Shoulder disorders are a common health problem in western societies. Several treatment protocols have been developed for the
clinical management of persons with shoulder pain. However available evidence does not support any protocol as being superior
over others. Systematic reviews provide some evidence that certain physical therapy interventions (i.e. supervised exercises
and mobilisation) are effective in particular shoulder disorders (i.e. rotator cuff disorders, mixed shoulder disorders and
adhesive capsulitis), but there is an ongoing need for high quality trials of physical therapy interventions. Usually, physical
therapy consists of active exercises intended to strengthen the shoulder muscles as stabilizers of the glenohumeral joint
or perform mobilisations to improve restricted mobility of the glenohumeral or adjacent joints (shoulder girdle). It is generally
accepted that a-traumatic shoulder problems are the result of impingement of the subacromial structures, such as the bursa
or rotator cuff tendons. Myofascial trigger points (MTrPs) in shoulder muscles may also lead to a complex of symptoms that
are often seen in patients diagnosed with subacromial impingement or rotator cuff tendinopathy. Little is known about the
treatment of MTrPs in patients with shoulder disorders. 相似文献
Background Insular thyroid carcinoma was described as a tumor with aggressive behavior, and patients usually present themselves with
an advanced tumor stage. Whether the insular component is an independent factor for poor prognosis remains unclear. Therefore,
in the present study, we compared the survival of patients with advanced insular, follicular, and papillary thyroid cancer.
Materials and methods The clinical behavior of tumors in three groups of patients with T4 thyroid carcinoma—8 patients with insular, 11 patients
with follicular, and 21 patients with papillary thyroid carcinomas—was compared. Disease-free survival and disease-specific
death were analyzed statistically. Cox regression analysis was used to evaluate the influence of histotype and other prognostic
factors.
Results At 3 years, survival was 37.5% (mean 26 months) among patients with insular thyroid carcinoma, 80% (mean 59 months) among
those with follicular, and 89% (mean 126 months) among those with papillary thyroid carcinomas (p = 0.007). Disease-free survival in patients without initial distant metastasis was worst in patients with insular thyroid
carcinoma (20%) compared to those with follicular (75%) and those with papillary thyroid carcinomas (71%).
Conclusion Patients with advanced insular thyroid carcinoma have a poorer outcome in comparison to patients with similar advanced stage
who have follicular or papillary thyroid carcinoma. 相似文献
Background: Auricular acupuncture at the relaxation point has been previously shown to be an effective treatment for anxiety in the preoperative setting. The purpose of this prospective, randomized, blinded study was to determine whether auricular acupressure can reduce stress and anxiety during ambulance transport.
Methods: Patients who required ambulance transport secondary to medical conditions were randomized to receive auricular acupressure at the relaxation point (n = 17) or at a sham point (n = 19). A visual analog scale was used to assess state anxiety as well as patient anticipation of hospital medical treatment (estimated waiting period for treatment, anticipated pain during treatment, attitude toward the physicians, and treatment outcomes). These variables were assessed at baseline and on arrival to the hospital.
Results: Patients in the relaxation group reported significantly less anxiety than patients in the sham group on arrival to the hospital (visual analog scale mean +/- SD: 37.6 +/- 20.6 to 12.4 +/- 7.8 mm vs. 42.5 +/- 29.9 to 46.7 +/- 25.9 mm, respectively;P = 0.002). Similarly, patient perception of pain during treatment (mean visual analog scale +/- SD: 32.7 +/- 27.7 to 14.5 +/- 8.1 mm vs. 17.2 +/- 26.1 to 28.8 +/- 21.9 mm, respectively;P = 0.006) and treatment outcomes of their illnesses (mean visual analog scale +/- SD: 46.7 +/- 29.4 to 19.1 +/- 10.4 mm vs. 35.0 +/- 25.7 to 31.5 +/- 20.5 mm, respectively;P = 0.014) were significantly more positive in the relaxation group than in the sham group. No differences were found in the other variables assessed. 相似文献
Isolated pure dislocations of the fifth carpo-metacarpal joint are extremely rare injuries. The dorsal form was described
in mere 12 cases. The diagnosis can be easily missed. The lesion is also often overlooked in the routine diagnostic X-ray.
Lateral and oblique views are important for the recognition of the true extent of the lesion. Treatment of these injures is
still controversial and both closed reduction with percutaneous pinning or open reduction with internal fixation are advocated.
The goal of treatment is early reduction and fixation of the metacarpal. Early diagnosis is the key to success. The aim of
this paper is to review literature and present two new cases. 相似文献
With a view to the development of new controlled drug delivery systems, the formation of an interpolyelectrolyte complex (IPEC)
between chitosan (CTS) and Eudragit L100 (L-100) has been studied. The structure of this IPEC is such that two maxima are
observed in the curves of IPEC swelling in the media with different pH values. The release of a model drug (ibuprofen) from
IPEC-based tablets is significantly retarded, and this delay can be controlled by changing the molecular weight of CTS in
the IPEC composition.
__________
Translated from Khimiko-Farmatsevticheskii Zhurnal, Vol. 39, No. 12, pp. 44–46, December, 2005. 相似文献
Introduction Amisulpride is a substituted benzamide that, at low doses, selectively blocks D2 and D3 presynaptic dopamine receptors, enhancing
dopaminergic transmission in frontal cortex and limbic areas. Many clinical studies versus placebo, tricyclic antidepressants
and selective serotonin reuptake inhibitors showed amisulpride antidepressant effect, supporting its safety and rapid onset
of action. In oncological population, depression is quite frequent and difficult to treat because of the particular sensitivity
of cancer patients to the antidepressants’ side effects.
Goals of work The aims of this study were to evaluate efficacy, safety and tolerability of low doses of amisulpride (50 mg) in oncological,
depressed patients during chemotheraphy.
Materials and methods One hundred six consecutive cancer outpatients with depressive symptoms were treated in a prospective, intention to treat,
4-week study, and were evaluated in single-blind with Montgomery Asberg rating scale for depression (MADRS), clinical global
impression (CGI) and dosage record treatment emergent symptom scale (DOTES) to assess side effects of treatment.
Main results After 4 weeks of treatment, scores of MADRS and CGI significantly improved (p < 0.002; p < 0.001, respectively), with a reduction of depressive symptoms concerning both emotional (such as apparent sadness, reported
sadness, inner tension, etc.) and physical cluster (such as lack of appetite, reduction in weight, tiredness and insomnia)
with good tolerability (only two patients dropped out).
Conclusions This study is the first trial on the use of amisulpride in a cohort of oncological, depressed patients during chemotherapy.
Amisulpride demonstrated high efficacy and safety. Controlled studies are needed to confirm these preliminary data. 相似文献
The implantation of chondrocytes, seeded on matrices such as hyaluronic acid or collagen membranes, is a method that is being widely used for the treatment of chondral defects. The aim of the present study was to evaluate the distribution, viability and phenotype expression of the cells seeded on a collagen membrane just at the time of the implantation. Twelve patients who were suffering from articular cartilage lesions were treated by the MACI® procedure. The residual part of each membrane was tested by colorimetric assay (MTT) and histochemical and ultrastructural analyses were carried out. In all of the samples a large number of viable cells, quite homogenously distributed, was detected. The cells expressed the markers of the differentiated hyaline chondrocytes. These data reassure in that the MACI procedure provides a suitable engineered tissue for cartilage repair, in line with the clinical evidences emerging in the literature. 相似文献
The following article is an attempt to encapsulate an historical overview of spirituality in nursing. Despite a plethora of information relative to spirituality in nursing, the decision was to do an eclectic overview that was not reflective of any one spiritual/religious group. The authors at times found this goal difficult when writing about the Pre-Christian and Christian eras. Most of the major religions have their own perspective on the concept of spirituality, and historical personalities recorded maybe reflective of that particular religion. Another factor that impacted on the writing of this article was the concept that spirituality was not always linked specifically to religion. Spirituality was an experiential component of the wonders of nature and life, a domain that the authors took into account but did not expound upon. Finally the authors realized that spirituality has almost always been an aspect of African-American life and certainly of those in nursing. To this end the authors realize that there is a need for more research in this area. 相似文献
Complement is a multifunctional system of receptors and regulators as well as effector molecules. Both the pathogenic and diagnostic power of complement is based on the capacity of the complement system to amplify innate and adaptive immunity. This amplification is accomplished through two strategies: (1) enzymatic reactions in the complement cascade, and (2) stimulation of leukocytes, platelets and parenchymal cells through specific receptors or receptor-independent pore formation. The mechanisms by which complement mediates and modifies nonspecific inflammation, antibody-mediated injury and T-cell responses are of particular significance to the pathogenesis of transplant rejection. Understanding the mechanisms by which complement integrates the interactions of leukocytes, platelets and parenchymal cells offers opportunities to further refine the diagnosis of rejection. 相似文献
We experienced a rare case of giant cell tumor (GCT) arising in the 5th rib involving the 5th vertebral body and transverse process. A 57-year-old man presented with a well-defined mass in the left thoracic cavity on chest x ray examination. Chest computed tomography showed a heterogeneous 7cm-diameter mass originating in the posterior segment of the left 5th rib. The tumor had spread to the 5th thoracic vertebra destroying the left half of the body and transverse process. Magnetic resonance imaging showed a heterogeneous-intensity mass involving the 4th to 6th ribs. A radical excision of the tumor followed by a 50 Gy radiotherapy was performed after embolization of the feeding arteries. The pathological diagnosis was a GCT. The patient remains well without evidence of recurrence for 6 years following surgery. The present case is only the 14th case of GCT arising in the rib to have been reported in Japan. 相似文献