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81.
D R Charnock G D Chapman R E Taylor A Wozniak 《Archives of otolaryngology--head & neck surgery》1992,118(5):507-508
The core tissue microflora of 40 patients who underwent tonsillectomies were examined with cultures, DNA probe tests, enzyme immunoassays, and direct immunofluorescence antibody tests for Chlamydia and Mycoplasma. We believe this is the largest and most accurate prospective study that has examined the role of Chlamydia and Mycoplasma in the core tonsil tissue of patients with recurrent or chronic tonsillitis. The data strongly indicate that, unlike acute tonsillopharyngitis, Chlamydia and Mycoplasma are not involved in recurrent or chronic tonsillitis. 相似文献
82.
83.
Background: Although managed care organizations (MCOs) may be optimal settings for implementing tobacco use cessation clinical guidelines,
such guidelines remain poorly implemented in many MCO settings.Purpose: We examined issues related to the implementation of guidelines in MCOs, to provide examples of studies that have addressed
issues related to guideline implementation and to suggest ways behavioral medicine researchers can play a role in examining
issues of how guidelines can be better implemented.Methods: Surveys of clinical guideline implementation, studies from the Robert Wood Johnson Foundation addressing tobacco use cessation
in a managed care database, selected to illustrate issues related to system-wide implementation.Results: Surveys show that effective tobacco use cessation interventions remain underutilized in MCOs. A few studies have evaluated
and shown the benefit of insurance coverage for tobacco use and dependence treatments, clinician reimbursement and leadership
incentives, practice feedback, and leveraging administrative data to create tobacco use tracking systems. The studies also
point to the need for large-scale, multidisciplinary, methodologically rigorous studies that allow one to isolate the effects
of promising strategies as well as to explore synergistic effects as different system changes are combined.Conclusions: Tobacco use cessation guidelines need to be better implemented in MCOs. Behavioral medicine research needs to move beyond
treatment efficacy and effectiveness studies to focus on rigorous evaluations of these and other strategies to enhance guideline
implementation and dissemination.
This research was supported by grants from the Tobacco-Related Disease Research Program (Taylor) and from the Robert Wood
Johnson Foundation (Taylor and Curry). 相似文献
84.
AM Manganoni† C Farisoglio† G Tucci† F Facchetti‡ PG Calzavara Pinton† 《Journal of the European Academy of Dermatology and Venereology》2007,21(10):1333-1336
BACKGROUND: Development of more than one primary melanoma in a patient is a relatively uncommon but well-recognized phenomenon. Its frequency has ranged from 1.2% to 8.2% in several series. This subgroup of patients with multiple primary lesions has not been characterized sufficiently. We report the experience of the Melanoma Unit of University Hospital Spedali Civili of Brescia, Italy. METHOD: Study subjects were drawn from 1240 patients with histologically confirmed melanoma, including melanoma in situ. From this group, multiple melanomas developed in 47 patients (3.79%). Every one of our patients has been taught to perform self-examination of the skin to detect suspicious pigmented lesions. RESULTS: Of the 47 patients described in this study, 38 had two primary melanomas, 7 had three melanomas and 2 had 5 and 10 melanomas, respectively. Mean age at first diagnosis was 46.2 years. The majority of subsequent melanomas (74.5%) were removed within 5 years of the initial operation. Synchronous lesions were found in 10 patients. In male patients, the lesion appeared most frequently on the trunk; in female patients, melanoma appeared mostly on the lower extremities. The second primary melanomas developed in the same anatomic region from the first in 53.2% of our patients. The proportion of in situ to invasive melanomas was greater for the second melanomas compared with the first melanomas. Regarding invasive melanomas, the mean thickness of the first melanomas was 1.31 mm compared with 0.66 mm for the second ones. Dividing patients into two groups, of more and less than 50, it is highlighted that in older patients synchronous lesions appear more frequently (36.4% vs. 8.0%); the median time interval between sequential melanomas is longer (84 vs. 63.7 months); and the ratio between the primary and secondary melanoma mean thickness is lower (1.21 : 1.08 vs. 1.43 : 0.63 mm). CONCLUSIONS: The study confirms that second primary melanoma is usually thinner than the first lesion, and it is more common in the same region of the body as the initial melanoma. The highest risk for a second melanoma is during the first 5 years, but a much longer time interval of 28 years is possible. Continued medical follow-up with complete skin examinations seems prudent, but it is very important to promote self-skin evaluation in patients to detect not only metastases but also subsequent primary melanomas in their earliest phases. 相似文献
85.
Orbital volume measured by a low-dose CT scanning technique. 总被引:6,自引:0,他引:6
A method for measuring orbital volume using low-dose CT with contiguous 3 mm transaxial sections is described. The accuracy of the method is 1.6%, as demonstrated by comparing CT volume measurements with those derived directly from alginate impressions and on repeat scanning the precision of the measurement was judged as 1.3%. Within the same individual, the right and left orbital volumes were observed to be within 0.6 cm3 (s.d. +/- 0.33 cm3) of each other. This study demonstrates that low-dose CT scanning is a practical method of determining orbital volume and could be used to advantage in the management of traumatic enophthalmos and blow-out fractures of the orbit. 相似文献
86.
K Taylor 《British journal of hospital medicine》1992,47(1):71-72
How much pension will you receive from the NHS Superannulation Scheme upon retirement? Some hospital doctors do not have a clear idea of the likely benefits or indeed any appreciation of the ancillary features included in the NHSSS. It is therefore appropriate to begin this series of articles on pension options for doctors with an overview of the NHS Scheme. 相似文献
87.
Prediction of Remission of Acute Posttraumatic Stress Disorder in Motor Vehicle Accident Victims 总被引:1,自引:0,他引:1
Edward B. Blanchard Edward J. Hickling Catherine A. Forneris Ann E. Taylor Todd C. Buckley Warren R. Loos James Jaccard 《Journal of traumatic stress》1997,10(2):215-234
One hundred forty five individuals who sought medical attention as a result of a motor vehicle accident (MVA), and who were initially assessed 1 to 4 months post-MVA, were followed up prospectively for 6 months to determine how many of the 55 with posttraumatic stress disorder (PTSD) and the 43 with sub-syndromal PTSD would remit and what variables would predict remission. Thirty (55%) of those with initial PTSD had remitted at least in part by 6 months while 67% of those with sub-syndromal PTSD had remitted (and 5% had worsened). Four variables, including severity of initial symptoms, degree of initial physical injury, relative degree of physical recovery by 4 months and whether a close family member suffered a trauma during the follow-up interval, combined to classify 6-month clinical status of 84% of those with initial PTSD secondary to MVAs. 相似文献
88.
MASATO FUKUDA MD AKINOBU HATA MD SHIN-ICHI NIWA MD KEN-ICHI HIRAMATSU MD MASAFUMI YOKOKOJI MD SEIKI HAYASHIDA AM KENJI ITOH DENG KAZUYUKI NAKAGOME MD AKIRA IWANAMI MD 《Psychiatry and clinical neurosciences》1996,50(2):85-88
Abstract A female patient exhibiting functional hearing loss in her left ear demonstrated reduced amplitude of P3 component in event-related potentials (ERP) to left monaural stimulation, with preserved N1 and N2 components to stimulation of either ear. This result suggested that stimuli in the affected ear were conducted successfully up to the auditory cortex but that further processing in higher brain regions was 'repressed'. Event-related potential examination for such hysterical disorders could be useful in clarifying their brain mechanism and offer a useful diagnostic clue to its nature. 相似文献
89.
A total of 9 patients with macroscopic hematuria from various causes, none with evidence of disseminated intravascular coagulation, received low oral, divided doses (approximately 150 mg. per kg. per day) of epsilon aminocaproic acid for up to 21 consecutive days. The hematuria was controlled effectively without overt clinical reactions. Parameters of hepatic and renal function, indicators of muscular damage, were studied in detail in 3 patients. No significant abnormalities were found. The use of small doses of epsilon aminocaproic acid was not accompanied by significant complications and appeared to be effective in special situations for the control of urinary bleeding. This therapy may have indications in a number of urological states accompanied by excessive hematuria. 相似文献
90.
Use of an enzyme immunoassay to detect serum IgG antibodies to Haemophilus ducreyi 总被引:11,自引:0,他引:11
K Museyi E Van Dyck T Vervoort D Taylor C Hoge P Piot 《The Journal of infectious diseases》1988,157(5):1039-1043
An experimental enzyme immunoassay (EIA) for detecting serum IgG antibody to Haemophilus ducreyi was developed using an ultrasonicated whole-cell antigen. The mean optical densities (OD) for sera from men with proven chancroid from Nairobi (47 patients) and Bangkok (72 patients) were significantly higher than those obtained from Nairobi men with genital ulcers not due to H. ducreyi, from Nairobi men with urethritis, from pregnant women in Nairobi, and from European men with sexually transmitted disease. When an OD of 0.500 was taken as the cutoff value, 89% and 55% of men with proven chancroid in Nairobi and Bangkok, respectively, were positive for H. ducreyi antibody, as compared with 2%-17% in the control groups. A rise in OD was observed in five of 18 patients with clinical chancroid. These results confirm the development of circulating antibodies in chancroid and suggest that this EIA may be useful for the diagnosis and epidemiological study of H. ducreyi infection. 相似文献