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991.
992.
Onkar Singh Shilpi Gupta Sonia Moses Devendra K. Jain 《Indian journal of gastroenterology》2009,28(3):88-92
Objective
To compare the effectiveness of percutaneous catheter drainage (PCD) and percutaneous needle aspiration (PNA) in the management of large (>10 cm diameter) liver abscesses. 相似文献993.
994.
Niraj N. Mahajan 《Archives of gynecology and obstetrics》2009,279(6):853-855
Introduction Creation of the bladder flap, i.e., dissecting the urinary bladder from the lower segment of the uterus is a standard part
of cesarean section (CS). However, it is yet to be established whether the formation of bladder flap is advantageous.
Review of literature Pelosi and Ortega in 1994 introduced a new minimally invasive technique of CS, which included the omission of bladder dissection
together with other modifications. Omission of the bladder flap provides short-term benefits such as reduction of operating
time and incision-delivery interval, wound infection, reduced blood loss and analgesic requirement. In addition, it is associated
with good long-term outcomes with regards to adhesion formation.
Conclusion Further large-scale controlled randomized clinical trials are needed to investigate the safety of this technique with respect
to in deeply engaged head, preterm, subsequent pregnancies and trial of labor and also to determine the future role of this
technique that will contribute to advancement and popularity of this technique amongst obstetricians. 相似文献
995.
996.
997.
Craig N. Parnaby Alisdair J. MacDonald John T. Jenkins 《International journal of colorectal disease》2009,24(5):585-592
Purpose Enhanced recovery programs aim to expedite gut function after elective colorectal surgery. Early oral feeding simulates gut
function but is not always feasible. Gum chewing, a form of sham feed, is an alternative. We assessed current evidence for
gum chewing and gut function.
Study design All randomized controlled trials (RCTs) between 1990 and 2008 comparing gum chewing with controls/placebo were analyzed irrespective
of language, blinding, or publication bias. The Jadad scale was used to assess study quality. Endpoints were time to flatus/feces,
postoperative complications, and hospital stay. Random and fixed models were employed to aggregate study endpoints and assess
heterogeneity.
Results Six RCTs containing 256 patients were included. Significant heterogeneity was identified and random effects model was employed.
Heterogeneity may be explained through variations in delivery of surgical care. Significant reductions in the time to flatus
and time to feces were identified but no significant difference in hospital or in-hospital postoperative complications were
found.
Conclusions Gum chewing significantly reduced time to flatus and feces; however, hospital stay and postoperative complications were not
reduced. Significant study heterogeneity means that these results should be interpreted with caution.
Presentation to European Society of Coloproctology Annual Scientific Meeting Malta September 2007
Presentation to West of Scotland Surgical Association Annual Scientific Meeting October 2007 相似文献
998.
Yukihiro Yokoyama Masato Nagino Hideki Nishio Tomoki Ebata Tsuyoshi Igami Yuji Nimura 《Journal of hepato-biliary-pancreatic sciences》2007,14(5):447-454
The clinical application of portal vein embolization (PVE) has contributed to improving the postoperative outcome of hilar cholangiocarcinoma. The enlarged nonembolized lobe after PVE protects the patient from postoperative hepatic failure, due to the increased functional reserve, and shortens the hospital stay. Although numerous reports have shown beneficial effects of PVE on postoperative outcome after extended hepatectomy, no randomized controlled study has been performed so far. It is urgent to establish a “gold standard” of PVE, because the indications, approach to the portal vein, types of embolic materials, and methods used to evaluate the function of the future liver remnant are variable among institutions. The indications and procedures of PVE for hilar cholangiocarcinoma may be different from those for hepatocellular carcinoma or colorectal metastasis, because, in many patients with hilar cholangiocarcinoma, biliary cancer is associated with biliary obstruction and cholangitis. This review article summarizes the contribution of PVE to the outcome of postoperative management in patients with hilar cholangiocarcinoma needing extended hepatectomy. We also describe our PVE procedure, which has been established from our experience of more than 240 cases of biliary cancer. Furthermore, the drawbacks of PVE, which may reduce the pool of candidates for surgery, are also discussed. 相似文献
999.
Michael J. Davison George Ioannidis Monica R. Maly Jonathan D. Adachi Karen A. Beattie 《Clinical rheumatology》2016,35(2):371-379
Severe constant and intermittent knee pain are associated with “unacceptable” symptoms in older adults with osteoarthritis (OA) [22]. We hypothesized that constant and intermittent pain would be independently related to physical function, with intermittent knee pain being a better predictor of future declines in physical function in early symptomatic knee OA. This study included men (n?=?189) and women (n?=?133) with radiographic, unilateral knee OA, observed using data from the Osteoarthritis Initiative (OAI). Pain types were measured using the Intermittent and Constant Osteoarthritis Pain (ICOAP) scale. Physical function was measured using the Western Ontario and McMaster Universities Arthritis Index (WOMAC-PF) and Knee Injury and Osteoarthritis Outcome Score (KOOS-FSR) and physical performance tests. High baseline intermittent (B?=?0.277; p?=?0.001) and constant (B?=?0.252; p?=?0.001) knee pain were related to poor WOMAC-PF. Increased constant (B?=?0.484; p?=?0.001) and intermittent (B?=?0.104; p?=?0.040) pain were related to 2-year decreased WOMAC-PF. High baseline intermittent knee pain predicted poor KOOS-FSR at year 2 (B?=??0.357; p?=?0.016). Increased constant pain was related to decreased chair stand test performance over 2 years in women (B?=?0.077; p?=?0.001). High baseline intermittent pain was related to poor performance on repeated chair stands (B?=?0.035; p?=?0.021), while baseline constant pain was related to poor 400-m walk performance in women (B?=?0.636; p?=?0.047). Intermittent and constant knee pain were independent factors in self-perceived physical function and were important predictors of future limitations in physical function. Identifying intermittent and constant pain in early symptomatic OA may allow patients to adopt strategies to prevent worsening pain and future declines in physical function. 相似文献
1000.
Bertha M. Córdova-Sánchez Juan M. Mejía-Vilet Luis E. Morales-Buenrostro Georgina Loyola-Rodríguez Norma O. Uribe-Uribe Ricardo Correa-Rotter 《Clinical rheumatology》2016,35(7):1805-1816
Several classification schemes have been developed for anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), with actual debate focusing on their clinical and prognostic performance. Sixty-two patients with renal biopsy-proven AAV from a single center in Mexico City diagnosed between 2004 and 2013 were analyzed and classified under clinical (granulomatosis with polyangiitis [GPA], microscopic polyangiitis [MPA], renal limited vasculitis [RLV]), serological (proteinase 3 anti-neutrophil cytoplasmic antibodies [PR3-ANCA], myeloperoxidase anti-neutrophil cytoplasmic antibodies [MPO-ANCA], ANCA negative), and histopathological (focal, crescenteric, mixed-type, sclerosing) categories. Clinical presentation parameters were compared at baseline between classification groups, and the predictive value of different classification categories for disease and renal remission, relapse, renal, and patient survival was analyzed. Serological classification predicted relapse rate (PR3-ANCA hazard ratio for relapse 2.93, 1.20–7.17, p?=?0.019). There were no differences in disease or renal remission, renal, or patient survival between clinical and serological categories. Histopathological classification predicted response to therapy, with a poorer renal remission rate for sclerosing group and those with less than 25 % normal glomeruli; in addition, it adequately delimited 24-month glomerular filtration rate (eGFR) evolution, but it did not predict renal nor patient survival. On multivariate models, renal replacement therapy (RRT) requirement (HR 8.07, CI 1.75–37.4, p?=?0.008) and proteinuria (HR 1.49, CI 1.03–2.14, p?=?0.034) at presentation predicted renal survival, while age (HR 1.10, CI 1.01–1.21, p?=?0.041) and infective events during the induction phase (HR 4.72, 1.01–22.1, p?=?0.049) negatively influenced patient survival. At present, ANCA-based serological classification may predict AAV relapses, but neither clinical nor serological categories predict renal or patient survival. Age, renal function and proteinuria at presentation, histopathology, and infectious complications constitute the main outcome predictors and should be considered for individualized management. 相似文献