PURPOSE: Little has been written regarding the ultrasound imaging features that might allow prediction of fetal viability in abdominal pregnancies. Toward this goal, we present our experience with a series of 11 abdominal pregnancies. MATERIALS AND METHODS: From 1981 to 1993, 11 patients presented to Universidad Catolica, Santiago, and Universidad de Austral, Valdivia, Chile, with third trimester abdominal pregnancies. Five had complete ultrasound examinations, and these five patients were managed expectantly. The other six women presented as acute abdominal emergencies and underwent emergent surgery. RESULTS: Four of five fetuses that survived had a complete placental attachment to the uterus, and one surviving neonate had a partial attachment of the placenta to the uterus. Three fetuses died prior to delivery, and all three had a complete mesenteric placental attachment. Two died in the early neonatal period. One had a complete uterine placental attachment, and the other had a partial attachment. CONCLUSIONS: The survival rate of abdominal pregnancies may be better than is generally believed. Placental attachment to the uterus appears to be a factor related to fetal survival and maternal morbidity. More cases are necessary to determine the feasibility of managing women with abdominal pregnancies expectantly.

Birth Weight↗

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Tolerance and short-term effect of a cluster schedule with pollen-extracts quantified in mass-units.

We performed a prospective, multicenter study to assess the tolerance and possible short-term effects of allergen vaccines administered according to a cluster schedule in the months immediately preceding the onset of the pollen season. The study was carried out in eight centers and included 191 patients (children and adults) with allergic respiratory disease due to sensitization to olive tree and/or grass pollen. Of these, 34 patients acted as controls and the remaining patients received immunotherapy administered in the initiation phase according to a cluster schedule of eight doses injected on four visits. After 3 months of treatment, significant differences were found between the two groups in medication consumption (antihistamines in drops and oral formulations: p = 0.045 and p = 0.001, respectively; short-acting beta2-agonist treatments: p = 0.004) and respiratory symptoms (wheezing and coughing: p = 0.035 and 0.014, respectively). The cytokine profile (interleukin [IL]-4, 5, 10 and 2, interferon [IFN-gamma], and tumor necrosis factor [TNF-alpha]) was determined before the start of treatment and at the end of follow-up (4-5 months). Levels of IL-4, 5 and 10 (Th2 profile) decreased while those of IL-2, IFN-gamma, and TNF-alpha (Th1 profile) decreased. These differences were more marked in the active group than in the control group but were not statistically significant. No severe adverse effects were recorded. This study shows that the schedule tested had an acceptable tolerance profile and produced significant changes in symptom and medication scores after a few months of treatment. A double-blind, placebo-controlled study is needed to confirm these results.

Adult↗

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Cause of death of the American Indians.

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Haiti↗

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Character pathology and ECT.

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Electroconvulsive Therapy↗

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[Evolution of work duties in manufacturing activities].

The present work deals with duties' evolution according to the aspect of the investment's increase in facilities and equipment for employ, of industry-wide agreement, of cost accounting, of added value, of plant lay-out, of job competence and of production technologies. The mutual relation between duties and risk of cumulative trauma disorders is studied in qualitative and quantitative way making use of active and waiting labour time allotment during the labour cycle, rest and fatigue factor, labour losses, collective and individual breaks, high repeated work and worked items' variability. In conclusion the paper presents elements and examples about investments in automation and organisation with relay-out.

Arm Injuries↗

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[Not Available].

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Americas↗

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[Not Available].

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General Surgery↗

PubMedDate not supplied

[Teleworking].

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Humans↗

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Assessment of a self-designed protocol on patients with adverse reactions to beta-lactam antibiotics.

Suspected adverse reactions to beta-lactam antibiotics are the most frequent reason for consultation in relation WMH drug allergy. Because of their therapeutical usefulness and wide use, we developed a protocol for confirmation or exclusion of this type of allergy. The proposed protocol is based on clinical, causal and laboratory criteria that are used to assign scores from 0 to 9 points. Patients with scores between 0 and 3 are considered to be highly prone to beta-lactam antibiotic allergy and are given an alternative therapy that is selected by applying skin provocation tests (SPT). Those with a score of 9 points are excluded. Finally, those with scores between 4 and 8 are subjected to skin tests with 5 antigens (penicillin G, ampicillin, cephalothin, Penkit PPL and Penkit MDM); if they give negative results they are subsequently subjected to oral provocation with beta-lactam antibiotics. In this work we report the results obtained from 150 patients analysed for 28 variables altogether. The results allowed us to rule out adverse reactions in 94 patients. Only 9 individuals yielded positive skin tests, and only one gave a positive oral provocation (bronchospasm, 6 hours after subjection to the test). The usefulness of the proposed protocol, the profitability of the test applied and the mechanisms involved are assessed.

Adolescent↗

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IgG4 levels in relation to Olea europaea immunotherapy.

We determined olive pollen-specific IgG4 levels in 100 patients, 39 of whom had been subjected to no immunotherapy (IT) for Olea (31 allergic and 8 nonallergic individuals) and 61 of whom had been administered IT as extracts, including Olea pollen (29 extracts in BUs, 24 allergenic extracts polymerized with glutaraldehyde:Allergoid and 8 extracts standardized in PNUs). IgG4 levels were correlated to the clinical picture, type of extract and average cumulative dose (ACD). We found average IgG4 levels of 0.80 +/- 0.74, 8.60 +/- 13.07 (p < 0.01) and 1.42 +/- 2.5 micrograms/ml (n.s.) for the untreated group and those treated with BU and Allergoid, respectively. The difference between the IT-BU-treated and IT-Allergoid-treated patients was significant at p < 0.01. On the other hand, we found no significant differences among the average IgG4 levels of the three groups in relation to age or sex. The group of asthmatic patients treated with BU extracts had average IgG4 levels of 16 +/- 17.34 micrograms/ml, while those of the rhinoconjunctivitic, non-asthmatic group were 5.05 +/- 6.149 micrograms/ml, with p < 0.05 (Student's "t" test). Thus, patients treated with extracts polymerized with glutaraldehyde had IgG4 levels that were similar to those of the patients subjected to no IT. Also, the group treated with IT extracts standardized in BUs had increased IgG4 levels that were correlated with the cumulative dose, particularly in asthmatic patients.

Adolescent↗

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Primary and exclusive gingival localization of non-Hodgkin lymphomas. Case report.

A case of primary and exclusive gingival localization of a non-Hodgkin lymphoma (NHL) personally observed at the Surgical Out-patients Unit of the Department of Dentistry at the Umberto I Hospital in Rome, is described. A 71 year-old caucasian male was referred by his private dentist because of a severe pain at the soft tissue of the mandible even after dental, neurologic and parodontal treatments. At clinical examination, a severe gingival swelling in the symphysis region with hard bleeding, palpable lymph nodes and no important evidence in radiographic and CT examinations were found. After incisional biopsy and its examination, a diagnosis of NHL was made. Further examinations did not show metastasis dissemination. The patient was referred to the Hematology Department and after 4 chemotherapy cycles over 12 months, he completely recovered. After an introduction on NHL, the clinical case is described as well as how to make a correct diagnosis; moreover, the importance of the dentist in identifying diseases even not strictly related to oral cavity but whose signs and manifestations appear over there, is stressed.

Aged↗

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Subantral filling by deantigenated heterologous bone and immediate fixture placement.

AIM: A successful implant therapy depends on sufficient quantity of available bone. Latero-posterior maxillary area often represents a hardly useful zone for routine implant therapy in long time edentulous patients. Standard procedures of maxillary sinus lifting are the goals of implant-prosthetic rehabilitation. Among different grafting materials used in this kind of procedures, the deantigenated heterologous bone reliability has been tested. METHODS: In a clinical case of maxillary bone atrophy (Misch classification, SA3) a deantigenated heterologous bone grafting and immediate fixture placement has been performed; before prosthetic finalization a biopsy in the grafting site has been carried out in order to obtain an histological evaluation of the graft integration. RESULTS: The histological analysis and X-ray at 1 year follow-up show the formation of osteoid tissue integrated with the surrounding bone tissue, reaching bone maturity by calcification. In spite of a longer time for grafting integration, the advantages of a single-time surgery and the reduction of surgical timing are stressed. CONCLUSIONS: X-rays and histological results lead authors to consider the tested heterologous bone as a valid alternative to autologous bone, especially in those patients where it is preferable to avoid a second surgical site in order to take an inlay graft.

Adult↗

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A search for multidrug resistance modulators: the effects of retinoids in human colon carcinoma cells.

The development of multidrug resistance (MDR) is one of the major causes of failure in cancer therapy. The use of cell lines with acquired resistance to anticancer agents represents a very good tool for investigation into the possibility of reversal of MDR. In this study the ability of all-trans-retinoic acid (RA) and its derivative 6-OH-11-O-hydroxyphenanthrene (IIF; pat. WIPO W000 /117143) as antitumor agents was investigated in the human colon carcinoma cell line LoVo and in the counterpart resistant derivative LoVo/MDR cell line. Cell proliferation was measured by MTT assay, apoptosis was evaluated using DNA fragmentation and Annexin V detection assay. Retinoids suppressed cell proliferation in a time- and dose-dependent manner. Interestingly, IIF was significantly more effective than RA, particularly on LoVo/MDR cells. RA and IIF induced apoptosis in both cell lines, with IIF effect significantly higher than that of RA. Furthermore, on the basis that MDR phenotype is often caused by drug efflux due to overexpression of the membrane P-glycoprotein (P-gp), it was demonstrated that RA and IIF reduced P-gp synthesis in LoVo/MDR cells. Our results suggest that IIF could be a powerful tool in the development of colon carcinoma treatments, even when tumor cells present an MDR phenotype.

ATP Binding Cassette Transporter, Subfamily B, Mem↗