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121.
E. Andrs G. Kaltenbach E. Noel M. Noblet‐Dick A.‐E. Perrin T. Vogel J.‐L. Schlienger M. Berthel J. F. Blickl 《International journal of laboratory hematology》2003,25(3):161-166
Background: It has been suggested that oral cobalamin (vitamin B12) therapy may be an effective therapy for treating cobalamin deficiencies related to food‐cobalamin malabsorption. However, the duration of this treatment was not determined. Patients and method: In an open‐label, nonplacebo study, we studied 30 patients with established cobalamin deficiency related to food‐cobalamin malabsorption, who received between 250 and 1000 μg of oral crystalline cyanocobalamin per day for at least 1 month. Endpoints: Blood counts, serum cobalamin and homocysteine levels were determined at baseline and during the first month of treatment. Results: During the first month of treatment, 87% of the patients normalized their serum cobalamin levels; 100% increased their serum cobalamin levels (mean increase, +167 pg/dl; P < 0.001 compared with baseline); 100% had evidence of medullary regeneration; 100% corrected their initial macrocytosis; and 54% corrected their anemia. All patients had increased hemoglobin levels (mean increase, +0.6 g/dl) and reticulocyte counts (mean increase, +35 × 106/l) and decreased erythrocyte cell volume (mean decrease, 3 fl; all P < 0.05). Conclusion: Our findings suggest that crystalline cyanocobalamin, 250–1000 μg /day, given orally for 1 month, may be an effective treatment for cobalamin deficiencies not related to pernicious anemia. 相似文献
122.
In a randomized cross-over design, 7 patients with winter depression were treated with a week of a bright (1700 lx) dawn simulation (0400 to 0600) and a week of standard bright (1700 lx) morning (0600 to 0800) light therapy. The Hamilton Rating Scale for Depression scores decreased significantly for the standard light therapy (18.9 to 6.6) but not for the bright dawn therapy (18.0 to 11.3). Early morning awakening was a frequent side effect with the bright dawn simulation. Although dawn simulation at a lower illuminance may be an effective treatment, the bright dawn used in this study showed only a nonsignificant trend to lower depression ratings. The illuminance of dawn simulation should be adjusted to minimize side effects. 相似文献
123.
In a sample of 55 consecutive methadone maintenance admissions to our clinic, 42% were diagnosed with antisocial personality disorder (ASPD) using the National Institute of Mental Health Diagnostic Interview Schedule NIMH DIS. Individuals with ASPD exhibited greater risk for HIV infection as defined by more sexual contacts, needle use and equipment sharing. Data at 1 year follow-up were obtained on this group of patients. The objective was to compare the ASPD and non-ASPD groups with regards to demographics, drug abuse history, outcome and retention in treatment. There were no significant differences between the groups on any demographic or treatment outcome variables. Survival analysis indicated that there were no group differences in treatment retention. In conclusion, although there were no differences in treatment outcome between ASPD and non-ASPD groups it is possible that ASPD patients who drop out of treatment will be at higher risk for contracting and spreading HIV within the IV drug using population. These data also suggest that in this population the diagnosis of ASPD using primarily behavioral traits as measured in the NIMH-DIS-III, has little utility in predicting treatment outcome. 相似文献
124.
异位妊娠是是妇产科常见的急腹症之一,随着高敏感度的血β-HCG测定、阴道超声及腹腔镜临床应用,使异位妊娠得以早期诊断。以往异位妊娠的治疗原则以手术治疗为主.异位妊娠的早期诊断使药物治疗和保守性手术治疗成为可能。 相似文献
125.
目的对部分顽固性癫痫病人,在严格充分的术前评价之后.依据结果将几种手术方式适当的组合使用,并对其临床效果进行评价。方法对同济大学东方医院神经外科收治的116例顽固性癫痫中的25例病人施行联合手术的治疗方法。发作形式为全身强直一阵挛性发作、复杂部分性发作及失神发作等,其中有14例存在两种发作形式。术前均服过多种抗癫痫药.病程后期同时服用2~3种抗癫痫药。25例病人术前均行24h脑电监测及头颅MRI检查.有19例术前行硬膜下皮层电极和深部电极检测,其中1例行头颅PET检查。手术在皮层脑电及深部电极监测下进行。13例行额颢开颅,颞前叶及海马、杏仁核切除+额部部分区域的软膜下横切术(MST),其中7例附加胼胝体前部切开术;11例行额部开颅,额部软化灶切除+运动区MST,其中2例附加胼胝体前部切开术;1例行双侧枕顶部开颅,左枕叶萎缩皮层切除+胼胝体后部切开+右侧顶枕的MST。结果术后无死亡及严重并发症。术后抗癫痫药物使用减少,术后23例服用一种抗癫痫药,2例服用两种抗癫痫药。术后随访6~12个月,17例手术效果为Engel 1级,4例为Engel2级,4例为Engel3级。40岁以下的患者手术后癫痫控制的可能性显著大于40岁以上者(P〈0.05);病程在10年以下的患者术后癫痫无发作的可能性显著大于10年以上者(P〈0.05)。头颅MRI上有无明显的结构异常对病人的预后没有影响(P〉0.05)。结论在严格术前评价的前提下,尤其是在有精通神经电生理知识的神经外科医生综合分析下,采用多种手术方式组合治疗顽固性癫痫效果显著。 相似文献
126.
Adorján F. Kovács Waleed Megahed Michael Scholz Robert Sader 《Mund-, Kiefer- und Gesichtschirurgie》2007,11(5):267-283
PURPOSE: The development of overall survival of a DOSAK (German-Austrian-Swiss Cooperative Group on tumours of the maxillofacial region) clinic's overall population comprising a time period of more than 20 years (1983-2004) should be assessed. At a cutoff date (January 1st, 1997), a change from a primarily surgically based to a consequent multi-modality treatment regimen was implemented. The periods of time before and after that change should be compared. METHODS AND PATIENTS: The data of the DOSAK registry entries on 1038 patients suffering from primary untreated oral and oropharyngeal carcinomas were updated with respect to follow-up and mortality data to achieve a 100% quality of follow-up. The end point (death) was reached in 67% of the overall population. Statistical analysis was carried out by the Trium Analysis Online corporation, Munich. RESULTS: The portion of female and older tumor patients increased, more than half of all tumor patients were clearly in stage IV of the disease at first referral. The portion of patients operated on persisted approximately (80%), the portion of additional treatment modalities could be increased considerably. The fact of a bony infiltration by the tumor and the operability remained highly significantly relevant for survival in multivariate analysis, despite of multi-modality treatment. The survival rate of the patients remained significantly dependent on the clinical stage of the disease in multivariate analysis but could be improved by 10% in the clinical stages II and III and in the patients who could not be operated on. All in all, the cutoff date was statistically relevant for survival in multivariate analysis, i.[Symbol: see text]e. the change in the treatment regimen had a verifiable positive effect on the survival of a unicentric overall population. CONCLUSION: Survival improvement in an overall population via change in treatment strategy is possible in relatively short time; the clinical stages II and III and the non-operable patients have the greatest benefit from a multi-modality treatment. 相似文献
127.
Johan Grunewald 《The clinical respiratory journal》2007,1(2):64-73
Introduction: Sarcoidosis is a granulomatous disorder of unknown aetiology, affecting young adults and frequently involving the lungs. Objective: The aim of the present review was to give an overview of the clinical aspects in sarcoidosis. Results: The majority of patients recover, but some develop a chronic disease that may result in fibrosis and respiratory failure. Besides the lungs, peripheral lymph nodes, the skin, the liver and the eyes are commonly affected as well. The genetic background, as well as environmental factors, is of importance for developing sarcoidosis. The incidence varies in different populations, in the Nordic countries approximately with 20/100 000 new patients yearly. Sarcoidosis is diagnosed when clinical and radiological findings are supported by histological evidence in the form of non‐caseating epithelioid cell granulomas, and when other causes of these features are excluded. Patients in need of treatment are usually treated with corticosteroids, topically or as oral steroids. A clinical effect of immunomodulatory drugs blocking tumour necrosis factor (TNF)α has been suggested from several case reports, while two controlled studies showed only minor effects; however, with a tendency to a more pronounced effect on patients with a more severe disease. The immune response in sarcoidosis, with a typical accumulation of CD4+ T‐cells to the lungs, indicate the existence of specific antigens in this disease. Recently, antigens derived from infectious agents such as Mycobacteria and Proprionibacterium acnes have come into focus. Lymphocyte populations with immunoregulatory functions have recently been investigated and seem to be dysfunctional in sarcoidosis, opening the possibility of developing new treatment strategies in this disease. Conclusion: Recent technical developments have provided better tools, enabling detailed and more thorough analyses of the inflammatory process in sarcoidosis. Please cite this paper as: Grunewald J. Clinical aspects and immune reactions in sarcoidosis. The Clinical Respiratory Journal 2007; 1:64–73. 相似文献
128.
局部亚低温治疗急性脑出血的临床研究 总被引:7,自引:2,他引:5
目的观察冰帽加双侧颈动脉区冰敷治疗急性脑出血的临床疗效和探讨最佳治疗时机。方法 174例急性脑出血患者随机分为治疗组和对照组 ,每组 87例。对照组给予常规治疗 ,治疗组在常规治疗的基础上同时给予亚低温治疗 ;治疗组中 46例在发病 3小时内治疗 ,41例在发病 3小时后治疗。观察治疗组与对照组以及治疗组中发病 3小时内与发病 3小时后两组的临床疗效和预后情况。结果亚低温治疗组与对照组比较 ,神经功能改善 (P <0 0 5 ) ,生存率及恢复良好率提高 (P <0 0 5 )。发病 3小时内开始治疗者优于 3小时后开始者 (P <0 0 5 )。结论亚低温治疗能有效减轻急性脑出血后的神经功能缺损 ,降低病死率和致残率 ;最佳治疗时机在发病 3小时以内。 相似文献
129.
130.