A retrospective study of 97 patients undergoing 101 image-guided adrenal biopsies (IGABs) was performed to analyze the effects of specific pathologic results on test characteristics. Three categories ...of pathologic results (benign adrenal tissue, malignant tissue, and nondiagnostic) were compared with outcomes. Diagnostic samples were obtained in 86% of cases. Among 72 patients with proved outcomes, IGAB had an accuracy of 96%, a sensitivity of 93%, and a negative predictive value of 91% (92% in patients with bronchogenic carcinoma). In this subset of patients, 33 had biopsy specimens that contained benign adrenal tissue. In these 33 patients, three masses (each smaller than 3 cm) proved malignant. In the 14 patients with nondiagnostic samples, two masses proved malignant. Obtaining benign adrenal tissue was highly predictive of benignity, even in the setting of lung cancer. The authors conclude that IGAB is an accurate procedure in both oncologic and nononcologic patients. However, when the biopsy specimen does not contain benign adrenal tissue or malignant cells, repeat percutaneous biopsy or surgery should be considered.
Quality of life measurement may be helpful in randomized clinical trials in osteoporosis to assess therapeutic tradeoffs and compare effects of different interventions. Quality of life measures ...include generic measures, disease targeted measures, and performance based measures. Disease targeted measures increase the coverage of domains that are of particular importance to the patient with established osteoporosis. Several disease targeted measures are currently available. These measures show discriminant validity, but data on longitudinal responsiveness and validity in randomized clinical trials are not yet available.
We examined the incidence of hip fracture in Non-Hispanic White, Hispanic, Black, and Asian Americans for the years 1983 and 1984 using a data base which contains a summary of all hospitalizations ...for the State of California. We found a consistently lower risk for hip fracture after age 60 in Hispanic, Black, and Asian American females than in White females who were not Hispanic. Overall age-adjusted hip fracture rates in Hispanic, Black, and Asian females were 49.7, 57.3, and 85.4, respectively, and 140.7/100,000 in White females who were not Hispanic. These differences were not found in males, although Whites (not Hispanic) had the highest incidence of hip fractures among males.
Celotno besedilo
Dostopno za:
DOBA, FSPLJ, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
The purpose of this work was to correlate the CT, ultrasound, and pathologic features of metanephric adenoma, a rare benign renal tumor in adults.
Retrospective review of medical records (1990-1997) ...revealed three adult female patients who had both preoperative imaging and nephrectomy with pathologic diagnosis of metanephric adenoma performed at our institution. CT (n = 3) and ultrasound (n = 2) features were reviewed in consensus by two radiologists and correlated with pathologic findings.
In all three cases, the metanephric adenoma was of increased attenuation relative to adjacent renal parenchyma on unenhanced CT scans. No septa or calcifications were seen. Ultrasound images showed both tumors to be hyperechoic with enhanced through-transmission.
The CT and ultrasound findings correlate with the pathologic features of a high nuclear-to-cytoplasmic ratio and psammomatous calcifications. In the adult population, it is unlikely that metanephric adenoma can be prospectively differentiated from renal cell carcinoma based on imaging features.
The quality of care rendered to residents of nursing facilities continues to gain attention from legislators, regulators, and the courts. Advocates for improvements in the quality of care by ...government-funded healthcare providers have identified the False Claims Act (FCA) as a potent tool. The Second Circuit decision in Mikes v. Straus might be viewed as a barrier to FCA claims against nursing facilities. Any impediment imposed by this decision, however, is limited by the facts of the case; the authors believe that carefully-crafted pleadings can enable litigants to rely upon the FCA in pursuing quality-of-care claims against nursing facilities.
Calcitonin Silverman, S L
Rheumatic diseases clinics of North America,
02/2001, Letnik:
27, Številka:
1
Journal Article
Recenzirano
Calcitonin reduces the risk of vertebral fracture in postmenopausal women with osteoporosis. Calcitonin produces small increments in the bone mass of the spine and modestly reduces bone turnover in ...women with osteoporosis. No significant effect on nonvertebral fractures has been observed. Calcitonin may have analgesic benefit.
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