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B Gerdts AFPM Vloemans RW Kreis 《Journal of the European Academy of Dermatology and Venereology》2007,21(6):781-788
BACKGROUND: Toxic epidermal necrolysis (TEN) is a severe and potentially fatal drug reaction characterized by an extensive skin rash with blisters and exfoliation, frequently accompanied by mucositis. The wounds caused by TEN are similar to second-degree burns and severe cases may involve large areas of skin loss. OBJECTIVES: Analysis of our results in patients with TEN and evaluation of the variety of therapeutic interventions that has been studied and suggested in TEN. PATIENTS/METHODS: Retrospective analysis of 19 consecutive patients with TEN treated in our burns centre between 1989 and 2004. RESULTS: Immediate withdrawal of any potentially fatal drug, maximum supportive care, and a restricted and tailored antibiotic, medical and surgical treatment regimen confined mortality to 21%, whereas prognosis scores like APACHE II and SCORTEN predicted mortality of 22 and 30%, respectively. A positive contribution of selective digestive decontamination is suggested but has yet to be established. CONCLUSIONS: Because of a potentially fatal outcome, fast referral of a patient suspected of TEN to a specialized centre (mostly a burns unit or specialized dermatology centre) for expert wound management and tailored comprehensive care is strongly advised and contributes to survival. 相似文献
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1背景 育龄妇女常见慢性下腹痛,可造成身体损害、情绪忧伤及导致巨大的健康服务费用。美国在这方面的花费超过8亿8千万美元(Mathias 1996)。英国全国数据库的一般性诊治资料显示,慢性下腹痛发病率及流行率与偏头痛、背部痛、哮喘发病率相似(Zondervan 1999)。 相似文献
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This study investigates thyroid control of growth and energy metabolism plus growth-dependent and growth-independent behavioral effects of thyroid manipulation in lizards. Experiments were done on surgically thyroidectomized (Tx) and sham-operated (Sh) yearling Sceloporus undulatus enclosed in their natural habitat. Lizards were placed in an outdoor enclosure in early August. Growth rate was measured and behavior was observed until mid-October. Subsequently, lizards were returned to the lab for measurements of plasma thyroxine (T4), standard metabolic rate (SMR), and running endurance. Thyroidectomy reduced plasma T4 from 4.3 +/- 0.56 ng/ml to undetectable levels (P = 0.006) and SMR by 44% (P less than 0.0001). Thyroid deficiency produced a threefold reduction in growth rate (Tx: 0.04 +/- 0.010 mm/day, n = 12 vs Sh: 0.11 +/- 0.006 mm/day, n = 11, P less than 0.0001). Growth rate was correlated with SMR among individuals (length-specific: r = 0.55, P = 0.027, n = 16), even after statistical removal of mass and treatment effects. The total volume of oxygen consumed for standard metabolism during the growth period, as estimated from allometric equations, was correlated with cumulative growth (R2 = 0.94, P = 0.013) and was significantly lower for thyroid-deficient lizards than for controls (P less than 0.0001). Distance moved in the field and running endurance on a treadmill both scaled on body mass (M0.98 +/- 0.418, P = 0.030 and M1.72 +/- 0.763, P = 0.040, respectively), indicating that larger lizards moved farther and had greater stamina than their smaller counterparts. Neither of these behavioral factors was affected directly by thyroid status. Thyroid-deficient lizards were active for a smaller percentage of the day than controls (Tx: 42.6 +/- 5.7%, n = 11 vs Sh: 57.4 +/- 3.2%, n = 12, P = 0.040), independent of differences in body size. On an interindividual basis, the frequency of activity was significantly correlated with SMR (r = 0.57, P = 0.020, n = 16) and growth rate (mass-specific: r = 0.47, P = 0.025, n = 23). 相似文献
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Dou Q; Tarnuzzer RW; Williams RS; Schultz GS; Chegini N 《Molecular human reproduction》1997,3(11):1005-1014