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Beginning in the late 1980s, after a long period of declining interest in home care for the terminally ill, several projects and experiments were initiated in the Netherlands. This article describes this trend and provides background information on the Dutch health services, a definition of terminal home care, and statistical information about the different types of home care in the Netherlands. Findings from 3 recent studies of these projects and experiments are presented along with the guidelines for providing good terminal home care formulated by the Dutch Health Council in 1991. 相似文献
3.
骨巨细胞瘤的MRI诊断价值 总被引:10,自引:0,他引:10
目的探讨骨巨细胞瘤的MRI表现特点及其病理基础。资料与方法搜集经手术病理证实的12例骨巨细胞瘤患者资料,分析其MRI征象并与病理结果对照。结果T1WI上肿瘤实体表现为低、等信号,T2WI上为不均匀高信号,Gd-DTPA增强扫描呈中度到明显强化。此外,MRI还可显示肿瘤内坏死、出血、含铁血黄素沉着等。结论MRI能够提供比较全面的影像学信息,可提高对骨巨细胞瘤诊断的准确性。 相似文献
4.
C. T. Schrijvers J. P. Mackenbach J. M. Lutz M. J. Quinn M. P. Coleman 《British journal of cancer》1995,72(3):738-743
We studied the association between deprivation and survival from breast cancer in 29,676 women aged 30 and over who were diagnosed during the period 1980-89 in the area covered by the South Thames Regional Health Authority. The measure of deprivation was the Carstairs Index of the census enumeration district of each woman''s residence at diagnosis. We studied the impact of stage at diagnosis, morphology and type of treatment on this association, with the relative survival rate and the hazard ratio as measures of outcome. There was a clear gradient in survival, with better survival for women from more affluent areas. At all ages, women in the most deprived category had a 35% greater hazard of death than women from the most affluent areas after adjustment for stage at diagnosis, morphological type and type of treatment. In younger women (30-64 years), the survival gradient by deprivation category cannot be explained by these prognostic factors. In older women (65-99 years), part of the unadjusted gradient in survival can be explained by differences in the stage of disease: older women in the most deprived category were more often diagnosed with advanced disease. Other factors, so far unidentified, are responsible for the gradient in breast cancer survival by deprivation category. The potential effect on breast cancer mortality of eliminating the gradient in survival by deprivation category is substantial (7.4%). In women aged 30-64 years, 10% of all deaths within 5 years might be avoidable, while in older women this figure is 5.8%. 相似文献
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6.
Ricardo Pietrobon Anand Shah Paul Kuo Matthew Harker Mariana McCready Christeen Butler Henrique Martins CT Moorman Danny O Jacobs 《BMC medical informatics and decision making》2006,6(1):32-11
Background
Although regulatory compliance in academic research is enforced by law to ensure high quality and safety to participants, its implementation is frequently hindered by cost and logistical barriers. In order to decrease these barriers, we have developed a Web-based application, Duke Surgery Research Central (DSRC), to monitor and streamline the regulatory research process. 相似文献7.
Dr. Linda K. Green MD Susan Zachariah MS CT David Y. Graham MD 《Digestive diseases and sciences》1990,35(11):1421-1425
Summary Secondary neoplasms of the stomach are rare and are often clinical and diagnostic problems. Three patients with bleeding volcano-like ulcers were diagnosed by combined endoscopic salvage cytology and surgical biopsy as having metastatic submucosal lesions from hematologic spread. The combination of endoscopic appearance, clinical findings, and tissue and cytologic examination can lead to the correct diagnosis. The results from these cases support the utility of this cytologic technique in combination with biopsy in this clinical setting. 相似文献
8.
Hendriks JM Van Schil PE Schrijvers D Van Marck E Eyskens E 《Acta chirurgica Belgica》1999,99(6):312-314
A 38-year-old patient presented with an anterior mediastinal mass after chemotherapeutic and surgical treatment for lung metastases from a malignant histiocytoma. Because of the risk for tumour recurrence the thymic mass was resected. Thymic hyperplasia was found on pathological examination. In this case thymic hyperplasia is a rebound phenomenon aflcer chemotherapy. It appears to atrophy during the administration of chemotherapy and regrow afterwards. Surgical resection provides the definitive diagnosis and treatment. 相似文献
9.
van Doorm WA Schouten AN van Eeden MK Schrijvers AJ 《Nederlands tijdschrift voor tandheelkunde》1996,103(8):298-300
Simple dental procedures in mentally handicapped patients can be facilitated by the use of intravenous sedation. This article describes our experiences with eleven such patients undergoing a total of eighteen procedures in 1994-1995. Sedation was administered by a consultant anesthetist using propofol in 'Sterrenberg'--a home for the mentally handicapped in the Netherlands. The article describes the organization of the patients selection and pre- per- and post-sedation care using a management protocol. It is concluded that the technique is effective and safe for simple dental procedures such as examination, removal of tartar, radiography and the treatment of cavities, provided that patients selection and care are meticulous. 相似文献
10.
Early stage nasopharyngeal carcinoma: radiotherapy dose and time factors in tumor control 总被引:1,自引:0,他引:1
Chang JT; See LC; Liao CT; Chen LH; Leung WM; Chen SW; Chen WC 《Japanese journal of clinical oncology》1998,28(3):207-213
OBJECTIVE: To evaluate radiotherapy dose and length of treatment in the
control of early stage nasopharyngeal carcinoma (NPC) treated with a
combination of external radiotherapy and brachytherapy, MATERIALS &
METHODS: We reviewed the records of 133 patients with early stage
nasopharyngeal carcinoma (stage I or II, AJC/UICC staging system) who
received definitive radiotherapy in Chang Gung Memorial Hospital from 1979
to 1991. The median follow-up time was 7.1 years with a minimum of 2 years.
All patients were treated with megavoltage external radiotherapy to the
nasopharynx area (63-72 Gy) followed by high dose rate intracavitary
brachytherapy (5-16.5 Gy in one to three fractions, spaced 1-2 weeks
apart). The median total dose and time of irradiation was 75 Gy (69.8-81.4
Gy) and 11.6 weeks (7.8-20 weeks) respectively. Survival analysis was used
to examine the effect of several variables on prognosis. RESULTS: The
5-year rates were 86.4% for local control, 84.7% for disease free survival,
88.5% for actuarial survival and 84.2% for overall survival. The treatment
group (combination of time and dose of irradiation) was the most important
prognostic factor according to Cox's proportional hazard model. Patients
receiving radiation at a total dose of < or = 75 Gy completed in < 12
weeks showed the best prognosis. CONCLUSION: Treatment time and total
treatment dose are both important factors in treating early stage NPC.
Decreasing the total radiation time to < 12 weeks and not exceeding a
radiation dose of 75 Gy gave the best results.
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