Medical science monitor : international medical journal of experimental and clinical research
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If adopted without adequate cause, the lifestyle of an invalid is a grave misfortune for the patient and for its reflection on current social attitudes that foster such states. Psychological illnesses are frequently invoked and are often a genuine source of suffering and disability. However, patients who may be rewarded by large financial settlements in courts, may also on occasion exaggerate their claims. ⋯ It is wrong to blame everything on society and to deny the free choice of the individual. Nevertheless, the pressures of society can be difficult to withstand for those not gifted with resilience. We should also recognise and try to eliminate the contribution made by doctors and health workers who mistakenly aid and abet a 'culture' that promotes this state of chronic disability
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Editorial Comparative Study
The ABCs of research on pulsatile versus nonpulsatile perfusion during cardiopulmonary bypass.
The literature suggests that pulsatile flow should be routinely used during cardiopulmonary bypass (CPB) in moderate- to high-risk cardiac surgery patients, especially those who must undergo more than 45 minutes of aortic crossclamping. Nevertheless, the use of pulsatile versus nonpulsatile perfusion remains controversial, mainly owing to a lack of precise, complete quantification of pressure-flow waveforms. This editorial briefly summarizes the major factors, or 'basic ABCs, ' that affect the validity of research in this area. ⋯ C. In conducting clinical trials of the perfusion modes, researchers must use appropriate patient-selection criteria, use pulsatile flow continuously during CPB, and choose extracorporeal-circuit components carefully. By following these basic ABCs, researchers will produce more valid and meaningful results that will translate into better outcomes for CPB patients.
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Severe hypoglycemia leading to permanent brain damage is rare in non-diabetic population. We present one such case where chronic alcoholism combined with prolonged fasting lead to such a state and patient ended in a persistent vegetative state. ⋯ Alcohol induced ketoacidosis is usually associated with normal blood glucose. The probable etiology of low blood sugar in our patient was alcohol-induced inhibition of gluconeogenesis along with starvation. The prolonged hypoglycemia caused cortical damage simulating ischemic brain damage. Ten months in to follow-up patient is still in persistent vegetative state with no noticeable neurological recovery.
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Clinical Trial
Etoposide added to weekly leucovorin (LV)/5-fluorouracil (5-FU) in LV/5-FU pre-treated patients with advanced colorectal cancer.
We evaluated the efficacy and safety of the weekly combination of etoposide, leucovorin (LV) and 5-fluorouracil (5-FU) when administered as second-line chemotherapy in patients with relapsed/refractory advanced colorectal cancer (ACC), previously treated with weekly LV + 5-FU. ⋯ The combination of etoposide with LV+5-FU has limited activity when administered after failure of weekly LV+5-FU in patients with ACC.
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ED overcrowding is fast becoming a national crisis although no definition exists. The purpose of this study is to develop and pilot a sampling form that accurately reflects the concept of ED Overcrowding. ⋯ This analysis clarifies the definition of overcrowding, helps indicate the variance among responses to overcrowding questions, and provides the foundation for prospective analysis of overcrowding in multiple EDs.