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11.
Use of fMRI to predict psychiatric adverse effects of interferon treatment for Hepatitis C – preliminary report 下载免费PDF全文
Donald H Marks Mehdi Adineh Binquan Wang Sudeepa Gupta 《Neuropsychiatric Disease and Treatment》2007,3(5):655-667
Interferon alfa2 (IFN-α2) is a parenterally administered cytokine used to treat patients with Hepatitis C and B, and malignancy. Interferon (INF) has a relatively high rate of central nervous system (CNS) adverse effects, including agitation, depression, fatigue, cognitive dysfunction, suicidal thought and drug craving. Using functional magnetic resonance imaging (fMRI) we studied patients with Hepatitis C virus (HCV) infection who were not more than mildly clinically depressed at baseline for their CNS reaction to IFN-α2. During fMRI, patients underwent visual stimulation with pictures designed to induce feelings of depression. In the two patients who became clinically depressed or markedly anxious while on treatment with interferon, but not in patients who did not experience these effects, there was a significant activation in specific areas of the brain known to be involved with depression, along with an increase above baseline in the Beck Depression Scale for the patient who developed INF-induced depression. The activation pattern differed from that previously observed for endogenous depression, indicating that INF-induced depression may differ in its underlying neuropathology. Functional magnetic resonance imaging can be an important tool in understanding and monitoring for (INF and other) medication-induced CNS effects, and response to treatment. 相似文献
12.
Since the first transurethral resection of the prostate (TURP) was performed by Guyon at the Necker Hospital in Paris in 1901,
this treatment modality has replaced open prostatectomy as the procedure of choice for more than 95% of patients. TURP has
been used in surgical treatment of benign prostatic hyperplasia (BPH) and remains the gold standard treatment. Transurethral
vapor resection of the prostate (TUVRP) and holmium laser enucleation of the prostate (HoLEP) are new treatment modalities
for the treatment of BPH. Each procedure has its own advantages and disadvantages. Availability of instruments, surgical expertise,
and specific indications for a particular procedure are of utmost importance for successful outcome, with minimal morbidity.
TURP can be either monopolar or bipolar, using thin or thick loop. Bipolar TURP is associated with less bleeding and less
chances of dilutional hyponatremia. TUVRP, using a thick wedge loop, causes vaporization and resection of the prostate, and
is associated with less bleeding and short operative time. HoLEP is another effective alternative for the surgical treatment
of BPH. The holmium laser possesses the ideal combination of cutting and coagulation; however, it has a learning curve. 相似文献
13.
Nand L. Sharma Vikram K. Mahajan Neelam Gupta Nitin Ranjan and Anju Lath 《Journal of cutaneous pathology》2009,36(4):486-492
Ehlers-Danlos syndrome – vascular type, the only lethal form, is rarely reported in dermatology literature. It is characterized by translucent, atrophic skin, easy bruising, arterial, intestinal and/or uterine fragility manifesting as varicose veins, aneurysms and vascular/visceral/uterine rupture. As its dermatopathologic features are not well elucidated, diagnosis is often made after a catastrophic complication or at autopsy. This 36 year-old non-consanguineous male had brown-black plaques with atrophy and frequent ulceration over legs and dorsal feet and tortuous varicose veins around ankles for the past 15 years. Perivenous skin was translucent and hypopigmented. He had multiple and ecchymotic keloids and small atrophic, pityriasis versicolor-like lesions over trunk. He did not have hypermobile/hyperextensible skin and joints and showed no systemic or investigative abnormality. Histopathologic features of atrophic lesion included blood extravasation in atrophic epidermis/dermis, focal clustering and dilatation of blood vessels, malformed vessel walls, abundant hemosiderin in the dermis and homogenously stained/whorled patterned collagen especially around blood vessels. Pathology of keloidal lesion showed new collagen and vascular fragility. These histopathologic features appear of diagnostic value especially in patients who have compatible clinical findings but cannot afford confirmation by biochemical testing for abnormal synthesis of type III procollagen or identification of mutations in the COL3A1 gene. 相似文献
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The abdominal compartment syndrome is a life threatening condition resulting from pathologic elevation of the intraabdominal pressure. Prompt diagnosis is required to avoid significant sequelae. Diagnosis of this syndrome is based on clinical findings and intra abdominal pressure monitoring. Treatment consists of decompressive laparotomy, which corrects the pathology. Various surgical techniques are described to manage the open abdomen. Despite considerable attention accorded to this disorder, it is still associated with high morbidity and mortality. This review article deals with the identification of risk factors, pathophysiology, diagnostic criteria and treatment of critically ill patients with the abdominal compartment syndrome. 相似文献
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R. Das Gupta P. P. Chakravorty A. Kaviraj 《Bulletin of environmental contamination and toxicology》2010,85(1):83-86
The 96 h LC50 values of six insecticides were determined on a non-target epigeic earthworm Perionyx excavatus under laboratory conditions. Cypermethrin was found most toxic to P. excavatus (LC50-0.008 mg/kg), followed by endosulfan (LC50-0.03 mg/kg), carbaryl (LC50-6.07 mg/kg), chlorpyrifos (LC50-7.3 mg/kg), aldicarb (LC50-10.63 mg/kg) and monocrotophos (LC50-13.04 mg/kg). When these LC50 values were compared with their respective recommended agricultural doses, aldicarb and carbaryl appeared more dangerous
than other pesticides because of their lower LC50 values than their respective recommended agricultural dose. Mean lethal time to cause 50% mortality at recommended agricultural
dose (LT50) also indicated that aldicarb achieved the fastest LT50 (26 h) followed by endosulfan (38 h) and carbaryl (44 h) indicating the danger of these pesticides to P. excavatus. 相似文献
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Infections caused by extended-spectrum beta-lactamase (ESBL)-producing pathogens, particularly Klebsiella pneumoniae, are increasing. The epidemiology of ESBL-producing K. pneumoniae, the mechanisms of resistance, and treatment strategies for infections caused by these organisms are reviewed. 相似文献
20.
B. S. Sharma Sumit Sinha V. S. Mehta A. Suri Aditya Gupta A. K. Mahapatra 《Child's nervous system》2007,23(3):327-333
Object Intracranial aneurysms are rare in children and have different epidemiological, clinical, and morphological characteristics
and outcome from those in adults.
Materials and methods We analyzed demographic, clinical, radiologic features, treatment, and outcome in 55 patients <18 years of age, treated from
Jan 1995 through December 2005.
Results Intracranial aneurysms in children below 18 years constituted 4% of all intracranial aneurysms. Internal Carotid artery (ICA)
bifurcation was the commonest location. About half of the aneurysms were complex. Three-fourth of the patients required surgical
treatment. Two patients died, constituting 5% mortality. Two patients (5%) had poor outcome, whereas the majority (90%) had
a favorable outcome.
Conclusions Pediatric aneurysms have male predominance, higher incidence of clinical features of mass effect or seizures, high incidence
of large, traumatic/mycotic aneurysms, associated illnesses and ICH/IVH and hydrocephalus, better Hunt and Hess grades at
presentation, ICA bifurcation as the commonest site, and better outcome than their adult counterparts. 相似文献