The first 150 words of the full text of this article appear below.Key points Coronary artery disease accounts for >30% ofdeaths in Western society. The diagnosis of myocardial infarctionshould be qualified by size, causation and time from occurrence. Mortalityis reduced by immediate or primary percutaneouscoronary intervention or thrombolysis within the first 24 hof onset of ST-segment elevation myocardial infarction. Strategiesto reduce platelet activation (glycoprotein IIb/IIIa receptorantagonists, or clopidogrel) are now recommended in the treatmentof high-risk non-ST-segment myocardial infarction/unstable angina. Elevatedserum troponins may be the result of non-ischaemic myocardialdamage, especially in critical illness.
Pathophysiology
Changes in the definition of terms relating to the diagnosisof myocardial infarction (MI) have evolved by better understandingof the pathophysiology culminating in the new term of acutecoronary syndrome (ACS). Figure 1 illustrates the processesthat occur in the development of an acute coronary event.
High altitude exposure and/or aviator status correlate significantly with cancerous conditions of the skin, testicles, bladder, and thyroid based upon a comprehensive literature review and survey of governmental sources. Other lesser significantly associated conditions include leukemia, lymphosarcoma, and Hodgkin's disease. Although radiation and sunlight are strongly associated with cancer incidence and risk at high altitudes, other intervening variables are discussed and critically reviewed using malignant melanoma of the skin as an example. 相似文献
Objective Ovarian dysgerminoma is an uncommon ovarian malignancy, Its clinicai features are special and there are many factors affecting
its prognosis. If treated properly, the patient can be cured. Otherwise it may endanger the patient’s life. The aim of this
study is to investigate the clinical features and factors related to prognosis of ovarian dysgerminoma.
Methods Data from 57 patients with pure ovarian dysgerminoma were analyzed retrospectively. The patients were admitted to the Cancer
Center, Sun Yat-sen University from January 1.1964 to December 31, 2000.
Results The main clinical features were abdominal mass (56.1% ), abdominal pain (21.1% ), abdominal swelling (17.5%.), vaginal bleeding
(5.3% )and genital tract abnormalities (5.3%). Twenty-six patients had stage I diseases, 8 stage II.9 stage III.1 stage IV
and 13 recurrent and persistent diseases. The uterus was involved in 41.2% of patients with stage II -III diseases. Combined
modality was given to 52 cases and a single-method treatment to 5 cases. The total overall 5 and 10-year survival rates for
stages I-IV was 80.1 % and 70.0% respectively. The 5-year survival rate for stage I was 100%, stage II 55.2%. stage III 55.6%
and stage IV 0%; for recurrent and persistent diseases, 72.7%. The stage I group of 12 patients. received adnexectomy and
14 patients underwent hysterectomy and adnexa removal. There was no significant difference between the 5 and 10-year survival
rates (all 100%). Of the 23 patients in the stage I group to whom oniy chemotherapy was given after operation, 19 cases received
3 or more courses and were well without recurrence; 4 patients received only one course and one of them recurred 21 months
after the operation. In the group of stages II and III cases, the 5-year survival rate was 86.7% for those whose chemotherapy
courses were 3≥ 4 and 25.0% for patients who received less than 4 courses of chemotherapy (P<0.05).
Conclusions The prognosis of ovarian dysgerminoma is closely related to the disease stage and treatment modality. A fertility-preserving
operation can be considered in early -staged patients, but caution needs to be exercised in the middle to late staged cases.
Good results can be achieved with an operation-based combined modality in recurrent patients. 相似文献
Periodontal bio‐repositories, which allow banking of clinically validated human data and biological samples, provide an opportunity to derive biomarkers for periodontal diagnosis, prognosis and therapeutic activities which are expected to improve patient management. This article presents the establishing of the Malaysian Periodontal Database and Biobank System (MPDBS) which was initiated in 2011 with the aim to facilitate periodontal research. Partnerships were established with collaborating centres. Policies on specimen access, authorship and acknowledgement policies were agreed upon by all participating centres before the initiation of the periodontal biobank. Ethical approval for the collection of samples and data were obtained from institutional ethics review boards. A broad‐based approach for informed consent was used, which covered areas related to quality of life impacts, genetics and molecular aspects of periodontal disease. Sample collection and processing was performed using a standardized protocol. Biobanking resources such as equipment and freezers were shared with the Malaysian Oral Cancer Database and Tissue Bank System (MOCDTBS). In the development of the MPDBS, challenges that were previously faced by the MOCDTBS were considered. Future challenges in terms of ethical and legal issues will be faced when international collaborations necessitate the transportation of specimens across borders. 相似文献
Humans are reliant on their caregivers for an extended period of time, offering numerous opportunities for environmental factors, such as parental attitudes and behaviors, to impact brain development. The default mode network is a neural system encompassing the medial prefrontal cortex, posterior cingulate cortex, precuneus, and temporo-parietal junction, which is implicated in aspects of cognition and psychopathology. Delayed default mode network maturation in children and adolescents has been associated with greater general dimensional psychopathology, and positive parenting behaviors have been suggested to serve as protective mechanisms against atypical default mode network development. The current study aimed to extend the existing research by examining whether within- default mode network resting-state functional connectivity would mediate the relation between parental acceptance/warmth and youth psychopathology. Data from the Adolescent Brain and Cognitive Development study, which included a community sample of 9,366 children ages 8.9–10.9 years, were analyzed to test this prediction. Results demonstrated a significant mediation, where greater parental acceptance/warmth predicted greater within- default mode network resting-state functional connectivity, which in turn predicted lower externalizing, but not internalizing symptoms, at baseline and 1-year later. Our study provides preliminary support for the notion that positive parenting behaviors may reduce the risk for psychopathology in youth through their influence on the default mode network.