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61.
Ulrik Ringborg David Bergqvist Bengt Brorsson Eva Cavallin-st hl Jeanette Ceberg Nina Einhorn Jan-erik Fr din Johannes J rhult Gunilla Lamnevik Christer Lindholm Bo Littbrand Anders Norlund Urban Nyl n M ns Ros n Hans Svensson Torgil R. M ller 《Acta oncologica (Stockholm, Sweden)》2003,42(5):357-365
A systematic assessment of radiotherapy for cancer was conducted by The Swedish Council on Technology Assessment in Health Care (SBU) and published in 1996. The assessment reviewed the scientific literature up to 1993 on the use of radiotherapy in the treatment of solid tumours, and estimated the costs associated with radiotherapy. It also described the current practise of radiotherapy in Sweden 1992 and compared practise with scientific knowledge. The SBU has now conducted a follow-up study on radiotherapy for cancer, including a review of the scientific literature from 1994 and a prospective survey of radiotherapy practise in Sweden 2001. The following conclusions were drawn: The role of radiotherapy as an important form of treatment for cancer with both curative and palliative intent has been further confirmed.The use of radiotherapy in Sweden has increased and is now at the internationally recommended level.Radiotherapy in Sweden is mostly given in accordance with the scientific evidence but may still be underutilized in certain situations.The resources for radiotherapy are being utilized more efficiently.The costs of radiotherapy are still 5% of the total cost of cancer care, while the cost of an individual treatment (fraction) has decreased.The need for radiotherapy capacity will increase. In addition, half of the treatment equipment will have to be replaced in the next few years. 相似文献
62.
Diagnostic imaging in femur head necrosis 总被引:9,自引:0,他引:9
Diagnosis of avascular necrosis (AVN) of the hip has been improved by the technical progress of imaging modalities during the last decade. For a long period, only plain radiographs had been available. Scintigraphy and computed tomography contributed to differential diagnosis and early detection of bone necrosis. In the meantime, MR imaging has gained special value in the evaluation of AVN. It is now the method of choice for early detection as well as for assessment in later stage disorders. Using the ARCO system, all imaging modalities and their diagnostic viability are described. Findings regarding the different stages of AVN are correlated to tissue-specific changes. 相似文献
63.
64.
Postoperative prophylactic administration of beta-adrenergic blockers in patients at risk for myocardial ischemia 总被引:11,自引:0,他引:11
Urban MK Markowitz SM Gordon MA Urquhart BL Kligfield P 《Anesthesia and analgesia》2000,90(6):1257-1261
Perioperative myocardial ischemia (MI) is associated with postoperative cardiac morbidity. Postoperative sympatholysis may reduce the incidence of MI. This study evaluated such a reduction postoperatively with the administration of prophylactic beta-blockers in patients undergoing elective total knee arthroplasty with epidural anesthesia and postoperative epidural analgesia. One hundred seven patients were preoperatively randomized into two groups, control and beta-blockers, who received postoperative esmolol infusions on the day of surgery and metoprolol for the next 48 h to maintain a heart rate less than 80 bpm. Patients were followed for ST segment depression by using a Holter monitor and adverse cardiac outcomes. Postoperative electrocardiographic ischemia was significantly more prevalent in the control group compared with the beta-blocker group during esmolol blockade (0 of 52 vs 4 of 55; P = 0.04) and tended to be more common in the control group the next two days (8 of 55 vs 3 of 52; P = 0.135). In addition, the number of ischemic events (control, 50; beta-blockers, 16) and total ischemic time (control, 709 min; beta-blocker, 236 min) were also significantly different from the control group. Myocardial infarctions and cardiac events were more common in the control group, but these differences were not significant. Our results suggest that the use of prophylactic beta-blocker therapy may reduce the incidence of postoperative MI. Implications: Prophylactic beta adrenergic blockade administered after elective total knee arthroplasty was associated with a reduced prevalence and duration of postoperative myocardial ischemia detected with Holter monitoring. 相似文献
65.
James E Stahl David Rattner Richard Wiklund Jessica Lester Molly Beinfeld G Scott Gazelle 《Medical decision making》2004,24(5):461-471
PURPOSE: To determine the cost-effectiveness of a proposed reorganization of surgical and anesthesia care to balance patient volume and safety. METHODS: Discrete-event simulation methods were used to compare current surgical practice with a new modular system in which patient care is handed off between 2 anesthesiologists. A health care system's perspective, using hospital and professional costs, was chosen for the cost-effectiveness analysis. Outcomes were patient throughput, flow time, wait time, and resource use. Sensitivity analyses were performed on staffing levels, mortality rates, process times, and scheduled patient volume. RESULTS: The new strategy was more effective (average 4.41 patients/d [median = 5] v. 4.29 [median = 4]) and had similar costs (average cost/ patient/d = 5327 dollars v. 5289 dollars) to the current strategy with an incremental cost-effectiveness of 318 dollars/additional patient treated/d. Surgical mortality rate must be >4% or hand-off delay >15 min before the new strategy is no longer more effective. CONCLUSION: The proposed system is more cost-effective relative to current practice over a wide range of mortality rates, hand-off times, and scheduled patient volumes. 相似文献
66.
Kjellman UW Hallgren P Bergh CH Lycke J Oldfors A Wiklund L 《The Annals of thoracic surgery》2000,69(2):628-630
We describe a 19-year-old woman developing acute left ventricular heart failure during her first exacerbation of multiple sclerosis. Histopathologic examination of myocardial tissue showed extensive myocytolysis. A left ventricular assist device was implanted. Three months later the cardiac function was restored and the left ventricular assist device was explanted. After 1 year the patient still remains well and her cardiac function is normal. 相似文献
67.
L. Kurch D. Hasenclever R. Kluge T. Georgi L. Tchavdarova M. Golombeck O. Sabri A. Eggert W. Brenner K.W. Sykora F.M. Bengel C. Rossig D. Krholz M. Schfers T. Feuchtinger P. Bartenstein R.A. Ammann T. Krause C. Urban R. Aigner S. Gattenlhner W. Klapper C. Mauz‐Krholz 《Pediatric blood & cancer》2019,66(3)
68.
Simon P. Jochems Karin de Ruiter Carla Solrzano Astrid Voskamp Elena Mitsi Elissavet Nikolaou Beatriz F. Carniel Sherin Pojar Esther L. German Jesús Rein Alessandra Soares-Schanoski Helen Hill Rachel Robinson Angela D. Hyder-Wright Caroline M. Weight Pascal F. Durrenberger Robert S. Heyderman Stephen B. Gordon Hermelijn H. Smits Britta C. Urban Jamie Rylance Andrea M. Collins Mark D. Wilkie Lepa Lazarova Samuel C. Leong Maria Yazdanbakhsh Daniela M. Ferreira 《The Journal of clinical investigation》2022,132(11)
69.
70.
Nilsson S Waldenström U Engström AB Hellberg D 《Journal of assisted reproduction and genetics》2007,24(5):167-171
Purpose: To investigate the outcome of IVF following intracytoplasmic sperm injection (ICSI) from ejaculate, percutaneous epididymal
sperm aspiration (PESA) and testicular sperm extraction (TESE), with subsequent blastocyst culture and single blastocyst transfer.
Methods: Single blastocyst transfer was performed after ejaculate ICSI (oligozoospermia) in 587 patients, TESE/PESA (azoospermia)
in 31 patients, and standard IVF in 680 women.
Results: There were only minor differences in IVF characteristics between the standard IVF and the PESA-TESE couples. Couples where
ejaculate ICSI were performed seemed to represent a slightly poorer prognostic group. A viable fetus after the 12th gestational
week, i.e. ongoing pregnancy, was present in 41.4% after ICSI/ET, 51.6% after PESA-TESE/ET and in 40.4% after standard IVF/ET
(no significant differences).
Conclusion: Single blastocyst transfer after ejaculate ICSI or after PESA/TESE appears to give similar results as conventional IVF blastocyst
culture. 相似文献