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简介：Purposes:Wereportedtherolesandfunctionsofnursesinhomevisitsforbraintumorpatientsusingthefamilyhealthassessmentguideinthestudy.Methods:Onepatientofbraingliomawaschosenasthecaseillustration.Thenursesassessedthepatients’situation,theirfamiliesandlivingenvironmentindividually.Allthesefactorswereanalyzedtogether.Results:Thenursesthenimplementedtheirknowledgeandskillstoadoptdifferentmeasuresindifferentconditions,investigatedthepatients’healthproblemsandcarriedoutpersonalizedeffectiveactions.Conclusions:Nursesshouldputeffortintocommunitynursingtoallowpatientstoliveinasafeenvironment,tosatisfythehealthneedsofhumanbeingandtheirneedsforhealthknowledge,andenhancetheirself-careabilities.

简介：OBJECT:Optimummanagementforelderlypatientswithnewlydiagnosedglioblastoma(GBM)inthetemozolomide(TMZ)eraisnotwelldefined.Theobjectofthisstudywastoclarifyoutcomesinthispopulation.METHODS:Theauthorsretrospectivelyreviewed105consecutivecasesinvolvingelderlypatients(age≥65years)withnewlydiagnosedGBMwhoweretreatedattheMayoClinicbetween2003and2008.RESULTS:Thepatients'medianagewas74years(range66-87years),andthemedianKarnofskyPerformanceStatus(KPS)scorewas80(range40-90).Halfofthepatientsunderwentbiopsyandhalfunderwentresection.Patientswithdeep-seatedlesions(19patients[18%])ormultifocallesions(34patients[32%])weremorelikelytohavebiopsythanresection(p=0.0001and0.0009,respectively).Newpersistentneurologicaldeficitsdevelopedin7patients(6.7%).Postoperativehemorrhageoccurredin6patients(5.7%),allofwhomunderwentbiopsy.Completefollow-updataregardingadjuvanttreatmentwasavailablein84patients.Forty-one(49%)weretreatedwithchemotherapy(mostlyTMZ)andradiationtherapy(RT),and23(27%)withRTalone.Nineteen(23%)receivedonlypalliativecareaftersurgery(morecommonwithbiopsy,p=0.03).Chemotherapycomplicationsoccurredin28.6%(Grade3or4hematologicalcomplicationsin11.9%).Themedianvaluesforprogression-freesurvival(PFS)andoverallsurvival(OS)were3.5and5.5months.Inamultivariateanalysis,youngerage(p=0.03,riskratio[RR]0.34,95%CI0.13-0.89),singlelesion(p=0.02,RR0.51,95%CI0.30-0.89),resection(p=0.04,RR0.54,95%CI0.31-0.94),andadjuvanttreatment(p=0.0001,RR0.24,95%CI0.11-0.49)wereassociatedwithbetterOS.OnlyadjuvanttreatmentwassignificantlyassociatedwithprolongedPFS(p=0.0007,RR0.27,95%CI0.13-0.57).Withcombinedtherapywithresection,RT,andchemotherapy,themedianPFSandOSwere8and12.5months,respectively.CONCLUSIONS:TheprognosisforGBMworsenswithincreasingageinelderlypatients.Withimportantrisks,resectionandadjuvanttreatmen

简介：AIM:Toevaluatetheindications,complications,andvisualandgraftsurvivaloutcomesineyesthathadundergonesimultaneouscataractextractionandpenetratingkeratoplasty(PKP).·METHODS:Wedescribedaretrospectivestudyof101patientswhohadundergonesimultaneouscataractextractionandPKPatKingKhaledEyeSpecialistHospitalbetweenJanuary1,2001,andDecember31,2002.Allpatientswerefolloweduppostoperativelywithmaximumfollow-up68months.·RESULTS:Themeanageofpatientswas61years.Themeanoverallfollow-upwas27months.Themostcommonindicationsforsurgerywerecornealscarring(45.5%),previousfailedgraft(15.8%),cornealulcer(12.9%),Fuchsendothelialdystrophy(8.9%),stromaldystrophy(2.9%),andotherconditions(14.5%).Overall,69grafts(68.3%)remainedclearatfinalfollow-up.Previousglaucomaorpostoperativeglaucomahadnostatisticallysignificanteffectsongraftoutcome(P>0.05).Thegraftrejectionrate(17.8%)wasasignificantriskfactorforfailure(P=0.00).Age,gender,indicationsforsurgery,cornealgraftdiameter,andintraoperativevitreouslosshadnostatisticallysignificanteffectsonthePKPoutcome(P>0.05).Postoperativevisualacuitywassignificantlyassociatedwithpreoperativevisualacuity(P<0.01).·CONCLUSION:Thepresentstudyprovidesevidencethatperformingacombinedprocedureresultsinmorerapidvisualrehabilitationandgoodgraftclarity.

简介：Purpose:Theaimofthisstudywastoevaluatetheprogram"Nomoresmoking!It’stimeforphysicalactivity",withamixedmethodsdesign,inordertocollectinformationtoimprovetheprogramforfutureapplications.Methods:Fortypatientsacrossfiveanti-smokingclinicsinCentralGreececompletedtheprogram.Counselors’recordsandparticipants’questionnairesandinterviewswereusedasdatainordertoevaluatetheprograms’processandoutcome.Results:Quantitativemeasuresbeforeandaftertheprogramrevealedsignificantdifferencesonsmokingbehavior,physicalactivity(PA)behavior,self-efficacy,andsmokinghabitmeasures.QualitativedataimpliedthatthepromotionofPAasacessationaidwasperceivedaspositivebytheparticipantsandbothparticipants’andcounselors’statementswereencouragingfortheeffectivenessofPApromotionduringtheprogramasacessation-aidtechnique.Conclusion:Evaluationofthe"Nomoresmoking!It’stimeforphysicalactivity"programshowedencouragingresults.PeoplewhotrytoquitsmokingcanbecomemorephysicallyactivethroughtargetedinterventionandtheyregardPAasasignificantaidintheireffortstoquitsmoking.

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简介：Metastasisoflungcancertothetemporalboneisaveryrarediseaseandsubjectivetinnitusasthepresent-ingsymptominthesepatientsisevenrarer.Herewereportacaseinwhicha42-year-oldmalepresentedwithsubjectivetinnitusofthreemonths,withnopulmonarydiseasesymptoms.Puretoneaudiometryindi-catedmoderateconductivedeafnessinleftearwithanair-bonegapof21.3dB.HRCTtemporalbonescan-ningindicatedhigh-densityshadowsintheleftepitympaniccavity,sinustympaniandmastoidcavity.Chron-icotitismediawithcholesteatomawassuspectedandsurgicaltreatmentrecommended.However,preopera-tivechestx-rayrevealedhigh-densitymilletlesionsscatteredwidelyinbothlungs.HRCTlungscanningconfirmedthelungslesionsandindicatedlungcancer.Inordertodeterminecorrelationsbetweenthetempo-ralboneandpulmonarylesions,aCT-guidedtrans-mastoidaspirationbiopsyandimmunohistochemicalstudywereconducted,whichconfirmedthatthetemporalbonelesionwasmetastaticfromthelungs.Thepa-tientwasgivenaseriesofchemotherapyimmediatelyandhistinnitussignificantlyimprovedafterthreemonthsoftreatment,withfullrecoveryofhishearingandcompleteresolutionofshadowsinthemastoidcavity.Unfortunately,hesubsequentlydevelopedmultiplebonemetastasesinthe9thmonthandcerebralmetastasisinthe18thmonth.Multipleorganfailureresultedindeathin2.5years.

简介：Objective:Tovalidatemalnutritionscreeningtoolofnutritionriskindex(NRI)againstpatient-generatedsubjectiveglobalassessment(PG-SGA)asagoldstandardtoolincolorectalcancerpatientsbeforeradiotherapy.Methods:Nutritionalstatusof52volunteercolorectalcancerpatientswithameanageof54.1±16.8yearswhoreferredtoradiotherapycenterwereassessedbyPG-SGA(goldstandardmethod)andNRI.Serumalbuminlevelsofpatientsweredeterminedbycolorimetricmethod.Acontingencytablewasusedtodeterminethesensitivity,specificity,andpredictivevalueoftheNRIinscreeningpatientsatriskofmalnutrition,incomparisonwiththePG-SGAinpatientsbeforeradiotherapy.Results:ThefindingsofPG-SGAandNRIshowedthat52%and45%ofpatientsinourstudyweremoderatelyorseverelymalnourishedrespectively.TheNRIhadasensitivityof66%andaspecificityof60%againstPG-SGA.Thepositivepredictivevaluewas64%andthenegativepredicativevaluewas62%.TheagreementbetweenNRIandPG-SGAwasstatisticallyinsignificant(kappa=0.267;P>0.05).Conclusions:Thefindingsofpresentstudyshowedthattheprevalenceofmalnutritionwashighinpatientswithcolorectalcancer.Moreover,NRImethodhadlowsensitivityandspecificityinassessingnutritionalstatusofpatientswithcancer.Itseemsthatthecombinationofanthropometric,laboratoryparametersandasubjectivescoringsystemmaybehelpfultoolsinscreeningofmalnutritionincancerpatients.

简介：Theacquisitionofsecondarychromosomalaberrationsinchronicmyeloidleukemia(CML)patientswithPhiladelphiachromosome-positive(Ph+)karyotypesignifiesclonalevolutionassociatedwiththeprogressionofthediseasetoitsacceleratedorblasticphase.Therefore,theseaberrationshaveclinicalandbiologicalsignificance.T(3;12)(q26;p13),whichisarecurrentchromosomalaberrationobservedinmyeloidmalignancies,istypicallyassociatedwithdysplasiaofmegakaryocytes,multilineageinvolvement,shortdurationofanyblasticphase,andextremelypoorprognosis.Wehaveidentifiedarecurrentreciprocaltranslocationbetweenchromosomes3and12withdifferentbreakpointatbands3q21inthemalignantcellsfroma28-year-oldman.ThepatientwasinitiallydiagnosedashavingPh+CMLinthechronicphase.Thet(3;12)(q21;p13)translocationoccurred4yearsafterthepatientwasfirstdiagnosedwithCMLwhileundergoingtyrosinekinaseinhibitortherapy.Weconfirmedthet(3;12)(q21;p13)translocationviafluorescenceinsituhybridizationassaybyusingwhole-chromosomepaintprobesforchromosomes3and12.Ourfindingsdemonstratethat,similartootherrecurrenttranslocationsinvolving3q26suchast(3;3)andt(3;21),thet(3;12)(q21;p13)translocationisimplicatednotonlyinmyelodysplasticsyndromeandacutemyeloidleukemiabutalsointheprogressionofCML.Thesefindingsextendthediseasespectrumofthiscytogeneticaberration.

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