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121.
M. S. Reddy S. A. White B. C. Jaques N. Torpey D. M. Manas 《American journal of transplantation》2007,7(10):2422-2424
As demand for donor pancreases increases, attempts are being made to utilize even marginal grafts for transplantation. Injury during pancreas recovery can predispose to posttransplant complications and graft loss. Early recognition and correction can salvage these grafts. The authors report an instance of poor segmental perfusion of the pancreas graft that was salvaged by pancreas head resection and enteric drainage through a Roux-en-Y pancreatico-jejunostomy. 相似文献
122.
Steven D. Wexner MD FACS FRCS FRCS Lester Rosen MD Todd H. Baron MD FASGE 《Gastrointestinal endoscopy》2007,65(7):1104-1105
123.
Sumon Nandi Steven Maschke Peter J. Evans Jeffrey N. Lawton 《Hand (New York, N.Y.)》2009,4(4):368-379
Elbow motion is essential for upper extremity function to position the hand in space. Unfortunately, the elbow joint is prone
to stiffness following a multitude of traumatic and atraumatic etiologies. Elbow stiffness can be diagnosed with a complete
history and physical exam, supplemented with appropriate imaging studies. The stiff elbow is challenging to treat, and thus,
its prevention is of paramount importance. When this approach fails, non-operative followed by operative treatment modalities
should be pursued. Upon initial presentation in those who have minimal contractures of 6-month duration or less, static and
dynamic splinting, serial casting, continuous passive motion, occupational/physical therapy, and manipulation are non-operative
treatment modalities that may be attempted. A stiff elbow that is refractory to non-operative management can be treated surgically,
either arthroscopically or open, to eliminate soft tissue or bony blocks to motion. In the future, efforts to prevent and
treat elbow stiffness may target the basic science mechanisms involved. Our purpose was to review the etiologies, classification,
evaluation, prevention, operative, and non-operative treatment of the stiff elbow. 相似文献
124.
Biostatisticians have frequently uncritically accepted the measurements provided by their medical colleagues engaged in clinical research. Such measures often involve considerable loss of information. Particularly, unfortunate is the widespread use of the so‐called ‘responder analysis’, which may involve not only a loss of information through dichotomization, but also extravagant and unjustified causal inference regarding individual treatment effects at the patient level, and, increasingly, the use of the so‐called number needed to treat scale of measurement. Other problems involve inefficient use of baseline measurements, the use of covariates measured after the start of treatment, the interpretation of titrations and composite response measures. Many of these bad practices are becoming enshrined in the regulatory guidance to the pharmaceutical industry. We consider the losses involved in inappropriate measures and suggest that statisticians should pay more attention to this aspect of their work. Copyright © 2009 John Wiley & Sons, Ltd. 相似文献
125.
Steven Z George John D Childs Deydre S Teyhen Samuel S Wu Alison C Wright Jessica L Dugan Michael E Robinson 《BMC musculoskeletal disorders》2007,8(1):92
Background
There are few effective strategies reported for the primary prevention of low back pain (LBP). Core stabilization exercises targeting the deep abdominal and trunk musculature and psychosocial education programs addressing patient beliefs and coping styles represent the current best evidence for secondary prevention of low back pain. However, these programs have not been widely tested to determine if they are effective at preventing the primary onset and/or severity of LBP. The purpose of this cluster randomized clinical trial is to determine if a combined core stabilization exercise and education program is effective in preventing the onset and/or severity of LBP. The effect of the combined program will be compared to three other standard programs. 相似文献126.
Vanaporn Wuthiekanun Varunee Desakorn Gumphol Wongsuvan Premjit Amornchai Allen C. Cheng Bina Maharjan Direk Limmathurotsakul Wirongrong Chierakul Nicholas J. White Nicholas P. J. Day Sharon J. Peacock 《Clinical and Vaccine Immunology : CVI》2005,12(4):555-556
An immunofluorescent (IF) method that detects Burkholderia pseudomallei in clinical specimens within 10 min was devised. The results of this rapid method and those of an existing IF method were prospectively compared with the culture results for 776 specimens from patients with suspected melioidosis. The sensitivities of both IF tests were 66%, and the specificities were 99.5 and 99.4%, respectively. 相似文献
127.
Patient-controlled analgesia. Does a concurrent opioid infusion improve pain management after surgery? 总被引:4,自引:0,他引:4
OBJECTIVE.--To assess the influence of a continuous (basal) morphine infusion as part of a patient-controlled analgesia (PCA) system on the postoperative analgesic requirement and on recovery parameters following abdominal hysterectomy. DESIGN.--Single-center, randomized, controlled protocol. SETTING.--University medical center. PARTICIPANTS.--A total of 230 adult women were randomly assigned to receive no morphine infusion (control group) or a continuous 0.5-, 1.0-, or 2.0-mg/h morphine infusion. Each patient was able to self-administer supplemental intravenous bolus doses of morphine (1 to 2 mg) using a PCA infuser. MAIN OUTCOME MEASURES.--Use of the PCA device, opioid-related side effects, recovery times, and the patients' assessment of pain and sedation on linear visual analog scales were recorded during the 72-hour study period. Follow-up questionnaires were completed by the patients and their health care professionals to assess the overall adequacy of PCA therapy. RESULTS.--Patients who received the 2-mg/h morphine infusions received significantly more opioid medication 9 to 72 hours after their operation than those who received no infusion (control group). The presence of a continuous morphine infusion of 0.5 to 2 mg/h did not significantly decrease the number of patient demands or supplemental bolus doses administered compared with the control group. Overall, 168 (84%) of the 199 patients who completed the 72-hour study were able to achieve adequate analgesia without requiring changes in the PCA regimen or experiencing major side effects. Recovery times and outcome variables were similar in all four groups. CONCLUSION.--The routine use of a continuous opioid infusion in combination with a standard PCA regimen does not improve pain management compared with PCA alone after abdominal hysterectomy. 相似文献
128.
129.
Synergistic effect of low dose Cyclosporine A and human interleukin 10 overexpression on acute rejection in rat lung allotransplantation 总被引:3,自引:0,他引:3
Jaroslaw Pierog Amiq Gazdhar Uz Stammberger Matthias Gugger Steven Hyde Iacob Mathiesen Tomasz Grodzki Ralph A. Schmid 《European journal of cardio-thoracic surgery》2005,27(6):1030-1035
Objective: Electroporation mediated transfer of plasmid DNA into peripheral muscle results in high transfection efficiency. The aim of this study was to investigate the effect of gene transfer of human IL-10 (hIL-10) into the tibialis anterior muscle (MTA) in combination with low dose Cyclosporine A (CsA) on acute rejection of lung allografts in the rat. Methods: Lung allotransplantation was performed from male BN donor to male Fisher F344 rats. Gene transfer was achieved by intramuscular injection into the MTA of the recipient followed by electroporation (4×20 ms impulses at 200 V/cm) 24 h prior to the transplantation. Group A (n=5) received CsA (2.5 mg/kg bw ip) for 5 days post-transplant and group B (n=5) 2.5 μg of PCIK hIL-10 (plasmid expression vector containing human CMV immediate early gene promoter and enhancer) and a low dose CsA (2.5 mg/kg bw i.p.). Graft function was assessed by blood gas at day 5 after exclusion of the native lung. Animals were sacrificed and blood was drawn to measure serum hIL-10 levels (ELISA) and tissue was sampled for histological grading of rejection. Results: Local expression of hIL-10 was confirmed at the mRNA level by in situ hybridization. All group A control animals showed severe signs of rejection. At day 5 all grafts in group B showed good gas exchange mean PaO2 233±123 mmHg, vs 44±8 mmHg in group A. Histological examination revealed moderate to severe rejection in all animals in group A (IIIB, ISHLT) in contrast to low moderate rejection in group B (II–IIIA). hIL-10 serum levels on day 5 were 14±7 pg/ml in group B vs. 0 in group A. Conclusions: Electroporation mediated hIL-10 overexpression in a peripheral muscle of the recipient in combination with low dose CsA reduces acute rejection in this model of rat lung allotransplantation. 相似文献
130.