296 research outputs found
Assessment of Prognostic Factors in Clinical Medicine
No full textPatients suffering from a certain disease generally differ greatly regarding the course
of their disease. The identification of factors from which much of this variability
between patients can be explained may be of great importance. The study of such prognostic
factors in clinical medicine is usually done for a variety of reasons which to
some extent may overlap each other. One of the reasons may be to better understand
how the disease is likely to behave. It is hardly ever possible nowadays to study the
pure natural history of a disease because usually some form of treatment will have
been undertaken. The treatment often will be curative in intent, but may also be
directed towards the relief of symptoms or avoiding or delaying these in case no
curative treatment is available. It is known from their natural history that certain
illnesses do not require treatment at all because they are self-limited processes.
Knowledge about prognostic factors in such cases will make it possible to provide
information to the patient about the probable duration and course of the disease.
Knowledge of factors which are related to the outcome of disease may be helpful to
physicians in understanding the mechanism of the disease. Such better understanding
may assist in modifying treatment protocols, searching for new treatments or fonnulating
strategies for the optimal use of expensive medical tests. Sometimes knowledge
of prognostic factors may be of use to alter the course of disease by remedial action.
This will particularly be so if these factors are elements of lifestyle such as diet,
exercise or habits. For instance, patients with alcoholic liver cirrhosis who stop taking
alcohol appear to have a better prognosis regarding survival as compared to those
who continue drinking alcohol [Borowsky et ai, 1981]. Such scientifically based facts
may be helpful in encouraging patients to change their drinking habits.
Knowledge of prognostic factors often will be of importance in planning therapeutic
trials. It may be desirable to evaluate certain therapies only in patients who belong to
certain prognostic categories. Also the number of patients required in a randomized
clinical trial depends on the distribution of prognostic factors among patients to be
included in the study
Irradiation of True Pelvis for Bladder and Prostatic Carcinoma in Supine, Prone or Trendelenburg Position
No full textRe: Radiation-Induced Bladder Tumors, by R. E. Duncan, D. W. Bennett, A. T. Evans, B. S. Aron and H.F. Schellhas, J. Urol., 118: 43-45, 1977.
No full textDe stap over de horizon: Een ontleding van het formele ontwerp in de landschapsarchitectuur
No full textArchitectur
Fabricageschema voor een smeerolieraffinaderij
No full textDocument(en) uit de collectie Chemische ProcestechnologieDelftChemTechApplied Science
Dodecylbenzeen
No full textDocument(en) uit de collectie Chemische ProcestechnologieDelftChemTechApplied Science
Carcinoma of the Urinary Bladder (Category T1NxMo) Treated Either by Radium Implant or by Transurethral Resection Only
No full textEliminating the need for per-operative frozen section analysis of pelvic lymph nodes during radical prostatectomy
No full textSubfascial endoscopic perforating vein surgery as treatment for lateral perforating vein incompetence and venous ulceration
No full textAbstractIntroductionEndoscopic ligation of perforating veins (subfascial endoscopic perforating vein surgery [SEPS]) is valuable in treatment of venous ulcer on the medial aspect of the lower leg. Venous ulcerations on the lateral aspect of the lower leg are less common, but are of equal clinical importance.Material and methodsOver 4 years we performed SEPS on the lateral aspect of the lower leg in 13 patients. Preoperative and postoperative duplex scanning of the perforating veins was performed in all patients.ResultsMean follow-up was 53 months (range, 33-81 months). Complete healing of venous ulcer was achieved in six patients within 6 months. Ulceration persisted in six patients, and ulcer recurred in three patients after 17, 29, and 60 months, respectively. Postoperative duplex scans showed persistent insufficient perforating veins in about 25% of patients.ConclusionThere is a considerable difference between the results of SEPS on the medial side of the lower leg and the same procedure on the lateral side. SEPS on the lateral side of the lower leg, as performed in this small series, does not contribute to ulcer healing or recurrence. A considerable number of perforating veins are missed at surgery, resulting in persistent insufficient perforating veins postoperatively. The poor results of this study emphasize the need for adequate anatomic information to improve the surgical outcome
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