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【Objective】 Corin, a transmembrane serine protease that can cleave atrial natriuretic peptide precursor (pro-ANP) into atrial natriuretic peptide with smaller bioactive molecules, participates in the pathophysiological process of hypertension and cardiac hypertrophy. The purpose of this study was to explore the relationship of Corin gene variation with blood pressure responses to sodium and potassium dietary interventions. 【Methods】 In 2004, we recruited 514 participants from 124 families in 7 villages of Baoji, Shaanxi Province, China. All the subjects received a 3-day normal diet, a 7-day low-salt diet, a 7-day high-salt diet, and finally a 7-day high-salt and potassium supplementation. Fifteen single nucleotide polymorphisms (SNPs) of Corin gene were selected for final analysis. 【Results】 SNPs rs12509275 were significantly associated with diastolic blood pressure (DBP) response to low-salt diet, while rs3749584 was associated with pulse pressure (PP) response to low-salt diet.SNP rs3749584 and rs10517195 were significantly associated with PP response to high-salt diet. In addition,rs17654278 were significantly associated with systolic blood pressure (SBP) response to high-salt and potassium supplementation, rs2271037 was significantly correlated with DBP responses to high-salt and potassium supplementation, and rs4695253, rs12509275, rs2351783, rs36090894 were significantly associated with PP response to high-salt and potassium supplementation. 【Conclusion】 Corin gene polymorphisms were associated with blood pressure response to sodium and potassium, suggesting that Corin gene may be involved in pathophysiological process of salt sensitivity and potassium sensitivity.
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Most critically ill children are in a state of severe stress and prone to malnutrition, which lead to a decline in the body′s resistance to disease and repair ability, thus aggravating the condition of children.After the initial support treatment of multiple organ functions, nutritional support should be considered as soon as possible to improve the metabolic status and supplement the metabolic needs of children, which can improve the nutritional status of children.Reasonable nutritional support treatment can not only improve nutritional status of the body, but also benefit the recovery and prognosis of the disease.Enteral nutrition is highly valued because it conforms to the gastrointestinal physiology and improves the mucosal barrier function of gastrointestinal tract.
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Objective:To investigate the fertility intention and psychological pressure of women of childbearing age in Yanshan County, Jiangxi Province, and to provide data support for the targeted promotion of fertility.Methods:Using the method of random sampling, women of childbearing age in 10 communities in Yanshan County, Jiangxi Province were given questionnaires and psychological stress rating tables to understand the basic information, the status of marriage and childbearing, childbearing intentions, and the Chinese version of the Perceived Stress Scale (CPSS) score, and explore the related factors that may affect childbearing intentions and psychological stress of women of childbearing age.Results:In this survey, 1 500 questionnaires were distributed to women of childbearing age, 913 of which were returned, and 65.0%(593/913) of them were willing to have children. The CPSS score of women of childbearing age was 8-28(16.84±2.75). The CPSS scores of women of childbearing age in different occupations were statistically significant ( P<0.05). Public officials (including civil servants and employees of public institutions) had the least psychological pressure, while self-employed and other (unemployed) had the most psychological pressure. There was no significant difference in CPSS scores among women of childbearing age with different education levels, annual income levels, marital status and willingness to have children (all P>0.05). The correlation analysis showed that there was a statistical significance between the psychological pressure of women of childbearing age and their occupation ( r=0.230, P<0.05), and there was no significant correlation between other factors such as education level, annual income, fertility desire, fertility status, etc. and psychological pressure (all P>0.05). Conclusions:The fertility intention desire of women of childbearing age in Yanshan County, Jiangxi Province is basically normal, and the desire to have more children is not strong. There is no significant correlation between fertility intention and psychological pressure. The psychological pressure of women of childbearing age is significantly related to their occupation.
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Objective:The aim of this study was to investigate the efficacy and safety of rtansabdominal wall press to adjust ovarian position in patients with difficulty in oocyte retrieval.Methods:A retrospective case-control study was conducted to collect 177 patients with difficulty in oocyte retrieval from January 2020 to December 2021 in the Reproductive Medical Center of Peking University Shenzhen Hospital. Among the 177 patients with difficulty in oocyte retrieval, 76 patients used transabdominal wall press to adjust the position of the ovary (pushing group), and the other 101 patients were treated with routine oocyte retrieval (control group). The oocyte retrieval rate, the number of oocyte and mature oocyte, the number of transferable embryos and high-quality embryos were compared between the two groups, and the incidence of complications was recorded.Results:There was no significant difference between the two groups in the ovarian stimulation program, the dosage of ovulation promoting drugs and the number of follicles ≥14 mm on human chorionic gonadotropin (HCG) day (all P>0.05). The days of promoting ovulation in the pushing group were longer than those in the control group, and the level of estradiol on HCG day was significantly higher than that in the control group (all P<0.05). The rate of oocyte retrieval, the number of oocytes retrieved, the number of transferable embryos and high-quality embryos in the pushing group were significantly higher than those in the control group (all P<0.05). The incidence of complications during oocyte retrieval in the pushing group was significantly lower than that in the control group ( P=0.003). Conclusions:Transabdominal wall press to adjust ovarian position can improve oocyte retrieval rate and reduce the incidence of complications in patients with difficulty in oocyte retrieval.
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OBJECTIVE@#To reveal the effect and mechanism of Jiaotai Pill (, JTP) on insomniac rats.@*METHODS@#The insomniac model was established by intraperitoneal injection of p-chlorophenylalanine (PCPA). In behavioral experiments, rats were divided into control, insomniac model, JTP [3.3 g/(kg•d)], and diazepam [4 mg/(kg•d)] groups. The treatment effect of JTP was evaluated by weight measurement (increasement of body weight), open field test (number of crossings) and forced swimming test (immobility time). A high performance liquid chromatography-electrochemical detection (HPLC-ECD) method was built to determine the concentration of monoamine transmitters in hypothalamus and peripheral organs from normal, model, JTP, citalopram [30 mg/(kg•d)], maprotiline [40 mg/(kg•d)] and bupropion [40 mg/(kg•d)] groups. Expressions of serotonin transporter (SERT), dopamine transporter (DAT), and norepinephrine transporter (NET) were analyzed by quantitative polymerase chain reaction (qPCR) and Western blot in normal, model and JTP groups. A high performance liquid chromatography-electrospray ionization mass spectrometry (HPLC-ESI-MS/MS) method was established to determine the pharmacokinetics, urine cumulative excretion of metformin in vivo, and tissue slice uptake in vitro, which were applied to assess the activity of organic cation transporters (OCTs) in hypothalamus and peripheral organs.@*RESULTS@#Compared with the insomniac model group, the body weight and spontaneous locomotor were increased, and the immobility time was decreased after treatment with JTP (P<0.01). Both serotonin and dopamine contents in hypothalamus and peripheral organs were increased (P<0.01). The norepinephrine content was increased in peripheral organs and decreased in hypothalamus (P<0.05 or P<0.01). At the same time, SERT, DAT, OCT1, OCT2, and OCT3 were down-regulated in hypothalamus and peripheral organs (P<0.05). NET was down-regulated in peripheral organs and up-regulated in hypothalamus (P<0.05 or P<0.01). Moreover, the activity of OCTs in hypothalamus and peripheral organs was inhibited (P<0.05).@*CONCLUSION@#JTP alleviates insomnia through regulation of monoaminergic system and OCTs in hypothalamus and peripheral organs.
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Objective To evaluate the effects of continuous nursing on the therapy of type 2 diabetics retinopathy. Methods A total of 100 DR patients hospitalized in our hospital from June 2015 to January 2016 were enrolled, and they were randomly divided into 2 groups:50 in the intervention group, and the other 50 as controls. The control group received routine nursing, while the intervention group received continuous nursing on the basis of routine nursing. Two groups were both provided nursing satisfaction questionnaire and the Summary of Diabetes Self-Care Activitiesby a certain personnel. Relative evaluation indices were collected at the time when the patients were discharged and 1 year, 2years after that. The differences of nursing satisfaction, self-management ability, fasting blood glucose, blood glucose 2 hours after meal, visual acuity and readmission rate between two groups were compared with statistical methods. Results The fasting blood glucose, postprandial 2 hour blood glucoseafter one and two years were (5.71 ± 0.64), (9.42 ± 0.86), (5.89 ± 0.64) and (9.58 ± 0.80)mmol/L, respectively. The results ofthe control group were (6.81 ± 0.95), (11.32 ± 1.50), (7.24 ± 0.81) and (12.63 ± 2.17)mmol/L, respectively, and there were significant difference between 2 groups (t =-9.306--6.814, all P<0.05). The score of Summary of Diabetes Self-Care Activities score of the intervention group at the end of the follow-up period was 53.74 ± 7.82, while that in the control group was 42.02 ± 5.07, and the difference between the 2 groups was statistically significant (t = 8.883, P< 0.05).The rate of visual acuity, visual acuity after 1 and 2 years and nursing satisfaction were 2％ (1/50), 6％ (3/50) and 100％ (50/50) in the intervention group,and those in the control group were 18％ (9/50), 32％ (16/50), 78％ (39/50), with a significant difference between 2 groups (Z =-2.653,-3.297,-5.541, P<0.05). The readmission rate patients in the intervention group was 2％(1/50), while the control group was 28％(14/50), and there was significant difference between 2 groups (χ2=13.43, P<0.05). Conclusions When continuous nursing care was applied to type 2 diabetic retinopathy, the subjective initiative of patients and their family would be mobilized, and the patients′self-management ability would be improved, thus helped to control blood glucose andvisual acuity, and consequently promotes the prognosis while delays the progress of diabetic retinopathy, reduces the incidence of blinding due to DR, decreases the rate of readmission, reduces the economic burden of patients, improves patients′satisfaction.Continuous nursing care has great application value in medicine.
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Pediatric acute respiratory distress syndrome (PARDS) is the most leading cause of death in Pediatric Intensive Care Unit.PARDS can be classified as mild, moderate, and severe according to the oxygenation index.In recent years, because of the application of lung protection ventilation strategy, the outcome of PARDS has been greatly improved, but the mortality of severe PARDS still remains high.Therefore, it is of great clinical significance to understand the definition, diagnosis, and the application of lung protective ventilation strategy and the application of extracorporeal membrane oxygenation in severe PARDS.
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Objective To evaluate the effect of positive end-expiratory pressure (PEEP) on lung atelectasis using lung ultrasound ( LUS) in the pediatric patients without high risk factors. Methods One hundred American Society of Anesthesiologists physical statusⅠor Ⅱ patients of both sexes, aged 1-6 yr, with body mass index in the normal range, scheduled for elective non-abdominal surgery, were divided into no PEEP group (group C, n=50) and PEEP group (group P, n=50) using a random number table meth-od. The animals were mechanically ventilated in volume-controlled mode after intravenously injecting propo-fol, with PEEP 5 cmH2 O, tidal volume 8 ml/kg, inspiratory/expiratory ratio 1 : 2, respiratory rate 20-25 breaths/min in group P. In group C, the animals received no PEEP, and the other treatments were similar to those previously described in group P . Lung ultrasound was carried out after anesthesia induction and at the end of surgery. The severity and development of lung atelectasis were recorded. Results Compared with group C, the severity of lung atelectasis was significantly reduced after anesthesia induction and at the end of surgery, and the incidence of lung atelectasis was decreased in group P ( P＜0. 05) . Conclusion Early application of PEEP 5 cmH2 O can reduce the occurrence of atelectasis for the pediatric patients with-out high risk factors for atelectasis.
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Objective To evaluate the effect of hypothermia on the endotracheal tube cuff pressure during cardiopulmonary bypass in the pediatric patients with congenital heart disease. Methods Forty pedi-atric patients of both sexes, of American Society of Anesthesiologists physical status Ⅱ-Ⅳ, aged 1 months-14 yr, weighing 3-58 kg, scheduled for elective surgery for congenital heart disease using cardiop-ulmonary bypass, were included in this study. All the pediatric patients were intubated with a cuffed endo-tracheal tube. After anesthesia induction and endotracheal intubation, the air was injected into the cuff to make the cuff pressure reach 20 cm H2 O ( baseline) . The endotracheal tube cuff pressure was recorded when the esophageal temperature was reduced to 34, 32, 30, 28 and below 28℃ and returned to 28, 30, 32, 34 and 36 ℃. Results The cuff pressure was significantly decreased when the esophageal temperature was reduced to 30 and 28 ℃ and below 28 ℃ and returned to 28, 30, 32 and 34 ℃ as compared with the baseline ( P<0. 05) . Conclusion Hypothermia can reduce the endotracheal tube cuff pressure during car-diopulmonary bypass, and it is recommended to routinely monitor the cuff pressure in the pediatric patients with congenital heart disease.
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Objective To evaluate the effect of injecting alkalinized lidocaine into the tracheal tube cuff on the responses to extubation in pediatric patients.Methods One hundred and twenty-six pediatric patients,aged 3-13 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective abdominal surgery under general anesthesia requiring oral tracheal intubation,were divided into 3 groups (n =42 each) using a random number table:control group (group C),normal saline group (group NS) and alkalinized lidocaine group (group L).Air was injected into the tracheal tube cuff in group C.Normal saline was injected into the tracheal tube cuff in group NS.Alkalinized lidocaine was injected into the tracheal tube cuff in group L.Cuff pressure was monitored and maintained below 20 cmH2O.The differences in mean arterial pressure (ΔMAP) and heart rate (ΔHR) immediately after stopping inhalation of anesthetics and immediately after extubation were calculated.The response to extubation was defined as Δ MAP or / HR＞20％ of the baseline value and/or development of moderate and severe bucking and agitation.The development of coughing,hoarseness and sore throat during the period in postanesthesia care unit and the period from being discharged from postanesthesia care unit until 8 h after extubation were recorded.Results Compared with group C and group NS,the incidence of response to extubation and sore throat was significantly decreased (P＜0.05),and no significant change was found in the incidence of coughing or hoarseness in group L (P＞0.05).The volume of the alkalized lidocaine solution in the cuff was (4.2±2.3) ml[(60±33) mg] in group L.No cuffdamage was found in three groups.Conclusion Injecting alkalinized lidocaine into the tracheal tube cuff can safely and effectively inhibit responses to extubation and is helpful in improving outcomes in pediatric patients.
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OBJECTIVE Pancreatic ductal adenocarcinoma (PDAC), a lethal cancer in need of new, effective therapies, has a unique tumor microenvironment characterized by a dense fibrotic stroma (desmoplasia) that is generated by pancreatic cancer- associated fibroblasts (PCAFs) derived from pancreatic stellate cells (PSCs) and pancreatic fibroblasts (PFs). METHEDS and RESULTS Hypothe?sizing that G protein-coupled receptors (GPCRs) may regulate PCAFs, we used an unbiased GPCRomic array approach to compare GPCR expression in PCAFs, PFs and PSCs and identified 82 GPCRs commonly expressed by PCAFs derived from primary tumors of five PDAC patients. We discovered that PCAFs have increased expression of numerous GPCRs, in particular aGPCR with much higher expression in PCAFs compared to both PFs and PSCs. Immunohistochemistry revealed increased expression of this GPCR in PDAC tumors. Co- culture of PSCs with PDAC cells or incubation with TNFα induced its expression. Activation of the GPCR in PCAF sincreased expression of interleukin-6 (IL-6) via a cAMP/PKA/CREB signaling pathway. GPCR knockdown with siRNA diminished IL-6 production and secretionby PCAFs and ability of PCAF conditioned media to enhance proliferation of PDAC cells. CONCLUSION We conclude that PDAC cells induce expression by PCAFs of a novel GPCR, resulting in increased IL-6 production by PCAFs and promotion of PDAC cell proliferation. This PCAF-expressed GPCR thus contributes to PDAC cell-PCAF interaction and as such, may be a novel therapeutic target for PDAC tumors.
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Objective Total 21 pulmonary artery sling( PA sling)combined with tracheal stenosis children who received treatment in our hospital were reviewed. The feasibility of treatment strategy including left pulmonary artery( LPA)re-implantation without tracheoplasty was discussed in this study. Methods From April 2009 to November 2015,a total of 21 pediatric patients received surgical treatment due to PA sling with tracheal stenosis. Six patients received LPA re-implantation and trachea intervention simultaneously. The other 15 patients received LPA re-implantation alone to relieve the trachea compression without tracheoplasty. The postoperative strategy including early extubation and CPAP ventilation was employed in PICU. Results A total of 21 PA sling with tracheal stenosis children who underwent surgical treatment in our hospital were recruited. There were 9 females and 12 males. Ages of these children were from 1 months to 10 years old,and body weights were from 2. 9 kg to 25. 0 kg. Five patients needed mechanical ventilation for severe respiratory symptoms preoperatively. Six patients received LPA re-implantation and tracheal interven-tion simultaneously. Among them,3 patients received slide tracheoplasty,and one was discharged after recov-ery. The remaining 3 patients received tracheal stent implantation,but finally died. The survival rate was 16. 7% in these patients. Fifteen patients received LPA re-implantation alone,and slide tracheoplasty was per-formed in 2 patients for extubation failure who finally died of air leakage. The survival rate of 15 patients who received LPA re-implantation alone was 86. 7%. Conclusion The strategy in LPA re-implantation alone to relieve the trachea compression without tracheoplasty and early extubation and CPAP ventilation postoperative may be an ideal treatment for the pediatric patients with PLA sling combined with tracheal stenosis.
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To predict the mechanism of liver injury induced by Genkwa Flos, we investigated the effect of chloroform extract on UGTs and UGT1A1 activities of the liver microsomes in rat and human. In the present study, 4-nitrophenol(4-NP) and β-estradiol were elected as substrates to determine activities of UGTs and UGT1A1 by UV and HPLC. The results showed that there were 1.00% of apigenin, 6.40% of hydroxygenkwanin and 18.38% of genkwanin in chloroform extract; and total diterpene mass fraction was 31.40%. Compared with the control group, chloroform extract could significantly inhibit the activity of UGTs in rat liver microsomes(RLM) system, while the inhibitory effect was not obvious in human liver microsomes(HLM) system. UGT1A1 activity was inhibited by chloroform extract in rat liver microsomes and human liver microsomes (based on genkwanin, IC₅₀=8.76, 10.36 μmol•L⁻¹). The inhibition types were non-competitive inhibition(RLM) and uncompetitive inhibition(HLM). In conclusion, the results indicated that chloroform extract showed different inhibitory effects on UGTs and UGT1A1 activity, which may be one of the mechanisms of liver injury induced by Genkwa Flos.
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In the present study, the effects of six Coptidis alkaloids (berberine, epiberberine, coptisine, jatrorrhizine, palmatine and magnoflorine) on liver microsomes UGTs and UGT1A1 activities in rats and mice were investigated in vitro and in vivo to study the mechanism of metabolic drug-drug interactions of Coptidis Rhizoma with other drugs. In vitro rat and mice liver microsomal incubation systems combined with UDPGA were applied, as well as mice liver microsomes after administration of six Coptidis alkaloids. 4-Nitrophenol and β-estradiol were selected as substrates to determine activities of UGTs and UGT1A1 by UV and HPLC, respectively. According to the in vitro rat study, berberine, epiberberine, coptisine and jatrorrhizine significantly inhibited rat liver microsome UGTs activity, particularly epiberberine showed the strongest inhibition. UGT1A1 activity was lowly inhibited by jatrorrhizine, with IC₅₀ at about 227 μmol•L⁻¹, whereas coptisine and magnoflorine significantly activated UGT1A1. According to the in vitro mice study, berberine, coptisine, jatrorrhizine and palmatine significantly inhibited mice liver microsome UGTs activity, and the six alkaloids all significantly activated UGT1A1. According to the in vivo mice study, UGTs activity was significantly activated only in berberine group, while UGT1A1 activity was significantly activated only in jatrorrhizine group. In conclusion, the effects of Coptidis alkaloids on UGT activity showed significant differences in species and between in vitro and in vivo. Meanwhile, the changes in structures of Coptidis alkaloids also have a big impact on UGT activity, which may be one of the causes for the drug-drug interactions between Coptidis Rhizoma and other drugs.
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To predit the mechanism of metabolic drug-drug interactions of hydroxygenkwanin with other drugs, we investigated the inhibition inhibitory effect of hydroxygenkwanin on UGTs and UGT1A1 activities of different liver microsomes. In the present study, 4-nitrophenol (4-NP) and β-estradiol were elected as substrates to determine activities of UGTs and UGT1A1 by UV and HPLC, respectively. The results showed that, hydroxygenkwanin significantly inhibited UGTs activity in rat, mouse and human liver microsomes. UGT1A1 activity was inhibited by hydroxygenkwanin to varying degrees, with IC₅₀ about 190, 10.93, 20.07, 76.31 μmol•L⁻¹ in mouse liver microsome(MLM), rat liver microsome (RLM) and recombinant UGT1A1, and human liver microsome (HLM), respectively. The inhibition types were competitive inhibition (RLM, HLM) and linear mixed-typed linear inhibition (recombinant UGT1A1). The order for the inhibitory intensity was RLM>rUGT1A1>HLM>MLM. In conclusion, hydroxygenkwanin has an inhibitory effect on UGTs and UGT1A1 activities of different liver microsomes, with differences in species, indicating its potential drug interactions based on UGT1A1 enzyme. This study aims to provide a reliable experimental basis for its further research and development of hydroxygenkwanin, and provide theoretical reference for the clinic drug combination research.
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Cirrhosis with portal hypertension is a common disease which has a significant impact on the quality of patients' life. Esophagogastric devascularization (EGDV) has been demonstrated to be an effective method to treat portal hypertension, however certain complications are associated with it. The purpose of this study was to evaluate the effectiveness and clinical outcome of the selective EGDV (sEGDV) for the treatment of portal hypertension. The study was conducted prospectively from Jan. 1 2011 to Dec. 31, 2012, and 180 patients were randomized to the sEGDV group (n=90) or the non-sEGDV (n-sEGDV) group (n=90). Patients' demographics, preoperative lab test results and operative details were comparable between the two groups. Postoperative and short-term complications were analyzed in two groups. There was statistically significant difference (P<0.01) in the PVF reduction between the two groups. Post-operative complications showed no statistically significant difference between the two groups in the incidence of bleeding, ascites, acute portal vein thrombosis, fever and hepatic encephalopathy. Mortality between two groups was comparable. The incidence of splenic fossa effusion after the surgery was lower in sEGDV group than in n-sEGDV group. There were no significant differences in the short-term follow-up data such as esophageal varices and portal hypertensive gastropathy (P>0.05). It is suggested that sEGDV is a safe, simple and effective surgical procedure. It has both the advantages of the shunt and devascularization because it preserves body's voluntary diversion. With the advantage of low incidence of postoperative complications, it is an ideal surgical approach for the treatment of portal hypertension.
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Adult , Female , Humans , Male , Middle Aged , Esophagus , General Surgery , Gastrointestinal Hemorrhage , Pathology , Hepatic Encephalopathy , Pathology , Hypertension, Portal , Pathology , General Surgery , In Vitro Techniques , Postoperative Complications , Pathology , Prospective Studies , Stomach , General Surgery , Thrombosis , PathologyABSTRACT
Cirrhosis with portal hypertension is a common disease which has a significant impact on the quality of patients' life. Esophagogastric devascularization (EGDV) has been demonstrated to be an effective method to treat portal hypertension, however certain complications are associated with it. The purpose of this study was to evaluate the effectiveness and clinical outcome of the selective EGDV (sEGDV) for the treatment of portal hypertension. The study was conducted prospectively from Jan. 1 2011 to Dec. 31, 2012, and 180 patients were randomized to the sEGDV group (n=90) or the non-sEGDV (n-sEGDV) group (n=90). Patients' demographics, preoperative lab test results and operative details were comparable between the two groups. Postoperative and short-term complications were analyzed in two groups. There was statistically significant difference (P0.05). It is suggested that sEGDV is a safe, simple and effective surgical procedure. It has both the advantages of the shunt and devascularization because it preserves body's voluntary diversion. With the advantage of low incidence of postoperative complications, it is an ideal surgical approach for the treatment of portal hypertension.
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Objectives :To determine oral health related behavior; knowledge; attitudes and beliefs among secondary school students in Iringa municipality. Design: Cross-sectional descriptive study. Results: All participants reported to brush their teeth at least once a day; only 24brush twice a day. The use of plastic tooth brush was reported to be 97.1. 72.7of participants who reported to know about dental checkup and 84.6; recommended the interval of dental check ups to be between one to six months. About 58.6reported to experience dental problems and the tooth ache was the most problem experienced (33.6); tooth decay was 20.1and (17.4) experienced bleeding gum. The attitude towards dental health problems was found to be positive and girls had more positive attitude than boys. In measuring beliefs on dental treatment; the majority held positive beliefs with no difference between boys and girls. CONCLUSION The findings of this study have shown that the participants had conducive oral health behavior; sufficient knowledge; positive attitude and held positive beliefs regarding dental treatments
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Attitude , Culture , Oral HealthABSTRACT
Myasthenia Gravis is an infrequent disease. Diagnosis and treatment must be done early to avoid high morbidity that can compromise patients lives. Nine cases were identified during the eight year 1990-1997 at the Santo Tomas Hospital of Panama city but one had to be excluded because he refused treatment. Most of the patients (7/8) had symptoms for more than 3 months. The diagnosis of Myasthenia Gravis requires a high index of suspicion and the clinical impressión must be confirmed by various diagnostic studies that include the edrophonium test, the repetitive stimulation test, the therapeutic test with pyridostigmine, the determination of acetylcholine anti-receptor antibodies and a CT Scan of the thorax. Medical treatment consists mainly of anticholinesterase agents and surgical treatment consists of thymectomy by means of an extended transternal ablation. Operative results were excellent, seven out of eight improved
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Myasthenia Gravis/diagnosis , Pyridostigmine Bromide/therapeutic use , Age Distribution , Cholinesterase Inhibitors/therapeutic use , Myasthenia Gravis/drug therapy , Myasthenia Gravis/surgery , ThymectomyABSTRACT
Se revisan las historias clinicas de 225 ninos con fiebre tifoidea, observados en un periodo de 10 anos, encontrandose que 75 de ellos (33.3%) presentaron por lo menos una complicacion o proceso asociado a dicha enfermedad, siendo las mas frecuentes las siguientes: hepatitis, neumonia, sangrado digestivo y perforacion intestinal