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11.
12.
Results of the routine use of a modified endoprosthesis to drain the common bile duct after laparoscopic choledochotomy 总被引:6,自引:1,他引:5
A. L. DePaula K. Hashiba M. Bafutto C. Machado A. Ferrari M. M. Machado 《Surgical endoscopy》1998,12(7):933-935
Background: One hundred eighty-one patients were submitted to laparoscopic common bile duct exploration.
Methods: A transcystic approach was used in 147 patients, choledochotomy in 14, and both in 20. The indications to perform a choledochotomy
included stones larger than 20 mm, stones proximal to the cystic duct entrance, and cases in which the transcystic duct approach
proved impossible or unsuccessful.
Results: The common bile duct was drained by a T-tube in four patients, by laparoscopic sphincterotomy in one, by laparoscopic choledochoduodenostomy
in one, and by a 10 Fr endoprosthesis in 28. The stent placement was technically feasible in all patients but one. The biliary
drainage was adequate. Mean hospital stay was 2.1 days. Complication was limited to one umbilical infection and one self-limited
biliary leak.
Conclusions: The procedure proved to be technically simple, safe, and efficient, and resulted in a low morbidity rate and short hospital
stay.
Received: 29 March 1996/Accepted: 12 June 1996 相似文献
13.
António Travassos Susana Teixeira Pinto Ferreira Isaura Regadas Ana Sofia Travassos Florindo Esteves Esperancinha Isabel Prieto Grapa Pires Robert van Velze A Valido Maria do Céu Machado 《Ophthalmic surgery, lasers & imaging》2007,38(3):233-237
The anatomic response to intravitreal bevacizumab injection in three patients with aggressive, posterior retinopathy of prematurity is described. In all cases, the worse eye was treated with a single intravitreal injection of 0.75 mg of bevacizumab as monotherapy or complementary to laser therapy. In 24 hours, all injected eyes showed regression of the tunica vasculosa lentis and iris vessel engorgement and disappearance of iris rigidity. In addition, plus disease and retinal proliferation began to regress. None of the eyes required additional treatment. Follow-up of up to 10 months 相似文献
14.
Andr ia Kist Fernandes Felipe Mallmann Ana Maria Pasquali Steinhorst Fernando Lopes Nogueira Eduardo Mü ller vila Dumitriu Zunino Saucedo Francisco Juchem Machado Marcelo Greg rio Raymundi S rgio Saldanha Menna Barreto Paulo de Tarso Roth Dalcin 《The Journal of asthma》2003,40(6):683-690
Asthma patients that depend on emergency department (ED) services are generally considered to have extremely poor disease control and prognosis. It is important to identify characteristics related to poor disease control and frequent visits to the ED to apply appropriate clinical management. This study comprised a cross-sectional survey of consecutive patients with asthma exacerbation (age ≥12 years) presenting at the adult ED of a large, tertiary care, university-affiliated hospital over a 2-month period. The frequent visitors (FV) were defined by ≥3 visits to the ED in the preceding year, and the occasional visitors (OV) by ≤2 visits. Eighty-six patients (61 females and 25 males) were included in the study (mean age 38 ± 18 years). Of these patients, 51.2% were FV and 48.8% were OV. Sixty-nine percent had annual income lower than A$3000 and 66.3% had ≤8 years of the formal education. Only 18.6% had used inhaled corticosteroids, 79.1% identified the asthma attack severity, 70.9% increased or initiated inhaled β-agonist, 20.9% increased or initiated steroid therapy, and 55.8% had an asthma action plan for attack. The number of hospital admissions in past year (OR 4.3, P = .02), use of home nebulizer (OR 3.6, P = .05) and the lack of a written asthma action plan (OR 3.3, P = .03) were independently associated with frequent visits to the ED. We conclude that a substantial proportion of the patients that visit the ED are FV. These patients are more likely to have hospital admission in the past year, to use a home nebulizer, and to lack a written asthma action plan. They should be considered the most important target for asthma education. 相似文献
15.
Sung-Eun Kong Lewis R. Blennerhassett Kathryn A. Heel Rosalie D. McCauley John C. Hall 《ANZ journal of surgery》1998,68(8):554-561
Ischaemia-reperfusion injury (IRI) is of obvious relevance in situations where there is an interruption of blood supply to the gut, as in vascular surgery, or in the construction of free intestinal grafts. It is now appreciated that IRI also underlies the gut dysfunction that occurs in early shock, sepsis, and trauma. The events that occur during IRI are complex. However, recent advances in cellular biology have started to unravel these underlying processes. The aim of this review is to provide an outline of current knowledge on the mechanisms and consequences of IRI. Initially, IRI appears to be mediated by reactive oxygen metabolites and, at a later stage, by the priming and activation of polymorphonuclear neutrophils (PMN). Ischaemia-reperfusion injury can diminish the barrier function of the gut, and can promote an increase in the leakage of molecules (intestinal permeability) or the passage of microbes across the wall of the bowel (bacterial trans-location). Ischaemia-reperfusion injury to the gut can result in the generation of molecules that may also harm distant tissues. 相似文献
16.
The interaction of parafluorohexahydrosiladiphenidol at muscarinic receptors in vitro 总被引:6,自引:6,他引:0 下载免费PDF全文
R M Eglen A D Michel W W Montgomery E A Kunysz C A Machado R L Whiting 《British journal of pharmacology》1990,99(4):637-642
1. The antagonistic actions of parafluorohexahydrosiladiphenidol (pFHHSiD) at muscarinic receptors has been studied in cardiac muscle, smooth muscle and cell culture preparations. In this paper, the classification scheme of Doods et al. (1987) is employed. This scheme is based upon differential affinities of muscarinic antagonists. pFHHSiD exhibited high pA2 values at M3 receptors mediating contractions of guinea-pig ileum and oesophageal muscularis mucosae (7.8 and 8.2 respectively) whereas low values were determined at M2 receptors mediating negative inotropic responses in guinea-pig atria (6.0). Intermediate pA2 values were determined at M1 receptors mediating contractions of the canine femoral and saphenous veins. 2. The pA2 values of pFHHSiD at receptors mediating endothelial-dependent relaxation of rat aortic rings, rabbit jugular vein and canine femoral artery (7.6-7.9) were similar to those determined on the ileum. However, the pA2 values of pFHHSiD at receptors mediating contractions of the guinea-pig trachea (7.1), which has been previously shown to possess M3 receptors, were different from those determined in the ileum. 3. The similarity in pA2 values of pFHHSiD between the M3 receptors in guinea-pig ileum and the receptors mediating endothelial-dependent relaxations provide further evidence for the role of M3 receptors in this vascular response. Taken together, pA2 values for pFHHSiD range from 7.1 to 8.2, depending upon the M3 preparation used. The selectivity of the compound therefore for the M3 versus the M2 muscarinic receptor ranged from 13 to 163 fold.(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献
17.
M. L. Vizuete M. Santiago A. J. Herrera J. L. Venero A. Machado J. Cano 《Journal of neural transmission (Vienna, Austria : 1996)》1991,85(3):231-242
Summary Levels of dopamine (DA), noradrenaline (NA) and 5-hydroxytryptamine (serotonin, 5-HT) and their metabolites, and the activities of tyrosine hydroxylase (TH), tryptophan hydroxylase (TPH) and monoamine oxidase A and B (MAO-A and MAO-B) have been determined in the rat posterior thalamus after enucleation during postnatal development. DA and 5-HT turnover rate have been measured as 3,4-dihydroxyphenylalanine (DOPA) and 5-hydroxytryptophan (5-HTP) accumulation rates after central decarboxylase inhibition by 3-hydroxybenzylhydrazine (NSD-1015). The major changes were an increase in noradrenergic and serotoninergic metabolism in enucleated animals compared with control animals. A decrease of the MAO-A to MAO-B ratio during postnatal development was found.Abbreviations
DA
dopamine
-
DOPAC
3,4-dihydroxyphenylacetic acid
-
HVA
homovanillic acid
-
DOPA
3,4-dihydroxyphenylalanine
-
NA
noradrenaline
-
MHPG
3-methoxy-4-hydroxyphenylgly-col
-
NMN
normetanephrine
-
TRP
tryptophan
-
5-HTP
5-hydroxytryptophan
-
5-HT
serotonin
-
5-HIAA
5-hydroxy-3-indolacetic acid
-
TH
tyrosine hydroxylase
-
TPH
tryptophan hydroxylase
-
MAO-A
monoamine oxidase-A
-
MAO-B
monoamine oxidase-B
Recipients of fellowships from I.I.E. del FISS Reincorporación de doctores y tecnólogos del M.E.C., and Perfeccionamiento de doctores y tecnólogos del MEC, Spain 相似文献
18.
19.
Marta Padilla Castillo Yaiza Machado RyderManuel Cazorla Betancor Rocío Acebes TostiMargarita Medina Castellano Rosa Rodríguez-Mano 《Progresos de Obstetricia y Ginecología》2006
Heterotopic pregnancy is the combination of intrauterine and ectopic pregnancy. This potentially fatal condition rarely occurs in spontaneous conception cycles and consequently its diagnosis requires a high index of suspicion. We report a case of heterotopic pregnancy in a 30-year old primipara with no known risk factors who presented with acute abdominal pain due to a spontaneous heterotopic pregnancy. The ectopic pregnancy was resected via laparoscopy. After surgery, the intrauterine pregnancy was uneventful. 相似文献
20.
Can nurses practice caring within a healthcare system that promotes codependency? Caring promotes mutual empowerment of all participants while codependent caring disempowers. Nurses are expected to practice caring with clients, The authors contend, however, that nursing, as historically and currently practiced within bureaucratic/patriarchal organizations, is founded on a vlue system that fosters codependency. Until nursing is practiced within the context of caring organizations and a caring healthcare system, nurses will continue to be powerless to shape their own practice as carers and burnout will continue to be a problem. 相似文献