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71.
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72.
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
73.
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
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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
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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
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