Acquired cystic kidney disease (ACKD) can be developed duringchronic renal insufficiency. The probability of developing cysticdiseases rises with the increase of time in dialysis [1]. Menand African-American population are more likely to develop ACKD.Also, kidney volumes are bigger and cyst size increases fasterin this population [1,2]. Typical complications of ACKD areintra- and pericystic bleeding as well as rupture with retroperitonealhaemorrhage. Patients with ACKD also present a higher risk ofmalignant transformation. Haemoperitoneum is an unusual complicationin patients undergoing peritoneal dialysis (PD), most casesbeing attributed to mechanical, gynaecological or intraperitoneal  相似文献   
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Anesthesia of a woman with extreme morbid obesity (260 kg)     
J Canet  J Vallés  P Vila  F Vidal 《Revista espa?ola de anestesiología y reanimación》1990,37(6):366-369
Patients with morbid obesity present a series of functional and morphologic alterations and require a careful planning for anesthetic management. We report a case of a woman weighing 260 kg who was operated on twice for the treatment of her base condition. In the first operation, general anesthesia was carried out and in the second one, epidural anesthesia was conducted. Main complications included hypoxemia and hypercapnia which persisted during the first week after operation carried out under general anesthesia.  相似文献   
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Quantitative study of the morphological changes in the thyroid gland following IR laser radiation     
C. Parrado  A. Peláez  L Vidal  I. Pérez De Vargas 《Lasers in medical science》1990,5(1):77-80
The morphological changes produced in the thyroid glands of albino rats following radiation with a 904 nm infrared laser were studied. Two different levels of radiation were applied: 46.8 J/cm2 and 140.4 J/cm2. Evaluation of the changes in the densities of the epithelial, colloidal and follicular volumes and of the activation index revealed that the laser beam produced changes in the thyroid parenchyma. It was observed that there was a direct relationship between the severity of the lesion and the radiation energy applied.  相似文献   
1 [2] [3] [4] [5] [6] [7] [8] [9] [10] [11] 下一页 » 末  页»
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Background

Physicians treating nonvalvular atrial fibrillation (AF) assess stroke and bleeding risks when deciding on anticoagulation. The agreement between empirical and physician-estimated risks is unclear. Furthermore, the association between patient and physician sex and anticoagulation decision-making is uncertain.

Methods

We pooled data from 2 national primary care physician chart audit databases of patients with AF (Facilitating Review and Education to Optimize Stroke Prevention in Atrial Fibrillation and Coordinated National Network to Engage Physicians in the Care and Treatment of Patients with Atrial Fibrillation Chart Audit) with a combined 1035 physicians (133 female, 902 male) and 10,927 patients (4567 female and 6360 male).

Results

Male physicians underestimated stroke risk in female patients and overestimated risk in male patients. Female physicians estimated stroke risk well in female patients but underestimated the risk in male patients. Risk of bleeding was underestimated in all. Despite differences in risk assessment by physician and patient sex, > 90% of patients received anticoagulation across all subgroups. There was modest agreement between physician estimated and calculated (ie, CHADS2 score) stroke risk: Kappa scores were 0.41 (0.35-0.47) for female physicians and 0.34 (0.32-0.36) for male physicians.

Conclusions

Our study is the first to examine the association between patient and physician sex influences and stroke and bleeding risk estimation in AF. Although there were differences in agreement between physician estimated stroke risk and calculated CHADS2 scores, these differences were small and unlikely to affect clinical practice; further, despite any perceived differences in the accuracy of risk assessment by sex, most patients received anticoagulation.  相似文献   
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