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101.
Riccardo Torta Carlotta Berra Luca Binaschi Roberto Borio 《Supportive care in cancer》2007,15(5):539-546
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
102.
Adam J. Singer MD Steve A. McClain MD Alexander Romanov DVM Jean Rooney BS Tom Zimmerman DVM 《Academic emergency medicine》2007,14(12):1125-1129
Objectives Cutaneous burns are dynamic injuries with a central zone of necrosis surrounded by a zone of ischemia. Conversion of this ischemic zone to full necrosis over the days following injury is due in part to highly reactive oxygen radicals. Curcumin is a component of the Oriental spice turmeric that has been shown to have antioxidant and antiapoptotic properties. The authors hypothesized that treatment of burns with curcumin would reduce the conversion of the ischemic zone to full necrosis. Methods This was a randomized controlled experiment. Twenty Sprague‐Dawley rats were used. Two burns were created on each animal's dorsum using a brass comb with four rectangular prongs preheated in boiling water and applied for 30 seconds, resulting in four rectangular 10 × 20–mm full‐thickness burns separated by three 5 × 20–mm unburned interspaces (zone of ischemia). Animals were randomized to curcumin or vehicle by oral gavage 30 minutes before injury and at 24, 48, and 72 hours after injury. Wounds were observed at one, two, and three days after injury for visual evidence of necrosis in the unburned interspaces. Full‐thickness biopsy specimens from the interspaces were evaluated with hematoxylin and eosin staining seven days after injury for evidence of necrosis. The percentage of interspaces that progressed to necrosis was compared with chi‐square tests. Results Forty comb burns with 120 unburned interspaces were created, evenly distributed between curcumin and vehicle alone. The percentage of interspaces that progressed to full‐thickness necrosis at one, two, three, and seven days after injury in the curcumin and vehicle groups were 30% versus 63% (p = 0.003), 30% versus 70% (p < 0.001), 63% versus 95% (p = 0.02), and 63% versus 95% (p = 0.02), respectively. Conclusions Pretreatment of rats with oral curcumin followed by once‐daily oral treatment for three days reduced the percentage of unburned skin interspaces that progressed to full necrosis. 相似文献
103.
Government reform of the NHS in the UK has sought to increase the involvement of doctors (clinicians) in hospital management. Using frameworks from the psychological contract and organisational misbehaviour literatures, this paper examines the processes involved when clinicians assume management roles. This literature seeks to explain breaches to expectations regarding prior agreements with management and subsequent actions of 'getting even' as a result of breaches to the employment relationship. A qualitative methodology using interviews was undertaken, which identified two distinct groups of clinician-manager. Investors actively pursued a management opportunity as an alternative to clinical medicine, whilst reluctants tended to assume a management role to protect particular specialities from outside influence or from those they thought would be inappropriate clinician-managers. Investors and reluctants often had very little prior experience of management and managers and had problems reconciling their dual clinician-management role. Poor relationships with hospital managers who often had no understanding of their dual responsibilities led to tensions and conflict, which questions continued developments in this important area of UK health policy. Suggestions for improving this process are outlined. 相似文献
104.
Yukinori Sakao Toru Sakuragi Yuji Takeda Masafumi Natsuaki Tsuyoshi Itoh 《General thoracic and cardiovascular surgery》2003,51(10):537-540
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
105.
Zhao-Jin Chen Mamun Al-Mahtab Salimar Rahman Ngiap-Chuan Tan Nan Luo Bee-Choo Tai 《Quality of life research》2010,19(9):1343-1348
Purpose
Hepatitis B virus (HBV) is endemic in Bangladesh, and the quality of life (QoL) of these patients remains unknown as there is no instrument available in the native language. In this study, we translated the 56-item Hepatitis Quality of Life Questionnaire (HQLQ) into Bengali and evaluated its validity and reliability. 相似文献106.
Healthcare information systems (HISs) are often implemented to enhance the quality of care and the degree to which it is patient-centered,
as well as to improve the efficiency and safety of services. However, the outcomes of HIS implementations have not met expectations.
We set out to organize the knowledge gained in qualitative studies performed in association with HIS implementations and to
use this knowledge to outline an updated structure for implementation planning. A multi-disciplinary team performed the analyses
in order to cover as many aspects of the primary studies as possible. We found that merely implementing an HIS will not automatically
increase organizational efficiency. Strategic, tactical, and operational actions have to be taken into consideration, including
management involvement, integration in healthcare workflow, establishing compatibility between software and hardware and,
most importantly, user involvement, education and training. The results should be interpreted as a high-order scheme, and
not a predictive theory. 相似文献
107.
Ian F. Dunn Pankaj K. Agarwalla Alexander M. Papanastassiou William E. Butler Edward R. Smith 《Child's nervous system》2007,23(10):1191-1194
Objective Approximately 10% of patients with neurofibromatosis I (NFI) patients will have central nervous system (CNS) tumors. The most
common of these are hypothalamic–optic gliomas, followed by brainstem and cerebellar pilocytic astrocytomas. While isolated
pilocytic astrocytomas in NFI are well described, the appearance of multiple pilocytic astrocytomas in an individual patient
is less common. The most frequent combination in NFI patients with more than one pilocytic astrocytoma is optic tract/hypothalamic
and brainstem. Other combinations are exceedingly rare; multiple pilocytic astrocytomas have only been reported once in the
cerebral hemispheres in a patient with NFI. This report presents the first documented case, to our knowledge, of multiple
pilocytic astrocytomas in the cerebellum of a patient with NF1.
Methods Case report.
Conclusion The finding of multiple cerebellar pilocytic astrocytomas in a patient with NF1 is important because it expands the spectrum
of presentations for patients with NF1 and also highlights specific diagnostic and therapeutic challenges faced by the treating
physicians. The genetic and molecular basis of NF1 is reviewed. Strategies of diagnosis and treatment outlined here are relevant
to both patients with NF1 and all patients with multiple posterior fossa tumors. 相似文献
108.
Association of Hypoalbuminemia on the First Postoperative Day and Complications Following Esophagectomy 总被引:1,自引:0,他引:1
Aoife M. Ryan Aine Hearty Ruth S. Prichard Aileen Cunningham Suzanne P. Rowley John V. Reynolds 《Journal of gastrointestinal surgery》2007,11(10):1355-1360
Objective Changes in serum albumin may reflect systemic immunoinflammation and hypermetabolism in response to insults such as trauma
and sepsis. Esophagectomy is associated with a major metabolic stress, and the aim of this study was to determine if the absolute
albumin level on the first postoperative day was of value in predicting in-hospital complications.
Methods A retrospective study of 200 patients undergoing esophagectomy for malignant disease at St. James Hospital between 1999 and
2005 was performed. Patients who had pre and postoperative (days 1, 3, and 7) serum albumin levels measured were included
in the study. Patients were subdivided into three postoperative albumin categories <20 g/l, 20–25 g/l, >25 g/l. Logistic regression
analysis was performed to calculate the odds of morbidity and mortality according to the day 1 albumin level.
Results Patients with an albumin of less than 20 g/l on the first postoperative day were twice as likely to develop postoperative
complications than those with an albumin of greater than 20 g/l (54 vs 28% respectively, p < 0.011). Correspondingly, these patients also had a significantly higher rate of Adult Respiratory Distress Syndrome (22
vs 5%, p < 0.001), respiratory failure (27 vs 8%, p < 0.01) and in-hospital mortality (27 vs 6% (p < 0.001). On multivariate logistic regression analysis, day 1 albumin level was independently related to postoperative complications
(odds ratios, 0.89: 95%; confidence intervals, 0.83–0.96; p < 0.005). In addition, albumin <20 g/l on the first postoperative day was associated with the need for further surgery and
a return to ICU.
Conclusion Serum albumin concentration on the first postoperative day is a better predictor of surgical outcome than many other preoperative
risk factors. It is a low cost test that may be used as a prognostic tool to detect the risk of adverse surgical outcomes. 相似文献
109.
110.
Factors affecting aseptic loosening of 4750 total hip arthroplasties: multivariate survival analysis
Barbara Bordini Susanna Stea Manuela De Clerico Sergio Strazzari Antonio Sasdelli Aldo Toni 《BMC musculoskeletal disorders》2007,8(1):69