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991.
Acute pancreatitis: prognostic value of CT 总被引:66,自引:0,他引:66
Balthazar EJ; Ranson JH; Naidich DP; Megibow AJ; Caccavale R; Cooper MM 《Radiology》1985,156(3):767-772
In 83 patients with acute pancreatitis, the initial computed tomographic (CT) examinations were classified by degree of disease severity (grades A-E) and were correlated with the clinical follow-up, objective prognostic signs, and complications and death. The length of hospitalization correlated well with the severity of the initial CT findings. Abscesses occurred in 21.6% of the entire group, compared with 60.0% of grade E patients. Pleural effusions were also more common in grade E patients. Grades A and B patients did not have abscesses, and none died, regardless of the number of prognostic signs. Abscesses were seen in 80.0% of patients with six to eight prognostic signs, compared with 12.5% of those with zero to two. The use of prognostic signs with initial CT findings results in improved prognostic accuracy. Early CT examination of patients with acute pancreatitis is a useful prognostic indicator of morbidity and mortality. 相似文献
992.
Multiple giant cell tumors and Paget disease of bone: radiographic and clinical correlations 总被引:3,自引:0,他引:3
The clinical and radiographic findings of four patients with multicentric giant cell tumor (GCT) of bone and Paget disease were retrospectively reviewed. Three patients underwent magnetic resonance (MR) imaging evaluation; all patients underwent computed tomography (CT). The MR characteristics of the bone component in pagetic GCT appeared to reflect the pagetic phase; a sclerotic pattern was largely represented by hypointense marrow signal intensity on images obtained with both long and short repetition times (TRs) and echo times (TEs). Conversely, a tumor appearing in a mixed pagetic phase demonstrated more heterogeneous signal intensity with all pulse sequences. Extensive soft-tissue components, noted in all cases, showed largely intermediate signal intensity on short TR/TE images and foci of increased signal intensity on longer TR/TE images. In most cases, dramatic reduction in tumor bulk was noted with the use of steroids alone. An awareness of this entity is important because the appearance of lytic lesions with soft-tissue extension in patients with Paget disease does not necessarily imply a grave prognosis. Serial CT or MR imaging is helpful in monitoring the remissions and exacerbations that reflect response to therapy in Paget disease and GCT. 相似文献
993.
BACKGROUND: The communication between GP and specialists is vital for the
patient suffering from breast cancer. OBJECTIVES: The aim of this study was
to investigate (i) the speed and type of communication between GPs,
specialists and patients with breast cancer, and (ii) the problems that GPs
encounter in the communication with specialists concerning these patients.
METHOD: In April 1995, 246 Dutch GPs from the Zwolle region (600 000
inhabitants) were invited to complete a questionnaire, using the
information from the medical record and focusing on the last patient
consulted with a confirmed diagnosis of breast cancer. RESULTS: Valid
replies were received from 150 (61 %) GPs. The median period between
initial referral date and receipt of the definite diagnosis from the
surgeon was 4 weeks. After the patient's first appointment with the
surgeon, the GPs received reports for 24% of the patients within 3 days;
for 31% within 3-7 days; and for 16% of the patients after more than 2
weeks. After the first consultation between patient and surgeon, 68 (45%)
of the 150 GPs reported that the patient contacted them; at this stage only
30 (20%) of these GPs had received a report from the surgeon. Thirty-one
(21%) GPs did not contact the patient after receival of the definite
diagnosis. GPs stated that the communication on patients with breast cancer
is too slow (49%), or not frequent enough (25%); 25% of GPs found that the
distribution of tasks between them and the specialists are not well
described. CONCLUSION: In the diagnostic stage of breast cancer the
communication between GPs, specialists and patients varies widely, is too
slow and is incomplete. An effect of this unsatisfactory communication is
that the patient herself is the messenger of the bad news.
相似文献
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995.
Segmental anatomy of the liver: poor correlation with CT 总被引:20,自引:0,他引:20
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The spontaneous disappearance of the inhibitor to factor VIII (FVIII) was observed in two human immunodeficiency virus (HIV)-infected men with hemophilia A. Both men had end-stage HIV infection, one with acquired immune deficiency syndrome (AIDS) and one with severe AIDS-related complex (ARC). Loss of the inhibitor was associated with a fall in T4 helper lymphocytes to less than 100 per mm3 in both patients. Subsequent spontaneous and traumatic hemorrhages were treated successfully with standard doses of FVIII concentrate, resulting in adequate FVIII:C levels and good hemostasis. The mechanism by which the anti-FVIII inhibitor disappears is not known, but it is likely to be related to a quantitative decline in T4 cell number. 相似文献