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Kazumasa Fujitani Jaffer A. Ajani Christopher H. Crane Barry W. Feig Peter W. Pisters Nora Janjan Garrett L. Walsh Stephen G. Swisher Ara A. Vaporciyan David Rice Angela Welch Jackie Baker Josephine Faust Paul F. Mansfield MD 《Annals of surgical oncology》2007,14(4):1305-1311
Background Significant tumor downstaging has been achieved in patients with localized gastric or gastroesophageal adenocarcinoma by induction
chemotherapy and preoperative chemoradiotherapy (CTX–CTXRT). However, the influence of CTX–CTXRT on operative morbidity and
mortality has not yet been clarified. The aim of the present study was to document the frequency and nature of morbidity and
mortality after surgery combined with CTX–CTXRT, and identify factors predictive of postoperative complications in patients
with localized gastric or gastroesophageal adenocarcinoma.
Methods A prospectively collected database on 71 consecutive patients who underwent CTX–CTXRT at M.D. Anderson Cancer Center between
January 1997 and August 2004 was reviewed. Postoperative morbidity and mortality were investigated, and risk factors for overall
complications were identified by multivariate logistic regression analysis.
Results Overall morbidity and mortality rates were 38.0% (27 patients) and 2.8% (2 patients), respectively. Age greater than 60 years
[relative risk 11.3 (95% confidence interval 2.50–50.6)] and body mass index (BMI) of 26 kg/m2 or above [relative risk 4.08 (95% confidence interval 1.08–15.4)] were significant risk factors for overall complications.
Conclusions CTX–CTXRT can be performed safely with an acceptable operative morbidity and a low operative mortality rate in patients with
gastric or gastroesophageal cancer, with careful consideration of added risk associated with age and obesity. 相似文献
3.
AE Castellano G Micieli P Bellantonio MG Buzzi S Marcheselli F Pompeo F Rossi G Nappi 《Cephalalgia : an international journal of headache》1998,18(9):622-630
Intracerebral vascular reactivity induced by the nitric oxide (NO) donor isosorbide dinitrate (IDN, 5 mg sublingually) is more major and longer-lasting in migraine patients who develop delayed headache in response to the drug. The headache is purportedly due to neuronally-mediated vascular mechanisms. Indomethacin inhibits prostaglandin synthesis, which is involved in NO generation. Indomethacin also decreases cerebral blood flow by constricting precapillary resistance vessels. In the present study, the hemodynamic effects of indomethacin were evaluated in migraine patients and healthy controls by means of transcranial Doppler monitoring. Indomethacin caused a significant decrease in mean flow velocity in the middle cerebral artery. This was an additional effect to the mean velocity decrease induced by IDN. The interactions between the two drugs suggest that their effects on cerebral hemodynamics (and pain) may be of relevance both in understanding the role of NO in migraine pathogenesis and in evaluating symptomatic treatments for migraine attacks. 相似文献
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Luis Bell Vishnu Bhat Grace George Abolade Ajani Awotedu Bomkazi Gqaza 《Suid-Afrikaanse tydskrif vir geneeskunde》2007,97(5):374-377
OBJECTIVE: To examine glucose tolerance in sputum-positive non-treated pulmonary tuberculosis (TB) patients as part of a general metabolic profile. Subjects. Sixty-three sputum-positive non-treated patients (male and female) attending the pulmonary clinic at Mthatha General Hospital in the Eastern Cape and 89 apparently healthy sex and age-matched volunteers. METHODS: Sixty-three untreated TB patients who came to the Mthatha General Hospital's pulmonary clinic with classic symptoms of TB, confirmed by sputum analysis, were recruited for the study. Eighty-nine apparently healthy sex and age-matched volunteers served as the control group. Anthropometric measurements were taken using an electronic scale. Standard oral glucose tolerance tests (OGTTs) were performed in both groups in the morning after an overnight fast. Anticoagulant-treated blood was analysed for glucose and insulin using Peridochrome Glucose (Boehringer Mannheim, Mannheim, Germany) and radioimmunoassay (RIA) (Diagnostic Products Corporation, Los Angeles, USA) respectively. RESULTS: There was sluggish response to glucose and insulin in the TB patient group compared with the control group. Glucose and insulin levels were significantly higher in patients at 0, 30, 60, 120, and 180 minutes. Analysis of variance gave the following p-values, viz. p = 0.0000, 0.0004, 0.0000, 0.0000 and 0.0000 for glucose, and p = 0.0317, 0.0071, 0.0000, 0.0005 and 0.0000 for insulin respectively. CONCLUSIONS: The results of this study suggest an altered glucose/insulin metabolism in TB patients. This might play an important role in the clinical course of the disease. 相似文献
6.
The effect of a continuous i.v. infusion of alpha-difluoromethylornithine (DFMO) on the polyamine metabolism of tumor and normal host tissue was determined. Non-tumor-bearing Fischer 344 rats or rats bearing a transplantable fibrosarcoma received continuous infusions of DFMO through a central venous catheter at three dose levels. Treatment with DFMO resulted in a time- and dose-dependent, cytostatic effect on the growth of the tumor. In fibrosarcoma-bearing rats the tumor putrescine levels were reduced after 6 and 12 days of DFMO treatment. Tumor spermidine levels were consistently reduced after 6 and 12 days of treatment with the reduction being dose dependent. The decrease in tumor ornithine decarboxylase activity was dose dependent. Erythrocyte putrescine levels were decreased in tumor- and non-tumor-bearing rats, suggesting that DFMO reduces the tumor contribution to the erythrocyte pool. Erythrocyte spermidine levels of fibrosarcoma- and non-tumor-bearing rats were elevated at the lower DFMO doses administered for 12 days but returned to normal as the dose was increased. Erythrocyte spermine levels were elevated in both groups of rats at all DFMO doses. Although normal host tissue weights were not affected by treatment with DFMO, the putrescine and spermidine levels of liver, spleen, and kidney and ornithine decarboxylase activity of the liver and kidney were decreased. These data demonstrate that i.v. DFMO has a cytostatic effect toward a rapidly growing fibrosarcoma associated with the depletion of both tumor putrescine and spermidine levels. 相似文献
7.
AE Boothroyd BVS Murthy A Darbyshire AJ Petros 《Acta paediatrica (Oslo, Norway : 1992)》1996,85(12):1422-1425
Objective: Right upper lobe collapse is a common radiographic finding in intubated children. We hypothesized that deep suctioning and uncontrolled negative pressures during endotracheal tube suctioning were significant contributory factors. Methods : The incidence of right upper lobe (RUL) collapse in intubated, ventilated children on a paediatric cardiac intensive care unit was determined over a 3-month period ( n = 102). Graduated suction catheters and suction vacuums of < 165 cm H2 O were then introduced. Another prospective audit was carried out 3 months later ( n = 60). Results : We found that 24% developed RUL collapse and 4 developed an apical pneumothorax. Following the introduction of graduated catheters and controlled vacuums pressures, a significant reduction in the incidence of RUL collapse, to 7%, was observed ( p < 0.05). Conclusions : We conclude that high negative pressure and deep-suctioning causes RUL collapse in children. Any lobar collapse not only prolongs the child's stay in intensive care, but can be associated with further morbidity which may have a serious implication. By improving suctioning technique this morbidity can be significantly reduced. 相似文献
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10.
Short-term therapy for recurrent abortion using intravenous immunoglobulins: results of a double-blind placebo-controlled Italian study 总被引:1,自引:3,他引:1
Perino A; Vassiliadis A; Vucetich A; Colacurci N; Menato G; Cignitti M; Semprini AE 《Human reproduction (Oxford, England)》1997,12(11):2388-2392
It is still unclear whether i.v. immunoglobulins (Ig) can facilitate the
reproductive prognosis of women who have suffered recurrent pregnancy loss.
We report the results of a multicentre placebo- controlled study on the
effect of Ig administration on pregnancy outcome in 46 women who had
suffered at least three recurrent miscarriages. All were screened to
exclude chromosomal or Mullerian abnormalities, the presence of antinuclear
antibodies, lupus anticoagulant (LA) or elevated titres of anticardiolipin
antibodies which may have revealed an underlying autoimmune problem. To
avoid a selection bias towards ongoing pregnancies, i.v. Ig or placebo were
administered between weeks 5 and 7 of gestation for 2 consecutive days as
soon as each woman knew she was pregnant and before embryonic heart
activity could be detected. A further infusion was administered at week 8
when ultrasonography confirmed an ongoing embryonic development. In all,
68% of the women who received Ig went to term versus 79% of those who
received a placebo (not significant), with no significant differences in
the pregnancy course or the perinatal outcome. These results suggest either
that women with recurrent miscarriages who have no recognized cause of
pregnancy loss have a good reproductive prognosis without any treatment or
that the emotional care associated with the administration of a placebo can
indirectly facilitate the progression of pregnancy.
相似文献