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981.
Physician accuracy in diagnosing colorectal polyps 总被引:3,自引:4,他引:3
Dr. Anne Victoria Neale Ph.D. M.P.H. Raymond Y. Demers M.D. M.P.H. Harish Budev M.D. Richard O. Scott M.A. 《Diseases of the colon and rectum》1987,30(4):247-250
Since the medical management of persons with adenomatous colorectal polyps differs from that of those with hyperplastic polyps,
accuracy of diagnosis is essential. Although many physicians have grown confident that their skills of visual diagnosis are
adequate, few data exist to support this confidence. In order to examine the accuracy of physicians' judgments regarding colorectal
polyp histology, the visual diagnosis of physicians experienced in endoscopy was compared with the histologic report. Eighty-one
polyps were discovered by flexible sigmoidoscopy among 718 participants in a colon cancer screening program. Eighty percent
of all polyps were detected accurately. The diagnostic sensitivity of detecting adenomas was 69 percent, while specificity
(accurate diagnosis of hyperplastic polyps) was 86 percent, and there were an additional eight false negative and eight false
positive diagnoses. Further analyses revealed that there are individual patterns of diagnostic mistakes made by physicians
and that mistakes frequently are related to polyp size. These findings are particularly important in light of the expanding
numbers of relatively inexperienced primary care providers performing flexible sigmoidoscopy whose diagnoses may be strongly
dependent on polyp size.
This research was done through, and supported by, the Center for Occupational Health, Department of Family Medicine, Wayne
State University, Detroit, Michigan. 相似文献
982.
Mangaloglu L Cheung RC Van Iderstine SC Taghibiglou C Pontrelli L Adeli K 《Metabolism: clinical and experimental》2002,51(4):409-418
A novel animal model of insulin resistance, the fructose-fed Syrian golden hamster has been previously documented to exhibit considerable hepatic very-low-density lipoprotein (VLDL) overproduction concomitant with the development of whole body insulin resistance. Here, we investigated whether hepatic lipoprotein overproduction can be ameliorated by treatment with a hydroxymethyl glutaryl conenzyme A (HMG-CoA) reductase inhibitor, atorvastatin, using a series of ex vivo experiments. Hamsters were fed a fructose-enriched diet for 14 days to induce a state of insulin resistance, and then continued on a fructose-enriched diet supplemented with or without 40 mg/kg atorvastatin per day for 14 days. Fructose feeding in the first 2 weeks caused a significant increase in plasma total cholesterol and triglyceride levels. There was a significant decline in plasma triglyceride levels following supplementation with the inhibitor (50% to 59%; P <.05). Experiments with primary hepatocytes revealed a decreased VLDL-apolipoprotein B (apoB) production (37.4% +/- 10.4%; P <.05) in hamsters treated with atorvastatin. Interestingly, atorvastatin treatment partially attenuated (by 23%) the elevated hepatic level of microsomal triglyceride transfer protein (MTP) induced by fructose feeding. There was molecular evidence of improved hepatic insulin sensitivity with atorvastatin treatment based on assessment of the phosphorylation status of the insulin receptor and the expression of protein tyrosine phosphatase-1B. The improvement in insulin signaling was not mediated by a change in hepatic triglyceride accumulation as no significant difference was observed in liver triglyceride levels. Taken together, these data suggest that statins can ameliorate the VLDL-apoB overproduction state observed in a fructose-fed, insulin-resistant hamster model, and may potentially contribute to an enhanced hepatic insulin sensitivity. 相似文献
983.
Reactive arthritis (ReA) is sterile arthritis occurring after extra articular bacterial infection. The aim of this study was to analyze, over 30 years, clinical, biological and imaging characteristics as well as therapeutic management of new cases of ReA, comparing two periods.
Methods
retrospective monocentric study, data of all the patients followed in our unit between January 1st 1984 and April 2014 with the diagnosis or ReA were analyzed (clinical and biological features, management and outcome), and compared between two periods: from January 1984 to December 1993, and from January 2004 to December 2013.Results
Sixty two patients fulfilling international diagnosis criteria were analyzed. There was no significant difference between the two periods in number of new cases, clinical presentation, biological data or outcome. Changes in therapeutic management were obvious with occurrence of anti TNF in the recent period.Conclusion
Reactive arthritis is still a current rheumatologic problem in a developed country, with a need of early and tailored rheumatologic management. 相似文献984.
Fluorescence In Situ Hybridization Characterization of New Translocations Involving TEL (ETV6) in a Wide Spectrum of Hematologic Malignancies 总被引:1,自引:1,他引:1
985.
Chairs Louis-Philippe Boulet Qutayba Hamid Co-authors of sections of the document Simon L Bacon C��line Bergeron Louis-Philippe Boulet Yue Chen Anne E Dixon Pierre Ernst Qutayba Hamid Fernando Holguin Charles G Irvin R John Kimoff Sushma Komakula Catherine Laprise Kim L Lavoie Stephanie A Shore Mihaela Teodorescu Marie-Claude Vohl 《Canadian respiratory journal》2007,14(4):201-208
Asthma and obesity are frequently associated, and obesity has been considered a factor contributing to both an increase in severity of asthma and to its development. The present document summarizes the proceedings of a symposium held in Montreal, Quebec, on November 2, 2006, under the auspices of the Réseau en santé respiratoire du Fonds de la recherche en santé du Québec in collaboration with the McGill University – Strauss Severe Asthma Program, Université Laval (Quebec City) and Université de Montréal. It includes an overview of the various aspects of the relationships between asthma and obesity with regard to animal models; genetic, hormonal and physiological determinants; influence of comorbidities (eg, sleep apnea syndrome); epidemiology; clinical and psychological features; and management of asthma in the obese population. 相似文献
986.
Systemic effects of inhaled corticosteroids 总被引:1,自引:0,他引:1
Harrison TW Tattersfield AE 《American journal of respiratory and critical care medicine》2003,167(7):1037-8; author reply 1038
987.
988.
Diverse taxa of cyanobacteria produce beta-N-methylamino-L-alanine, a neurotoxic amino acid
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Cox PA Banack SA Murch SJ Rasmussen U Tien G Bidigare RR Metcalf JS Morrison LF Codd GA Bergman B 《Proceedings of the National Academy of Sciences of the United States of America》2005,102(14):5074-5078
Cyanobacteria can generate molecules hazardous to human health, but production of the known cyanotoxins is taxonomically sporadic. For example, members of a few genera produce hepatotoxic microcystins, whereas production of hepatotoxic nodularins appears to be limited to a single genus. Production of known neurotoxins has also been considered phylogenetically unpredictable. We report here that a single neurotoxin, beta-N-methylamino-L-alanine, may be produced by all known groups of cyanobacteria, including cyanobacterial symbionts and free-living cyanobacteria. The ubiquity of cyanobacteria in terrestrial, as well as freshwater, brackish, and marine environments, suggests a potential for wide-spread human exposure. 相似文献
989.
Obesity, regional body fat distribution, and the metabolic syndrome in older men and women 总被引:1,自引:0,他引:1
Goodpaster BH Krishnaswami S Harris TB Katsiaras A Kritchevsky SB Simonsick EM Nevitt M Holvoet P Newman AB 《Archives of internal medicine》2005,165(7):777-783
BACKGROUND: The metabolic syndrome is a disorder that includes dyslipidemia, insulin resistance, and hypertension and is associated with an increased risk of diabetes and cardiovascular disease. We determined whether patterns of regional fat deposition are associated with metabolic syndrome in older adults. METHODS: A cross-sectional study was performed that included a random, population-based, volunteer sample of Medicare-eligible adults within the general communities of Pittsburgh, Pa, and Memphis, Tenn. The subjects consisted of 3035 men and women aged 70 to 79 years, of whom 41.7% were black. Metabolic syndrome was defined by Adult Treatment Panel III criteria, including serum triglyceride level, high-density lipoprotein cholesterol level, glucose level, blood pressure, and waist circumference. Visceral, subcutaneous abdominal, intermuscular, and subcutaneous thigh adipose tissue was measured by computed tomography. RESULTS: Visceral adipose tissue was associated with the metabolic syndrome in men who were of normal weight (odds ratio, 95% confidence interval: 2.1, 1.6-2.9), overweight (1.8, 1.5-2.1), and obese (1.2, 1.0-1.5), and in women who were of normal weight (3.3, 2.4-4.6), overweight (2.4, 2.0-3.0), and obese (1.7, 1.4-2.1), adjusting for race. Subcutaneous abdominal adipose tissue was associated with the metabolic syndrome only in normal-weight men (1.3, 1.1-1.7). Intermuscular adipose tissue was associated with the metabolic syndrome in normal-weight (2.3, 1.6-3.5) and overweight (1.2, 1.1-1.4) men. In contrast, subcutaneous thigh adipose tissue was inversely associated with the metabolic syndrome in obese men (0.9, 0.8-1.0) and women (0.9, 0.9-1.0). CONCLUSION: In addition to general obesity, the distribution of body fat is independently associated with the metabolic syndrome in older men and women, particularly among those of normal body weight. 相似文献
990.
Intravenous gammaglobulin treatment of chronic idiopathic thrombocytopenic purpura 总被引:11,自引:0,他引:11
Bussel JB; Kimberly RP; Inman RD; Schulman I; Cunningham-Rundles C; Cheung N; Smithwick EM; O'Malley J; Barandun S; Hilgartner MW 《Blood》1983,62(2):480-486
High-dose intravenous gammaglobulin (IVIgG) was given to 12 children and adults with chronic idiopathic thrombocytopenic purpura (ITP) to avoid splenectomy or because they either failed to respond to or required maintenance with high doses of steroids and/or immunosuppressives. The average platelet count increase to initial therapy was 239,500/microliters (range 23,000-790,000). A concomitant IgG Fc receptor blockade, measured by IgG-sensitized 51Cr-labeled autologous erythrocytes, was seen in 11 of 11 patients tested, both splenectomized and not splenectomized, lasting 3-4 wk. Six or more months after treatment, 2 children are in remission, 2 children and 2 adults are stable requiring no therapy with platelet counts of approximately 50,000 and 30,000, respectively, 3 children require maintenance IVIgG therapy at 2-10-wk intervals, and 1 child and 2 adults have become refractory to further IVIgG. Splenectomy was not performed in 4 children. Two adults were able to discontinue daily prednisone. The 3 patients who became unresponsive to Swiss Red Cross gamma-globulin (IgSRK) therapy did so in conjunction with a markedly elevated platelet-associated IgG and IgM. Serum IgM increased an average of 103 mg/dl after the IVIgG infusions. No significant side effects were seen. 相似文献