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Implications for Practice
Breast cancer is far more curable than in the past but requires multimodality treatment. Great care must be taken to use the least leukemogenic treatment programs that do not sacrifice efficacy. Elimination of radiation and anthracycline/alkylating agent regimens will be helpful where possible, particularly in younger patients and possibly those with homologous repair deficiency (HRD). Use of colony-stimulating factors should be limited to those who truly require them for safe chemotherapy administration. Further study of a possible leukemogenic association with HRD and the various forms of colony-stimulating factors is badly needed.4.
Neetu Radhakrishnan M.D. Chong. H. Park M.D. Barry M. Kaplan M.D. F.A.C.C. Rajiv Jauhar M.D. F.A.C.C. 《The International journal of angiology》2006,15(1):37-42
A 65-year-old man developed acute limb ischemia, severe abdominal wall and lower limb livedo reticularis following a coronary
angiogram. The differential diagnoses of acute limb ischemia and multiple cholesterol emboli syndrome (MCES) are discussed.
This work was performed at Long Island Jewish Medical Center, 270-05, 76th Avenue, New Hyde Park, NY 11040. 相似文献
5.
C. Edwin Polk DDS MSD David Buchanan PhD 《American journal of orthodontics and dentofacial orthopedics》2003,124(6):663-669
The cephalometric measurement known as Wits appraisal (AOBO) was studied to determine its importance in diagnosis, treatment, and prediction of treatment success. The Wits appraisal is used primarily to identify unreliable ANB values (those that do not accurately reflect the degree of horizontal jaw discrepancy, ie, those that differ greatly from the AOBO value). Therefore, differences between AOBO and ANB also were evaluated. Because neither measurement alone can assess jaw discrepancies with total accuracy, they were combined, plotted on a scattergram, and divided into equal zones to create a new index of horizontal skeletal discrepancies and treatment predictability. Pretreatment values correspond to treatment difficulty, and posttreatment values correspond to the effectiveness of treatment. Treatment time for each zone also was evaluated. We were able to draw several conclusions from this study. First, combining AOBO and ANB values results in a more accurate measurement of treatment difficulty. These combined values also can be used to predict both treatment time and the success of treatment for horizontal discrepancies. Second, the AOBO value predicts variations in treatment time at each ANB value. Finally, adding ANB and AOBO values and then dividing the total yields zones that represent statistically significant differences in treatment times and percentages of success. The zones also correlate with the difference between AOBO and ANB measurements. 相似文献
6.
D Bild L S Geiss S M Teutsch B Gabella B A Hudspeth R M Schubert C W Gollmar D J Kaplan F A Connell J C Will 《Journal of clinical epidemiology》1988,41(10):999-1006
The pilot study for a sentinel health events surveillance system for deaths among persons under age 45 with diabetes was conducted in six states in 1984 and 1985. Two hundred and thirty-three events were identified. Information from death certificates, physicians, and families revealed that 22% died from acute complications of diabetes and 53% from chronic complications. Blood pressure measurement and urinalysis testing had been performed in the last year for almost all of the decedents, but other preventive practices were reported less frequently. Hypertension was present in 57% and of those, was not controlled in 73%. Forty-four percent were cigarette smokers at the time of death. Agreement between physicians and families was generally higher for clinical conditions than for care practices. This surveillance system appears to yield information about the health care of persons with diabetes not readily available from other sources, although modifications may be necessary before implementation. 相似文献
7.
Edwin B. Fisher Jr. 《Addictive behaviors》1997,22(6):680
The commodity model of social support and features of Nondirective Support may clarify varied results of support interventions for smoking cessation. A commodity model views social support as attractive in and of itself and as an alternative to high-risk choices such as smoking. If such support is easily accessible, a would-be quitter is less likely to choose to smoke. Consistent with the commodity model, social support interventions tend to be effective as long as support remains available, but they lose their effects when support is terminated. From a second approach, Nondirective Support entails accepting recipients' goals, cooperating without taking control, and validating recipients' feelings. In contrast, Directive Support entails taking control and telling recipients what to do and feel. Review of support interventions indicates the value of the continued availability of support suggested by the commodity model and of Nondirective Support's flexibility and responsiveness to the person. 相似文献
8.
Changing attentional demands in left hemispatial neglect. 总被引:1,自引:0,他引:1
R F Kaplan M Verfaellie M E Meadows L R Caplan M S Pessin L D DeWitt 《Archives of neurology》1991,48(12):1263-1266
Seven variations of a letter cancellation test were used to examine how varying attentional demands affect hemispatial neglect in patients with right hemisphere lesions. While the 14 targets always remained in the same location, the number of distractors (zero, nine, 28, or 82) as well as their complexity (one letter or nine different letters) were varied. The percentage of targets canceled in the left hemispace was linearly related to the number of distractors. There were no differences between the complexity conditions. In a second study, the same 14 targets were presented but the distractors (zero, 14, or 41) were all placed on the right. Increasing the number of distractors on the right increased neglect on both sides of the space. Taken together, these results suggest that, while the limited attentional resources of the left hemisphere are biased toward the right hemispace, the absence of contralateral attentional demands allows these resources to be directed ipsilaterally. 相似文献
9.
The following recommendations of the Neonatal Hemostasis Subcommittee of the Scientific and Standardization Committee of the ISTH for the management of neonatal immune thrombocytopenia were prepared by the working party on neonatal immune thrombocytopenia. Evaluation, diagnosis, and treatment of the mother and neonate with alloimmune and autoimmune thrombocytopenia are discussed and current recommendations provided. This document is likely to require frequent future revision(s). 相似文献
10.
Poverty and health. Prospective evidence from the Alameda County Study 总被引:52,自引:0,他引:52
To examine the reasons for the association between socioeconomic status and poor health, the authors examined the nine-year mortality experience of a random sample of residents aged 35 and over in Oakland, California. Residents of a federally designated poverty area experienced higher age-, race-, and sex-adjusted mortality over the follow-up period compared with residents of nonpoverty areas (relative risk = 1.71, 95 per cent confidence interval 1.20-2.44). This increased risk of death persisted when there was multivariate adjustment for baseline health status, race, income, employment status, access to medical care, health insurance coverage, smoking, alcohol consumption, physical activity, body mass index, sleep patterns, social isolation, marital status, depression, and personal uncertainty. These results support the hypothesis that properties of the sociophysical environment may be important contributors to the association between low socioeconomic status and excess mortality, and that this contribution is independent of individual behaviors. 相似文献