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101.
Osteomyelitis: detection with US 总被引:2,自引:0,他引:2
To evaluate the role of ultrasound (US) in the detection of osteomyelitis, the authors prospectively studied 48 patients clinically suspected of having osteomyelitis. A sonographic diagnosis was made if fluid was seen directly in contact with bone, without intervening soft tissues. Twelve of the 48 patients were subsequently found to have osteomyelitis. In 10 of them, US demonstrated abnormal fluid adjacent to the bone. This fluid was thought to represent an inflammatory exudate dissecting in a subperiosteal and/or extraperiosteal location. Eight of the 48 patients had soft-tissue fluid collections. The rest of the patients either had no abnormalities or had cellulitis. The authors conclude that US can be useful in the detection of osteomyelitis. 相似文献
102.
K Kakizaki R Didlake G Basadonna B D Kahan R C Merrell 《The Journal of surgical research》1987,42(5):494-497
Combination therapy with one dose of 3 M KCl extracted donor-soluble antigen (Ag) and a short course of cyclosporine (CsA) has proven to prolong the survival of kidney allografts by enhancing specific T-suppressor populations. This regimen is tested in rat islet allografts in this study (Lewis to ACI). A 3-day perioperative course of 10 mg/kg/day CsA on Days -1, 0, and 1 did not prolong graft survival (MST = 10.7 +/- 2.5 days vs 9.4 +/- 1.2 days in controls). When this course of CsA therapy was combined with a single dose of donor antigen on Day -1, the survival time was prolonged slightly but significantly (MST = 14.0 +/- 5.8 days). Three cycles of a 3-day course of CsA therapy at 7-day intervals, a total of nine doses of 10 mg/kg/day CsA, were effective in delaying rejection of islet allografts (MST = 26.4 +/- 30.3). Moreover, combined therapy with donor antigen and three cycles of a 3-day course of CsA prolonged the survival of islet allografts (MST = 57.7 +/- 51.4 days) with 50% of recipients still normoglycemic at 60 days after transplantation. These findings indicate that the combination therapy of donor antigen with a short course of CsA has a powerful effect to prevent the rejection of islet allografts, as shown in kidney allografts, in rats. 相似文献
103.
Growth hormone therapy for protein catabolism 总被引:5,自引:0,他引:5
GH and IGF-I have shown remarkable consistency of effect in a wide range of
catabolic conditions. Doses of around 10 IU/m2/day of GH and 80
micrograms/kg/day of IGF-I over short periods of time can improve net
protein synthesis and preserve lean body mass. Most studies have reported
metabolic endpoints, but favorable clinical effects have included decreased
hospital stay and mortality in burns, improved respiratory muscle function
in COAD, preserved grip strength post- operatively, and improvements in
cardiac and bowel failure. Adverse effects of GH treatment are uncommon and
usually related to glycaemic control. GH and IGF-I have differential
effects on insulin concentrations--increasing or decreasing concentrations,
respectively. The hypoglycaemic effects of IGF-I are dependent on route of
administration and are avoided by subcutaneous delivery. Occasional
patients have needed to discontinue GH treatment due to hyperglycaemia,
although the anabolic action of GH may be partially mediated by increased
insulin levels. The co-administration of GH and IGF-I has theoretical
advantages by both increasing IGF binding-protein concentrations and
balancing glycaemic control. An initial study with combination therapy in
calorically-restricted volunteers has shown anabolic effects greater than
with either agent alone. This approach requires further study in catabolic
patients. There is a need for large, well-designed trials with clinical
rather than purely metabolic end-points, and some of these are already
underway. Should these studies confirm the early findings, financial
considerations will become paramount, although it remains possible that
treatment may be self-financing if lengths of hospital admissions are
shortened.
相似文献
104.
LP Ham F Andrasik RC Packard CM Bundrick 《Cephalalgia : an international journal of headache》1994,14(2):118-126
In this study, the psychological functioning of patients with chronic post-traumatic headache (PTH), chronic combination headache and chronic low back pain without headache, whose time of onset was similar, and a matched group of controls was investigated. The Symptom Checklist 90-Revised (SCL-90-R), State-Trait Anger Expression Inventory (STAXI), State-Trait Anxiety Inventory, Form Y (STAI-Y), and Beck Depression Inventory (BDI) were used to assess the degree of psychopathology. A MANOVA test indicated highly significant differences between groups. In general, the pain groups fell along a continuum with PTH subjects demonstrating the highest elevations, back pain subjects demonstrating the next highest elevations, and combination subjects demonstrating fewer elevations. A cluster analysis indicated that findings were best classified into four clusters, but no one pain diagnosis predominated in any cluster. Eighty-nine percent of controls were assigned to clusters 1 or 2, which revealed essentially normal scores on all tests. It is suggested that while chronic pain patients demonstrate more psychopathology than non-pain controls, a variety of coping styles exists within each pain group independent of diagnostic categorization. 相似文献
105.
106.
RC Cook MBChB J Zachariah MB BS F Cree BSc HE Harrison PhD 《International journal of clinical practice》1996,50(3):125-128
SUMMARY A new amoxycillin/clavulanate regimen (‘Augmentin-Duo’ 400/57), to be given orally in two divided doses, has been proposed to overcome the inconvenience of tid dosing. This observer-blind, multicentre study randomised children aged two to 12 years with lower respiratory tract infection to seven days' treatment with either amoxycillin/clavulanate bid at a dose of 25/3.6mg/kg/day (221 patients) or the currently prescribed amoxycillin/clavulanate regimen of 20/5mg/kg/day tid (216 patients). Clinical success (cure) rates at follow up were 81.0% for the bid group and 77.8% for the tid group [difference 3.2%; 95% CI (-4.36, 10.80)], indicating that the regimens were of equivalent efficacy. Both regimens were well tolerated, and there was no statistically significant difference in the incidence of adverse experiences between the two groups. Compliance with study medication was high and similar for both groups (80% compliance: bid 90.0%; tid 87.0%). 相似文献
107.
108.
Continuous Cardiac Monitoring around Atrial Fibrillation Ablation: Insights on Clinical Classifications and End Points
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109.
Background
Noise exposure is an inherent part of duty of the aircrew and maintenance staff in the Indian Air Force (IAF). An audiometric survey of IAF personnel was carried out to analyze the prevalence and severity of noise induced hearing loss (NIHL).Methods
An audiometric study of 1000 IAF personnel of various trades, age and exposure groups were carried out at an operational base. Age related correction of 5 dB per decade was applied for personnel above SO years of age. Personal factors like smoking, blood group and use of ear defenders were analysed for their effect on the prevalence of NIHL.Result
The study revealed an overall incidence of NIHL of 22.9 % in the personnel with a higher prevalence among the technical trades (26.18 %) as compared to non technical trades (12.5 %). There was a significant increase in prevalence of hearing loss with duration of exposure with 50.8% of personnel above 30 years of exposure having hearing loss. A higher incidence of hearing loss was observed in personnel of blood group O and smokers whereas use of ear defenders was protective.Conclusion
The study reveals a significantly increased prevalence of NIHL among the technical trades of the IAF personnel. The deleterious effects of smoking and protective effect of regular use of ear defenders are emphasized.Key Words: Noise induced hearing loss, Smoking, Ear defenders 相似文献110.
Rosser JC Lynch PJ Cuddihy L Gentile DA Klonsky J Merrell R 《Archives of surgery (Chicago, Ill. : 1960)》2007,142(2):181-6; discusssion 186
BACKGROUND: Video games have become extensively integrated into popular culture. Anecdotal observations of young surgeons suggest that video game play contributes to performance excellence in laparoscopic surgery. Training benefits for surgeons who play video games should be quantifiable. HYPOTHESIS: There is a potential link between video game play and laparoscopic surgical skill and suturing. DESIGN: Cross-sectional analysis of the performance of surgical residents and attending physicians participating in the Rosser Top Gun Laparoscopic Skills and Suturing Program (Top Gun). Three different video game exercises were performed, and surveys were completed to assess past experience with video games and current level of play, and each subject's level of surgical training, number of laparoscopic cases performed, and number of years in medical practice. SETTING: Academic medical center and surgical training program. PARTICIPANTS: Thirty-three residents and attending physicians participating in Top Gun from May 10 to August 24, 2002. MAIN OUTCOME MEASURES: The primary outcome measures were compared between participants' laparoscopic skills and suturing capability, video game scores, and video game experience. RESULTS: Past video game play in excess of 3 h/wk correlated with 37% fewer errors (P<.02) and 27% faster completion (P<.03). Overall Top Gun score (time and errors) was 33% better (P<.005) for video game players and 42% better (P<.01) if they played more than 3 h/wk. Current video game players made 32% fewer errors (P=.04), performed 24% faster (P<.04), and scored 26% better overall (time and errors) (P<.005) than their nonplaying colleagues. When comparing demonstrated video gaming skills, those in the top tertile made 47% fewer errors, performed 39% faster, and scored 41% better (P<.001 for all) on the overall Top Gun score. Regression analysis also indicated that video game skill and past video game experience are significant predictors of demonstrated laparoscopic skills. CONCLUSIONS: Video game skill correlates with laparoscopic surgical skills. Training curricula that include video games may help thin the technical interface between surgeons and screen-mediated applications, such as laparoscopic surgery. Video games may be a practical teaching tool to help train surgeons. 相似文献