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101.
British law on informed consent does not require as high a standard of disclosure as do American and Canadian law. In a recent decision, Hills v. Potter, the judge held that a physician has a duty to inform a patient according to the practice adopted by a competent body of his peers, rather than an absolute duty of full disclosure. Brahams argues that the patient is entitled to all the information that will enable him or her to weigh the risks and benefits of the proposed therapy, even if this disclosure leads to rejection of beneficial treatment. 相似文献
102.
Marian Annett Diana Kilshaw 《Cortex; a journal devoted to the study of the nervous system and behavior》1982,18(4):547-568
The hypothesis that special ability in mathematics is associated with a reduction in bias to dextral preference and skill was examined in several samples of students and in 97 male and 27 female teachers of mathematics, mainly in Universities and Polytechnics. The maths students and maths teachers differed from controls, both general and academic, in the direction predicted and several comparisons were statistically significant. Differences were in most cases clearer for males than females.An analysis of the findings in relation to the right shift (RS) theory of handedness (Annett, 1972, Annett, 1978) suggests that the incidence of left preference and skill is slightly raised in mathematicians not because of any intrinsic advantage of left preference but rather because extreme bias to the right, as expected in those carrying a hypothesised rs++ genotype, is disadvantageous for mathematical thinking. If the role of mathematics can be regarded as one of developing languages to describe those aspects of human experience which otherwise could be understood only in visuo-spatial images, it can be seen to require a coordination of those aspects of human intelligence which have been distinguished as depending differentially on the left and right cerebral hemispheres. The present findings suggest that this process might be impeded by a double dose of a gene which promotes left hemisphere language specialisation. 相似文献
103.
John H Krystal Ismene L Petrakis Diana Limoncelli Elizabeth Webb Ralitza Gueorgueva D Cyril D'Souza Nashaat N Boutros Louis Trevisan Dennis S Charney 《Neuropsychopharmacology》2003,28(11):2020-2028
Ethanol is an antagonist of the N-methyl-D-aspartate (NMDA) glutamate receptor. Ethanol dependence upregulates NMDA receptors and contributes to crosstolerance with selective NMDA receptor antagonists in animals. This study evaluated whether recovering ethanol-dependent patients show evidence of a reduced level of response to the effects of the NMDA receptor antagonist, ketamine. In this double-blind study, 34 recently detoxified alcohol-dependent patients and 26 healthy comparison subjects completed 3 test days involving a 40-min infusion of saline, ketamine 0.1 mg/kg, or ketamine 0.5 mg/kg in a randomized order. Recovering ethanol-dependent patients showed reduced perceptual alterations, dysphoric mood, and impairments in executive cognitive functions during ketamine infusion relative to the healthy comparison group. No attenuation of ketamine-induced amnestic effects, euphoria, or activation was observed. The alterations in NMDA receptor function observed in recovering ethanol-dependent patients may have important implications for ethanol tolerance, ethanol dependence, and the treatment of alcoholism. 相似文献
104.
Diana Crivellari Aron Goldhirsch Alan Coates 《Journal of clinical oncology》2004,22(6):1164-5; author reply 1165
105.
Carlos A. Fuster Diana Enrique Fuster Diana Nieves Martínez Alzamora Antonio García Vilanova Julia Giménez Climent Carlos Vázquez Albaladejo 《Clinical & translational oncology》2004,6(8):472-482
Introduction. Breast cancer remains the most frecuent tumor among women in developed countries. The prognosis is linked to a great variety clinic and pathological factors. The objectives from this study are to identify markers related to survival of patients with primary diagnosis of breast cancer. Material and methods. We have reviewed the medical dossier from 2.227 consecutive women diagnosed for infiltrating breast cancer between January 1966 and december 2000 in a single institution. For statistic analysis we used 10.0 SPSS software. Results. In the univariate analysis, factors with the strongest predictive value for overall survival were: PEV, estrogene and progesterone receptors, TNM stage, lymphatic vessel involvement, histologic grade, Scarff differentiation and mitosis rate, elastosis, presence of histiocitosis, and the percentage of involved stage I and III lymph nodes (Berg clasification). In the multivariate analysis, 5 factors; progesterone receptors, Scarff mitotic rate, lymphatic vessel involvement, percentage of involved stage I lymph nodes, and presence of metastasis; were independent prognostic markers of survival. Conclusions. Many independent factors interact in the survival of patients with primary breast cancer. Determination of hormonal receptors, mainly progesterone’s, appear as the most powerful indicators. The analysis has generated a prognostic simplified classification, based in the 5 independent variables, that provides specific rates for survival at 2, 5 and 10 years. 相似文献
106.
Expression of TRAIL and TRAIL death receptors in stage III non-small cell lung cancer tumors. 总被引:1,自引:0,他引:1
Diana C J Spierings Elisabeth G E de Vries Wim Timens Harry J M Groen H Marike Boezen Steven de Jong 《Clinical cancer research》2003,9(9):3397-3405
PURPOSE: Several in vitro studies have shown that non-small cell lung cancer (NSCLC) cell lines are sensitive to apoptosis induction by the recombinant human (rh) tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) death ligand, indicating that rhTRAIL might become an attractive molecule for treatment of NSCLCs. To investigate the therapeutic potential of rhTRAIL, the expression of TRAIL and its apoptosis-inducing receptors DR4 and DR5 was evaluated in tumors of stage III NSCLC patients. EXPERIMENTAL DESIGN: Before treatment, tumor biopsies from locally advanced NSCLC patients were obtained by bronchoscopy. DR4, DR5, and TRAIL expression were determined immunohistochemically in 87 tumors. Patients were randomized for treatment with 60 Gy radiotherapy with or without carboplatin as radiosensitizer. RESULTS: DR4, DR5, and TRAIL were expressed in 99%, 82%, and 91% of the tumors, respectively. Seventeen percent of the samples expressed only DR4 and no DR5. In NSCLCs with squamous cell differentiation, a typical staining pattern for DR4 and DR5 was observed. Cells from the basal layer were strongly positive, and the more mature cells were less positive or negative. An inverse staining pattern was observed for TRAIL. Poorly differentiated areas showed strong staining intensity for DR4, DR5, and TRAIL. DR5-positive staining was associated with increased risk of death (odds ratio, 5.76; 95% confidence interval, 1.04-31.93; P = 0.045). CONCLUSIONS: The majority of the locally irresectable stage III NSCLCs expressed at least one of the two death receptors for TRAIL. Therefore, these death receptors may provide a target for the use of rhTRAIL as a new adjunct in the treatment of stage III NSCLC. 相似文献
107.
Carbonic anhydrase IX expression, hypoxia, and prognosis in patients with uterine cervical carcinomas. 总被引:5,自引:0,他引:5
David Hedley Melania Pintilie Jennifer Woo Andrew Morrison Diana Birle Anthony Fyles Michael Milosevic Richard Hill 《Clinical cancer research》2003,9(15):5666-5674
PURPOSE: Hypoxia is associated with adverse outcome for a number of solid tumors, including cervical carcinomas. Direct pO(2) measurement requires specialized equipment and expertise that is not generally available. Immunohistochemical measurement of intrinsic tissue markers of hypoxia is an alternative approach. Recent studies suggest that carbonic anhydrase IX (CA IX), which is regulated via hypoxia-inducible factor 1, is a useful intrinsic marker of tumor hypoxia. EXPERIMENTAL DESIGN: Biopsies were obtained from 110 patients with locally advanced cervical carcinoma treated with radiotherapy or chemoradiotherapy. Tissue sections were labeled using an immunofluorescence technique and CA IX expression in the viable tumor area measured using a semiautomated fluorescence image analysis technique. Results were compared with direct pO(2) values obtained using an Eppendorf probe and to patient outcome. Intratumoral heterogeneity of CA IX expression was examined in a subgroup of patient who underwent multiple biopsies. RESULTS: The median percentage of tumor area staining for CA IX was 3.56 (range, 0.01-58.85). CA IX staining did not correlate with the Eppendorf pO(2) measurements. Whereas the latter values were predictive of patient outcome, the CA IX levels were not. Measurement of CA IX in multiple biopsies indicated that intratumoral heterogeneity accounted for 41% of the total variance in the data set. CONCLUSIONS: In contrast to some recent studies, we did not find significant associations between CA IX expression and tumor pO(2) levels or patient outcome in locally advanced carcinomas of the cervix. Probable explanations relate to the problems of sampling error using single biopsies and the existence of biological factors other than hypoxia that influence CA IX levels. 相似文献
108.
The authors report a case of thrombosis of the spermatic veins associated with Henoch-Sch?nlein purpura mimicking an acute scrotum, which responded to a low-molecular-weight heparin treatment. 相似文献
109.
The metabolic syndrome among postmenopausal women in Ecuador. 总被引:1,自引:0,他引:1
Luis A Hidalgo Peter A Chedraui Nancy Morocho Mariela Alvarado Diana Chavez Angelica Huc 《Gynecological endocrinology》2006,22(8):447-454
BACKGROUND: The prevalence of the metabolic syndrome increases with age and after the onset of menopause, and may explain in part the apparent acceleration of cardiovascular disease in postmenopausal women. OBJECTIVE: To determine the prevalence of metabolic syndrome and related risk determinants among postmenopausal women in Ecuador. METHODS: Postmenopausal women >or=40 years of age, non-users of hormone therapy and with an intact uterus, were asked to participate in a metabolic syndrome screening and educational program at the Institute of Biomedicine of the Universidad Católica of Guayaquil, Ecuador. Sociodemographic data, waist circumference and blood pressure measurements were recorded, and a fasting blood sample obtained for serum glucose and lipid profile determinations. Woman were counseled and managed according to the results. Metabolic syndrome was defined in accordance with the criteria of the Third Adult Treatment Panel (ATP III). RESULTS: Three hundred and twenty-five postmenopausal women entered the program. Mean (+/-standard deviation) age was 55.9 +/- 8.1 years, 53.5% of them were aged >or=54 years (median). The prevalence of metabolic syndrome, according to ATP III criteria, was 41.5%. Using the same criteria, 38.8%, 16.6%, 56.9% and 54.2% of the women presented with hypertension, diabetes, hypertriglyceridemia and abdominal obesity, respectively. More than 40% of women determined to have hypertension or diabetes lacked knowing so. Logistic regression analysis determined that age increased the risk of presenting hypertension and diabetes (odds ratio (95% confidence interval): 2.0 (1.2-3.2) and 1.6 (0.9-3.0), respectively, p < 0.05), entities which in turn duplicated the risk of having high triglyceride levels. Sedentary women with <5 years since menopause onset were at higher risk of having abdominal obesity, which was directly related to diabetes and hypertension. CONCLUSIONS: In this postmenopausal Ecuadorian population the prevalence of the metabolic syndrome was high and its determinant factors related to age, time since menopause onset and sedentary habits. Because of the implications for cardiovascular risk, counseling programs directed toward high-risk populations should be encouraged. 相似文献
110.