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Not only the high risk of necrobiotic alterations in the acetabulum fragment, but more important the osteoarthritic signs and pains very few years after tripleosteotomy are cogent arguments against this measure. The bad results of tripleosteotomy are well explained by simple biomechanic causes.
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Because the etiology of inflammatory bowel diseases is unclear, no causative therapy is available. However, pathophysiology of the disease offers a lot of possibilities to disrupt the inflammatory cascade that maintains the inflammatory process. The aim of every therapy is to maintain remission as long as possible and to amend the natural course of the disease. Pharmacotherapy includes 5-Aminosalicylates, glucocorticoids, immunosupressants (methotrexate, azathioprine) as well as specific pharmacologic interventions like monoclonal antibodies directed against TNF-alpha (Infliximab). Important supportive tools are available to improve symptoms like diarrhea and pain. Dietetic treatment and surgical procedures represent important alternatives or supplement pharmacotherapeutic interventions.
The development and clinical introduction of targeted therapies has resulted in significant progress for the treatment of malignant diseases. These forms of therapy supplement traditional methods of chemotherapy, radiation, and surgery. As new therapies increase the complexity of therapeutic options in oncology, the treatment costs steadily climb as well. Parameters need to be identified which will predict a response to new substances, and this effort is the subject of ongoing studies.
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Several treatments for anal fissure offer different responses and risks for complications. Reversible chemical sphincterotomy with topical nitroglycerin is an alternative to surgical sphincterotomy. The aim of this observational prospective study was to compare the effectiveness of topical nitroglycerin with the conventional medical treatment. Forty-three patients with anal fissure were treated: 22 (16 chronic and 6 acute) received 0.25% nitroglycerin topically, and 21 (16 chronic and 5 acute) received conventional treatment. Nitroglycerin or placebo was administered in two daily applications for two weeks. Median follow-up was 39 weeks. Healing rate with NTG was 75% for chronic and 83% for acute fissures, but recurrence rate for chronic fissures at 9 months was 67%. Healing rate with placebo for chronic fissures was only anecdotical (1 out of 16 patients). Headache as side effects occurred in 17 cases (77%). In conclusion, both treatments were effective for acute fissures, whereas for chronic ones NTG had a high healing rate but also a high recurrence rate.
During the first decades of the 20th century, many anthropologists who had previously adhered to a linear view of human evolution, from an ape via Pithecanthropus erectus (today Homo erectus) and Neanderthal to modern humans, began to change their outlook. A shift towards a branching model of human evolution began to take hold. Among the scientific factors motivating this trend was the insight that mammalian evolution in general was best represented by a branching tree, rather than by a straight line, and that several new fossil hominids were discovered that differed significantly in their morphology but seemed to date from about the same period. The ideological and practical implications of imperialism and WWI have also been identified as formative of the new evolutionary scenarios in which racial conflict played a crucial role. The paper will illustrate this general shift in anthropological theory for one particular scientist, William Sollas (1849-1936). Sollas achieved a synthesis of human morphological and cultural evolution in what I will refer to as an imperialist model. In this theoretical framework, migration, conflict, and replacement became the main mechanisms for progress spurred by 'nature's tyrant,' natural selection.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
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Staged flexor tendon grafting was conducted in sixteen young adults for isolated loss of the flexor digitorum profundus. Though thirteen of sixteen achieved a subjectively pleasing result, only seven of the sixteen cases achieved satisfactory results. Five major complications occurred in four patients. The overall results were no better than the results obtained for single stage flexor tendon grafting through an intact superficialis. This study establishes no advantage of staged flexor tendon grafts, over unstaged grafts for isolated profundus loss.
The authors expose their experience in neuroradiological applications of dynamic-CT (D-CT) or angio-CT. The examinations are performed by means of a G.E. 8.800 CT/T. A special software offers automatic analysis of the region of interest. Vascular and tumoral patients are examined trying to evaluate: (a) the blood flow in patients suffering from transient ischaemic attacks and (b) to estimate the possibilities of D-CT in the evaluation of tumoral vascularity and in the identification of characteristic curves for different kinds of tumors.
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We describe 2 patients who were receiving antidepressant therapy before excimer laser surgery, at the time of surgery, and after surgery. Both patients experienced the ocular side effects of antidepressant drugs, ie, symptoms due to dry eyes and mydriasis.
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OBJECTIVE: To determine whether the introduction of a patient information sheet about do not attempt resuscitation (DNAR) orders and personal motivation of the medical staff results in an improvement in the documentation of the DNAR orders in the medical records. DESIGN: Retrospective chart review. METHOD: The medical records for all hospital admissions during February 2005 were checked for age, sex, admission time, admitting specialty, admission type (acute or planned), death, documentation of the DNAR order on the admission form, and if this order was complied with and under whose initiative the order was implemented or not. These data were compared to the medical records from 2 years earlier. RESULTS: In 2005, 119 (9.3%) medical records a DNAR order was found, compared to 10.7% in 2003. In the 43 patients who died DNAR orders were documented more often (18.6%) than in other patients (9%). The DNAR order was written more frequently for patients who were older (46.5 years versus 67.5 years), had a longer hospital admission period (4.2 versus 12.4 days) and for acute admissions. No difference was found for sex. Of the specialties with more than 10 admissions a month, the most frequently written DNAR orders came from internal medicine (36%) and pulmonology (31%); the least from cardiology (2.2%) and thoracic surgery (0%). In 9 of the 119 (7.6%) the DNAR orders were explained, most were initiated by the doctor (7), 1 by the patient an 1 by the family. CONCLUSION: Giving patients more information about DNAR orders and motivating medical staff personally does not influence the documentation of DNAR orders. If documented, it occurred more in the elderly and the deceased patients. Only a few DNAR orders were specified and most were initiated by the doctor.