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91.
Normal respiration involves a highly detailed neurophysiologic process that results in the exchange of inspired and expired air through various anatomic structures. An understanding of these structures is important to the clinician involved in maintaining or reestablishing the normal airway. The following anatomic discussion focuses on the features crucial for the establishment and maintenance of a tracheal airway. 相似文献
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Toursarkissian B Shireman PK Harrison A D'Ayala M Schoolfield J Sykes MT 《The American surgeon》2002,68(7):606-610
Our objective is to describe our current experience with major lower-extremity amputation secondary to vascular disease. We conducted a retrospective review of sequential amputations over a 3-year period at one Veterans Affairs institution. One hundred thirteen amputations were performed in 99 men (age 70 +/- 11 years). Seventy-five per cent were diabetic and 23 per cent were on dialysis. Fifty-six per cent were primary amputations. The final AKA/BKA (above-knee to below-knee amputation) ratio was 3:2 and was not related to prior bypass, ethnicity, or dialysis status (P > 0.5). Forty-three per cent of amputations were BKAs in diabetics versus 26 per cent in nondiabetics (P = 0.08). The in-hospital and 30-day mortality rates were 2.6 and 8 per cent and were not related to amputation level (P = 0.76). Forty per cent experienced postoperative complications that were most frequently wound related (22%). Wound complications were more frequent with BKA than AKA (P = 0.04). At an average follow-up of 10 +/- 8 months only 65 per cent were alive. Although 51 per cent were discharged to rehabilitation units only 26 per cent regularly wore a prosthesis with 23 per cent ambulating. BKA patients were more likely to ambulate than AKA (34% vs 9%; P = 0.001), and dialysis patients were less likely to ambulate than nondialysis patients (5% vs 25%; P < 0.02). During follow-up 17 per cent of patients discharged with an intact contralateral limb required amputation of that limb and 7 per cent had bypass surgery on that limb. Complication rates were higher in African Americans and Hispanics than in whites (59%, 45%, and 23%, respectively; P < 0.001), although mortality and ambulation rates were similar. Despite an acceptable perioperative mortality complication rates remain high especially in nonwhites. One-year mortality is high. Low rehabilitation rates especially in dialysis patients mandate further efforts in this regard. Vigilant follow-up of the contralateral limb is essential. 相似文献
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DL DSouza SB Heinze RJ Dowling 《Journal of Medical Imaging and Radiation Oncology》2006,50(3):246-248
Lung cancer is not commonly known to metastasise to the perirenal space, with only five such cases previously published. We present an unusual case of perirenal lung metastases manifesting as diffuse perinephric stranding which to our knowledge has not been described before. 相似文献
97.
Procalcitonin may help differentiate disseminated herpes simplex viral infection from bacterial sepsis in neonates 总被引:3,自引:0,他引:3
Disseminated herpes simplex virus infection is a potentially fatal condition which may be difficult to differentiate from
bacterial sepsis. We report the case of a neonate with overwhelming herpes simplex (type 2) viraemia who presented with `septic
shock'.
Conclusion A low procalcitonin level (1.6 ng/ml), inconsistent with bacteraemia, suggests an alternative aetiology and may strengthen
the case for antiviral therapy.
Received: 28 March 1999 / Accepted: 10 August 1999 相似文献
98.
Brandon DL Marshall Thomas Kerr Chris Livingstone Kathy Li Julio SG Montaner Evan Wood 《Harm reduction journal》2008,5(1):35
Aboriginal people experience a disproportionate burden of HIV infection among the adult population in Canada; however, less
is known regarding the prevalence and characteristics of HIV positivity among drug-using and street-involved Aboriginal youth.
We examined HIV seroprevalence and risk factors among a cohort of 529 street-involved youth in Vancouver, Canada. At baseline,
15 (2.8%) were HIV positive, of whom 7 (46.7%) were Aboriginal. Aboriginal ethnicity was a significant correlate of HIV infection
(odds ratio = 2.87, 95%CI: 1.02 – 8.09). Of the HIV positive participants, 2 (28.6%) Aboriginals and 6 (75.0%) non-Aboriginals
reported injection drug use; furthermore, hepatitis C co-infection was significantly less common among Aboriginal participants
(p = 0.041). These findings suggest that factors other than injection drug use may promote HIV transmission among street-involved
Aboriginal youth, and provide further evidence that culturally appropriate and evidence-based interventions for HIV prevention
among Aboriginal young people are urgently required. 相似文献
99.
100.
The amount of backward walking induced in mice by co-administration of clenbuterol, a beta-adrenoceptor agonist and putative antidepressant, and the benzodiazepine chlordiazepoxide was plotted as a three-dimensional surface, using modified Uniras software. The surface was compared with the theoretical surface to be expected if the interactions between the two drugs were merely additive. The difference between the theoretical and the obtained surfaces was plotted and a functional representation of statistical variability was 'draped' over the difference model. The computer methods can be applied to small amounts of irregularly distributed data, and results are apparent from simple inspection, e.g. the highest peak of backward walking is also the most reliable statistically. The technique is useful for both laboratory and clinical studies. 相似文献