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991.
Background:It is well known that mammographic screening reducesbreast cancer mortality. One possible explanation for this effect is thatscreening makes it possible to detect smaller breast cancers with fewerinvolved nodes, but another hypothesis is that some screening-detected tumorsare in a pathologically and biologically different phase of evolution fromthose that are detected clinically. The aim of the present study was tocompare the biological, pathological and clinical characteristics ofsymptomatic vs. asymptomatic breast cancers. Patients and methods:The study considers a series of 1916consecutive patients who underwent surgery for stage I and II infiltratingbreast cancer at Verona hospitals after having undergone ultrasound andmammography (at least one of which was positive). They were divided into twogroups on the basis of why they decided to undergo the imaging examinations:group A refers to the 1247 patients with a palpable lump, and group B to the616 who were asymptomatic. Results:The patients in group A were older, and had larger tumorsand a higher percentage of positive nodes than those in group B; they also hadsignificantly higher grade tumors, higher Ki-67 levels, and a higherpercentage of ER and PgR negative and c-erbB-2 positive tumors (allof the P-values were significant). A logistic regression analysisadjusted for tumor diameter and age showed a reduction in the significance ofeach of the considered variables, but all of them remained significantlyassociated with the modality of diagnosis except ER, PgR andc-erbB-2. Conclusions:Our results suggest that asymptomatic tumors arebiologically different from their clinically presenting counterparts, thusconfirming the hypothesis that progression towards greater malignancy mayoccur during the natural history of breast cancer.  相似文献   
992.
Objectives To describe gender differences in work modifications and changed job characteristics during return-to-work after sickness absence. Methods A 13 month prospective cohort study was performed among 119 employees (54 women and 65 men) who had reported sick for more than 1 month due to mental or musculoskeletal disorders. Men and women were of comparable ages and educational levels, worked in similar sectors, at corresponding functional levels, and were experiencing the same types of health disorders. They were interviewed bi-monthly. Work modifications and job characteristics were assessed at return-to-work. Job characteristics were also assessed upon the employee’s inclusion in the study. Results Work modifications occurred in 77.4% of the return-to-work attempts (no gender differences); reduced working hours, reduced work pace, or task reassignments were most frequent. Compared to men, reduced hours and pace were more often used for women between 12 and 20 weeks of absence (P > 0.001 and 0.01 < P < 0.001 respectively) and reduced hours also during the whole period (0.01 < P < 0.001). Applying reduced hours related to type of disorder in men and applying different time-schedules in women. Upon return to work both women and men reported increased job autonomy and emotional demands (P < 0.001); women reported more job satisfaction (P < 0.001). Conclusions Work modifications were widely applied during the return-to-work process and predominantly aimed at reduction of pressure at work. Women had a few more work modifications. The marginal gender differences may be due to male and female respondents having similar characteristics. Upon return to work some job characteristics improved.  相似文献   
993.
目的分析湖南省急性出血性结膜炎(AHC)的流行特征和时空聚集性。 方法收集2007年—2021年湖南省AHC监测数据,并进行描述性分析;通过Arc GIS、GeoDa和SaTScan软件进行空间自相关分析及时空扫描分析。 结果2007年—2021年湖南省共报告AHC 31 028例,年发病率3.11/10万。AHC多发于夏秋季,6月—10月为高发月份;发病较高的地区为长沙市和湘西自治州;男性发病率高于女性(P<0.05);发病人群主要以农民、学生为主。除2007年和2010年外,其余年份发病不具有空间依赖性;局部空间自相关“高-高”聚集区主要在湘西自治州、株洲市、衡阳市、邵阳市、怀化市和岳阳市。时空扫描共发现5个聚集区,其中一级聚集区集中在湖南省西北部(P<0.05)。 结论湖南省AHC以夏秋季多发,好发于农民和学生,高聚集区域为西北部。  相似文献   
994.
本研究采用信函调查法对《中国卫生事业管理》杂志读者进行抽样调查,用方法对读者的人口学特征、身份特征、阅读习惯进行分析。为确定杂志的基本服务对象,为提高杂志质量,开拓发行市场,提供了理论依据和数据  相似文献   
995.
This article reports the results of a study designed to evaluate both pancreatic echogenicity and success of visualizing recognizable pancreatic tissue. The acoustic characteristics of the normal pancreas were compared with those of the liver. Of 100 scans reviewed, 65 scans (65 percent) depicted recognizable pancreatic tissue. Two cases were discarded on the basis of hepatocellular disease, and one case was discarded because of hepatic metastases. Thirty-two cases demonstrated pancreatic echogenicity greater than that of the liver, and 30 cases demonstrated pancreatic echogenicity equivalent to that of the liver. We found no normal pancreas that displayed less echogenicity than the liver. A hypothesis is offered to explain the observed results.  相似文献   
996.
润滑剂是口服固体制剂中常用的一类药用辅料,可以有效提高物料流动性、减小物料和机械摩擦系数等。然而,由于不同厂家采用的原料、工艺、质控要求等存在差异,可能导致“虽然润滑剂通用名一致,但不同来源润滑剂物料属性不一致”的情形,进而导致润滑性能存在差异。本研究征集了不同厂家来源的硬脂酸镁(Magnesium stearate, MgSt)和香精作为研究对象,全面考察了其堆密度、振实密度、粒度分布、比表面积等粉体学性质和玻璃化转变温度、熔点等热力学性质,并研究其在压片时的出片力表现,明确了影响其润滑性能的关键物料属性,为相关辅料的质量控制和功能性相关指标研究提供参考。  相似文献   
997.
汉字识别是模式识别领域最富挑战性、又极具应用前景的研究课题之一 ,而联机汉字识别是近期需求十分迫切的技术 .字量大、字形复杂多变、笔顺没有一定规范、笔划数目变动等多种因素 ,是联机汉字识别的主要困难 .笔划相对易于提取是联机识别的优点 .针对联机手写体汉字的特点 ,提出笔划轨迹点方向量化的方法 ,提取笔划和计算笔划间的连接关系 ,形成输入样本字的特征 .  相似文献   
998.
This paper examines the correlation between axillary lymph node status and primary tumour characteristics in breast cancer and whether this can be used to select patients for axillary lymphadenectomy. The results are based on a retrospective analysis of 909 patients who underwent axillary dissection in our unit. Axillary lymph nodes containing metastases were found in 406 patients (44.7%), all with invasive carcinomas, but in none of the 37 carcinomas-in-situ. Nodal status was negative in all T1a tumours, but lymph node metastases were present in 16.3% and 35.7% of T1b and T1c tumours respectively. When histological grade was taken into account, positivity for grade I T1b and T1c tumours fell to 13.6% and 26.7% respectively. Lymph node metastases were found in 85% of patients with lymphovascular invasion in their tumours as compared to only 15.4% of those without and in 45.5% of oestrogen and progesterone receptor-positive tumours. When one or both hormone receptors were absent this figure was much higher. It appears that for T1a breast cancers axillary dissection is not necessary, whereas for T1b, T1c and grade I T2 tumours other histopathological parameters should be taken into consideration in deciding who should undergo axillary lymphadenectomy.  相似文献   
999.
Transmission of hepatitis A through household contact   总被引:3,自引:0,他引:3  
In the USA, cost effectiveness assessments support childhood hepatitis A vaccination in geographical areas with elevated disease rates, but not nationally. However, these studies do not address the reduction in disease transmission which may result from routine childhood vaccination. Using decision analysis, we estimated the number and age distribution of secondary hepatitis A cases occurring within households with an index case. Based on the age of the index case, we determined household size and age composition, the proportion of household members susceptible to hepatitis A, the probability of disease transmission, and the likelihood secondarily infected household members would exhibit symptoms. Our model indicates that for every 100 index cases age 6–11 years, 47.2 secondary infections would occur within households, with 23.1 causing overt disease. Lower transmission rates for older index cases reflect smaller household sizes and a higher proportion of household contacts with hepatitis A immunity. When disease transmission rates are applied to a model simulating lifetime risks of hepatitis A, universal vaccination of an annual USA birth cohort is estimated to prevent 24 100 cases of overt disease among household contacts in addition to 71 000 cases among vaccinees. Sensitivity analysis provides a wide range of estimates, but even conservative assumptions suggest routine vaccination would yield an important reduction in secondary cases. Evaluations of hepatitis A prevention should consider the ability of immunization to protect household and other personal contacts.  相似文献   
1000.
Bickerstaff脑干脑炎是一组以意识障碍、眼外肌麻痹、对称性迟缓性四肢瘫、共济失调、双侧面瘫、Babinski征、瞳孔异常和球麻痹等为表现的临床综合征。本文检索以往文献旨在分析其发病特点,并且与格林—巴利综合征变异型的Fisher综合征进行鉴别诊断。  相似文献   
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