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131.
WY Khoder AJ Becker B Schlenker S Tritschler PJ Bastian CG Stief 《European journal of medical research》2009,14(7):320-322
Introduction
Rectal polypectomy causes thinning (or even perforation) of the rectal wall in addition to thermic injury at the polypectomy site.Case report
We present a rare case of spontaneous rectal perforation after uncomplicated nerve sparing endoscopic extraperitoneal radical prostatectomy in a patient with a previous history of rectal polypectomy at the perforation site. The patient could be treated conservatively. There was complete healing of the fistula without any effect on functional results. This Conservative therapy for such rectal perforations is indicated if the patient''s general condition remains stable without any signs of infection.Conclusions
Polypectomy is an important risk factor for rectal perforation during nsEERPE. Adequate time interval should be given to allow healing and avoid adding further thermal wall damage which may obscure healing leading to complications like fistula. Conservative therapy for small missed rectal perforations constitutes an attractive, feasible and non invasive treatment entity. Following this principle we have not faced this complication in following similar cases. 相似文献132.
133.
W Allan Walker Eric C Martens Philip M Sherman Johanna W Lampe Meredith AJ Hullar Christine D Wu 《Nutrition reviews》2009,67(1):40-48
The extended abstracts in this report are based on presentations from the 11th Special Conference on Functional Foods for Health Promotion, cosponsored by the Technical Committee on Food Components for Health Promotion of the North American Branch of the International Life Sciences Institute (ILSI NA) and the American Society for Nutrition (ASN) at the Experimental Biology (EB) meeting in April 2008. Evidence that foods and their components offer health benefits beyond basic nutrition continues to captivate the interest of scientific communities, federal agencies, and the general public. The theme of the 2008 special conference was "Microbes and Health". It began with a general introduction and overview of how diet or dietary components can influence microbial growth and, ultimately, disease risk and overall health. Subsequent presentations provided fundamental information about how the food supply can set the landscape for gene expression in microbes and, ultimately, their influence on health (with some comments on how microbes might contribute to the obesity epidemic), child health and infections, role of microbes in cancer prevention, and effects of foods and their bioactive constituents as modifiers of microbes in the oral cavity. 相似文献
134.
Christine AE Schutgens Merel Schuring Toon AJ Voorham Alex Burdorf 《BMC public health》2009,9(1):197-11
Background
The relationship between poor health and unemployment is well established. Health promotion among unemployed persons may improve their health. The aims of this study were to investigate characteristics of non-participants and drop-outs in a multidisciplinary health promotion programme for long-term unemployed persons with health complaints, to evaluate changes in physical health among participants, and to investigate determinants of improvement in physical health. 相似文献135.
Antonina A Mikocka-Walus Deborah A Turnbull Jane M Andrews Nicole T Moulding Ian G Wilson Hugh AJ Harley David J Hetzel Gerald J Holtmann 《Clin Pract Epidemiol Ment Health》2008,4(1):15
Background
In independent studies, IBD, IBS and HCV have each been associated with a substantially increased risk of psychological problems such as depression and anxiety and impairment of quality of life compared to the general healthy population. However, the relative psychological burden for each of these diagnoses is unknown as it has never been compared contemporaneously at one institution. Current local data are therefore needed to enable an evidence-based allocation of limited clinical psychological resources.Methods
Overall, 139 outpatients (64 IBD, 41 HCV, and 34 IBS) were enrolled in this cross-sectional study. The HADS, SCL90, SF-12 and appropriate disease-specific activity measures were administered. Differences between groups were assesed with ANOVA, the Chi-Square test and the independent samples t-test (two-tailed).Results
Each of the three groups had significantly lower quality of life than the general population (p < 0.05). Overall, a total of 58 (42%) participants met HADS screening criteria for anxiety and 26 (19%) participants for depression. The HCV group had a significantly higher prevalence of depression than either of the other groups (HCV = 34%, IBS = 15% and IBD = 11%, p = 0.009). In the SCL90, the three disease groups differed on 7 out of 12 subscales. On each of these subscales, the HCV group were most severely affected and differed most from the general population.Conclusion
Patients with these common chronic gastrointestinal diseases have significant impairment of quality of life. Anxiety is a greater problem than depression, although patients with HCV in particular, should be regularly monitored and treated for co-morbid depression. Evaluation of specific psychological interventions targeting anxiety is warranted.136.
Cobo M Gutiérrez V Alcaide J Alés I Villar E Gil S Durán G Martínez J Carabantes F Bretón JJ Benavides M 《Lung cancer (Amsterdam, Netherlands)》2007,56(2):255-262
OBJECTIVE: We conducted a phase II trial to evaluate the efficacy and toxicity of a combination consisting of second-line docetaxel and gemcitabine in patients with advanced non-small-cell lung cancer (NSCLC) previously treated with platinum-based chemotherapy. PATIENTS AND METHODS: Eligibility criteria: histologically confirmed advanced NSCLC with progressive disease to platinum-based chemotherapy, ECOG performance status (PS) 0 or 1, and adequate kidney, liver and bone marrow function. Treatment consisted of docetaxel 36 mg/m(2) i.v. over 60 min followed by gemcitabine 1000 mg/m(2) i.v. over 30 min on days 1 and 8 of each 3-week cycle for a planned six cycles or unacceptable toxicity. RESULTS: Of the 52 patients enrolled, 50 were evaluable for response and toxicity. The mean age was 59 years (range 42-79), 46 male and 4 female. Histology subtypes were: adenocarcinoma 26 patients, bronchioloalveolar 1 patient, large cell carcinoma 5 patients, and squamous cell carcinoma 18 patients. Thirty-eight patients had ECOG PS 1 and 12 patients had PS 0. The median number of cycles administered was four (range 2-6). The overall response rate was 28%. The median follow-up was 9 months (range 5-34 months). The median survival time (MST) was 8.2 months (95% CI, 4-12%), and the 1-year survival was 25%. The median progression-free survival was 4.4 months (95% CI, 2-6%). In the Cox regression model, survival was only significantly affected by the PS. The median survival in patients with PS 0 was 17.8 months (95% CI, 18.8-21.8%) compared with a median survival for patients with PS 1 of 6.1 months (95% CI, 4.1-8.2%) (P=0.0057). Toxicity: three patients had grade 3 anemia, three patients had grade 3 thrombocytopenia, four patients had grade 3 neutropenia and only one patient developed grade 4 febrile neutropenia. Non-hematologic toxicity was also mild; the most frequent was asthenia, with grade 3 in eight patients (16%), and one patient with grade 4. CONCLUSION: This regimen of docetaxel in combination with gemcitabine in advanced second-line NSCLC is an active and safe regimen. 相似文献
137.
José Ángel García Fernández Blanca Paredes RosFernando Magdaleno Dans Inmaculada Rincón RicoteAntonio González González Ramón Cansino Alcaide 《Progresos de Obstetricia y Ginecología》2011,54(7):383-385
Retroperitoneal hemorrhage is a very rare event, especially during pregnancy, and is associated with high morbimortality for both the mother and fetus. The cause is usually traumatic, but these hemorrhages can occur spontaneously, which further hampers their diagnosis. Presenting symptoms are abdominal pain and maternal hypovolemic shock, with rapid fetal compromise. We present a case of maternal retroperitoneal hemorrhage, which occurred at week 35 of pregnancy due to spontaneous rupture of the left renal vein, although the first manifestation was placental abruption. 相似文献
138.
Mid-trimester loss--appraisal of a screening protocol 总被引:1,自引:0,他引:1
The main causes for mid-trimester loss are known. There is likely to be
overlap with those of first trimester loss, but the proportions may be
different. We wished to perform an aetiological survey in a large
population of patients with a history of recurrent miscarriage, for
possible explanations for their second trimester miscarriages. Database
analysis of 636 patients attending a UK University Teaching Hospital
dedicated miscarriage clinic between 1991 and 1996 revealed a 25%
prevalence (n = 158) for second trimester miscarriage. Results from an
investigative screening protocol were positive in 50% of cases: 33% (n =
52) tested positive for antiphospholipid syndrome (APS); 8% (n = 13)
fulfilled strict criteria for cervical incompetence; there was a 4%
prevalence of uterine anomaly; 3% for infection (n = 5) and 2% of patients
(n = 3) proved to be hypothyroid. Importantly, dual pathology was found in
5% of patients with a history of second trimester miscarriage. As
idiopathic mid-trimester loss is a diagnosis by exclusion, a high index of
suspicion is required, as are modern diagnostic techniques.
相似文献
139.
140.
Twenty-six patients over the age of 50 years with proven iron deficiency anaemia were identified, investigated and followed up in general practice over a five-year period. The anaemia was symptomatic in 50% of patients but only 20% had symptoms related to the gut. Faecal occult blood testing was positive in five patients only and negative tests occurred in three patients with significant disease, including one caecal carcinoma. All patients agreed to oesophagogastroduodenoscopy (OGD) and fibreoptic sigmoidoscopy carried out on the same occasion. In eight patients, significant abnormalities were found on OGD and in two patients on sigmoidoscopy. Four patients declined barium enema examinations, two of whom had significant OGD abnormalities. Barium enema examination of the other 22 patients showed polyposis of the colon and a caecal carcinoma and initially missed one carcinoma of the caecum which was found subsequently. The likelihood of finding significant disease in iron-deficient patients over 50 years of age is high and should be assumed to be due to blood loss into the gut. Investigation by OGD, sigmoidoscopy and barium enema in the first instance seems warranted and is a condition that can be safely managed by the GP. (Br J Clin Pract 1997; 51(2) : 78-80) 相似文献