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991.
Møller FV Christensen P Rasmussen PC Laurberg S 《Diseases of the colon and rectum》2006,49(9):1458-1461
Placing of ileal conduit at the time of pelvic exenteration in combination with a same-side vertical rectus abdominis myocutaneous
flap is controversial. We report our experience with the placement of the ileal conduit at the same side as the donor site
of the vertical rectus abdominis myocutaneous flap in 12 patients and describe our technical approach.
Reprints are not available. 相似文献
992.
Background Bone disease has been described in patients after surgical treatment for obesity, but few studies have dealt with the impact
of vertical banded gastroplasty on mineral metabolism. We have examined bone mineral metabolism in morbidly obese patients
before and after 3 months after vertical banded gastroplasty without vitamin D supplementation.
Methods Sixteen morbidly obese patients (14 women, 2 men) with a mean (±SD) age of 38 ± 9 years and a body mass index (BMI) of 47.1 ± 8.1 kg/m2 were studied. No vitamin D supplementation was given. Body weight, fat mass, calcium, 25OHD, iPTH, bone remodeling markers,
and leptin levels were measured at baseline and after weight loss.
Results Mean weight loss was 28 ± 11 kg; BMI and body fat mass decreased by 20 and 35%, respectively. Bone resorption markers and
albumin-corrected serum calcium increased after operation, whereas iPTH fell. Serum 25OHD levels rose. Leptin levels decreased.
Serum iPTH was positively correlated with weight, BMI, and fat mass before operation (p < 0.05), and its decline after weight reduction was negatively associated with the increase in bone resorption markers (p < 0.01). Leptin concentration was correlated with BMI and body fat mass (p < 0.05) both before and after surgery.
Conclusions Weight reduction obtained in morbidly obese subjects 3 months after vertical banded gastroplasty increases bone turnover markers
and decreases PTH secretion. Serum 25OHD levels rose. Therefore, no reasons for a metabolic bone disease related to hypovitaminosis
D were readily apparent. However, an increase in bone turnover, which is generally regarded as a potential risk factor for
osteoporosis, was observed. Further work is needed to clarify the importance of this turnover increase in the long run. 相似文献
993.
Saunders J Ballantyne GH Belsley S Stephens DJ Trivedi A Ewing DR Iannace VA Capella RF Wasileweski A Moran S Schmidt HJ 《Obesity surgery》2008,18(10):1233-1240
BACKGROUND: An increasing importance has been placed on a bariatric program's readmission rates. Despite the importance of such data, there have been few studies that document 1-year readmission rates. There have been even fewer studies that delineate the causes of readmission. The objective of this study is to delineate the rates and causes of readmissions within 1 year of bariatric operations performed in a high-volume center. METHODS: Records for all patients undergoing bariatric operations during a 31-month period were harvested from the hospital electronic medical database. Readmissions for these patients were then identified within the hospital database for the year following the index operation. The electronic medical records of all readmitted patients were reviewed. RESULTS: The overall 1-year readmission rate for 1,939 consecutive bariatric operations was 18.8%. The laparoscopic adjustable gastric band (LAGB) had the lowest readmission rate of 12.69%. Next was the vertical banded gastroplasty-Roux-en-Y gastric bypass (VBG-RYGB) with a rate of 15.4%. The laparoscopic Roux-en-Y gastric bypass (LRYGB) had the highest readmission rate of 24.2%. Leading causes of readmission were abdominal pain with normal radiographic studies and elective operations. Independent factors predicting readmission were found to be LOS > 3 days (odds ratio 1.69 p = 0.004) and having a LRYGB (odds ratio of 1.49 p = 0.003). The previously reported reoperation rate for bowel obstruction of 9.7% had decreased to 3.7% due to changes in operative technique. CONCLUSION: Rates of readmissions for patients undergoing bariatric surgery center at our high-volume center decreased over time and are comparable to other major abdominal operations. 相似文献
994.
Creek T Ntumy R Mazhani L Moore J Smith M Han G Shaffer N Kilmarx PH 《AIDS and behavior》2009,13(2):356-364
In Francistown, Botswana, approximately 40% of pregnant women are HIV positive. PMTCT has been available since 1999, antiretroviral
(ARV) therapy since 2001, and 95% of women have antenatal care (ANC) and deliver in hospital. However, in 2002, only 33% of
ANC clients were tested for HIV, and not all women with HIV received services. In 2003, we conducted a survey of 504 pregnant
and postpartum women to explore reasons for poor program uptake, and interviewed 82 health providers about PMTCT. Most women
(95%) believed that all pregnant women should be tested for HIV. In multivariate analysis, factors associated with having
an HIV test included being interviewed at an urban site, having a high PMTCT knowledge score, knowing someone receiving PMTCT
or ARV therapy, and having a partner who had been tested for HIV. Neither fear of stigma nor resistance from partners were
frequent reasons for refusing an HIV test. Providers of HIV services reported discomfort with their knowledge and skills,
and 84% believed HIV testing should be routine. Ensuring adequate knowledge about HIV and PMTCT, creating systems whereby
HIV-positive women receiving care can educate and support other women, and making HIV testing routine for pregnant women may
improve the uptake of HIV testing. 相似文献
995.
Kim EY Yoon MS Kim HH Nam CM Park ES Hong SH 《Clinical and experimental otorhinolaryngology》2012,5(1):1-9
Objectives
Resonance problems in hearing impaired (HI) individuals have been described as aspects of nasality. However, there are limitations in being able to explain the range of resonance problems. Therefore, this study suggests a perceptual rating that will effectively explain the characteristics of resonance problems in HI individuals.Methods
Nasalance scores were obtained from 32 subjects in each of HI and normal hearing (NH) groups using a nasometer. The subjects were categorized into groups based on normal and abnormal nasalance ranges. The abnormal nasalance range group was further divided into hyper-, hypo-, and mixed-nasal groups. Nasalance scores were based the individuals performance in a series of passage and syllable tasks. The perceptual rating was evaluated using a newly introduced tool, ''vertical focus of resonance'' (VFR), which focuses on the resonance energy in the frontal, throat, pharyngeal and nasal locations.Results
The NH group demonstrated a significantly lower nasalance score in the oral coupling and passage tasks than the HI group. Based on the results of nasalance correlation analysis, the HI group showed highly significant correlations between syllable and passage tasks, as contrasted with the NH group. There were significant differences in VFR between the nasalance types in both the NH and the HI groups.Conclusion
The HI hyper-nasal group showed tendencies of velopharyngeal opening, as opposed to the HI hypo-nasal group which showed tendencies of velopharyngeal closure. The HI mixed-nasal group showed inappropriate coordination of velopharyngeal function. In the HI group, the results of VFR showed that the air flow and the resonance energy were not released from the cavity of resonance. The suggested VFR tool explains the focusing characteristics of resonance energy within a continuation of speech sound regardless of the phonetic environment. Therefore, VFR may be a useful tool in explaining the deviant resonance patterns of HI individuals. 相似文献996.
上颌第一前磨牙纵折黏结的应力分析 总被引:2,自引:1,他引:1
目的:分析上颌第一前磨牙纵折黏接修复后牙体各部位的应力改变。方法:在上颌第一前磨牙纵折模型上,假设分别由ClearfilSEBond和SuperBondC&B代替折裂缝处,并进行垂直和侧向加载,采用三维有限元法计算牙体各部位的应力变化。结果:黏结后的纵折牙垂直加载和侧向加载时,牙体应力值和应力改变趋势与正常牙模型相似,ClearfilSEBond黏结的纵折牙应力变化趋势更接近正常牙体。结论:黏结再植术治疗纵折后牙是有效的,治疗时应选用弹性模量与牙本质较接近的黏结材料,以减少破坏应力,提高纵折牙的远期治疗效果。 相似文献
997.
目的构建三级医院护理垂直管理模式架构与实践策略集,以推进护理管理改革。方法在文献系统评价和半结构式访谈的基础上拟订初稿,采用德尔菲法对来自全国16个省市三级医院的20名专家进行2轮咨询。结果2轮专家咨询的权威系数分别为0.93和0.94,肯德尔和谐系数为0.043~0.233。最终确立的三级医院护理垂直管理模式架构与实践策略集包含垂直联合扁平化的管理架构、转换型领导、标准化的护理专业实践、组织授权、创新与实践和支持系统6个维度、17个要素和60个要素特征及其实践策略。结论构建的护理垂直管理模式架构与实践策略集科学、实用、内容较全面,可为国内三级医院护理管理模式改革与实践提供依据。 相似文献
998.
分离性垂直偏斜的手术治疗 总被引:1,自引:0,他引:1
王漫 《眼外伤职业眼病杂志》2001,23(6):667-668
目的探索治疗分离性垂直斜视(DVD)的更有效的手术方法.方法对21例(24眼)不同程度DVD患者行不同量手术,评定不同量手术的效果.结果24眼术后外观均取得较满意效果.23眼术后第一眼位垂直斜度<5°,1眼术后第一眼位垂直斜度为8°.结论上直肌大量后徙联合下斜肌切断移位术对DVD患者的斜视矫正能取得较满意效果,未联合下斜肌转位术的效果稍差. 相似文献
999.
Victoria Lee Zhi Hui Yaxin Xie Kaiwen Zhang Haoran Chen Wenze Han Ye Tian Yijia Yin Xianglong Han 《The Angle orthodontist》2022,92(5):598
ObjectivesTo analyze the anatomical limitations and characteristics of maxillary and mandibular retromolar regions affecting molar distalization using cone-beam computed tomography (CBCT).Materials and MethodsA total of 120 qualifying patients were classified into equal groups of skeletal Class II and Class III and stratified by vertical growth pattern, age, sex, and third molar presence. The available distance along the axis of distalization and cortical bone thickness (CBT) were measured in the maxillary and mandibular retromolar regions of Class II and Class III patients, respectively. One-way analysis of variance was used to examine the effects of the factors on the measured data.ResultsThe minimum available distance of the Class II maxilla was observed at a level 3 mm from the cementoenamel junction (CEJ), while that of the Class III mandible was at a level 9 mm from the CEJ. The average available distance at the limit level was 4.06 ± 1.93 mm in the Class II maxilla, and the average corresponding CBT was 1.00 mm. The average available distance at the limit level in the Class III mandible was 2.80 ± 1.96 mm, and the corresponding CBT was 2.24 mm. In both skeletal Class II and Class III patients, hyperdivergent groups had the least available distance for molar distalization.ConclusionsThe limit for available distance in the Class II maxilla is closer to the coronal level, while that of the Class III mandible is closer to the apical level. A hyperdivergent growth pattern in a patient is indicative of less potential for molar distalization. Axial slices of CBCT images provide valuable evaluation for molar distalization regarding limit levels. 相似文献
1000.
慢乙肝母婴传播阻断和治疗策略的建议 总被引:2,自引:1,他引:2
慢性乙型肝炎患者感染HBV的主要途径为母婴传播,根据胎儿发育史,从分析母婴传播的可能机制入手,提出阻断母婴传播的措施应当是母婴共同进行免疫预防,即HBsAg( )孕妇应从妊娠第16周开始,最迟不应晚于20 wk,应进行每月1次的乙肝免疫球蛋白200 IU肌注(若HBV DNA阳性也可以用400 IU/次),直至分娩;娩出的新生儿应进行主动-被动联合免疫,即娩出24 h(最好6 h)内注射乙肝免疫球蛋白200 IU, 2 wk后再重复一次,并同时进行疫苗接种,以期得到最佳保护效果.慢性乙型肝炎治疗以抗病毒为主,同时兼顾提高机体免疫的疗法,并提出以HBV DNA定量为基础的慢乙肝简单分类方法,便于推广应用. 相似文献