Search Results

You are looking at 111 - 120 of 1,822 items for :

  • Medical and Health Sciences x
  • Refine by Access: All Content x
Clear All

Absztrakt

A chylothorax napjainkban rendszerint műtéti vagy baleseti szövődmény, ritkábban daganat következménye. Prospektív vagy randomizált vizsgálatok hiányában a bizonyítékalapú kezelés személyes tapasztalaton, ideálisan a retrospektív elemzések ismeretében történik. A szerzők célja a chylothorax modern kezelésének áttekintése. A PubMed adatbázist „chylothorax” kulcsszóra szűrték az elmúlt tíz év közleményei között, kiemelve az összehasonlító értékeléseket. A módszerek és ajánlások kritikai elemzésekor a szerzők együttes 39 éves klinikai tapasztalatukra támaszkodtak. A konzervatív kezelés sikere az etiológiától függően nagy szórást mutat (3–90%). A non- és szemi-invazív intervenciós eljárások sikerrátája 50–100% közötti. Eredménytelen konzervatív kezeléskor a sebészi kezelés, elsősorban a ductus thoracicus lekötése jelenti a standard terápiát. Ezen beavatkozások sikerességi aránya 64–100% közötti, a morbiditási/mortalitási mutató elérheti a 25%-ot. A kezelést konzervatívan kell megkezdeni, majd egy lépcsőzetes agresszivitású terápia ajánlott, amelyben a beteg állapota és a drénvolumen irányítják a döntéshozatalt. Az intervenciós radiológiai eljárások biztonságosak, sikeresek és helyet kaptak a konzervatív és műtéti megoldások mellett. Orv. Hetil., 2016, 157(2), 43–51.

Restricted access
Orvosi Hetilap
Authors: Mária Csóka, Sándorné Molnár, Éva Kellős, and Gyula Domján

Absztrakt

Bevezetés: A Parkinson-kór becslések szerint több mint 6,3 millió embert érint a világon. Ezek többségének és hozzátartozóinak egyedül kell megbirkóznia a gyógyszerszint-ingadozások motoros következményeivel és az anti-Parkinson-gyógyszerek pszichotikus mellékhatásaival. Nemritkán még az ellátók számára is gondot jelent a fellépő problémák helyes értelmezése és menedzselése. Célkitűzés: A szerzők célul tűzték ki a Parkinson-kóros betegek igényeinek rendszerezett áttekintését és ezek alapján egy bizonyítékokra épülő komplex Parkinson ápolási-gondozási modell kidolgozását. Módszer: A jelentkező igények meghatározásánál a szerzők egy idős, 28 éve Parkinson-kóros beteg többéves megfigyelése során szerzett tapasztalatokra támaszkodtak. A Parkinson ápolási-gondozási modellben a betegség specifikumaihoz illeszkedő multidiszciplináris ellátási keretrendszert fogalmaztak meg, amely meghaladja a standard ápolási modellek korlátait. Eredmények: A modell tartalmazza az egyes betegek köré szerveződő kooperatív problémamegoldási folyamat leírását és a betegek lehetséges problémáinak individualizált megoldására vonatkozó javaslatokat. Következtetések: A modell alkalmazása javíthat a Parkinson-kóros betegek életminőségén és megkönnyítheti az érintett családok életét, feltéve, ha a családok tisztában vannak az új ellátási forma előnyeivel. Orv. Hetil., 2016, 157(22), 855–868.

Open access

and the efficacy of ceftiofur treatment . J. Vet. Diagn. Invest. 15 , 26 – 29 . Clinical and Laboratory Standards Institute ( 2013 ): Performance Standards for Antimicrobial Susceptibility Testing; Twenty

Restricted access

Introduction

Exhaled carbon monoxide (eCO) has been widely implicated as a pulmonary biomarker in respiratory diseases. The aim of this study was to investigate whether the treatment of patients with severe acute exacerbation of chronic obstructive pulmonary disease (AECOPD) could be aided by monitoring the changes in eCO.

Methods

The levels of eCO along with routine clinical parameters were analyzed in 29 current smoker and 33 ex-smoker COPD patients, first at the time of hospital admission, and again at discharge following the standard treatment. Patients with AECOPD were also stratified according to sputum bacteria.

Results

At exacerbation, the levels of eCO were increased in current smokers compared to ex-smokers (6.0 [2.0–9.5] versus 1.0 [1.0–2.0] ppm, p < 0.001). Similarly, eCO levels were higher in smokers after treatment (7.0 [2.0–12.5] versus 1.0 [1.0–2.0] ppm, p < 0.001). Treatment of AECOPD did not affect eCO concentrations. The levels of eCO were not statistically different between bacterial and non-bacterial AECOPD either. Investigating a subgroup of current smoker patients (n = 15), there was a significant correlation between the levels of eCO and blood carboxyhemoglobin concentrations both at exacerbation and discharge. No associations were found between eCO and lung function or blood gas parameters.

Conclusion

Our results suggest that monitoring eCO during the treatment of AECOPD is of limited clinical value.

Restricted access
Acta Veterinaria Hungarica
Authors: Tulay Bakirel, Fulya Ustun Alkan, Oya Ustuner, Suzan Çinar, Ceren Anlas, and Ataman Bilge Sari

Currently, there is a growing interest in combining anticancer drugs with the aim to improve outcome in patients suffering from tumours and reduce the long-term toxicity associated with the current standard of treatment. In this study, we evaluated the possible role of deracoxib against the toxicity of doxorubicin on normal canine mammary epithelial cells. The effect of deracoxib and doxorubicin combination on cell viability was determined by MTT assay. Apoptosis was characterised by flow cytometry. Cell nitrite concentrations were measured with the Griess reaction. Deracoxib (50 and 100 μM) treatment decreased the cytotoxic action of doxorubicin at 0.9 μM in the cells, from 33.63% to 13.4% and 25.82%, respectively. Our results also showed that the reverse effect of deracoxib on doxorubicin-induced cytotoxic activity in the cells was associated with a marked (3.04- to 3.57-fold) decrease in apoptosis. In additional studies identifying the mechanism of the observed effect, deracoxib exhibited an activity to prevent doxorubicin-mediated overproduction of nitric oxide in the cells. Our in vitro study results indicate that deracoxib (50 and 100 μM) can be beneficial in protecting normal cells from the toxic effect of doxorubicin in conjunction with apoptosis by the modulation of nitric oxide production.

Restricted access

The DSM-IV classification of eating disorders introduced the new category of Binge Eating Disorder (BED), characterized by recurrent eating binges, which can be associated with overweight and obesity. Obese patients with BED, who are only a fraction of all obese individuals, show a higher mean degree of overweight, a greater comorbidity with medical conditions and mental disorders, and a greater impairment of health-related quality of life. Depressive symptoms are common among patients with BED, who could have a less favourable response to standard weight-reducing treatments. However, antidepressant drugs appear to have little effect in these patients, while psychotherapy (cognitive-behaviour therapy in particular) is effective for reducing frequency of eating binges, but not for weight control. Attempts at defining a neuroendocrine, genetic or metabolic base for BED have been, so far, rather inconclusive. Many authors question the clinical utility of the nosographic category of BED; in fact, episodic binge eating is characterized by psychopathological features similar to those of BED, even when established diagnostic thresholds of frequency of binges are not reached. Furthermore, other patterns of disturbed eating behaviour in obese patients could share some common characteristics with typical eating binges. Further research is needed to explore the complex pattern of eating disturbances in obesity, possibly using a dimensional, rather than a categorical, approach.

Restricted access

Abstract

To evaluate the effects of ionizing radiation on chromosomal aberration in lymphocytes of α-thalassemia variants compared to normal controls, venous blood samples were obtained from 10 healthy volunteers and 30 α-thalassemia patients. Different types of α-thalassemia were diagnosed by multiplex polymerase chain reaction. Blood samples were divided into two parts, the first exposed to 3 Gy gamma rays generated from a 60Co source and the other without any irradiation. The blood samples were used for preparation of metaphase cells according to standard methods. Results showed that the frequency of spontaneous aberration (about 0.012 per cell) was similar in all study groups. Irradiated samples showed significantly higher frequency of aberrations (about 0.6 per cell) compared to non-irradiated samples in all groups but similar for control and α-thalassemia variants. The frequency of dicentric chromosomes was significantly higher than other aberrations. In normal individuals in all of the chromosomes except in chromosome 1, a random distribution of break points proportional to their length based on their DNA content was observed. In α-thalassemia variant individuals in all of the chromosomes, a random distribution of break points proportional to their length based on their DNA content was observed.

Restricted access
Interventional Medicine and Applied Science
Authors: Andreas Schuster, Amedeo Chiribiri, Masaki Ishida, Geraint Morton, Matthias Paul, Shazia T. Hussain, Boris Bigalke, Divaka Perera, Tobias Schaeffter, and Eike Nagel

Abstract

Purpose

An isolated perfused pig heart model has recently been proposed for the development of novel methods in standard clinical magnetic resonance (MR) scanners. The original set-up required the electrical system to be within the safe part of the MR-room, which introduced significant background noise. The purpose of the current work was to refine the system to overcome this limitation so that all electrical parts are completely outside the scanner room.

Methods

Four pig hearts were explanted under terminal anaesthesia from large white cross landrace pigs. All hearts underwent cardiovascular magnetic resonance (CMR) scanning in the MR part of a novel combined 3T MR and x-ray fluoroscopy (XMR) suite. CMR scanning included real-time k-t SENSE functional imaging, k-t SENSE accelerated perfusion imaging and late gadolinium enhancement imaging. Interference with image quality was assessed by spurious echo imaging and compared to noise levels acquired while operating the electrical parts within the scanner room.

Results

Imaging was performed successfully in all hearts. The system proved suitable for isolated heart perfusion in a novel 3T XMR suite. No significant additional noise was introduced into the scanner room by our set-up.

Conclusions

We have substantially improved a previous version of an isolated perfused pig heart model and made it applicable for MR imaging in a state of the art clinical 3T XMR imaging suite. The use of this system should aid novel CMR sequence development and translation into clinical practice.

Restricted access
Interventional Medicine and Applied Science
Authors: István Hartyánszky, A. Tóth, G. Veres, B. Berta, E. Zima, Z. Szabolcs, G. Y. Acsády, B. Merkely, and F. Horkay

Abstract

Background: Although circular ventricle resection techniques are the gold standard of left ventricle restoration, these techniques can lead to suboptimal results. Postoperative systolic resection line can be inadequate, as it must be planned on a heart stopped in diastole. The impaired geometry and contractility may lead to increased short- and long-term mortality. Moreover, postoperative low cardiac output due to insufficient left ventricular volume results in a potentially unstable condition, and cannot be corrected. Our aim was to find a preoperative method to minimize risk and maximize outcome with left ventricle restoration. Methods: We have created a novel method combining surgery with modern imaging techniques to construct a preoperative 3D systolic heart model. The model was utilized to determine resection could be intraoperatively used to create the new left ventricle. Results: The computer assisted ventricle engineering technique is described step by step through a successful aneurysmectomy of a 61-year-old female patient with a complicated giant left ventricle aneurysm. Conclusions: Using this model we are able to find the optimal resection line providing excellent postoperative result, thus minimizing the risk of low cardiac output syndrome. This is the first report of our new combined approach to left ventricle restoration.

Restricted access

Abstract

Background

Otitis media with effusion is the most common cause of conductive hearing loss in the pediatric population. Insertion of ventilation tubes with or without adenoidectomy is the accepted and standard surgical procedure. CO2 laser myringotomy without tube placement has been advocated as an alternative treatment.

Aim

To compare long-term follow-up results of laser versus classical myringotomy with ventilation tube insertion over five years.

Materials and Methods

86 patients with bilateral otitis media with effusion were divided into two groups: laser myringotomy group and myringotomy with ventilation tube insertion group, with follow-up in hearing results and recurrence rates over five years.

Results

The mean patency time of myringotomy in laser group was 23 days, while the mean patency time of the ventilation tubes ears was 4.0 months in myringotomy group. Twelve patients in laser group (13.9%) showed a recurrent otitis media with effusion compared to 9 patients in myringotomy group (10.4%).

Conclusion

Laser fenestration is a less effective alternative to myringotomy and tube placement. The recurrence rates after both procedures did not show statistical significance over long follow-up. It might be considered as an effective alternative to classical surgery and ideal for short-term ventilation.

Restricted access