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61.
Renal angiomyolipoma: 6 case reports and literature review 总被引:4,自引:0,他引:4
M J Malone P R Johnson B M Jumper P J Howard T B Hopkins J A Libertino 《The Journal of urology》1986,135(2):349-353
We report 6 cases of renal angiomyolipomas and review the pertinent literature concerning this disease. One case involved the rare association of tuberous sclerosis and pregnancy. Another patient without tuberous sclerosis had renal cell carcinoma and later suffered a contralateral angiomyolipoma. The pathological conditions of renal angiomyolipomas with and without tuberous sclerosis are discussed. Since angiomyolipomas present with multiple clinical similarities to renal cell carcinoma, the primary task for the clinician is to differentiate this hamartoma from carcinoma. The distinguishing characteristics and the clinical management of renal angiomyolipomas are discussed. 相似文献
62.
Anucha Apisarnthanarak Pattarachai Kiratisin Kanokporn Thongphubeth Chananart Yuakyen Linda M Mundy 《Infection control and hospital epidemiology》2007,28(5):637-639
We describe a pseudo-outbreak of Acinetobacter lwoffii infection that was recognized early. The pseudo-outbreak involved 16 patients and occurred 3.5 months after the GNS-506 Vitek automated system was introduced in the microbiology laboratory. Prompt confirmation of incomplete use of the automated system's algorithm as the point source of the misidentified A. lwoffii clinical isolates averted a full outbreak investigation and excess use of infection control resources. 相似文献
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Bibhuti B Das Linda B Pauliks Ole A Knudson Scott Kirby Kak-Chen Chan Lilliam Valdes-Cruz Raul O Cayre 《Journal of the American Society of Echocardiography》2005,18(3):231-236
We identified 18 patients with double-orifice mitral valve (DOMV) and intact atrioventricular (AV) septum out of 40,179 echocardiographic studies performed between 1997 and 2002 at Children's Hospital, Denver, CO. In this study we describe (1) the anatomic characteristics of the DOMV in the absence of AV septal defect, (2) the function of the mitral valve by spectral and color Doppler flow mapping, and (3) associated lesions. The topographic location of the orifices in the leaflets suggests possible embryologic mechanisms of DOMV. In this series, DOMV was most commonly associated with left-sided obstructive lesions (in 39% of patients). Spectral and color Doppler interrogation demonstrated a normal flow profile in most cases; only 2 patients had significant mitral regurgitation or stenosis. Therefore, due to the uncertain natural history of this lesion and the potential need for endocarditis prophylaxis, careful imaging of the mitral valve is recommended, particularly in the presence of left-sided obstructive lesions. 相似文献
66.
Miriam Stewart Linda Reutter Edward Makwarimba Irving Rootman Deanna Williamson Kim Raine Doug Wilson Janet Fast Rhonda Love Sharon McFall Deana Shorten Nicole Letourneau Karen Hayward Jeff Masuda William Rutakumwa 《Revue canadienne de recherche en sciences infirmières》2005,37(3):104-131
Poverty influences health status, life expectancy, health behaviours, and use of health services. This study examined factors influencing the use of health-related services by people living in poverty. In the first phase, 199 impoverished users of health-related services in 2 large Canadian cities were interviewed by their peers. In the second phase, group interviews with people living in poverty (n = 52) were conducted. Data were analyzed using thematic content analysis. Diverse health-related services were used to meet basic and health needs, to maintain human contact, and to cope with life's challenges. Use of services depended on proximity, affordability, convenience, information, and providers' attitudes and behaviours. Use was impeded by inequities based on income status. To promote the health of people living in poverty, nurses and other health professionals can enhance the accessibility and quality of services, improve their interactions with people living in poverty, provide information about available programs, offer coordinated community-based services, collaborate with other sectors, and advocate for more equitable services and policies. 相似文献
67.
Cora E Lewis Susan K Ewing Brent C Taylor James M Shikany Howard A Fink Kristine E Ensrud Elizabeth Barrett-Connor Steven R Cummings Eric Orwoll 《Journal of bone and mineral research》2007,22(2):211-219
We examined determinants of nonvertebral fracture in elderly men from six U.S. communities followed an average of 4.1 years. Six clinical risk factors predicted fracture risk independent of hip BMD: tricyclic antidepressant use, previous fracture, inability to complete a narrow walk trial, falls in previous year, age > or =80 years, and depressed mood. INTRODUCTION: There are few prospective studies of fracture determinants in men. We examined the associations between a comprehensive set of clinical risk factors and risk of nonspine fracture in older men and whether determinants of fracture risk were independent of total hip BMD. MATERIALS AND METHODS: A total of 5995 men > or =65 years of age were recruited from six communities in the Unites States and followed prospectively for an average of 4.1 years. Baseline assessments of demographic, lifestyle, medical history, functional status, anthropometry, and cognitive, visual, and neuromuscular function were assessed by questionnaire or examination. Triannual mailed questionnaires ascertained incident fracture; reported fractures were adjudicated by physicians using medical records and X-ray reports. Proportional hazards models were used to develop multivariable models, selecting variables and controlling for BMD. RESULTS: Of 5876 men, 4.7% (N = 275) reported an incident nonspine fracture during follow-up (11.46/1000 person-years). Tricyclic antidepressant use (hazard ratio [HR], 2.36; 95% CI, 1.25-4.46), history of fracture at or after age 50 (HR, 2.07; 95% CI, 1.62-2.65), inability to complete a narrow walk trial (HR, 1.70; 95% CI, 1.23-2.34), falls in previous year (HR, 1.59; 95% CI, 1.23-2.05), age > or =80 years (HR, 1.33; 95% CI, 1.01-1.76), depressed mood (HR, 1.72; 95% CI, 1.00-2.95), and decreased total hip BMD (HR, 1.53; 95% CI, 1.34-1.74) were independently related to increased risk. Compared with having none (48.0% of men), having three or more of the clinical risk factors (4.9% of men) increased fracture risk 5-fold, independent of BMD. Having three or more risk factors and being in the lowest tertile of BMD was associated with a 15-fold greater risk than having no risk factors and being in the highest BMD tertile. CONCLUSIONS: Several clinical risk factors were independently associated with nonspine fractures in elderly men. The combination of multiple risk factors and low BMD was a very powerful indicator of fracture risk. 相似文献
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Linda S Baas 《Dimensions of critical care nursing》2004,23(3):131-138
An ex post facto correlational study was conducted to examine predictors of quality of life in persons 3 to 6 months after a myocardial infarction. Self-care resources, self-care knowledge (needs), activity level, and selected demographic variables were examined as predictor variables. A convenience sample of 86 subjects with a mean age of 61 years, was recruited for participation in this study. The study that explained 35% of the variance in quality of life included self-care resources available, activity level, and self-care needs. Modeling and Role Modeling Paradigm provided a useful explanation of how self-care resources and self-care knowledge can be applied to persons recovering from myocardial infarction. 相似文献
70.
Perry D. Cohen Linda Herman Sheryl Jedlinski Peggy Willocks Paula Wittekind 《Neurotherapeutics》2007,4(3):537-544
A patient-centered paradigm for clinical research and medical care is presented as a solution to the problem of declining
innovation and increasing costs and development time in the pipeline for new therapies. Fundamental differences in values
and motivations among scientists, clinicians, industry sponsor, and patients in neurotherapeutics provide a framework for
analysis of ethical conflicts and the loss of public confidence in medical research. Parkinson advocates’ views on clinical
trial participation, perceived risks and benefits, placebo controls, and sham surgery are presented. These views reflect the
sense of urgency and the unique perspective that comes from living with this progressive, debilitating condition full time.
A patient-centered paradigm that includes authentic voices of patients as collaborators at every stage of development will
help to resolve conflicts, build trust, recruit trial participants, and accelerate new therapies. Key elements are adaptive
clinical trial methods and the development of information technology for the assessment of outcomes and surveillance of safety
over the life cycle of a medical product. Supported by the Parkinson’s Disease Foundation, the Parkinson Pipeline Project
is a grassroots group of Parkinson’s patients whose goal is to represent an authentic voice for patients in the treatment
development process. This group promotes education and communication between members of the Parkinson’s community and active
stakeholders in medical research, industry, and regulatory agencies. Its members are an example of a new breed of knowledgeable
consumers, armed with first-hand access to research findings and reinforced by on-line connections to like-minded peers throughout
the world. 相似文献