1,929 research outputs found

    The use of Dermoscopy Following a one-day Workshop Among Family Medicine Residents

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    Skin cancer is the most common form of cancer in the United States. The purpose of this study is to determine if a single grand rounds workshop impacts the use of dermoscopy in a single Family Medicine Residency training program. Dermoscopy is a non-invasive tool to allow for higher magnification of skin lesions thereby increasing the ability to assess qualities which are unable to be seen by the naked eye. This study utilized a pre- and post-workshop survey questionnaire to assess participant practices in evaluation, diagnosis, and management of skin lesions. Eighteen (18) residents completed the survey prior to the grand rounds workshop. Nine (9) residents completed the follow-up survey three-months post-workshop. The results showed that the frequency of dermoscopy use increased post-workshop (Pearson’s Chi Square=8.83, p=0.012; Fischer’s Exact=0.008) and residents felt dermoscopy decreased the need to refer skin lesions (Pearson’s Chi Square=9.11, p=0.028; Fischer’s Exact=0.023). However, there was no significant change in resident comfort level when using dermoscopy post-educational workshop (Pearson’s Chi Square=5.34, p=0.255; Fischer’s Exact=0.272)

    An evaluation of preoperative CA 15-3 measurement in primary breast carcinoma.

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    In this study of 500 patients with breast carcinoma, we have prospectively assessed the role of preoperative CA 15-3 as a marker of disease burden over a 7 year period. CA 15-3 levels at presentation correlate with stage of disease, tumour size, lymph node status, the presence of metastases and lymphocyte infiltration into the tumour. CA 15-3 alone is not an independent prognostic indicator, although a serum level of > 40 U ml-1 has a positive predictive value of 83% for the presence of advanced disease. We recommend the routine use of this marker in the preoperative assessment of primary breast carcinoma

    Coronary microvascular ischemia in hypertrophic cardiomyopathy - a pixel-wise quantitative cardiovascular magnetic resonance perfusion study.

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    BACKGROUND: Microvascular dysfunction in HCM has been associated with adverse clinical outcomes. Advances in quantitative cardiovascular magnetic resonance (CMR) perfusion imaging now allow myocardial blood flow to be quantified at the pixel level. We applied these techniques to investigate the spectrum of microvascular dysfunction in hypertrophic cardiomyopathy (HCM) and to explore its relationship with fibrosis and wall thickness. METHODS: CMR perfusion imaging was undertaken during adenosine-induced hyperemia and again at rest in 35 patients together with late gadolinium enhancement (LGE) imaging. Myocardial blood flow (MBF) was quantified on a pixel-by-pixel basis from CMR perfusion images using a Fermi-constrained deconvolution algorithm. Regions-of-interest (ROI) in hypoperfused and hyperemic myocardium were identified from the MBF pixel maps. The myocardium was also divided into 16 AHA segments. RESULTS: Resting MBF was significantly higher in the endocardium than in the epicardium (mean ± SD: 1.25 ± 0.35 ml/g/min versus 1.20 ± 0.35 ml/g/min, P < 0.001), a pattern that reversed with stress (2.00 ± 0.76 ml/g/min versus 2.36 ± 0.83 ml/g/min, P < 0.001). ROI analysis revealed 11 (31%) patients with stress MBF lower than resting values (1.05 ± 0.39 ml/g/min versus 1.22 ± 0.36 ml/g/min, P = 0.021). There was a significant negative association between hyperemic MBF and wall thickness (β = −0.047 ml/g/min per mm, 95% CI: −0.057 to −0.038, P < 0.001) and a significantly lower probability of fibrosis in a segment with increasing hyperemic MBF (odds ratio per ml/g/min: 0.086, 95% CI: 0.078 to 0.095, P = 0.003). CONCLUSIONS: Pixel-wise quantitative CMR perfusion imaging identifies a subgroup of patients with HCM that have localised severe microvascular dysfunction which may give rise to myocardial ischemia

    On the limits of Brans-Dicke spacetimes: a coordinate-free approach

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    We investigate the limit of Brans-Dicke spacetimes as the scalar field coupling constant omega tends to infinity applying a coordinate-free technique. We obtain the limits of some known exact solutions. It is shown that these limits may not correspond to similar solutions in the general relativity theory.Comment: LaTeX, 16 pp, report DF/UFPB/02-9
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