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Sanjay Sisodiya J Helen Cross Ingmar Blümcke David Chadwick John Craig Peter B Crino Paul Debenham Norman Delanty Frances Elmslie Mark Gardiner Jeffrey Golden David Goldstein David A Greenberg Renzo Guerrini Michael Hanna John Harris Paul Harrison Michael R Johnson George Kirov Dimitri M Kullman Andrew Makoff Carla Marini Rima Nabbout Lina Nashef Jeffrey L Noebels Ruth Ottman Munir Pirmohamed Asla Pitk?nen Ingrid Scheffer Simon Shorvon Graeme Sills Nicholas Wood Sameer Zuberi 《Epileptic Disord》2007,9(2):194-236
The Sixth Epilepsy Research Foundation workshop, held in Oxford in March 2006, brought together basic scientists, geneticists, epidemiologists, statisticians, pharmacologists and clinicians to consider progress, issues and strategies for harnessing genetics to improve the understanding and treatment of the epilepsies. General principles were considered, including the fundamental importance of clear study design, adequate patient numbers, defi ned phenotypes, robust statistical data handling, and follow-up of genetic discoveries. Topics where some progress had been made were considered including chromosomal abnormalities, neurodevelopment, hippocampal sclerosis, juvenile myoclonic epilepsy, focal cortical dysplasia and pharmacogenetics. The ethical aspects of epilepsy genetics were reviewed. Principles and limitations of collaboration were discussed. Presentations and their matched discussions are produced here. There was optimism that further genetic research in epilepsy was not only feasible, but might lead to improvements in the lives of people with epilepsy. 相似文献
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Osteochondral Fracture of the Fourth Metatarsal Head Treated by Open Reduction and Internal Fixation
Praveen K.R. Mereddy MBBS MSOrth DNB Orth MRCSEd Andrew Molloy MBchB MRCS FRCS Michael S. Hennessy BSc MBchB FRCSEd 《The Journal of foot and ankle surgery》2007,46(4):320-322
Fracture of the metatarsal head is uncommon, and reports of isolated osteochondral fracture of the metatarsal head are rare. Because of the distal location of the fracture, it is difficult to achieve and maintain reduction, and potential complications include avascular necrosis and subchondral fatigue fracture. The authors present a case of an osteochondral fracture in a 40-year-old man, which was treated by open reduction and internal fixation with a single twist-off screw, with good results 12 months postoperatively. 相似文献
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Qualitative Data Analysis: An Introduction 总被引:1,自引:1,他引:0
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Transabdominal sacrocolpopexy has been shown, in multiple long-term studies of its success and durability, to be the definitive
treatment option for post-hysterectomy vaginal vault prolapse. It is, however, associated with greater morbidity than vaginal
repair. We describe a minimally invasive technique for vaginal vault prolapse repair and present our experience with a minimum
of one-year follow-up. The surgical technique involves five laparoscopic ports—three for the da Vinci robot and two for the
assistant. After appropriate dissection a polypropylene mesh is attached to the sacral promontory and to the vaginal apex
by use of Gore-Tex sutures. The mesh material is then covered by the peritoneum. Patient analysis focused on complications,
urinary continence, patient satisfaction, and morbidity, with a minimum of 12 months follow-up. Forty-two patients with post-hysterectomy
vaginal vault prolapse underwent robot-assisted laparoscopic sacrocolpopexy at our institute and 35 have a minimum of 12 months
follow-up, with a mean follow-up of 36 months (range 12–48) in the group. Mean age was 67 (47–83) years and mean operating
time was 3.1 (2.15–4.75) h for the entire cohort. All but one patient were discharged home on postoperative day one; one patient
left on postoperative day two. One developed recurrent grade three rectocele, one had recurrent vault prolapse, and two suffered
from vaginal extrusion of mesh. All patients were satisfied with their outcome. The robot-assisted laparoscopic sacrocolpopexy
is a minimally invasive technique for vaginal vault prolapse repair, combining the advantages of open sacrocolpopexy with
the reduced morbidity of laparoscopy. We observed reduced hospital stay, low occurrence of complications, and high patient
satisfaction, with a minimum of 1-year follow-up. Most importantly, the long-term results of the robotic repair are similar
to those of open repair, but with significantly less morbidity. 相似文献
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Ruth McDonald BA MSc PhD Stephen Harrison BSc MPhil PhD 《Health & social care in the community》2004,12(3):194-201
Recent New Labour policy for the ‘modernisation’ of Government places a good deal of emphasis on decentralisation. This emphasis is particularly marked in relation to the organisation of primary care. However, like hospitals and other National Health Service institutions, primary care trusts (PCTs) are subject to a substantial raft of centrally established performance targets and indicators, including those which contribute to the public award of between zero and three performance ‘stars’. This raises questions about the extent to which employees can exercise autonomy in the context of rigid top‐down directives. This paper presents findings from a study using participant observation and interviews to examine the impact of a training course aimed ostensibly at increasing employee autonomy in an English PCT. The suggestion is that attempts to make employees more autonomous can be seen as a strategy for increasing central control based upon the internalisation by the employees of centrally promulgated values. The attraction of such strategies is that they may be potentially more effective and less costly than alternative strategies of direct control. However, the study suggests that the outcome of attempts by such methods as programmes to increase employee autonomy may be very different from those intended. 相似文献
29.
Alfred Philip James Lake BSc MBBS FFARCS ; Kathiravelpillai Puvanachandra MBBS DO FRCS FRCOphth 《Pain practice》2004,4(2):130-131
Abstract: Stellate ganglion block is commonly used to treat the sympathetically maintained pain which may occur in one‐third of patients with complex regional pain syndrome type 1. A complication that followed a single block and presented a diagnostic dilemma for the ophthalmologist is reported. 相似文献
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