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1.
R Malcolm J M Von P M O'Neil H S Currey J D Sexauer E Riddle 《Southern medical journal》1988,81(5):632-639
This article updates a paper published in this journal more than a decade ago. We detail the ensuing decade's developments in the treatment of obesity, reviewing innovations, established techniques, and the current status of behavior modification. We evaluate newer developments, such as anorectic drugs, very low calorie diets, and intragastric balloon bezoars, and we describe other approaches to the treatment of obesity, such as residential and comprehensive outpatient programs. We conclude by recommending a multidisciplinary approach to this complex problem. 相似文献
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Cortina Chandler S. Bergom Carmen Craft Morgan Ashley Fields British Brazauskas Ruta Currey Adam Kong Amanda L. 《Annals of surgical oncology》2021,28(10):5568-5579
Annals of Surgical Oncology - Management of axillary lymph nodes in breast cancer has undergone significant change over the past decade through landmark clinical trials. This study aimed to assess... 相似文献
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Background
Improving the timely recognition and response to clinical deterioration is a critical challenge for clinicians, educators, administrators and researchers. Clinical deterioration leading to Rapid Response Team review is associated with poor patient outcomes. A range of factors associated with clinical deterioration and its outcomes have been identified, and may help with early identification of deteriorating patients. However, the relative importance of each factor on the development of clinical deterioration is unknown.Objective
To identify the relative importance of factors contributing to the development of clinical deterioration in ward patients, as perceived by health professionals who have experience in recognising or responding to clinical deterioration, or in the management, administration or governance of RRSs.Methods
A written questionnaire containing 12 pre-determined factors was provided to participants. Participants were asked to rank the items from most to least important contributors to ward patient deterioration. The study took place during a session of the Australia and New Zealand Intensive Care Society Rapid Response Team conference.Results
A final sample of 233 (83% response rate), returned the questionnaire. The sample comprised specialist ICU registered nurses with direct patient contact (64%), ICU consultant doctors (17%), ICU nurse managers (7%), hospital administrators (2%), ICU registrars (2%), quality coordinators (2%) and non-hospital staff (4%). The patient’s presenting illness/main diagnosis was the highest ranked factor, followed by pre-existing co-morbidities, seniority of nursing ward staff, medical documentation, senior medical staff, and interdisciplinary communication. Almost two-thirds of participants ranked patient characteristics as the most important contributor to clinical deterioration.Conclusion
Health professionals who have experience in recognising or responding to clinical deterioration, or in the management, administration or governance of RRSs perceive that patient characteristics such as the patient’s primary diagnosis and comorbidities to be the most important contributors to clinical deterioration. 相似文献6.
Reducing the Human Burden of Breast Cancer: Advanced Radiation Therapy Yields Improved Treatment Outcomes 下载免费PDF全文
Adam D. Currey MD Carmen Bergom MD PhD Tracy R. Kelly MD J. Frank Wilson MD 《The breast journal》2015,21(6):610-620
Radiation therapy is an important modality in the treatment of patients with breast cancer. While its efficacy in the treatment of breast cancer was known shortly after the discovery of x‐rays, significant advances in radiation delivery over the past 20 years have resulted in improved patient outcomes. With the development of improved systemic therapy, optimizing local control has become increasingly important and has been shown to improve survival. Better understanding of the magnitude of treatment benefit, as well as patient and biological factors that confer an increased recurrence risk, have allowed radiation oncologists to better tailor treatment decisions to individual patients. Furthermore, significant technological advances have occurred that have reduced the acute and long‐term toxicity of radiation treatment. These advances continue to reduce the human burden of breast cancer. It is important for radiation oncologists and nonradiation oncologists to understand these advances, so that patients are appropriately educated about the risks and benefits of this important treatment modality. 相似文献
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Rima M. Wazen Jennifer A. Currey Hongqiang Guo John B. Brunski Jill A. Helms Antonio Nanci 《Acta biomaterialia》2013,9(5):6663-6674
Implant loading can create micromotion at the bone–implant interface. The interfacial strain associated with implant micromotion could contribute to regulating the tissue healing response. Excessive micromotion can lead to fibrous encapsulation and implant loosening. Our objective was to characterize the influence of interfacial strain on bone regeneration around implants in mouse tibiae. A micromotion system was used to create strain under conditions of (1) no initial contact between implant and bone and (2) direct bone–implant contact. Pin- and screw-shaped implants were subjected to displacements of 150 or 300 μm for 60 cycles per day for 7 days. Pin-shaped implants placed in five animals were subjected to three sessions of 150 μm displacement per day, with 60 cycles per session. Control implants in both types of interfaces were stabilized throughout the healing period. Experimental strain analyses, microtomography, image-based displacement mapping, and finite element simulations were used to characterize interfacial strain fields. Calcified tissue sections were prepared and Goldner trichrome stained to evaluate the tissue reactions in higher and lower strain regions. In stable implants bone formation occurred consistently around the implants. In implants subjected to micromotion bone regeneration was disrupted in areas of high strain concentrations (e.g. >30%), whereas lower strain values were permissive of bone formation. Increasing implant displacement or number of cycles per day also changed the strain distribution and disturbed bone healing. These results indicate that not only implant micromotion but also the associated interfacial strain field contributes to regulating the interfacial mechanobiology at healing bone–implant interfaces. 相似文献
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Parallel genetic basis for repeated evolution of armor loss in Alaskan threespine stickleback populations 下载免费PDF全文
Cresko WA Amores A Wilson C Murphy J Currey M Phillips P Bell MA Kimmel CB Postlethwait JH 《Proceedings of the National Academy of Sciences of the United States of America》2004,101(16):6050-6055
Most adaptation is thought to occur through the fixation of numerous alleles at many different loci. Consequently, the independent evolution of similar phenotypes is predicted to occur through different genetic mechanisms. The genetic basis of adaptation is still largely unknown, however, and it is unclear whether adaptation to new environments utilizes ubiquitous small-effect polygenic variation or large-effect alleles at a small number of loci. To address this question, we examined the genetic basis of bony armor loss in three freshwater populations of Alaskan threespine stickleback, Gasterosteus aculeatus, that evolved from fully armored anadromous populations in the last 14,000 years. Crosses between complete-armor and low-armor populations revealed that a single Mendelian factor governed the formation of all but the most anterior lateral plates, and another independently segregating factor largely determined pelvic armor. Genetic mapping localized the Mendelian genes to different chromosomal regions, and crosses among these same three widely separated populations showed that both bony plates and pelvic armor failed to fully complement, implicating the same Mendelian armor reduction genes. Thus, rapid and repeated armor loss in Alaskan stickleback populations appears to be occurring through the fixation of large-effect variants in the same genes. 相似文献
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Polymorphonuclear cell function in rheumatoid arthritis and in Felty''s syndrome. 总被引:1,自引:3,他引:1 下载免费PDF全文
Tests for polymorphonuclear cell (PMN) chemotaxis, adherence, and electrophoretic mobility (EPM) were carried out on blood PMN isolated from 27 normal subjects, 16 patients with uncomplicated rheumatoid arthritis (RA), and 9 patients with Felty's syndrome. Chemotaxis was measured by a modification of the Boyden chamber technique, adherence by retention of cells on nylon fibre columns, and EPM in a cylindrical electrophoretic assembly. There was no significant difference between the chemotactic migration of normal and rheumatoid PMN as assessed by the leading front measurement. However, PMN from patients with Felty's syndrome showed significantly reduced chemotaxis (P less than 0.001). Computerised image analysis showed this impaired migration to be due to an overall reduction in cell motility rather than loss of a subset cells. Activated serum from patients with RA and Felty's syndrome were as good chemoattractants as activated pooled AB serum. There was no significant difference in the adhesiveness of PMN from normal persons and rheumatoid patients, though PMN from patients with Felty's syndrome did show a trend to lower adhesiveness. Both RA and Felty's syndrome patients had an increase in the proportion of PMN of lower surface charge than controls. Direct correlations were observed between cells of high surface charge and nonadhesiveness. 相似文献