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51.
Immediate Implants Placed in Infected and Noninfected Sites after Atraumatic Tooth Extraction and Placement with Ultrasonic Bone Surgery 下载免费PDF全文
52.
Inter‐Institutional Pathology Consultation: The Importance of Breast Pathology Subspecialization in a Setting of Tertiary Cancer Center 下载免费PDF全文
Inter‐institutional pathology consultation (IPC) has shown to be significant in patient care. The purpose of the study was to evaluate the impact of IPC for breast biopsies in our institution. A total of 502 consecutive consult cases of breast core needle biopsies were reviewed. The original pathology reports from the referring institutions and our reports were compared for all cases. All cases were reviewed by specialized breast pathologists. Discordance was divided into minor and major based on the impact on patient care. We reviewed the subsequent excisional biopsy for all discordant cases. Discordance was seen in 104 (20.7%) cases; 40 (8%) had a major discordance and 64 (13%) had a minor discordance. Subsequent surgical excision was available for 25 (62.5%) cases with major discordance and for 13 (20.3%) with minor discordance. Our interpretation changed management in 15 (3%) patients, while 25 (5%) had a potential of management change. The cases with major discordance could be subcategorized into five groups, malignant 5 (12.5%), premalignant 16 (40%), biomarkers 10 (25%), fibroepithelial lesions 6 (15%), and others 3 (7.5%). Our findings support the value of IPC review in decreasing the likelihood of diagnostic errors that may lead to significant impact on patient care. It is necessary that outside pathology material in the referral settings been reviewed by a specialized breast pathologist. 相似文献
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Muringampurath-John D Jaye DL Flowers CR Saxe D Chen Z Lechowicz MJ Weisenburger DD Bast M Arellano ML Bernal-Mizrachi L Heffner LT McLemore M Kaufman JL Winton EF Lonial S Armitage JO Khoury HJ 《British journal of haematology》2012,158(5):608-614
Diffuse large B‐cell lymphoma (DLBCL) occasionally presents with circulating malignant cells. The clinical characteristics and long‐term outcomes of these patients have not been described. Twenty‐nine newly diagnosed DLBCL presenting in leukaemic phase were identified between 1996 and 2010, at two institutions. Median age was 48 years, and patients presented with leucocytosis, high lactate dehydrogenase levels, B symptoms, and high International Prognostic Index score. Extra nodal site involvement was observed in all patients and affected the bone marrow (100%), spleen (62%), pleura/lung (41%), liver (21%), bone (17%), bowels (7%) and cerebrospinal fluid (14%). Blood lymphomatous cells co‐expressed CD19, CD20, CD22, CD38, CD45, HLA‐DR and FMC7 in >90%, and kappa or lambda light chain restriction in >50%. Ninety per cent received rituximab and anthracycline‐based chemotherapy. Overall, remission was complete in 54% and partial in 31%; 15% had resistant disease. Median follow‐up was 47 months; 13 (45%) patients remain alive in complete remission. Median progression‐free and overall survivals were 11·5 and 46·7 months, respectively. In summary, patients with DLBCL in leukaemic phase present with high tumour burden and frequent involvement of extra nodal sites. In this uncommon DLBCL subgroup, anthracycline‐based regimens with rituximab are associated with early morbidity and mortality, but yield approximately 50% 4‐year survival. 相似文献
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Todd M. Jenkins C. Ralph Buncher Rachel Akers Stephen R. Daniels M. Louise Lawson Philip R. Khoury Tawny P. Wilson Thomas H. Inge 《Obesity surgery》2013,23(9):1404-1412
Background
Past body weight may be a more informative factor than current weight for risk of chronic disease development. Often, investigators must rely on subject recall to gauge past body weights. The Cincinnati Weight History Questionnaire (CWHQ) was developed to aid in the retrospective identification of adults who were obese during adolescence.Methods
To assess validity, the CWHQ was administered to a subset of National Heart, Lung, and Blood Growth and Health Study (NGHS) participants, a group of young adult females for whom historical measured anthropometrics were available. One hundred ninety-eight NGHS participants were contacted, of whom 191 (97 %) responded (age 26–29). Participants were asked to recall height and weight from ages 13 and 18, which were compared to previously measured values. Multiple indices of validity (Bland–Altman plots, sensitivity, and specificity) were calculated.Results
The CWHQ was moderately sensitive (range, 19–66 %), but highly specific (range, 89–100 %). Recalled height and weight values used to determine body mass index (BMI) underestimated BMI based on recorded height and weight at ages 13 and 18. Differences in calculated BMI based on recalled and measured height and weight were found to increase with BMI calculated using measured values.Conclusions
The CWHQ proved to be a moderately sensitive, but highly specific instrument for detecting adolescent obesity in a cohort of young adult females. Epidemiologic research seeking to discriminate between adults with adult-onset vs. adolescent-onset obesity may find the CWHQ useful. 相似文献59.
Helen M. Heneghan Sean T. Martin Ravi P. Kiran Wisam Khoury Luca Stocchi Feza H. Remzi Jon D. Vogel 《Journal of gastrointestinal surgery》2013,17(3):548-554