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71.
A popular rule of thumb has often prevailed in treating oral cancer: Try one modality first; if it fails, try the other--the chance for cure will still be good. To study this dogma, a group of 160 consecutive patients with oral cavity squamous carcinoma were reviewed. A hypothesis was formed: secondary treatment for recurrent cancer, whether surgery after radiation failure or vice versa, would salvage essentially as many patients as primary treatment, say within 15%. Results show a large difference in success rates between first and second treatments when all stages are considered together, a difference well over 15 percentage points. Regarding each stage separately, the largest difference occurs in stage II (28 percentage points); other stages exceed 15 point differences. No significant differences in successful salvage occur between "home" failures and "elsewhere" failures. Local recurrence was a major cause of failure in both groups (55%). We conclude that recurrence of oral squamous cancer after first treatment markedly reduces patients' chance for cure. 相似文献
72.
Lupus vulgaris responding to double antituberculous therapy 总被引:1,自引:0,他引:1
G L Heller G P Pavlidakey K Hashimoto M Greenberg M Rosenberg 《Cutis; cutaneous medicine for the practitioner》1984,34(5):481-483
A patient with a 3 by 4 cm ulcerated lesion on the nose and upper lip in whom previous antibiotics and antifungal treatments for a "mixed infection" were of no avail is presented. Her history revealed that she has had pulmonary and pharyngeal tuberculosis and subsequently scrofuloderma of cervical lymph nodes. She eventually responded well to isoniazid, rifampin, and pyridoxine therapy. 相似文献
73.
Tudor Kate Maloney Shannon Raja Anam Baer Ruth Blakemore Sarah-Jayne Byford Sarah Crane Catherine Dalgleish Tim De Wilde Katherine Ford Tamsin Greenberg Mark Hinze Verena Lord Liz Radley Lucy Opaleye Emerita Satiro Taylor Laura Ukoumunne Obioha C. Viner Russell Kuyken Willem Montero-Marin Jesus 《Prevention science》2022,23(6):934-953
Prevention Science - There is evidence that universal school-based mindfulness training (SBMT) can have positive effects for young people. However, it is unknown who benefits most from such... 相似文献
74.
Christopher C. Stahl Sarah A. Jung Alexandra A. Rosser Aaron S. Kraut Benjamin H. Schnapp Mary Westergaard Azita G. Hamedani Rebecca M. Minter Jacob A. Greenberg 《American journal of surgery》2021,221(2):369-375
BackgroundEntrustable Professional Activities (EPAs) contain narrative ‘entrustment roadmaps’ designed to describe specific behaviors associated with different entrustment levels. However, these roadmaps were created using expert committee consensus, with little data available for guidance. Analysis of actual EPA assessment narrative comments using natural language processing may enhance our understanding of resident entrustment in actual practice.MethodsAll text comments associated with EPA microassessments at a single institution were combined. EPA—entrustment level pairs (e.g. Gallbladder Disease—Level 1) were identified as documents. Latent Dirichlet Allocation (LDA), a common machine learning algorithm, was used to identify latent topics in the documents associated with a single EPA. These topics were then reviewed for interpretability by human raters.ResultsOver 18 months, 1015 faculty EPA microassessments were collected from 64 faculty for 80 residents. LDA analysis identified topics that mapped 1:1 to EPA entrustment levels (Gammas >0.99). These LDA topics appeared to trend coherently with entrustment levels (words demonstrating high entrustment were consistently found in high entrustment topics, word demonstrating low entrustment were found in low entrustment topics).ConclusionsLDA is capable of identifying topics relevant to progressive surgical entrustment and autonomy in EPA comments. These topics provide insight into key behaviors that drive different level of resident autonomy and may allow for data-driven revision of EPA entrustment maps. 相似文献
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78.
B. N. Chodirker S. P. Coburn L. E. Seargeant M. P. Whyte C. R. Greenberg 《Journal of inherited metabolic disease》1990,13(6):891-896
Summary We measured plasma levels of pyridoxal-5-phosphate (PLP), a cofactor form of vitamin B6 and apparent natural substrate for alkaline phosphatase (ALP), in carriers and in non-carriers of the severe perinatal and infantile forms of hypophosphatasia, both before and after an oral load of pyridoxine (i.e. 1/3 mg/kg body weight). The assignment of carrier status was determined by serum ALP activity, level of serum inorganic phosphate, and if necessary urinary phosphoethanolamine excretion. Plasma PLP levels were significantly increased in the carriers both before and especially after B6 loading. 相似文献
79.
Greenberg MS Jones JM 《Journal of AHIMA / American Health Information Management Association》1997,68(2):22-6, 28
NCVHS has made recommendations to the DHHS to standardize 42 core health data elements, a number of which relate to medical conditions and services. The committee has asked the DHHS Data Council to actively promote, both within the department and externally, standardization of data elements and definitions where substantial consensus already exists. For those elements that have been recognized as significant core data elements, but for which there is not consensus on approach or definition, the NCVHS is recommending that the Data Council support the formation of a public-private working group to conduct further study and evaluation. This group, or a separate group, could also be the focus for evaluating additions to the list of core data elements and for setting up methods for testing and promulgating the final products. The coming 12-18 months will be exceedingly important for health data standardization efforts in the US as the DHHS responds to both the NCVHS recommendations and the legislation recently enacted by Congress. 相似文献
80.
Drs. Jonathan Shuter MD Peter L. Alpert MD Max G. DeShaw MD Drs. Barbara Greenberg PhD Chee Jen Chang PhD Robert S. Klein MD 《Journal of urban health》1999,76(2):237-246
Background The human immunodeficiency virus (HIV) epidemic in the US increasingly involved urban heterosexual adults, particularly women,
belonging to ethnic minority groups. An understanding of gender-based differences in HIV risk behaviors within these groups
would be of value in the ongoing struggle to limit HIV transmission in metropolitan centers.
Methods This was a prospective study of demographic and historical characteristics and HIV risk behaviors. The study utilized a structured
interview format, which was administered to all patients treated by participating emergency department physicians.
Results On univariate analysis of data obtained from 1,460 patients who had neither a known HIV infection nor a chief complaint or
final emergency department diagnosis associated with HIV risk behaviors, men were more likely to be older, homeless, to have
ever injected drugs, used crack, engaged in same-gender sex, paid for sex, been incarcerated, or had syphilis or gonorrhea.
Women were more likely to report prior chlamydia infection or to report that their sole sex partners had other partners within
the past year. On multivariate analysis, variables independently associated with male gender included homelessness, injection
drug use, crack use, any prior sexually transmitted disease (in subjects 35 years of age or older), and sex with prostitutes.
In a separate analysis of patients admitting to drug use, the male predominance of other risk behaviors was not observed;
the only significant differences between genders were a higher rate of prostitution among women and a higher rate of sexual
contact with a prostitute among men.
Conclusions In patients visiting an inner-city emergency department in the Bronx, HIV risk behaviors are generally more common in men,
but rates of risk behaviors among male and female drug users are comparable.
This work was supported in part by a collaborative agreement with the Centers for Disease Control and Prevention (U64/CCU200714).
Drs. Shuter, Alpert, and DeShaw were supported in part by a training grant (5-T32-AI070183) from the National Institute of
Allergy and Infectious Diseases. This study was presented in part at the 32nd Annual Meeting of the Infectious Diseases Society
of America, October 1994, Orlando, Florida. 相似文献