Asunto(s)
Enfermedades Renales/epidemiología , Trasplante de Hígado/efectos adversos , Complicaciones Posoperatorias/epidemiología , Lesión Renal Aguda/etiología , Lesión Renal Aguda/prevención & control , Adulto , Calcineurina/efectos adversos , Femenino , Humanos , Inmunosupresores/uso terapéutico , Incidencia , Enfermedades Renales/etiología , Fallo Renal Crónico/etiología , Fallo Renal Crónico/prevención & control , Fallo Renal Crónico/terapia , Pruebas de Función Renal , Pruebas de Función Hepática , Trasplante de Hígado/inmunología , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Diálisis Renal , Estudios RetrospectivosRESUMEN
BACKGROUND: Mammographic screening for breast cancer not only reduces the overall mortality from breast cancer but allows greater opportunities for breast-conserving operations. The predicted degree of breast conservation is not being realized, but is increasing in centres that have published their results. METHODS: The operative management of breast cancers diagnosed by BreastScreen Central and Eastern Sydney Screening and Assessment Service were compared between two time periods: January 1988-December 1992 (group 1) and January 1993-December 1995 (group 2). The rate of breast conservation, and other data were compared between the two periods. An attempt was made with multivariate analysis to identify some of the factors that made mastectomy rather than conservation more likely. RESULTS: There were 723 cancers detected that were suitable for analysis (group 1, n = 273; group 2, n = 450). In group 1 the breast conservation rate was 42.9%; this increased significantly to 60.4% in group 2 (P < 0.001). The data were examined to determine if there was any other factor that had changed over the time periods which might account for the increased rate of breast conservation. The use of pre-operative diagnostic techniques such as fine needle aspirate cytology and core biopsy increased significantly. Multivariate analysis comparing the differences in patient age, diagnostic technique, tumour type, grade, size, location and lymph node status, both independently and compositely did not account for the increase in breast conservation in group 2. CONCLUSION: The increase in breast conservation is due to other factors such as the surgeons' approach and patient attitude. The use of pre-operative, minimally invasive tissue sampling techniques is increasing.
Asunto(s)
Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/cirugía , Mamografía , Tamizaje Masivo , Adulto , Anciano , Anciano de 80 o más Años , Biopsia/estadística & datos numéricos , Mama/patología , Neoplasias de la Mama/patología , Femenino , Humanos , Metástasis Linfática , Mamografía/estadística & datos numéricos , Tamizaje Masivo/estadística & datos numéricos , Mastectomía/estadística & datos numéricos , Persona de Mediana Edad , Nueva Gales del Sur , Selección de Paciente , Radioterapia AdyuvanteAsunto(s)
Ácido Aspártico Endopeptidasas/química , Ácido Aspártico Endopeptidasas/metabolismo , Dipéptidos/metabolismo , Morfolinas/metabolismo , Inhibidores de Proteasas/metabolismo , Conformación Proteica , Renina/antagonistas & inhibidores , Trichoderma/enzimología , Sitios de Unión , Cristalografía por Rayos X , Dipéptidos/química , Humanos , Enlace de Hidrógeno , Modelos Moleculares , Morfolinas/química , Inhibidores de Proteasas/químicaRESUMEN
In two comparable series of medicolegal necropsies the lead content of ribs was found to be much higher in three soft water than in three hard water towns in England and Wales. Fourteen out of 96 "overnight" tap water samples from five soft water and five hard water towns in England and Wales and from Glasgow (soft water) had lead concentrations of over 0.1 p.p.m.; values over 0.3 p.p.m. were found only in Glasgow. The possible relevance of the findings to the association of cardiovascular disease and soft drinking water is discussed.
Asunto(s)
Huesos/análisis , Plomo/análisis , Abastecimiento de Agua , Adulto , Autopsia , Enfermedades Cardiovasculares/mortalidad , Enfermedad Coronaria/etiología , Inglaterra , Femenino , Humanos , Masculino , Persona de Mediana Edad , Escocia , GalesAsunto(s)
Calcio/efectos adversos , Enfermedades Cardiovasculares/mortalidad , Ablandamiento del Agua , Abastecimiento de Agua , Adulto , Anciano , Presión Sanguínea , Calcio/orina , Colesterol/sangre , Creatinina/orina , Muerte Súbita , Electrocardiografía , Auscultación Cardíaca , Frecuencia Cardíaca , Hematócrito , Humanos , Hipertensión/epidemiología , Magnesio/orina , Masculino , Persona de Mediana Edad , Fosfatos/orina , Aptitud Física , Pruebas de Función Respiratoria , Fumar , Reino UnidoAsunto(s)
Enfermedad Coronaria/etiología , Abastecimiento de Agua , Anciano , Arteriosclerosis/etiología , Cadmio/efectos adversos , Calcio/efectos adversos , Calcio/análisis , Carbonato de Calcio/análisis , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/mortalidad , Enfermedad Coronaria/epidemiología , Enfermedad Coronaria/mortalidad , Femenino , Humanos , Plomo/análisis , Magnesio/análisis , Masculino , Persona de Mediana Edad , Potasio/análisis , Sodio/análisis , Trombosis/etiología , Oligoelementos/análisis , Contaminación Química del Agua , Ablandamiento del Agua , Equilibrio HidroelectrolíticoAsunto(s)
Calcio , Mortalidad Infantil , Abastecimiento de Agua , Adulto , Análisis de Varianza , Anencefalia/epidemiología , Inglaterra , Exposición a Riesgos Ambientales , Femenino , Muerte Fetal/epidemiología , Humanos , Lactante , Recién Nacido , Edad Materna , Paridad , Embarazo , Factores Socioeconómicos , GalesRESUMEN
Cardiovascular diseases are often found to be associated with certain physicochemical characteristics of the environment-namely, the hardness of the water and the types of rock and soil underlying the area. Areas supplied with soft water usually have higher cardiovascular death rates than do areas supplied with hard water. Evidence linking cardiovascular diseases with the geochemistry of rocks and soils is more limited. The nature of these associations is still speculative but it is possible that certain trace elements are involved, some being beneficial and others harmful. Further epidemiological studies to identify these various trace elements are desirable.