检索结果-南通市图书馆

Laparoscopic approach in gastrointestinal emergencies

World Journal of Gastroenterology 2016年第9期22卷 2701-2710页

作者： Rosa M Jimenez Rodriguez Juan José Segura-Sampedro Mercedes Flores-Cortés Francisco López-Bernal Cristobalina Martín Verónica Pino Diaz Felipe Pareja Ciuro javier Padillo ruiz Department of Surgery Hospital Universitario Virgen del Rocio 41013 Sevilla Spain Hospital Universitario Son Espases 07010 Palma de Mallorca Spain

This review focuses on the laparoscopic approach to gastrointestinal emergencies and its more recent indications. Laparoscopic surgery has a specific place in elective procedures, but that does not apply in emergency situations. In specific emergencies, there is a huge range of indications and different techniques to apply, and not all of them are equally settle. We consider that the most controversial points in minimally invasive procedures are indications in emergency situations due to technical difficulties. Some pathologies, such as oesophageal emergencies, obstruction due to colon cancer, abdominal hernias or incarcerated postsurgical hernias, are nearly always resolved by conventional surgery, that is, an open approach due to limited intraabdominal cavity space or due to the vulnerability of the bowel. These technical problems have been solved in many diseases, such as for perforated peptic ulcer or acute appendectomy for which a laparoscopic approach has become a wellknown and globally supported procedure. On the other hand, endoscopic procedures have acquired further indications, relegating surgical solutions to a second place; this happens in cholangitis or pancreatic abscess drainage. This endoluminal approach avoids the need for laparoscopic development in these diseases. Nevertheless, new instruments and new technologies could extend the laparoscopic approach to a broader array of potentials procedures. There remains, however, a long way to go.

关键词： Minimally invasive surgery Gastrointestinal surgery Emergency surgery Digestive emergencies Abdomina

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Sleep Deprivation Affects Working Memory in Low but Not in High Complexity for the N-Back Test

引用

Neuroscience & Medicine 2012年第4期3卷 380-386页

作者： Guadalupe J. Terán-Pérez Alejandra E. ruiz-Contreras Rosa O. González-Robles Rosario Tarrago-Castellanos Roberto E. Mercadillo Anabel Jiménez-Anguiano javier Velázquez-Moctezuma Department of Reproductive Biology Universidad Autónoma Metropolitana-Iztapalapa Iztapalapa México Institute of Neurobiology Universidad Nacional Autónoma de México México City México Laboratorio de Neurogenómica Cognitiva Laboratorio de Psicofisiología Facultad de Medicina Universidad Nacional Autónoma de México México City México Mathematic Department Universidad Autónoma Metropolitana-Iztapalapa Iztapalapa México Sleep Disorder Laboratory Universidad Autónoma Metropolitana-Iztapalapa Iztapalapa México

Sleep clearly influences learning and memory since sleep deprivation and stress impairs both cognitive processes. Working memory is an essential cognitive process and refers to a short-term holding of incoming information required to update the long-term mnemonic storage and to manipulate new elements in order to solve problems and make decisions. Nevertheless, the influence of sleep deprivation on working memory has scarcely been studied. In this study we evaluated working memory using the N-back test after increasing periods of wakefulness. Healthy young males were kept awake for 36 hours and the two N-back tasks with low (1-Back) and high (3-Back) levels of complexity were applied every 6 hours. Additionally, salivary cortisol was determined along the study. Unlike the control non-deprived participants, the sleep deprived volunteers showed a significant decrease in their efficiency to solve the 1-Back task after 24 hours of sleep deprivation. However, no differences were observed after 30 and 36 hours of sleep deprivation. Concerning the 3-Back task no differences were observed after sleep deprivation. Regarding reaction time, the deprived group manifested slower responses for the 1-Back task and for the 3-Back task after 30 hours and 36 hours of sleep deprivation, respectively. Cortisol levels presented the normal daily oscillation and no differences were observed between groups. This data suggests that sleep deprivation affects basal states of attention instead of working memory while performing simple tasks. The impact of sleep deprivation on the cognitive performance depends on the moment of day when the task is applied and the complexity of the tests used to assess these mnemonic skills.

关键词： Sleep Deprivation Working Memory Cortisol Levels N-Back Task Stress

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

陶瓷云

引用

中国建筑装饰装修 2011年第9期 54-57页

作者：隈研吾 javier Villar ruiz Ryuya Umezawa Enrico Rombi Alberto Zen Marco Introini CCDP Reggio Emilia

设计师被邀请设计一座Casalgrande纪念碑,它位于意大利的以传统文化和陶瓷技术而闻名的ReggioEmilia地区的公路迂回处,周围有着美丽的景色。

关键词：陶瓷技术传统文化设计师纪念碑意大利景色

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Transcraneal Magnetic Stimulation Improves Sleep Parameters in Patients Affected with Imsomnia Associated to Electroencephalographic Abnormalities

引用

Neuroscience & Medicine 2014年第1期5卷 72-77页

作者： Oscar Sánchez-Escandón Yoaly Arana-Lechuga Guadalupe Terán-Pérez ángel ruiz-Chow Enrique Esqueda-Leon Rosa Obdulia González-Robles Paul Shkurovich-Bialik Miguel ángel Collado-Corona javier Velázquez-Moctezuma American British Cowdray Medical Center Neurological Center Santa Fe Campus Ciudad de México México Mathematics Department Universidad Autónoma Metropolitana-Iztapalapa Ciudad de México México Psychiatry Department Hospital General Naval de Alta Especialidad Ciudad de México México Sleep Disorders Clinic Universidad Autónoma Metropolitana-Iztapalapa Ciudad de México México

Insomnia is one of the most frequently observed sleep disorders, affecting nearly 10% of the general population. It has multiple etiological factors. Recently, it has been reported that EEG abnormalities are associated with insomnia in patients previously diagnosed as idiopathic insomniacs. In addition, transcranial magnetic stimulation (TMS) has shown to be effective in the treatment of disorders characterized by neural hyper-excitability. Method: In the present study, patients with insomnia and EEG abnormalities were submitted to slow repetitive trans-cranial magnetic stimulation, for 15 minutes daily during 10 days. Polysomnographic recordings were performed before and after TMS. Results: The results indicate that the presence of EEG abnormalities significantly decreased after TMS. In addition, most of the sleep parameters showed significant improvement. Conclusions: These data support the notion that TMS is a reliable therapeutic tool for patients affected with abnormalities linked to neuronal hyper-excitability.

关键词： Insomnia Transcraneal Magnetic Stimulation EEG Abnormalities Hyperexcitability Sleep Architecture Polysomnographic

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

GOECP/SEOR clinical guidelines on radiotherapy for malignant pleural mesothelioma

引用

World Journal of Clinical Oncology 2021年第8期12卷 581-608页

作者： javier Luna Andrea Bobo Joaquín José Cabrera-Rodriguez María Pagola Margarita Martín-Martín María Ángeles González ruiz Miguel Montijano Aurora Rodríguez Lira Pelari-Mici Almudena Corbacho Marta Moreno Felipe Couñago Department of Radiation Oncology Institute of OncohealthFundación Jiménez DíazMadrid 28040Spain Department of Radiation Oncology Institution of Ruber Internacional HospitalMadrid 28034Spain Department of Radiation Oncology Hospital Universitario de BadajozBadajoz 06080Spain Department of Radiation Oncology Institution of Onkologikoa/Hospital Universitario DonostiaSan Sebastián 20014Spain Department of Radiation Oncology Institution of Hospital Universitario Ramón y CajalMadrid 28034Spain Department of Radiation Oncology Institution of Hospital Universitario Virgen de la MacarenaSevilla 41009Spain Department of Radiation Oncology Institution of Genesis care SpainMadrid 28005Spain Department of Radiation Oncology Institution of Hospital de MéridaMérida 06800Spain Department of Oncology Institution of University NavarraClinical UniversityPamplona 31008Spain Department of Radiation Oncology Institution of Hospital Universitario Quirónsalud and Hospital LaLuzEuropean University of MadridMadrid 28028Spain

Malignant pleural mesothelioma(MPM)is a rare tumor with poor prognosis and rising *** care is common in MPM as radical treatment with curative intent is often not possible due to metastasis or extensive locoregional *** therapeutic advances have been made in recent years,including the use of less aggressive surgical techniques associated with lower morbidity and mortality(e.g.,pleurectomy/decortication),technological advancements in the field of radiotherapy(intensity-modulated radiotherapy,image-guided radiotherapy,stereotactic body radiotherapy,proton therapy),and developments in systemic therapies(chemotherapy and immunotherapy).These improvements have had as yet only a modest effect on local control and *** in the management of MPM and standardization of care are hampered by the evidence to date,limited by high heterogeneity among studies and small sample *** this clinical guideline prepared by the oncological group for the study of lung cancer of the Spanish Society of Radiation Oncology,we review clinical,histologic,and therapeutic aspects of MPM,with a particular focus on all aspects relating to radiotherapy,including the current evidence base,associations with chemotherapy and surgery,treatment volumes and planning,technological advances,and reradiation.

关键词： Malignant pleural mesothelioma Chemotherapy Surgery Radiotherapy Radiation techniques Reradiation

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Management of primary achalasia: The role of endoscopy

引用

World Journal of Gastrointestinal Endoscopy 2015年第6期7卷 593-605页

作者： Marisol Luján-Sanchis Patricia Suárez-Callol Ana Monzá-Gallego Inmaculada Bort-Pérez Lydia Plana-Campos Luis Ferrer-Barceló Laura Sanchis-Artero María Llinares-Lloret Juan Antonio Tuset-ruiz javier Sempere-Garcia-Argüelles Pilar Canelles-Gamir Enrique Medina-Chuliá Digestive Diseases Unit General University Hospital of Valencia

Achalasia is an oesophageal motor disorder which leads to the functional obstruction of the lower oesophageal sphincter(LES) and is currently incurable. The main objective of all existing therapies is to achieve a reduction in the obstruction of the distal oesophagus in order to improve oesophageal transit, relieve the symptomatology, and prevent long-term complications. The most common treatments used are pneumatic dilation(PD) and laparoscopic Heller myotomy, which involves partial fundoplication with comparable shortterm success rates. The most economic non-surgical therapy is PD, with botulinum toxin injections reserved for patients with a higher surgical risk for whom the former treatment option is unsuitable. A new technology is peroral endoscopic myotomy, postulated as a possible non-invasive alternative to surgical myotomy. Other endoluminal treatments subject to research more recently include injecting ethanolamine into the LES and using a temporary self-expanding metallic stent. At present, there is not enough evidence permitting a routine recommendation of any of these three novel methods. Patients must undergo follow-up after treatment to guarantee that their symptoms are under control and to prevent complications. Most experts are in favour of some form of endoscopic follow-up, however no established guidelines exist in this respect. The prognosis for patients with achalasia is good, although a recurrence after treatment using any method requires new treatment.

关键词： Achalasia Endoscopic treatment Dilation Botulinum toxin Myotomy

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Puma能源巴拉圭总部

引用

城市建筑 2018年第16期15卷 98-103页

作者： ruiz Pardo – Nebreda architects ruizPardo–Nebreda建筑师事务所

项目名称：Puma能源巴拉圭总部业主：巴拉圭Puma能源建设地点：巴拉圭设计单位：ruiz Pardo–Nebreda建筑师事务所用地面积：1 110 m2建筑面积：1 600 m2建筑层数：3层结构形式：后张法双向板材料应用：混凝土,玻璃,铝项目负责人：Marce... 详细信息

项目名称：Puma能源巴拉圭总部业主：巴拉圭Puma能源建设地点：巴拉圭设计单位：ruiz Pardo–Nebreda建筑师事务所用地面积：1 110 m2建筑面积：1 600 m2建筑层数：3层结构形式：后张法双向板材料应用：混凝土,玻璃,铝项目负责人：Marcelo ruiz Pardo建筑设计：Sonia Nebreda,Arturo Alberquilla,javier E. Lecumberri,Alejandra M. de la Riva结构设计.

关键词：巴拉圭自然光办公空间双向板

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

船厂1862

引用

建筑实践 2019年第7期2卷 118-125页

作者： javier Villar ruiz 寺崎丰秋天 Rita Topa 陈威志胡秀芝洪人杰陶鈊潆涌田纯树加纳永一 Kengo Kuma 隈研吾建筑都市设计事务所

我们将建造于1972年的造船厂改造为由剧院、多功能厅、商业店铺三个功能组成的综合设施。造船厂是为了制作巨大尺度的货轮而建,因此它和通常的建筑尺寸不同,拥有独特的尺度感。建筑长200m、高30m,中间没有隔断,净高几乎保持在26m,是一... 详细信息

我们将建造于1972年的造船厂改造为由剧院、多功能厅、商业店铺三个功能组成的综合设施。造船厂是为了制作巨大尺度的货轮而建,因此它和通常的建筑尺寸不同,拥有独特的尺度感。建筑长200m、高30m,中间没有隔断,净高几乎保持在26m,是一个巨大的通透空间。改建时,首先想到的是如何保留这种尺度感。为此,我们设置了穿过建筑纵向的孔(中庭),同时这个孔也贯穿着建筑的垂直方向,因此当人们进入到这个孔时,瞬间就可以感受到建筑的大小。

关键词：尺度感多功能厅建筑尺寸商业店铺中庭综合设施隔断造船厂

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Efficacy of a Strategy for Implementing Guidelines for the Control of Cardiovascular Risk in Primary Healthcare

引用

World Journal of Cardiovascular Diseases 2020年第3期10卷 117-130页

作者： Maria Jesús Fernández-Luque Luis María Sánchez-Gómez Vicente Pastor y Aldeguer Carmen Suárez-Fernández Belén Sierra-García Soledad Mayayo-Vicente Marta ruiz-López ángela Gallego-Arenas Rosa Sánchez Alcalde Pilar Loeches-Belinchón javier López-González Francisco Rodríguez-Salvanés Blanca Novella-Arribas Dirección General de Investigación Docencia y Documentación Consejería de Sanidad Comunidad de Madrid Madrid Spain Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa (IP) Madrid Spain Universidad Autónoma de Madrid Facultad de Medicina Madrid Spain Hospital Universitario de la Princesa SERMAS Consejería de Sanidad Comunidad de Madrid Madrid Spain Gerencia Asistencial de Atención Primaria D.G. de Coordinación de Asistencia Sanitaria SERMAS Consejería de Sanidad Comunidad de Madrid Madrid Spain Unidad de Evaluación de Tecnologías Sanitarias de Madrid Procesos Integrados de Salud Consejería de Sanidad Madrid Spain

Background: A number of strategies exist for the implementation of clinical practice guides (CPGs). Aim: To assess the efficacy of implementing a cardiovascular risk CPG based on an educational method involving opinion leaders, and the habitual method of dissemination among primary healthcare teams. Design and Setting: Controlled, blinded, community intervention trial randomised by clusters. Methods: 21 primary healthcare centres were randomly assigned to either the intervention arm (n = 11) or the control arm (n = 10). The study subjects were patients aged ≥45 years assigned to the centres. The overall impact of the intervention was measured as the difference between the increase in the proportion of patients whose medical records showed the recording of all the variables necessary to calculate cardiovascular risk in both arms. Analyses were performed with Generalized Lineal Model on an intention-to-treat basis. Results: 917 subjects were included at the beginning of the trial (437 in the intervention arm and 480 in the control arm). 826 subjects were included in the final evaluation (436 in the intervention group and 390 in the control arm). At the end of the trial, the recording of the variables necessary for the calculation of the cardiovascular risk in the intervention group had increased more than in the control group (difference between increases 7.49% (95% CI 4.62 - 10.35)) after adjusting for confounding variables. Conclusions: Compared to the habitual method of dissemination, the implementation of this CPG using an educational method involving opinion leaders, improved the recording of the variables needed to calculate patients’ cardiovascular risk.

关键词： Randomized Controlled Trial Cluster Analysis Clinical Practice Guidelines Primary Healthcare Risk Factors Cardiovascular Diseases

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Gastric necrosis: A late complication of nissen fundoplication

引用

World Journal of Gastrointestinal Surgery 2014年第9期6卷 183-186页

作者： javier Salinas Tihomir Georgiev Juan Antonio González-Sánchez Elena López-ruiz José Antonio Rodríguez-Montes Department of General Surgery Hospital Universitario La Paz Department of Pathology Hospital Universi-tario La Paz

Gastric necrosis is a rare condition because of the rich blood supply and the extensive submucosal vascular network of the stomach. "Gas-bloat" syndrome is a well known Nissen fundoplication postoperative complica-tion. It may cause severe gastric dilatation, but very rarely an ischemic compromise of the organ. Other factors, such as gastric outlet obstruction, may concur to cause an intraluminal pressure enough to blockade venous return and ultimately arterial blood supply and oxygen deliver, leading to ischaemia. We report a case of a 63-year-old women, who presented a total gastric necrosis following laparoscopic Nissen fundoplication and a pyloric phytobezoar which was the trigger event. No preexisting gastric motility disorders were present by the time of surgery, as demonstrated in the preop-erative barium swallow, thus a poor mastication(patient needed no dentures) of a high fiber meal(cabbage) may have been predisposing factors for the develop-ment of a bezoar in an otherwise healthy women at the onset of old age. A total gastrectomy with esophagojejunostomy was performed and patient was discharged home after a 7-d hospital stay with no immediate com-plications. We also discuss some technical aspects of the procedure that might be important to reduce the incidence of this complication.

关键词： gastrectomy submucosal stomach otherwise obstruction compromise dilatation barium postoperative incidence

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：