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K A Burkman R W Gaines S R Kashani R D Smith 《Archives of physical medicine and rehabilitation》1988,69(2):132-134
Herpes zoster probably occurs more often than generally thought. Since it produces a radicular distribution of pain, it should be included in the differential diagnosis of radiculopathy. A case is presented in which evaluating the radicular low back pain before the characteristic rash appears was misleading. Careful history-taking concerning the exact nature of the pain and sensory changes is needed to differentiate between zoster and radiculopathy, if no rash is evident. 相似文献
3.
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
4.
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
5.
E M Sacks L L Fajardo B J Hillman G W Drach J A Gaines H R Claypool N J Clinger D J Fillmore K R Hunt G D Pond 《The Journal of urology》1990,144(6):1341-1346
Most publications citing the effectiveness of renal extracorporeal shock wave lithotripsy have used plain abdominal radiography to assess residual calculi after treatment. We compared radiologist sensitivity and specificity in the detection of calculi on plain abdominal radiographs versus conventional film-screen and digital renal tomograms in extracorporeal shock wave lithotripsy patients. Of the patients 50 were imaged before and within 24 hours after lithotripsy. Six radiologists evaluated the resultant 300 studies for the presence and location of calculi. The mean sensitivity for digital tomograms was 83% for pre-lithotripsy and post-lithotripsy studies, which was significantly higher than for plain abdominal radiography and conventional tomography after lithotripsy. However, there were significantly more false positive stone diagnoses associated with digital tomogram interpretation. Signal detection analysis verified the over-all superiority of digital tomography for post-extracorporeal shock wave lithotripsy imaging. Calculus detection by conventional and digital tomography is superior to detection by plain abdominal radiography. However, because we did not perform delayed imaging, it is not possible to say what impact digital tomography might have on the management of extracorporeal shock wave lithotripsy patients. 相似文献
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A comparative analysis of radiological and surgical placement of central venous catheters 总被引:3,自引:1,他引:2
Kieran D. McBride Ross Fisher Neil Warnock David A. Winfield Malcolm W. Reed Peter A. Gaines 《Cardiovascular and interventional radiology》1997,20(1):17-22
Purpose To compare the differences in practice and outcome of all radiologically and surgically placed central venous catheters retrospectively
over a 2-year period simultaneously, at a single institution.
Methods A total of 253 Hickman catheters were inserted in 209 patients; 120 were placed radiologically in 102 patients and 133 were
placed surgically in 107 patients. The indication was chemotherapy in 76% of radiological and in 47% of surgical cases; the
remainder were for total parenteral nutrition and venous access.
Results There were 6 (4.5%) primary surgical failures and a further 17 (13%) surgical cases requiring multiple placement attempts.
Pneumothorax occurred once (0.8%) surgically and four times (3.3%) radiologically. There were no radiological primary misplacements
but there were five (3.7%) surgical ones. Catheter or central vein thrombosis occurred in four (3.3%) radiological and five
(3.7%) surgical cases. The rate of infection per 1000 catheter-days was 1.9 in radiologically placed catheters and 4.0 in
surgically placed ones (p<0.001). Average catheter life-span was similar for the two placement methods (100±23 days).
Conclusion Radiological placement is consistently more reliable than surgical placement. There are fewer placement complications and
fewer catheter infections overall. 相似文献
8.
Timothy J. Hodgson Peter A. Gaines Jonathon D. Beard 《Cardiovascular and interventional radiology》1994,17(6):333-335
Acute lower limb ischemia secondary to Buerger's disease in a young patient responded to thrombolysis and subsequent popliteal and anterior artery angioplasty. The value of angioplasty in non-limb-threatening ischemia in Buerger's disease has not been established but this case illustrates a role for thrombolysis and angioplasty in acute ischemia. 相似文献
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