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At least 91 records · Page 5Linked to original sources
PubMed1991

[The connectivity between the greater occipital nerve and adjacent structures: anatomo-clinical considerations].

In order to offer anatomical basis that aid for clinical interpretation of headache of cervical origin a macro-mesoscopic study of greater occipital nerve and its subcutaneous rise out site was accomplished. The authors observed that in its course this nerve delineates angles and direction shifts that can stand for critical points in etiology of occipital pain, so that in its subcutaneous rise out region both occipital artery and vein shape the vasculo-nervous bundle wrapped by sheath of fibrous connective tissue which has continuity and contiguity relation with the adjoining epimysium and perimysium. From our results, anatomo-clinical aspects are discussed.

Cranial Nerves↗
PubMed1978

[Radiological and clinical considerations on navicular disease (author's transl)].

The radiological and clinical interpretation of alterations of the navicular bone, the interaction of radiological and clinical symptoms in relation to the age of the animal, the influence of work-load on this interaction and the possibility of predicting navicular disease at an early stage are discussed. The discussion is based on experience in a study of 130 horses.

Age Factors↗
PubMed1999

[Fundamental and clinical consideration of repeated intracordal injection therapy of atelocollagen--a histological study of canine vocal cords and a review of clinical data of 96 patients].

Hoarseness or aspiration due to recurrent laryngeal nerve paralysis confront many patients with problems in their daily living. At our outpatient clinic, patients with unilateral laryngeal paralysis due to recurrent laryngeal nerve paralysis are treated by injecting atelocollagen (3% non crosslinked atelocollagen, Koken Co., Ltd.) into the vocal cords under endoscopic control, using a soft fiberscope. A single injection may not be effective, but a relatively satisfactory therapeutic result can be obtained after several repeated injections. In the present study, the tissue levels of atelocollagen in the vocal cords of 8 adult dogs were determined after intracordal injection to evaluate the efficacy of repeated injection therapy of atelocollagen. In addition, clinical data of 96 patients who were treated by this therapy at our outpatient clinic (57 males and 39 females with a mean age of 54.5 years) were assessed. Histological investigation indicated that relatively good amounts of atelocollagen were retained and accumulated in the vocal cord tissue after repeated injection, and that the tissue around the injection site showed no appreciable foreign body reaction. The clinical data showed that about half of the 96 patients had received repeated intracordal injection therapy of atelocollagen. Maximum phonation time (MPT) was determined in 75 of 96 patients. The preoperative mean MPT was 3.27 sec, whereas MPT after a single injection and after all injections increased to 6.67 and 7.16 sec, respectively. The difference was statistically significant (p < 0.001), as assessed by the paired t-test. The results of this study indicate that besides being beneficial in accidents that result in recurrent laryngeal nerve paralysis, injection therapy with atelocollagen is of clinical value because the patient can receive repeated injections under endoscopic control at the outpatient clinic at reasonable intervals of time, and thus makes the therapy more convenient.

Adolescent↗
PubMed1983

Acute renal failure in the intensive care unit--clinical considerations.

The pathogenesis of acute renal failure remains uncertain. From a clinical viewpoint the magnitude of the problem of nephrotoxic acute renal failure is now recognised as is the frequency of non-oliguric acute renal failure. Advances in patient management include the use of daily dialysis, lower heparin doses, single-needle dialysis, bicarbonate-base dialysis fluid, artificial kidneys with biocompatible membranes, H2 antagonists, and the use of soft silastic Tenckhoff catheters if peritoneal dialysis is the preferred form of therapy.

Abdomen↗
PubMedDate not supplied

Outer layer breaks and asymptomatic schisis detachment: clinical considerations.

BACKGROUND AND OBJECTIVE: To provide a detailed description of the clinical features that are considered forerunners of symptomatic complications in asymptomatic degenerative retinoschisis, and to show that in selected cases at this stage prophylactic photocoagulation may be a better choice than mere observation. MATERIALS AND METHODS: Forty-three eyes of 27 patients with asymptomatic bullous degenerative retinoschisis and outer layer breaks (OLBs) were studied through binocular indirect dynamic ophthalmoscopy and retinal biomicroscopy with the Goldmann 3-mirror lens, fundus drawings, and photographs where feasible. Argon laser treatment was performed on each eye: first, around the posterior border of the schisis to achieve a full-thickness retinal scar, and then on the schisis itself to promote scarring of the retinal pigment epithelium, thus avoiding retinal detachment. The follow up was 2 years minimum after treatment. RESULTS: OLBs usually involved the largest schises when multiple retinal splittings were present. Breaks were single in 18 eyes (peripheral in 16 and posterior in 2) and multiple in 25 (peripheral in 15 and posterior in 10). Overall, 23 eyes showed asymptomatic retinal detachment (schisis detachment): 20 with peripheral outer layer breaks and 3 with posterior breaks. Schisis detachment was localized to the schisis area in the first group, whereas it extended beyond the posterior boundary of retinoschisis in the latter. After treatment, no posterior progression of retinoschisis was noted nor did symptomatic retinal detachment arise. Only 1 eye had complications in the second step of the treatment that was later resolved with medical care. CONCLUSION: Prophylactic Argon laser photocoagulation can be used safely in the asymptomatic stage of bullous retinoschisis with outer layer breaks to avoid the onset of acute symptomatic retinal detachment.

Adult↗
PubMedDate not supplied

Clinical considerations in case selection for all-ceramic fixed partial dentures.

All-ceramic systems have been utilized for fixed partial dentures (FPDs) to replace a missing tooth since the early 1990s. Clinical studies that assess the long-term outcome of both anterior and posterior three-unit all-ceramic FPDs are required to determine whether they can serve as a viable treatment option for functional and aesthetic tooth replacement. This article discusses the evolution and development of all-ceramic systems for FPDs as well as the clinical and laboratory considerations for treating patients using these restorations.

Adult↗
PubMed1996

Esthetic restorations for posterior teeth: practical and clinical considerations.

The current abundance of posterior esthetic restorative materials and techniques may be confusing. This paper describes a simple and logical global concept that assists clinicians in choosing the appropriate therapeutic modality according to well-defined clinical criteria. Practical considerations about cavity preparation, base-lining, filling, luting, and finishing procedures are reviewed.

Bicuspid↗
PubMed1983

Clinical considerations in the diagnosis and treatment of intra-alveolar root fractures.

Clinical and radiographic data collected from the 14 cases of intra-alveolar root-fractures, with follow-ups of one to 25 years, complement the findings of other investigators in that the prognosis of the endodontium is extremely favorable. A survey of reports indicate that 75% to 80% of the pulps in intra-alveolar root fractures recover with no need of any endodontic therapy. Furthermore, pulpal pain is seldom encountered. Although the electric pulp tester is considered an important diagnostic tool, it does have limitations. The significance of the negative response is questionable, especially in young, undeveloped teeth with open apexes. The failure to respond to the tester may be attributed to a high electrical impedance. As nociceptor nerve fibers are last to develop, failure to respond to the tester in young teeth may give a false signal of pulp necrosis. Traumatized vital teeth often give an initial negative response, as does a tooth with rapid dentin deposition. Fracture detection can be increased by taking X rays from more than one angle. Radiolucent areas occur in the region of the root fracture more readily than in the periapical region, in a ratio of 7 to 1. Variations in angulations can give false impressions of complete dentinal union and complete or incomplete calcification of the pulpal space and an illusion of a comminuted fracture. The latter seldom occur in intra-alveolar root fractures. Furthermore, the apparent obliteration of the canal and pulp chamber, as seen on the radiograph, does not imply total obliteration with calcific tissue. The root canals are most often patent and negotiable.(ABSTRACT TRUNCATED AT 250 WORDS)

Dental Pulp↗
PubMed1989

Clinical considerations and costs associated with formulary conversion from tobramycin to gentamicin.

The clinical and financial effects of replacing tobramycin with gentamicin on the formulary of a 550-bed teaching hospital were studied. On the recommendation of the pharmacy and therapeutics committee, the formulary aminoglycoside was changed from tobramycin to gentamicin in June 1985; the nonformulary status of amikacin was unchanged. Five weeks later, physician compliance was assessed and the reasons for prescribing nonformulary aminoglycosides were determined. Two four-month-long evaluations were done at 6 and 18 months after implementation to assess patterns of use of nonformulary aminoglycosides. The impact on costs was determined after one and two years by considering use patterns of formulary and nonformulary aminoglycosides, as well as those of third-generation cephalosporins and mezlocillin. Resistance patterns of two gram-negative organisms, Pseudomonas aeruginosa and Serratia marcescens, were assessed for 1982-1987. Finally, the rate of nephrotoxicity in gentamicin-treated patients was determined. During the first five weeks after the formulary conversion, 80.3% (106 of 132) of the aminoglycoside orders received were for gentamicin. After telephone follow-up by the pharmacy department, that figure rose to 93.9%. During the four-month reviews beginning at 6 and 18 months, nonformulary orders accounted for 10.9% and 7.4%, respectively, of the total number of courses of aminoglycosides prescribed. In the majority of these cases, tobramycin and amikacin were used to treat infections caused by organisms with documented resistance to gentamicin or to gentamicin and tobramycin, respectively. No clear-cut changes in resistance patterns for Ps. aeruginosa or S. marcescens could be associated with the formulary conversion.(ABSTRACT TRUNCATED AT 250 WORDS)

Bacteria↗
PubMed1995

Anatomo-clinical considerations on the ovarian fibroma.

The Authors analysed from an anatomo-clinical point of view, 17 cases of ovarian fibroma, observed during the period between 1968 and 1992. The incidence of ovarian fibroma in this study was 2.52% and it affected women in different age groups, though with greater frequency those above 50 years. Even the symptomatology was variable and was characterized by pain in the hypogastric quadrant (47.1%); alteration of the menstrual cycle (17.6%); metrorrhagic episodes (17.6%); sterility (5.9%). Due to the fact that the ovarian fibroma can appear at any age, this suggests different surgical approaches according to age, general conditions of the patient and fertility.

Adult↗
PubMed1982

[Radiological and clinical considerations on the proximal sesamoid bones of young horses (author's transl)].

Several clinical and radiological studies of the proximal sesamoid bones were done in eleven horses from the age of one month to three years. The X-ray findings were found to be inconstant. The number of nutrient canals visualized increased or decreased, and the bone structure gradually became more irregular. Bone deposits along the borders of the sesamoid bones usually did not become apparent until the second or third year of life. Particularly this growth of new bone was found to be a significant clinical feature. On the other hand, nutrient canals and irregular bone structures were also observed in horses in which clinical examination failed to reveal any changes.

Age Factors↗
PubMed1977

Polycystic ovarian disease: clinical considerations.

Although the pathogenesis of the PCO syndrome remains obscure, several endocrine aberrations are clinically measurable in this syndrome. It has been shown that this syndrome is associated with inappropriate gonadotropin secretion and elevated serum LH, A and T levels. Various levels of E2 and E1 have been noted. The evaluation of these individuals should include studies to determine the state of androgen production in them. Treatment should be based upon an understanding of the pathophysiology, a thorough evaluation of androgen production and the patient's expectations based upon age, marital status and desire for pregnancy. The physician's expectations should be related to prevention of endometrial hyperplasia, the restoring of ovulation and amelioration of many of the androgenic side effects seen.

Androstenedione↗
PubMed1997

[Fibrous dysplasia of the maxillofacial bones. Clinical considerations].

OBJECTIVE: After a wide survey of the literature, the results of a clinical-statistic study carried out on twelve cases of maxillo-facial bones fibrous dysplasia, diagnosed and treated at the Oral and Maxillo-Facial Surgery Department of the II University of Naples, are reported. EXPERIMENTAL ASSAY: Retrospective study. MATERIALS AND METHODS: All the patients examined showed fibro-osseus lesions involving the mandible in eight cases, the maxilla in three cases and the frontal bone in one case. Seven patients were females and five males, aged between nine and seventy-two years. The surgical treatment was carried out on eleven patients: four cases were treated by complete surgical excision of the fibro-osseous lesions and seven cases by a conservative removal of the portion of the lesion contributing to the bone deformity. RESULTS AND CONCLUSIONS: All cases examined involved maxillo-facial skeleton structures as a sole localization, confirming that the polyostotic forms are more infrequent than the maxillary monostotic ones. The distribution of the cases according to age classes and lesion localization showed a higher incidence of fibrous dysplasia in the third decade of life and a clear predilection for the mandible. The observation of active lesions in old age shows that the disease may evolve also after the growth. The cases treated by radical excision of the lesions have not been followed from relapse; on the contrary three of the seven cases treated by conservative excision relapsed after a few years.

Adolescent↗