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51.
R Pregazzi C Bouchè G Ricci F G Toffoletti R Levi D'Ancona F Barciulli 《Minerva ginecologica》1991,43(7-8):335-339
This study concerns clinical data of 142 women, who were subjected to functional evaluation of perineum during the last part of pregnancy. The 16 cases characterized by synergic activation, during the examination of perineal muscles ("perineal testing"), of antagonist muscles ("inverted control"), were examined taking into account data regarding evolution of labour and perineal outcome. "Inverted control" seems to influence, in this study, length of the second stage and frequency of operative deliveries whereas we can't confirm the importance of this disorder within pathogenesis of perineal obstetric complications. 相似文献
52.
Minghetti L Greco A Cardone F Puopolo M Ladogana A Almonti S Cunningham C Perry VH Pocchiari M Levi G 《Journal of neuropathology and experimental neurology》2000,59(10):866-871
The levels of 2 arachidonic acid metabolites formed either by enzymatic activity of cyclooxygenase, i.e. prostaglandin E2 (PGE2), or by free radical-catalyzed peroxidation, i.e. F2-isoprostane 8-epi-prostaglandin F2alpha (8-epi-PGF2alpha), were measured in the CSF of subjects with sporadic and familial Creutzfeldt-Jakob disease (CJD) and in brain homogenates of scrapie-infected mice. The CSF levels of both metabolites were increased in sporadic CJD (n = 52) and familial CJD (n = 10) patients when compared with a group of patients with noninflammatory disorders. Similarly, PGE2 and 8-epi-PGF2alpha levels were higher in brain homogenates obtained from C57BL/6J mice infected with the ME7 scrapie strain than in brain homogenates from control animals. As PGE2 is 1 of the most abundant prostaglandins released during inflammation and 8-epi-PGF2alpha is a quantitative marker of lipid peroxidation, our results provide in vivo biochemical evidence for the occurrence of inflammation and oxidative stress in human and experimental transmissible spongiform encephalopathies (TSEs), a concept so far based mainly on histopathological and in vitro evidence. Interestingly, in sporadic CJD patients, high CSF levels of PGE2, but not 8-epi-PGF2alpha, correlated with short survival time, suggesting that the inflammatory response correlates with the clinical duration of disease. 相似文献
53.
Radical Resection of Periampullary Tumors in the Elderly: Evaluation of Long-term Results 总被引:5,自引:0,他引:5
Bathe OF Levi D Caldera H Franceschi D Raez L Patel A Raub WA Benedetto P Reddy R Hutson D Sleeman D Livingstone AS Levi JU 《World journal of surgery》2000,24(3):353-358
Increasingly, patients of advanced age are coming for evaluation of periampullary tumors. Although several studies have demonstrated
the safety of resecting periampullary tumors in older patients, few long-term survival data have been reported. Between 1983
and 1992 various periampullary masses were resected in 70 patients over age 65 (range 65–87 years). Total pancreatectomy was
performed in 11 patients, and 59 patients underwent pancreaticoduodenectomy. The mean duration of hospitalization was 17 ±
15 days. Major complications occurred in 27 patients (39%), and operative mortality rate was 8.5%. Overall median survival
was 24 months; and 5-year survival was 25%. Perioperative outcome was compared in patients aged 65 to 74 years and in patients
≥75 years old. The older age group required longer periods in the surgical intensive care unit postoperatively, but the long-term
survival was similar in the two age groups. Radical resection with the intent to cure periampullary tumors is safe in selected
patients of advanced age, and long-term survival is in the range of expected survival for younger patients with the same tumors. 相似文献
54.
M Malvezzi C Bosetti L Chatenoud T Rodríguez F Levi E Negri C La Vecchia 《Annals of oncology》2004,15(11):1712-1718
BACKGROUND: Few data on cancer mortality have been published for Mexico over the last few decades. It is therefore of interest to conduct a systematic and updated analysis of cancer mortality in this country. PATIENTS AND METHODS: Age-standardised (world population) mortality rates, at all ages and truncated at age 35-64 years, from major cancers and all cancers combined were computed on the basis of certified deaths derived from the World Health Organization database for the period 1970-99. RESULTS: Mortality rates for all neoplasms showed an upward trend in men of all ages (from 58.2/100,000 in 1970-74 to 87.1/100,000 in 1995-99) and in middle-aged men (from 76.1 to 93.7/100,000, respectively). This reflects the rise until the early 1990s in lung cancer mortality (from 8.1/100,000 in 1970-74 to 15.6/100,000 in 1995-99) and prostate cancer (from 5.5 to 12.2/100,000, respectively). In women, overall mortality rates showed an increase between the early 1970s (75.4/100,000) and the late 1990s (82.3/100,000). Total cancer mortality rates remained low, however, compared with other American countries (e.g. 153.3/100,000 men and 108.6/100,000 women in 1999 in the United States). Truncated rates were stable (126.5/100,000 in 1970-74 and 125.8/100,000 in 1995-99), although they were much higher than overall rates, reflecting exceedingly high rates for uterine (mostly cervical) cancer mortality in middle-aged women (29.5/100,000 in 1995-99). CONCLUSIONS: Total cancer mortality in Mexico has remained comparably low on a worldwide scale, and the upward trends in mortality rates for lung and other tobacco-related neoplasms have tended to level off over the last decade. However, steady rises have been observed for other major cancers, including prostate and breast. Cervical cancer remains a major health problem in women. 相似文献
55.
The management of traumatic cervical bilateral facet fracture-dislocations with unicortical anterior plates 总被引:4,自引:0,他引:4
The goal of this study was to evaluate single-level anterior cervical discectomy and stabilization for bilateral facet fracture dislocations using bone graft and anterior titanium plates with unicortical screw fixation in the clinical setting. We conducted a retrospective review during a consecutive 6-year period of patients treated in a single institution for traumatic single-level cervical bilateral facet fracture-dislocation. All fracture-dislocations that could be aligned with traction were subsequently stabilized using an anterior cervical discectomy with bone graft and titanium unicortical locking plates. All patients were examined after operation for radiographic evidence of healing and neurologic outcome. Twenty-two patients (M:F ratio, 16:6; average age, 47.7 years) underwent an anterior cervical discectomy and stabilization with either an allograft (n = 12) or an autograft (n = 10) and a titanium unicortical locking plate. Most patients had sustained a spinal cord injury (87%) or a radicular injury (9%). The average follow-up was 32 months, with a minimum follow-up of 1 year (range, 13 to 77 months). There was one instrumentation-related failure, but all 22 patients ultimately had evidence of stability at the instrumented level on the final follow-up examination. Anterior fixation with unicortical cervical locking plates as a single procedure offers an excellent surgical alternative in the management of many cervical bilateral facet fracture dislocations in patients who can be reduced preoperatively. 相似文献
56.
Mortality from gallbladder cancer has been traditionally high in Eastern Europe, and lower in northern countries. Trends in 18 European countries, including the European Union (EU) and selected Eastern European countries, have been updated using official death certification data abstracted from the WHO database over the period 1980-1999. In the EU, age-standardized rates declined by about 30% between the late 1980s and 1999 to reach 1.8/100 000 for women, and by about 10% to reach 1.4/100 000 for men. In the Czech Republic and Hungary, rates for women were over 6/100 000 until the early 1990s, and declined by about 25% thereafter. For males, gallbladder cancer mortality showed no consistent trend, with rates over 3/100 000. Thus, a high mortality area from gallbladder cancer is still evident for both sexes in Central and Eastern Europe. The trends in mortality from gallbladder cancer are probably influenced by changes in risk factor exposure, such as diet, nutrition or tobacco, but essentially reflect more widespread and earlier adoption of cholecystectomy in the EU, since gallstones are the major risk factor for gallbladder cancer. The data also indicate the scope for further improvement of the management of gallbladder disease in Eastern Europe. 相似文献
57.
S Gallus A Altieri C Bosetti S Franceschi F Levi E Negri L Dal Maso E Conti P Zambon C La Vecchia 《Annals of oncology》2003,14(2):209-213
BACKGROUND: Tobacco smoking is one of the main risk factors for oral, pharyngeal and oesophageal cancers in developed countries. Information on the role of the tar yield of cigarettes in upper digestive tract carcinogenesis is sparse and needs to be updated because the tar yield of cigarettes has steadily decreased over the last few decades. PATIENTS AND METHODS: We analysed two case-control studies, from Italy and Switzerland, conducted between 1992 and 1999, involving 749 cases of oral and pharyngeal cancer and 1770 controls, and 395 cases of squamous-cell oesophageal carcinoma and 1066 matched controls. Odds ratios (ORs) were estimated by unconditional multiple logistic regression models, including terms for age, sex, study centre, education and alcohol consumption. RESULTS: Based on the brand of cigarettes smoked for the longest time, the multivariate ORs for current smokers compared with never smokers were 6.1 for <20 mg and 9.8 for >or=20 mg tar for oral and pharyngeal neoplasms, and 4.8 and 5.4 for oesophageal cancer, respectively. For the cigarette brand smoked in the previous six months, the ORs for >or=10 mg compared with <10 mg were 1.9 for cancer of the oral cavity and pharynx and 1.8 for oesophageal cancer, after allowance for number of cigarettes and duration of smoking. CONCLUSIONS: The present study confirms the direct relationship between the tar yield of cigarettes and upper digestive tract neoplasms, and provides innovative information on lower tar cigarettes, which imply reduced risks compared with higher tar ones. However, significant excess risks were observed even in the lower tar category, thus giving unequivocal indications for stopping smoking as a priority for prevention of upper digestive tract neoplasms. 相似文献
58.
BACKGROUND: Deep median sternotomy wound infection is a significant source of morbidity and mortality after cardiac operations. Management of an infected median sternotomy incision is a subject of controversy. The aim of this study was to assess our experience with primary closure without any irrigation system for infected deep median sternotomy wound. METHODS: Between January 1994 and December 1997, 4,227 consecutive open heart procedures via a median sternotomy under cardiopulmonary bypass were performed in our department. A total of 27 (0.64%) consecutive patients with deep sternotomy wound infection were identified. The mean age of the patients was 45 years. Six were female and 21 were male. RESULTS: The incidence of deep sternal wound infection was therefore 0.64%. The mean duration between the primary operation and the onset of deep sternal wound infection was 2.5 weeks. Staphylococcus aureus and Staphylococcus epidermidis were the most common pathogen causing postoperative mediastinal infection. Out of the 27 cases, 17 were successfully treated, 8 (30%) died and 2 had a persistent fistula. The mean follow-up time was 18 months (range 4 to 52 months). The mortality in the pediatric group was 4/8 (50%) and 4/19 (21%) in the adult group. The mortality for mediastinitis presenting before one week or after 4 weeks after operation was 63%. In contrast, the mortality for mediastinitis presenting after one week but before 4 weeks after operation was 17%. CONCLUSIONS: Mediastinitis after cardiac surgical procedures remains a devastating complication. Primary closure without irrigation-suction system should only be considered in selected patients. 相似文献
59.
Background: Lung cancer mortality in men has been decliningsince the late 1980s in most European countries. In women, althoughrates are still appreciably lower than those for men, steadyupward trends have been observed in most countries. To quantifythe current and future lung cancer epidemic in European women,trends in lung cancer mortality in women over the last fourdecades were analyzed, with specific focus on the young. Patients and methods: Age-standardized (world standard) lungcancer mortality rates per 100 000 womenat all ages,and truncated 3564 and 2044 yearswere derivedfrom the WHO for the European Union (EU) as a whole and for33 separate European countries. Joinpoint regression analysiswas used to identify points where a significant change in trendsoccurred. Results: In the EU overall, female lung cancer mortality ratesrose by 23.8% between 19801981 and 19901991 (from7.8 to 9.6/100 000), and by 16.1% thereafter, to reach the valueof 11.2/100 000 in 20002001. Increases were smaller inthe last decade in several countries. Only in England and Wales,Latvia, Lithuania, Russia and Ukraine did female lung cancermortality show a decrease over the last decade. In several Europeancountries, a decline in lung cancer mortality in young women(2044 years) was observed over the last decade. Conclusions: Although female lung cancer mortality is stillincreasing in most European countries, the more favorable trendsin young women over recent calendar years suggest that if effectiveinterventions to control tobacco smoking in women are implemented,the lung cancer epidemic in European women will not reach thelevels observed in the USA. Key words: Europe, lung cancer, mortality, trends, women 相似文献
60.
Most midwives are aware of the need to collect clinical practice data and of its usefulness in supporting the care they provide, which contributes to healthy outcomes for mothers and babies. For the individual midwife, there is more than one easily accessible, standardized data collection instrument from which to choose. However, despite these choices, in an American College of Nurse-Midwives (ACNM) Division of Research (DOR) survey on midwifery clinical data collection (N = 263), the majority of member respondents (n = 135; 51%) reported using a self-designed data collection tool, and more than one-third did not know of the ACNM Nurse-Midwifery Clinical Data Sets (NMCDS). On a larger scale, the midwifery profession is also in need of an organized and consistent approach to data collection for the purpose of capturing midwifery practice and outcomes in order to provide data to support legislation, practice, and policy changes. However, the profession currently lacks a single common midwifery practice database. In order to facilitate data aggregation that captures a larger view of midwifery practice at the local, regional, and national levels, it is imperative that all midwives collect relevant data that are uniform and standardized, and that the midwifery professional organizations move forward with the development of a common electronic database. This article describes currently available data collection tools as well as their best uses, applications to practice, and future directions. 相似文献