The identification of conditions associated with an increased risk of venous thromboembolism may indicate the need for aggressive prophylaxis during periods of high risk, prolonged anticoagulant therapy after an initial venous thromboembolic episode, the investigation of asymptomatic family members and the avoidance of oral contraceptives. Advances in laboratory medicine have led to the identification and assessment of many proteins responsible for normal hemostasis, and associations between abnormalities in a number of these proteins and venous thromboembolism have been reported. Without the ability to appraise this information critically, physicians may be unable to determine whether or how they should modify their clinical practice. Criteria for determining whether specific laboratory abnormalities have a relationship with venous thromboembolism are proposed here, and one example of the application of these guidelines is provided. 相似文献
Background: Prediabetes or diabetes (characterized by hemoglobin A1c [HbA1c] levels ≥ 5.7 gm%) has been associated with numerous long-term complications. Family consumer behaviors are important risk factors that lead to impaired glucose tolerance or diabetes. However, few studies have studied the association between the family consumer environment and prediabetes and diabetes in adolescents.
Objective: The aim of this study was to examine the association between family consumer behaviors (healthy food availability and supermarket spending) and adolescent prediabetes and diabetes (ClinicalTrials.gov identifier #NCT03136289.)
Methods: Data from a nationwide survey conducted by the Centers for Disease Control and Prevention (National Health and Nutrition Examination Survey [NHANES] 2007–2010 data) were used for these analyses. Adolescents aged 12–19 years were selected for this study. Bivariate analyses and logistic regression models assessed the relationship between family consumer behaviors and the prevalence of adolescent prediabetes and diabetes. Multivariable models adjusted for age, gender, ethnicity, physical activity, education, income, and household size.
Results: A total of 2520 adolescents were eligible for this study. Adolescents with healthier household food availability had negative odds (odds ratio [OR] = 0.74, 95% confidence interval [CI], 0.55–1.00), as did higher log supermarket spending (OR = 0.69; 95% CI, 0.57–0.85). Interaction models demonstrated that adolescent females had more negative odds of prediabetes/diabetes for both healthier food availability (OR = 0.79, 95% CI, 0.39–1.29) and for greater log supermarket spending (OR = 0.69, 95% CI, 0.57–0.85).
Conclusion: This study shows that both healthy food availability and an increase in supermarket spending were associated with a decreased adjusted prevalence of prediabetes and diabetes in adolescents, with a greater effect in females. These results suggest the need for policy and dietary interventions targeting the consumer environment. 相似文献
Head and neck rhabdomyosarcoma lymph node staging is challenging due to varied patterns of lymphatic drainage and the suboptimal predictive value of available imaging modalities. Furthermore, regional relapse rates are unacceptably high, and the toxicity of empiric radiation is undesirable in the pediatric and young adult population. In an attempt to improve locoregional control without excess morbidity, we have adopted routine sentinel lymph node biopsy in head and neck rhabdomyosarcoma, which is safe and feasible in pediatric patients. Of six procedures reported here, pathologic findings led to intensification of regional and/or systemic therapy in two patients. 相似文献