Objectives. The goal of this study was to examine quality of life and mood in long- term survivors of cervical and endometrial cancer. Relationships of quality of life and mood with demographic and disease factors wer...Objectives. The goal of this study was to examine quality of life and mood in long- term survivors of cervical and endometrial cancer. Relationships of quality of life and mood with demographic and disease factors were also investigated. Methods. One-hundred fifty-two survivors of cervical or endometrial cancer diagnosed and treated 5- 20 years ago at the University of Iowa Hospitals and Clinics participated. Eighty-nine healthy controls were recruited from a hospital gynecology clinic. Quality of life, mood, and demographics were assessed by questionnaires. Disease characteristics of cancer survivors were abstracted from medical records. Results. There were no significant differences in quality of life or depressive symptoms between the three groups. Cervical cancer survivors reported significantly more anxiety than endometrial cancer survivors, and more dysphoria, anger, and confusion than either endometrial cancer survivors or healthy controls. Greater depression and mood disturbance were reported by unemployed and unmarried cancer survivors. Treatment modality, stage of disease, and length of time since diagnosis were not related to quality of life or mood. Conclusions. Quality of life in cervical and endometrial cancer survivors approximates that of healthy controls by 5 years post-diagnosis. However, cervical cancer survivors report more negative mood than survivors of endometrial cancer or healthy controls. Cancer survivors who are unemployed or living alone may be especially at risk for mood and mental health difficulties.展开更多
Streptococcus pneumoniae (S. pneumoniae) has been associated with hemolytic uremic syndrome (HUS),which is an unusual but serious disease in childhood. We conducted a retrospective review of children aged less than 18...Streptococcus pneumoniae (S. pneumoniae) has been associated with hemolytic uremic syndrome (HUS),which is an unusual but serious disease in childhood. We conducted a retrospective review of children aged less than 18 years with S. pneumoniae-associated HUS in northern Taiwan from January 2000 to June 2005. The demographic characters,clinical courses,and outcomes were analyzed. Seven children (three girls,four boys)with S. pneumoniae-associated HUS were studied. The median age at onset of HUS was 40 months (range: 25-60 months). The median duration of hospital stay was 36 days (range: 15-50 days). The interval between the onset of illness attributable to S. pneumoniae and the development of HUS was around 1-2 weeks. The onset of oliguria developed within 2 weeks after illness. Six patients required dialysis with median duration of 16 days. Three patients had leukopenia as the initial presentation. All seven patients had pneumococcal pneumonia complicating with empyema,and two of them received decortication via video-assisted thoracoscopic surgery. Between patients who needed dialysis or not,there was no significant difference in age,sex,duration of thrombocytopenia,incidence of extra-renal complications,such as hepatitis,pancreatitis,and hypertension,and length of hospital stay. The seven patients survived with normal renal function. HUS is a potentially fatal complication of S. pneumoniae infection. Clinicians managing patients with pneumococcal pneumonia with empyema accompanied by leukopenia should beware of the development of HUS. The long-term prognosis for recovery of renal function appears to be good in these patients in northern Taiwan.展开更多
Objectives: To evaluate the benefit of fluconazole prophylaxis in preventing i nvasive fungal infection in very low birth weight (VLBW) infants with central va scular access. Study design: A 3-year baseline period (19...Objectives: To evaluate the benefit of fluconazole prophylaxis in preventing i nvasive fungal infection in very low birth weight (VLBW) infants with central va scular access. Study design: A 3-year baseline period (1998 to 2000)was compare d with a subsequent 3-year period (2001 to 2003) during which a different proto col for preventing invasive fungal infection was used. All infants with a birth weight < 1500 g and with central vascular access were eligible for the study. Fl uconazole (Diflucan R)was administered for 28 days at a dose of 6 mg/kg every th ird day during the first week and daily after the first week. Results: There wer e no significant differences between the baseline and the fluconazole groups in demographic characteristics or risk factors for fungal infection. Fungal infecti on developed in 9 of the infants in the baseline group and in none of those in t he fluconazole group (P = .003). A trend of decreasing mortality rate between th e 2 groups (12.6%vs 8.1%; P = .32) was observed but was not statistically sign ificant. No adverse effects of fluconazole therapy were documented. Conclusions: Fluconazole prophylaxis appeared to be beneficial in preventing invasive fungal infection in VLBW infants.展开更多
PURPOSE: Hyperplastic polyps are usually considered to be an innocent finding with little or no potential to progress to colorectal cancer. However, recent literature suggests that some of these polyps may be morpholo...PURPOSE: Hyperplastic polyps are usually considered to be an innocent finding with little or no potential to progress to colorectal cancer. However, recent literature suggests that some of these polyps may be morphologically and genetically distinct and lead to microsatellite unstable colorectal cancers. The purpose of this study was to define the cancer risk associated with hyperplastic polyposis. METHODS: All patients with hyperplastic polyposis diagnosed by a single colorectal surgeon at a university hospital were followed prospectively. The diagnosis of hyperplastic polyposis was made by the presence of more than 20 hyperplastic polyps distributed throughout the colon and/or a hyperplastic polyp at least 1 cm in size in diameter in the right colon. Patient demographics, family history, size, location, and distribution of polyps and the development of colorectal cancer were noted. RESULTS: Thirteen patients who met the criteria for hyperplastic polyposis were identified and followed prospectively. All of these patients had at least 30 polyps distributed throughout the colon, often > 100. Nine of 13 also had a hyperplastic polyp at least 1 cm in size, usually in the right colon. Of particular note, 7 of 13 patients (54 percent) were diagnosed with colorectal cancer during the study period. Four had cancer on initial diagnosis and three patients developed cancer despite frequent colonoscopic surveillance. Five of seven colorectal cancers were located in the right colon. CONCLUSIONS: Patients with hyperplastic polyposis are at high risk for colorectal cancer. Failure to identify this subset of patients could have dire consequences.展开更多
The goal of this study was to examine whether sociodemo-graphic,clinical,and other servic e -related factors,as well as preventability issues affec t a woman’s progression along the continuum of morbidity and mortali...The goal of this study was to examine whether sociodemo-graphic,clinical,and other servic e -related factors,as well as preventability issues affec t a woman’s progression along the continuum of morbidity and mortality.This was acase -control study of pregnancy -re lated deaths,women with near -miss morbidity,and those with other severe,but not life threatening,morbidity.Factors associated with maternal outcome were examined.Pro vider factors(related to preventability)and clinical diagnosis were signifi cantly associated with progression along t he continuum after con-trolling for sociodemographic characteristics(P <.01for both associations).In order to improve mortality rates,we must understand maternal morbidity and how it may lead to death.This study shows that importa nt initiatives include addressing preventability,in particular,provider factors,which may play a role in moving women a long the contin-uum of morbidity and mortality.展开更多
文摘Objectives. The goal of this study was to examine quality of life and mood in long- term survivors of cervical and endometrial cancer. Relationships of quality of life and mood with demographic and disease factors were also investigated. Methods. One-hundred fifty-two survivors of cervical or endometrial cancer diagnosed and treated 5- 20 years ago at the University of Iowa Hospitals and Clinics participated. Eighty-nine healthy controls were recruited from a hospital gynecology clinic. Quality of life, mood, and demographics were assessed by questionnaires. Disease characteristics of cancer survivors were abstracted from medical records. Results. There were no significant differences in quality of life or depressive symptoms between the three groups. Cervical cancer survivors reported significantly more anxiety than endometrial cancer survivors, and more dysphoria, anger, and confusion than either endometrial cancer survivors or healthy controls. Greater depression and mood disturbance were reported by unemployed and unmarried cancer survivors. Treatment modality, stage of disease, and length of time since diagnosis were not related to quality of life or mood. Conclusions. Quality of life in cervical and endometrial cancer survivors approximates that of healthy controls by 5 years post-diagnosis. However, cervical cancer survivors report more negative mood than survivors of endometrial cancer or healthy controls. Cancer survivors who are unemployed or living alone may be especially at risk for mood and mental health difficulties.
文摘Streptococcus pneumoniae (S. pneumoniae) has been associated with hemolytic uremic syndrome (HUS),which is an unusual but serious disease in childhood. We conducted a retrospective review of children aged less than 18 years with S. pneumoniae-associated HUS in northern Taiwan from January 2000 to June 2005. The demographic characters,clinical courses,and outcomes were analyzed. Seven children (three girls,four boys)with S. pneumoniae-associated HUS were studied. The median age at onset of HUS was 40 months (range: 25-60 months). The median duration of hospital stay was 36 days (range: 15-50 days). The interval between the onset of illness attributable to S. pneumoniae and the development of HUS was around 1-2 weeks. The onset of oliguria developed within 2 weeks after illness. Six patients required dialysis with median duration of 16 days. Three patients had leukopenia as the initial presentation. All seven patients had pneumococcal pneumonia complicating with empyema,and two of them received decortication via video-assisted thoracoscopic surgery. Between patients who needed dialysis or not,there was no significant difference in age,sex,duration of thrombocytopenia,incidence of extra-renal complications,such as hepatitis,pancreatitis,and hypertension,and length of hospital stay. The seven patients survived with normal renal function. HUS is a potentially fatal complication of S. pneumoniae infection. Clinicians managing patients with pneumococcal pneumonia with empyema accompanied by leukopenia should beware of the development of HUS. The long-term prognosis for recovery of renal function appears to be good in these patients in northern Taiwan.
文摘Objectives: To evaluate the benefit of fluconazole prophylaxis in preventing i nvasive fungal infection in very low birth weight (VLBW) infants with central va scular access. Study design: A 3-year baseline period (1998 to 2000)was compare d with a subsequent 3-year period (2001 to 2003) during which a different proto col for preventing invasive fungal infection was used. All infants with a birth weight < 1500 g and with central vascular access were eligible for the study. Fl uconazole (Diflucan R)was administered for 28 days at a dose of 6 mg/kg every th ird day during the first week and daily after the first week. Results: There wer e no significant differences between the baseline and the fluconazole groups in demographic characteristics or risk factors for fungal infection. Fungal infecti on developed in 9 of the infants in the baseline group and in none of those in t he fluconazole group (P = .003). A trend of decreasing mortality rate between th e 2 groups (12.6%vs 8.1%; P = .32) was observed but was not statistically sign ificant. No adverse effects of fluconazole therapy were documented. Conclusions: Fluconazole prophylaxis appeared to be beneficial in preventing invasive fungal infection in VLBW infants.
文摘PURPOSE: Hyperplastic polyps are usually considered to be an innocent finding with little or no potential to progress to colorectal cancer. However, recent literature suggests that some of these polyps may be morphologically and genetically distinct and lead to microsatellite unstable colorectal cancers. The purpose of this study was to define the cancer risk associated with hyperplastic polyposis. METHODS: All patients with hyperplastic polyposis diagnosed by a single colorectal surgeon at a university hospital were followed prospectively. The diagnosis of hyperplastic polyposis was made by the presence of more than 20 hyperplastic polyps distributed throughout the colon and/or a hyperplastic polyp at least 1 cm in size in diameter in the right colon. Patient demographics, family history, size, location, and distribution of polyps and the development of colorectal cancer were noted. RESULTS: Thirteen patients who met the criteria for hyperplastic polyposis were identified and followed prospectively. All of these patients had at least 30 polyps distributed throughout the colon, often > 100. Nine of 13 also had a hyperplastic polyp at least 1 cm in size, usually in the right colon. Of particular note, 7 of 13 patients (54 percent) were diagnosed with colorectal cancer during the study period. Four had cancer on initial diagnosis and three patients developed cancer despite frequent colonoscopic surveillance. Five of seven colorectal cancers were located in the right colon. CONCLUSIONS: Patients with hyperplastic polyposis are at high risk for colorectal cancer. Failure to identify this subset of patients could have dire consequences.
文摘The goal of this study was to examine whether sociodemo-graphic,clinical,and other servic e -related factors,as well as preventability issues affec t a woman’s progression along the continuum of morbidity and mortality.This was acase -control study of pregnancy -re lated deaths,women with near -miss morbidity,and those with other severe,but not life threatening,morbidity.Factors associated with maternal outcome were examined.Pro vider factors(related to preventability)and clinical diagnosis were signifi cantly associated with progression along t he continuum after con-trolling for sociodemographic characteristics(P <.01for both associations).In order to improve mortality rates,we must understand maternal morbidity and how it may lead to death.This study shows that importa nt initiatives include addressing preventability,in particular,provider factors,which may play a role in moving women a long the contin-uum of morbidity and mortality.
