Search PubMed⌕ Search

Biomedical subjects

M Greenberg

Publications and source records attributed to M Greenberg.

At least 325 records · Page 18Linked to original sources
PubMedDate not supplied

Cancer self-help groups and family physicians.

PURPOSE: Despite the phenomenal growth during the past decade of cancer self-help groups for adult patients with cancer, little research has been conducted to document the interface between these groups and healthcare professionals, especially physicians. This study was initiated to provide information about family physician practices, awareness, and attitudes about self-help groups. DESCRIPTION: A survey questionnaire was mailed to a random sample of Ontario family physicians drawn from the College of Family Physicians of Canada's membership database. RESULTS: A total of 911 completed questionnaires were returned, for a response rate of 64%. A majority (56.8%) of respondents were aware of at least one cancer self-help group in their region; 26.8% of these spoke frequently with their cancer patients about such groups. Most family physicians indicated that they were positively inclined toward cancer self-help groups, giving especially high ratings of helpfulness to sharing common experiences, overcoming isolation, feeling understood, and sharing information. Ratings of potential harm were low, with the most concern expressed about the possible provision of misinformation and the promotion of unconventional therapies. Responses to an open-ended question showed that many family physicians qualify their support for cancer self-help groups, depending on patient need, group composition, and leadership. CLINICAL IMPLICATIONS: Family physicians and other members of the cancer care team should give increased attention to informing cancer patients about the potential benefits of self-help groups. Efforts need to be made to assist cancer self-help groups in developing informational brochures and to ensure that groups are listed in cancer resource directories. Educational initiatives about self-help groups would be useful for family physicians and other health professionals engaged in the care of cancer patients.

Adult↗
PubMedDate not supplied

Ductal carcinoma in situ. Part I: Definition and diagnosis.

The frequency of diagnosis of ductal carcinoma in situ (DCIS) has increased in Australia, largely because of the national screening programme. Ductal carcinoma in situ presents a dilemma because of problems with its diagnosis and variations in reporting pathological and radiological findings, making it difficult to define optimal treatment and communicate information in a way that helps the patient understand the problems and make decisions. There is considerable inter-observer variation, particularly in differentiating low-grade DCIS from ductal hyperplasia, with or without atypia, but pathologists who participate in regular pathological review sessions vary less in their opinions. Mammography remains the main investigative tool for DCIS and the American College of Radiology has recommended standardized reports. A team approach is required for the removal and diagnosis of possible DCIS. Although the team may be best co-located in the one facility, this is not practical in many community hospital settings which lack on-site radiology and pathology services. The decision about how much breast tissue to remove will need to be made for each patient and depends on the size of the microcalcification and how suspicious the mammogram is for DCIS. We recommend the use of synoptic reports for DCIS, and we document the minimum factors that should be reported by pathologists. The evaluation and management of DCIS by a multidisciplinary team will allow the patient access to information required to make often difficult treatment decisions. In this paper, we review the literature about the natural history, pathology, cytology and radiology of DCIS and document the 20 critical steps required for the diagnosis of impalpable, mammographic microcalcifications suspected to be DCIS.

Biopsy↗
PubMedDate not supplied

Optic pathway/hypothalamic gliomas: a dilemma in management.

Optic pathway gliomas follow an unpredictable course. Some remain static for years; others increase rapidly in size and often lead to death. This unpredictability, along with the histological similarity of these tumors, has resulted in controversy about their management. We have reviewed the results of management of all 62 patients with a diagnosis of optic pathway/hypothalamic glioma treated at The Hospital for Sick Children during the years 1976-1990. Twelve patients received no direct treatment, and 3 only a biopsy. Six patients were treated with radiotherapy alone. Eight patients received radiotherapy following a biopsy. Seventeen patients were treated by resection alone and 16 had a resection followed by radiotherapy. Eight patients received chemotherapy in addition to other therapy, and in 5 of them the chemotherapy was given as an initial therapy. Forty-eight patients are well with their visual deficits but 7 of them are receiving hormone replacement therapy. Six patients have significant neurologic deficits and 8 have died.

Brain Neoplasms↗
PubMedDate not supplied

Salud Ocupacional.

Explore the source record for details and available documents.

Academies and Institutes↗
PubMedDate not supplied

Psychiatric presentations of epilepsy.

The abnormal neuronal excitability underlying seizure disorders may alter behavior. Behavioral alterations associated with epilepsy can occur during the ictal period, especially in patients who suffer partial seizures of temporal or frontal lobe origin, or during the interictal period in the setting of chronic temporolimbic seizure discharges. We use case descriptions to illustrate behavioral presentations of epilepsy that resemble primary psychiatric illnesses, including schizophrenic psychoses, mood disorders, panic disorder, and dissociative disorders. The varied secondary psychiatric syndromes produced by epilepsy are elucidated by a consideration of normal functions of temporal and frontolimbic structures. The clinical pictures provide clues to the causes of primary psychiatric disorders.

Adult↗
PubMedDate not supplied

Developing alternate revenue sources.

During the 1990s, with the proliferation of managed care and aggressive negotiating postures by insurance companies, the reimbursement paid to physicians decreased drastically. In order to compensate, physicians have had to extend their work week, reduce overhead or seek alternative revenue sources. Developing alternative sources of revenue without having to work additional hours is the most palatable option. In our practice, almost 15 percent of revenue is derived from alternate or non-physician revenues collected at 100 percent of posted charges. This article highlights some of these solutions and discusses their applicability and appropriateness within a practice.

Humans↗
PubMedDate not supplied

Blue Thursday? Homicide and suicide among urban 15-24-year-old black male Americans.

A comparative analysis was made of day of the week variations in homicide and suicide deaths among 15-24-year-old white males, black males, white females, and black females in the 22 counties with the most black persons in the United States. Thirty-seven percent of black Americans and 14 percent of white Americans lived in these densely populated counties. The authors expected a weekend excess of homicide and a Monday excess of suicide. They found a pronounced excess of homicides on weekends, especially among white males. A slight excess of suicide was observed on Monday, but other slight excesses of suicide were also found. Young black males exhibited an unexpected excess of homicides and suicides on Thursday. On Thursdays the black male-white male ratio for homicide was 1.43 and for suicide, 1.26. Possible explanations for the young black males' blue Thursday phenomenon are offered.

Adolescent↗
PubMedDate not supplied

Initial experience with the "Smart" laser in the treatment of atherosclerotic occlusions.

A dual laser system capable of distinguishing atherosclerotic plaque from components of normal arterial wall was used to deliver laser energy to cut a channel through occluded vessels. This system was used to facilitate balloon angioplasty of short (3-17 cm) total occlusions of the superficial femoral or popliteal arteries in 17 patients. In 10 patients the occluding lesion was traversed by the laser wire and patency was effectively restored by balloon angioplasty. Satisfactory luminal patency has persisted for 2 to 12 months (mean 6 months) in 9 cases; the lesion in the tenth patient restenosed at 3 months. The laser procedure was unsuccessful in all 3 cases with occlusions over 10 cm and in 4 others. There were no clinically important complications. This experience suggests that most patients who presently require interventional treatment can be managed by standard angioplasty methods and/or require a bypass operation. The "Smart" laser is safe and effective short-term in facilitating angioplasty in some patients in whom standard angioplasty techniques are not feasible. The implications of these findings are discussed.

Angiography↗
PubMedDate not supplied

Fine needle aspiration cytology of granulomatous mastitis. Report of a case and review of the literature.

A case of granulomatous mastitis diagnosed by fine needle aspiration (FNA) cytology alone is reported. A 24-year-old pregnant woman presented with a six-week history of a rapidly enlarging breast mass, considered clinically to be malignant. The FNA smears contained numerous aggregates of epithelioid histiocytes admixed with Langhans' and foreign-body giant cells, lymphocytes, neutrophilic leukocytes and apoptotic debris, leading to a diagnosis of granulomatous mastitis. The features of granulomatous mastitis and its differential diagnoses are discussed.

Adult↗
PubMedDate not supplied

The cytologic diagnosis of adenocarcinoma in situ of the cervix uteri and related lesions. II. Microinvasive adenocarcinoma.

Criteria for the cytologic diagnosis of microinvasive adenocarcinoma of the cervix have not been previously established. Such cytologic criteria were evolved through the detailed analysis of cervical smears from 40 histologically confirmed cases. The cellular features of cervical adenocarcinoma in situ (AIS) were always associated with microinvasion. Syncytia of glandular cells, small cells in very crowded sheets and papillary groupings of cells, when seen in conjunction with AIS, were suggestive of microinvasion. Dissociation of cells was common. Nuclear pleomorphism with an irregular chromatin pattern and inconspicuous-to-prominent nucleoli was frequently present. In some cases, a tumor diathesis was seen in the smear background. Using these criteria, our predictive accuracy for diagnosing microinvasive cervical adenocarcinoma is improving steadily and now approaches 50%. Ongoing investigation of these cases must include a diagnostic come biopsy to further improve the predictive accuracy for this lesion.

Adenocarcinoma↗
PubMedDate not supplied

The cytologic diagnosis of adenocarcinoma in situ of the cervix uteri and related lesions. III. Pitfalls in diagnosis.

Potential pitfalls in the cytologic diagnosis of adenocarcinoma in situ (AIS) of the cervix are illustrated by the presentation of three cases of benign cervical lesions initially diagnosed as AIS: cervical endometriosis, tubal metaplasia of the endocervix and changes due to a previous biopsy. The differential diagnosis of endocervical glandular abnormalities is discussed.

Adenocarcinoma↗
PubMedDate not supplied

The cytologic diagnosis of adenocarcinoma in situ of the cervix uteri and related lesions. I. Adenocarcinoma in situ.

Seventy cases of histologically confirmed adenocarcinoma in situ (AIS) of the cervix uteri have been predicted in this laboratory using cytologic criteria, which are illustrated in this paper. The architectural features that were of primary diagnostic importance included an exfoliation pattern consisting of sheets of cells and tissue fragments in the form of cellular strips and rosettes. Nuclear criteria allowed the distinction of AIS into well-differentiated and poorly differentiated types. The former showed nuclear enlargement, an oval nuclear shape, hyperchromasia and moderate-to-coarse granularity as usual features. In the latter, nuclear enlargement was even greater, with an oval-to-round shape, prominent nucleoli and chromatin that was usually only finely granular. Variant patterns of AIS included endocervical, endometrioid and intestinal subtypes, each with characteristic cytologic appearances that correspond closely with their histologic appearances. The evolution of the description of AIS reveals a range of precursor lesions that may match the range of invasive adenocarcinomas originating in the cervix. This suggests that invasive adenocarcinoma of the cervix uteri could be preventable as is its more common squamous counterpart.

Adenocarcinoma↗