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排序方式: 共有416条查询结果,搜索用时 15 毫秒
1.
Objective: To compare the nasal valsalva with the trumpet manoeuvre and anterior neck skin traction as aids to nasendoscopic examination of the hypopharynx. Design: Randomised, controlled comparison of examination techniques. Setting: Single tertiary referral centre. Participants: Twenty‐six adult patients requiring hypopharyngeal nasendoscopic examination were recruited. Patients were examined with both techniques in a randomised order that was recorded to video cassette. Main Outcome Measures: Blinded assessment of the percentage visualisation of the pyriform fossae, post‐cricoid and upper oesophageal sphincter was carried out by three consultant otolaryngologists independently. Results: Mean percentage scores (and 95% confidence intervals) for nasal valsalva versus trumpet manoeuvre for the three consultants, respectively, were as follows: right pyriform fossa: 77(68, 87) versus 80(71, 91), 61(55, 66) versus 60(54, 66), 46(38, 54) versus 45(37, 54); left pyriform fossa: 76(65, 87) versus 80(69, 91), 59(53, 64) versus 55(49, 61), 42(35, 49) versus 42(35, 50); post‐cricoid: 55(44, 67) versus 59(47, 71), 53(46, 60) versus 53(46, 60), 32(25, 39) versus 32(25, 39); upper oesophageal sphincter: 11(1, 21) versus 21(11, 31), 15(9, 21) versus 20(14, 26), 4(0, 8) versus 7(3, 11). No significant difference was found between the two techniques at any subsite. Individual differences were noted in a minority of patients where one or other technique gave a clearly improved view. Conclusions: The nasal valsalva and the trumpet manoeuvre with anterior neck skin traction are complementary techniques for improving the view of the hypopharynx. 相似文献
2.
A. Poobalan L. Aucott W. C. S. Smith A. Avenell R. Jung J. Broom A. M. Grant 《Obesity reviews》2004,5(1):43-50
This paper aims to review the evidence for long‐term effectiveness of weight loss on cholesterol, high‐density lipoprotein (HDL), low‐density lipoprotein (LDL) and triglycerides in overweight/obese people. Current evidence is mostly based on short‐term studies. A systematic review of long‐term lipid outcomes of weight loss in studies published between 1966 and 2001, was conducted. Inclusion criteria included all cohort studies and trials carried out on participants with body mass index of greater than or equal to 28 kg m?2. Studies had at least two weight change measurements and follow‐up of more than 2 years. Thirteen long‐term studies with a follow‐up of more than 2 years were included. Cholesterol has a significant positive linear relationship with weight change (r = 0.89) where change in weight explains about 80% of the cholesterol difference variation (Adj R2 = 0.80). For every 10 kg weight loss a drop of 0.23 mmol L?1 in cholesterol may be expected for a person suffering from obesity or are grossly overweight. Weight loss has long‐term beneficial effects especially on LDL and cholesterol. Weight loss in obese patients should be encouraged and sustained. 相似文献
3.
Anulus fibrosus in bulging intervertebral disks 总被引:1,自引:0,他引:1
In this investigation the association of radial tears of the anulus fibrosus and bulging of the intervertebral disk was studied. An index of disk bulging was measured in sagittal anatomic sections in 149 lumbar disks from 31 cadavers. The indexes of disk bulging were correlated with stages of disk development and the presence of an annular tear. The largest disk-bulging indexes were always associated with radial tears of the anulus. Eighty-four percent of the disks with radial tears had disk-bulging indexes greater than 2.5 mm. Most normal adult disks had an index of less than 2.5 mm. The results challenge the concept that the anulus fibrosus is intact in bulging disks, although ruptured in herniated disks. 相似文献
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Coulter P Lema C Flayhart D Linhardt AS Aucott JN Auwaerter PG Dumler JS 《Journal of clinical microbiology》2005,43(10):5080-5084
Lyme disease is usually diagnosed and treated based on clinical manifestations. However, laboratory testing is useful for patients with confusing presentations and for validation of disease in clinical studies. Although cultivation of Borrelia burgdorferi is definitive, prior investigations have shown that no single test is optimal for Lyme disease diagnosis. We applied high-volume blood culture, skin biopsy culture, PCR, and serodiagnosis to a cohort of patients with suspected Lyme disease acquired in Maryland and southern Pennsylvania. The study was performed to confirm the relative utility of culture and to identify laboratory testing algorithms that will supplement clinical diagnosis. Overall, 30 of 86 patients (35%) were culture positive, whereas an additional 15 of 84 (18%) were seropositive only (51% total sero- and culture positive), and PCR on skin biopsy identified 4 additional patients who were neither culture nor seropositive. Among 49 laboratory test-positive patients, the highest sensitivity (100%) for diagnosis was obtained when culture, skin PCR, and serologic tests were used, although serologic testing with skin PCR was almost as sensitive (92%). Plasma PCR was infrequently positive and provided no additional diagnostic value. Although culture is definitive and has a relatively high sensitivity, the results required a mean of 3.5 weeks to recovery. The combination of acute-phase serology and skin PCR was 75% sensitive, offering a practical and relatively rapid alternative for confirming clinical impression. The full battery of tests could be useful for patients with confusing clinical signs or for providing strong laboratory support for clinical studies of Lyme disease. 相似文献
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Early stage nasopharyngeal carcinoma: radiotherapy dose and time factors in tumor control 总被引:1,自引:0,他引:1
Chang JT; See LC; Liao CT; Chen LH; Leung WM; Chen SW; Chen WC 《Japanese journal of clinical oncology》1998,28(3):207-213
OBJECTIVE: To evaluate radiotherapy dose and length of treatment in the
control of early stage nasopharyngeal carcinoma (NPC) treated with a
combination of external radiotherapy and brachytherapy, MATERIALS &
METHODS: We reviewed the records of 133 patients with early stage
nasopharyngeal carcinoma (stage I or II, AJC/UICC staging system) who
received definitive radiotherapy in Chang Gung Memorial Hospital from 1979
to 1991. The median follow-up time was 7.1 years with a minimum of 2 years.
All patients were treated with megavoltage external radiotherapy to the
nasopharynx area (63-72 Gy) followed by high dose rate intracavitary
brachytherapy (5-16.5 Gy in one to three fractions, spaced 1-2 weeks
apart). The median total dose and time of irradiation was 75 Gy (69.8-81.4
Gy) and 11.6 weeks (7.8-20 weeks) respectively. Survival analysis was used
to examine the effect of several variables on prognosis. RESULTS: The
5-year rates were 86.4% for local control, 84.7% for disease free survival,
88.5% for actuarial survival and 84.2% for overall survival. The treatment
group (combination of time and dose of irradiation) was the most important
prognostic factor according to Cox's proportional hazard model. Patients
receiving radiation at a total dose of < or = 75 Gy completed in < 12
weeks showed the best prognosis. CONCLUSION: Treatment time and total
treatment dose are both important factors in treating early stage NPC.
Decreasing the total radiation time to < 12 weeks and not exceeding a
radiation dose of 75 Gy gave the best results.
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