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71.
Barcos LO Gimeno EJ Ibarra O Leanes LF Schudel AA 《Revue scientifique et technique (International Office of Epizootics)》1999,18(1):104-121
The authors review the policies designed to prevent and deal with animal health emergencies which have been implemented in countries of South America. They describe the evolution of the epidemiological situation of the continent, the new arrangements for international trade in animals and products of animal origin arising from the creation of the World Trade Organization (WTO), and the consequences of such developments for livestock production in South America. Veterinary systems used to prevent and deal with emergencies in the eleven OIE Member Countries on the continent are described, together with emerging problems which confront the Veterinary Services of the continent, namely: exotic diseases, abnormal occurrence of endemic diseases subject to control programmes, faults in food-safety mechanisms, diseases which have an environmental impact, and problems connected with animal welfare. The emergencies which present the greatest risk to South America are foot and mouth diseases, transmissible spongiform encephalopathies, the porcine reproductive and respiratory syndrome, food poisoning, Newcastle disease and fowl plague. Other problems are the appearance of new strains of existing agents, and the presence of resistant individuals among species of bacteria or harmful arthropods. The authors emphasise the need to co-ordinate the prevention of emergencies with development work at the international level, particularly regional and international agreements, harmonization of procedures, progress in animal health and public health, risk analysis, etc. These systems and methods of prevention have a contribution to make in enhancing the potential of animal production in South America, and the adoption of stricter health and quality standards, according to criteria established by the WTO Agreement on the Application of Sanitary and Phytosanitary Measures. 相似文献
72.
73.
San Vicente B Castañón M Mulet J Morales L 《Cirugía pediátrica : organo oficial de la Sociedad Espa?ola de Cirugía Pediátrica》2000,13(2):84-86
Aneurysms are uncommon in the pediatric age-group. Unlike adults, in which aneurysms appear after alteration of the arterial wall due to systemic diseases, in children the traumatic etiology has to be considered: blunt trauma may disrupt the arterial wall and cause false aneurysm (pseudoaneurysm). Most aneurysms are asymptomatic, or they present as a pulsatile mass on an arterial traject. Diagnosis is confirmed with Doppler ultrasound and angiography. We present the case of a girl who, after blunt trauma of the right upper limb developed a pulsatile mass on the traject of the right humeral artery. Doppler ultrasound and angiography confirmed aneurysm of the humeral artery. She was successfully treated with surgical resection of the aneurysm and reconstruction of the arterial wall. 相似文献
74.
Visceral leishmaniasis should be suspected in renal transplant recipients in whom a fever develops of unknown origin. A 53-year-old renal transplant recipient developed pyrexia, hepatosplenomegaly, and pancytopenia 4 years after transplantation. Antileishmaniasis serology was negative, and the diagnosis was confirmed through bone marrow examination. Treatment with glucantine (N-methylglucamine antimoniate) led to acute pancreatitis, and treatment with ketoconazole plus allopurinol for 21 days was effective to eradicate Leishmania donovani. 相似文献
75.
Edgardo Rivera Vicente Valero Deborah Francis Aviva G Asnis Larry J Schaaf Barbara Duncan Gabriel N Hortobagyi 《Clinical cancer research》2004,10(6):1943-1948
PURPOSE: We conducted a pilot study assessing the effects of the selective estrogen receptor modulator, tamoxifen, on the pharmacokinetics, pharmacodynamics, and safety of the steroidal, irreversible aromatase inhibitor (AI), exemestane, when the two were coadministered in postmenopausal women with metastatic breast cancer. EXPERIMENTAL DESIGN: Patients with documented or unknown hormone receptor sensitivity were eligible. Patients received oral exemestane at 25-mg once daily. Starting day 15, oral tamoxifen at 20-mg once daily, was added. We measured plasma concentrations of exemestane, estrone, estrone sulfate, and estradiol after 14 days of exemestane monotherapy and after approximately 4 weeks of combination therapy. The incidence and severity of adverse events were assessed by physical examination and patient reporting. RESULTS: We treated 18 patients. All had received prior chemotherapy and/or hormonal therapy, eight and six, respectively, with single-agent selective estrogen receptor modulators or irreversible aromatase inhibitors; no hormonal therapy was given within 30 days of study entry. Plasma exemestane concentrations and estrone, estrone sulfate, and estradiol suppression were unchanged after approximately 4 weeks of tamoxifen coadministration. All drug-related adverse events were grades 1 or 2; none was unexpected. Although not a formal study end point, antitumor activity was noted, with two partial responses and four cases of stable disease among 17 evaluable patients after a 9-month median follow-up (range, 2.5-19 months). CONCLUSIONS: This pilot study provides evidence that coadministration of tamoxifen does not affect exemestane pharmacokinetics or pharmacodynamics and that the combination is well-tolerated and active. Further clinical investigation is warranted. 相似文献
76.
Vicente Valentín Maganto Maite Murillo González María Valentín Moreno 《Clinical & translational oncology》2004,6(7):448-457
Continuous care for the cancer patient is an open concept that is not only applicable only to the terminal stage. Such a simplification
could generate inequities of therapy and discrimination. Historically, oncology services have been structured as networks
dispensing chemotherapy and radiotherapy rather than services dedicated to the integrated care of the cancer patient. This
situation has changed in a continuous and progressive manner over the past few years, as reflected in the latest Spanish Libro
Blanco de Oncología. We are still far from reaching the optimum level of integrated care, possibly because we have not, as
yet, achieved services that are structured and appropriate for the care-needs of the patient and, perhaps, to the lack of
the necessary personnel. We must always make sure that cancer patients receive the best possible treatment, irrespective of
whet-her the disease is in relapse. Oncologists must not “give up”, indicating that, in addition to using the most effective
anticancer treatments available, they should deploy their best knowledge and experience to control the symptoms of cancer
while providing psycho-social help to the patient and family. This is best conducted with a communication that is adjusted
to the changing needs of the patient over the longterm clinical process, and should be provided by a multidisciplinary team,
according to the needs of the patient and the family.
Within a program of integrated care, it is possible to coordinate the existing care structures without creating parallel health
networks so as to cover the needs of the greatest number of cancer patients in advanced stage of the disease. 相似文献
77.
Preoperative uracil, tegafur, and concomitant radiotherapy in operable rectal cancer: a phase II multicenter study with 3 years' follow-Up. 总被引:2,自引:0,他引:2
Carlos Fernández-Martos Jorge Aparicio Carles Bosch Marilo Torregrosa Juan Manuel Campos Salvador Garcera Jose Maria Vicent Inmaculada Maestu Miguel Angel Climent Jose Luis Mengual Alejandro Tormo Ana Hernandez Rafael Estevan Jose Maria Richart Vicente Viciano Natalia Uribe Jorge Campos Ramon Puchades Francisco Arlandis Daniel Almenar 《Journal of clinical oncology》2004,22(15):3016-3022
PURPOSE: To assess tolerance and efficacy of preoperative treatment with uracil/tegafur and radiotherapy (RT) followed by surgery and postoperative flurouracil (FU)/leucovorin (LV) in patients with rectal cancer. PATIENTS AND METHODS: Patients (n = 94) with potentially resectable tumors, ultrasound at stages T2N+ (n = 4), T3 (n = 77), T4 (n = 13) were treated with UFT (400 mg/m2/d, 5 days a week for 5 weeks) and concomitant RT to the pelvis (45 Gy; 1.8 Gy/d over 5 weeks). Patients underwent surgery 5 to 6 weeks later followed by four cycles of FU/LV. Primary end points included downstaging, pathologic responses, and sphincter-preserving surgery. Secondary end points were recurrence-free survival and overall survival. RESULTS: All patients received the full RT dose. Fifteen patients (16%) needed UFT dose reduction. Preoperative G3+ toxicities included diarrhea (14%), leukopenia (1%), thrombocytopenia (1%), and nausea (4%). The downstaging rate was 54%, pathologic complete response (pCR) was 9% and, in an additional 23%, there were only residual microscopic foci. When cellular viability criteria were taken into account, the pCR was 15%. From 43 patients with abdominoperineal resection indication, 11 (25%) had sphincter-preserving surgery performed. Postoperative scheduled chemotherapy dose was not administered to 24% of patients because of G3+ toxicity (diarrhea, 8%; mucositis, 9%; and leukopenia, 7%). Patients with downstaging had significantly higher survival and recurrence-free survival rates than those without. At 3 years, actuarial patterns of failure were pelvic, 5% and distant, 11%. OS was 75%. CONCLUSION: UFT combined with RT is safe and effective. In resectable rectal cancer, if preoperative treatment is considered, this approach can be an option. 相似文献
78.
79.
80.
Conservative treatment for postintubation tracheobronchial rupture 总被引:10,自引:0,他引:10
Jougon J Ballester M Choukroun E Dubrez J Reboul G Velly JF 《The Annals of thoracic surgery》2000,69(1):216-220
BACKGROUND: Postintubation tracheobronchial rupture is usually responsible for unstable intraoperative or postoperative conditions, and its management is discussed. We insist on conservative treatment as a viable alternative after late diagnosis of postintubation tracheobronchial rupture. METHODS: We conducted a retrospective study including 14 consecutive patients treated between April 1981 and July 1998. RESULTS: Twelve tracheobronchial ruptures occurred after intubation for general surgery and two after thoracic surgery. In all cases, the tear consisted of a linear laceration of the posterior membranous wall of the tracheobronchial tree ranging from 2 to 6 cm. One death occurred in a very weak patient unfit to undergo a redo operation for surgical repair. Seven patients were treated conservatively and cured without sequelae. Six patients underwent surgical repair, of whom 2 were diagnosed and repaired intraoperatively. CONCLUSIONS: Aggressive surgical repair is not always mandatory after delayed diagnosis of iatrogenic tracheobronchial rupture. Conservative treatment must often be considered, except after lung resection. 相似文献