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31.
Valery L Feigin Craig S Anderson Anthony Rodgers Neil E Anderson Alistair J Gunn 《Journal of clinical neuroscience》2002,9(5):502-507
Current treatment of acute stroke remains unsatisfactory. This review presents experimental and clinical data which suggest that mild induced hypothermia could be a potent and practicable neuroprotective treatment of acute ischaemic stroke and intracerebral haemorrhage. Hypothermia, if proven to be safe, effective and widely practicable in patients with acute stroke, could have an enormous positive impact on reducing the burden of stroke worldwide. Critical issues that will need to be considered in a well designed randomised controlled trial of induced hypothermia in acute stroke patients are discussed. 相似文献
32.
33.
Neil R Miller 《Journal of neuro-ophthalmology》2006,26(3):200-208
Optic nerve sheath meningiomas are by far the most common tumors of the optic nerve sheath. The diagnosis can be suspected in most cases from clinical findings and supported by the results of neuroimaging, obviating tissue biopsy in the majority of cases. Observation may be appropriate in patients with mild or no visual deficit or in whom visual loss is not progressing, whereas stereotactic fractionated radiation therapy has been demonstrated to improve or stabilize vision in progressive or advanced cases. Attempts at surgical excision, and even biopsy, of optic nerve sheath meningiomas are associated with a high risk of blindness and should be reserved for the rare case of an anteriorly located, primarily exophytic tumor with focal involvement of the dural sheath. 相似文献
34.
Susan D. Ross M.D. Angela DiGeorge B.S. Janet E. Connelly B.S. Gregory W. Whiting B.S Neil McDonnell Pharm.D. 《Pharmacotherapy》1998,18(6):1290-1297
We performed a literature search for all clinical studies reporting outcomes in patients with the acquired immunodeficiency syndrome (AIDS) receiving granulocyte-macrophage colony-stimulating factor (GM-CSF) for any indication. Safety outcomes included human immunodeficiency virus replication, immune status, and frequency of opportunistic infections and neoplasms. Data were synthesized qualitatively. We identified 22 studies (274 patients): 12 addressed AIDS neutropenia, 8 AIDS cancer therapy, and 2 opportunistic infections. Viral burden was assessed by serum p24Ag in 15 studies. Nine reported no change in levels, three net decreases, and three net increases. All studies showing net increases involved patients receiving GM-CSF without a concurrent antiretroviral. The CD4 counts were unchanged in 5 studies, increased in 3, and not reported in 14. The incidence of neoplasms or new opportunistic infections was low. The literature suggests no increased risk of viral replication or clinical deterioration in patients with AIDS who take GM-CSF concurrently with zidovudine. 相似文献
35.
36.
37.
Population toxicokinetics of tetrachloroethylene 总被引:1,自引:0,他引:1
F. Y. Bois A. Gelman J. Jiang D. R. Maszle L. Zeise G. Alexeef 《Archives of toxicology》1996,70(6):347-355
In assessing the distribution and metabolism of toxic compounds in the body, measurements are not always feasible for ethical
or technical reasons. Computer modeling offers a reasonable alternative, but the variability and complexity of biological
systems pose unique challenges in model building and adjustment. Recent tools from population pharmacokinetics, Bayesian statistical
inference, and physiological modeling can be brought together to solve these problems. As an example, we modeled the distribution
and metabolism of tetrachloroethylene (PERC) in humans. We derive statistical distributions for the parameters of a physiological
model of PERC, on the basis of data from Monster et al. (1979). The model adequately fits both prior physiological information
and experimental data. An estimate of the relationship between PERC exposure and fraction metabolized is obtained. Our median
population estimate for the fraction of inhaled tetrachloroethylene that is metabolized, at exposure levels exceeding current
occupational standards, is 1.5% [95% confidence interval (0.52%, 4.1%)]. At levels approaching ambient inhalation exposure
(0.001 ppm), the median estimate of the fraction metabolized is much higher, at 36% [95% confidence interval (15%, 58%)].
This disproportionality should be taken into account when deriving safe exposure limits for tetrachloroethylene and deserves
to be verified by further experiments.
Received: 20 April 1995/Accepted: 24 August 1995 相似文献
38.
A comparative analysis of radiological and surgical placement of central venous catheters 总被引:3,自引:1,他引:2
Kieran D. McBride Ross Fisher Neil Warnock David A. Winfield Malcolm W. Reed Peter A. Gaines 《Cardiovascular and interventional radiology》1997,20(1):17-22
Purpose To compare the differences in practice and outcome of all radiologically and surgically placed central venous catheters retrospectively
over a 2-year period simultaneously, at a single institution.
Methods A total of 253 Hickman catheters were inserted in 209 patients; 120 were placed radiologically in 102 patients and 133 were
placed surgically in 107 patients. The indication was chemotherapy in 76% of radiological and in 47% of surgical cases; the
remainder were for total parenteral nutrition and venous access.
Results There were 6 (4.5%) primary surgical failures and a further 17 (13%) surgical cases requiring multiple placement attempts.
Pneumothorax occurred once (0.8%) surgically and four times (3.3%) radiologically. There were no radiological primary misplacements
but there were five (3.7%) surgical ones. Catheter or central vein thrombosis occurred in four (3.3%) radiological and five
(3.7%) surgical cases. The rate of infection per 1000 catheter-days was 1.9 in radiologically placed catheters and 4.0 in
surgically placed ones (p<0.001). Average catheter life-span was similar for the two placement methods (100±23 days).
Conclusion Radiological placement is consistently more reliable than surgical placement. There are fewer placement complications and
fewer catheter infections overall. 相似文献
39.
40.
Alan G. Rose M.D. Neil G. Heselson M. Med. Richard K. Marks F.R.C.S. Dorothea Kranold F.F.RAD 《Skeletal radiology》1992,21(2):140-145
A man presented with a mass in the left first metacarpal bone. Later, his chest radiograph showed extensive, bilateral, rounded opacities in both lungs with enlarged hilar lymph nodes, and he developed expanding lesions in the left radius, ulna, and metacarpal bones. The pulmonary lesions were treated with radiotherapy and cytotoxic agents, and the tumor mass in the first metacarpal was debulked. All biopsies showed similar features of a mixed tumor (pleomorphic adenoma) with metastatic or embolic pulmonary involvement; ultrastructural and immunocytochemical investigations supported this unique diagnosis. The patient remains well 15 years after the initial diagnosis. It is possible that the myoepithelial elements in this case had been displaced intraosseously during development. We are not aware of a similar case in the literature. 相似文献