Long term follow-up of prophylactic caval clipping

120 high risk patients who underwent prophylactic inferior vena cava clipping were retrospectively evaluated to determine the incidence of post clipping leg swelling and pulmonary embolism. Each one of those patients had at least two criteria for the clipping. These criteria of high risk factors were precisely identified. There were two patients who had postoperative pulmonary embolism but none of them was fatal, i.e. less than two per cent. Two patients developed severe leg swelling (less than two per cent) and six had mild leg swelling (less than six per cent). Prophylactic inferior vena cava clipping is a safe and effective mean to prevent post-operative pulmonary embolism.     

Long term clinical evaluation of three luting materials

A last critical step in the completion of a cast restoration is permanent cementation. With the development of new luting agents the practitioner has to be aware of the physical and biological properties as well as the long term clinical performance of these materials. In this study three commonly used luting agents were evaluated over a four year period. The three cements, a zinc phosphate, a glass ionomer and a resin cement were tested for their reaction to periodontal tissues, pulpal response and other clinical parameters. In twenty six patients, 61 crowns, onlays or bridge abutments were cemented. Evaluations were made at 0 hour, after 7 days, 6 and 12 months and 4 years. In general the cements performed satisfactorily. Health of periodontal tissues adjacent to the crowns improved considerably after 7 days. Postcementation hypersensitivity appeared to be a negligible problem, which was attributed to the time span between preparation and cementation, which exceeded in most instances four weeks. The choice of a final luting agent should be based on anticipated postoperative pulpal reactions, rather than exclusive reliance on physical properties.     

本钢3号高炉炉况长期不顺的原因分析

介绍了本钢３号高炉炉况长期不顺的操作情况,并结合高炉大修,总结了破损情况,分析了操作不顺的原因,提出了改进意见及完善高炉操作的措施与对策。     

Long term control of diabetes in general practice

Longterm follow-up and counselling of the diabetic patient faces the family doctor with highly specific tasks. The importance of optimum cooperation from the patient is stressed and the method of carrying out periodic checkups is described. The doctor should obtain information about the carbohydrate metabolism from urinary tests performed by the patient himself. Also, the symptoms of late diabetic syndrome should be detected as early as possible.     

Long term results of treatment of carcinoma of cervix

In this survey of 602 patients treated for carcinoma of the uterine cervix during the period 1944--1968 (with a 100 per cent follow-up) survival rates at 5, 10, 15 and 20 years after radiotherapy were 41, 28, 18 and 11 per cent. The crude five-year cure rate of over 70 per cent for Stage I and 58 per cent for Stage II cases and an overall five-year survival rate of 42 per cent for all stages compares favourably with results published from other institutions in the United Kingdom.     

Long term disability rates in a cohort of Air Canada pilots

Causes of long term disability (LTD) were collected between January 1, 1981 and December 31, 1990 among all active pilots in a cohort of Air Canada pilots. During this 10-yr period, 474 (20.9%) of the 2271 pilots had LTD; there were 1107 cases of LTD corresponding to a total duration of leave of absence of 4161 mo. Frequencies of the main diagnostic categories were: injuries: 249 (22.5%); mental disorders: 175 (15.8%); circulatory system: 157 (14.2%); digestive system: 128 (11.6%); and musculoskeletal system: 121 (10.9%). LTD rates increased with age, ranging from 1.86-9.22 per 1000 pilots per year from the younger (20-29 yr) to the older age group (50-59 yr), respectively. Several causes of LTD could be potentially preventable, in particular injuries which accounted for 63.6% of all causes in the younger age group and remained a significant condition at subsequent ages.     

Long term effects of 50 mg acetylsalicylic acid alone and in combination with dipyridamole on platelet function after coronary bypass surgery

In a prospective randomized trial in 42 patients undergoing coronary artery bypass surgery, we analyzed the long term platelet inhibiting effects of 50 mg acetylsalicylic acid (ASA) by itself and in combination with dipyridamole (2 x 200 mg), in comparison with phenprocoumon. Three and six months therapy led to significant inhibition of maximum aggregation induced by collagen 1 microgram/ml in platelet rich plasma (PRP) by more than 50% (p < or = 0.05). In PRP stimulated with 5 micrograms/ml collagen maximum inhibition amounted to nearly 20% (n.s.). The groups treated with ASA/ASA + dipyridamole showed an ADP threshold concentration 2.5 times higher than the group treated with phenprocoumon (p < or = 0.05). After stimulation with collagen 1 microgram/ml and 5 micrograms/ml thromboxane B2 synthesis in vitro in both groups treated with ASA was reduced to 1% of the base line values (p < or = 0.01). Inhibition of aggregation in whole blood appeared evident, but was not statistically significant due to considerable fluctuation of measurement. An additional effect of dipyridamole was not detectable. In conclusion, treatment with 50 mg ADA/d results in a lasting, effective inhibition of aggregation of platelets in patients with coronary artery bypass surgery. There is no synergistic effect of additional dose of 400 mg dipyridamole/d.     

Clinical, endocrine, and metabolic effects of two doses of gestrinone in treatment of pelvic endometriosis

AIM: To study the effect of prokinetic treatment with cisapride in patients with constipation-predominant irritable bowel syndrome. PATIENTS AND METHODS: Ninety-six patients were randomly assigned to treatment with either cisapride 5 mg three times daily or placebo three times daily for a period of 12 weeks. The dosage could be doubled after 4 weeks. Presence of the target symptoms abdominal pain, constipation and abdominal bloating was an obligatory criterion for inclusion in the study. RESULTS: After 12 weeks of treatment, 31%, 56% and 27% of the cisapride treated patients were found to be without the three target symptoms (P < 0.05). The corresponding percentages for the placebo-treated patients were 31%, 58% and 19%, respectively, (P < 0.05). The visual analogue scale (VAS) symptom scores assessed by the patients for global rating of bowel disease, general well-being and frequency of stool passage improved significantly within each treatment group (P < 0.05). Evaluation of efficacy parameters using intention-to-treat analysis showed no statistically significant differences between the groups. Using efficacy analysis, the difficulty of stool passage showed a significantly higher improvement with cisapride (P < or = 0.05). CONCLUSIONS: These results indicate that cisapride is not superior to placebo in the treatment of constipation and abdominal discomfort as components of irritable bowel syndrome. It may, however, be of use in improving the difficulty of stool passage.     

The importance of dietary control in metabolic studies of manic-depressive patients

Diet control of electrolyte intake appears to diminish day to day variation of urinary electrolyte output. Urine sodium concentration is more affected by diet control than potassium, possibly due to the greater variation in sodium ingestion on uncontrolled diets. The coefficient of variation of urinary sodium excretion on the controlled diet was not significantly greater than the variation in sodium ingestion. These experimental results suggest that controlled diets reduce random variation in sodium and potassium excretion and therefore enhance the possibility of observing illness-related biological changes.     

Microcounseling for a counseling-like verbal response set: Differential effects of two micromodels and two methods of counseling supervision.

Compared the use of 2 models employing behavioral supervision and recall interrogation in teaching a counseling-like verbal response set to 16 guidance students. Pre-post1 and pre-post2 criterion performance gains of the experimental Ss and a no-treatment control group (n = 14) were measured on the Counselor Verbal Response Scale. Results from a 2 * 2 factorial design with a single control group reveal that microcounseling Ss gained significantly more in criterion performance than the controls. There was virtually no difference in the effectiveness of the 2 micromodels, and behavioral supervision was somewhat more successful than recall interrogation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A randomized comparative study of the metabolic effects of two regimens of gestrinone in the treatment of endometriosis

OBJECTIVE: To study some of the metabolic effects of oral gestrinone on plasma lipoprotein risk markers for cardiovascular disease and on bone density, a risk marker for osteoporosis. DESIGN: Randomized double-blind study. SETTING: All patients were referred to Gynaecology Clinic of Royal Free Hospital Medical School. PATIENTS: Twenty premenopausal women with laparoscopically confirmed endometriosis. INTERVENTIONS: Subjects were randomized in a double-blind fashion to receive either 1.25 mg or 2.5 mg gestrinone two times per week for 6 months. MAIN OUTCOME MEASURE: Laparoscopy was performed before treatment, and clinical responses were determined by second laparoscopy after 6 months. Plasma lipid and bone density measurements during and after therapy were compared with baseline. RESULT: Median total endometriosis scores decreased from 7.5 to 1.0 in the 1.25-mg group and from 7.0 to 0 in the 2.5-mg group. There were no significant between-group differences in endometriosis scores. At both doses, bone density in the spine and the proximal femur was conserved, but plasma concentrations of low-density lipoproteins rose by 13% and those of high-density lipoproteins fell by 40%. CONCLUSIONS: Reducing the dose of gestrinone to 1.25 mg appeared to maintain the therapeutic effectiveness of this treatment but was still associated with potentially unfavorable effects on lipids and lipoproteins.     

Long term follow up of multifocal motor neuropathy with conduction block under treatment

OBJECTIVE: To determine the accuracy and potential harmfulness of the drug information in a newsgroup on the Internet, sci.med.pharmacy. DESIGN: In this cross-sectional study, two independent reviewers analyzed the nonsubjective drug information in this newsgroup. Drug information was classified as correct, incorrect or could not verify. Information was determined to have no harm, minor harm, moderate harm, or severe harm. RESULTS: About one-half of the drug information was found to be correct in this newsgroup. Although 68% of the drug information was found to result in no harm, 19.4% was classified as harmful. CONCLUSIONS: If drug information on the Internet contains inaccuracies, its ready accessibility may pose a public health problem. With the number of Internet users growing, health professionals need to be aware of the potential for dissemination of misinformation, and need to become familiar with the Internet and the various health information resources available to the public.     

Adjuvant preoperative radiotherapy in patients with rectal carcinoma. Adverse effects during long term follow-up of two randomized trials

BACKGROUND: Adjuvant preoperative radiotherapy of patients with primary rectal carcinoma improves local control and survival, but also may increase the risk of early postoperative morbidity and mortality. In addition, the possible late adverse effects of this treatment are largely unknown. METHODS: The present study was based on 1027 curatively operated patients included in 2 prospective randomized trials of preoperative radiotherapy for rectal carcinoma patients (Stockholm I and Stockholm II Trials). The goal was to assess whether long term intercurrent morbidity and mortality were increased in patients allocated to the preoperative treatment. A computerized linkage of the randomized patients to a population-based registry of the Stockholm County Council was used to study hospital admissions for six groups of a priori defined diseases, putatively related to late adverse effects of the radiation. RESULTS: Preoperative radiotherapy significantly increased the incidence of venous thromboembolism (P = 0.01), femoral neck and pelvic fractures (P = 0.03), intestinal obstruction (P = 0.02), and postoperative fistulas (P = 0.01). For arterial disease and genitourinary tract diseases, no difference in risk was found between irradiated and non irradiated patients. Radiotherapy significantly reduced rectal carcinoma deaths in both trials and also improved overall survival in the Stockholm II trial. The late intercurrent mortality was similar in irradiated and nonirradiated patients. CONCLUSIONS: Although high dose, short term, preoperative radiotherapy can improve outcome after surgery for rectal carcinoma, there also may be an increased risk for long term morbidity. Refinement of the radiotherapy technique and a more accurate selection of patients suitable for the treatment will probably further improve the results, at least in regard to treatment-related complications.