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New antimicrobial pathogens resistant to vancomycin are wreaking havoc in medical centers throughout the nation. Their tendency to colonize or infect severely ill, hospitalized patients who have undergone invasive procedures and received prolonged courses of antimicrobial therapy is alarming. The most potent weapon in the physician's arsenal against these enemies is familiarity with their key features, with the guidelines for prudent use of drug therapy, and with the precautionary measures necessary to limit contact and spread.  相似文献   
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Determinants of tumor size and growth in vestibular schwannomas.   总被引:2,自引:0,他引:2  
OBJECT: This study was undertaken to analyze factors associated with the size of unilateral vestibular schwannomas (VSs). METHODS: A retrospective analysis of an unselected and sequential series of 433 patients with unilateral VSs was conducted. Tumor size was defined by the largest dimension of the tumor in the cerebellopontine angle, and the size was tested for a relationship with patient age and sex. In a subgroup of 231 patients in whom data were available, tumor size was also tested for a relationship with tumor cysts or the absence of an internal auditory canal (IAC) component. Some patients underwent a period of surveillance with serial imaging studies to monitor for tumor growth. Data from these patients, excluding those with cystic tumors, were analyzed to see if tumor growth was related to patient age, sex, or tumor size. CONCLUSIONS; Larger tumors were found in younger patients, in females, in the subgroup of cystic tumors, and in patients in whom there was no tumor component in the IAC. The probable explanations for these larger tumors are a faster growth rate and/or a delay in symptom onset. When untreated tumors are managed with observation, measurable growth is more often seen in larger tumors, although smaller tumors have a faster relative growth rate than larger ones.  相似文献   
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Smoking is a high-risk behavior that affects the health and economic welfare of society. Thus, it is important to quantify the economic burden smoking places on social institutions in the United States.
OBJECTIVE: The purpose of this review paper is to analyze smoking cost studies and to provide estimates that represent the economic costs of smoking from different perspectives of society, and as a whole.
METHODS: Current Contents (1996–), Health Star (1970–), and Medline (1966–) databases were searched through the use of pertinent subject headings and key words: tobacco use, smoking, cost, and economics. The internet was utilized to identify potential sources of epidemiological and cost information on smoking. Recent cost-of-illness studies using different methodologies: human capital, incidence, and prevalence were chosen for review based on their relevance.
RESULTS: Preliminary results indicate that the published cost studies available underestimate the "true" costs of smoking. The most current articles approximate annual direct medical costs to health care payers of $50 billion (1993); inflating to 1997 equals $59 billion or $1,200 per smoker. Although the latest cost studies do not attempt to estimate indirect costs, past studies have found indirect costs to be 1.5–2 times the direct costs. Therefore, using direct and indirect costs we estimate total smoking costs to be $150 billion (1993); inflating to 1997 equals $176 billion or $3,500 per smoker.
CONCLUSION: Quantifying the cost of smoking is a difficult task due to tobacco use infiltrating many aspects of life and the dependency of cost on perspective. Cost-of-illness studies provide cost estimation data which can be useful in aiding decision-makers who are allocating health care resources.  相似文献   
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Babb RW 《Rehab management》2007,20(1):54, 56, 58 passim
Opening your own outpatient therapy center will likely seem an insurmountable task at times. Broken down into the stages of mission establishment, planning and goal setting, establishing financial viability, choosing equipment, promoting your product, and, finally, hiring staff, this task will become less onerous. Remember, it is your practice. True to your vision, and just like high school, be prepared for an emotional roller-coaster ride. Done correctly, this experience will be just as thrilling and ultimately much more gratifying.  相似文献   
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BACKGROUND: Two of the major goals of tobacco prevention and control activities are to change social norms and influence policy. The news media can play an important role for achieving both goals. METHODS: The Centers for Disease Control and Prevention's Office on Smoking and Health created a surveillance system to track tobacco stories in the news media beginning in 2004. The system was developed based on reviewing lessons from previous news media tracking efforts, including defining the purpose of the system, using a parsimonious approach to sample media outlets, and attending to data-quality issues. Tobacco news stories were systematically identified and coded from ten newspapers, four news wire services, and seven national television networks. RESULTS: Findings indicated that from January 2004 through June 2005, tobacco-related stories were in selected major newspapers virtually every day. More than 70% of all newspaper stories contained one of only three main story themes: policy or regulation (31.0%), legal issues (23.8%), or health effects or statistics (18.1%). Television news stories on tobacco were much less common, but increased substantially during the first 6 months of 2005 compared to 2004. Health effects/statistics (50.5%) were the dominant theme for television, with policy/regulation a distant second (19.5%). CONCLUSIONS: Tobacco-related media coverage can be systematically tracked and characterized. These findings may have value to public health researchers and policymakers who wish to evaluate efforts to curb tobacco-related disease.  相似文献   
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