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Maternal and Child Health Journal - Background Prenatal substance use screening is recommended. The 4 P’s Plus screener includes questions on perceived problematic substance use in parents...  相似文献   
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Purpose

To evaluate the feasibility of a same-day yttrium-90 (90Y) radioembolization protocol with resin microspheres (including pretreatment angiography, lung shunt fraction [LSF] determination, and radioembolization) for the treatment of hepatocellular carcinoma (HCC) and liver metastases.

Materials and Methods

All same-day radioembolization procedures performed over 1 y (February 2017 to January 2018) were included in this single-institutional retrospective analysis, in which 34 procedures were performed in 26 patients (median age, 63 y; 13 women), 19 with liver metastases and 7 with HCC. Yttrium-90 treatment activities were calculated by body surface area method. Tumor imaging response was assessed by Response Evaluation Criteria In Solid Tumors (RECIST) 1.1 for liver metastases and modified RECIST for HCC. Clinical side effects and adverse events were graded per Common Terminology Criteria for Adverse Events version 4.0.

Results

All planned cases were technically successful, and no cases were canceled for elevated LSF or vascular anatomic reasons. Pretreatment angiography modified the planned 90Y treatment activity in 1 case in which vascular anatomy required a lobar-dose split into 2 for segmental infusions. In 18% of cases, patients were briefly admitted after the procedure for observation or symptom management. Imaging evaluation of initial efficacy at 1 month demonstrated partial response in 25% and stable disease in 67% of patients with liver metastases and partial/complete response in 43% and stable disease in 14% of patients with HCC. Grade ≥ 3 adverse events occurred in 6% of cases, with no systemic therapy–limiting toxicities. The mean total procedure time was 4.2 hours.

Conclusions

A same-day 90Y radioembolization protocol with resin microspheres is feasible in select patients, which can expedite cancer therapy.  相似文献   
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Summary Adrenaline, when administered in dental local anaesthetic solutions, significantly reduces the plasma potassium concentration in young healthy adults. This effect occurs within 10 min of extravascular injections into the maxillary buccal sulcus and may influence the choice of local anaesthetic solution for patients receiving kaliuretic diuretics.  相似文献   
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A lawsuit directed by parents at a day care program following an outbreak of infectious disease would most likely be based on the legal theory of negligence--the failure to exercise due care as required by circumstances. In the determination of liability for infectious diseases in child day care, the element of causation is most critical. Did the day care facility's actions or failure to act cause the harm? Another important question is whether an infectious disease can be occupational and under what circumstances. Although worker's compensation laws initially had no provisions for occupational disease, now all states recognize responsibility for them. Awareness of potential problems with legal liability and establishment of procedures to minimize risk are important for day care providers, public health officials, clinicians, and parents.  相似文献   
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In a study of rock music preferences, listening/watching behavior, and views on destructive rock lyrics, 894 adolescents in grades 9 through 12 in rural, urban, suburban public, and metropolitan parochial schools were administered a questionnaire. Demographic information on parents was also collected. It was found that 17.5% of the students were fans of rock music with lyrics that promote homicide, suicide, or satanic practices (HSSR). Loglinear and multiple regression analyses were used to analyze the data. Parents' marital status, student sex, race, and school environment (urban, rural, suburban, etc.) were found to be significant predictors of HSSR status. As compared with non-HSSR fans, the HSSR fans were more likely to have parents who were “Never married” or “Remarried” and less likely to have parents in the “married” category. The HSSR fans were more likely to be male, white, and enrolled in urban schools but not parochial schools than expected; HSSR status also significantly predicted other music-related attitudes and behaviors. The HSSR fans reported liking both the sound and the lyrics of rock music more often than did non-HSSR fans, as did females and urban students. The HSSR fans more often felt that children under 10 years of age should be allowed to listen to HSSR lyrics, and they more frequently expressed the conviction that HSSR music does not affect adolescents' homicidal or self-destructive behavior. The HSSR fans and females reported more nearly complete knowledge of lyrics than did non-HSSR fans and males. The HSSR fans reported that they watch more MTV than did any other group except rural students.  相似文献   
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Dyssynchronous ventricular contraction in severe heart failurecontributes to low cardiac output, worsening symptoms, and poorprognosis. Recognition of the effect of dyssynchrony in heartfailure, and the possibility of manipulating the sequence ofelectrical cardiac activation to improve the efficiency of mechanicalevents, led Cazeau et al. to attempt four-chamber pacing in1994.1 This early system could stimulate both atria and bothventricles extrinsically, and could dictate the temporal relationshipbetween atrial systole and ventricular systole, and the ventriculo-ventricularrelationship. Modern cardiac resynchronization therapy (CRT),involving pacing of the right and left ventricles, with rightatrial pacing to optimize atrio-ventricular delay, has evolvedrapidly from this beginning. Left bundle branch block (LBBB) on the surface electrocardiogram(ECG) has been considered a marker of mechanical dyssynchronyas it represents a delay in conduction of depolarization tothe left ventricle, with the greatest delay usually being in  相似文献   
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With their unique perspectives in the identification, design, promotion, and evaluation of cancer patient education programs and services, the National Cancer Institute and the American Cancer Society have the abilities to meet a wide variety of cancer patient education needs. With federal support and connections to national organizations and the comprehensive and clinical cancer center networks, the National Cancer Institute has access to nationwide experts in medical care and the resources to develop, design, and promote quality, state-of-the-art education programs. The American Cancer Society, with its strong volunteer community base, can pull together local expertise and collaborate with local organizations to meet the special needs of local population groups. In addition, the American Cancer Society volunteer committees have the flexibility to individualize programming and resources to answer specific patient/family education problems. As the number of people affected by cancer continues to raise, and as organizations realize the need to maximize their resources with collaborative efforts, the National Cancer Institute and the American Cancer Society are challenged to focus their energies on the patient education initiatives that build upon and combine their unique strengths.  相似文献   
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