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1.
Diagnosis of scaphoid fractures:A prospective multicenter study of 1,052 patients with 160 fractures
Bo Munk Johnny Fr kj r Claus Falck Larsen Hans Gad Johannsen Lars Lundager Rasmussen Annette Edal Lilla Demeney Rasmussen 《Acta orthopaedica》1995,66(4):359-360
In a prospective multicenter study of 1,052 patients with clinical signs of a scaphoid fracture, mammo-graphic films and fine intensifying screens were used at the radiographic examination. 5 standardized projections including 3 special projections focused on the scaphoid were taken. 150 fractures were diagnosed at the first examination but in 10 cases the fracture was first diagnosed at a second radiographic examination after 10-14 days.
The second examination still seems mandatory despite the use of high quality radiographs with optimal spatial resolution and contrast, and the value of supplementary special projections. 相似文献
The second examination still seems mandatory despite the use of high quality radiographs with optimal spatial resolution and contrast, and the value of supplementary special projections. 相似文献
2.
Fabrizio Sottile Rosaria De Luca Lilla Bonanno Giuseppina Finzi Carmela Casella 《Issues in mental health nursing》2018,39(4):353-356
Cotard's syndrome is a neuropsychiatric disease characterized by a variety of nihilistic delusions, commonly associated with several psychotic and major affective disorders, and neurological diseases, including stroke, dementia, and mental retardation. A 39-year-old male with mental retardation developed Cotard's syndrome, following an important episode of fear. During admission to our neurological unit, the patient underwent an accurate assessment, including neuroradiological, clinical, and neuropsychological examinations. At the psychiatric evaluation, he presented nihilistic delusions, in which he negated the existence of his body parts and the existence of his family members. The neuropsychological assessment ruled out other possible causes of misidentification, including the post-traumatic stress disorder. Thus, since also organic causes of Cotard's syndrome were excluded, the correlation between fear and the syndrome has been postulated and the patient opportunely treated, using a multidisciplinary approach. Our case suggests that in predisposed individuals negative emotions, including fear, may lead to delusional syndromes. 相似文献
3.
First description of blaNDM-1, blaOXA-48, blaOXA-181 producing Enterobacteriaceae strains in Romania
Edit Székely Ivelina Damjanova Laura Jánvári Krisztina E. Vas Szabolcs Molnár Doina V. Bilca Lilla K. Lőrinczi Ákos Tóth 《International journal of medical microbiology : IJMM》2013,303(8):697-700
We report the first isolation and characterization of several Enterobacteriaceae strains harboring blaNDM-1, blaOXA-48 and/or blaOXA-181 genes in a Romanian emergency teaching hospital. Between January 2010 and September 2012 nine carbapenemase-producing Enterobacteriaceae strains were identified. The blaNDM-1 gene was present in two Enterobacter cloacae strains, an Escherichia coli and two Klebsiella pneumoniae strains. One of these K. pneumoniae strains also harbored the blaOXA-181 gene. Three other K. pneumoniae strains and one Serratia marcescens carried blaOXA-48. 相似文献
4.
Zsóka Weiszhár András Bikov Gabriella Gálffy Lilla Tamási Ildikó Ungvári Csaba Szalai György Losonczy Ildikó Horváth 《Journal of clinical immunology》2013,33(2):496-505
Background
The alternative pathway of the complement system is known to play a role in the generation of asthmatic airway inflammation, but its regulatory complement protein, factor H has not been investigated in this disease.Purpose
Our aim was to determine the local bronchial complement factor H (CFH) levels in asthma, and to investigate its relationship with complement activation, systemic CFH concentrations and clinical characteristics of patients.Methods
Induced sputum and plasma were collected from 21 healthy and 26 asthmatic subjects, and complement factor H and SC5b-9 concentrations were assessed by ELISA. Total protein concentrations were determined by biuret-reaction based microassay system from induced sputa.Results
CFH was detectable in 81 % of healthy and 100 % of asthmatic subjects, while SC5b-9 exceeded the detection limit in 62 % of healthy subjects and 85 % of asthmatic patients. Sputum CFH concentrations and CFH/protein ratios were increased in samples from asthmatic patients, and correlated with loss of lung function, asthma control, severity and medication intensity, but not with plasma CFH concentrations. Sputum CFH/protein ratios were in positive correlation also with sputum eosinophilic cell counts in asthma. SC5b-9 concentrations were not higher in the asthmatic sputa, although they correlated with sputum CFH concentrations.Conclusions
CFH level is elevated on asthmatic airway surface, and may be associated with uncontrolled inflammation in asthma. 相似文献5.
Viviana Lo Buono Rosanna Palmeri Simona De Salvo Matteo Berenati Agata Greco Rosella Ciurleo Chiara Sorbera Vincenzo Cimino Francesco Corallo Placido Bramanti Silvia Marino Giuseppe Di Lorenzo Lilla Bonanno 《中国神经再生研究》2021,16(3):587
Anxiety and depression in Parkinson’s disease (PD) reduce well-being of the patients. Emotional alterations influence motor skills and cognitive performance; moreover, they contribute significantly and independently to worsen rehabilitative treatment response. We investigated anxiety, depression, and quality of life in PD patients subjected to multidisciplinary rehabilitative training. The self-controlled study included 100 PD patients (49 males and 51 females with the mean age of 64.66 years) admitted to 60 days hospitalization rehabilitative program, between January 2017 and December 2018. Motor, cognitive, linguistic abilities, and functional independence were evaluated at admission (T0 baseline visit) and 60 days after (T1) the multidisciplinary rehabilitation including motor exercises, speech therapies, and cognitive intervention. The multidisciplinary rehabilitation improved functional status in PD patients and exerted its positive effects on mood, motor abilities, autonomy in the activities of daily life, perception of quality of life, cognitive performance and speech skills. Non-motor symptoms may worsen severe disability and reduce quality of life. They are often poorly recognized and inadequately treated. Nonetheless, multidisciplinary rehabilitative training represents an optimal strategy to improve disease management. The study was approved by Istituito di Ricovero e Cura a Carattere Scientifico (IRCCS) Centro Neurolesi “Bonino-Pulejo” Ethical Committee (approval No. 6/2016) in June 2016. 相似文献
6.
Kamrul Hasan Shivakumar Shankar Aadhar Sharma Alison Carter Razi Zaidi Suzie Cro John Skinner Andy Goldberg 《Journal of orthopaedics and traumatology》2016,17(4):291-295
Background
The burden of traumatic and elective hip surgery is set to grow. With an increasing number of techniques and implants against the background of an aging population, the emphasis on evidence-based treatment has never been greater. The purpose of this study was to assess changes in the levels of evidence in the hip literature over a decade.Materials and methods
Articles pertaining to hip surgery from the years 2000 and 2010 in Hip International, Journal of Arthroplasty, Journal of Bone and Joint Surgery and The Bone and Joint Journal were analysed. Articles were ranked by a five-point level of evidence scale and by type of study, according to guidelines from the Centre for Evidence-based Medicine.Results
531 articles were analysed from 48 countries. The kappa value for the inter-observer reliability showed excellent agreement between the reviewers for study type (κ = 0.956, P < 0.01) and for levels of evidence (κ = 0.772, P < 0.01). Between 2000 and 2010, the overall percentage of high-level evidence (levels I and II) studies more than doubled (12 to 31 %, P < 0.001). The most frequent study type was therapeutic; the USA and UK were the largest producers of published work in these journals, with contributions from other countries increasing markedly over the decade.Conclusions
There has been a significant increase in high levels of evidence in hip surgery over a decade (P < 0.001). We recommend that all orthopaedic journals consider implementing compulsory declaration by authors of the level of evidence to help enhance quality of evidence.Level of evidence
Level 2: economic and decision analysis.7.
In this paper, by applying a feminist bioethical perspective, we identify a new form of medical paternalism that still shapes contemporary legal policies on human egg cryopreservation performed without medical reasons. The fear of negligent, careless women who opt to delay their pregnancy for mere convenience is a widely known gender biased stereotype. Nevertheless, the opinions and judgments of medical professionals on this issue have not yet been sufficiently explored by in-depth research. In this essay, therefore, first we look at the broader bioethical, legal, and social aspects of human egg cryopreservation. In the second part of the paper we discuss a unique qualitative study conducted with professionals working at Hungarian IVF clinics. We argue, based on a bioethical analysis of the collected data, that when new reproduction technologies provide opportunities for women to widen their range of reproductive choices, the traditional forms of medical paternalism can be reinforced by gendered paternalism, as well. We identify several elements of gendered paternalism that characterized the attitudes of the IVF staff and discuss the professionals’ resistance to elective egg freezing and vitrification of eggs for the future. We conclude by suggesting directions for future policy. Although we focus on the Hungarian case in this paper, we are aware that similar attitudes can be observed in some other countries where this technology has become available and requested by women, but where they also face difficulties in their access to it. 相似文献
8.
A. Loforte A. MontaltoP. Lilla della Monica A. LappaC. Contento A. MenichettiF. Musumeci 《Transplantation proceedings》2014
Background
Currently, ventricular assist device (VAD) or total artificial heart (TAH) mechanical support provides an effective treatment of unstable patients with advanced heart failure. We report our single-center experience with mechanical circulatory support therapy.Methods
From March 2002 to December 2012, 107 adult patients (mean age, 56.8 ± 9.9 y; range, 31–76 y) were primarly supported on temporary or long-term VAD or TAH support as treatment for refractory heart failure at our institution. Temporary extracorporeal radial VAD support (group A) was established in 49 patients (45.7%), and long-term paracorporeal and intracorporeal VAD or TAH (group B) in 58 patients (54.2%). Left ventricular (LVAD) support was established in 55 patients (51.4%; n = 33, Heartmate II; n = 6, Heartmate I XVE; n = 4, Heartware HVAD; and n = 12, Centrimag) and biventricular (BVAD/TAH) support (group B) in 28 patients (26.1%; n = 10, Thoratec paracorporeal; n = 2, Heartware HVAD, n = 1, Thoratec implantable; n = 1, Syncardia TAH; and n = 14, Centrimag). The temporary Centrimag was the only device adopted as isolated right ventricular (RVAD) support, and it was inserted in 24 patients (22.4%).Results
In group A, overall mean support time was 10.2 ± 6.6 days (range, 3–43 d). In group B, LVAD mean support time was 357 ± 352.3 days (range, 1–902 d) and BVAD/TAH support time was 98 ± 82.6 days (range, 8–832 d). In group A, the overall success rate was 55.1% (27 patients). In group B, LVAD overall success rate was 74.4% (32 patients) and BVAD/TAH success rate was 50% (7 patients). Overall heart transplantation rate for both groups was 27.1% (n = 2, group A; n = 27, group B). Overall 1-year and 5-year survivals after heart transplantation were 72.4% (n = 21) and 58.6% (n = 17), respectively.Conclusions
Mechanical circulatory support is an effective strategy even in cases of end-stage heart failure according to our experience. Further improvement of VAD and TAH technologies may support their adoption as an encouraging alternative to heart transplantation in the near future. 相似文献9.
Imran A Siddiqui Shiraz A Sabah Keshthra Satchithananda Adrian K Lim Suzie Cro Johann Henckel John A Skinner Alister J Hart 《Acta orthopaedica》2014,85(4):375-382
Background and purpose
Metal artifact reduction sequence (MARS) MRI and ultrasound scanning (USS) can both be used to detect pseudotumors, abductor muscle atrophy, and tendinous pathology in patients with painful metal-on-metal (MOM) hip arthroplasty. We wanted to determine the diagnostic test characteristics of USS using MARS MRI as a reference for detection of pseudotumors and muscle atrophy.Patients and methods
We performed a prospective cohort study to compare MARS MRI and USS findings in 19 consecutive patients with unilateral MOM hips. Protocolized USS was performed by consultant musculoskeletal radiologists who were blinded regarding clinical details. Reports were independently compared with MARS MRI, the imaging gold standard, to calculate predictive values.Results
The prevalence of pseudotumors on MARS MRI was 68% (95% CI: 43–87) and on USS it was 53% (CI: 29–76). The sensitivity of USS in detecting pseudotumors was 69% (CI 39–91) and the specificity was 83% (CI: 36–97). The sensitivity of detection of abductor muscle atrophy was 47% (CI: 24–71). In addition, joint effusion was detected in 10 cases by USS and none were seen by MARS MRI.Interpretation
We found a poor agreement between USS and MARS MRI. USS was inferior to MARS MRI for detection of pseudotumors and muscle atrophy, but it was superior for detection of joint effusion and tendinous pathologies. MARS MRI is more advantageous than USS for practical reasons, including preoperative planning and longitudinal comparison.Approximately 1.5 million metal-on-metal (MOM) hip arthroplasties have been implanted worldwide since 1996 (FDA 2012). A high early failure rate for these prostheses has recently been demonstrated (Smith et al. 2012). The pattern of failure appears to differ from other hip arthroplasty types, with adverse reactions to wear-related metal debris being a prominent feature (Pandit et al. 2008, Kwon et al. 2011). These solid or cystic lesions have been termed pseudotumors (Pandit et al. 2008). A wide spectrum of adverse tissue reactions have been described. Histologically, using their pseudocapsules, these have been termed aseptic lymphocytic vasculitis-associated lesions (ALVALs) (Willert et al. 2005).Health regulatory guidelines recommend investigation with cross-sectional imaging, using either metal artifact reduction sequence (MARS) MRI or ultrasound scanning (USS), to evaluate the periprosthetic soft tissues. A number of advantages and disadvantages have been reported (Sabah et al. 2011, Liddle et al. 2013). The high-resolution capability of USS allows detailed imaging of solid or cystic extra-articular lesions and also detection of muscle atrophy (Sofka et al. 2004), joint effusions, gluteal tendon avulsion, and iliopsoas or trochanteric bursitis (Long et al. 2012). USS is also commonly used during guided anesthetic injection or fluid aspiration.Table 1.
A comparison of the advantages and disadvantages of MARS MRI and ultrasound imaging of metal-on-metal hipsUltrasound | MARS MRI | |
---|---|---|
1) Clinical evaluation | No metal artifact produced. Operator-dependent; requires an experienced musculoskeletal sonographer. Must be reported at the time of scanning. | Not operator dependant. Can be reported later. Images can be sent off-site for specialist opinion. Useful during preoperative planning for revision arthroplasty (Hart et al. 2012). |
a) Pseudotumors | Excellent at visualizing extra-articular fluid collections (including within the iliopsoas and trochanteric bursa). Can differentiate easily between solid and fluid composition. Deep posterior lesions and small lesions can often be missed (Nishii et al. 2012). | High sensitivity for the detection of solid and cystic soft tissue lesions including both small lesions and posterior lesions (Hart et al. 2012, Liddle et al. 2013). |
b) Muscles | Dual-view function can be used to simultaneously compare muscles on contralateral sides. Currently not validated to assess muscle atrophy of the hip rotator cuff. | T1-weighted images excellent for assessment of the degree of muscle atrophy (Bal and Lowe 2008, Sabah et al. 2011). Complete cross-sectional imaging allows easy comparison with the contralateral side. Images can be accurately compared over time. |
c) Other pathology | Sensitive for joint effusion diagnosis (Foldes et al. 1992). Can visualize the iliopsoas and gluteal tendons in detail. Can be used to detect tendon avulsion of hip abductor muscles (Garcia et al. 2010). Dynamic imaging is possible. Hands-on examination can help localize pathology. | Sensitive modality for the assessment of gluteal tendon avulsion. Other pathology can be identified, including metastatic disease, fractures, and muscle and bone marrow edema. Metal artifact may obscure effusions and tendons directly adjacent to the implant. |
2) Patient acceptability | Safe, with no major contraindications (can be used on patients with cardiac pacemaker implants). No problems with claustrophobia. Non-invasive. Invasive when used for guided fluid aspiration or injection. |
Enclosed space often unacceptable to patients with claustrophobia.
Contraindicated in patients with incompatible metallic implants (e.g. a cardiac pacemaker). |
3) General | Relatively low costs. Compact equipment requires minimal space. Often readily accessible in smaller healthcare trusts. |
Relatively expensive.
The bulky equipment requires a relatively large space. May not be accessible in smaller healthcare trusts. |
10.
Mouse leukemia L1210 cells selected for resistance to drugs targeted specifically at each of the protein subunits of ribonucleotide reductase were studied for their ability to grow in vivo. The life-span of the mice injected with hydroxyurea-resistant L1210 cells, which have elevated levels of the mRNA and protein for the non-heme iron (NHI, R2) subunit of ribonucleotide reductase, was approximately twice that of the mice injected with equal numbers of the parental wild-type L1210 leukemia cells. The life-span of mice injected with the L1210 cells that had alterations in the effector-binding subunit (EB, R1) was considerably shorter than the mice injected with the parental wild-type L1210 cells. These results provide direct evidence that tumor cells with alterations in the properties of ribonucleotide reductase grow differently in vivo, with defined effects on the host mouse that cause either an increased survival time or a decreased survival time compared to the effects of wild-type L1210 leukemia cells on tumor-bearing mice. 相似文献