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Diet,ageing and genetic factors in the pathogenesis of diverticular disease 被引量:5
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作者 Daniel Martin Commane Ramesh Pulendran Arasaradnam +2 位作者 Sarah Mills John Cummings Mathers Mike Bradburn 《World Journal of Gastroenterology》 SCIE CAS CSCD 2009年第20期2479-2488,共10页
Diverticular disease(DD) is an age-related disorder of the large bowel which may affect half of the population over the age of 65 in the UK.This high prevalence ranks it as one of the most common bowel disorders in we... Diverticular disease(DD) is an age-related disorder of the large bowel which may affect half of the population over the age of 65 in the UK.This high prevalence ranks it as one of the most common bowel disorders in western nations.The majority of patients remain asymptomatic but there are associated life-threatening co-morbidities, which, given the large numbers of people with DD, translates into a considerable number of deaths per annum.Despite this public health burden, relatively little seems to be known about either the mechanisms of development or causality.In the 1970s, a model of DD formulated the concept that diverticula occur as a consequence of pressureinduced damage to the colon wall amongst those with a low intake of dietary fiber.In this review, we have examined the evidence regarding the influence of ageing, diet, inflammation and genetics on DD development.We argue that the evidence supporting the barotrauma hypothesis is largely anecdotal.We have also identified several gaps in the knowledge base which need to be filled before we can complete a model for the etiology of diverticular disease. 展开更多
关键词 Diverticular disease Dietary factors GENETICS COLON INFLAMMATION
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Tuberculosis in pregnancy—Diagnostic dilemma 被引量:3
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作者 Narmatha Kangeyan Sophia N. E. Webster +1 位作者 Aparna Sanyal Remko Beukenholdt 《Open Journal of Obstetrics and Gynecology》 2012年第2期174-175,共2页
The worldwide incidence of tuberculosis (TB) is rising and is linked to immigration patterns and the rise in incidence of HIV. Extra-pulmonary disease, in particular, can lead to diagnostic dilemmas. Because the total... The worldwide incidence of tuberculosis (TB) is rising and is linked to immigration patterns and the rise in incidence of HIV. Extra-pulmonary disease, in particular, can lead to diagnostic dilemmas. Because the total number of cases of TB in pregnancy in developed countries is small and often concentrated in specific urban areas with large immigrant populations, clinicians may rarely encounter the problem. This paper provides actual clinical experience of one recent case. 展开更多
关键词 TUBERCULOSIS (TB) PREGNANCY EXTRA-PULMONARY TB ABDOMINAL TUBERCULOSIS ABDOMINAL TUBERCULOSIS in PREGNANCY PREGNANCY and TUBERCULOSIS
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Pleomorphic lobular carcinoma in situ of the breast: Can the evidence guide practice?
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作者 Andrew Pieri James Harvey Nigel Bundred 《World Journal of Clinical Oncology》 CAS 2014年第3期546-553,共8页
The clinical significance of pleomorphic lobular carcinoma in situ(PLCIS) is a subject of controversy. As a consequence, there is a risk of providing inconsistent management to patients presenting with PLCIS. This rev... The clinical significance of pleomorphic lobular carcinoma in situ(PLCIS) is a subject of controversy. As a consequence, there is a risk of providing inconsistent management to patients presenting with PLCIS. This review aims to establish whether the current guidelines for the management of PLCIS are consistent with current evidence. A systematic electronic search was performed to identify all English language articles regarding PLCIS management. The data was analysed, specifically looking at: incidence of concurrent disease, recurrence rates, long-term prognosis and PLCIS management. A search was also performed for PLCIS management guidelines for the United Kingdom, United States, Canada, Australia, Germany and pan-European. The results of the evidence analyses were compared to the guidelines in order to establish whether the recommended management is consistent with the published evidence. Nine studies(level 3-4 evidence), involving a total of 176 patients and five management guidelines(from United Kingdom, United States, Australia and pan-European) were included in the review. From the evidence, 46 of 93(49%) patients were found to have PLCIS with concurrent invasive disease on excision specimen analysis. Regarding recurrence rates, 11 of 117(9.4%) patients developed a recurrence of PLCIS. There were no instances of invasive disease or ductal carcinoma in situ(DCIS) on recurrence histology. There were no studies assessing long-term outcomes in PLCIS cases. With regards to the management guidelines, the Association of Breast Surgery(United Kingdom) and the National Breast and Ovarian Cancer Care(Australia) do not mention PLCIS. The National Comprehensive Cancer Network(United States) suggest considering excision of PLCIS with negative margins. The NHS Breast Screening Programme(United Kingdom) and the European Society of Medical Oncology(pan-European) recommend PLCIS should be treated as with DCIS. We conclude that high quality evidence to inform guidance is lacking, thus recommendations are relatively vague. However, based on the available evidence, it would seem prudent to treat PLCIS in a similar manner to DCIS. 展开更多
关键词 PLEOMORPHIC LOBULAR CARCINOMA in SITU BREAST cancer BREAST CARCINOMA CARCINOMA in SITU Guideline EXCISION margin Recurrence rate
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Identification and treatment of individuals with attentiondeficit/ hyperactivity disorder and substance use disorder: An expert consensus statement 被引量:1
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作者 Susan Young Cyrus Abbasian +19 位作者 Zainab Al-Attar Polly Branney Bill Colley Samuele Cortese Sally Cubbin Quinton Deeley Gisli Hannes Gudjonsson Peter Hill Jack Hollingdale Steve Jenden Joe Johnson Deborah Judge Alexandra Lewis Peter Mason Raja Mukherjee David Nutt Jane Roberts Fiona Robinson Emma Woodhouse Kelly Cocallis 《World Journal of Psychiatry》 SCIE 2023年第3期84-112,共29页
Attention-deficit/hyperactivity disorder(ADHD)often co-occurs with substance use(SU)and/or substance use disorder(SUD).Individuals with concurrent ADHD and SU/SUD can have complex presentations that may complicate dia... Attention-deficit/hyperactivity disorder(ADHD)often co-occurs with substance use(SU)and/or substance use disorder(SUD).Individuals with concurrent ADHD and SU/SUD can have complex presentations that may complicate diagnosis and treatment.This can be further complicated by the context in which services are delivered.Also,when working with young people and adults with co-existing ADHD and SU/SUD,there is uncertainty among healthcare practitioners on how best to meet their needs.In February 2022,the United Kingdom ADHD Partnership hosted a meeting attended by multidisciplinary experts to address these issues.Following presentations providing attendees with an overview of the literature,group discussions were held synthesizing research evidence and clinical experience.Topics included:(1)A review of substances and reasons for use/misuse;(2)identification,assessment and treatment of illicit SU/SUD in young people and adults with ADHD presenting in community services;and(3)identification,assessment and treatment of ADHD in adults presenting in SU/SUD community and inpatient services.Discussions highlighted inter-service barriers and fragmentation of care.It was concluded that a multimodal and multi-agency approach is needed.The consensus group generated a table of practice recommendations providing guidance on:identification and assessment;pharmacological and psychological treatment;and multi-agency interventions. 展开更多
关键词 Attention-deficit/hyperactivity disorder Substance use PHARMACOKINETICS Assessment Treatment COMORBIDITY
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出生时临床检查怎样才能有效检出先天性心脏病
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作者 Patton C. Hey E. 李开 《世界核心医学期刊文摘(儿科学分册)》 2006年第12期11-12,共2页
Aims:To assess what proportion of all cardiac abnormality can be suspected at birth when all clinical examination before discharge is undertaken by a small stable team of clinicians.Methods:A prospective audit of all ... Aims:To assess what proportion of all cardiac abnormality can be suspected at birth when all clinical examination before discharge is undertaken by a small stable team of clinicians.Methods:A prospective audit of all the 14 572 births in a maternity unit only staffed by nurse practitioners between 1996 and 2003. Results:1.2%of all babies born in the unit were found to have a structural defect (as confirmed by echocardiography)within a year of birth. The number not suspected before discharge declined over time,and only 6%were first suspected after discharge in the last four years of this eight year study. Four potentially life threatening conditions initially went unsuspected in 1996-8,but none after that. A policy of referring every term baby with a murmur at 1 day of age that was still present at 7-10 days resulted in 4.2%requiring cardiac referral; 54%of these babies still had a murmur when assesse done to two weeks later,and 33%had a structural defect. Parents said in independent,retrospectively conducted,interviews that they found it confidence building to have any possible heart defect identified early and the cause of any murmur clearly and authoritatively explained. Conclusions:Effective screening requires experience and a clear,structured,referral pathway,but can work much better than most previous reports suggest.Whether staff bring a medical or nursing background to the task may well be of less importance. 展开更多
关键词 先天性心脏病 心脏杂音 生时 出生后 超声心动图 出生婴儿 产科病房 致命性疾病 执业护士 临床筛查
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