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Krista Kupres DO Capt Usa MC Steven E. Rasmussen MD MAJ Usaf Fs MC John G. Albertini MD MAJ Usaf MC 《Dermatologic surgery》2002,28(5):388-389
BACKGROUND: Low cost, nonsterile examination gloves are used routinely to perform various dermatologic procedures. OBJECTIVE: To evaluate the perforation rate of nonsterile examination gloves in routine dermatologic procedures. METHODS: Three hundred fifty nonsterile latex examination gloves used to perform shave biopsies were evaluated for perforations using an air inflation/water submersion method. Ninety gloves, which were intentionally perforated with a 30-gauge needle, were used as controls to assess our evaluation method. RESULTS: Eight of the 350 gloves were found to have a perforation, which corresponds to a 2.3% perforation rate. Seven of the eight perforations were found in the web space between the second and third finger sleeves, with one being an obvious manufacturing error. All 90 perforations of the control group were correctly identified. CONCLUSION: There appears to be a very low risk of glove perforation when nonsterile examination gloves are used in routine dermatologic procedures. 相似文献
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Liliana Ala Andrade Renato Z Torres An José Fs Sales Regina Vicentini Gustavo A De Souza 《Pathology oncology research : POR》1998,4(1):44-47
Three cases of intravenous leiomyomatosis (IVL) of the uterus, a rare benign smooth-muscle tumor, are described. A preoperative
diagnosis of IVL was not made in any of the patients, all of which presented with a pelvic mass with the presumptive diagnosis
of leiomyoma. Surgical exploration confirmed the presence of uterine mass and two of the three cases showed extra-uterine
extension into the ovarian or uterine veins. Histological examination demonstrated a fascicular pattern of bland spindle-shaped
smooth-muscle cells, which extended to veins inside the myometrium or to extrauterine veins. This was confirmed by immunohistochemical
stain for desmin and factor VIII. Despite their histological benignity, these lesions have a tendency to metastasize and are
closely related to the conditions called “benign metastasizing leiomyoma” and “intracaval mass and cardiac extension”. The
primary treatment of IVL is hysterectomy and excision of any extrauterine tumor, when technically feasible. Anti-estrogenic
therapy has been suggested as potentially useful in controlling of unresectable tumor. According to the literature, the follow-up
must be long and periodic postoperative ultrasonic or magnetic nuclear resonance imaging studies may be useful in detecting
growth of residual intravascular tumor. 相似文献
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With the growing use of low-molecular-weight heparins (LMWH) for the treatment and prevention of venous thromboembolism (VTE), it is important to provide an evidence-based comparison with unfractionated heparin (UFH) concerning rates of heparin-induced thrombocytopenia (HIT). Such comparisons are essential in clinical decision-making and cost-modeling. In this paper we review data regarding non-surgical (medical) patients. We conclude that the lack of uniform evaluation and standardized testing for HIT in the current literature precludes making a reliable estimate of the relative risk of HIT in UFH vs. LMWH in either the treatment or prevention of VTE in non-surgical patients. However, current data suggest that the risk of thrombocytopenia and HIT is low and similar for non-surgical patients who receive either LMWH or UFH. 相似文献
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Sasisopin Kiertiburanakul David Boettiger Man Po Lee Sharifah Fs Omar Junko Tanuma Oon Tek Ng Nicolas Durier Praphan Phanuphak Rossana Ditangco Romanee Chaiwarith Pacharee Kantipong Christopher Kc Lee Mahiran Mustafa Vonthanak Saphonn Winai Ratanasuwan Tuti Parwati Merati Nagalingeswaran Kumarasamy Wing Wai Wong Fujie Zhang Thanh Thuy Pham Sanjay Pujari Jun Yong Choi Evy Yunihastuti Somnuek Sungkanuparph 《Journal of the International AIDS Society》2014,17(1)
Introduction
Although antiretroviral therapy (ART) has been rapidly scaled up in Asia, most HIV-positive patients in the region still present with late-stage HIV disease. We aimed to determine trends of pre-ART CD4 levels over time in Asian HIV-positive patients and to determine factors associated with late ART initiation.Methods
Data from two regional cohort observational databases were analyzed for trends in median CD4 cell counts at ART initiation and the proportion of late ART initiation (CD4 cell counts <200 cells/mm3 or prior AIDS diagnosis). Predictors for late ART initiation and mortality were determined.Results
A total of 2737 HIV-positive ART-naïve patients from 22 sites in 13 Asian countries and territories were eligible. The overall median (IQR) CD4 cell count at ART initiation was 150 (46–241) cells/mm3. Median CD4 cell counts at ART initiation increased over time, from a low point of 115 cells/mm3 in 2008 to a peak of 302 cells/mm3 after 2011 (p for trend 0.002). The proportion of patients with late ART initiation significantly decreased over time from 79.1% before 2007 to 36.3% after 2011 (p for trend <0.001). Factors associated with late ART initiation were year of ART initiation (e.g. 2010 vs. before 2007; OR 0.40, 95% CI 0.27–0.59; p<0.001), sex (male vs. female; OR 1.51, 95% CI 1.18–1.93; p=0.001) and HIV exposure risk (heterosexual vs. homosexual; OR 1.66, 95% CI 1.24–2.23; p=0.001 and intravenous drug use vs. homosexual; OR 3.03, 95% CI 1.77–5.21; p<0.001). Factors associated with mortality after ART initiation were late ART initiation (HR 2.13, 95% CI 1.19–3.79; p=0.010), sex (male vs. female; HR 2.12, 95% CI 1.31–3.43; p=0.002), age (≥51 vs. ≤30 years; HR 3.91, 95% CI 2.18–7.04; p<0.001) and hepatitis C serostatus (positive vs. negative; HR 2.48, 95% CI 1.−4.36; p=0.035).Conclusions
Median CD4 cell count at ART initiation among Asian patients significantly increases over time but the proportion of patients with late ART initiation is still significant. ART initiation at higher CD4 cell counts remains a challenge. Strategic interventions to increase earlier diagnosis of HIV infection and prompt more rapid linkage to ART must be implemented. 相似文献
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