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81.
Minimally invasive surgery is gaining popularity around the world because it achieves the same or even superior results when compared to standard surgery but with less morbidity. Minimally invasive breast surgery is a broad concept encompassing new developments in the field of breast surgery that work on this minimally invasive principle. In this regard, breast-conserving surgery and sentinel lymph node biopsy are good illustrations of this concept. There are three major areas of progress in the minimally invasive management of breast disease. First, percutaneous excisional devices are now available that can replace the surgical excision of breast mass lesions. Second, various ablative treatments are capable of destroying breast cancers in situ instead of surgical excision. Third, mammary ductoscopy provides a new approach to the investigation of mammary duct pathology. Clinical experience and potential applications of these new technologies are reviewed. 相似文献
82.
Boena WIELGOSZEWSKA Charlotte BOOTH Michael J GREEN Olivia KL HAMILTON Jacques WELS 《Industrial health》2022,60(4):345
Little is known about the relationship between homeworking and mental health during the Covid-19 pandemic and how it might differ by keyworker status. To understand this relationship, we use longitudinal data collected over three time points during the pandemic from three British cohort studies born in 1958 (National Child Development Study), 1970 (British Cohort Study) and 1989–90 (Next Step) as well as from a population-based study stratified by four age groups (Understanding Society). We estimate the association between life satisfaction, anxiety, depression, and psychological distress and homeworking by key worker status using mixed effects models with maximum likelihood estimation to account for repeated measurements across the pandemic, allowing intercepts to vary across individuals after controlling for a set of covariates including pre-pandemic home working propensities and loneliness. Results show that key workers working from home showed the greatest decline in mental health outcomes relative to other groups. Pre-pandemic homeworking did not significantly change the nature of such a relationship and loneliness slightly attenuated some of the effects. Finally, mental health outcomes varied across age-groups and time points. The discussion emphasises the need to pay attention to key workers when assessing the relationship between mental health and homeworking. 相似文献
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PC Ng TF Fok CH Lee KL Cheung CK Li KW So W Wong PMP Yuen 《Acta paediatrica (Oslo, Norway : 1992)》1998,87(11):1197-1199
Two cases of homozygous α-thalassaemia who received active treatment in accordance with parental wishes are reported. One infant survived and the other, although successfully weaned off mechanical respiratory support, unexpectedly developed portal vein thrombosis and died. Homozygous a-thalassaemia, a condition previously considered to be universally fatal, and an indication for therapeutic abortion, is now potentially curable with advances in diagnostic technology and treatment. However, active management of these cases raises serious ethical questions and has major financial implications on the health-care system. Invasive prenatal and intensive postnatal interventions should remain experimental and cannot be recommended as routine clinical practice until the questions of long-term neurodevelopmental outcome, and the morbidity and mortality associated with bone-marrow transplantation have been fully addressed. As a result of advances in information technology, more and more parents of affected foetuses are likely to request active treatment. 相似文献
85.
86.
Paget disease of the nipple: radiologic-pathologic correlation 总被引:1,自引:0,他引:1
87.
Benzimra RE; Antao AJ; Donovan KL; Williams AJ 《QJM : monthly journal of the Association of Physicians》1998,91(6):417-422
Haemolytic uraemic syndrome (HUS) and thrombotic thrombocytopenic purpura
(TTP) are conditions in which thrombocytopenia and microangiopathic
haemolytic anaemia are associated with organ damage due to thrombotic
microangiopathy (TMA). The prognosis for adults with HUS is variable, with
some patients presenting with an acute illness from which a full recovery
is made, whilst others develop irreversible renal failure. Evidence of
retinal ischaemia was noted on presentation in a normotensive patient with
irreversible renal failure due to HUS. This study examined prospectively
the optic fundi of all patients who subsequently presented to a single
adult renal unit (catchment population approximately 700,000) with HUS.
Eleven patients presented with HUS over 12 years (1985-1997). Six patients
with irreversible renal failure had retinal abnormalities either at the
time or within a few days of initial presentation. The other five patients
whose renal function recovered did not develop retinal changes during the
course of their illness. Retinal ischaemia associated with TMA is a poor
prognostic sign in adults with HUS.
相似文献
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90.
U Poddar BR Thapa K Vaiphei KL Rao SK Mitra K Singh 《Archives of disease in childhood》1998,78(3):264-266
The clinical profile, malignant potential, and management of 17 children with juvenile polyposis (more than five juvenile polyps) were evaluated clinically and endoscopically. Colonoscopy and polypectomy were done three weekly until colonic clearance was achieved, and thereafter two yearly. All polyps were subjected to histological examination. Mean age was 7.7 years, with a male preponderance (3:1). Presentation was with rectal bleeding (94%), pallor (65%), stunted growth (53%), and oedema (47%), and the mean (SD) duration of symptoms was 33 (27) months. None had a positive family history or any congenital anomaly. Two children had six polyps up to the transverse colon; the rest had numerous polyps all over the colon. All children had juvenile polyps on histology and 10 (59%) had adenomatous changes (dysplasia). Total colectomy was done in six for intractable symptoms. Colon clearance was achieved in eight after an average 3.4 polypectomy sessions, and three were still on the polypectomy programme. In conclusion, juvenile polyposis is commonly associated with low grade dysplasia. Serial colonoscopic polypectomy is effective but colectomy is required for intractable symptoms and when clearance of the colon is not possible. 相似文献