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961.
962.
M.T. Fernández Martín S. López Álvarez M.A. Pérez Herrero 《Revista espa?ola de anestesiología y reanimación》2018,65(8):456-460
Introduction
The administration of local anaesthetic in the serratus-intercostal space provides adequate analgesia in non-reconstructive breast surgery. The aim of this study was to evaluate whether the blockage of the last intercostal nerves (T7-T11) can lead to opioid savings in supra-umbilical open surgery procedures.Material and methods
A prospective observational study was conducted on patients undergoing open supra-umbilical surgery under general anaesthesia and with a serratus-intercostal plane block [modified Blocking the bRanches of IntercostaL nerves in the Middle Axillary line (BRILMA)] as an associated analgesic strategy. Post-operative pain was assessed with the numerical verbal scale (NVS 0 to 10) on admission to the post-anAesthesia recovery unit, at 6, 12, 24, and 48 h postintervention and by need for analgesic rescues with opioids (2 mg iv of morphine, if values higher than 3 in NVS). Adverse events related to the technique were also recorded. The statistical package used in the analysis of the data was SPSS® for Windows.Results
The study recruited 52 patients. Differences, with a p<.05, were found intra-operatively in the consumption of fentanyl: 400 + 80 μg versus 110 + 50 μg in patients who underwent pre-incisional blockade. In the first 24 hours, only 3 cases (two gastrectomies and one cholecystectomy) required morphine (single bolus of 2 mg). Between 24 h and 48 h it was necessary to administer several morphine boluses (8 + 2 mg) in four patients (three gastrectomies and one cholecystectomy). Four patients presented with nausea and / or vomiting and there were no complications related to the analgesic technique.Conclusion
The intercostal nerves block (T7-T11) in the serratus-intercostal space may constitute an opioid-sparing analgesic strategy in open supra-umbilical surgery. 相似文献963.
964.
Bálint Andó Péter Zoltán Álmos Viola Luca Németh Ildikó Kovács Anna Fehér-Csókás Ildikó Demeter 《Journal of substance use》2016,21(4):344-348
Background and objectives: Twelve-step based interventions promote the recovery from alcohol dependence, support relapse prevention and are associated with improved mental status indices (e.g. depression). This treatment model largely relies on spiritual experience. We tested three different alcohol treatment settings, which differently involve elements of spirituality in order to reveal its possible mediator effect on the level of depressive and anxiety symptoms. Methods: Patients were involved from (1) detoxification (n?=?34), (2) long-term – 12-step based – therapeutic community treatment (n?=?89), (3) and from Alcoholics Anonymous (AA) groups after at least 3 years of attendance (n?=?46). Anxiodepressive symptoms and spirituality/transcendence were compared and the potential mediator role of spirituality was assessed in the levels of depressive and anxiety symptoms. Results: Long-term 12-step based rehabilitation and sustained AA attendance was connected to lower levels of anxiodepressive symptoms and to more pronounced spirituality. The spiritual component of the different treatments played a mediator role in the decrease of state anxiety but this mediation was not detected in the case of depressive symptoms and trait anxiety. Conclusions/Importance: The role of spirituality in the decrease of state anxiety indicates acute beneficial effect. Therefore, long term, regular attendance in AA groups is essential. 相似文献
965.
Distribution of storage iron as body stores expand in patients with hemochromatosis. 总被引:5,自引:0,他引:5
L S Valberg J B Simon P N Manley W E Corbett J Ludwig 《The Journal of laboratory and clinical medicine》1975,86(3):479-489
The relative distribution of storage iron between bone marrow and liver has not been adequately studied in patients with iron-loading disorders. To help clarify this we assessed iron metabolism in patients with iron overload and in control subjects with cirrhosis but no excess body iron. In 4 patients with advanced iron overload studied late in the course of their illness, excess hemosiderin was present in both bone marrow and liver, as expected. In contrast, 2 patients with idiopathic hemochromatosis whose excess iron had been depleted by phlebotomy subsequently developed progressive hepatic parenchymal and reticuloendothelial (RE) deposition of iron, yet marrow hemosiderin remained sparse. Moreover, surface radioactivity over the liver after an oral dose of 59Fe. These results suggest that during the initial stages of hemochromatosis there is a dissociation in the rate of iron accumulation between the bone marrow and liver. Excess hemosiderin appears to be deposited predominantly and preferentially in hepatic storage sites until the later stages of the disease. 相似文献
966.
Matti Aapro Ivo Abraham Carsten Bokemeyer Heinz Ludwig Karen MacDonald Pierre Soubeyran Matthew Turner 《Supportive care in cancer》2008,16(2):193-200
Goal The benefit of supportive care with erythropoiesis-stimulating agents (ESAs) for patients with cancer-related anaemia is well
known. However, the European Cancer Anaemia Survey (ECAS, data from 2001) showed that about 60% of cancer patients with anaemia
do not receive any treatment. Since ECAS, evidence-based guidelines have provided recommendations for ESA use, but it is not
known to what extent current treatment patterns follow these guidelines. To address this issue, the Anaemia Cancer Treatment
(A.C.T.) study was initiated. The background to the development of the A.C.T. study and study methodology are described.
Materials and methods The A.C.T. study is a global, retrospective, pharmacoepidemiologic study of at least 2,560 medical records of anaemic patients
with cancer who were previously treated with an ESA from a minimum of 186 centres. Records from patients aged greater than
or equal to 18 years with a diagnosis of solid tumour or myeloma or lymphoma and who were started on ESAs 3–12 months before
inclusion and followed for 8–10 weeks will be eligible. Factors associated with ESA non-responsiveness will also be evaluated.
Main results Completion of the European phase of the study is anticipated in late 2007 with the rest of the world closing in late 2007
or early 2008. Publication of findings is anticipated in 2008.
Conclusions By examining the extent to which anaemia management in clinical practice is congruent with best practice guidelines, the A.C.T.
study will provide a further foundation for the development of evidence-based supportive cancer care. 相似文献
967.
968.
Noelia Vicente Oliveros PharmD Covadonga Pérez Menendez‐Conde PharmD PhD Teresa Gramage Caro PharmD Ana María Álvarez Díaz PharmD Manuel Vélez‐Díaz‐Pallarés PharmD PhD Beatriz Montero Errasquín MD Gema Nieto Gómez RN Teresa Rodríguez Cubilot RN Sagrario Martín‐Aragón Álvarez PhD Teresa Bermejo Vicedo PharmD PhD Eva Delgado Silveira PharmD PhD 《Journal of evaluation in clinical practice》2016,22(5):745-750
969.
970.
Y Ueno J O Phillips J Ludwig S N Lichtman N F LaRusso 《Proceedings of the National Academy of Sciences of the United States of America》1996,93(1):216-220
The cholangiopathies are a group of hepatobiliary diseases in which intrahepatic bile duct epithelial cells, or cholangiocytes, are the target for a variety of destructive processes, including immune-mediated damage. We tested the hypothesis that cholangitis could be induced in rodents by immunization with highly purified cholangiocytes. Inbred Wistar rats were immunized with purified hyperplastic cholangiocytes isolated after bile duct ligation from either syngeneic Wistar or allogeneic Fischer 344 rats; control rats were immunized with bovine serum albumin (BSA) or hepatocytes. After immunization with cholangiocytes, recipient animals developed histologic evidence of nonsuppurative cholangitis without inflammation in other organs; groups immunized with BSA or hepatocytes showed no cholangitis. Immunohistochemical studies revealed that portal tract infiltrates around bile ducts consisted of CD3-positive lymphocytes, some of which expressed major histocompatibility complex class II antigen; B cells and exogenous monocytes/macrophages were essentially absent. Transfer of unfractionated ConA-stimulated spleen cells from cholangiocyte-immunized (but not BSA-immunized) rats into recipients also caused nonsuppurative cholangitis. Moreover, these splenocytes from cholangiocyte-immunized (but not BSA-immunized) rats were cytotoxic in vitro for cultured rodent cholangiocytes; no cytotoxicity was observed against a rat hepatocyte cell line. Also, a specific antibody response in sera of cholangiocyte-immunized rats was demonstrated by immunoblots against cholangiocyte proteins. Finally, cholangiograms in cholangiocyte-immunized rats showed distortion and tortuosity of the entire intrahepatic biliary ductal system. This unique rodent model of experimental cholangitis demonstrates the importance of immune mechanisms in the pathogenesis of cholangitis and will prove useful in exploring the mechanisms by which the immune system targets and damages cholangiocytes. 相似文献