Biomedicine
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 TRAUMATIC ISOLATED PERICARDIO-DIAPHRAGMATIC RUPTURE
作者  Hidir Esme, Yusuf Yürümez, Dursun Ali Sahin, Osman San
作者单位  
期刊  European Journal of General Medicine 卷期  Vol. 2, No. 3, 2005 时间  2011.01.20
关键词  Trauma, Pericardio-diaphragmatic rupture
摘要   Pericardio-diaphragmatic rupture is an uncommon problem that poses a diagnostic challenge to surgeons. This article reports an unusual case of traumatic pericardio-diaphragmatic rupture in a 36-year-old male who has no additional intraabdominal visceral injury or thoracic pathology. There was a 7 cm lateral tear on the left dome of the diaphragm and a 2 cm medial tear, also involving pericardio-diaphragmatic junction, with the heart uninjured. The partially herniated stomach was easily pulled out from the thorax cavity through the diaphragmatic rupture. The rupture was reparied by interrupted non-absorbable sutures. The patient had no complaints on his follow up.
 CASE REPORT - VASCULAR PATHOLOGY OF THE GREATER OMENTUM: Report of two cases
作者  Montiel-Jarquin A.J, Sanabria-Macias, Sanchez-Turati J.G, Iturbide-Garcia J, Sandoval-Cruz M.V.H, Ra
作者单位  
期刊  European Journal of General Medicine 卷期  Vol. 1, No. 3, 2004 时间  2010.12.20
关键词  Infarction, right-sided segmental torsion, greater omentum
摘要   Vascular pathology of the greater omentum is still being very rare, since Bush described the first case in 1896. The objectives are to describe two clinical cases, the first one about right-sided segmental torsion of the greater omentum and the other one about infarction of the greater omentum, which were diagnosed and treated in our hospital; as well as to check pertinent literature. In first case, a forty year old male, thin, with one week evolution: right lower quadrant pain, nausea, hiporexia, a previous prescription of an antiamebic and antispasmodic with no healing, fever, mild leukocytosis, neutrophilia, Simple X ray of the abdomen suggesting acute appendicitis. The patient underwent Exploratory Laparotomy which revealed right-sided segmental torsion of the greater omentum. In second case, a thirty year old female, thin, presenting a six day evolution: pain in the whole right hemiabdomen, difficulty for walking, abdominal distention, hiporexia, fever, bad general condition, with a previous prescription based on metamizol, ampicilin with no healing, mild leukocytosis, neutrophilia and simple X-ray of the abdomen also suggesting acute appendicitis. This patient was also surgically treated with the diagnosis of right-sided segmental infarction of the greater omentum. In conclusion, vascular pathology of the Greater Omentum is still being very rare. Its clinical presentation is nonspecific and forms a great part of pathology which causes right lower quadrant pain, commonly confused with acute appendicitis. Despite medical breakthrough its diagnosis is difficult. The treatment is surgical, evolution is good if the treatment is adequate, and prognosis is favorable.
 INTRADURAL DISC HERNIATION A case report and review of the literature
作者  Nebi Yilmaz, Nejmi Kiymaz, Ömer Etlik, Çigdem Mumcu
作者单位  
期刊  European Journal of General Medicine 卷期  Vol. 2, No. 4, 2005 时间  2010.09.20
关键词  Intradural disc, surgery, cauda equina syndrome
摘要   Intradural disc herniation (IDH) is a rare pathology. Intradural disc herniations comprise 0.26-0.30% of all herniated discs. The preoperative knowledge of an intradural herniation is important because it has an influence on the operative strategy. A 55-year-old man suffered from decrease in the motor function of the lower extremities and urinary incontinence. Noncontrast MRI exam showed the intradural disc with caudal migration of an excluded fragment at the L3-4 level. At surgery, the L3 and L4 laminas were removed and after dura had been openned, a nucleus pulposus was seen which compressed the conus medullaris to the right and left of the spinal canal. Every neurosurgeuon involved in spinal surgery must be aware of this rare patology which, when overseen during the intervention, could have disastrous consequences for the patient.
 Childhood Bone and Soft Tissue Tumours: A review of 43 Treated at two University Teaching Hospitals
作者  Makanga, M.;Majyambere, J.P. & Kakande, I.
作者单位  
期刊  East and Central African Journal of Surgery 卷期  Vol. 13, No. 1, 2008 时间  2010.08.23
关键词  
摘要   Back ground:Cancer represents one of the major causes of death in the world estimated at 1 out of 10 deaths. Globally, 160,000 children are diagnosed to have cancer each year. In the developing countries, one child out of two with cancer will die because of this disease mostly because they present with advanced disease or due to limited resources for proper management1,2. This study was aimed at determining the prevalence, the histological types and the management outcome of childhood bone and soft tissue tumours in Rwanda Methods:A retrospective descriptive study of 43 histologically confirmed cases of bone and soft tissue tumours in children was done in the Surgery Departments of University Teaching Hospitals (CHUB and CHUK). The period of study was 6 years from January 2001 to December 2006. Only children aged 16 years or below were included in the study. Data was obtained from patient’s clinical files, pathology register and theatre registers. Information obtained was recorded using a special questionnaire; Data obtained was analyzed using Epidata 2.1b, SPSS 11.5 computer programs. Statistic test Pearson Chi-carré (P) was considered significant if P value was less than or equal to 0.05. Results:During 6 years period, 43 children aged 2 to 16 years were seen having bone and soft tissue tumours. Males accounted for 28 (65.1%) of the cases. The 10 to 16 year age group was predominantly affected, accounting for 72% (n=31) of all cases.. Pain and swelling were the main clinical signs in 100%of cases. Tumours were benign in 17 (40%) and malignant in 26 (60%) of cases. History of local trauma and pain was associated with malignant bone tumours (P=0.003 and P=0.000), respectively (n=23). Delay time between the onset of symptoms and consultation to hospitals was associated with death for malignant tumours (P=0.049). The bones were affected in 76.7% (n=33), being malignant in 23 (69.7%)of them. The hospital mortality rate was 18% for malignant tumours. Pulmonary and bone spread of the disease were observed in all fatal cases. Conclusion:Limitation of diagnostic and therapeutic means and lack of an oncology department that would provide chemotherapy and radiotherapy) in our University teaching hospitals (CHUB and CHUK) made the management of malignant tumours and the follow up after discharge inadequate, unsuitable and difficult.
 Characterization of bovine Paratuberculosis in dual purpose cattle at the plains of Monagas state, V
作者  Coromoto Alfaro, Morela de Rolo, Antonia Clavijo, y Alberto Valle
作者单位  
期刊  Zootecnia Tropical 卷期  Vol. 24, No. 3, 2006 时间  2010.08.23
关键词  Paratuberculosis, prevalence, diagnostic, double purpose cattle, Monagas.Paratuberculosis bovina, prevalencia, diagnóstico, ganado doble propósito, Monagas.
摘要   To characterize the situation of the bovine Paratuberculosis or Johne's disease in dual purpose cattle in the Monagas plains, the prevalence of this disease was determined using two diagnostic techniques: the skin test (Johnina) for cellular immunity and a serological ELISA test for humoral immunity. There were selected eight production systems, located in the Municipality Ezequiel Zamora and in Maturín, in two different agro ecological zones: high plains and low plains, respectively. The animal sample size was calculated by means of the sample technique for prevalence studies (OPS-OMS, 1973); so 30 mature animals for each farm were evaluated. The analysis of the data was made by using the Z-test to compare the proportions of prevalence among farms, and factors associated to the disease. The results showed significant differences (P<0.05) in relation to the disease prevalence. According to the method of diagnostic used, these values were: 4.16% and 72.1% for Johnina and ELISA tests, respectively. Also, there was observed highly significant differences (P<0.001) between agro ecologic zones: 61.7% and 82.25 for high plains and low plains, respectively. Regarding to the management conditions in the farms, the results were (P<0.05): 69.9 and 77.3% for the open and closed system, respectively. When draining condition of the farms was considered, there was observed differences (P<0.10) between the well 67.0% and bad drained 76.7% status. Due to the economic losses, its effect on the farms productivity and some risks of a potential zoonosis, it was concluded, based on the laboratory diagnosis, that is important to consider the presence of this pathology in Monagas, so some strategies for controlling this disease could be applied under each particular condition of the production system.Para caracterizar la situación de la Paratuberculosis bovina o enfermedad de Johne en ganado doble propósito de los llanos de Monagas, se determinó la prevalencia de esta enfermedad utilizando dos técnicas de diagnóstico, la prueba intradérmica o Johnina para inmunidad celular y serología ELISA para inmunidad humoral. Se seleccionaron ocho sistemas de producción ubicados en los Municipios Ezequiel Zamora y Maturín en diferentes zonas agroecológicas, llanos altos y llanos bajos respectivamente. El tamaño de la muestra animal se calculó sobre la base de la técnica de muestreo para estudios de prevalencia (OPS-OMS, 1973), en cada finca se evaluaron 30 animales adultos con ambas pruebas. El análisis de los datos se efectuó mediante la prueba de Z, para la comparación de proporciones o prevalencia entre fincas y factores asociados a la enfermedad. Los resultados obtenidos muestran diferencias significativas (P<0,05) en relación con la prevalencia de la enfermedad, de acuerdo al método de diagnóstico utilizado 4,16% y 72,1% Johnina y ELISA, respectivamente. Asimismo, se observaron diferencias altamente significativas (P<0,001) entre zonas agroecológicas 61,7% llanos altos y 82,5% llanos bajos, condiciones de manejo sistema abierto 69,9% en comparación con sistema cerrado 77,3% (P<0,05) y buen sistema de drenaje 67,4 % en contraste con mal drenaje 76,7% (P<0,10). En virtud de las pérdidas económicas, de su efecto sobre la productividad de las explotaciones y su posible condición de zoonosis, es importante considerar la presencia de esta patología en Monagas para diseñar estrategias de control fundamentadas en el diagnóstico de laboratorio y las condiciones particulares de los sistemas de producción.
 Characterization of bovine Paratuberculosis in dual purpose cattle at the plains of Monagas state, V
作者  Coromoto Alfaro, Morela de Rolo, Antonia Clavijo, y Alberto Valle
作者单位  
期刊  Zootecnia Tropical 卷期  Vol. 24, No. 3, 2006 时间  2010.08.23
关键词  Paratuberculosis bovina, prevalencia, diagnóstico, ganado doble propósito, Monagas.Paratuberculosis, prevalence, diagnostic, double purpose cattle, Monagas.
摘要   Para caracterizar la situación de la Paratuberculosis bovina o enfermedad de Johne en ganado doble propósito de los llanos de Monagas, se determinó la prevalencia de esta enfermedad utilizando dos técnicas de diagnóstico, la prueba intradérmica o Johnina para inmunidad celular y serología ELISA para inmunidad humoral. Se seleccionaron ocho sistemas de producción ubicados en los Municipios Ezequiel Zamora y Maturín en diferentes zonas agroecológicas, llanos altos y llanos bajos respectivamente. El tamaño de la muestra animal se calculó sobre la base de la técnica de muestreo para estudios de prevalencia (OPS-OMS, 1973), en cada finca se evaluaron 30 animales adultos con ambas pruebas. El análisis de los datos se efectuó mediante la prueba de Z, para la comparación de proporciones o prevalencia entre fincas y factores asociados a la enfermedad. Los resultados obtenidos muestran diferencias significativas (P<0,05) en relación con la prevalencia de la enfermedad, de acuerdo al método de diagnóstico utilizado 4,16% y 72,1% Johnina y ELISA, respectivamente. Asimismo, se observaron diferencias altamente significativas (P<0,001) entre zonas agroecológicas 61,7% llanos altos y 82,5% llanos bajos, condiciones de manejo sistema abierto 69,9% en comparación con sistema cerrado 77,3% (P<0,05) y buen sistema de drenaje 67,4 % en contraste con mal drenaje 76,7% (P<0,10). En virtud de las pérdidas económicas, de su efecto sobre la productividad de las explotaciones y su posible condición de zoonosis, es importante considerar la presencia de esta patología en Monagas para diseñar estrategias de control fundamentadas en el diagnóstico de laboratorio y las condiciones particulares de los sistemas de producción.To characterize the situation of the bovine Paratuberculosis or Johne's disease in dual purpose cattle in the Monagas plains, the prevalence of this disease was determined using two diagnostic techniques: the skin test (Johnina) for cellular immunity and a serological ELISA test for humoral immunity. There were selected eight production systems, located in the Municipality Ezequiel Zamora and in Maturín, in two different agro ecological zones: high plains and low plains, respectively. The animal sample size was calculated by means of the sample technique for prevalence studies (OPS-OMS, 1973); so 30 mature animals for each farm were evaluated. The analysis of the data was made by using the Z-test to compare the proportions of prevalence among farms, and factors associated to the disease. The results showed significant differences (P<0.05) in relation to the disease prevalence. According to the method of diagnostic used, these values were: 4.16% and 72.1% for Johnina and ELISA tests, respectively. Also, there was observed highly significant differences (P<0.001) between agro ecologic zones: 61.7% and 82.25 for high plains and low plains, respectively. Regarding to the management conditions in the farms, the results were (P<0.05): 69.9 and 77.3% for the open and closed system, respectively. When draining condition of the farms was considered, there was observed differences (P<0.10) between the well 67.0% and bad drained 76.7% status. Due to the economic losses, its effect on the farms productivity and some risks of a potential zoonosis, it was concluded, based on the laboratory diagnosis, that is important to consider the presence of this pathology in Monagas, so some strategies for controlling this disease could be applied under each particular condition of the production system.
 The Nardi Test In Sphincter Of Oddi Dysfunction: Is It Still Relevant?
作者  Seetharam, Prasad & Rodrigues, Gabriel
作者单位  
期刊  European Journal of General Medicine 卷期  Vol. 5, No. 3, 2008 时间  2010.08.13
关键词  Abdominal pain, sphincter of Oddi, dysfunction, bile duct, pancreas, surgery
摘要   Recurrent abdominal pain is one of the common symptoms encountered in daily practice and a pathology affecting the sphincter of Oddi (SO) as a cause, is never thought of at the first instance. Various disease states affecting the SO, mainly its dysfunction (SOD) seem to be important to be kept in mind while treating patients with intractable abdominal pain, especially postcholecystectomy cases. As the clinical syndrome of SOD is poorly defined and incompletely understood, an accurate estimate of the problem cannot be made. The most widely used pharmacologic test to determine SOD is the morphine-prostigmine provocative test of Nardi. In this article we have discussed the relevance of this test in modern day practice.
 Short Report - Unusual presentation of the
作者  Sujit Kumar GSamson, Chacko AriG, Rajshekhar Vedantam
作者单位  
期刊  Neurology India 卷期  Vol. 52, No. 4, 2004 时间  2010.07.19
关键词  Craniectomy, cranioplasty, intracranial pressure
摘要   A 45-year-old lady underwent right fronto-parietal craniotomy and subtotal excision of a parasagittal meningioma. Bone flap was not replaced as it was infiltrated by the tumor. In the postoperative period she developed episodes of altered sensorium associated with worsening of left hemiparesis and a sunken scalp at the site of bone defect. Computed tomography (CT) of brain showed sunken scalp flap in the right fronto-parietal region with compression of the underlying brain. A diagnosis of syndrome of the trephined was considered and her symptoms improved with cranioplasty. Pathophysiology of the syndrome of the trephined is discussed.
 Progression of chronic pulmonary tuberculosis in mice intravenously infected with ethambutol resista
作者  Srivastava, S;Ayyagari, A;Dhole, TN;Krishnani, N;Nyati, KK & Dwivedi, SK
作者单位  
期刊  Indian Journal of Medical Microbiology 卷期  Vol. 26, No. 4, 2008 时间  2010.07.05
关键词  Balb/c mice, Ethambutol resistance, immunopathology, M. tuberculosis.
摘要   Purpose:Ethambutol (EMB) is an important first line drug, however little information on its molecular mechanism of resistance and pathogenicity of resistant isolates is available. Present work was designed to study virulence of the EMB resistant M. tuberculosis strains and the host responses in-vivo on infection of EMB resistant M. tuberculosis using Balb/c mouse model of infection. Methods:Three groups of Balb/c mice (female, age 4-6 wk; 21 mice in each group) were infected intravenously with 106 CFU of M. tuberculosis H37Rv and two EMB resistant clinical isolates. Age and sex matched control animals were mock inoculated with Middlebrook 7H9 broth alone. At 10, 20, 30, 40, 50, 60, and 70 days post-infection three animals from each group were sacrificed by cervical dislocation and lung tissue was collected for further analysis. Results:Infection with EMB resistant M. tuberculosis led to progressive and chronic disease with significantly high bacillary load (p=0.02). Massive infiltration and exacerbated lung pathology with increased expression of IFN-γ and TNF-α was observed in lungs of mice infected with EMB resistant strains. The present study suggests that infection with EMB resistant M. tuberculosis leads to chronic infection with subsequent loss of lung function, bacterial persistence with elevated expression of TNF-α resulting in increased lung pathology. Conclusion:These findings highlight that EMB resistant M. tuberculosis regulates host immune response differentially and its pathogenicity is different from drug sensitive strains of M. tuberculosis.
 Education Forum - Orphan diseases and drugs
作者  Randhawa GK
作者单位  
期刊  Indian Journal of Pharmacology 卷期  Vol. 38, No. 3, 2006 时间  2010.07.05
关键词  Drugs for neglected diseases initiative, neglected diseases orphan drugs.
摘要   The World Health Organization defines orphan diseases, as all pathological conditions, affecting 0.65-1 out of every 1000 inhabitants. They are usually not studied for their pathophysiology or for newer therapeutic options, as these are not economically viable. The Orphan Drug Act was passed on January 28, 1983 by USA to stimulate the research, development and approval of those products that treat orphan diseases. Till date, 11 drugs (4.87%) for tropical infectious diseases have been designated with orphan drug status and as many drugs for other infectious diseases. Several drugs with orphan status are used in the treatment of diseases that no longer meet orphan status criteria, such as AIDS and end-stage renal disease. Understanding of the human genome, nuclear cloning, rational drug designing and application of high throughput screening in drug discovery programs, might lead to new drug discoveries for orphan diseases. Hence, there is hope in future for patients neglected by for-profit drug discovery efforts.
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