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101.
Shyam Singh Mukhand L. Sharma Reyaz A. Lone Mehmood A. Wani Zahur Hussain Ishtiyaq Mir Puja Vimesh 《World journal of surgery》2009,33(3):489-491
Background Hemothorax has been reported to occur along with spontaneous pneumothorax due to adhesion disruption. Rupture of pleural adhesions
spontaneously or after unnoticeable trivial trauma causing massive hemothorax alone is rare.
Methods We present a series of seven cases of idiopathic massive spontaneous hemothorax due to adhesion disruption, of which all required
emergency thoracotomy with ligation or cauterization of bleeding adhesions.
Results Six patients had bleeding pleural lung adhesions of which five involved the upper lobes. Another had bleeding from pleuropericardial
adhesions. All patients are doing well on follow-up.
Conclusions Disruption of pleural adhesions may cause massive hemothorax, requiring early surgical intervention. After thoracotomy the
outcome in these patients is excellent. 相似文献
102.
G Morris-Stiff J D'Souza S Raman S Paulvannan MH Lewis 《Annals of the Royal College of Surgeons of England》2009,91(8):637-640
INTRODUCTION
The aims of this study were to audit results of a 10-year experience of surgery for acute limb ischaemia (ALI) in terms of limb salvage and mortality rates, and to compare results with a historical published series from our unit.PATIENTS AND METHODS
All emergency operations performed during the period 1993–2003 were identified from theatre registers and patient notes reviewed to determine indications for, and outcome of, surgery. Data were compared to a similar cohort who underwent surgery from 1980 to 1990.RESULTS
There was a 33% increase in workload from 87 to 116 patients between the two time periods. The number of patients with idiopathic ALI reduced (24% versus 4%; P < 0.05), and there were fewer smokers (71% versus 39%; P < 0.05) and a greater number of claudicants (17% versus 35%; P < 0.05) in those treated from 1993–2003. Latterly, more patients underwent pre-operative heparinisation (33% versus 80%; P < 0.05), received prophylactic antibiotics (14% versus 63%; P < 0.05), and had anaesthetic presence in theatre (46% versus 88%; P < 0.05). There was also a reduction in local anaesthetic procedures (80% versus 41%; P < 0.05). Despite increased pre-operative (15% versus 47%; P < 0.05) and on-table imaging (0% versus 16%; P < 0.05) technical success did not improve. Whilst complication rates were identical at 62%, there were fewer cardiovascular complications in the recent cohort. The 30-day mortality rate for embolectomy fell from 45% to 33%. Multivariate analysis revealed age > 70 years, prolonged symptom duration, ASA score ≥ III, lack of prophylactic antibiotics, absence of an anaesthetist, and operations performed under local anaesthetic to be associated with increased risk of mortality. Factors adversely affecting limb salvage included prolonged duration from symptom onset to operation, and a history of claudication or smoking.CONCLUSIONS
Despite improvements in pre- and peri-operative management, arterial embolectomy/thrombectomy remains a procedure with a high morbidity and mortality. Further attempts to improve outcome must be directed at early diagnosis and referral as delay from symptom onset to surgery is a major determinant of outcome. 相似文献103.
Vita W Jongen Thijs Reyniers Zorah MH Ypma Maarten F Schim van der Loeff Udi Davidovich Hanne ML Zimmermann Liza Coyer Mark AM van den Elshout Henry JC de Vries Kristien Wouters Tom Smekens Bea Vuylsteke Maria Prins Marie Laga Elske Hoornenborg 《Journal of the International AIDS Society》2021,24(8)
IntroductionDaily and event‐driven PrEP are both efficacious in reducing the risk for HIV infection. However, the practice of event‐driven PrEP (edPrEP) is less well studied, in particular when provided as an alternative to daily PrEP. We studied regimen preferences and switches, and sexually transmitted infection (STI) incidence.MethodsWe analysed pooled data from two prospective cohort studies among MSM: Be‐PrEP‐ared, Belgium and AMPrEP, the Netherlands. In both projects, participants could choose between daily and edPrEP at three‐monthly study visits, when they were also screened for sexually transmitted infections including hepatitis C (HCV). We assessed the proportion choosing each regimen, and the determinants of choosing edPrEP at baseline. Additionally, we compared the incidence rates (IRs) of HCV, syphilis and chlamydia or gonorrhoea between regimens using Poisson regression. The study period was from 3 August 2015 until 24 September 2018.Results and discussionWe included 571 MSM, of whom 148 (25.9%) chose edPrEP at baseline. 31.7% of participants switched regimen at least once. After 28 months, 23.5% used edPrEP. Older participants (adjusted odds ratio (aOR) = 1.38 per 10 years, 95% confidence interval (CI) = 1.15 to 1.64) and those unemployed (aOR = 1.68, 95% CI = 1.03 to 1.75) were more likely to initially choose edPrEP. IR of HCV and syphilis did not differ between regimens, but the IR of chlamydia/gonorrhoea was higher among daily users (adjusted incidence rate ratio = 1.61, 95% CI = 1.35 to 1.94).ConclusionsA quarter of participants chose edPrEP at baseline and at 28 months this proportion was similar. Although the IR of HCV and syphilis were similar in the two regimens, the lower incidence of chlamydia and gonorrhoea among edPrEP users may suggest that less frequent STI testing of this group could be considered. 相似文献
104.
SM Vieira HP Lemos R Grespan MH Napimoga D Dal-Secco A Freitas TM Cunha WA Verri Jr DA Souza-Junior MC Jamur KS Fernandes C Oliver JS Silva MM Teixeira FQ Cunha 《British journal of pharmacology》2009,158(3):779-789
Background and purpose:
Chemokines orchestrate neutrophil recruitment to inflammatory foci. In the present study, we evaluated the participation of three chemokines, KC/CXCL1, MIP-2/CXCL2 and LIX/CXCL5, which are ligands for chemokine receptor 2 (CXCR2), in mediating neutrophil recruitment in immune inflammation induced by antigen in immunized mice.Experimental approach:
Neutrophil recruitment was assessed in immunized mice challenged with methylated bovine serum albumin, KC/CXCL1, LIX/CXCL5 or tumour necrosis factor (TNF)-α. Cytokine and chemokine levels were determined in peritoneal exudates and in supernatants of macrophages and mast cells by elisa. CXCR2 and intercellular adhesion molecule 1 (ICAM-1) expression was determined using immunohistochemistry and confocal microscopy.Key results:
Antigen challenge induced dose- and time-dependent neutrophil recruitment and production of KC/CXCL1, LIX/CXCL5 and TNF-α, but not MIP-2/CXCL2, in peritoneal exudates. Neutrophil recruitment was inhibited by treatment with reparixin (CXCR1/2 antagonist), anti-KC/CXCL1, anti-LIX/CXCL5 or anti-TNF-α antibodies and in tumour necrosis factor receptor 1-deficient mice. Intraperitoneal injection of KC/CXCL1 and LIX/CXCL5 induced dose- and time-dependent neutrophil recruitment and TNF-α production, which were inhibited by reparixin or anti-TNF-α treatment. Macrophages and mast cells expressed CXCR2 receptors. Increased macrophage numbers enhanced, while cromolyn sodium (mast cell stabilizer) diminished, LIX/CXCL5-induced neutrophil recruitment. Macrophages and mast cells from immunized mice produced TNF-α upon LIX/CXCL5 stimulation. Methylated bovine serum albumin induced expression of ICAM-1 on mesenteric vascular endothelium, which was inhibited by anti-TNF-α or anti-LIX/CXCL5.Conclusion and implications:
Following antigen challenge, CXCR2 ligands are produced and act on macrophages and mast cells triggering the production of TNF-α, which synergistically contribute to neutrophil recruitment through induction of the expression of ICAM-1. 相似文献105.
Acute generalized exanthematous pustulosis due to thallium 总被引:4,自引:0,他引:4
MH Aziz Jalali S Mirzazadeh Javaheri P Salehian 《Journal of the European Academy of Dermatology and Venereology》2004,18(3):321-323
Acute generalized exanthematous pustulosis (AGEP) is characterized clinically by fever, pruritus and acute pustular eruption. Usually a drug is found to be the responsible agent. We present a patient who experienced an acute generalized exanthematous pustulosis due to radioactive thallium. The eruption cleared rapidly after discontinuation of the drug and systemic corticosteroid therapy. 相似文献
106.
107.
Uzma Rasheed Mughal Rashad Mehmood Bakhat Ali Muhammad Safder Rasool Bakhsh Tareen 《Journal of Asian natural products research》2013,15(6):601-606
Spiraeamide (1), a new sphingolipid, has been isolated from the ethyl acetate-soluble fraction of the methanolic extract of the whole plant of Spiraea brahuica, along with marrubiin (2), 19-acetylmarrubenol (3), and 6-acetylmarruenol (4). Their structures were elucidated by 1H and 13C NMR spectra, and COSY, NOESY, HMQC, HMBC, EI-MS, and FAB-MS experiments. 相似文献
108.
109.
110.
Zafar Iqbal Khan Ilker Ugulu Kafeel Ahmad Sumaira Yasmeen Ijaz Rasool Noorka Naunain Mehmood Muhammad Sher 《Bulletin of environmental contamination and toxicology》2018,101(6):787-795
This study focused on evaluating the metal and metalloid contamination and associated risks in the two vegetables crops, coriander (Coriandrum sativum) and spinach (Spinacia oleracea) treated with three water regimes, canal water, groundwater and municipal wastewater. These vegetables are widely consumed by people and are also used in traditional medicine for treating various disorders. Metal and metalloid accumulation (Zn, Pb, Se, Cu, As, Mo, Fe, Ni) was found higher in vegetables treated with wastewater. Wastewater treated soil had high pollution load index. Fe, Zn, As and Pb had higher values in water, soil and vegetables as compared to other studied metals. Overall, metal correlation for soil and vegetables was significant and positive except for Fe and Cu in spinach. The highest value for daily metal intake was estimated for Fe while Se had the lowest value for the same index. It was thus concluded that trace metal and metalloid accumulation was a major health concern for the public consuming these vegetables. 相似文献