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951.
Frank P MacMaster Aileen Russell Yousha Mirza Matcheri S Keshavan S Preeya Banerjee Rashmi Bhandari Courtney Boyd Michelle Lynch Michelle Rose Jennifer Ivey Gregory J Moore David R Rosenberg 《Neuropsychopharmacology》2006,59(3):252-257
BACKGROUND: Abnormalities in the limbic-hypothalamic-pituitary-adrenal (LHPA) axis have been implicated in the pathogenesis of obsessive-compulsive disorder (OCD). To our knowledge, however, no prior study has measured pituitary gland volume in OCD. METHODS: Volumetric magnetic resonance imaging studies were conducted in 31 psychotropic drug-na?ve children (10 boys, 21 girls) aged 8-17 years and 31 case-matched healthy comparison subjects. RESULTS: Pituitary volume was significantly smaller in patients with OCD as compared with healthy control subjects (11% smaller). Smaller pituitary volume in patients with OCD was associated with increased compulsive but not obsessive symptom severity. Boys with OCD had smaller pituitary gland volumes compared with control boys (20% smaller). No significant differences in pituitary volume were observed between girls with OCD and control girls. Boys with OCD had significantly smaller pituitary volumes than girls with OCD (31% smaller), whereas control boys also had smaller pituitary gland volumes compared with control girls (21% smaller). CONCLUSIONS: These findings provide new evidence of reduced pituitary volume in pediatric OCD that seems to be more prominent in male patients. The observed alterations in pituitary volume are consistent with neuroendocrine studies that have reported abnormalities in the LHPA axis in OCD. 相似文献
952.
Ali Ghoz Ehab Kheir Anil Kotru Karim Halazun David Kessel Jai Patel J J Peter A Lodge 《Hepatobiliary & Pancreatic Diseases International》2007,(3)
BACKGROUND:Spontaneous hemoperitoneum of hepato- biliary origin is commonly due to hemorrhage from a liver tumor.It is rarely caused by spontaneous rupture of aneurysm in visceral arteries. METHODS:We report an unusual case of hemoperitoneum caused by rupture of cystic artery pseudoaneurysm,and also outline the approach to its management through surgical and radiological methods. RESULTS:In our patient,the pseudoanurysm was initially treated with percutaneous thrombin injection.However this method of treatment failed after initial success.The pseudoanurysm was finally obliterated successfully using microcoil embolization. CONCLUSIONS:The mainstay of treatment of cystic artery pseudoaneurysm is cholecystectomy and ligation of the aneurysm.Recent publications showed success in using microcoil embolisation.In this case we also outline the use of percutaneous thrombin injection as a definitive treatment method and discuss its success or failure as a new method of treatment. 相似文献
953.
Jacqueline A Jumpsen Neil E Brown Alan B R Thomson S F Paul Man Yeow K Goh David Ma M T Clandinin 《Journal of cystic fibrosis》2006,5(2):77-84
The objective of this study was to investigate the effect of docosahexaenoic acid (DHA) supplementation on blood and intestinal DHA levels and lung function in mild/moderately affected adult CF patients with the DeltaF508 genotype. BACKGROUND: Cystic Fibrosis (CF) patients often present with plasma fatty acid levels indicating low levels of linoleic (18:2n-6) and docosahexaenoic (22:6n-3) acids and an increased level of arachidonic acid (20:4n-6). Improved dietary fat intake or reducing fat malabsorption with pancreatic enzymes has failed to normalize this biochemical deficiency of DHA. METHODS: Five CF patients, aged 18-43, received 70 mg of DHA/kg body weight/d for six weeks. At baseline and at six weeks a physical exam, lung function, 3-day dietary intake, duodenal mucosal biopsy and blood sample were assessed. The blood was analyzed for plasma vitamin A, D and E levels, liver function tests, clinical chemistry (CBC, differential and electrolytes). Plasma and red blood cell fatty acid levels were also analyzed. At three weeks, assessment included a physical exam, lung function test and fasting blood sample (vitamin levels, liver function and clinical chemistry only). RESULTS: Pre- and post-measurements were compared for the four subjects who completed the study. An increase in DHA content (% w/w) was observed in all phospholipid fractions of plasma, red blood cell and mucosal samples. No significant differences in vitamin levels, liver function or lung function were observed. CONCLUSIONS: The study proves the concept that an increase in tissue DHA levels in CF patients can be achieved by supplementing for six weeks with 70 mg/kg/d DHA. 相似文献
954.
Jonas T. Johnson MD Editor John K. Niparko MD Editor-in-Chief Paul A. Levine MD Editor David W. Kennedy MD Editor Pete Weber MD Editor-in-Chief Randal S. Weber MD Editor Michael S. Benninger MD Past Editor in Chief Richard M. Rosenfeld MD MPH Editor in Chief Robert J. Ruben MD Editor in Chief Richard J.H. Smith MD Editor in Chief Robert Thayer Sataloff MD DMA Editor in Chief Neil Weir MA FRCS Editor Emeritus 《Otolaryngology--head and neck surgery》2006,135(6):829-830
955.
956.
Anne W Wojner Lewis Morgenstern Andrei V Alexandrov Diana Rodriguez David Persse James C Grotta 《American journal of critical care》2003,12(5):411-417
BACKGROUND: Rapid diagnosis and transport by paramedics and efficient, effective emergency management are essential to improving care of acute stroke patients. OBJECTIVES: To measure the performance of paramedics and emergency departments providing care for patients with suspected acute stroke. METHODS: Two stroke centers and 4 other hospitals where most patients with acute stroke in Houston, Tex, are admitted participated. Hospital and paramedic performance data were collected prospectively on 446 patients with suspected acute stroke transported by paramedics between September 1999 and February 2000. RESULTS: Paramedics had a sensitivity of 66%, specificity of 98%, and overall accuracy of 72% in diagnosing stroke. For patients with suspected stroke, 58.5% arrived in the emergency department within 120 minutes of symptom onset; in confirmed cases, that percentage was 67%. Mean total transport time was 42.2 minutes and was significantly longer (P < .001) to inner-city hospitals (44 minutes) than to suburban, community-based centers (39 minutes). Door to computed tomography times were significantly (P < .001) shorter for the 2 stroke centers than the other hospitals. Overall thrombolysis treatment rate among patients with confirmed ischemic stroke was 7.4% (range, 0-19.4%); treatment rates at the 2 stroke centers were 5.9% and 19.4%. CONCLUSIONS: More than half of patients with suspected stroke arrive at hospitals while thrombolytic treatment is still feasible. Although the current rate for thrombolytic treatment in Houston exceeds the national rate, performance of paramedics and hospitals in treating acute stroke can be improved by increasing efficiency and standardizing medical practices. 相似文献
957.
Kallol Ray Chaudhuri Pablo Martinez-Martin Anthony H V Schapira Fabrizio Stocchi Kapil Sethi Per Odin Richard G Brown William Koller Paolo Barone Graeme MacPhee Linda Kelly Martin Rabey Doug MacMahon Sue Thomas William Ondo David Rye Alison Forbes Susanne Tluk Vandana Dhawan Annette Bowron Adrian J Williams Charles W Olanow 《Movement disorders》2006,21(7):916-923
Nonmotor symptoms (NMS) of Parkinson's disease (PD) are not well recognized in clinical practice, either in primary or in secondary care, and are frequently missed during routine consultations. There is no single instrument (questionnaire or scale) that enables a comprehensive assessment of the range of NMS in PD both for the identification of problems and for the measurement of outcome. Against this background, a multidisciplinary group of experts, including patient group representatives, has developed an NMS screening questionnaire comprising 30 items. This instrument does not provide an overall score of disability and is not a graded or rating instrument. Instead, it is a screening tool designed to draw attention to the presence of NMS and initiate further investigation. In this article, we present the results from an international pilot study assessing feasibility, validity, and acceptability of a nonmotor questionnaire (NMSQuest). Data from 123 PD patients and 96 controls were analyzed. NMS were highly significantly more prevalent in PD compared to controls (PD NMS, median = 9.0, mean = 9.5 vs. control NMS, median = 5.5, mean = 4.0; Mann-Whitney, Kruskal-Wallis, and t test, P < 0.0001), with PD patients reporting at least 10 different NMS on average per patient. In PD, NMS were highly significantly more prevalent across all disease stages and the number of symptoms correlated significantly with advancing disease and duration of disease. Furthermore, frequently, problems such as diplopia, dribbling, apathy, blues, taste and smell problems were never previously disclosed to the health professionals. 相似文献
958.
David Bernard 《L'évolution Psychiatrique》2006,71(4):717
This study examines what happens to shame in paranoid psychosis, and emphasizes how the treatment of shame can follow on from delusion, via the construction of a persecuting ‘Other’. This may give rise to the impression that the paranoid subject is free from shame, placing all the shameful enjoyment on this ‘Other’. It will be demonstrated that this is not the case when this subject returning from their deluded state is convinced, in particular, that their dignity has been affected and that they have been reduced, by the ‘Other’, to the level of a shameful object. 相似文献
959.
Objective To describe dislocation of the elbow with articular fracture of the distal humerus,a type of elbow fracture-dislocation about which little has been written.Methods Four patients with a dislocation of the elbow and fracture of the distal humerus were identified.Three had dislocation and complex intraarticular fracture of the capitellum,trochlea,and lateral epicondyle.Results Two patients(one treated with a second operation to address avascular necrosis of the capitellum)achieved a functional arc of elbow motion and one patient was lost after removal of the implants 3 months after fracture with documented healing.The fourth patient had a complex open fracture dislocation involving the entire articular surface.An attempt to salvage the articular surface resulted in deep infection.Extensive heterotopic bone led to arthrodesis of the elbow.Conclusions Dislocations of the elbow with articular fracture of the humerus are uncommon.Most injuries involve the capitellum,lateral trochlea,and lateral epicondyle.Open reduction and internal fixation of the distal humerus fracture can restore stability without repairing the medial collateral ligament. 相似文献
960.
Deborah G Murdoch Eaton David Wertheim Rowena Oozeer Lilly MS Dubowitz Victor Dubowitz 《Acta paediatrica (Oslo, Norway : 1992)》1994,83(5):486-492
Murdoch Eaton DG, Wertheim D, Oozeer R, Dubowitz LMS, Dubowitz V. Reversible changes in cerebral activity associated with acidosis in preterm neonates. Acta Paediatr 1994;83:486–92. Stockholm. ISSN 0803–5253
Computerized online EEG monitoring in ventilated preterm infants less than 32 weeks' gestation enabled evaluation of the effect of acidosis on cerebral function. All episodes of acidosis were found to be associated with changes in the levels of cerebral activity. In 21 of the 32 episodes, EEG activity returned to pre-acidosis levels after therapeutic intervention. The duration of EEG abnormality was related to the severity of acidosis. However, the time to recovery of the EEG after therapeutic procedures was not related to duration of the EEG change. 相似文献
Computerized online EEG monitoring in ventilated preterm infants less than 32 weeks' gestation enabled evaluation of the effect of acidosis on cerebral function. All episodes of acidosis were found to be associated with changes in the levels of cerebral activity. In 21 of the 32 episodes, EEG activity returned to pre-acidosis levels after therapeutic intervention. The duration of EEG abnormality was related to the severity of acidosis. However, the time to recovery of the EEG after therapeutic procedures was not related to duration of the EEG change. 相似文献