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91.
92.
Alan R. Stanford md David S. Mezebish md Mark W. Cobb md 《International journal of dermatology》1997,36(11):856-858
A 29–year-old black vi/oman presented with a 6–year history of lupus nephritis, cerebritis, arthritis, and recurrent facial erythema. She was admitted to the National Naval Medical Center following an acute lupus flare manifested by the onset of acute tubular necrosis requiring the initiation of hemodialysis. The patient had also developed a Staphylococcus aureus septicemia secondary to an infected IV site. During the first and second weeks in hospital, the patient responded well to aggressive antibiotic therapy and oral prednlsone. As the oral prednisone was decreased from 60 mg to 40 mg per day on day 19 in hospital, the patient developed several tender, erythemafous, subcutaneous nodules over the lower extremities (Fig. 1). There was no cutaneous ulceration or drainage. Although the initial clinical diagnosis was erythema nodosum, a deep incisional biopsy was performed to rule out infectious, vasculitic, or lupus panniculitis. Histologic findings of a representative leg nodule included lobular panniculitis with extensive fat necrosis,' ghost cell' formation, acute suppurative inflammation, and focal calcification (Fig. 2). Stains and cultures for organisms were negative. These findings were felt to be pathognomonic for nodular fat necrosis associated with pancreatic disease. Laboratory data revealed serum amylase and lipase to be markedly elevated at 1342 U/L (A/=28–110 U/L) and 4160 U/L (W=7–60 U/L), respectively; white blood cell count and differential were within normal limits. Other significant laboratory data included an anti-DNA of 692 lU/mL (A/=<100 IU/mL) and positive anti-Sjogren's syndrome-A. Simultaneous punch biopsy of an erythematous facial macule revealed epidermal atrophy, vacuolar interface change, and a mild perivascular and periadnexal lymphohistiocytic infiltrate, consistent with lupus erythematosus. Computed tomography (CT) scan and ultrasound exannination of the abdominal cavity failed to provide further evidence of pancreatitis. Although the patient was initially asymptomatic, 1 week following the onset of her leg nodules she developed severe ankle and knee arthralgias, abdominal pain, nausea, and vomiting which were attributed to her pancreatitis. She was treated with high-dose prednisone and Cytoxan for control of her lupus flare, which brought about the resolution of her leg nodules and associated symptoms over the following 6 weeks. Only post-inflammatory hyperpigmentation remained in the skin overlying the sites of nodular fat necrosis. 相似文献
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97.
Surendra K. Mattoo md Shubh M. Singh md Rahul Bhardwaj md Suresh Kumar md dnb Debasish Basu md dnb Parmanand Kulhara md frcpsych 《Psychiatry and clinical neurosciences》2009,63(4):580-582
Life-time prevalence of epileptic seizures was assessed in 626 consecutive patients treated for substance abuse. Seizures were reported in 8.63% (9.2% in alcohol abusers, 12.5% in opioid abusers). A total of 64.8% of the seizures were associated with substance use. These occurred during withdrawal in the alcohol cohort and during intoxication with dextropropoxyphene and withdrawal from heroin or poppy husk in the opioid cohort. Results indicate that seizures may be more common in older patients with longer duration of dependence among those abusing alcohol. 相似文献
98.
A.P. GREYSTOKE bsc mbchb mrcp registrar medical oncology D.I. JODRELL dm msc frcpe professor of cancer therapeutics M. CHEUNG msc mrpharms oncology pharmacist I. RIVANS mrpharms pgdip oncology pharmacist & M.J. MACKEAN mbchb msc mrcp md consultant medical oncologist 《European journal of cancer care》2010,19(1):80-90
GREYSTOKE A.P., JODRELL D.I., CHEUNG M., RIVANS I. & MACKEAN M.J. (2009) European Journal of Cancer Care 19 , 80–90 How many cisplatin administration protocols does your department use? The introduction, 30 years ago, of the co‐administration of appropriate hydration and ensuring a diuresis occurs during the administration of cisplatin was important in its development, allowing clinically significant doses to be given with acceptable rates of toxicity. The clinical usage of cisplatin has increased and hydration protocols have been amended to increase patient comfort and reduce resource utilization. We suspected that this had led to unnecessary variations in practice both in clinical trials and subsequently in the clinic. Therefore, we reviewed practice in the Edinburgh Cancer Centre and discovered that 25 different hydration protocols were in use, with wide variation in dilution of cisplatin, total fluid administered, use of electrolyte (potassium and magnesium) supplementation and diuretics. These differences are a reflection of adoption of variations in hydration regimes published in pivotal clinical trials. A review of the available evidence relating to cisplatin associated hydration regimens was performed and recommendations will be made for the future design of evidence‐based protocols. 相似文献
99.
J.M. GARCÍA PRIM
md phd F.J. GONZÁLEZ BARCALA
md phd J. PAZ ESQUETE
md A. POSE REINO
md phd A. FONDEVILA LÓPEZ
md L. VALDÉS CUADRADO
md phd 《European journal of cancer care》2010,19(2):227-233
GARCÍA PRIM J.M., GONZÁLEZ BARCALA F.J., PAZ ESQUEJE J., POSE REINO A., FONDEVILA LÓPEZ A. & VALDÉS CUADRADO L. (2010) European Journal of Cancer Care 19 , 227–233 Lung cancer in a health area of Spain: incidence, characteristics and survival To examine the incidence, characteristics, therapeutic approach and survival of diagnosed lung cancer (LC) in the Santiago de Compostela Health Area. A retrospective study was carried out on LC for a period of 3 years. Of the 481 cases collected, 92.7% were male. The median age was 66.93 years. The crude incidence for men and women was 80.71 and 5.84 per 100 000 inhabitants respectively. Among the non‐small cell lung cancers (NSCLC), 68.1% were diagnosed in stage IIIB or IV. The cancer had already spread in 62.2% of the small cell lung cancer (SCLC). Chemotherapy was used in 51.6% of patients. The survival probability from the first to the fifth year was 47.7%, 24.3%, 12.9%, 10% and 8.9% respectively. The median survival at 5 years was 12.12 months for NSCLC, rising to 29.8 months in stage I, and 8.85 months in SCLC. In our Health Area LC occurs more often in men, in whom the prevalence of smoking is very high. The most common histology type was squamous cell carcinoma. In the majority of cases, the diagnosis is made in the advanced stages, which accounts for the low percentage of surgical treatments and the short survival. 相似文献
100.
A.F. STREET
phd J.W. COUPER
md A.W. LOVE
phd S. BLOCH
mb phd D.W. KISSANE
md B.C. STREET
ma 《European journal of cancer care》2010,19(2):234-242
STREET A.F., COUPER J.W., LOVE A.W., BLOCH S., KISSANE D.W. & STREET B.C. (2010) European Journal of Cancer Care 19 , 234–242 Psychosocial adaptation in female partners of men with prostate cancer The objective was to explore the psychosocial adaptation of female partners living with men with a diagnosis of either localized or metastatic prostate cancer. Semi‐structured qualitative interviews were conducted with 50 women at two time points (baseline and 6 months later). The interviews examined emotions, experiences, attitudes to sexual and continence issues and treatment decision making. As part of a larger prospective observational study, demographic data and scores for depression and anxiety were collected. Initial analysis demonstrated that the group of 11 women assessed as distressed on the anxiety and depression measures described reduced coping skills and poorer adaptation after 6 months. In contrast, the 39 women in the non‐distressed group reported emotional adaptation that fitted the Lazarus and Folkman pattern of coping through appraisal of the impact of the diagnosis on their partner and themselves, appraisal of coping strategies and reappraisal of the situation. A surprise finding was the high level of resilience displayed by majority of these women. Results suggest that a psychosocial intervention could strengthen healthy adaptation and provide better coping skills for distressed couples. 相似文献