the breast comprehensive management of benign and malignant disorders

... to the design of the study and coauthored the article BT contributed to the design of the study, participated in the training of GPs, and coauthored this article CM contributed to the design of ... of the economic evaluation and coauthored the article DV coauthored the article GF contributed to the design of the study and coauthored the article HS contributed to the design of the study and ... ZonMW, the Netherlands Organisation for Health Research and Development Author details Netherlands Institute of Mental Health and Addiction (Trimbos-institute), Utrecht, the Netherlands 2The EMGO...

Ngày tải lên: 10/08/2014, 11:20

... period of evolution and typically in the late-onset form of the disease We just remind that, further in his book, James Parkinson admitted that: "as the debility increases and the influence of the ... results from the coexistence of AD In favor of this hypothesis, there is a high frequency of Alzheimer-like changes in the cerebral cortex, a high level of abnormal tau protein in temporal and prefrontal ... type, and 3) a severe form of dementia showing neuropathological changes in the basal ganglia and in the cortex, the latter of the Alzheimer type This proposal fits clinical syndromes Finally, the...

Ngày tải lên: 08/08/2014, 21:20

... circulating androgen, is converted by the enzyme 5αreductase to dihydrotestosterone in the gland The periurethral portion of the gland increases in size during puberty and after the age of 55 due to the ... (PSA) and acid phosphatase are produced in the epithelial cells Both prostate epithelial cells and stromal cells express androgen receptors and depend on androgens for growth Testosterone, the ... Clinical states of prostate cancer PSA, prostate-specific antigen Anatomy and Pathology The prostate is located in the pelvis and is surrounded by the rectum, the bladder, the periprostatic and dorsal...

Ngày tải lên: 07/07/2014, 02:20

... which the tempo of the illness is altered and symptoms controlled until the patient dies of other causes These can be equivalent therapeutically from a patient standpoint if the patient has not ... detected in the finasteride group were high-grade [37% (280 of 757 cancers) vs 22% (237 of 1068 cancers) for the placebo group] have been shown to be an artifact of the reduced volume of the malignant ... proviso that the risks and benefits of the performance of these tests are not defined The National Comprehensive Cancer Network advises testing at age 40, tailoring additional testing to the age-specific...

Ngày tải lên: 07/07/2014, 02:20

... palpable, and of these, 70% are pathologically organ-confined The downside of widespread PSA screening is the detection and treatment of cancers with such a low malignant potential that they would ... examined for the presence of cancer, and the amount of cancer is quantified based on the length of the tumor within the core and the percentage of the core involved ... course of antibiotics before biopsy Men with an abnormal PSA and negative biopsy are advised to undergo a repeat biopsy Each core of the biopsy is examined for the presence of cancer, and the amount...

Ngày tải lên: 07/07/2014, 02:20

... to the extent of the disease within the gland, the presence or absence of capsular invasion, involvement of seminal vesicles, and extension of disease to lymph nodes Because of the inadequacy of ... identified solely on the basis of an abnormal PSA (T1c), those that are palpable but clinically confined to the gland (T2), and those that have extended outside the gland (T3 and T4) (Table 91-1) ... for staging, the staging system was modified to include the results of imaging studies Unfortunately, no single test has proven to indicate accurately the stage or the presence of organ-confined...

Ngày tải lên: 07/07/2014, 02:20

... more advanced the disease, the lower the probability of local control and the higher the probability of systemic relapse More important is that within the categories of T1, T2, and T3 disease ... radiation therapy, or active surveillance Choice of therapy requires the consideration of several factors: the presence of symptoms, the probability that the untreated tumor will adversely affect the ... of outcomes of various forms of therapy is limited by the lack of prospective trials, referral bias, and differences in the outcomes used The primary outcomes are cancer control and treatment-related...

Ngày tải lên: 07/07/2014, 02:20

... radiation therapy (IMRT) to maximize the dose to the prostate and to minimize the exposure of the surrounding normal structures The addition of IMRT has permitted further shaping of the dose, ... radiation therapy The aim is to decrease the size of the prostate and, consequently, to reduce the exposure of normal tissues to full-dose radiation, to increase local control rates, and to decrease the ... pretreatment, the dose administered, and the time of assessment Postradiation erectile dysfunction is related to a disruption of the vascular supply and not the nerve fibers Neoadjuvant hormone therapy...

Ngày tải lên: 07/07/2014, 02:20

... surgery and/ or radiation therapy By definition, patients have no evidence of disease on scan For these patients the central issue is whether the rise in PSA results from persistent disease in the ... undergone radiation therapy The decision to recommend radiation therapy after prostatectomy is often made on the basis of the pathologic findings at surgery, as imaging studies such as CT and bone scan ... estimated that 10–15% of patients had "insignificant" cancers Given the multifocality of the disease, a concern is the limited ability to predict pathologic findings on the basis of a needle biopsy,...

Ngày tải lên: 07/07/2014, 02:20

... 69, and 79% if the doubling time was short (

Ngày tải lên: 07/07/2014, 02:20

... Outcomes of Androgen Depletion The antiprostate cancer effects of the various androgen depletion strategies are similar, and the clinical course is predictable: an initial response, then a period of ... quality of life Combined androgen blockade the administration of an antiandrogen plus a GnRH analogue or surgical orchiectomy—was designed to inhibit both testicular and adrenal androgens at the ... patients treated with radiation therapy and years of androgen depletion relative to radiation alone, was criticized for the poor outcomes of the control group Another showing a survival benefit...

Ngày tải lên: 07/07/2014, 02:20

... at bedtime) act by relaxing the smooth muscle of the bladder neck and increasing peak urinary flow rates No data show that these agents influence the progression of the disease Surgical approaches ... Over 5 how often past month, the have you found it difficult to postpone urination? Over the past month, how often have you had a weak urinary stream? Over the (No (1 (2 (3 (4 (5 how often past ... regardless of the size of the gland, while those with an inability to urinate, gross hematuria, recurrent infection, or bladder stones may require surgery In patients with symptoms, uroflowmetry...

Ngày tải lên: 07/07/2014, 02:20

... organisations such as the NHS and local authorities, should address the prevention and management of obesity, because of the considerable impact on the health of the workforce and associated costs ... 43 42 1.2.4.3 The results of the discussion should be documented, and a copy of the agreed goals and actions should be kept by the person and the healthcare professional or put in the notes as ... 1.2.1.3 The choice of any intervention for weight management must be made through negotiation between the person and their health professional 1.2.1.4 The components of the planned weight-management...

Ngày tải lên: 21/02/2014, 11:20

... allowing other parties to make decisions as to the validity and authenticity of the use of an address The efforts to improve the security of the routing system and offer capabilities to support the ... pace of adoption was influenced by several drivers First among these were the 2003 mandate of the US Department of Defense (DoD) and 2005 mandate by the United States Office of Management and ... address space The repercussions of other qualification mechanisms, and of the absence of such forms of qualification, are also under investigation Whether the RIRs have the means and resources...

Ngày tải lên: 06/03/2014, 21:20

... by the basal metabolic rate, the thermic effect of food, and the energy cost of physical activity.8 The basal metabolic rate and the thermic effect of food account for about 60 to 70 per cent and ... Behavioural therapy can increase the effectiveness of other weight-loss treatments, and the duration of the therapy influences the ability to maintain the weight loss No single behavioural therapy ... about the lack of evidence for the use of alternative, over -the- counter weight-loss medications and, in some cases, the possible dangers of their use xxviii Clinical Practice Guidelines for the Management...

Ngày tải lên: 08/03/2014, 14:20

... we could tell, one of the first studies conducted of the institutions themselves about how they use social media Our overarching goal of this research is to create knowledge and resources to assist ... assist education professionals as they assess and implement social media strategies for communication and engagement Some of the questions we hoped it would answer include: How professionals in education ... into their marketing and communication strategies, initiatives, and campaigns? What are their goals for social media? Which social media sites and tools are in use in the education sector and...

Ngày tải lên: 08/03/2014, 19:20

... organisations such as the NHS and local authorities, should address the prevention and management of obesity, because of the considerable impact on the health of the workforce and associated costs ... 43 42 1.2.4.3 The results of the discussion should be documented, and a copy of the agreed goals and actions should be kept by the person and the healthcare professional or put in the notes as ... 1.2.1.3 The choice of any intervention for weight management must be made through negotiation between the person and their health professional 1.2.1.4 The components of the planned weight-management...

Ngày tải lên: 22/03/2014, 09:20

... Page On-demand digital access to the scholarly record The database of record for graduate research; the official respository for the Library of Congress The ProQuest Dissertations & Theses (PQDT) ... orders of hard bound, soft bound and microfilm dissertation copy purchases • Digital Archiving and Access Program offers a full range of comprehensive digitization services, combining the best of ... Theses – UK & Ireland – the most comprehensive available record of doctoral theses from the United Kingdom and Ireland comprising over half a million records is now available in the ProQuest research...

Ngày tải lên: 23/03/2014, 12:20

Ngày tải lên: 12/06/2014, 11:27

... mission of the Health and Safety Executive, and to further that of the Safety and Reliability Group of the IMechE, in ensuring a safer world It exceeds the recommended syllabus on the subject by the ... management of safety and dependability 1.7.3 The Railtrack disasters (UK) Perhaps the worst extreme of ignoring the input of engineering was the case of Railtrack in the UK The board of management ... out because many of the pumping stations had failed Figure 1.3 shows a map of the east side of the city, which faced the brunt of the hurricane, and shows the damage caused to the flood control...

Ngày tải lên: 21/06/2014, 12:20