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41.
42.
S. H. Sindrup L. Arendt-Nielsen K. Brøsen P. Bjerring H. R. Angelo B. Eriksen L. F. Gram 《European journal of clinical pharmacology》1992,42(6):587-591
Summary We have studied the hypoalgesic effect of codeine (100 mg) after blocking the hepatic O-demethylation of codeine to morphine via the sparteine oxygenase (CYP2D6) by quinidine (200 mg). The study was performed in 16 extensive metabolizers of sparteine, using a double-blind, randomized, four-way, cross-over design. The treatments given at 3 h intervals during the four sessions were placebo/placebo, quinidine/placebo, placebo/codeine, and quinidine/codeine. We measured pin-prick pain and pain tolerance thresholds to high energy argon laser stimuli before and 1, 2, and 3 h after codeine or placebo.After codeine and placebo, the peak plasma concentration of morphine was 6–62 (median 18) nmol·.l–1. When quinidine pre-treatment was given, no morphine could be detected (<4 nmol·l–1) after codeine. The pin-prick pain thresholds were significantly increased after placebo/codeine, but not after quinidine/codeine compared with placebo/placebo. Both placebo/codeine and quinidine/codeine increased pain tolerance thresholds significantly. Quinidine/codeine and quinidine/placebo did not differ significantly for either pin-prick or tolerance pain thresholds.These results are compatible with local CYP2D6 mediated formation of morphine in the brain, not being blocked by quinidine. Alternatively, a hypoalgesic effect of quinidine might have confounded the results. 相似文献
43.
Adriano Chiò Elena Herrero Hernandez Gabriele Mora Consuelo Valentini Gianluigi Discalzi Enrico Pira 《Amyotrophic lateral sclerosis and other motor neuron disorders》2004,5(3):188-191
A 34-years-old floor-layer developed optic neuropathy and motor neuron disease after being accidentally exposed to a solvent mixture containing methanol and other substances. Optic neuropathy is a complication of methanol poisoning, but the onset of a motor neuron disorder resembling amyotrophic lateral sclerosis after the exposure to these substances has not been previously described. The temporal onset of the clinical symptoms, biological plausibility, young age of the patient and absence of neurological disorders in the family history raises suspicion of a possible causative relationship. 相似文献
44.
John J. Carey Miriam F. Delaney Thomas E. Love Bradford J. Richmond Barbara A. Cromer Paul D. Miller Martha Manilla-McIntosh Steven A. Lewis Charles L. Thomas Angelo A. Licata 《Journal of clinical densitometry》2007,10(4):11-358
Central dual-energy X-ray absorptiometry (DXA) is the gold standard for non-invasive measurement of bone mineral density (BMD). Using this value and subject demographics, DXA software calculates T-scores and Z-scores. Professional society guidelines for the management of osteoporosis are based on T-scores and Z-scores, rather than on the actual BMD value. Although one expects T-scores and Z-scores to be very similar in young men and women for any given BMD measurement, little literature exists on this issue. Our clinical experience shows that some younger adult individuals (premenopausal women and men younger than 50 yr) have larger than expected difference between their DXA T-score and Z-score. This cross-sectional study evaluates the extent of this discordance between Z-scores and T-scores in a sample of 4275 men and women aged 20–49 yr. All subjects were scanned by central DXA using equipment manufactured by GE Lunar, GE, Madison, WI, or Hologic, Inc., Bedford, MA. Significant differences between Z-scores and T-scores were seen within individuals at the lumbar spine, total hip, femoral neck, and trochanter (p value < 0.001) for both DXA systems. Although these differences were less than half a standard deviation (SD) in most instances, the magnitude of difference was substantial at times, being 1 or more SD in up to 11% of cases (range: −1.95 to +1.54 SD). The smallest differences were seen at the total hip and the largest differences were seen at the femoral neck for both technologies. This is in part because there is no single standard Z-score definition, resulting in different methods of calculation across, and even within, DXA manufacturers. Standardization of Z-score definition and method of calculation is indicated. DXA Z-scores should be interpreted with caution in men and women aged 20–50 yr. 相似文献
45.
F. D’Angelo M. Giudici M. Molina G. Margaria 《Journal of orthopaedics and traumatology》2005,6(3):111-116
Abstract
The femoral neck fracture is actually the most important traumatic event in the elderly, because of its high rate and terrible
complications. We reviwed clinical records of 314 patients treated in our institution with a bipolar implant for femoral neck
fracture. At a mean follow-up of 5 years, 15 patients (4.8%) were lost to followup so data for 299 patients was studied to
identity factors associated with mortality. Ten predictor variables were examined: age, sex, waiting time for surgery, pulmonary
dysfunction, fracture etiology, and comorbidity with ischemic heart disease, and heart failure, hypertension, cerebrovascular
disease, and chronic renal failure. Cumulative mortality rate during the first 6 months was 19% (55 of 299 patients) and in
the first year it was 25% (76 of 299). At logistic regression analysis, mortality was associated with age, male gender, waiting
period for surgery and presence of neoplastic disease or pathological fracture.
Waiting for surgery was a significant factor for mortality at 6, 12 and 24 months: patients surgically treated in the first
24 hours had lower mortality than those who waited longer. The risk of mortality in the first 6 months doubled for an age
increase of 12 years, while mortality within 2 years doubled for an age increase of 9 years. Although the motality rate after
surgery for femoral neck fracture was high in the first year (25%), it dropped off in successive years to levels observed
in a healthy population. Thus, we agree with the literature that femoral fracture is a risk factor for survival only in the
first year after trauma, above all in the elderly. 相似文献
46.
Rigatelli Gianluca; Braggion Gabriele; Cardaioli Paolo; Faggian Giuseppe 《European heart journal》2007,28(3):309
Embryonic remnants of incomplete septation may complicate occlusiondevice implantation in secundum atrial septal defects (sASD)even if stiff devices such as the Amplatzer Occluder are used. A 35-year-old woman was referred to our center for evaluationof a sASD. 相似文献
47.
Thompson Debra A.; Janecke Andreas R.; Lange Jessica; Feathers Kecia L.; Hubner Christian A.; McHenry Christina L.; Stockton David W.; Rammesmayer Gabriele; Lupski James R.; Antinolo Guillermo; Ayuso Carmen; Baiget Montserrat; Gouras Peter; Heckenlively John R.; den Hollander Anneke; Jacobson Samuel G.; Lewis Richard A.; Sieving Paul A.; Wissinger Bernd; Yzer Suzanne; Zrenner Eberhart; Utermann Gerd; Gal Andreas 《Human molecular genetics》2006,15(9):1559
Human Molecular Genetics 相似文献
48.
The present study was designed to investigate whether or not arginine vasopressin (AVP) is released from magnocellular neurons within the median eminence (ME) in vivo. Urethane-anesthetized adult male Wistar rats were equipped with a microdialysis probe aimed at the supraoptic (SON) or paraventricular nucleus (PVN), a push-pull perfusion probe resting in the ME, and a blood microdialysis probe within the jugular vein. Dialysis of the SON (but not the PVN) with Ringer's solution containing 56 mmol l−1 K+ resulted in an increase in AVP release within the ME (to 492 ± 192% of release during basal conditions,P < 0.05) and into blood (to 138 ± 9%,P < 0.01) whereby the release probably occurred from axonal swellings and nerve terminals of supraoptic neurons which project through the internal zone of the ME to the posterior pituitary. The calculated amount of AVP released into the extracellular fluid of the ME was high enough (approximately 1 pg/μ1) to hypothesize that the neuropeptide could enter the portal blood capillaries in physiologically relevant concentrations. Taken together, the present study indicates that activation of magnocellular neurons is accompanied by release of AVP within the median eminence. We assume that AVP released in this way might mediate a communication between the hypothalamic-neurohypophysial system and the hypothalamic-pituitary-adrenal axis in response to selected stressful stimuli. 相似文献
49.
50.
Angelo Stefanini 《Tropical medicine & international health : TM & IH》1997,2(3):278-283
After introducing the context in which health systems exist in developing as well as in industrialized countries, the author describes the role that hospitals are expected to play as 'enterprises'. The rationale behind such a role is explored and the experience so far available discussed. Evidence from several developing countries suggests caution and tends to discourage radical and indiscriminate introduction of market‐oriented reforms, which international donors seem to be spearheading in Africa's health systems. It is likely, however, that a limited, gradual introduction of selected elements of these reforms (such as some aspects of contracting out, managerial decentralization, the split between purchasing and providing functions) may find its place and eventually have a positive impact on the performance of the health systems. But the 'mystique of markets' must not be allowed to deprive public hospitals of the sense of social utility and of the caring ethos which are essential requisites of a meaningful and effective public health system. 相似文献