• 【分娩试验期间子宫破裂和硬膜外镇痛。】 复制标题 收藏 收藏
    DOI:10.1111/j.1365-2044.1997.107-az0110.x 复制DOI
    作者列表:Rowbottom SJ,Critchley LA,Gin T
    BACKGROUND & AIMS: A case of complete uterine rupture during a trial of labour in which epidural analgesia was used is described. The pain of uterine rupture was not masked by the addition of fentanyl 25 micrograms to bupivacaine 0.25% 6 ml but was relieved by bupivacaine 0.375% 6 ml.

    背景与目标: 描述了在使用硬膜外镇痛的分娩试验中子宫完全破裂的情况。在布比卡因0.25% 6毫升中添加芬太尼25微克并没有掩盖子宫破裂的疼痛,但布比卡因0.375% 6毫升减轻了子宫破裂的疼痛。
  • 【[念珠菌脊椎炎和硬膜外脓肿]。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Di Stilio G,Rica CM,Nine C,Catalano HN
    BACKGROUND & AIMS: :Candida spondylodiscitis associatd with epidural abscess is rarely seen. We present a patient with Hodgkin lymphoma who received chemotherapy and developed systemic Candida infection, which was complicated by Candida spondylodiscitis and epidural abscess.
    背景与目标: : 与硬膜外脓肿相关的念珠菌脊柱炎很少见。我们介绍了一名霍奇金淋巴瘤患者,该患者接受了化学疗法并发展为系统性念珠菌感染,并伴有念珠菌性脊柱炎和硬膜外脓肿。
  • 【自我收集的宫颈阴道采样,用于基于HPV的初级宫颈癌筛查的护理地点: 在服务不足的希腊农村人群中的一项初步研究。】 复制标题 收藏 收藏
    DOI:10.1080/01443615.2017.1323197 复制DOI
    作者列表:Chatzistamatiou K,Chatzaki Ε,Constantinidis Τ,Nena E,Tsertanidou A,Agorastos T
    BACKGROUND & AIMS: :In the present pilot study, the feasibility of a site-of-care cervicovaginal self-sampling methodology for HPV-based screening was tested in 346 women residing in underserved rural areas of Northern Greece. These women provided self-collected cervicovaginal sample along with a study questionnaire. Following molecular testing, using the cobas® HPV Test, Roche®, HPV positive women, were referred to colposcopy and upon abnormal findings, to biopsy and treatment. Participation rate was 100%. Regular pap-test examination was reported for 17.1%. Among hrHPV testing, 11.9% were positive and colposcopy/biopsy revealed 2 CIN3 cases. Non-compliance was the most prevalent reason for no previous attendance. Most women reported non-difficulty and non-discomfort in self-sampling (77.6% and 82.4%, respectively). They would choose self-sampling over clinician-sampling (86.2%), and should self-sampling being available, they would test themselves more regularly (92.3%). In conclusion, self-sampling is feasible and well-accepted for HPV-based screening, and could increase population coverage in underserved areas, helping towards successful prevention.
    背景与目标: : 在本试点研究中,对居住在希腊北部服务不足的农村地区的346名妇女进行了基于HPV筛查的护理现场宫颈阴道自采样方法的可行性进行了测试。这些妇女提供了自我收集的宫颈阴道样本以及研究问卷。在分子测试之后,使用cobas®罗氏HPV检测®HPV阳性女性被转诊至阴道镜检查和异常发现后,进行活检和治疗。参与率为100%。报告定期进行17.1% 巴氏试验检查。在hrHPV检测中,11.9% 例为阳性,阴道镜/活检显示2例CIN3。不遵守是以前没有出席的最普遍原因。大多数妇女报告说,自我取样没有困难,也没有不适 (分别为77.6% 和82.4%)。他们将选择自采样而不是临床医生采样 (86.2%),并且如果自采样可用,他们将更定期地测试自己 (92.3%)。总之,自我采样对于基于HPV的筛查是可行的且被广泛接受,并且可以增加服务不足地区的人口覆盖率,从而有助于成功预防。
  • 【小容量硬膜外血液补片治疗自发性颅内低血压后的膀胱和肠功能障碍。】 复制标题 收藏 收藏
    DOI:10.1016/j.jocn.2012.02.022 复制DOI
    作者列表:Han IB,Ropper AE,Teng YD,Ryoo YH,Kim O
    BACKGROUND & AIMS: :Epidural blood patch (EBP) is an effective procedure for the treatment of spontaneous intracranial hypotension (SIH). Neurological compromise following EBP, although rare, is recognized as a serious potential complication. We describe a 33-year-old female patient in whom long-term bladder and bowel dysfunction developed following a small volume (10 mL) EBP to treat SIH. We also discuss the possible pathophysiological mechanisms related to this complication in the postprocedure setting.
    背景与目标: : 硬膜外血贴 (EBP) 是治疗自发性颅内低血压 (SIH) 的有效方法。EBP后的神经系统损害虽然很少见,但被认为是严重的潜在并发症。我们描述了一名33岁的女性患者,在小体积 (10 mL) EBP治疗SIH后,长期出现膀胱和肠功能障碍。我们还讨论了在术后环境中与这种并发症有关的可能的病理生理机制。
  • 【B7-H3促进宫颈癌细胞的增殖、迁移和侵袭,是预后不良的指标。】 复制标题 收藏 收藏
    DOI:10.3892/or.2017.5730 复制DOI
    作者列表:Li Y,Zhang J,Han S,Qian Q,Chen Q,Liu L,Zhang Y
    BACKGROUND & AIMS: :B7-H3 is an immune regulatory molecule whose aberrant expression in tumors is associated with adverse outcomes. Upregulation of B7-H3 may promote tumor cell proliferation and metastasis in vitro, but the role of B7-H3 in cervical cancer has not yet been investigated. We measured B7-H3 expression in 90 cervical cancer patient and 20 non‑cervical lesion patient tissues using immunohistochemistry and in 30 cervical cancer patient and 30 healthy donor blood samples using ELISA. The association of B7-H3 expression and the prognosis of cervical cancer patients was investigated. B7-H3 knockdown in CaSki and SiHa cell lines was performed using small hairpin (sh)RNA lentiviral transfection and B7-H3 overexpression in CaSki and HeLa cell lines was performed using plasmid-vector lentivirus transduction. Cell proliferation, invasion and migration were then measured using MTT and Transwell assays in vitro. B7-H3 expression was significantly higher in the cervical cancer tissues compared to that noted in the normal cervical tissues (mean 72.22 vs. 15.00%; p<0.001). Using Kaplan‑Meier and Cox analyses, our data revealed that patients with strong intensity staining were significantly more likely to have a worse prognosis. The B7-H3 level in cervical cancer patient blood was significantly higher than that in the normal donors (13.41±6.12 vs. 9.90±3.16 ng/ml; p=0.007). MTT assay revealed that high expression of B7-H3 promoted cervical cancer cell proliferation. Transwell assay data revealed that high expression of B7-H3 enhanced cervical cancer cell migration and invasion (CaSki, p=0.003; HeLa, p=0.03). In conclusion, expression of B7-H3 was significantly higher in cervical cancer tissues compared to normal cervical tissues, and this high expression was associated with worse prognosis for cervical cancer patients. In addition, B7-H3 promoted proliferation, invasion and migration of cervical cancer and may be a potential target for treating cervical cancer.
    背景与目标: : B7-H3是一种免疫调节分子,其在肿瘤中的异常表达与不良后果有关。B7-H3的上调可能在体外促进肿瘤细胞的增殖和转移,但B7-H3在宫颈癌中的作用尚未得到研究。我们使用免疫组织化学方法测量了90例宫颈癌患者和20例非宫颈病变患者组织中的B7-H3表达,并使用ELISA测量了30例宫颈癌患者和30例健康供体血样中的表达。研究了B7-H3表达与宫颈癌患者预后的关系。使用小发夹 (sh)RNA慢病毒转染在CaSki和SiHa细胞系中进行B7-H3敲除,并使用质粒载体慢病毒转导在CaSki和HeLa细胞系中进行B7-H3过表达。细胞增殖,然后在体外使用MTT和Transwell测定法测量侵袭和迁移。与正常宫颈组织相比,宫颈癌组织中的B7-H3表达明显更高 (平均72.22对15.00%; p<0.001)。使用kaplan-meier和Cox分析,我们的数据显示,强染色的患者预后更差。宫颈癌患者血液中的B7-H3水平明显高于正常供体 (13.41 ± 6.12 vs. 9.90 ± 3.16 ng/ml); p = 0.007)。MTT分析显示B7-H3的高表达促进了宫颈癌细胞的增殖。tranwell分析数据显示B7-H3的高表达增强了宫颈癌细胞的迁移和侵袭 (CaSki,p = 0.003; HeLa,p = 0.03)。总之,b7-H3在宫颈癌组织中的表达明显高于正常宫颈组织,这种高表达与宫颈癌患者预后差有关,此外,B7-H3促进了宫颈癌的增殖、侵袭和迁移,可能是治疗宫颈癌的潜在靶点。
  • 【一种用于植入可植入门静脉系统的技术,用于硬膜外长期施用阿片类药物治疗癌症疼痛。】 复制标题 收藏 收藏
    DOI:10.1177/0310057X8501300206 复制DOI
    作者列表:Cherry DA,Gourlay GK,Cousins MJ,Gannon BJ
    BACKGROUND & AIMS: :The feasibility of using a subcutaneously implanted portal system attached to a conventional 16-gauge epidural catheter has been evaluated in 50 patients with sever pain associated with cancer. This technique allowed for the percutaneous epidural administration of morphine at 8-12-hourly intervals for pain control. The mean duration of implantation was 12 weeks and the longest period a portal remained in situ was 36 weeks. Five portals had to be removed for various reasons. The injection system has blocked on eight occasions due to catheter blockage (six times) and portal blockage (two occasions). These patients have continued to obtain excellent analgesia when either catheter or portal were replaced. In a cadaver, 300 injections were simulated using either 22-gauge Huber point needles or disposable needles (25 gauge) and the injectate examined by both light and scanning electron microscopy. Both needle types resulted in particulate contamination which was greater with the recommended Huber point needles.
    背景与目标: : 已在50例与癌症相关的严重疼痛患者中评估了使用固定在常规16号硬膜外导管上的皮下植入门静脉系统的可行性。该技术允许以8-12小时的间隔经皮硬膜外施用吗啡以控制疼痛。植入的平均持续时间为12周,而原位保留的最长时间为36周。由于各种原因,必须删除五个门户。由于导管阻塞 (六次) 和门静脉阻塞 (两次),注射系统有八次阻塞。当更换导管或门静脉时,这些患者继续获得出色的镇痛效果。在尸体中,使用22号Huber点针或一次性针 (25号) 模拟300注射,并通过光学和扫描电子显微镜检查注射物。两种类型的针头都会导致颗粒污染,推荐的Huber点针头会更大。
  • 【MiR-34a和miR-206可作为宫颈癌的新型预后和治疗生物标志物。】 复制标题 收藏 收藏
    DOI:10.1186/s12935-017-0431-9 复制DOI
    作者列表:Chen AH,Qin YE,Tang WF,Tao J,Song HM,Zuo M
    BACKGROUND & AIMS: BACKGROUND:Recent evidence indicated that the aberrant expression of microRNA plays a crucial role in the development of cervical cancer. The overall shorter survival was strongly related to the abnormal expression of microRNA-34a (miR-34a) and microRNA-206 (miR-206), which target B cell lymphoma-2(Bcl2) and c-Met. Hepatocyte growth factor (HGF)/c-Met pathway is related to the occurrence, development and prognosis of cervical cancer, and c-Met is significantly overexpressed in cervical squamous cell carcinoma. Bcl2 is also considered to be a promising target for developing novel anticancer treatments. METHODS:In this study, we detect the expression of miR-34a and miR-206 in the cervical cancer tissue through quantificational real-time polymerase chain reaction (qRT-PCR) assay, and the expression of Bcl2 and c-Met from cervical cancer tissue were detected by immunohistochemistry. RESULTS:The expression of miR-34a and miR-206 were down-regulated in the cervical cancer tissue through qRT-PCR assay. As target genes of miR-34a and miR-206, Bcl2 and c-Met were up-regulated in cervical cancer tissues through qRT-PCR assay and immunohistochemistry. Kaplan-Meier and log-rank analysis revealed that down-regulated expression of miR-34a and miR-206 were strongly related to shorter overall survival. Multivariate Cox proportional hazards model for all variables that were statistically significant in the univariate analysis demonstrated that miR-34a (P = 0.038) and miR-206 (P = 0.008) might be independent prognostic factors for overall survival of patients suffering from cervical cancer. CONCLUSIONS:The up-regulation of Bcl2 and c-Met promotes the cervical cancer's progress, and the expression of miR-34a and miR-206 significantly correlated with the progression and prognosis in cervical cancer. All of these suggested that miR-34a and miR-206 might be the novel prognostic and therapy tools in cervical cancer.
    背景与目标:
  • 【制定预先通知传单以鼓励首次邀请进行子宫颈筛查: 一项定性研究。】 复制标题 收藏 收藏
    DOI:10.1093/her/cys103 复制DOI
    作者列表:Sadler L,Albrow R,Shelton R,Kitchener H,Brabin L
    BACKGROUND & AIMS: :Cervical screening attendance among women aged 25-29 years in England is lower than at older ages. There is some evidence that pre-notification leaflets motivate women who have not yet considered their response to a health intervention. We aimed to identify key information to motivate young women at their first cervical screening invitation. Six focus groups were conducted, five with young women aged 17-25 registered with a General Practice in Manchester, UK, and one with Practice nurses. Some women took part in two further groups to discuss leaflet design. There was low awareness of the purpose or procedures of cervical screening, and most women were de-motivated by reports of bad experiences. Some intended to be screened, but not immediately after invitation. Screening was viewed as a test for a cancer that affected older women. Since none of the participants believed that they had cervical cancer, screening seemed unnecessary. We conclude that the perception that screening is unimportant when you are young needs to be challenged. Women also need to be better informed of screening procedures. A pre-notification leaflet incorporating key information was designed and will be tested in a randomized trial of complex interventions within the routine cervical screening programme.
    背景与目标: : 英格兰25-29岁女性的子宫颈筛查出勤率低于老年人。有证据表明,预先通知的传单会激励尚未考虑对健康干预措施做出反应的妇女。我们的目标是确定关键信息,以激励年轻女性首次接受子宫颈筛查邀请。进行了六个重点小组,其中五个是在英国曼彻斯特注册的17-25岁的年轻女性,其中一个是执业护士。一些妇女参加了另外两个小组,讨论传单设计。人们对宫颈筛查的目的或程序的认识不足,大多数妇女因不良经历的报道而缺乏动力。有些人打算放映,但不是在邀请后立即放映。筛查被视为对影响老年妇女的癌症的测试。由于没有参与者相信自己患有宫颈癌,因此筛查似乎没有必要。我们得出的结论是,年轻时筛查不重要的看法需要受到挑战。妇女还需要更好地了解筛查程序。设计了包含关键信息的预通知传单,并将在常规子宫颈筛查计划中进行复杂干预的随机试验中进行测试。
  • 【宫颈利多卡因治疗IUD插入性疼痛: 一项随机对照试验。】 复制标题 收藏 收藏
    DOI:10.1016/j.ajog.2012.09.018 复制DOI
    作者列表:McNicholas CP,Madden T,Zhao Q,Secura G,Allsworth JE,Peipert JF
    BACKGROUND & AIMS: OBJECTIVE:Anticipated pain with intrauterine device (IUD) insertion may be a barrier to widespread use. Our objective was to evaluate the efficacy of intracervical 2% lidocaine gel for pain relief with IUD insertion. STUDY DESIGN:We performed a double-blind, randomized controlled trial of women undergoing IUD insertion. Participants were randomly assigned to 2% lidocaine or placebo gel. Study gel (3 mL) was placed 3 minutes prior to IUD insertion. Pain scores were measured at various time points using a 10-point visual analog scale. RESULTS:Of the 200 participants randomized, 199 completed the study. Pain scores among lidocaine and placebo arms were similar at tenaculum placement (lidocaine and placebo: median, 4; range, 0-10; P = .15) and with insertion (lidocaine: median, 5; range, 1-10; placebo: median, 6; range, 0-10; P = .16). These results did not differ by parity. CONCLUSION:Topical or intracervical 2% lidocaine gel prior to IUD insertion does not decrease pain scores.
    背景与目标:
  • 【硬膜外麻醉和腰麻联合缺血再灌注损伤对大鼠腹直肌肌皮瓣的影响比较。】 复制标题 收藏 收藏
    DOI:10.1097/SAP.0b013e31824f220e 复制DOI
    作者列表:Acar Y,Bozkurt M,Firat U,Selcuk CT,Kapi E,Isik FB,Kuvat SV,Celik F,Bozarslan BH
    BACKGROUND & AIMS: :The purpose of this study is to compare the effects of spinal and epidural anesthesia on a rat transverse rectus abdominus myocutaneous flap ischemia-reperfusion injury model.Forty Sprague-Dawley rats were divided into 4 experimental groups: group I (n = 10), sham group; group II (n = 10), control group; group III (n = 10), epidural group; and group IV (n = 10), spinal group. After the elevation of the transverse rectus abdominus myocutaneous flaps, all groups except for the sham group were subjected to normothermic no-flow ischemia for 4 hours, followed by a reperfusion period of 2 hours. At the end of the reperfusion period, biochemical and histopathological evaluations were performed on tissue samples.Although there was no significant difference concerning the malonyldialdehyde, nitric oxide, and paraoxonase levels in the spinal and epidural groups, the total antioxidant state levels were significantly increased, and the total oxidative stress levels were significantly decreased in the epidural group in comparison to the spinal group. The pathological evaluation showed that findings related to inflammation, nuclear change rates and hyalinization were significantly higher in the spinal group compared with the epidural group.Epidural anesthesia can be considered as a more suitable method that enables a decrease in ischemia-reperfusion injuries in the muscle flaps.
    背景与目标: : 本研究的目的是比较脊髓和硬膜外麻醉对大鼠腹直肌横肌肌皮瓣缺血再灌注损伤模型的影响。将40只Sprague-Dawley大鼠分为4个实验组: I组 (n = 10),假手术组; II组 (n = 10),对照组; III组 (n = 10),硬膜外组; IV组 (n = 10),脊髓组。腹直肌肌皮瓣抬高后,除假手术组外,所有组均进行常温无血流缺血4小时,然后再灌注2小时。在再灌注期结束时,对组织样本进行生化和组织病理学评估。尽管脊髓和硬膜外组的丙二醛,一氧化氮和对氧磷酶水平没有显着差异,但总抗氧化状态水平显着增加,与脊髓组相比,硬膜外组的总氧化应激水平显着降低。病理评估表明,与硬膜外组相比,脊柱组与炎症,核改变率和透明化有关的发现明显更高。硬膜外麻醉可以认为是一种更合适的方法,可以减少肌肉皮瓣的缺血再灌注损伤。
  • 【剧烈颈部按摩后颈部肿胀。诊断: 宫颈淋巴性膨出】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Ceylan A,Akçam T,Karatas E,Celenk F
    BACKGROUND & AIMS: -2
    背景与目标: -2
  • 【市中心地区子宫颈筛查的初步研究-国家计划的经验教训。】 复制标题 收藏 收藏
    DOI:10.1046/j.1365-2303.1997.4475044.x 复制DOI
    作者列表:Herity B,McDonald P,Johnson Z,Carroll B,Cody M,Duignan N,McGee D,O'Kelly F,Hurley M
    BACKGROUND & AIMS: :The objectives of this study were to examine aspects of organization of a proposed national screening programme based in general practice. The target population of women aged 25-59 years and their general practitioners (GPs), in a defined inner city area, was identified from a population register of persons eligible for free medical services; a computerized system was developed for invitations and record linkage of cytology results. Smears were examined in one laboratory and follow up of women with abnormal smears was undertaken by one gynaecologist. A random sample of non-responders was surveyed by questionnaire. Response following two invitations was only 20%. Practices with male doctors only had significantly lower response rates (P < 0.001) than those with a female doctor/nurse. A survey of non-responders showed that over 20% of addresses were incorrect and 16% of those interviewed were ineligible for smear tests. A preference for a female to undertake smears was expressed by 67%, and 77% believed that the purpose of the cervical smear was to detect cancer. An accurate population register, health promotion, support for GP practices, provision of alternative venues for smear tests, development of computer systems, accurate data entry and fail-safe follow up are aspects of a cervical screening service which must be addressed prior to setting up a national service.
    背景与目标: : 这项研究的目的是根据一般实践研究拟议的国家筛查计划的组织方面。从有资格获得免费医疗服务的人的人口登记册中确定了在确定的内城地区25-59岁妇女及其全科医生的目标人群; 开发了一个计算机化系统,用于邀请和细胞学结果的记录联系。在一个实验室中检查了涂片,并由一名妇科医生对涂片异常的妇女进行了随访。通过问卷调查对无反应者进行了随机抽样调查。仅20% 了两次邀请后的答复。男性医生的实践仅比女性医生/护士的实践具有显着较低的反应率 (P <0.001)。对无应答者的调查显示,超过20% 的地址不正确,并且16% 的受访者不符合涂片检查的资格。67% 表示偏爱女性进行涂片检查,77% 认为宫颈涂片检查的目的是检测癌症。准确的人口登记、健康促进、对全科医生做法的支持、提供涂片检查的替代场所、计算机系统的开发、准确的数据输入和故障安全随访是子宫颈筛查服务的各个方面,在建立国家服务之前必须解决这些问题。
  • 【以铂类为基础的化疗治疗的转移性或复发性宫颈癌患者的预后和预测因素。】 复制标题 收藏 收藏
    DOI:10.1186/s12885-017-3435-x 复制DOI
    作者列表:Karageorgopoulou S,Kostakis ID,Gazouli M,Markaki S,Papadimitriou M,Bournakis E,Dimopoulos MA,Papadimitriou CA
    BACKGROUND & AIMS: BACKGROUND:Recognizing resistance or susceptibility to the current standard cisplatin and paclitaxel treatment could improve therapeutic outcomes of metastatic or recurrent cervical cancer. METHODS:Forty-five tissue samples from patients participating in a phase II trial of cisplatin and ifosfamide, with or without paclitaxel were collected for retrograde analysis. Immunohistochemistry and genotyping was performed to test ERCC1, III β-tubulin, COX-2, CD4, CD8 and ERCC1 (C8092A and N118 N) and MDR1 (C3435T and G2677 T) gene polymorphisms, as possible predictive and prognostic markers. Results were statistically analyzed and correlated with patient characteristics and outcomes. RESULTS:Patients with higher levels of ERCC1 expression had shorter PFS and OS than patients with low ERCC1 expression (mPFS:5.1 vs 10.2 months, p = 0.027; mOS:10.5 vs. 21.4 months, p = 0.006). Patients with TT in the site of ERCC1 N118 N and GT in the site of MDR1 G2677 T polymorphisms had significantly longer PFS (p = 0.006 and p = 0.027 respectively). ERCC1 expression and the ERCC1 N118 N polymorphism remained independent predictors of PFS. Interestingly, high III beta tubulin expression was associated with chemotherapy resistance and fewer responses [5/20 (25%)] compared to lower III β-tubulin expression [15/23 (65.2%)] (p = 0.008). Finally, ΙΙΙ β-tubulin levels and chemotherapy regimen were independent predictors of response to treatment. CONCLUSIONS:ERCC1 expression proved to be a significant prognostic factor for survival in our metastatic or recurrent cervical cancer population treated with cisplatin based chemotherapy. ERCC1 N118 N and MDR1 G2677 T polymorphism also proved of prognostic significance for disease progression, while overexpression of III β-tubulin was positively correlated with chemotherapy resistance.
    背景与目标:
  • 【颈椎压迫性脊髓病: 融合是主要的预后指标吗?】 复制标题 收藏 收藏
    DOI:10.3171/spi.2007.6.6.3 复制DOI
    作者列表:Sorar M,Seçkin H,Hatipoglu C,Budakoglu II,Yigitkanli K,Bavbek M,Kars HZ
    BACKGROUND & AIMS: OBJECT:A variety of factors may affect the neurological improvement in patients with cervical compression myelopathy (CCM) after surgery. The aim of this study was to report and discuss the prognostic factors in a group of patients with insufficient decompression of the spinal canal. METHODS:A prospective follow up and analysis of 20 consecutive patients with CCM treated between 2000 and 2002 was performed. All patients were surgically treated via an anterior approach, either by anterior cervical discectomy and fusion with instrumentation or by cervical corpectomy and fusion with instrumentation. The surgical results were examined using the modified Japanese Orthopaedic Asssociation disability scale, with reference to the findings of magnetic resonance imaging, computed tomography, and radiography. Seventeen patients (85%) experienced a 50% or more recovery rate as calculated using the Hirabayashi formula during the follow-up period (mean 32.5 months), despite a persistently narrow spinal canal and permanent or increased intramedullary high-intensity signal after surgery. CONCLUSIONS:Results of the study showed that patients with CCM benefited from anterior cervical discectomy and fusion with instrumentation or cervical corpectomy and fusion with instrumentation procedures despite insufficient decompression of the spinal canal. Fusion of the affected level(s) might be the reason for the acquired high recovery rates. The authors also conclude that the neurological improvement is not correlated with the reversal of or decrease in the intramedullary high-intensity signal change after surgery.
    背景与目标:
  • 【肉毒杆菌毒素在宫颈和颌面部疾病中的治疗用途: 循证综述。】 复制标题 收藏 收藏
    DOI:10.1016/j.tripleo.2007.02.004 复制DOI
    作者列表:Ihde SK,Konstantinovic VS
    BACKGROUND & AIMS: INTRODUCTION:The role of botulinum toxin as a therapeutic agent for several conditions is expanding. We sought to determine if botulinum toxin is safe and effective in treating patients with cervical dystonia and maxillofacial conditions. Our purpose was to establish a safety and efficacy profile to determine whether or not this treatment may be used prophylactically in patients undergoing dental implant therapy. METHODS:We performed a systematic search of the literature to identify randomized clinical trials evaluating patients treated with botulinum toxin as an adjunct to dental implant therapy, maxillofacial conditions including temporomandibular disorders (TMD), and cervical dystonia. RESULTS:Four randomized controlled trials (RCTs) met our search criteria in the area of cervical dystonia and chronic facial pain. No RCTs were identified evaluating dental implant therapy. Patients with cervical dystonia exhibited significant improvements in baseline functional, pain, and global assessments compared to placebo. Adverse events were mild and transient with numbers needed to harm (NNH) ranging from 12 to 17. Patients with chronic facial pain improved significantly from baseline in terms of pain compared to placebo. Rates of adverse events were less than 1%. CONCLUSION:Botulinum toxin appears relatively safe and effective in treating cervical dystonia and chronic facial pain associated with masticatory hyperactivity. No literature exists evaluating its use in dental implantology. Randomized clinical trials are warranted to determine its safety and efficacy in dental implantology and other maxillofacial conditions such as bruxism.
    背景与目标:

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