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61.
P Jolliet C Pichard G Biolo R Chioléro G Grimble X Leverve G Nitenberg I Novak M Planas J C Preiser E Roth A M Schols J Wernerman 《Clinical nutrition (Edinburgh, Scotland)》1999,18(1):47-56
Severe protein-calorie malnutrition is a major problem in many intensive care (ICU) patients, due to the increased catabolic state often associated with acute severe illness and the frequent presence of prior chronic wasting conditions. Nutritional support is thus an important part of these patient's management. Over the years, enteral nutrition (EN) has gained considerable popularity, due to its favorable effects on the digestive tract and its lower cost and rate of complications compared to parenteral nutrition. However, clinicians caring for ICU patients are often faced with contradictory data and difficult decision-making when having to determine the optimal timing and modalities of EN administration, estimation of patient requirements and choice of formulas. The purpose of this paper is to provide practical guidelines on these various aspects of enteral nutritional support, based on presently available evidence. 相似文献
62.
Long-term results after surgical basal cell carcinoma excision in the eyelid region 总被引:3,自引:0,他引:3
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Pieh S Kuchar A Novak P Kunstfeld R Nagel G Steinkogler FJ 《The British journal of ophthalmology》1999,83(1):85-88
AIMS: To evaluate the data for patients with basal cell carcinoma (BCC) in the eyelid region, to demonstrate histologically controlled tumour excision, and to prove the efficacy of the treatment on the basis of long term observations. METHODS: Retrospective analysis of 382 microscopically controlled BCC excisions in the eyelid apparatus (350 patients) in a follow up study over 5.7 (SD 1.1) years. Tumour location, tumour size, and histological results were recorded. The same procedure was followed for recurrences. Follow up examinations were carried out 1, 3, 6, and 12 months after the operation, and then annually for a further 4 years or longer. RESULTS: A recurrence rate of 5.36% was observed after the primary operation. 60.3% of first recurrences occurred in the medial canthus, 41.2% showed in depth extension, and sclerosing types were overly represented at 35.3%. After the second operation the recurrence rate increased to 14.7% and reached 50% after a third and fourth operation. CONCLUSIONS: The greatest risk of recurrence exists for BCCs of the medial canthus with in depth extension, and for sclerosing types. The recurrence rate increases after every operation. For high risk cases, consideration should be given to adjuvant treatment such as radiotherapy. 相似文献
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MJ McKinley RM McAllen GL Pennington A. Smardencas RS Weisinger BJ Oldfield 《Clinical and experimental pharmacology & physiology》1996,23(Z3):99-104
- 1 Autoradiographic binding studies have shown that the AT1 receptor is the predominant angiotensin II (AngII) receptor subtype in the central nervous system (CNS). Major sites of AT1 receptors are the lamina terminalis, hypothalamic paraventricular nucleus, the lateral parabrachial nucleus, rostral and caudal ventrolateral medulla, nucleus of the solitary tract and the intermediolateral cell column of the thoraco-lumbar spinal cord.
- 2 While there are differences between species, AT2 receptors are found mainly in the cerebellum, inferior olive and locus coeruleus of the rat.
- 3 Circulating AngII acts on AT1 receptors in the subfornical organ and organum vasculosum of the lamina terminalis (OVLT) to stimulate neurons that may have a role in initiating water drinking.
- 4 Centrally administered AngII may act on AT1 receptors in the median preoptic nucleus and elsewhere to induce drinking, sodium appetite, a sympathetic vasoconstrictor response and vasopressin secretion.
- 5 Recent evidence shows that centrally administered AT1 antagonists inhibit dipsogenic, natriuretic, pressor and vasopressin secretory responses to intracerebroventricular infusion of hypertonic saline. This suggests that an angiotensinergic neural pathway has a role in osmoregulatory responses.
- 6 Central angiotensinergic pathways which include neural inputs to the rostral ventrolateral medulla may use AT1 receptors and play a role in the function of sympathetic pathways maintaining arterial pressure.
65.
R. Novak 《International urology and nephrology》1983,15(1):43-49
In the introduction the author stresses that the main facts which decide the choice and prognosis of therapy are localization, length and the so-called complexity of the stricture. His 15-year material from 388 operations on 290 patients is presented.Circular strictures of the anterior urethra (a total of 135 operations) are treated through endoscopic urethrotomy as the primary procedure and mostly by open resection as the secondary one. Longitudinal strictures of the anterior urethra (199 operations) are treated by marsupialization, pedicled cutaneous flap and Michalowski's sleeve technique as primary procedures. As the secondary procedure (after failure of the first operation) marsupialization only was performed. Complex strictures of the posterior urethra (total 54) were treated mostly by transpubic approach, which showed good results in 74% cases on 41 operations. 相似文献
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C KAPPAGODA DN SCHELL RM HANSON & P HUTCHINS 《Journal of paediatrics and child health》1998,34(6):508-512