Biomedical subjects

T P Baker

Publications and source records attributed to T P Baker.

3 recordsLinked to original sources

PubMed1996

Descriptive and normative ethics: conscientious objection.

Conscientious objection preserves the personal integrity and wholeness of a health care professional's character and personality. Professionals are obligated not only to codes of ethics and standards of care that guide their practices, but also to personal values. When professional and personal values conflict with health care delivery, nurses are compelled to object on moral grounds on behalf of themselves and the public they serve.

Clinical Competence↗

PubMedDate not supplied

Hepatitis B or C virus serology as a prognostic factor in patients with hepatocellular carcinoma.

It is not clear whether chronic hepatitis B or C virus (HBV or HCV) infection is a prognostic factor for hepatocellular carcinoma. We performed this study to determine if chronic HBV or HCV infection had any impact on postresection survival or affected patterns of failure. The records of 77 patients undergoing surgical resection for hepatocellular carcinoma between January 1990 and December 1998 were reviewed. Forty-four patients (57%) had HCV infection, 18 patients (23%) had HBV infection, and 15 patients (20%) had negative serology. There were no differences in age, sex, or tumor size among the groups, and all patients had margin-negative resections. There was a significantly higher incidence of satellitosis and vascular invasion in patients with HCV infection (32% and 41% respectively; P <0.05 vs. other groups). With a median follow-up of 30 months, a significantly decreased local disease-free survival (LDFS) was seen in HBV-positive (5-year LDFS 26%) or HCV-positive (5-year LDFS 38%) patients compared to those with negative serology (5-year LDFS 79%; P <0.05). There was also a trend toward a decreased overall survival in patients with positive hepatitis serology compared to patients with negative serology (37% vs. 79%; P = 0.12). Univariate analysis revealed that only satellitosis was related to local recurrence and overall survival. Patients with positive serology for hepatitis B or C undergoing resection for hepatocellular carcinoma have a trend toward worse overall prognosis and a significantly decreased LDFS when compared to patients with negative serology.

Carcinoma, Hepatocellular↗

PubMedDate not supplied

Lactating adenoma: a diagnosis of exclusion.

This is a case of a large lactating adenoma which developed in a 26 year old primagravida during the third trimester of her pregnancy. The presentation was that of a grossly enlarged and engorged breast with breast erythema, warmth and tenderness. Radiologic and pathologic examinations were difficult because of the lactational changes in the breast and areas of infarcted tissue within the large tumor. Skin biopsies and core biopsies of the mass were performed to exclude malignancy. Surgical resection of the mass was necessary for definitive diagnosis. The pathology proved to be a lactating adenoma, which is the most prevalent breast mass in young pregnant females. The large size of this tumor, and the presentation of breast erythema and edema raised the possibility of inflammatory breast cancer. Following surgical resection and definitive diagnosis of this tumor, the patient required plastic surgical reconstruction of the breast because of redundant breast tissue. Although most lactating adenomas spontaneously involute, the diagnosis is not always straight-forward and surgical resection may be required for definitive diagnosis and exclusion of other pathologic processes.

Adenoma↗