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排序方式: 共有1144条查询结果,搜索用时 46 毫秒
91.
O'Mahony S; Morris AJ; Straiton M; Murray L; MacKenzie JF 《QJM : monthly journal of the Association of Physicians》1996,89(9):685-690
We report our experience with small-bowel push enteroscopy in 50 patients.
The indications for push enteroscopy were: anaemia/occult gastrointestinal
bleeding (22 patients); overt gastrointestinal bleeding (17 patients);
abnormal small-bowel radiology (8 patients) and miscellaneous (3 patients).
In those with undiagnosed gastrointestinal bleeding/anaemia, abnormalities
were detected in 24/39 patients (62%): small bowel arteriovenous
malformations (AVMs) were detected in 19 (49%), and five (13%) had lesions
in the upper gastrointestinal tract. Seventeen patients had heater-probe
ablation therapy of vascular lesions: nine patients had small-intestinal
lesions, four patients gastric lesions, and four patients combined gastric
and small- intestinal lesions. In those with abnormal small-bowel
radiology, abnormalities were detected in 6/8 patients. We conclude that
(i) push enteroscopy can establish a diagnosis in a high proportion of
patients with gastrointestinal bleeding; (ii) heater-probe ablation therapy
of vascular lesions can be performed routinely at the time of enteroscopy;
(iii) a significant proportion of patients (9/50) referred for enteroscopy
with undiagnosed gastrointestinal bleeding have lesions in the
stomach/proximal duodenum missed at diagnostic endoscopy. Push enteroscopy
is a valuable diagnostic and therapeutic endoscopic procedure.
相似文献
92.
A randomized double-blind placebo-controlled crossover study of subcutaneous sumatriptan in general practice 总被引:1,自引:0,他引:1
MB Russell OE Holm-Thomsen M Rishøj Nielsen A Cleal AJ Pilgrim J Olesen 《Cephalalgia : an international journal of headache》1994,14(4):291-296
Objective. To evaluate the therapeutic response to sumatriptan in the acute migraine attack. Material and methods. Two hundred and thirty migraineurs diagnosed by their general practitioners in accordance with their usual practice were included in the study. The patients treated two migraine attacks at home by subcutaneous injection of sumatriptan or placebo for the first attack and the alternative medication, i.e. placebo or sumatriptan, for the second attack (crossover). Following treatment, a neurology resident interviewed and examined the patients, Results. When sumatriptan was compared to placebo, significantly more of the 209 evaluable patients reported headache relief at I h (56% vs 8%, p < 0.001) and 2 h (62% vs 15%, p < 0.001) after the first injection. Resolution of nausea, photophobia, and phonophobia was significantly more common in patients on sumatriptan than in those on placebo ( p < 0.001 for all comparisons). The adverse events were usually transient and of mild or moderate severity; however, three patients withdrew due to adverse events. Ninety-five percent of patients evaluated by a neurology resident met the IHS criteria for migraine. Conclusion. In general practice, sumatriptan taken subcutaneously using an autoinjector at home was an effective and well tolerated acute treatment for migraine. 相似文献
93.
AJ Larner MRCP 《International journal of clinical practice》1994,48(5):272-274
SUMMARY A case is reported of pseudohyperphosphataemia in association with a monoclonal gammopathy of undetermined significance. 相似文献
94.
95.
A Hirsch F Windhausen JG Tijssen AJ Oude Ophuis WJ van der Giessen PM van der Zee JH Cornel FW Verheugt RJ de Winter 《European heart journal》2009,30(6):645-654
AIMS: In several observational studies, revascularization is associated with substantial reduction in mortality in patients with non-ST-segment elevation acute coronary syndrome (nSTE-ACS). This has strengthened the belief that routine early angiography would lead to a reduction in mortality. We investigated the association between actual in-hospital revascularization and long-term outcome in patients with nSTE-ACS included in the ICTUS trial. METHODS AND RESULTS: The study population of the present analysis consists of ICTUS participants who were discharged alive after initial hospitalization. The ICTUS trial was a randomized, controlled trial in which 1200 patients were randomized to an early invasive or selective invasive strategy. The endpoints were death from hospital discharge until 4 year follow-up and death or spontaneous myocardial infarction (MI) until 3 years. Among 1189 patients discharged alive, 691 (58%) underwent revascularization during initial hospitalization. In multivariable Cox regression analyses, in-hospital revascularization was independently associated with a reduction in 4 year mortality and 3 year event rate of death or spontaneous MI: hazard ratio (HR) 0.59 [95% confidence interval (CI) 0.37-0.96] and 0.46 (95% CI 0.31-0.68). However, when intention-to-treat analysis was performed, no differences in cumulative event rates were observed between the early invasive and selective invasive strategies: HR 1.10 (95% CI 0.70-1.74) for death and 1.27 (95% CI 0.88-1.85) for death or spontaneous MI. CONCLUSION: The ICTUS trial did not show that an early invasive strategy resulted in a better outcome than a selective invasive strategy in patients with nSTE-ACS. However, similar to retrospective analyses from observational studies, actual revascularization was associated with lower mortality and fewer MI. Whether an early invasive strategy leads to a better outcome than a selective invasive strategy cannot be inferred from the observation that revascularized patients have a better prognosis in non-randomized studies. 相似文献
96.
Irene M Dek Bram DJ van den Elzen Paul Fockens Erik AJ Rauws 《World journal of gastroenterology : WJG》2009,15(19):2423-2424
In this case report we present an elderly patient who was referred to our hospital with recurrent episodes of cholangitis that persisted after placement of five metal stents for a distal common bile duct (CBD) stenosis.All metal stents were endoscopically removed from the CBD by forceps after balloon dilatation of the papilla. A profoundly dilated CBD with sludge and concrements was seen. To ensure adequate bile drainage an enteral metal stent was inserted in the CBD. This case shows that proximally migrated uncovered metal stents in the CBD can be safely removed endoscopically under certain circumstances. We suggest that in the case of a CBD drainage problem due to an extremely dilated CBD, placement of an enteral metal stent in the CBD could be considered, especially in patients who are unfit for surgery. 相似文献
97.
Inactivation of factor XIa in human plasma assessed by measuring factor XIa-protease inhibitor complexes: major role for C1-inhibitor 总被引:2,自引:1,他引:2
Wuillemin WA; Minnema M; Meijers JC; Roem D; Eerenberg AJ; Nuijens JH; ten Cate H; Hack CE 《Blood》1995,85(6):1517-1526
From experiments with purified proteins, it has been concluded that factor XIa (FXIa) is inhibited in plasma mainly by alpha 1-antitrypsin (a1AT), followed by antithrombin III (ATIII), C1-inhibitor (C1Inh), and alpha 2-antiplasmin (a2AP). However, the validity of this concept has never been studied in plasma. We established the relative contribution of different inhibitors to the inactivation of FXIa in human plasma, using enzyme-linked immunosorbent assays (ELISAs) for the quantification of complexes of FXIa with a1AT, C1Inh, a2AP, and ATIII. We found that 47% of FXIa added to plasma formed complexes with C1Inh, 24.5% with a2AP, 23.5% with a1AT, and 5% with ATIII. The distribution of FXIa between these inhibitors in plasma was independent of whether FXIa was added to plasma, or was activated endogenously by kaolin, celite, or glass. However, in the presence of heparin (1 or 50 U/mL), C1Inh appeared to be the major inhibitor of FXIa, followed by ATIII. Furthermore, at lower temperatures, less FXIa-C1Inh and FXIa-a1AT complexes but more FXIa-a2AP complexes were formed. These data demonstrate that the contribution of the different inhibitors to inactivation of FXIa in plasma may vary, but C1Inh is the principal inhibitor under most conditions. 相似文献
98.
The purpose of the present study was to investigate a possible seasonal
pattern in various clinical and laboratory manifestations in a group of
systemic lupus erythamatosus (SLE) patients. One hundred and five SLE
patients were followed up during a 4 yr period. Data on each of the
clinical and laboratory variables examined, as well as the results of the
disease activity index (SLEDAI), were plotted against the month during
which they were obtained. Photosensitivity was the only variable to show a
seasonal pattern, having higher scores during the summer months (1.04 +/-
0.16 in July vs 0.58 +/- 0.12 in December). We were unable to show seasonal
patterns in any of the other variables examined. As a group, SLE patients
do not show any significant seasonal pattern in disease manifestations and
activity, except for photosensitivity. However, such a pattern may exist
for the individual patient.
相似文献
99.
Physiologic regulation and tissue localization of renal erythropoietin messenger RNA 总被引:7,自引:0,他引:7
Although erythropoietin (Epo) is produced primarily by the kidneys in response to hypoxia, the precise cell type(s) and mechanisms by which these cells regulate production are poorly understood. In the experiments we report, the kinetics of renal Epo production in response to acute hypoxia and the intrarenal localization of cellular Epo synthesis were studied at the level of Epo mRNA. Erythropoietin mRNA expression was determined by Northern blot analysis of rat kidney RNAs using a probe derived from the mouse Epo gene. Renal Epo mRNA content increased as early as 1 hour after initiation of hypoxia and continued to accumulate during 4 hours of stimulation. Discontinuation of the hypoxic stimulus resulted in rapid decay of mRNA levels. Kidney and plasma Epo levels measured by radioimmunoassay paralleled, with respective lag times, the changes in renal Epo mRNA content, suggesting that Epo production in response to acute hypoxia represents de novo synthesis and is regulated by changes in Epo mRNA. Northern blot analysis of RNAs extracted from separated glomerular and tubular tissue fractions revealed Epo mRNA in the tubular fraction, whereas glomerular tissue did not contain Epo mRNA. Thus, the site of cellular Epo synthesis is located in the renal tubule or its interstitium and not in the glomerular tuft. 相似文献