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1.
Biku J John Prashant Naik Alastair Ironside Brian R Davidson Guiseppe Fusai Roopinder Gillmore Jennifer Watkins Sakhawat H Rahman 《HPB : the official journal of the International Hepato Pancreato Biliary Association》2013,15(9):674-680
Introduction: The presence of positive nodal disease (LND) and the number of lymph nodes involved (LNB) are known to be significant prognostic markers for resected adenocarcinoma of the pancreas. In addition, the ratio of the number of involved nodes to the number of nodes resected known as the lymph node ratio (LNR) is emerging as an important prognostic marker. The role of the resection margin (RM) as presently defined (R1 ≤ 1 mm) is unclear as results differ based on the dataset. The aim of this study was to assess the impact of nodal disease and a redefined RM on outcome.Material and methods: Retrospective analysis of pancreatic head resections for adenocarcinomas from 2003–2009. The RM was re-analysed based on tumour clearance and categorized into: histopathological evidence of a tumour; ≤0.5 mm, ≤1 mm, ≤1.5 mm, or ≤2.0 mm of the actual surgical resection margin. The impact of histopathological variables on cancer-specific survival (CSS) and disease-free survival (DFS) was analysed.Results: LND, LNB and LNR were independent prognostic markers for CSS (P = 0.048, 0.003, 0.016) but, did not influence DFS. A LNR < 0.143 was associated with a higher CSS [38.16 ± 4.69 versus 20.59 ± 2.20 months, P = 0.0042, hazard ratio (HR) 3.74 (95% confidence interval (CI) 1.52–9.23)]. An R1 RM was not associated with CSS or DFS on multivariate analysis, irrespective of the distance. LNB and LNR maintained independent significance irrespective of the size of the RM.Conclusion: LNB and LNR are the only prognostic factors for CSS in patients with pancreatic head adenocarcinoma, but do not predict recurrence. Microscopic RMs does not seem to influence the outcome even when redefined. Further prospective studies are indicated to substantiate these findings. 相似文献
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Morokoff Andrew Jones Jordan Nguyen Hong Ma Chenkai Lasocki Arian Gaillard Frank Bennett Iwan Luwor Rod Stylli Stanley Paradiso Lucia Koldej Rachel Paldor Iddo Molania Ramyar Speed Terence P. Webb Andrew Infusini Guiseppe Li Jason Malpas Charles Kalincik Tomas Drummond Katharine Siegal Tali Kaye Andrew H. 《Journal of neuro-oncology》2020,148(3):401-418
Journal of Neuro-Oncology - We performed a systematic review and meta-analysis of clinical outcomes for patients with acromegaly treated with stereotactic radiosurgery (SRS). Primary outcomes were... 相似文献
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Reevaluation of the Mode of Action of Streptolydigin in Escherichia coli: Induction of Transcription Termination In Vivo 总被引:2,自引:0,他引:2 下载免费PDF全文
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Mancia G Ruilope L Palmer C Brown M Castaigne A De Leeuw P Rosental T Wagener G 《Blood pressure》2004,13(5):310-315
Aims: This study tested the effects on cardiovascular outcomes of treatments based on nifedipine gastrointestinal therapeutic system (GITS) compared with the diuretic combination co-amilozide in a pre-specified subset of patients with isolated systolic hypertension (ISH) enrolled in the International Nifedipine GITS Study: Intervention as a Goal in Hypertension Treatment (INSIGHT) study. Major findings: Of 6321 randomized patients, 1498 (23.7%) had ISH with a baseline mean BP of 173/88 mmHg in both treatment groups. Mean BP fell by 29/10 mmHg in the nifedipine and 30/10 mmHg in the diuretic group to a mean BP of 144/78 mmHg and 143/79 mmHg, respectively, at endpoint. The percentage of primary outcomes in patients with ISH was not significantly different between the two treatment groups (nifedipine GITS 6.0%, co-amilozide 6.6%). The number of ISH patients with composite secondary outcomes was 90 (12.2%) in the nifedipine GITS group and 110 (14.5%) in the co-amilozide group (not significant). The incidence rates of primary and secondary outcomes were similar in patients without ISH. Conclusion: In patients with ISH, nifedipine GITS and co-amilozide had similar effects on clinical outcomes and BP lowering. They lend support to international guidelines for the treatment of hypertension recommending the use of long-acting dihydropyridine calcium-channel blockers as one treatment option for patients with ISH. 相似文献
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Ramin Khatami Gianina Luca Christian R. Baumann Claudio L. Bassetti Oliviero Bruni Francesca Canellas Yves Dauvilliers Rafael Del Rio‐Villegas Eva Feketeova Raffaele Ferri Peter Geisler Birgit Högl Poul Jennum Birgitte R. Kornum Michel Lecendreux Antonio Martins‐da‐Silva Johannes Mathis Geert Mayer Teresa Paiva Markku Partinen Rosa Peraita‐Adrados Guiseppe Plazzi Joan Santamaria Karel Sonka Renata Riha Mehdi Tafti Aleksandra Wierzbicka Peter Young Gert Jan Lammers Sebastiaan Overeem European Narcolepsy Network 《Journal of sleep research》2016,25(3):356-364
Narcolepsy with cataplexy is a rare disease with an estimated prevalence of 0.02% in European populations. Narcolepsy shares many features of rare disorders, in particular the lack of awareness of the disease with serious consequences for healthcare supply. Similar to other rare diseases, only a few European countries have registered narcolepsy cases in databases of the International Classification of Diseases or in registries of the European health authorities. A promising approach to identify disease‐specific adverse health effects and needs in healthcare delivery in the field of rare diseases is to establish a distributed expert network. A first and important step is to create a database that allows collection, storage and dissemination of data on narcolepsy in a comprehensive and systematic way. Here, the first prospective web‐based European narcolepsy database hosted by the European Narcolepsy Network is introduced. The database structure, standardization of data acquisition and quality control procedures are described, and an overview provided of the first 1079 patients from 18 European specialized centres. Due to its standardization this continuously increasing data pool is most promising to provide a better insight into many unsolved aspects of narcolepsy and related disorders, including clear phenotype characterization of subtypes of narcolepsy, more precise epidemiological data and knowledge on the natural history of narcolepsy, expectations about treatment effects, identification of post‐marketing medication side‐effects, and will contribute to improve clinical trial designs and provide facilities to further develop phase III trials. 相似文献
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König C Hebestreit H Valenza G Abele-Horn M Speer CP 《Acta paediatrica (Oslo, Norway : 1992)》2005,94(10):1505-1507
A 5-y-old girl was admitted to our hospital with fever, cough, respiratory distress and rapidly increasing oxygen requirements. A chest radiograph showed bilateral central infiltrates. PCR was performed with pharyngeal washings and revealed Legionella DNA, while no genetic materials of other pathogens such as respiratory viruses, Mycoplasma and Chlamydia were detected. The clinical condition improved gradually after administration of steroids and therapy with clarithromycin. Further sequencing of Legionella DNA led to the identification of Legionella waltersii. This Legionella species has never been described as a human pathogen before. CONCLUSION: For the first time, L. waltersii was identified as a cause of severe pneumonia. Since L. waltersii is not detected by routine laboratory tests, it may be speculated that these bacteria, like other Legionella species, are underestimated as a probable cause of community-acquired pneumonia. 相似文献
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Trani C Biondi-Zoccai GG Burzotta F Todaro D Romagnoli E Abbate A Ramazzotti V Belloni F Mazzari MA Mongiardo R Crea F 《International journal of cardiology》2005,101(2):333-334
Reversible vascular obstructive lesions, i.e. pseudostenoses, may pose significant threats to interventional cardiologists as they can be mistaken for obstructive lesions and prompt inappropriate revascularization procedures. We hereby report for the first time in the literature a case of external iliac artery pseudostenosis due to catheter straightening of significant underlying vessel tortuosities. Despite the initial angiographic image obtained from retrograde catheterization of the right external iliac artery which was strongly suggestive for significant stenosis, a thorough review of clinical history, physical examination and a second-look angiography by means of contralateral catheterization and contrast injection showed the absence of any significant lesion in the tortuous left external iliac artery, thus avoiding an unnecessary and potentially harmful vascular intervention. This clinical vignette emphasizes the importance of a thorough clinical examination and angiographic assessment for the appropriate diagnosis and management of reversible stenoses. 相似文献