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1.
Rohi Shah Nomaan Sheikh Jitendra Mangwani Nicolette Morgan Hamidreza Khairandish 《Journal of Clinical Orthopaedics and Trauma》2021,12(1):138
Demographic projections for hip fragility fractures indicate a rising annual incidence by virtue of a multimorbid, ageing population with more noncommunicable diseases (NCDs). NCDs are characterised by slow progression and long duration ranging from ischaemic cardiovascular disease, cerebrovascular disease, diabetes, chronic obstructive pulmonary disease to various cancers. Management of this disease burden often involves commencing patients on oral anticoagulants to reduce the risk of thromboembolic events. The use of direct oral anticoagulants (DOACs) in clinical practice has increased due to their rapid onset of action, short half-life and predictable anticoagulant effects, without the need for routine monitoring. Safe and timely surgical intervention relies on reversal of anticoagulants. However, the lack of specific evidence-based guidelines for the perioperative management of patients on DOACs with hip fractures has proved challenging; in particular, the accessibility of DOAC-specific assays, justification of the cost-benefit ratio of targeted reversal agents and indications for neuraxial anaesthesia. This has led to potentially avoidable delays in surgical intervention. Following a literature review of the pharmacokinetic and pharmacodynamics of commonly used DOACs in our region including the role of surrogate markers, we propose a systematic, evidence-based guideline to the perioperative management of hip fractures DOACs. We believe this standardised protocol can be easily replicated between hospitals. We recommend that if patients are deemed suitable for a general anaesthesia, with satisfactory renal function, optimal surgical time should be 24 h following the last ingested dose of DOAC. 相似文献
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Piceatannol (3,4,3',5'-tetrahydroxy-trans-stilbene) (NSC 365798) has recently been isolated and was subsequently synthesized for NCI tumor panel testing as a new antileukemic natural product from the seeds of Euphorbia lagascae. During the synthesis, a bioactive reaction mixture of several partially O-methylated piceatannol analogues was obtained. This mixture has now been maximized and subjected to bioactivity-directed fractionation, using brine shrimp lethality, to yield 3,3',5'-tri-O-methylpiceatannol (NSC 381281); this new compound has improved stability and better bioactivity in several systems than piceatannol itself. To confirm the structure, 5 was synthesized from vanillin. In addition, the isovanillin analogue, 4,3',5'-tri-O-methylpiceatannol (NSC 381864), another new compound, was synthesized and found to be bioactive. 相似文献
6.
Anjana Trivedi Jitendra Patel Jagruti Kalola 《Indian journal of otolaryngology and head and neck surgery》2007,59(2):166-167
Oral tuberculosis is very rare and when present they are usually secondary to pulmonary tuberculosis. Tuberculous lesions
of the tongue have become so infrequent that they are virtually a forgotten disease entity and may pose a diagnostic problem.
The case reported in this paper emphasizes the importance of including tuberculosis in the differential diagnosis of any chronic
oral ulcer. The low number of oral infections by M. tuberculosis could be due to underreporting. 相似文献
7.
Bioactive stilbenes of Scirpus maritimus 总被引:1,自引:0,他引:1
8.
In the present work we report our studies on IgG separated from the serum of lepromatous patients and non-lepromatous leprosy cases using Laser Raman Spectroscopy. Striking spectral changes in LL cases have been observed in the following special regions: (a) the amide I and III, (b) the S-S and C-S stretching (c) the skeletal bending and (d) skeletal stretching regions. These changes indicate a decrease in the amount of beta-structure and a transition towards alpha-helical conformation. 相似文献
9.
R. Srinivas Reddy S. Bajaj A. R. Tolat J. Compson 《European journal of orthopaedic surgery & traumatology : orthopedie traumatologie》2007,17(4):373-376
Neurofibromas in the hand are uncommon and constitute less than 5% of all hand tumours. Accurate diagnosis and appropriate management are important because malignant transformation has been reported, especially in Von Recklinghausen’s neurofibromatosis. We report a case of a large neurofibroma in the right hand of an 18-year-old girl of Afro-Caribbean origin. She was symptomatic with complaints of pain and weakness of grip. General examination revealed multiple café-au-lait spots on the trunk and one nodular swelling in the forearm. The swelling was excised through a palmar approach and histology proved it to be a neurofibroma. The case is being reported for its rarity and it emphasizes the importance of general examination. Histopathological examination is vital in excluding malignant transformation. 相似文献
10.
S. S. Borwankar L. S. Kasat A. Naregal M. Jain R. Bajaj 《Pediatric surgery international》1998,14(1-2):129-130
A case of covered exstrophy without sequestration of a bowel segment is reported. A 4-year-old female presented with dribbling
of urine. Treatment to date has been simple excision of the covered membrane with functional closure of the bladder and bilateral
posterior iliac osteotomies, with reconstruction of the bladder neck and genitalia to be performed at a later date. The embryogenesis
of this rare variant, a review of the reported cases, and management options are discussed.
Accepted: 6 November 1997 相似文献