Special considerations for hiring an associate

If you 're thinking about hiring an associate for your medical practice, you will have many things to consider and many decisions to make. This article weighs the pros and cons of associateships and provides a 12-question quiz to help you determine whether an associate will be a good fit for your goal, philosophy, needs, and personality. It suggests helpful tips for recruiting and interviewing top-notch applicants to your associateship, including effective interview questions. It also offers advice about evaluating associateship applicants and suggests typical compensation arrangements. This article also includes questions to answer in your associateship contract and practical advice about restrictive covenants and externships. Finally, the article offers 12 suggestions for getting your new associate up to speed right away in your practice.     

双膦酸盐类药物在乳腺癌中的作用

每年世界上大约有100万妇女被诊断为乳腺癌,其中65%～75%的晚期患者最终发生骨转移.肿瘤转移造成的骨吸收增加了病理性骨折的风险及其他骨并发症: 骨痛、高钙血症(HCM)等.如果不应用双膦酸盐类药物治疗,大多数(几乎70%)乳腺癌合并骨转移的患者在其疾病发展过程中会发生一件或更多的骨并发症.约50%的患者会出现病理性骨折、40%的患者需要姑息性放疗.     

双膦酸盐类药物在乳腺癌中的作用

每年世界上大约有100万妇女被诊断为乳腺癌，其中65％～75％的晚期患者最终发生骨转移。肿瘤转移造成的骨吸收增加了病理性骨折的风险及其他骨并发症：骨痛、高钙血症(HcM)等。如果不应用双膦酸盐类药物治疗，大多数(几乎70％)乳腺癌合并骨转移的患者在其疾病发展过程中会发生一件或更多的骨并发症。约50%的患者会出现病理性骨折、40%的患者需要姑息性放疗。此外，     

改良乳腺癌根治术治疗乳腺癌

目的观察及探讨改良乳腺癌根治术治疗乳腺癌的临床效果。方法选取该院收治的乳腺癌患者100例,在征得患者同意的情况下,将其随机分为观察组及对照组,每组各50例,给予观察组患者采用改良乳腺癌根治术(保留胸大、小肌)进行治疗,给予对照组患者采用常规保乳手术进行治疗,观察两组患者治疗结果,对比两种方法疗效。结果经治疗后采用改良乳腺根治术的观察组患者疗效显著优于采用保乳术的对照组,且观察组患者经手术后乳房美观性较好。结论改良乳腺癌根治术治疗乳腺癌可保护神经免受伤害,术后进行综合性治疗,可获良好的肢体功能及胸廓外形,满足了患者美观需求,安全性高,对患者损伤小,术后恢复快,值得临床广泛应用。     

Choice of surgery for early breast cancer: psychosocial considerations

A prospective study was conducted with early breast cancer patients who had either been offered, or not been offered, a choice of surgery for treatment. The choice involved mastectomy or wide excision plus radiotherapy. Available evidence suggests that the medical outcome between these two options is similar; this study was designed to investigate selected psychosocial outcomes. It was found that whether or not patients were given a choice was of greater relevance to psychosocial outcomes that was the type of operation performed. Providing a choice led to improved reported adjustments with respect to the ability to undertake work, attitudes towards the future, beliefs about coping, and in physical and psychological functioning.     

Delay in treatment for breast cancer

Summary Data about delay in receiving treatment were obtained from 162 women with newly diagnosed breast cancer. Delay was found to occur both before and after the woman presented to her general practitioner. Women tended to delay because they assumed that their symptoms were not serious or were due to something other than cancer, or because of their domestic responsibilities. Delays within the Health Service were mostly due to diagnostic or administrative problems. Particular difficulties arose where the doctors expected benign history of previous benign breast disease. Age, a family history of breast cancer and the status of the woman (NHS or private patient) did not appear to influence delay.     

乳腺癌合并副乳腺癌诊治探讨

目的 探讨乳腺癌合并副乳腺癌的诊治.方法 2007-2010年收治5例副乳腺癌,其中1例合并乳腺癌,对其临床资料进行综合分析.结果 行乳腺癌改良根治术1例,行副乳腺扩大切除术+腋窝淋巴结清扫术4例.术后均给予化疗及放疗,1例行内分泌治疗.4例随访2年,均未发现复发及转移,1例现正在行术后CAP方案序贯化疗.结论 副乳腺癌是一种罕见且预后较差的恶性肿瘤.诊断主要依靠影像学检查和术后病理.应遵循以手术为主的综合治疗原则,术后辅助治疗有可能改善患者的生存期.     

Erysipelas after breast cancer treatment

BACKGROUND: Study of the epidemiological, clinical and evolutive characteristics of the erysipelas of patients treated for breast cancer. PATIENTS AND METHODS: Between February 93 and December 99, 20 patients among 700 (2.85%) treated for breast cancer in the radiotherapy department of sfax have presented an erysipelas. All of these patients had undergone a chirurgical treatment containing an axillary lymph node dissection with radiotherapy in 95% and adjuvent chemotherapy in 80% of cases. RESULTS: The medium delay between the appearance of the eryslpelas and the end of treatment was 23 months. The preferential localisation was the homolateral upper limb to the treated breast (95%). The immediate evolution was favourable in 85% after antibiotherapy. Recurrence of erysipelas was seen in 20% in cases. DISCUSSION: Erysipelas after treatment of breast cancer is known but rarely reported. The secondary lymphedema of the upper limb is the major favouring factor. CONCLUSION: Appearance of erysipelas among women treated for breast cancer is frequent, his recurrent character must always lead to antibiotic prophylaxis.