tme the surgeon s or the patient s preference

... instruments, such as the Euroqol 5D [15] Responsiveness of the OHS to change has been found to be greater than generic measures such as the SF-36 [16,18] and disease specific measures such as the ... of patients annotated answers they provided on the OHS, suggesting that the patients felt that the questions were inadequate to suitably express themselves Five general themes emerged from the ... walking stick Therefore, the score becomes dependant on whether the respondent chooses to take account of the walking stick These findings suggest that many respondents perceive the question as ambiguous...

Ngày tải lên: 20/06/2014, 15:20

... small GIST is mainly in the form of watchful waiting as suggested in the consensus statement by ESMO[12], however there is no strong evidence to support this statement Results In spite of these developments ... peritoneal or liver metastasis The mass was removed completely which proved to be GIST on histology with possible extra-gastrointestinal or gastric in origin Methods A case note study of all the patients ... The median follow up was for 12 months (range 3–72) Two patients died of unrelated causes at and months after the diagnosis Patients and 13 had GIST in the oesophagus and the second part of the...

Ngày tải lên: 09/08/2014, 07:21

... To establish the sensing threshold, sensitivity is decreased progressively until the sensed signal is lost The point at which that occurs is referred to as the sensing threshold Because the concept ... Non sensing This rhythm strip demonstrates lack of sensing of a QRS complex The differential diagnosis of this rhythm strip abnormality is discussed in the text • Poor electrode position or dislodged ... visits More frequent visits may be necessary depending on whether high-sensing or capture thresholds are observed at the initial follow-up visit or if historical and physical findings suggest...

Ngày tải lên: 24/01/2014, 01:20

... chapters, patients frequently not raise or discuss their CAM use with their physicians CAM use raises a host of ethics issues for patients and physicians, and questions about how the physician and the ... medicine These are practiced less often in the United States than the systems discussed here Non-Western Systems The two non-Western systems used most frequently in the United States are TCM ... interrupted or distorted causes disease or dysfunction Through various techniques, the goal of these systems is to restore the natural balance of the system by tapping into or unblocking the obstructed...

Ngày tải lên: 16/02/2014, 07:20

... assessing patient risks, in the second session In the third session, each state team presented its patient safety project and results All three sessions focus on the practical application of patient ... implemented one Some of these states noted that the PSIC training helped them to rethink their system, assess strengths and weaknesses, and make changes At least one state underscored that the information ... be using them on a regular basis Although they said they valued the exposure to these tools, they felt a bit removed from the exercises using the tools because they not see themselves ever using...

Ngày tải lên: 06/03/2014, 21:20

... 362.83 Disseminated chorioretinitis, unspecified Disseminated: choroiditis or chorioretinitis NOS retinitis or retinochoroiditis NOS 363.10 Disseminated choroiditis and chorioretinitis, peripheral ... retina specialist for possible treatment Such treatment consists of cryopexy or laserpexy, which is successful in completely The prognosis for patients with atrophic holes is good due to the low ... to the loss of the overlying retina If the edge of the dialysis remains close to the RPE, then the tear may not be discovered unless scleral depression is performed As the vitreous contracts, the...

Ngày tải lên: 22/03/2014, 09:20

... individual patients reported a specific theme, only the OK and CA responses were considered For the NY focus group responses it was simply assessed whether or not patient (s) in the focus group reported ... mood swings, were most emphasized during the focus group discussions Patients reported side effects of other treatments, such as hair loss and susceptibility to infection, less frequently Since ... explore the disease area and proposes a pathway for how benefits and risks of new treatments may impact the lives of ITP patients Also this pathway will assist researchers in selecting (or developing)...

Ngày tải lên: 18/06/2014, 22:20

... diagnosis (Table 52-4) For instance, the finding of scaling papules (present in patients with psoriasis or atopic dermatitis) places the patient in a different diagnostic category than would hemorrhagic ... papules, which may indicate vasculitis or sepsis (Figs 52-4 and 52-5, respectively) It is also important to differentiate primary from secondary skin lesions If the examiner focuses on linear erosions ... linear erosions overlying an area of erythema and scaling, he or she may incorrectly assume that the erosion is the primary lesion and the redness and scale are secondary, while the correct interpretation...

Ngày tải lên: 06/07/2014, 20:20

... crust and are caused by scratching Atrophy: An acquired loss of substance In the skin, this may appear as a depression with intact epidermis (i.e., loss of dermal or subcutaneous tissue) or as sites ... Erosion: Loss of epidermis without an associated loss of dermis Ulcer: Loss of epidermis and at least a portion of the underlying dermis Excoriation: Linear, angular erosions that may ... Ring-shaped lesions Cyst: A soft, raised, encapsulated lesion filled with semisolid or liquid contents Herpetiform: Grouped lesions Lichenoid: Violaceous to purple, polygonal lesions that resemble...

Ngày tải lên: 06/07/2014, 20:20

... cutaneous small vessel vasculitis (Courtesy of Robert Swerlick, MD; with permission.)[newpage] APPROACH TO THE PATIENT: SKIN DISORDER In examining the skin it is usually advisable to assess the patient ... is important that the patient be disrobed as completely as possible This will minimize chances of missing important individual skin lesions and make it possible to assess the distribution of the ... distributed on elbows, knees, and scalp, the most likely possibility based solely on distribution is psoriasis or dermatitis herpetiformis (Figs 52-7 and 52-8, respectively) The primary lesion...

Ngày tải lên: 06/07/2014, 20:20

... A–D The distribution of some common dermatologic diseases and lesions Figure 52-7 Psoriasis This papulosquamous skin disease is characterized by small and large erythematous papules and plaques ... is characterized by small and large erythematous papules and plaques with overlying adherent silvery scale Figure 52-8 ...

Ngày tải lên: 06/07/2014, 20:20

... erythematous plaques with a target or iris morphology It usually represents a hypersensitivity reaction to drugs (e.g., sulfonylamides) or infections (e.g., HSV) (Courtesy of the Yale Resident 's ... (Fig 52-10) or primary irritant dermatitis In contrast, lesions with a generalized arrangement are common and suggest a systemic etiology Figure 52-9 Erythema multiforme This eruption is characterized ... (e.g., sulfonylamides) or infections (e.g., HSV) (Courtesy of the Yale Resident 's Slide Collection; with permission.) Figure 52-10 ...

Ngày tải lên: 06/07/2014, 20:20

... arthralgias) Ongoing or previous illnesses History of allergies Presence of photosensitivity Review of systems Family history (particularly relevant for patients with melanoma, atopy, psoriasis, or ... biopsy In the latter technique, a punch is pressed against the surface of the skin and rotated with downward pressure until it penetrates to the subcutaneous tissue The circular biopsy is then ... 10 Social, sexual, or travel history as relevant to the patient DIAGNOSTIC TECHNIQUES Many skin diseases can be diagnosed on gross clinical appearance, but sometimes relatively simple diagnostic...

Ngày tải lên: 06/07/2014, 20:20

... Diascopy is designed to assess whether a skin lesion will blanch with pressure as, for example, in determining whether a red lesion is hemorrhagic or simply blood-filled Urticaria ... suspected allergens is applied to the patient 's back under occlusive dressings and allowed to remain in contact with the skin for 48 h The dressings are removed, and the area is examined for ... hypersensitivity reactions (e.g., erythema, edema, or papulovesicles) This test is best performed by physicians with special expertise in patch testing and is often helpful in the evaluation of patients...

Ngày tải lên: 06/07/2014, 20:20

... same as the prognosis of the person with aortic stenosis who develops the first symptoms of congestive heart failure (median survival, ~8 months) However, the patient with heart disease may ... the traitorous behavior of cancer cells is that the patient feels betrayed by his or her body The cancer patient feels that he or she, and not just a body part, is diseased The Magnitude of the ... registry exists; therefore, the incidence of cancer is estimated on the basis of the National Cancer Institute 's Surveillance, Epidemiology, and End Results (SEER) database, which tabulates cancer...

Ngày tải lên: 07/07/2014, 01:20

... of disease The past medical history may alert the physician to the presence of underlying diseases that may affect the choice of therapy or the side effects of treatment The social history may ... predisposition and point out the need to begin surveillance or other preventive therapy for unaffected siblings of the patient The review of systems may suggest early symptoms of metastatic disease ... evidence links the expression of certain genes with the prognosis and response to therapy (Chaps 79, 80) Occasionally a patient will present with a metastatic disease process that is defined as cancer...

Ngày tải lên: 07/07/2014, 01:20

... complaints; no evidence of disease 90 Able to carry on normal activity; minor signs or Status symptoms of disease 80 Normal activity with effort; some signs or symptoms of disease 70 Cares for self; ... the organ of origin to regional but not distant sites, or as metastatic to distant sites The most widely used system of staging is the TNM (tumor, node, metastasis) system codified by the International ... Instead, surrogate markers for physiologic reserve are used, such as the patient 's age or Karnofsky performance status (Table 77-4) Older patients and those with a Karnofsky performance status...

Ngày tải lên: 07/07/2014, 01:20

... partial response may also be based on a 30% decrease in the sums of the longest diameters of lesions (Response Evaluation Criteria in Solid Tumors, or RECIST, criteria) Progressive disease is defined ... nervous system symptoms that look like metastatic disease or may mimic paraneoplastic syndromes such as the syndrome of inappropriate antidiuretic hormone A definitive diagnosis should be pursued ... the patient and the pressure of a busy schedule greatly limit the time a physician spends with a patient who is receiving only palliative care Resist these forces In addition to the medicines...

Ngày tải lên: 07/07/2014, 01:20

... Pancreatitis, of the colon, pancreas, hepatitis, lung, breast, ovary inflammatory bowel disease, smoking Enzymes Prostatic acid Prostate cancer phosphatase Prostatitis, prostatic hypertrophy Neuron-specific ... enolase Lactate dehydrogenase Small cell cancer of the lung,neuroblastoma Lymphoma, Ewing 's sarcoma Hepatitis, hemolytic many others Tumor-Associated Proteins anemia, Prostate-specific Prostate ... Table 77-5 Tumor Markers Tumor Markers Cancer NonNeoplastic Conditions Hormones Human chorionic gonadotropin Gestational trophoblastic Pregnancy disease, gonadal germ cell tumor Calcitonin Medullary...

Ngày tải lên: 07/07/2014, 01:20

... techniques, and any persistent abnormality is biopsied If disease persists, the multidisciplinary team discusses a new salvage treatment plan If the patient has been rendered disease-free by the original ... should be tried, allowing 4–6 weeks for response Effective therapy should be continued at least months after resolution of symptoms If therapy is unsuccessful, other classes of antidepressants ... most patients who are cured of cancer return to normal lives Supportive Care In many ways, the success of cancer therapy depends on the success of the supportive care Failure to control the symptoms...

Ngày tải lên: 07/07/2014, 01:20