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941.
Twenty cervical abrasion lesions in five patients of mean age 58 years were restored with Tenure dentine bonding agent and Silux composite, without enamel etching.
The cumulative loss rates of restorations were 5 per cent, 5 per cent, and 11 per cent after 1 year, 2 years and 3 years, respectively, and there was a slight increase of marginal staining. The results are in agreement with other authors.  相似文献   
942.
Abstract: :Evidence-based clinical practice integrates the best available evidence with clinical expertise. This article presents a clinical case scenario and, using a four-step, evidence-based approach, demonstrates how to (1) ask an evidence-based question; (2) search MEDLINE for the best evidence; (3) critically appraise the evidence; and (4) apply the evidence to the patient. The procedure is demonstrated with the sample question, Does bleaching of bonded porcelain veneers increase marginal leakage? A MEDLINE search strategy was developed for synonyms of the key words that best identify the problem, the intervention, and the outcome. The synonyms were combined using the Boolean operator “or” to identify a “sensitive” (i.e., inclusive) universe of 140,000 journal articles. These categories were then combined using the Boolean operator “and” to identify the most “specific” (i.e., exclusive) four articles from among the 140,000. Finally, to find the best evidence, the articles were limited to “humans” and “randomized controlled trials.” This identified one article. Critical appraisal of the limited data in this one article indicates that the methods are valid and statistically significant, but because of the methods employed, may not be clinically important. Evidence-based methods take one to the edge of the available information universe in about 15 minutes. The results can be both exhilarating and sobering. They can indicate the depth or limits of available information and suggest gaps in the knowledge-base that require further study. Most importantly, however, the results allow practitioners to communicate incisively and truthfully with patients and to make more informed clinical choices.  相似文献   
943.
944.
We report a case of primary extragonadal germ cell tumor of the penis in a 2-year-old child with elevated serum alpha-fetoprotein. The patient responded well to a combination of bleomycin, etoposide and cisplatin, achieving a complete response within 3 cycles. He was alive and disease-free 8 months after diagnosis. To our knowledge this is the first case of an endodermal sinus tumor of the penis reported in the literature. The possible histogenesis of this tumor at such a rare site is discussed.  相似文献   
945.
Angiolymphoid hyperplasia with eosinophilia (ALHE) is an uncommon lesion with a predilection for skin of the head and neck region. It usually presents as one or a few smooth-surfaced nodules which are often asymptomatic. Histologically the nodules reveal two components: abnormal proliferating vessels and a cellular infiltrate consisting of lymphocytes and eosinophils, involving both the dermis and the subcutaneous tissue. A case is presented of an unusually large recurrent lesion on the scalp.  相似文献   
946.
From South Australia comes an interesting investigation of the use of modeling and its reinforcement to teach habits of oral hygiene effectively. Indentification with one's peers also served as a part of this experiment.  相似文献   
947.
A special-purpose laboratory designed to improve the efficiency of simulated teaching of oral-surgical techniques at both undergraduate and graduate levels is described The laboratory is recommended because it has simplified further the staging of oral-surgical-technique teaching. The possible risk of infections from the use of animal tissue in this type of laboratory is also discussed.  相似文献   
948.
Follicular dendritic cell tumor of the parapharyngeal region   总被引:2,自引:0,他引:2  
BACKGROUND: Follicular dendritic cell (FDC) tumors are rare. A majority of the reported cases were confined to the lymph nodes. We report a case of FDC tumor occurring in the parapharyngeal region in a 45-year-old woman. METHODS: Characteristic histopathologic features of the excised primary and recurrent parapharyngeal tumors in conjunction with immunohistochemistry and electron microscopy helped us to arrive at a diagnosis of FDC tumor. RESULTS: Histopathology of primary excision revealed a lobulated tumor with a suggestion of ill-defined whorls. The most striking feature was regular occurrence of aggregates of lymphocytes within the tumor, especially around the blood vessels. The anatomic location together with the histology indicated the possibilities of either a meningioma, a salivary gland tumor, or a nerve sheath tumor. Immunostains for cytokeratin (CK), S-100 protein, and smooth muscle actin (SMA) were negative. However, the tumor cells showed strong immunoreactivity for epithelial membrane antigen (EMA) and vimentin. A diagnosis of parapharyngeal meningioma appeared to be the closest possibility. One year later, the patient developed a recurrence at the same site. A reexcision showed an identical tumor with an additional feature of lymphatic embolization and angioinvasion. A review of the entire case with further immunoreactivity for CD21 and CD35 confirmed the diagnosis of FDC. CONCLUSIONS: Follicular dendritic cell tumor has distinctive morphologic features and immunohistochemical profile. It is also characterized by considerable potential for recurrences.  相似文献   
949.
950.

Purpose

Bilateral prophylactic mastectomy (BPM) is effective in reducing the risk of breast cancer in women with a well-defined family history of breast cancer or in women with BRCA 1 or 2 mutations. Evaluating patient-reported outcomes following BPM are thus essential for evaluating success of BPM from patient’s perspective. Our systematic review aimed to: (1) identify studies describing health-related quality of life (HRQOL) in patients following BPM with or without reconstruction; (2) assess the effect of BPM with or without reconstruction on HRQOL; and (3) identify predictors of HRQOL post-BPM.

Methods

We performed a systematic review of literature using the PRISMA guidelines. PubMed, Embase, PsycINFO, Web of Science, Scopus and Cochrane databases were searched.

Results

The initial search resulted in 1082 studies; 22 of these studies fulfilled our inclusion criteria. Post-BPM, patients are satisfied with the outcomes and report high psychosocial well-being and positive body image. Sexual well-being and somatosensory function are most negatively affected. Vulnerability, psychological distress and preoperative cancer distress are significant negative predictors of quality of life and body image post-BPM.

Conclusion

There is a paucity of high-quality data on outcomes of different HRQOL domains post-BPM. Future studies should strive to use validated and breast-specific PRO instruments for measuring HRQOL. This will facilitate shared decision-making by enabling surgeons to provide evidence-based answers to women contemplating BPM.
  相似文献   
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