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排序方式: 共有959条查询结果,搜索用时 15 毫秒
181.
182.
Darren D Ballard Neel Choksi Jingmei Lin Eun-Young Choi B Joseph Elmunzer Henry Appelman Douglas K Rex Hala Fatima William Kessler John M DeWitt 《World journal of gastrointestinal endoscopy》2016,8(20):763-769
AIM To investigate the outcomes and recurrences of p T1 b esophageal adenocarcinoma(EAC) following endoscopic mucosal resection(EMR) and associated treatments.METHODS Patients undergoing EMR with pathologically confirmed T1 b EAC at two academic referral centers were retrospectively identified.Patients were divided into 4 groups based on treatment following EMR:Endoscopic therapy alone(group A),endoscopic therapy with either chemotherapy,radiation or both(group B),surgicalresection(group C) or no further treatment/lost to follow-up(12 mo)(group D).Pathology specimens were reviewed by a central pathologist.Follow-up data was obtained from the academic centers,primary care physicians and/or referring physicians.Univariate analysis was performed to identify factors predicting recurrence of EAC.RESULTS Fifty-three patients with T1 b EAC underwent EMR,of which 32(60%) had adequate follow-up ≥ 12 mo(median 34 mo,range 12-103).There were 16 patients in group A,9 in group B,7 in group C and 21 in group D.Median follow-up in groups A to C was 34 mo(range 12-103).Recurrent EAC developed overall in 9 patients(28%) including 6(38%) in group A(median:21 mo,range:6-73),1(11%) in group B(median:30 mo,range:30-30) and 2(29%) in group C(median 21 mo,range:7-35.Six of 9 recurrences were local;of the 6 recurrences,5 were treated with endoscopy alone.No predictors of recurrence of EAC were identified.CONCLUSION Endoscopic therapy of T1 b EAC may be a reasonable strategy for a subset of patients including those either refusing or medically unfit for esophagectomy. 相似文献
183.
Claire Kelly Neel Bhuva Mark Harrison Andrew Buckley Mark Saunders 《European journal of cancer (Oxford, England : 1990)》2013,49(10):2303-2310
AimFluoropyrimidines are the backbone of the majority of approved chemotherapy regimens for colorectal cancer (CRC). However, there are reports of fluoropyrimidine treatments being associated with cardiotoxicity which have led to permanent cardiovascular damage and even death. Raltitrexed is indicated for palliative treatment of advanced CRC where 5-fluorouracil (5-FU) is not tolerated or inappropriate. A systematic review was undertaken to determine the incidence of cardiotoxicity associated with 5-FU, capecitabine and raltitrexed.MethodsAn electronic search of PubMed was undertaken to identify articles relating to cardiotoxicity associated with 5-FU, capecitabine or raltitrexed, published between January 1991 and August 2011. Additionally, a retrospective review of cardiotoxicity associated with raltitrexed at our treatment centres was conducted.ResultsTwenty studies were examined. The overall incidence of cardiotoxicity associated with 5-FU/capecitabine varied between 0.55% and 19% (mean: 5.0%, median: 3.85%). No published data were identified reporting cardiotoxicity associated with raltitrexed. A retrospective review at our treatment centres revealed that the incidence was 4.5% amongst high-risk patients treated with raltitrexed (n = 111) for advanced gastrointestinal cancer with a significant cardiac history and/or previous cardiotoxicity with 5-FU or capecitabine.ConclusionThe incidence of cardiotoxicity associated with raltitrexed in patients with advanced CRC treated is favourable in a highly skewed, at-risk patient population, all of whom had documented cardiotoxicity with other fluoropyrimidines or were unable to tolerate capecitabine due to cardiac history. Raltitrexed is therefore a suitable option for patients with fluoropyrimidine-induced cardiotoxicity or significant cardiovascular risk factors. 相似文献
184.
Purpose
Elective surgical resection is the curative treatment for colorectal cancer (CRC). Up to 30 % of patients present as surgical emergencies. The objective was to determine the association between presenting with an emergency condition and consequent outcomes of CRC surgery in the Appalachian state of West Virginia (WV) in comparison to the rest of the USA.Methods
Patients diagnosed with CRC who underwent a surgical procedure from January 1, 2003 to December 31, 2007 were selected, and those with a diagnosis requiring emergency surgery were identified. Primary outcome measures were length of stay (LOS), total hospital charges, and inpatient death.Results
Mean LOS was higher for WV. Mean charges were higher for the USA than for WV. Inpatient deaths in WV were greater than the rest of the USA. Those undergoing emergency surgery spent 51.9 % (β?=?0.40) more days in the hospital than those who did not. For WV, LOS was 7.6 % (β?=?0.07) higher than that of the US. Hospital charges for those that underwent emergency resection were 68.3 % (β?=?0.52) higher than those who did not. The odds of in-hospital death were 1.68 (95 % CI?=?1.42–1.98) times greater in WV than in the USA. Those that underwent emergency surgery had a nearly four times (OR 3.88; 95 % CI?=?3.74–4.03) greater chance of in-hospital death.Conclusions
The study stresses the ongoing burden of emergency surgeries in many states around the nation and the need to increase awareness about CRC screening practices, especially in patients who are at increased risk of the disease. 相似文献185.
Neel Desai Haukur Björnsson Volker Musahl Mohit Bhandari Max Petzold Freddie H. Fu Kristian Samuelsson 《Knee surgery, sports traumatology, arthroscopy》2014,22(5):1009-1023
Purpose
To determine whether anatomic double-bundle anterior cruciate ligament (ACL) reconstruction compared to anatomic single-bundle ACL reconstruction more effectively restored antero–posterior (A–P) laxity, rotatory laxity and reduced frequency of graft rupture. Our hypothesis was that anatomic double-bundle ACL reconstruction results in superior rotational knee laxity and fewer graft ruptures due to its double-bundle tension pattern, compared with anatomic single-bundle ACL reconstruction.Methods
An electronic search was performed using the PubMed, EMBASE and Cochrane Library databases. All therapeutic trials written in English reporting knee kinematic outcomes and graft rupture rates of primary anatomic double- versus single-bundle ACL reconstruction were included. Only clinical studies of levels I–II evidence were included. Data regarding kinematic tests were extracted and included pivot-shift test, Lachman test, anterior drawer test, KT-1000 measurements, A–P laxity measures using navigation and total internal–external (IRER) laxity measured using navigation, as well as graft failure frequency.Results
A total of 7,154 studies were identified of which 15 papers (8 randomized controlled trials and 7 prospective cohort studies, n = 970 patients) met the eligibility criteria. Anatomic ACL double-bundle reconstruction demonstrated less anterior laxity using KT-1000 arthrometer with a standard mean difference (SMD) = 0.36 (95 % CI 0.214–0.513, p < 0.001) and less A–P laxity measured with navigation (SMD = 0.29 95 % CI 0.01–0.565, p = 0.042). Anatomic double-bundle ACL reconstruction did not lead to significant improvements in pivot-shift test, Lachman test, anterior drawer test, total IRER or graft failure rates compared to anatomic single-bundle ACL reconstruction.Conclusion
Anatomic double-bundle ACL reconstruction is superior to anatomic single-bundle reconstruction in terms of restoration of knee kinematics, primarily A–P laxity. Whether these improvements of laxity result in long-term improvement of clinical meaningful outcomes remains uncertain.Level of evidence
II. 相似文献186.
Chylothorax results from injury to the thoracic duct or one of its branches. It is an uncommon but possibly serious complication of thoracic or head and neck surgery. We report a case of thoracic duct transection complicating a total laryngectomy with bilateral selective neck dissection for subglottic squamous cell carcinoma. High-output Jackson Pratt drainage was noted, resulting in patient hypovolemia that was unresponsive to volume resuscitation. Treatment consisted of percutaneous embolization of the thoracic duct proximal to the transection that subsequently normalized chylous output. 相似文献
187.
A 12 year old boy with gradually worsening global developmental delay was diagnosed and managed as quadriplegic cerebral palsy since child-hood. Subsequent evaluation revealed marked dystonia over spasticity leading to suspicion of Segawa syndrome. Dramatic improvement in clinical condition followed after therapy with low dose L-Dopa. 相似文献
188.
Yerem Yeghiazarians Yan Zhang Megha Prasad Henry Shih Shereen A Saini Junya Takagawa Richard E Sievers Maelene L Wong Neel K Kapasi Rachel Mirsky Juha Koskenvuo Petros Minasi Jianqin Ye Mohan N Viswanathan Franca S Angeli Andrew J Boyle Matthew L Springer William Grossman 《Molecular therapy》2009,17(7):1250-1256
We compared therapeutic benefits of intramyocardial injection of unfractionated bone marrow cells (BMCs) versus BMC extract as treatments for myocardial infarction (MI), using closed-chest ultrasound-guided injection at a clinically relevant time post-MI. MI was induced in mice and the animals treated at day 3 with either: (i) BMCs from green fluorescent protein (GFP)-expressing mice (n = 14), (ii) BMC extract (n = 14), or (iii) saline control (n = 14). Six animals per group were used for histology at day 6 and the rest followed to day 28 for functional analysis. Ejection fraction was similarly improved in the BMC and extract groups versus control (40.6 ± 3.4 and 39.1 ± 2.9% versus 33.2 ± 5.0%, P < 0.05) with smaller scar sizes. At day 6 but not day 28, both therapies led to significantly higher capillary area and number of arterioles versus control. At day 6, BMCs increased the number of cycling cardiomyocytes (CMs) versus control whereas extract therapy resulted in significant reduction in the number of apoptotic CMs at the border zone (BZ) versus control. Intracellular components within BMCs can enhance vascularity, reduce infarct size, improve cardiac function, and influence CM apoptosis and cycling early after therapy following MI. Intact cells are not necessary and death of implanted cells may be a major component of the benefit. 相似文献
189.
W H Meyer C B Pratt C A Poquette B N Rao D M Parham N M Marina A S Pappo H H Mahmoud J J Jenkins J Harper M Neel B D Fletcher 《Journal of clinical oncology》2001,19(1):171-182
PURPOSE: To determine the activity of carboplatin/ifosfamide in patients with previously untreated osteosarcoma and to estimate patient outcomes after a multiagent chemotherapy protocol that eliminated cisplatin. PATIENTS AND METHODS: Sixty-nine patients with newly diagnosed, previously untreated osteosarcoma received three cycles of carboplatin (560 mg/m(2) x 1) and ifosfamide (2.65 g/m(2)/d x 3). Assessment of response was evaluated after two (week 6) and three (week 9) chemotherapy cycles. At week 9, histologic response was assessed. Adjuvant therapy comprised two additional carboplatin/ifosfamide cycles, doxorubicin, and high-dose methotrexate. Patients were stratified at enrollment: stratum A, resectable primary tumor without metastases; stratum B, unresectable primary tumor; and stratum C, metastatic disease at diagnosis. Week 6 response was compared with that of a historic group that received only ifosfamide during the initial window evaluation. RESULTS: The clinical and radiographic response rate to three cycles of carboplatin/ifosfamide was 67.7% (95% confidence interval, 55.0% to 78.8%). Compared with the historic population who received only ifosfamide, the combination of carboplatin and ifosfamide reduced the progressive disease rate at week 6 (31.9% v 9%, P: = .003). For patients in stratum A, the 3-year event-free survival and survival were 72.3% +/- 6.7% and 76.4% +/- 6.4%, respectively. Patients who received carboplatin-based therapy had less long-term renal toxicity and ototoxicity. CONCLUSION: This pilot trial suggests that carboplatin/ifosfamide combination chemotherapy has substantial antitumor activity. In the context of a multiagent chemotherapy protocol comprising high-dose methotrexate and doxorubicin, we found that the addition of carboplatin/ifosfamide resulted in patient outcomes comparable to trials using cisplatin-based therapy with less long-term toxicity. 相似文献
190.