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71.
72.
LeRoy AJ; Williams HJ Jr; Bender CE; Segura JW; Patterson DE; Benson RC 《Radiology》1985,155(1):83-85
Two patients had colonic perforation as a result of percutaneous nephrostomy placement followed by track dilatation and renal calculus removal. We present the technical aspects of nephrostomy placement and stone removal, as well as the clinical diagnosis and management of these cases. Both patients recovered well with conservative therapy and required no surgical intervention. This report reviews the anatomic considerations for percutaneous nephrostomy in patients undergoing renal stone removal. 相似文献
73.
SR Mehta VSM HRA Prabhu AJ Swamy Harinder Dhaliwal Dinesh Prasad 《Medical Journal Armed Forces India》2004,60(1):25-27
The varied clinical manifestations and management of 14 male patients with delirium tremens (DT) have been studied. Eight patients were initially hospitalised for diseases unrelated to ethanol abuse i.e. 2 each for gun shot wound, myocardial infarction and stroke, and one each for pneumonia and gastroenteritis. One patient was going through withdrawal because of prodrome of viral hepatitis before he was hospitalised for uncontrolled agitation and delirium. Two known cases of mild essential hypertension on dietary therapy reported for agitation, abnormal behaviour, a single episode of tonic clonic seizure and hypertensive encephalopathy as they could not/did not get alcohol for 3 days. Three patients presented denovo with DT without concomitant illness. The other features besides delirium and hallucinations were tremulousness in 10, tachycardia in 12, fever in 3, diaphoresis in 2 and tonic clonic seizures in 4 patients. The symptoms fluctuated markedly at short intervals and 2 patients did not have any features of sympathetic overactivity. Altered hepatic biochemical parameters and ketonuria with normal blood sugar were noted in 4 and one patients respectively. Other biochemical parameters including serum electrolytes were normal. CT scan brain done for 5 patients revealed subdural haematoma in one. Cerebro spinal fluid (CSF) and EEG findings were noncontributory. All made good recovery with heavy doses of intravenous vitamin B complex, glucose and oral benzodiazepine. Short course of haloperidol was used in 2 patients. Two patients developed pancreatitis during follow up. All patients made complete recovery, and 8 patients have been followed for 8 to 12 months without relapse. The reason for hospitalisation in such cases is often unrelated to alcohol abuse; hence a detailed history of alcoholism is mandatory to identify those at risk as well as for prompt treatment and decreasing the mortality.Key Words: Alcohol withdrawal, Concomitant illnesses, Delirium, Precipitating events 相似文献
74.
Lothar AJ Heinemann Farid Saad Thomas Zimmermann Annoesjka Novak Eric Myon Xavier Badia Peter Potthoff Guy T'sjoen Pasi Pöllänen Nikolai P Goncharow Sehyun Kim Christelle Giroudet 《Health and quality of life outcomes》2003,1(1):1-5
Background
The interest of clinical research in aging males increased in recent years and thereby the interest to measure health-related quality of life (HRQoL) and symptoms of aging men. The Aging Males' Symptoms scale (AMS) became the most commonly used scale to measure HRQoL and symptoms in aging males in many countries worldwide. The aim of this paper is to review the current state of the instrument particularly concerning versions of the scale in different languages in the light of the quality of the translation process.AMS versions available
Most of the translations were performed following international methodological recommendations for linguistic & cultural adaptation of HRQoL instruments. Mainly the English version was used as source language for the translation into Dutch, Spanish, Portuguese, Italian, Swedish, and Japanese (attached as additional PDF-files). Preliminary versions that were derived only from forward translations are of secondary quality and available in Finnish, Flemish, and Russian. It is recommended to complete the translation process for the latter languages before using them in international studies.Translations in process
The AMS scale is in the process of consensus finding of two existing French versions, and the versions in the Korean, Thai, and Indonesian languages have not yet been completed in the translation process.Conclusion
The AMS scale is obviously a valuable tool for assessing health related quality of life in aging men, because it is used worldwide. It is a standardized scale according to psychometric norms. Most of the currently available language versions were translated following international standards for linguistic and cultural translation of quality of life scales. Assistance is offered to help interested parties in the translation process. 相似文献75.
Balancing autonomy and responsibility: the ethics of generating and disclosing genetic information 下载免费PDF全文
Hallowell N Foster C Eeles R Ardern-Jones A Murday V Watson M 《Journal of medical ethics》2003,29(2):74-79
Using data obtained during a retrospective interview study of 30 women who had undergone genetic testing-BRCA1/2 mutation searching-this paper describes how women, previously diagnosed with breast/ovarian cancer, perceive their role in generating genetic information about themselves and their families. It observes that when describing their motivations for undergoing DNA testing and their experiences of disclosing genetic information within the family these women provide care based ethical justifications for their actions. Finally, it argues that generating genetic information and disclosing this information to kin raise different types of ethical issues. The implications of these findings for ethical debates about informed choice in the context of genetic testing are discussed. 相似文献
76.
Lipton L Thomas HJ Eeles RA Houlston RS Longmuir M Davison R Hodgson SV Murday VA Norbury CG Taylor C Tomlinson IP 《Familial cancer》2001,1(3-4):189-195
It is not uncommon for cancer geneticists to be referred families with apparently Mendelian co-inheritance of breast and bowel cancer. Such families present a particular problem as regards the intensity of their screening for these diseases and the utility of genetic testing. Many 'breast-colon' cancer families probably result from chance clustering of two common cancers. Other 'breast-colon' cancer families may result from known cancer syndromes, such as hereditary breast-ovarian cancer or hereditary non-polyposis colon cancer, either by conferring a high risk of one cancer type and a slightly increased risk of the other, or through a predisposition to one of the two cancers and chance occurrence of the other. Anecdotally, however, many geneticists wonder about the existence of a distinct 'breast-colon cancer syndrome', since some families present good a priori evidence of genetic disease and yet cannot readily be accounted for by known genes or chance. The identification of unknown 'breast-colon cancer' genes is likely to be difficult, relying primarily on candidate gene analysis, including loci separately implicated in breast or colorectal cancer, or in other multiple cancer syndromes. Studies such as those on APC I1307K and CHEK2 1100delC may suggest the way forward for the identification of 'breast-colon cancer' genes. 相似文献
77.
R E Brolin MD JH Gorman MD RC Gorman MD AJ Petschenik M D LJ Bradley MS RD HA Kenler PhD RP Cody Pb D 《Journal of gastrointestinal surgery》1998,2(5):436-442
Although iron, vltamm B12, and folate deficiency have been well documented after gastric bypass operations performed for morbid obesity, there is surprisingly
little information on either the natural course or the treatment of these deficiencies in Roux-en-Y gastric bypass (RYGB)
patients Durmg a l0-year period, a complete blood count and serum levels of iron, total iron-binding capacity, vltamin B12, and folate were obtained in 348 patients preoperatively and postoperatively at 6-month intervals for the first 2 years,
then annually thereafter The principal objectives of this study were to determine how readily patients who developed metabolic
deficiencies after Roux-en-Y gastric bypass responded to postoperative supplements of the deficient micronutrient and to learn
whether the risk of developmg these deficiencies decreases over time Hemoglobin and hematocrit levels were slgnificantly decreased
at all postoperative intervals in comparison to preoperative values Moreover, at each successive interval through 5 years,
hemoglobin and hematocrit were decreased signifiantly compared to the preceding interval Folate levels were significantly
increased compared to preoperative levels at all time intervals Iron and vltamin B12 levels were lower than preoperative measurements and remained relatively stable postoperatively Half of the low hemoglobin
levels were not associated with iron deficiency Taking multivltamin supplements resulted in a lower incidence of folate deficiency
but did not prevent iron or vitamin B12 deficiency Oral supplementation of iron and vitamin B12 corrected defiaencies in 43% and 81% of cases, respectively Folate deficiency was almost always corrected with multivitamins
alone No patient had symptoms that could be attributed to either vitamin B12 or folate deficiency Conversely, many patients had symptoms of iron deficiency and anenua Lack of symptoms of vitamin B12 and folate deficiency suggests that these deficiencies are not clinically important after RYGB Conversely, iron deficiency
and anemia are potentially serious problems after RYGB, particularly in younger women Hence we recommend prophylactic oral
iron supplements to premenopausal women who undergo RYGB 相似文献
78.
Hasegawa DK; Bennett AJ; Coccia PF; Ramsay NK; Nesbit ME; Krivit W; Edson JR 《Blood》1980,56(4):585-595
Factor V deficiency has been identified in 8 of 8 patients 7--20 yr of age, with Philadelphia-positive (Ph1+) chronic myelogenous leukemia (CML). In these 8 patients, factor V deficiency was not due to hepatic dysfunction, factor V inhibitors, or disseminated intravascular coagulation. In 3 patients, factor V activity rose 10%--12% (0.10--0.12 U/ml) after the infusion of 28--31 ml/kg body weight of fresh frozen plasma (FFP). The rise persisted less than 14 hr. The mean measured postinfusion rise in factor V was 18% of the expected rise calculated from the volume of FFP infused in the patients' plasma volume. In 4 patients, a small transient rise in factor V activity occurred after splenectomy or plateletpheresis. Factor V deficiency was completely corrected after a marked reduction in bone marrow cellularity in 2 patients with Ph1+ CML treated with extensive chemotherapy, total body irradiation, and bone marrow transplantation. Factor V deficiency was retrospectively observed in 6 of 20 patients, ages 20--80 yr, with Ph1+ CML and 3 of 6 patients with other myeloproliferative disorders. The factor V deficiency appears to be associated with the large myeloid- megakaryocytic cell mass characteristic of CML and other myeloproliferative disorders. 相似文献
79.
3-Hydroxypropyl flufenamide (Flu-HPA) is one of a series of flufenamic acid derivatives that enhances blood clot lysis in vitro. Studies of possible mechanisms of action of Flu-HPA were undertaken. The profibrinolytic activity of Flu-HPA in clot lysis assays was found to be dependent on plasminogen. The influence of Flu-HPA on the ability of purified alpha 2-antiplasmin to inhibit purified plasmin was studied. Plasmin activity was determined using 125I-fibrin plates or the spectrophotometric tripeptide substrate, Val-Leu-Lys-paranitroanilide. At Flu-HPA concentrations greater than 1 mM, the inhibitory activity of alpha 2-antiplasmin was abolished in a time-dependent and concentration- dependent manner. The influence of Flu-HPA on the ability of purified Cl inhibitor to inhibit purified plasma kallikrein and beta-Factor XIIa was also studied. Cl inhibitor activity was abolished by Flu-HPA at concentrations greater than 2 mM. Notably, Flu-HPA up to 60 mM did not affect the amidolytic activities of plasmin, kallikrein, or beta-Factor XIIa. Flu-HPA did not release enzyme activity from preformed complexes of either alpha 2-antiplasmin and plasmin of Cl inhibitor and kallikrein. A water-soluble derivative of flufenamic acid, N-flufenamyl- glutamic acid, also inactivated alpha 2-antiplasm and Cl inhibitor. This inactivation was shown to be reversible. These results indicate that synthetic fibrinolytic compounds such as flufenamic acid derivatives may promote fibrinolysis by directly inactivating alpha 2- antiplasmin and Cl inhibitor. 相似文献
80.
Maria E Ostermann Chris A Rogers Imran Saeed Stephen R Nelson Andrew J Murday 《The Journal of heart and lung transplantation》2004,23(11):1231-1237
BACKGROUND: Survival after cardiac transplantation has not changed over the last 10 years. Our objective was to identify risk factors for 30-day mortality after cardiac transplantation with particular reference to focusing on the impact of pre-existing renal dysfunction. METHODS: We analyzed the data of all 1,180 patients who received a first heart transplant in the 8 adult transplant centers in the United Kingdom between April 1996 and March 2002 using the UK Cardiothoracic Transplant Audit database. Renal function at registration and transplantation was determined by calculation of creatinine clearance (CrCl) according to the Cockcroft-Gault formula. RESULTS: Multivariate analysis showed that ventilator dependence pre-transplantation and cold ischemia time >4 hours had the highest association with 30-day mortality, followed by CrCl =50 ml/min. Patients with a CrCl =50 ml/min on day of transplantation had a significantly higher 30-day mortality compared to patients with CrCl >50 ml/min (19.7% vs 9.5%; p < 0.01). The change in CrCl between registration and transplantation was not related to mean CrCl or waiting time. In 67 of the patients with a CrCl >50 ml/min at registration, CrCl was reduced to =50 ml/min on day of transplantation (30-day mortality 16.7%). CONCLUSIONS: Pre-operative CrCl =50 ml/min doubles the risk of death within 30 days after cardiac transplantation. Patients considered for cardiac transplantation should undergo regular measurement of renal function so that a more accurate risk-benefit assessment can be made. 相似文献