, and CER is one-way in which expenses could be curbed in the future by applying cost-effectiveness evidence to clinical decisions. China, India, South Korea, and the United Kingdom are of essential focus because these country''s economies and health care expenses continue to expand. The structures and use of CER are diverse throughout these countries, and each is of prime importance. By conducting this thorough comparison of CER in different nations, strategies and organizational setups from different countries can be applied to help guide public health and medical decision-making in order to continue to expand the establishment and role of CER programs. The patient-centered medical home has been created to help reduce costs in the primary care sector and to help improve the effectiveness of therapy. Barriers to CER are also important as many stakeholders need to be able to work together to provide the best CER evidence. The advancement of CER in multiple countries throughout the world provides a possible way of reducing costs to the healthcare system in an age of expanding expenses.KEY WORDS: Comparative effectiveness research, health care costs, pharmacoeconomics 相似文献
104.
Loss of bone mineral density in Chinese pre-menopausal women with systemic lupus erythematosus treated with corticosteroids 总被引:7,自引:1,他引:7
The adverse effect of disease and chronic corticosteroid therapy on bone
mineral density (BMD) in patients with systemic lupus erythematosus (SLE)
has been reported in several studies of Caucasian populations. As the
factors controlling bone homeostasis may be different in Asian populations,
we measured BMD in 52 pre-menopausal Chinese women (mean age 34.1 +/- 8.0
yr) with SLE (mean disease duration 6.4 +/- 4.5 yr) treated with prednisone
(mean daily dose 11.4 +/- 10.8 mg/day). Lumbar spine, hip (total and
subregions) and total body BMDs were measured in the SLE patients using
dual-energy X-ray absorptiometry (DEXA), and compared with those from
healthy controls matched for age, sex and body mass index. Compared to
controls, SLE patients were found to have lower BMD (g/cm2) at several
sites: the lumbar spine (0.98 vs 0.90, P = 0.001), Ward's triangle (0.72 vs
0.67, P = 0.03), total body (1.04 vs 1.01, P = 0.04) and total hip (0.87 vs
0.82, P = 0.05). There was no correlation between BMD at any region and
duration of disease, activity of disease or prednisone therapy (mean daily
dose, cumulative dose or treatment duration). When BMDs were compared
between controls and SLE patients, subgrouped according to those not on
calcium and those arbitrarily receiving calcium supplements (1 g/day),
significantly lower BMDs were found in those not on calcium compared to
both controls and SLE patients on calcium. BMDs in SLE patients on calcium
were not different from those in controls. The low prevalence of
osteoporosis in our SLE patients (4-6%) suggests significant loss of BMD in
Chinese SLE patients on corticosteroid therapy is less than that reported
in Caucasians (12-18%).
相似文献
105.
Nichols WC; Cooney KA; Mohlke KL; Ballew JD; Yang A; Bruck ME; Reddington M; Novak EK; Swank RT; Ginsburg D 《Blood》1994,83(11):3225-3231
An animal model for human type I von Willebrand disease (vWD) has been previously described in the inbred mouse strain RIIIS/J. Murine vWD is characterized by a prolonged bleeding time, normal von Willebrand factor (vWF) multimer distribution, autosomal dominant inheritance, and proportionately decreased plasma vWF antigen, ristocetin cofactor, and factor VIII (FVIII) activities. To study the molecular genetics of murine vWD, a portion of the vWF gene surrounding exon 28 was cloned, sequenced, and used to develop two informative DNA sequence polymorphisms for rapid genotyping by DNA polymerase chain reaction. RIIIS/J mice were crossed with PWK/Ph mice, an inbred line of Mus musculus musculus, and the F1 progeny backcrossed to the parental PWK/Ph strain. vWF antigen levels in F1 mice were not significantly different from the parental RIIIS/J strain but were markedly decreased compared with the parental PWK/Ph mice. Genetic linkage analysis of 104 backcross progeny showed no correlation between vWF antigen level and vWF genotype. These data indicate that murine vWD is caused by a defect at a novel genetic locus, distinct from the murine vWF gene. The distribution of vWF antigen levels among backcross progeny suggests the presence of one major dominant vWD gene in the RIIIS/J mouse with possible modifying contributions from one or more additional minor loci. These observations may provide new insights into the molecular basis and variable expressivity of human vWD. 相似文献
106.
107.
Tempero MA Arnoletti JP Behrman SW Ben-Josef E Benson AB Casper ES Cohen SJ Czito B Ellenhorn JD Hawkins WG Herman J Hoffman JP Ko A Komanduri S Koong A Ma WW Malafa MP Merchant NB Mulvihill SJ Muscarella P Nakakura EK Obando J Pitman MB Sasson AR Tally A Thayer SP Whiting S Wolff RA Wolpin BM Freedman-Cass DA Shead DA 《Journal of the National Comprehensive Cancer Network : JNCCN》2012,10(6):703-713
The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Pancreatic Adenocarcinoma discuss the workup and management of tumors of the exocrine pancreas. These NCCN Guidelines Insights provide a summary and explanation of major changes to the 2012 NCCN Guidelines for Pancreatic Adenocarcinoma. The panel made 3 significant updates to the guidelines: 1) more detail was added regarding multiphase CT techniques for diagnosis and staging of pancreatic cancer, and pancreas protocol MRI was added as an emerging alternative to CT; 2) the use of a fluoropyrimidine plus oxaliplatin (e.g., 5-FU/leucovorin/oxaliplatin or capecitabine/oxaliplatin) was added as an acceptable chemotherapy combination for patients with advanced or metastatic disease and good performance status as a category 2B recommendation; and 3) the panel developed new recommendations concerning surgical technique and pathologic analysis and reporting. 相似文献
108.
109.
A multidisciplinary team is essential for the optimal management of patients with metastatic neuroendocrine tumors. In this article, the systemic and regional nonsurgical therapeutic options for metastatic neuroendocrine cancers are discussed. In particular, the roles of biotherapy, chemotherapy, and hepatic artery embolization/chemoembolization are reviewed. A proposed treatment algorithm is provided with the aim of providing clinicians with a useful framework for managing these challenging patients. Finally, the rationale for promising investigational therapies is described. 相似文献
110.
EF Druyts BS Rachlis VD Lima SS Harvard W Zhang EK Brandson SA Strathdee JSG Montaner RS Hogg 《HIV medicine》2009,10(5):274-281