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N V Kornilov B M Rachkov V I Kulik V M Kustov 《Vestnik khirurgii imeni I. I. Grekova》1990,145(8):62-66
A retrospective analysis of results of treatment of 104 patients with fractures of long tubular bones associated with injuries of peripheral nerves has shown complex therapy to be necessary. Main components of this treatment were biogenic stimulators, vitamin B12, spasmolytic and dehydration drugs in combination with electrophoresis with potassium iodide and thermal procedures. Rapid disturbance of conductivity of nerve trunks after trauma should be followed by revision of the given segment of the extremity in order to remove hematoma and make reposition of displaced fragments of the bone, which can provide recovery of the disturbed function of the nerve. 相似文献
4.
Gilbert H. L. Tang Paul W. M. Fedak Terrence M. Yau Richard D. Weisel Alex Kulik Donald A. G. Mickle Ren-Ke Li 《European journal of cardio-thoracic surgery》2003,23(6):907-916
Current therapies for congestive heart failure are limited in efficacy or in applicability. Cardiac cell transplantation offers a novel therapeutic approach to improve heart function. Although significant progress has been made over the past decade in the development of cell transplantation, only recently have investigators studied the changes in ventricular function following cell transplantation. This review article describes the latest research developments, evaluates recent studies of ventricular function after cell transplantation, and discusses the future directions of cell transplantation as a new therapy to ‘repair broken hearts’. 相似文献
5.
Preferences for health care involvement, perceived control and surgical recovery: a prospective study 总被引:4,自引:0,他引:4
In a sample (N = 75) of coronary bypass patients, we examined the manner in which preoperative perceptions of personal control over recovery, desires for behavioral involvement in health care, and desires for information about health care predicted recovery in the hospital. Results indicated that preoperative control beliefs and desires for health care involvement predicted independently several important indices of recovery. Specifically, patients who prior to their surgery expressed a greater desire for information tended to experience less surgical pain and more negative psychological reactions. Greater preferences for behavioral involvement were associated with greater pain behavior, more ambulation, and shorter hospital stays. Finally, greater perceived personal control over recovery was associated with a shorter hospital stay. 相似文献
6.
Alexander Kulik Marc Ruel Michael E Bourke Lynn Sawyer John Penning Howard J Nathan Thierry G Mesana Pierre Bédard 《European journal of cardio-thoracic surgery》2004,26(4):694-700
OBJECTIVE: Non-steroidal anti-inflammatory drugs (NSAIDs) are routinely used after coronary artery bypass surgery (CABG), yet their effects have seldom been evaluated in randomized controlled settings. The aim of this study was to examine the efficacy and safety of a commonly used NSAID, naproxen. We hypothesized that naproxen would reduce postoperative pain following CABG without increasing complications. METHODS: Patients (N=98) undergoing primary CABG were randomized to receive naproxen (500 mg q12hX5 doses via suppository started 1h after operation, followed by oral 250 mg q8hX6 doses) or placebo. Standard analgesic and anti-emetic regimens were available to both patient groups. Interventions were double-blinded. Primary end-points were postoperative pain measured before and after chest physiotherapy by visual analog scale and pulmonary slow vital capacity (SVC). RESULTS: Baseline characteristics were equivalent between the two groups. Over the first 4 postoperative days, naproxen decreased pain by 47+/-17% on average before chest physiotherapy (P=0.034), and 44+/-13% after chest physiotherapy (P=0.0092). Patients who received naproxen also had better preservation of SVC over the first 4 postoperative days (mean loss of SVC from baseline: 2.1+/-0.1 vs. 2.5+/-0.1l, naproxen vs. placebo, P=0.0032). This was concomitant with a lower white blood cell count observed in naproxen patients (9.2+/-0.3 vs. 12.7+/-1.5x10(9)/l, naproxen vs. placebo, P=0.03). Patients who received naproxen had more chest tube drainage after 4h postoperatively, but there was no difference in the incidence or amount of transfusions. There was no difference in medication use, length of stay, or in the incidence of atrial fibrillation, azotemia, and other complications. CONCLUSIONS: Naproxen is an effective and low-cost adjunct for optimization of pain control and lung recovery after CABG. Its use may result in increased chest tube drainage, but no apparent increase in other complications. 相似文献
7.
Liana Beni-Adani Naresh Biani Liat Ben-Sirah Shlomi Constantini 《Child's nervous system》2006,22(12):1543-1563
Background and objective The classification of hydrocephalus in newborns and in infants is different from the classification in adulthood. This difference
exists due to disparity in the source pathologies that produce the hydrocephalus, and the practical distinctions in prognosis
and treatment choices. The objective of this paper is to present the spectrum of obstructive-communicating hydrocephalus,
which is more complex in the pediatric group, and to propose the relevance of this particular classification to treatment
options.
Materials and methods The authors categorized infants with active hydrocephalus at time of presentation into the following four groups along the
spectrum of communicating vs obstructive HCP. Group 1: patients with a purely absorptive (communicating) HCP. In these patients,
tetraventricular dilatation is usually observed with occasional extraaxial fluid accumulation. An extracranial CSF diversion
(shunt) is the treatment of choice. Group 2: patients with an obstructive component together with a persistent absorptive
component. In these patients, a technically successful endoscopic procedure will not prevent progression of clinical symptoms
of HCP. An extracranial CSF diversion (shunt) should be the treatment of choice even though some of these patients are currently
treated by endoscopy. Group 3: patients with an obstructive component together with a temporary absorptive component. In these
patients, a technically successful ETV should be followed by temporary CSF drainage [via LP, continuous spinal drainage (CLD),
or ventriculostomy] with or without supplemental medical treatment (i.e., Diamox) for several days. Such temporary drainage
may decrease failure rate in this subgroup. Group 4: patients with a purely obstructive HCP. In these patients, an endoscopic
procedure (ETV) is the treatment of choice. According to this spectrum classification, the authors classify different entities
with representative cases and discuss relevancy to treatment options and prognosis.
Results The data suggest that obstructive hydrocephalus in the very young population may be rather a combination of obstructive and
absorptive problem. The outcome of the patient depends mainly not only on the basic pathology causing the hydrocephalus but
also on the treatment that is chosen and its complications. While bleeding and infection represent the major causes for communicating
hydrocephalus, patients with complex pathologies of congenital type and intra- or interventricular obstructions may reflect
obstructive hydrocephalus. Treatment of these patients may be successful by shuntless procedures if the absorptive problem
is not the major component. In transient absorptive hydrocephalus, temporary measures were effective in many cases leading
to successful procedures of ETV and/or posterior-fossa decompression in selected cases.
Conclusions Shuntless procedures are the dream of a pediatric neurosurgeon provided it solves the problem and does not imply unacceptable
risk. However, the benefit has to be evaluated years after the procedure is performed, as only prospective multicenter studies
will truly show which procedure may have the best overall results in the developing child. Until such studies are available,
understanding the basic pathology or the combination of pathologies leading to hydrocephalus in a given child may open the
window of opportunities for other than shunt surgery in many hydrocephalic children with major obstructive component. 相似文献
8.
Adherence to continuous positive airway pressure treatment in patients with Alzheimer's disease and obstructive sleep apnea. 总被引:2,自引:0,他引:2
Liat Ayalon Sonia Ancoli-Israel Carl Stepnowsky Matthew Marler Barton W Palmer Lianqi Liu Jose S Loredo Jody Corey-Bloom Deborah Greenfield Jana Cooke 《The American journal of geriatric psychiatry》2006,14(2):176-180
OBJECTIVE: This analysis examined whether patients with Alzheimer disease (AD) tolerate continuous positive airway pressure (CPAP). METHOD: Thirty patients with AD were randomized to CPAP or sham CPAP and completed sleep, depression, and quality-of-life questionnaires. Participants could choose to continue treatment after the trial. RESULTS: Patients wore CPAP for 4.8 hours per night. More depressive symptoms were associated with worse adherence (rS=-0.37; N=30, p<0.04). Patients who continued using CPAP had fewer depressive symptoms (t [19]=2.45, p=0.02) and better adherence (t [19]=2.32, p=0.03) during the trial. CONCLUSION: Patients with AD with obstructive sleep apnea can tolerate CPAP. Adherence and long-term use may be more difficult among those patients with more depressive symptoms. 相似文献
9.
Patrice Lumumba Peoples' Friendship University, Moscow. (Presented by Academician T. T. Berezov, Academy of medical Sciences.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 113, No. 4, pp. 355–358, April, 1992. 相似文献
10.
Balloon dilation of the aortic valve: studies in normal lambs and in children with aortic stenosis 总被引:2,自引:0,他引:2
H Helgason J F Keane K E Fellows T J Kulik J E Lock 《Journal of the American College of Cardiology》1987,9(4):816-822
To evaluate the risks of and optimal method for valve dilation in aortic stenosis, balloons of different sizes were used to dilate the normal aortic root in 16 lambs and then stenotic valves in 15 children. In the lambs, inflated balloon to aortic anulus diameter ratios ranged from 0.9 to 1.5. These hearts were examined immediately after the procedure. Ratios of 0.9 to 1.1 did not produce significant damage to the left ventricular outflow tract, whereas those of 1.2 to 1.5 produced tears or hematomas, or both, of the aortic valve leaflets (n = 3), mitral valve leaflets (n = 4) and interventricular septum (n = 4). The 15 patients, aged 10 days to 15 years, underwent 16 balloon aortic valvotomy procedures. The balloon-aortic anulus ratio ranged from 0.67 to 1.1 (mean 0.90). The average pressure gradient decreased 69% and, overall, the peak systolic gradient decreased from 86 +/- 21 to 28 +/- 14 mm Hg (p less than 0.01) and the aortic valve area increased from 0.44 +/- 0.11 to 0.73 +/- 0.22 cm2/m2 (p less than 0.01). Immediately after the procedure an increase in aortic regurgitation was noted in 8 (57%) of 14 patients, but was never greater than 3+ and has been well tolerated. Other early complications encountered consisted of transient left bundle branch block in two patients, temporary femoral artery occlusion in three and femoral artery rupture requiring operative management in one infant. Balloon valvotomy can reduce the transvalvular gradient in most patients with valvular aortic stenosis when a balloon less than 1.1 times the aortic root diameter is used.(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献