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1.
Well‐being,health and fitness of children who use wheelchairs: Feasibility study protocol to develop child‐centred ‘keep‐fit’ exercise interventions 下载免费PDF全文
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The serrated pathway (SP) can be viewed as two parallel, but partially overlapping, arrays of colorectal precursor lesions, and their respective endpoint carcinomas, that are distinct from those of the conventional adenoma–carcinoma sequence (APC‐pathway). In this review we focus at the outset on the clinical impact, pathological features, molecular genetics and biological behaviours of the various SP cancers. Then we summarize the clinicopathological features, classification and molecular profiles of the two main precursor lesions that anchor the respective pathways: (i) sessile serrated adenoma/polyp (SSA/P), also called sessile serrated lesion (SSL), and (ii) traditional serrated adenoma (TSA). Activating mutations of the RAS–RAF–MAPK pathway initiate and sustain the lesions of the SP, and CpG island methylation of the promoter regions of tumour suppressor and DNA repair genes play the major role in their neoplastic progression. The SP includes microsatellite stable (MSS) carcinomas that are among the most biologically aggressive colorectal carcinomas (CRC), and also accounts for the great preponderance of sporadic hypermutated, mismatch repair (MMR)‐deficient or microsatellite instable (MSI) CRC. The identification, removal and appropriate classification of at‐risk SP precursors and surveillance of individuals who harbour these lesions present a challenge and opportunity for CRC prevention and mortality reduction. 相似文献
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Issues in carrying out epidemiologic research in the elderly 总被引:3,自引:0,他引:3
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J H Newcorn J M Halperin J M Healey J D O'Brien D M Pascualvaca L E Wolf A Morganstein V Sharma J G Young 《Journal of the American Academy of Child and Adolescent Psychiatry》1989,28(5):734-738
To assess the relationship between the DSM-III criteria for attention deficit disorder with hyperactivity (ADDH) and the DSM-III-R criteria for attention-deficit hyperactivity disorder (ADHD), children from an inner city parochial school were evaluated using a 30-item teacher questionnaire consisting of the DMS-III and DSM-III-R criteria for these disorders, the revised Conners Parent and Teacher Questionnaires, and a continuous performance test. Diagnostic groups were established based on teacher ratings of the DSM items and evaluated in relation to the rating scale data and continuous performance test. While children who were identified by teachers as having ADDH almost always satisfied the criteria for ADHD, a new group of children who were hyperactive and impulsive but less clearly inattentive also met the criteria for ADHD. Implications of the change in diagnostic criteria are discussed. 相似文献
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Presentations of acute appendicitis represent an ongoing challenge to surgeons. This case of retrocaecal perforated appendicitis presented clinically as a right lumbar abscess, with the concomitant new diagnosis of type 2 diabetes mellitus in a 66-year-old male. This case emphasises the importance of an abdominal CT scan in any patient presenting with unusual sepsis near the abdomen. 相似文献
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Clinical aspects of pelvic inflammatory disease 总被引:2,自引:0,他引:2
Pelvic inflammatory disease (PID) is a common and poorly managed condition.
Untreated or inadequately treated, it leads to tubal infertility, ectopic
pregnancy and chronic pelvic pain. Diagnostic difficulties are compounded
by the wide variety of clinical presentations and the insensitivity and
poor specificity of laboratory tests. Better recognition of mild and
atypical disease needs a high index of suspicion whenever young, sexually
active women present with gynaecological symptoms. Laparoscopy supplemented
by microbiological tests and fimbrial minibiopsy should be regarded as the
diagnostic 'gold standard' for research studies; new studies are required
to identify techniques which might reduce under- and over-diagnosis. Early
treatment reduces the risk of an adverse effect on fertility. Any
therapeutic regimen selected should be effective against the common
aetiological agents Chlamydia trachomatis, Neisseria gonorrhoeae, genital
mycoplasmas and aerobic and anaerobic bacteria. Since at least 60% of cases
of PID can be attributed to infection with a sexually transmitted organism,
partner notification forms an essential part of management.
相似文献