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妊娠期Vater壶腹腺癌的诊断及治疗

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世界核心医学期刊文摘（妇产科学分册） 2005年第8期1卷 8-8页

作者： haddad O. Porcu-Buisson g. Sakr R. 朱国栋 Department of Obstetrics Service Pr Gamerre Hospital La Conception 147 Boulevard Baille 13385 Marseille Cedex 05 France

Background: Cancer of the biliary tract has a poor prognosis and its association with pregnancy is uncommon. Early diagnosis allowing curative surgical resection offers the only hope of long-term survival. Case: This report describes the case of a young 26-week-pregnant woman admitted for cholestatis documented by clinical and laboratory examination. Ultrasonography (US) and magnetic resonance cholangiopancreatography (MRCP) were indicative of common bile tract obstruction. Caesarian section was performed at 32 weeks of pregnancy and the tumor was promptly biopsied. Histology demonstrated carcinoma of the ampulla of Vater. The patient underwent a Whipple procedure. Both mother and baby survived. Conclusion:Pregnant patients with digestive cancer require careful management. Acute non-invasive assessment and radical surgery improve outcome for both the mother and fetus.

关键词： Vater 壶腹癌胆汁淤积消化系统肿瘤胆管癌周因根治性手术早期诊断胰胆管子均

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盘状红斑狼疮与吸烟:1项病例对照研究

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世界核心医学期刊文摘（皮肤病学分册） 2005年第11期1卷 44-44页

作者： Miot H.A. Miot L.D.B. haddad g.R. 焦婷 Dr. Departamento de Dermatologia da UNESP SN Campus Rubio Jr Botucatu SP 18618-000 Brazil

Background: Discoid lupus erythematosus (DLE) is a chronic cutaneous disease affecting photoexposed areas and has also been associated with cigarette smoking. Objective: To evaluate the association between smoking and DLE. Methods: A casecontrol study was performed involving 57 cases diagnosed with DLE and 215 healthy controls. Results: Ahigher smoking prevalence was noted in DLE cases (84.2%) than controls (33.5%), and the odds ratio adjusted for gender, age and ultraviolet index in the city of origin was 14.4 (95%confidence interval 6.2-33.8; multiple logistic regression, p g exposure was not related to premature DLE development. At the beginning of the disease, smokers had more extensive involvement than non-smokers; compromise of the upper arms was statistically related to smoking. Conclusion: Cigarette smoking was statistically associated with DLE development. Other studies are needed in order to evaluate the effects of smoking cessation on the course of disease.

关键词：盘状红斑狼疮病例对照研究疾病进程慢性皮肤病暴露量疾病初期吸烟率

儿童期发病的系统性红斑狼疮的初期表现:法国的多中心研究

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世界核心医学期刊文摘（儿科学分册） 2005年第10期1卷 56-56页

作者： Bader-Meunier B. Armengaud J.B. haddad E. 李丹 Serv . de Pêdiat. gên. Hpital de Bicêtre 78 rue du Gên. Leclerc 94276 Le Kre mlin Bicêtre France Dr.

Objective: To describe the clinical and laboratory manifestations of childhood -onset systemic lupus erythematosus (SLE) at presentation. Study design: This r etrospective French multicenter study involved 155 patients in whom SLE develope d before the age of 16 years. Mean patient age at onset was 11.5 ±2.5 years (ra nge, 1.5-16 years). The female to male ratio was 4.5. Results: The most common initial manifestations were hematologic (72%), cutaneous (70%), musculoskeleta l (64%), renal (50%), and fever (58%). Thirty-two percent of children had at ypical symptoms, mainly including abdominal involvement in 26 patients, which le ad to negative laparotomy results for presumed appendicitis. Severe renal, neuro logic, hematologic, abdominal, cardiac, pulmonary, thrombotic, and/or cutaneous manifestations occurred within the first month after the diagnosis in 40%of pat ients. The mean erythrocyte sedimentation rate was 72 ±29 mm/h, and the mean C -reactive protein value 22 ±21 mg/L. Antinuclear antibodies an, anti-double s tranded DNA antibodies, and low C3 or C4 level were retrieved in 97%, 93%, and 78 %of patients, respectively. Conclusion: Initial manifestations of childhood -onset SLE are diverse and often severe. The diagnosis of SLE should be promptl y considered in any febrile adolescent with unexplained organ involvement, espec ially when associated with an increased erythrocyte sedimentation rate.

关键词：系统性红斑狼疮童期肺部表现红细胞沉降抗核抗体血栓形成发病年龄腹部症状研究设计 DNA