Unprecedented declines in invasive breast cancer rates occurred in the United States between 2001 and 2004, particularly for
estrogen receptor-positive tumors among non-Hispanic white women over 50 years. To understand the broader public health import
of these reductions among previously unstudied populations, we utilized the largest available US cancer registry resource
to describe age-adjusted invasive and in situ breast cancer incidence trends for non-Hispanic white women aged 50 to 74 years overall and by county-level rural/urban and
poverty status. 相似文献
Despite microvascular free tissue transfer being the mainstay of care in the reconstruction of larger maxillofacial defects, a significant number of patients experience postoperative complications due to impaired blood supply of the flap. In this context, the early influence of recipient bed perfusion remains unclear, but there is evidence that it is associated with free flap viability immediately after surgery.
Methods
We analyzed flap and recipient bed perfusion within the first 2 weeks after surgery by using the oxygen-to-see device. One hundred ninety-one patients who underwent free flap surgery in our department were included.
Results
Flow parameters were higher and postoperative complications were less frequent in radial forearm free flaps compared to any other type of flap. Flow parameters of the recipient bed were higher than transferred tissue at all times, implicating flap autonomization is not completed within 2 weeks. Previous radiotherapy significantly decreased flow parameters of the recipient bed but not of the flaps. Furthermore, irradiated patients with postoperative complications were found to have reduced flow parameters of their recipient bed compared to non-irradiated patients with postoperative complications.
Conclusion
We conclude that monitoring of recipient bed perfusion is useful for detecting flap compromise of irradiated patients in the early postoperative period.
Background. Few health degree programs incorporate sufficient tobacco cessation education in core curricula. Methods. A national survey of 132 PA programs assessed the extent to which tobacco is addressed, educational methods, perceived importance and adequacy of tobacco education, and perceived barriers to enhancing tobacco-related content. Results. Surveys (n=99; 75%) revealed a median of 150 minutes of tobacco education throughout the degree program. Key barriers to enhancing training are lack of curriculum time and lack of access to comprehensive, evidence-based resources. Two-thirds expressed interest in participating in a nationwide effort to enhance tobacco cessation training. Conclusions. Similar to other disciplines, enhanced tobacco education is needed in PA programs to adequately prepare graduates to address the primary known cause of preventable death in the United States. 相似文献
Markers of oxidative stress and antioxidant activity in plasma and erythrocytes were studied for 14 d after birth in infants with neonatal respiratory distress syndrome ( n = 9) and controls ( n = 36). In plasma, the total radical trapping antioxidant capacity and the chain-breaking antioxidants vitamin C, sulfhydryl groups and bilirubin were similar. The differences in uric acid levels were not consistent, but vitamin E levels and vitamin E/total-lipid ratio were lower in the neonatal respiratory distress group ( p < 0.01). In erythrocytes, the antioxidant enzymes glutathione peroxidase, glutathione reductase and superoxide dismutase did not differ postnatally. Indicators of oxidative damage in plasma (sulfhydryl/protein ratio and thiobarbituric acid reactive substances) showed the same postnatal course in both groups and were not influenced by oxygen therapy. In erythrocytes the reduced/oxidized glutathione ratio showed no consistent differences. In conclusion, this study, using erythrocytes and plasma, does not provide convincing evidence of oxidative damage and diminished antioxidant defenses in preterm infants with neonatal respiratory distress syndrome. 相似文献
In somatic cells phosphoinositide 3-kinase (PI 3-kinase) is activated upon
interaction with both receptor tyrosine kinases (RTK) and G- proteins
resulting in the production of moieties involved in the inositol
phospholipid signalling pathway. As G proteins, RTK and the inositol
phospholipids have all been implicated in the human sperm acrosome
reaction, experiments were carried out to determine whether PI 3-kinase was
also involved in this phenomenon. Wortmannin is a selective inhibitor of PI
3-kinase and was shown to significantly inhibit the acrosome reaction
induced by both mannose-bovine serum albumin (mannose-BSA) (10, 50 and 100
nM) and a polyclonal antibody raised against an extracellular region of the
sperm zona receptor kinase (ZRK, at 100 nM only). Wortmannin did not
inhibit the A23187- or progesterone-induced acrosome reaction. These
results suggest that PI 3- kinase is involved in the human sperm acrosome
reaction. The levels of tyrosine phosphorylation of sperm proteins as
detected by Western blotting using antiphosphotyrosine antibodies was not
affected by wortmannin in agonist (A23187 and mannose-BSA)-stimulated
spermatozoa. This indicated that PI 3-kinase operates downstream of
tyrosine phosphorylation in the signal transduction cascade which leads to
the human sperm acrosome reaction.
相似文献
Summary To determine the effect of age and comorbid diseases on treatment choice and survival, the medical records of 300 breast cancer patients of 55 years and older were reviewed. All patients were admitted to the Netherlands Cancer Institute (NKI) for first treatment between 1980 and 1987. Patients were classified according to severity level of comorbid diseases. Physicians were found to treat women of 75 years and older less often with adjuvant radiotherapy after a mastectomy, and more often to employ only primary endocrine treatment for local stage disease, as compared with younger patients. According to the treatment guidelines of the institute, the study sample was divided into patients who received standard vs. non-standard treatment. The treatment of 38 women (13.1%) did not correspond with the guidelines. Of these, 84% were 75 years and older and 50% had a severe comorbidity status. Logistic regression analysis indicated that advanced age, per se, was a better indicator of the risk of not being treated according to protocol than the comorbidity status. Cox multivariate analyses demonstrated that neither the severity of the comorbidity status nor the differences in treatment between younger and older patients had a significant effect on the risk of dying from breast cancer or on the risk of developing recurrences. In this analysis, age 75 years or more proved to be a significant and independent predictor of a worse overall and disease-specific survival as compared to age between 65–74 years. 相似文献