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At least 109 records · Page 6Linked to original sources
PubMed1991

Diagnosis by team work: an approach to conservatism.

In the Nottingham Breast Clinic 5000 new cases are seen annually; 3000 are sent because the general practitioner believes that he/she has found a lump. It is the diagnosis and management of this common problem that is considered in this chapter. The traditional management of the palpable breast lump included excision to establish accurate diagnosis; indeed up until 20 years ago even simple cysts were excised. Now most surgeons accept that a woman with no residual palpable abnormality after aspiration of blood-free fluid from a cyst requires no further treatment. Most solid breast lumps are benign on histological examination; their routine removal a mistake in judgement. The challenge in the management of a palpable lesion is to correctly diagnose all the cancers without having to remove those which are benign, unless the patient wishes.

Adenofibroma↗
PubMed1987

Reconstruction in head and neck cancer: a place for conservatism.

With the advent of microvascular free flaps and complex musculocutaneous flaps in head and neck reconstruction, simpler methods are often forgotten. Since complication rates have been high with more complex intraoral reconstructions, experience in 112 patients who were reconstructed using conservative methods whenever possible was reviewed. Complications were found to be minimal after simple reconstruction in less massive resections, and reconstructive results were satisfactory. More complex methods of reconstruction may well be reserved for those situations in which they are required for better results with respect to speech and swallowing.

Head and Neck Neoplasms↗
PubMed2002

Beyond conservatism and the boundaries of a medical discipline: a short history of the department of neurosurgery at kyoto university graduate school of medicine.

CONSTANT CHANGE AND the occasional fusion of two different entities can result in the creation of masterpieces, not only in art but also in neurosurgery. Chisato Araki is one of the pioneers of neurosurgery in Japan; his 2-year sojourn in the United States and Europe provided him with an extraordinary amount of experience. He traveled throughout the world at a time when it took 30 days to journey from Yokohama to New York, and he visited with most of the leading contemporary neurosurgeons and observed their operations, never abandoning his highly honed critical insights. Driven by passion and a deep sense of duty to pass on his knowledge and perspective, he became a beacon of hope and encouragement for young physicians working in a country devastated by war. His successor, Hajime Handa, established neurosurgery as one of the branches of neuroscience and fostered the collaborations and exchanges among different disciplines that have become a tradition and hallmark of our Department of Neurosurgery. Through anecdotes and glimpses of the evolution of neurosurgery at our institution, we offer insights into the unique nature of Japanese neurosurgery that may illuminate the path toward the resolution of some of the recent and enduring problems encountered in our specialty.

Education, Medical, Graduate↗
PubMed1978

Subcutaneous mastectomy: a plea for conservatism.

The course after subcutaneous mastectomy is not without problems and the esthetic results, even in the absence of complications, are frequently disappointing. The role of subcutaneous mastectomy in the management of breast pathology remains uncertain at this time.

Adult↗
PubMed2002

Uncertainty and conservatism in assessing environmental impact under paragraph 316(b): lessons from the Hudson River case.

Initially, regulation of cooling water intakes under paragraph 316(b) was extremely conservative due to the rapid increase predicted for generating capacity, and to the uncertainty associated with our knowledge of the effects of entrainment and impingement. The uncertainty arose from four main sources: estimation of direct plant effects; understanding of population regulatory processes; measurement of population parameters; and predictability of future conditions. Over the last quarter-century, the uncertainty from the first three sources has been substantially reduced, and analytical techniques exist to deal with the fourth. In addition, the dire predictions initially made for some water bodies have not been realized, demonstrating that populations can successfully withstand power plant impacts. This reduced uncertainty has resulted in less conservative regulation in some, but not all venues. New York appears to be taking a more conservative approach to cooling water intakes. The conservative approach is not based on regulations, but in a philosophy that power plant mortality is an illegitimate use of the aquatic resources. This philosophy may simplify permitting decisions, but it does not further the development of a science-based definition of adverse environmental impact.

Animals↗
PubMed2006

Patterns of diversification of Afrotropical Otiteselline fig wasps: phylogenetic study reveals a double radiation across host figs and conservatism of host association.

We studied the phylogenetic relationships of Otiteselline fig waSPS associated with Ficus in the Afrotropical region using rDNA sequences. African fig species usually host two species of Otiteselline fig waSPS. Phylogenetic analyses reveal that this pattern of association results from the radiation of two clades of waSPS superimposed on the fig system. Within each clade, wasp species generally cluster according to their host classification. The phylogenies of the two clades are also generally more congruent than expected by chance. Together these results suggest that Otiteselline wasp speciation is largely constrained by the diversification of their hosts. Finally, we show a difference in ovipositor length between the two Otiteselline species coexisting in the same Ficus species, which probably corresponds to ecological differences. The diversification of ecological niches within the fig is probably, with cospeciation, one of the key factors explaining the diversification and maintenance of species of parasites of the fig/pollinator system.

Animals↗
PubMed1994

Reducing conservatism in risk estimation for mixtures of carcinogens.

The excess cancer risk that might result from exposure to a mixture of chemical carcinogens usually must be estimated using data from experiments conducted with individual chemicals. In estimating such risk, it is commonly assumed that the total risk due to the mixture is the sum of the risks of the individual components, provided that the risks associated with individual chemicals at levels present in the mixture are low. This assumption, while itself not necessarily conservative, has led to the conservative practice of summing individual upper-bound risk estimates in order to obtain an upper bound on the total excess cancer risk for a mixture. Less conservative procedures are described here and are illustrated for the case of a mixture of four carcinogens.

Animals↗