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R S Brown P T Di Stanislao W T Beaver W K Bottomley 《Oral surgery, oral medicine, and oral pathology》1991,71(5):565-568
Twenty severely retarded institutionalized epileptic adults with phenytoin-induced gingival hyperplasia were divided into two groups and received a daily 3 mg capsule of either folic acid or lactose for 16 weeks in a randomized, double-blind, parallel study. Serum folate and phenytoin levels were recorded at baseline and on completion of the study. Twelve areas of the gingiva on each patient were graded at 4-week intervals for 16 weeks with respect to the three indexes: hyperplasia, gingival health, and plaque index. There were no significant differences between treatment groups for any of the three indexes over time. The poststudy serum folate levels were three times baseline levels for the active drug group (p less than 0.001) but unchanged in the placebo group. Phenytoin blood levels that began within the therapeutic window (10 to 20 micrograms/ml) tended to remain within the therapeutic window for both groups, with no reported seizure activity. A single daily oral 3 mg capsule of folic acid did not show efficacy as the sole therapeutic agent in the reduction of phenytoin-induced gingival hyperplasia. 相似文献
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Mukri F Bourne T Bottomley C Schoeb C Kirk E Papageorghiou AT 《BJOG : an international journal of obstetrics and gynaecology》2008,115(10):1273-1278
Objectives To examine whether viable early pregnancies that subsequently end in miscarriage exhibit evidence of first-trimester growth restriction.
Design Prospective cohort study.
Setting Early pregnancy unit (EPU) of a teaching hospital.
Population Women attending EPU between 5 and 10 weeks of gestation.
Methods Women with spontaneously conceived intrauterine, viable singleton pregnancies with certain last menstrual period and regular cycles were included. The deviation between the observed and expected crown–rump length (CRL) for gestation was calculated and expressed as a z score. Pregnancies were followed up until the 11–14 week scan, and the deviation between those that remained viable and miscarried subsequently was calculated.
Main outcome measures Viability at 11–14 week scan.
Results Over 6 months, 316 women met the inclusion criteria. Twenty-four (7.4%) women were excluded. Of the remaining 292, the pregnancy remained viable in 251 (86%) and 41 (14%) suffered a miscarriage. At the first transvaginal ultrasound, the z score of the mean measured CRL for pregnancies that remained viable was −0.82, SD 1.46, while in pregnancies that subsequently miscarried the z score was −2.42 and the CRL was significantly smaller, SD 1.31 ( P < 0.0001). In the latter group, the initial CRL was below the expected mean for gestational age in all women, while in 61% (25/41), the CRL was at least 2 SDs below the expected mean.
Conclusions CRL was significantly smaller in pregnancies that subsequently ended in miscarriage. This suggests that early first-trimester growth restriction is associated with subsequent intrauterine death. 相似文献
Design Prospective cohort study.
Setting Early pregnancy unit (EPU) of a teaching hospital.
Population Women attending EPU between 5 and 10 weeks of gestation.
Methods Women with spontaneously conceived intrauterine, viable singleton pregnancies with certain last menstrual period and regular cycles were included. The deviation between the observed and expected crown–rump length (CRL) for gestation was calculated and expressed as a z score. Pregnancies were followed up until the 11–14 week scan, and the deviation between those that remained viable and miscarried subsequently was calculated.
Main outcome measures Viability at 11–14 week scan.
Results Over 6 months, 316 women met the inclusion criteria. Twenty-four (7.4%) women were excluded. Of the remaining 292, the pregnancy remained viable in 251 (86%) and 41 (14%) suffered a miscarriage. At the first transvaginal ultrasound, the z score of the mean measured CRL for pregnancies that remained viable was −0.82, SD 1.46, while in pregnancies that subsequently miscarried the z score was −2.42 and the CRL was significantly smaller, SD 1.31 ( P < 0.0001). In the latter group, the initial CRL was below the expected mean for gestational age in all women, while in 61% (25/41), the CRL was at least 2 SDs below the expected mean.
Conclusions CRL was significantly smaller in pregnancies that subsequently ended in miscarriage. This suggests that early first-trimester growth restriction is associated with subsequent intrauterine death. 相似文献
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Cognitive function and patient‐reported memory problems after radiotherapy for cancers at the skull base: A cross‐sectional survivorship study using the Telephone Interview for Cognitive Status and the MD Anderson Symptom Inventory‐Head and Neck Module 下载免费PDF全文
Chase C. Hansen MD Joshua B. Smith BS Abdallah S. R. Mohamed MD MSc Collin F. Mulcahy MD Jeffrey S. Wefel PhD Katherine A. Hutcheson PhD Kelsey Chrane PA Jack Phan MD PhD Steven J. Frank MD Adam S. Garden MD Blaine D. Smith BS Hillary Eichelberger BA Carthal Anderson BS Colton McCoy BS Marina Horiates BS Conner Patrick BS Sarah Floris BS Chloe French BS Beth M. Beadle MD PhD William H. Morrison MD Shirley Y. Su MD Carol M. Lewis MD Michael E. Kupferman MD Jason M. Johnson MD Heath D. Skinner MD PhD Stephen Y. Lai MD PhD Ehab Y. Hanna MD David I. Rosenthal MD Clifton D. Fuller MD PhD G. Brandon Gunn MD The MD Anderson Head Neck Cancer Symptom Working Group 《Head & neck》2017,39(10):2048-2056
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Oscar Bernal‐Pacheco MD Genko Oyama MD PhD Kelly D. Foote MD Yunfeng E. Dai MS Samuel S. Wu PhD Charles E. Jacobson IV BS Natlada Limotai MD Pamela R. Zeilman ARNP Janet Romrell PA Nelson Hwynn DO Ramon L. Rodriguez MD Irene A. Malaty MD Michael S. Okun MD 《Neuromodulation》2013,16(1):35-40
Objectives: To screen for potentially underreported behavioral changes in patients with idiopathic Parkinson's disease (PD) pre‐ and post‐deep brain stimulation (DBS), a retrospective data base review was performed. Methods: In total, 113 patients who underwent unilateral or bilateral DBS at the University of Florida in either subthalamic nucleus or globus pallidus internus for PD were screened for behavioral issues by asking about the presence or absence of seven neuropsychiatric symptoms (panic, fear, paranoia, anger, suicidal flashes, crying, and laughing). Results: There was a high prevalence of fear (16.3%), panic (14.0%), and anger (11.6%) at baseline in this cohort. In the first six months following DBS implantation, anger (32.6%), fear (26.7%), and uncontrollable crying (26.7%) were the most frequent symptoms reported. Those symptoms also were present following six months of DBS surgery (30.2%, 29.1%, and 19.8%, respectively). New uncontrollable crying occurred more in the acute postoperative stage (less than or equal to six months) (p= 0.033), while new anger occurred more in the chronic postoperative stage (greater than six months) (p= 0.017). The frequency of uncontrollable laughing significantly increased with bilateral DBS (p= 0.033). Conclusions: Many of the neuropsychiatric issues were identified at preoperative baseline and their overall occurrence was more than expected. There was a potential for worsening of these issues post‐DBS. There were subtle differences in time course, and in unilateral vs. bilateral implantations. Clinicians should be aware of these potential behavioral issues that may emerge following DBS therapy, and should consider including screening questions in preoperative and postoperative interviews. Standardized scales may miss the presence or absence of these clinically relevant issues. 相似文献
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Rajeev Gupta MD Manuel Villa MD Emanuel Agaba MD Garry Ritter PA MHA Cristina Sison Corrado P. Marini MD Rafael Barrera MD 《JPEN. Journal of parenteral and enteral nutrition》2013,37(3):368-374
Background: The incidence of obesity is rising, and an increasing number of obese patients are admitted to surgical intensive care units (SICUs). However, it is not clear whether obesity is an independent risk factor for increased morbidity and mortality in SICU patients. We examined the effect of obesity on morbidity and mortality in patients admitted to the SICU in this study. Method: We reviewed prospectively acquired SICU data in normal and obese patients with an SICU length of stay >24 hours. Comparability of the groups was assessed using a χ2 test or Fisher exact test, as appropriate, for categorical variables and analysis of variance (ANOVA) or the Kruskal‐Wallis test, as appropriate, for continuous variables. Results: Of the 1792 consecutive patients evaluated, 711 had a normal body mass index (BMI), and 993 were either preobese or obese. There was no statistically significant difference across the 5 BMI groups with respect to any of the 3 comorbidity indices (Acute Physiology and Chronic Health Evaluation III [APACHE III], Simplified Acute Physiology Score, or Multiple Organ Dysfunction Score). There was no statistically significant difference in the intensive care unit (ICU) length of stay and hospital length of stay or time‐to‐ICU mortality (log‐rank test P = .054) among the 5 BMI groups. A Cox regression analysis and backward elimination algorithm selected APACHE III to be the most important explanatory variable for survival time. Conclusion: Obesity does not affect the mortality of patients admitted to the SICU. We conclude that obesity cannot be used as an independent predictive mortality outcome variable in patients admitted to the SICU. 相似文献
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A. Mathew T. Fysh J.R. Bottomley J.F. Thompson J.D. Beard 《European Journal of Vascular and Endovascular Surgery Extra》2010,19(3):e28-e30
Symptomatic lower limb ischaemia in endurance athletes and competitive cyclists is usually due to iliac artery compression syndrome. We report the cases of two competitive cyclists who presented with thigh claudication, with no previous cardiovascular or thrombo-embolic risk factors. They both had normal conventional and sports exercise tests. Further investigations revealed flush occlusion of the profunda femoris artery, believed to be due to dissection. Both patients improved with graduated exercise. We recommend contrast-enhanced MRA as the investigation of choice for this previously unreported condition. 相似文献