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101.
MJ Hwang A Bhangu CE Webster DM Bowley MX Gannon SS Karandikar 《Annals of the Royal College of Surgeons of England》2014,96(5):343-347
Introduction
In 2009 the Department of Health instructed McKinsey & Company to provide advice on how commissioners might achieve world class National Health Service productivity. Asymptomatic inguinal hernia repair was identified as a potentially cosmetic procedure, with limited clinical benefit. The Birmingham and Solihull primary care trust cluster introduced a policy of watchful waiting for asymptomatic inguinal hernia, which was implemented across the health economy in December 2010. This retrospective cohort study aimed to examine the effect of a change in clinical commissioning policy concerning elective surgical repair of asymptomatic inguinal hernias.Methods
A total of 1,032 patients undergoing inguinal hernia repair in the 16 months after the policy change were compared with 978 patients in the 16 months before. The main outcome measure was relative proportion of emergency repair in groups before and after the policy change. Multivariate binary logistic regression was used to adjust the main outcome for age, sex and hernia type.Results
The period after the policy change was associated with 59% higher odds of emergency repair (3.6% vs 5.5%, adjusted odds ratio [OR]: 1.59, 95% confidence interval [CI]: 1.03–2.47). In turn, emergency repair was associated with higher odds of adverse events (4.7% vs 18.5%, adjusted OR: 3.68, 95% CI: 2.04–6.63) and mortality (0.1% vs 5.4%, p<0.001, Fisher’s exact test).Conclusions
Introduction of a watchful waiting policy for asymptomatic inguinal hernias was associated with a significant increase in need for emergency repair, which was in turn associated with an increased risk of adverse events. Current policies may be placing patients at risk. 相似文献102.
Andre C. Felicio MD PhD Katherine Dinelle MSc Pankaj A. Agarwal MD DNB DM Jessamyn McKenzie LPN Nicole Heffernan RN Jeremy D. Road MD Silke Appel‐Cresswell MD Zbigniew K. Wszolek MD Matthew J. Farrer PhD Michael Schulzer MD PhD Vesna Sossi PhD A. Jon Stoessl CM MD FRCPC 《Movement disorders》2014,29(9):1197-1201
103.
Aung Myat MD Florence Mouy BMBS Luke Buckner BMBS James Cockburn MD Andreas Baumbach MD Philip MacCarthy PhD Adrian P. Banning MD Nick Curzen PhD Roland Hilling-Smith MD Daniel J. Blackman MD Michael Mullen MD Mark de Belder MD Ian Cox MD Jan Kovac MD Ganesh Manoharan MD Azfar Zaman MD Douglas Muir MBChB David Smith MD Stephen Brecker MD Mark Turner PhD Saib Khogali MD Iqbal S. Malik PhD Osama Alsanjari MRCP Francesca D'Auria PhD Simon Redwood MD Bernard Prendergast DM Uday Trivedi MD Derek Robinson DPhil Peter Ludman MD Adam de Belder MD David Hildick-Smith MD 《Catheterization and cardiovascular interventions》2021,98(3):E444-E452
104.
105.
Phenotypic and functional characterization of T-BAM (CD40 ligand)+ T- cell non-Hodgkin's lymphoma 总被引:1,自引:0,他引:1
The precise mechanisms regulating T-helper function have been intensively investigated. We and others have recently identified a new T-cell-B-cell-activating molecule called T-BAM that directs B-cell differentiation by interacting with the CD40 molecule on B cells. Using a specific monoclonal antibody against T-BAM (5C8), we have previously shown that T-BAM expressing T cells are predominantly CD4+CD8- and in normal lymphoid tissue have a unique distribution. However, no information has been obtained regarding the phenotype and functional properties of human neoplastic T cells. Therefore, we investigated T- BAM expression immunohistochemically in 87 well-characterized T-cell non-Hodgkin's lymphomas and lymphoid leukemias (LL). We found that 21/81 neoplasms expressed detectable T-BAM and these positive tumors belong almost exclusively to the CD4+CD8- subtype. In addition, to determine whether T-BAM expression could be induced on T-BAM-LL cells, we activated T-BAM-LLs in vitro and showed that T-BAM could be upregulated only in CD4+CD8- tumors. Our studies clearly show that T- BAM is constitutively expressed in a large number of T-cell neoplasms with a relative mature phenotype (CD4+CD8-) and that only CD4+ neoplastic T cells can be induced in vitro to express this molecule. Additional studies are necessary to identify the biologic significance of T-BAM expression and its potential and clinical implications. 相似文献
106.
Sotos Raptis Asimina Mitrakou Dimitrios Hadjidakis Emmanuel Diamantopoulos Costas Anastasiou Artemis Fountas Roland Müller 《Acta diabetologica》1987,24(3):181-192
Summary Based on the known action of xanthine derivatives on the insulin secretion, the effect of pentoxifylline on carbohydrate homeostasis
of type I (IDDM) and type II (NIDDM) diabetics was investigated. Pentoxifylline is known to exert a favorable influence on
hemorheological disturbances in such patients. Twenty-four hour blood glucose pattern and insulin requirements were evaluated
in type I and type II diabetics by the use of the artificial pancreas before and after a 14-day treatment with pentoxifylline
400 mg p.o. (Trental 400?) t.i.d. During the stabilization period before treatment with pentoxifylline, NIDDM patients required 10.1±3.8 U of insulin
and the IDDM 35±13.7 U. After 2 weeks on pentoxifylline, NIDDM required only 6.3±2.8 U (p<0.05) and IDDM 28.5±9.7 U (n.s.).
Average blood glucose during the 24h decreased by 15.8±3.5% in NIDDM and by 10.3±2.5% in IDDM. Moreover, a significant smoothing
of glucose fluctuations during the 24h was noted in both groups. It is concluded that pentoxifylline administered concurrently
to any antidiabetic type of treatment leads to better blood glucose control as well as to prevention or delay of vascular
complications.
This work was supported by grants from the Social Ministry, Athens, Greece; Department of Internal Medicine I, University
of Ulm, FRG;Deutsche Forschungsgemeinschaft SFB87 Endokrinologie, Ulm, FRG; the Alexander Onassis Foundation, Vaduz, Liechtenstein.
Dedicated to Prof. Dr. med. h.c. Ernst F. Pfeiffer on the occasion of his 65th birthday anniversary. 相似文献
107.
Platelet-derived growth factor (PDGF) is a potent mitogen for many cultured connective tissue cells. It is present in concentrated form within the platelet alpha-granules and is believed to be released during platelet degranulation at sites of vascular injury. We have used a sensitive radioreceptor assay to measure PDGF levels in whole blood serum from normal humans [17.5 +/- 3.1 (SD) ng/mL] and baboons (2.7 +/- 1.2 ng/mL). PDGF was not detected in plasma from either species. In addition, plasma was found to substantially reduce the ability of added purified PDGF to bind to the cell surface PDGF receptor on cultured cells, suggesting that plasma may contain a PDGF-binding protein that would serve to inactivate PDGF released into plasma. Calculations of PDGF concentrations in serum have been corrected for the effects of the binding protein. 125I-PDGF injected intravenously into normal baboons was cleared rapidly from the plasma (t1/2 = two minutes). The rapid clearance of 125I-PDGF did not result from iodination damage, as purified unlabeled PDGF was cleared with comparable kinetics. The rapid clearance of purified and iodinated PDGF did not result from changes in PDGF structure during purification or from removal of PDGF-associated proteins during purification, as PDGF present in freeze-thaw lysates of fresh platelets was cleared equally rapidly. We conclude that release of PDGF at sites of vascular injury would greatly increase the local concentration of PDGF and that PDGF not localized to the site of injury would be rapidly cleared from the circulation. 相似文献
108.
Dimitrios Dimitroulis Dimitrios Patsouras Athanasios Katsargyris Petros Charalampoudis Ioannis Anastasiou Gregory Kouraklis 《International surgery》2014,99(5):669-672
Primary carcinoma of the male urethra accounts for less than 1% of malignancies in men. Mucinous adenocarcinoma of the urethra is extremely rare, and its biologic behavior is poorly understood. We present herein a rare case of mucinous urethral adenocarcinoma in a male patient with longstanding ulcerative colitis and multiple sclerosis. The patient presented with a voluminous pelvic mass; core biopsy of the lesion demonstrated a mucus-producing adenocarcinoma. Given the patient''s history of subtotal colectomy, preoperative diagnosis was oriented towards a rectal stump adenocarcinoma. The patient underwent a pelvic exenteration: surprisingly, histology marked the prostatic urethra as the primary lesion site.Key words: Urethra, Adenocarcinoma, Mucinous, Ulcerative colitisPrimary enteric-type mucinous adenocarcinoma of the urethra is an extremely rare entity with aggressive clinical course regardless of treatment. Interestingly, it has been implied that inflammatory bowel disease and multiple sclerosis share common mechanisms of impaired histocompatibility. Moreover, patients with inflammatory bower disease who receive prolonged immunosuppression such as azathioprine tend to increasingly develop urinary tract malignancies. We report herein a complex case of enteric-type mucinous adenocarcinoma of urethral origin in a male with a longstanding history of ulcerative colitis and multiple sclerosis. 相似文献
109.
110.
Shalender Bhasin MB BS Thomas G. Travison PhD Todd M. Manini PhD Sheena Patel MS Karol M. Pencina PhD Roger A. Fielding PhD Jay M. Magaziner PhD Anne B. Newman MD MPH Douglas P. Kiel MD Cyrus Cooper DM FMedSci Jack M. Guralnik MD PhD Jane A. Cauley Dr.PH Hidenori Arai MD PhD Brian C. Clark PhD Francesco Landi MD PhD Laura A. Schaap PhD Suzette L. Pereira PhD Daniel Rooks PhD Jean Woo MD PhD Linda J. Woodhouse PhD Ellen Binder MD Todd Brown MD Michelle Shardell PhD Quian-Li Xue PhD Ralph B. DʼAgostino Sr PhD Denise Orwig PhD Greg Gorsicki PhD Rosaly Correa-De-Araujo MD PhD Peggy M. Cawthon PhD 《Journal of the American Geriatrics Society》2020,68(7):1410-1418