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1.
2.
Bombings and explosion incidents directed against innocent civilians are the primary instrument of global terror. In the present
review we highlight the major observations and lessons learned from these events. Five mechanisms of blast injury are outlined
and the different type of injury that they cause is described. Indeed, the consequences of terror bombings differ from those
of non-terrorism trauma in severity and complexity of injury, and constitute a new class of casualties that differ from those
of conventional trauma. The clinical implications of terror bombing, in treatment dilemmas in the multidimensional injury,
ancillary evaluation and handling of terror bombing mass casualty event are highlighted. All this leads to the conclusion
that thorough medical preparedness to cope with this new epidemic is required, and that understanding of detonation and blast
dynamics and how they correlate with the injury patterns is pivotal for revision of current mass casualty protocols. 相似文献
3.
Menahem Neuman Boris Friedman Avi Stein A. Ami Sidi Alexander Tsivian 《Gynecological surgery》2007,4(3):175-178
The objective of the study was to compare the clinical outcomes at the short-term follow-ups of two novel transobturator mid-urethral
sling procedures – the transobturator tape (TOT) procedure and the tension-free vaginal tape (TVT)-obturator procedure. The
study cohort consisted two groups of 40 women with urodynamically proven stress urinary incontinence (SUI). The patients in
one group underwent the TOT procedure, performed according to Delorme (Prog Urol 11:1306–1313, 2001); those in the second
group underwent the TVT-obturator operation, performed according to de Leval (Eur Urol 44:724–730, 2003). Intra-operative
diagnostic cystoscopy was not performed with either the TVT-obturator or the TOT procedures. The average follow-up was 12 months.
The two patient groups were similar in terms of demographic and therapeutic criteria, except for patient age, which was significantly
younger in the TVT-obturator group. Previously reported TVT-related operative complications, such as bladder penetration,
intra-operative bleeding, field infection and post-operative pelvic floor relaxation, were not observed in patients of either
group. Bowel and urethral injuries were also not recorded. The therapeutic failure rates were 10% for the TOT procedure and
5% for the TVT-obturator procedure. Urinary frequency and urgency post-operatively were reported in 25% of the TOT patients
and 19% of the TVT-obturator patients, pelvic or vaginal pain affected 10% of the TOT and 5% of the TVT-obturator patients,
while post-operative voiding difficulty was experienced by 12.5% of the TOT and 7.5% of the TVT-obturator patients. None of
the above-mentioned differences between the two patient groups were of statistical significance. The TVT-obturator and TOT
procedures, both minimally invasive, novel, mid-urethral sling procedures, seem to be safe, easy-to-perform and effective
in treating female SUI. The patients of both study groups suffered less intra- and post-operative surgical complications than
previously been reported in connection with the TVT operation. The TVT-obturator patients had fewer therapeutic failures,
less post-operative urinary frequency and urgency, less pelvic pain and less voiding difficulty. All of these findings, however,
had no statistical significance; consequently, long-term comparative data collection will be required before solid conclusions
can be drawn on the superiority of either of these two operative techniques. 相似文献
4.
Woo PC Lau SK Wong BH Tsoi HW Fung AM Kao RY Chan KH Peiris JS Yuen KY 《Journal of clinical microbiology》2005,43(7):3054-3058
The use of recombinant severe acute respiratory syndrome-coronavirus (SARS-CoV) nucleocapsid protein (N) enzyme-linked immunosorbent assay (ELISA)-based antibody and antigen tests for diagnosis of SARS-CoV infections have been widely reported. However, no recombinant SARS-CoV spike protein (S)-based ELISA is currently available. In this article, we describe the problems and solutions of setting up the recombinant SARS-CoV S-based ELISA for antibody detection. The SARS-CoV S-based immunoglobulin M (IgM) and IgG ELISAs were evaluated and compared with the corresponding N-based ELISA for serodiagnosis of SARS-CoV pneumonia, using sera from 148 healthy blood donors who donated blood 3 years ago as controls and 95 SARS-CoV pneumonia patients in Hong Kong. Results obtained by the recombinant S (rS)-based IgG ELISA using the regenerated S prepared by dialysis with decreasing concentrations of urea or direct addition of different coating buffers, followed by addition of different regeneration buffer, identified 4 M urea and 1 M sarcosine for plate coating and no regeneration buffer as the most optimal conditions for antibody detection. The specificities of the S-based ELISA for IgG and IgM detection were 98.6% and 93.9%, with corresponding sensitivities of 58.9% and 74.7%, respectively. The sensitivity of the rN IgG ELISA (94.7%) is significantly higher than that of the rS IgG ELISA (P < 0.001), whereas the sensitivity of the rS IgM ELISA is significantly higher than that of the rN IgM ELISA (55.2%) (P < 0.01). An ELISA for detection of IgM against S and N could be more sensitive than one that detects IgM against N alone for serodiagnosis of SARS-CoV pneumonia. 相似文献
5.
The Israeli Sexual Behavior Inventory (ISBI): Scale Construction and Preliminary Validation 总被引:1,自引:0,他引:1
This study describes the construction and preliminary validation of the Israeli Sexual Behavior Inventory (ISBI). The ISBI was primarily designed to assess the impact of sexual problems, chronic illness and disability on sexual functioning and experience. Scales were designed to measure three areas of healthy sexual functioning and three areas of sexual dysfunction for both males and females. To provide normative data to which clinical samples can be compared, a large randomly selected sample from an adult male and female population was used for scale construction and preliminary validation. Scale reliabilities, intercorrelations between the ISBI scales, comparisons between the above sample and a clinical sample provide evidence of the ISBI's reliability and validity. 相似文献
6.
Ji Chen Maureen M. Henneman Mark A. Trimble Jeroen J. Bax Salvador Borges-Neto Ami E. Iskandrian Kenneth J. Nichols Ernest V. Garcia 《Journal of nuclear cardiology》2008,15(1):127-136
Cardiac resynchronization therapy (CRT) has shown benefits in patients with severe heart failure. However, at least 30% of
patients selected for CRT by use of traditional criteria (New York Heart Association class III or IV, depressed left ventricular
[LV] ejection fraction, and prolonged QRS duration) do not respond to CRT. Recent studies with tissue Doppler imaging have
shown that the presence of LV dyssynchrony is an important predictor of response to CRT. Phase analysis has been developed
to allow assessment of LV dyssynchrony by gated single photon emission computed tomography myocardial perfusion imaging. This
technique uses Fourier harmonic functions to approximate regional wall thickness changes over the cardiac cycle and to calculate
the regional onset-of-mechanical contraction phase. Once the onset-of-mechanical contraction phases are obtained 3-dimensionally
over the left ventricle, a phase distribution map is formed that represents the degree of LV dyssynchrony. This technique
has been compared with other methods of measuring LV dyssynchrony and shown promising results in clinical evaluations. In
this review the phase analysis methodology is described, and its up-to-date validations are summarized. 相似文献
7.
Study Type – Therapy (case series) Level of Evidence 4 What’s known on the subject? and What does the study add? Laparoscopic nephron‐sparing procedures have been increasingly utilized. However, in the presence of multiple tumours the procedure choice is usually shifted to radical nephrectomy. In view of favourable perioperative outcomes, the benefits of minimally‐invasive, nephron‐sparing surgery in experienced hands could be safely extended to patients presenting with multiple ipsilateral renal masses.
OBJECTIVE
- ? To describe our experience with laparoscopic partial nephrectomy (LPN) for multiple kidney tumours and compare the outcomes with LPN performed for single masses.
PATIENTS AND METHODS
- ? Retrospective analysis of medical records of patients undergoing LPN at our institution between 2005 and 2009 was performed.
- ? The cohort was divided in two groups based on tumour focality: group 1, LPN for a single tumour (n= 99) and group 2, LPN for multiple ipsilateral tumours (n= 12).
- ? The groups were compared with regards to demographic and peri‐operative variables.
RESULTS
- ? Demographic variables were not different between the groups. Median dominant tumour size was 3.1 cm (interquartile range [IQR] 2.4–4.0) and 4.0 cm (2.3–5.9) in groups 1 and 2, respectively.
- ? Median secondary tumour size in group 2 was 1.0 cm (1.0–1.8).
- ? Operative times were longer in group 2 compared with group 1 (220 vs 160 min, P= 0.009).
- ? Warm ischaemia times (WIT) (23 vs 22 min) and estimated blood loss (EBL) (100 vs 85 mL) were similar.
CONCLUSIONS
- ? LPN is a viable option for the treatment of multiple ipsilateral renal tumours.
- ? Peri‐operative outcomes are similar to standard LPN with the exception of longer operative time.
- ? In experienced hands, the advantages of minimally invasive surgery may be extended to select patients with ipsilateral multifocal renal tumours.
8.
Abstract: Background: The acceptance and application of the concept that brain death is a valid determination of death is the central issue in organ donation. However, whether attitude to brain death of health care professionals influences the organ procurement process has not been systematically studied.
Methods: Questionnaires were distributed to health care professionals involved in the organ procurement process (intensive care, internal medicine, emergency room, anesthesia) in all hospitals in Israel. Attitude to brain death (defined as positive if the respondent accepted brain death as a valid determination of death, negative or do not know) and level of comfort in performing key donor-related tasks were analyzed.
Results: A total of 2366 completed questionnaires were returned (629 doctors and 1737 nurses; response rate 60.3%). Overall, 78.9% of respondents had a positive attitude to brain death. This was significantly associated with increasing age, higher professional status and was most prevalent amongst intensive care unit staff (p < 0.001 for all variables). These respondents felt significantly more comfortable informing the transplant coordinator of a potential donor, explaining brain death to the family, raising the subject of organ donation, approaching the family about donation and providing support to the grieving family. In addition, they believed the transplant coordinator should be involved early in the donation process.
Conclusions: The understanding and acceptance of brain death as a valid determination of death was associated with a positive effect on the level of comfort of health care professionals in performing key donor-related tasks. Reinforcing a positive attitude to brain death among health care professionals may facilitate the procurement process. 相似文献
Methods: Questionnaires were distributed to health care professionals involved in the organ procurement process (intensive care, internal medicine, emergency room, anesthesia) in all hospitals in Israel. Attitude to brain death (defined as positive if the respondent accepted brain death as a valid determination of death, negative or do not know) and level of comfort in performing key donor-related tasks were analyzed.
Results: A total of 2366 completed questionnaires were returned (629 doctors and 1737 nurses; response rate 60.3%). Overall, 78.9% of respondents had a positive attitude to brain death. This was significantly associated with increasing age, higher professional status and was most prevalent amongst intensive care unit staff (p < 0.001 for all variables). These respondents felt significantly more comfortable informing the transplant coordinator of a potential donor, explaining brain death to the family, raising the subject of organ donation, approaching the family about donation and providing support to the grieving family. In addition, they believed the transplant coordinator should be involved early in the donation process.
Conclusions: The understanding and acceptance of brain death as a valid determination of death was associated with a positive effect on the level of comfort of health care professionals in performing key donor-related tasks. Reinforcing a positive attitude to brain death among health care professionals may facilitate the procurement process. 相似文献
9.
The distribution of vascular endothelial growth factor in human meniscus and a meniscal injury model
Zhichao Lu Takayuki Furumatsu Masataka Fujii Ami Maehara Toshifumi Ozaki 《Journal of orthopaedic science》2017,22(4):715-721
Background
The meniscus plays an important role in controlling the complex biomechanics of the knee. Meniscus injury is common in the knee joint. The perimeniscal capillary plexus supplies the outer meniscus, whereas the inner meniscus is composed of avascular tissue. Angiogenesis factors, such as vascular endothelial growth factor (VEGF), have important roles in promoting vascularization of various tissues. VEGF-mediated neovascularization is beneficial to the healing of injured tissues. However, the distribution and angiogenic role of VEGF remains unclear in the meniscus and injured meniscus. We hypothesized that VEGF could affect meniscus cells and modulate the meniscus healing process.Methods
Menisci were obtained from total knee arthroplasty patients. Meniscal injury was created ex vivo by a microsurgical blade. VEGF mRNA and protein expression were detected by the polymerase chain reaction and immunohistochemical analyses, respectively.Results
In native meniscal tissue, the expression of VEGF and HIF-1α mRNAs could not be detected. However, VEGF and HIF-1α mRNAs were found in cultured meniscal cells (VEGF: outer > inner; HIF-1α: outer = inner). Injury increased mRNA levels of both VEGF and HIF-1α, with the increase being greatest in the outer area. Immunohistochemical analyses revealed that VEGF protein was detected mainly in the outer region and around injured areas of the meniscus. However, VEGF concentrations were similar between inner and outer menisci-derived media.Conclusions
This study demonstrated that both the inner and outer regions of the meniscus contained VEGF. HIF-1α expression and VEGF deposition were high in injured meniscal tissue. Our results suggest that injury stimulates the expression of HIF-1α and VEGF that may be preserved in the extracellular matrix as the healing stimulator of damaged meniscus, especially in the outer meniscus. 相似文献10.
Asma Dilawari Christopher Gallagher Princess Alintah Ami Chitalia Shruti Tiwari Richard Paxman Lucile Adams-Campbell Chiranjeev Dash 《The oncologist》2021,26(4):292-e548
Lessons Learned
- Despite U.S. Food and Drug Administration approval to reduce alopecia, data on efficacy of scalp cooling in Black patients with cancer are limited by lack of minority representation in prior clinical trials.
- Scalp cooling devices may have less efficacy in Black patients; additional studies are required to explore the possible causes for this, including hair texture and cap design.