Distinguishing benign tumors and pseudotumors of the liver from malignant tumors is a common clinical problem. Regenerative nodular hyperplasia (RNH) represents one of the more challenging pseudotumors to diagnose, because they can appear clinically indistinguishable from either a primary or a secondary liver malignancy. Even after comprehensive radiologic evaluation and image-guided percutaneous biopsy, the diagnosis of RNH can remain elusive.
View Article and Find Full Text PDFCurr Probl Diagn Radiol
February 2006
This article reviews the research to date, as well as our clinical experience from two institutions, on gadolinium-enhanced computed tomographic angiography (gCTA) for imaging the body. gCTA may be an appropriate examination for the small percentage of patients who would benefit from noninvasive vascular imaging, but who have contraindications to both iodinated contrast and magnetic resonance imaging. gCTA is more expensive than CTA with iodinated contrast, due to the dose of gadolinium administered, and gCTA has limitations compared with CTA with iodinated contrast, in that parenchymal organs are not optimally enhanced at doses of 0.
View Article and Find Full Text PDFInt Rev Psychiatry
October 2005
Despite the continued increase in female participation rates, Australia remains one of only two developed nations in the world without a paid maternity leave scheme. While research interest and public policy debate about paid maternity leave entitlements continues, little is known about the actual utilization of the 52 weeks unpaid parental leave that is currently available to all employees. Moreover, research and policy debate on the availability and provision of paid paternity leave has only just begun.
View Article and Find Full Text PDFAlthough most cases of hepatitis C virus (HCV) infection are associated with injection drug use, there are few data regarding the impact of putative barriers such as psychiatric disease and intercurrent drug use on HCV treatment outcomes. To define the impact of characteristics often cited as reasons for withholding HCV treatment, we studied HCV treatment in a real world sample of 76 recovering heroin users maintained on methadone. Overall, 21 (28%) had a sustained virological response and 18 (24%) discontinued treatment early.
View Article and Find Full Text PDFCancer Chemother Pharmacol
November 2005
Two studies of irinotecan (CPT-11) followed 24 h later by an antimetabolite were conducted. The objectives of the studies were: (1) to determine whether the increase in S-phase in tumor cells seen 24 h after CPT-11 administration in animal studies is seen in advanced solid tumors in patients, (2) to determine the dose of CPT-11 required to produce this effect, (3) to compare two methods (immunohistochemistry, IHC, for cyclin A, and DNA flow cytometry, FC) for evaluating S-phase in tumor biopsies from patients, and (4) to establish the maximum tolerated dose (MTD) and dose-limiting toxicity (DLT) of CPT-11, given 24 h before gemcitabine (GEM, 1000 mg/m(2)). In one study CPT-11 was followed 24 h later by 5-fluorouracil (5-FU), 400 mg/m(2) per week for 4 weeks every 6 weeks.
View Article and Find Full Text PDFDespite the high prevalence of hepatitis C virus (HCV) infection among drug users enrolled in methadone maintenance treatment programs, few drug users are being treated with combination therapy. The most significant barrier to treatment is lack of access to comprehensive HCV-related care. We describe a pilot program to integrate care for HCV infection with substance abuse treatment in a setting of maintenance treatment with methadone.
View Article and Find Full Text PDFWe report the unusual clinical manifestation and subsequent management of a symptomatic congenital bronchogenic cyst that connected to the trachea and presented in the neck of an adult. The embryology, clinical presentation, diagnostic evaluation, and management options of this rare aberration are discussed.
View Article and Find Full Text PDFObjective: To define the prevalence of and factors associated with having a negative purified protein derivative (PPD) among persons who self-report a prior positive PPD and to define the safety of repeat testing in such persons.
Design: Observational cohort study.
Setting: Methadone maintenance program with onsite primary care.
Benign lesions of the liver represent diagnostic dilemmas, clinically and radiographically; however, certain clues can help the extensive differential diagnosis of both benign and malignant processes. Hemangiomas and simple cysts have very distinct and very specific radiographic characteristics, and if diagnosed, no further work-up is necessary. The remaining benign lesions have significant overlap, even though there are some more common characteristics to each of the entities.
View Article and Find Full Text PDFIn the 1970s, four trials failed to demonstrate any mortality reduction using a combination of chest X-ray (CXR) and/or sputum cytology. The recent early lung cancer action project (ELCAP) demonstrated that modern screening is capable of detecting Stage I lung cancers. Bronchial epithelial changes leading up to cancers are now being understood to include histologic changes and genetic alterations.
View Article and Find Full Text PDFUterine rupture is an unexpected, relatively uncommon occurrence in the general obstetric population, but it is a potentially devastating complication. Uterine rupture of the unscarred uterus is extremely rare. Awareness of the risk factors as well as the signs and symptoms of uterine rupture are essential for an early diagnosis and prompt treatment.
View Article and Find Full Text PDFObjective: To demonstrate that gadopentetate dimeglumine is potentially an alternative contrast medium for computed tomographic angiography (CTA).
Methods: One 12.2-kg Beagle dog was studied as proof of principle; the cervical vessels of three adult human patients were imaged for presurgical planning of the neck.
Aim: To determine the relationship between affluence and the presence of diabetic retinopathy at time of diagnosis of Type 2 diabetes.
Methods: Records of patients held by Southampton Retinal Screening Programme were examined. Patients (n = 1844) newly diagnosed with Type 2 diabetes and subsequently receiving photographic retinal screening within 24 months were selected.
Purpose: To identify a dose and schedule of oxaliplatin (OXP) to be safely administered in combination with protracted-infusion (PI) fluorouracil (5-FU) and external-beam radiation therapy (XRT) for patients with primary esophageal carcinoma (EC).
Patients And Methods: Eligibility included therapeutically naïve EC patients with clinical disease stages II, III, or IV. Initial doses and schedules for cycle 1 consisted of OXP 85 mg/m(2) on days 1, 15, and 29; PI 5-FU 180 mg/m(2) for 24 hours for 35 days; and XRT 1.
Epidural analgesia is a popular and effective method for pain relief during labor. Bupivacaine is a commonly used local anesthetic for labor epidural analgesia. Ropivacaine is an amino acid local anesthetic that is structurally related to bupivacaine with a similar potency and duration, but ropivacaine has less cardiac toxicity than bupivacaine and produces less motor blockade.
View Article and Find Full Text PDFJ Allergy Clin Immunol
July 1997
Background: In the past, oral immunotherapy with allergens has had limited clinical effectiveness, presumably because of gastrointestinal destruction of allergens.
Objective: We have developed a new technique for microencapsulating protein antigens that permits them, when given orally, to bypass the stomach and be delivered to the small intestine in a highly immunogenic form. This study's purpose was to confirm the immunologic potency of orally administered short ragweed pollen extracts (SRW) microencapsulated (mSRW) by this new technique and to study the effectiveness of mSRW in controlling the symptoms of ragweed-induced hay fever.
Ann Allergy Asthma Immunol
August 1996
Background: Oral allergen immunotherapy with conventional allergens has not been a useful mode of treatment because of the lack of potency of allergens when administered by this route.
Objective: To study the immunologic potency of short ragweed pollen extracts microencapsulated by a new technique administered orally to short ragweed pollen-sensitive humans and to establish the dose of oral microencapsulated short ragweed pollen extract required for these effects.
Methods: Nine short ragweed pollen-sensitive patients were treated with a new oral agent for immunotherapy, microencapsulated short ragweed pollen extract, in an open study.
Fracture-separation of the distal humeral epiphysis in neonates is difficult to diagnose radiologically because the cartilaginous epiphysis is radiolucent. We report a case in which fracture-separation of the distal humeral epiphysis in a neonate was diagnosed with the help of ultrasonography, which provided a clear delineation of the injury.
View Article and Find Full Text PDFPhototherapy, an effective treatment for neonatal indirect hyperbilirubinemia, has guidelines for its initiation but none for its discontinuation. In our study, phototherapy was begun at a mean age of 90 hours in 28 full-term and 30 preterm infants with indirect nonhemolytic hyperbilirubinemia. After three days, phototherapy was halted at a mean bilirubin concentration of 13.
View Article and Find Full Text PDFObjective: A case is reported of a carbamazepine (CBZ)-treated epileptic mother whose newborn presented with transient hepatic dysfunction characterized by direct hyperbilirubinemia and high concentrations of gamma-glutamyltransferase (GGT).
Data Sources: Information was obtained from case reports, clinical trials, and relevant bibliographic laboratory studies.
Data Extraction: Data from case reports were evaluated and compared with those from our patient.
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