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Hyperbaric-oxygen treatment: An adjunctive therapy in acute renal failure due to crush injury

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Natural Science 2012年第8期4卷 699-704页

作者： Rumeyza Kazancioglu Cenk Gulgun Salih aydin Nilgun aysuna semra Bozfakioglu Mehmet S Sever Bezmialem Vakif University Faculty of Medicine Department of Nephrology Istanbul Turkey Istanbul University Istanbul Medical Faculty Department of Nephrology Istanbul Turkey Istanbul University Istanbul Medical Faculty Department of Undersea and Hyperbaric Medicine Istanbul Turkey

Objective: Major seismic events leave their survivors trapped under the rubble leading to extensive muscle damage and its devastating sequale of hemodynamic and metabolic disturbances and acute renal failure. Hypoxemia aggravated during each hemodialysis (HD) session is important in acute renal failure patients with massive tissue injury. We retrospectively analyzed the adjunctive role of hyperbaric-oxygen (HBO) therapy in patients treated with HD for acute renal failure due to crush injury in terms of dialysis duration. Patients and methods: 16 patients admitted after the Marmara earthquake to Istanbul Faculty of Medicine were treated with HBO. Only 8 (2M, 6F, mean age: 24.8 + 7.3 years) of them had required HD treatment. 29 (16M, 13F, mean age: 34.6 + 12.9 years) crush syndrome patients treated with HD but not with HBO were taken as controls and the clinical and laboratory data of the two groups were compared. Results: The mean duration time under the rubble for the HBO group was 9.4 + 3.2 hours. Mainly lower extremity fasciotomies were performed at 15.6 + 14.8 hours after extrication. There were no amputations in this group. There were three amputations in the control group. The mean number of HD sessions was 9.2 + 6.7/patient for 10.9+9.6 days until renal functions recovered and the patients had 27.4 + 15.6 HBO sessions until the recovery of their lesions. There were no correlations between the number of HBO sessions and any laboratory parameter nor the number of HD sessions. There was no statistical difference in the need for HD between the HBO and control group. Conclusions: Our results could not demonstrate any beneficial effect of HBO treatment in terms of HD duration;however, the valuable contribution of the HBO treatment was to increase the salvage of crushed limbs.

关键词： Hyperbaric Oxygen Treatment Crush Injury Hemodialysis

Midnight Salivary Cortisol and Other effective Factors in the Graduation of Clinical Suspect of Cushing Syndrome: Is There Any Reasonable Clinical Score?

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Open Journal of endocrine and Metabolic Diseases 2013年第1期3卷 52-54页

作者： Meral Mert Refik Tanakol Hande Karpuzoglu semra Abbasoglu Sema Yarman Harika Boztepe Faruk Alagol Istanbul University Istanbul Medical Faculty Department of Biochemistry Istanbul Turkey Istanbul University Istanbul Medical Faculty Department of Internal Medicine Division of Endocrinology and Metabolism Istanbul Turkey

Background: Diagnosis of Cushing’s Syndrome (CS) at the right time and with the right method is getting more important for the patients and clinicians due to high mortality rate. The most appropriate laboratory test will provide great benefits in terms of cost-effectiveness in the well-chosen group of patients. Selection of the high risk group is of crucial importance for the true diagnosis and treatment on time. Aim: The aim of this study was to evaluate the worth of the midnight salivary cortisol and to establish other effective factors in the graduation of clinical suspect of CS. Material and Methods: 115 patients were evaluated in weight, height, body mass index (BMI), waist/hip ratio, systolic, diastolic blood pressures, hirsutism, weight gain, purple-stria, plethore, buffalo-hump, supraclavicular fullness, temporal fat cushion, acnea, moonface, proximal muscle weakness, lower limb edema, ecchymosis, loss of libido, depression, diabetes mellitus, hypertension, allopecia of all patients were noted in the evaluation forms (23 findings). Patients were grouped according to clinical scores, low (16). Results: When we compare the groups in terms of midnight salivary cortisol, morning salivary cortisol after overnight dexamethasone suppression test, we found statistically significant relationship between the low and high clinical score groups, as well as between medium and high score groups (p: 0.0001). Urinary free cortisol was statistically significant only between low and high clinical score groups (p: 0.0001). Conclusion: This clinical scoring system which includes clinical signs and laboratory findings both, can be used for selection of the high risk group.

关键词： Salivary Cortsiol Clinical Suspect Clinical Score Cushing’s Syndrome

阿替卡因下颌神经阻滞麻醉后发生孤立性外展神经麻痹——多发性硬化首发症状1例报告

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中国口腔医学继续教育杂志 2010年第2期13卷 49-52页

作者： Belgin Kocer ,MD semra ergan, MD Bijen Nazliel, MD 李锴（译）傅开元（审）不详北京大学口腔医学院颞下颔关节病口颌面疼痛诊治中心北京海淀区中关村南大街22号100081

脊髓、全身及硬脊膜外麻醉往往能引起多发性硬化症的加重。但是至今仍没有阿替卡因下颌神经阻滞麻醉后多发性硬化发作的报道。本文报告了1例30岁男性患者，在右下颌第二．三磨牙拔除后第2天突发外侧视物复视症状。患者曾两次注射18ml的... 详细信息

脊髓、全身及硬脊膜外麻醉往往能引起多发性硬化症的加重。但是至今仍没有阿替卡因下颌神经阻滞麻醉后多发性硬化发作的报道。本文报告了1例30岁男性患者，在右下颌第二．三磨牙拔除后第2天突发外侧视物复视症状。患者曾两次注射18ml的4％阿替卡因溶液（含1：10万的肾上腺素）用于局部麻醉。神经系统检查发现患者左眼外侧视物受限。脑脊液检查发现免疫球蛋白G指数升高，寡克隆区带阳性。MRI检查显示在脑桥中部左侧、右侧小脑半球、双侧白质和脑室上区有髓鞘脱失斑块。在静脉注射甲泼尼龙（Methylprednisolone）治疗后左侧外展神经麻痹症状完全得到改善。阿替卡因下颌神经阻滞麻醉可能促使了多发性硬化症的发病或者发作。这一病例提示我们．牙科和神经科医师应将孤立性外展神经麻痹作为阿替卡因下颌神经阻滞麻醉的一个可能不良反应加以预防。

关键词：麻醉阿替卡因孤立性外展神经麻痹多发性硬化

Obesity and cardiometabolic disease risk factors among US adolescents with disabilities

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World Journal of Diabetes 2015年第1期6卷 200-207页

作者： Sarah e Messiah Denise C Vidot Gabriel Somarriba Kanathy Haney semra aytur Ruby A Natale Jeffrey P Brosco Kristopher L Arheart Division of Pediatric Clinical Research Department of Pediatrics University of Miami Leonard M. Miller School of Medicine Department of Public Health Sciences University of Miami Leonard M. Miller School of Medicine Department of Health Management and Policy University of New Hampshire Department of Pediatrics Mailman Center for Childhood Development University of Miami Leonard M. Miller School of Medicine Mailman Center for Childhood Development Department of Pediatrics University of Miami Leonard M. Miller School of Medicine

AIM: To generate prevalence estimates of weight status and cardiometabolic disease risk factors among adolescents with and without ***: Analysis of the 1999-2010 National Health and Nutrition examination Survey data was conducted among 12-18 years old with(n = 256) and without disabilities(n = 5020). Mean values of waist circumference, fasting glucose, high-density-lipoprotein cholesterol, triglycerides, systolic and diastolic blood pressure and metabolic syndrome(Met S, ≥ 3 risk factors present) were examined by the following standardized body mass index(BMI) categories for those with and without disabilities; overweight(BMI ≥ 85th- ercentile for age and sex), obesity(BMI ≥ 95 th percentile) and severe obesity(BMI ≥35 kg/m2). Linear regression models were fit with each cardiometabolic disease risk factor independently as continuous outcomes to show relationships with disability status. ReSULTS: Adolescents with disabilities were significantlymore likely to be overweight(49.3%), obese(27.6%) and severely obese(12%) vs their peers without disabilities(33.1%, 17.5% and 3.6%, respectively, P ≤ 0.01 for all). A higher proportion of overweight, obese and severely obese children with disabilities had abnormal SBP, fasting lipids and glucose as well as Met S(18.9% of overweight, 32.3% of obese, 55% of severely obese) vs their peers without disabilities(9.7%, 16.8%, 36.3%, respectively). US adolescents with disabilities are over three times as likely to have Met S(OR = 3.45, 95%CI: 1.08-10.99, P = 0.03) vs their peers with no ***: Results show that adolescents with disabilities are disproportionately affected by obesity and poor cardiometabolic health vs their peers with no disabilities. Health care professionals should monitor the cardiometabolic health of adolescents with disabilities.

关键词： Adolescents Children Disability Obesity Cardiometabolic Disease risk

The Conservation of energy Space-Time Metric for Space Outside Matter

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Journal of Modern Physics 2013年第8期4卷 1110-1118页

作者： V. N. e. Robinson eTP semra Pty Ltd. Canterbury Australia

By using experimentally determined measurements of potential energy together with the principle of conservation of energy and solving directly, the space-time geometry equation for space outside matter is obtained. That equation fits all the experimental observations that support the accepted Schwarzschild metric, yet predicts there isn’t a singularity at the Schwarzschild radius. The accepted Schwarzschild metric is the first approximation of the conservation of energy space-time metric. No observation yet made can distinguish between the predictions of the two metrics.

关键词： Gravity Photons Redshift Conservation of energy Space-Time Metric No Black Holes