冠心病中医体质类型、客观化及临床应用研究进展

冠心病的发生、发展与中医体质存在密切关系.冠心病患者在遗传物质的差异、生长地域环境的不同等影响因素下表现出中医体质类型的差异性.诸多体质学研究发现冠心病患者以偏颇体质、兼夹体质为主.中医体质研究从宏观角度反映冠心病患者的疾病特质,中医体质分布规律的研究对冠心病的认识具有重要意义,本文就近10年来冠心病中医体质类型分布、...     

Here,There, and Everywhere: The Wide Host Range and Geographic Distribution of Zoonotic Orthopoxviruses

The global emergence of zoonotic viruses, including poxviruses, poses one of the greatest threats to human and animal health. Forty years after the eradication of smallpox, emerging zoonotic orthopoxviruses, such as monkeypox, cowpox, and vaccinia viruses continue to infect humans as well as wild and domestic animals. Currently, the geographical distribution of poxviruses in a broad range of hosts worldwide raises concerns regarding the possibility of outbreaks or viral dissemination to new geographical regions. Here, we review the global host ranges and current epidemiological understanding of zoonotic orthopoxviruses while focusing on orthopoxviruses with epidemic potential, including monkeypox, cowpox, and vaccinia viruses.     

Vertebragenic dysphagia

Dysphagia due to external compression by anterior hyperostosis of the cervical spine is rare. The diagnosis may be established by conventional X-ray of the spine, oesophagogram, CT or MRI. CASES: We operated on one patient with an exostosis on the axis and another patient with large anterior osteophytes from C3 to C7 in Forestiers's disease. Postoperatively the patients were asymptomatic. CONCLUSIONS: Painful dysphagia due to anterior hyperostosis of the cervical spine is an indication for surgery. The anterolateral extrapharyngeal approach from C3 to C7 and the transoral intrapharyngeal approach to the vertebra C2 are preferred. In cooperation between orthopaedics and ENT the surgical treatment has no major complications and gives good functional results.     

Volumetric Assessment of Plaque Progression With 3-Dimensional Ultrasonography Under Statin Therapy

BACKGROUND AND PURPOSE: Lowering of serum cholesterol levels with HMG-CoA reductase inhibitors (statins) slowed the progression of atherosclerosis in the carotid arteries in several clinical trials using carotid artery intima media thickness as primary outcome measure. Whereas conventional ultrasonography is limited to thin 2-dimensional image planes, 3-dimensional (3D) ultrasonography provides quantitative measurement of the entire carotid artery plaque volume. This study aims to assess the feasibility of 3D ultrasonography to monitor plaque progression in hypercholesterolemic patients. METHODS: The authors prospectively assessed the progression of 31 carotid artery plaques over 15.1 +/- 4.5 months in a study of 23 patients (6 women, 17 men; mean age = 61.7 +/- 7.5 years) with hypercholesterolemia under therapy with HMG-CoA reductase inhibitors. All patients were maintained on a lipid-lowering diet. Sixteen patients were additionally treated with statins. Quantitative measurements of carotid artery plaque volumes were performed after 3D reconstruction of exactly parallel transverse duplex ultrasound scans (slice distance = 0.1 mm) into volumetric 3D data sets and segmentation of voxels representing the carotid artery plaque. RESULTS: Within the treatment group, plaques were significantly less frequently progressive if they had a hypoechoic echogenicity (11%, n = 9 vs 64%, n = 14; P = .016) or if baseline serum cholesterol levels were above 8.0 mmol/L (9%, n = 11 vs 75%, n = 12; P = .002). CONCLUSION: Three-dimensional ultrasonography extends the measurement of the arterial wall thickness to the 3D volume of an entire atherosclerotic plaque including analysis of its morphology and configuration. However, further clinical trials with an adequate sample size to achieve sufficient statistical power are necessary to assess the effect of statin therapy on plaque progression.     

Die postoperative Schmerztherapie

Wiener Medizinische Wochenschrift - Die erfolgreiche Behandlung postoperativer Schmerzen stellt noch immer eine große therapeutische Herausforderung dar. Dabei stehen mit den systemischen und...