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Internal curing

Xem 1-20 trên 25 kết quả Internal curing
  • This study attempts to utilize cold-bonded fly ash based artificial lightweight aggregate (ALWA) and retrieved unground rice husk ash (URHA) as internal curing (IC) agents for improving performance of typical supersulfated cement (SSC) mortar fabricated with ternary mixture of 85% slag, 10% gypsum, and only 5% blended Portland cement (PCB).

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  • Duration of Therapy and Treatment Failure Until recently, there was little incentive to establish the most appropriate duration of treatment; patients were instructed to take a 7- or 10-day course of treatment for most common infections. A number of recent investigations have evaluated shorter durations of therapy, especially in patients with communityacquired pneumonia. Table 127-10 lists common bacterial infections for which treatment duration guidelines have been established or for which there is sufficient clinical experience to establish treatment durations.

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  • Distribution To be effective, concentrations of an antibacterial agent must exceed the pathogen's MIC. Serum antibiotic concentrations usually exceed the MIC for susceptible bacteria, but since most infections are extravascular, the antibiotic must also distribute to the site of the infection. Concentrations of most antibacterial agents in interstitial fluid are similar to free-drug concentrations in serum.

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  • Harrison's Internal Medicine Chapter 127. Treatment and Prophylaxis of Bacterial Infections Treatment and Prophylaxis of Bacterial Infections: Introduction The development of vaccines and drugs that prevent and cure bacterial infections was one of the twentieth century's major contributions to human longevity and quality of life. Antibacterial agents are among the most commonly prescribed drugs of any kind worldwide. Used appropriately, these drugs are lifesaving.

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  • Acute Myeloid Leukemia: Treatment Treatment of the newly diagnosed patient with AML is usually divided into two phases, induction and postremission management (Fig. 104-2). The initial goal is to quickly induce CR. Once CR is obtained, further therapy must be used to prolong survival and achieve cure. The initial induction treatment and subsequent postremission therapy are often chosen based on the patient's age.

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  • Chronic Leukemia Allogeneic hematopoietic cell transplantation is the only therapy shown to cure a substantial portion of patients with chronic myeloid leukemia (CML). Fiveyear disease-free survival rates are 15–20% for patients transplanted for blast crisis, 25–50% for accelerated-phase patients, and 60–70% for chronic phase patients, with cure rates as high as 80% at selected centers. Use of unrelated donors results in more GVHD and slightly worse survival than seen with matched siblings, although 3-year disease-free survival rates of 70% have been reported at some large centers.

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  • Aplastic Anemia Transplantation from matched siblings after a preparative regimen of highdose cyclophosphamide and antithymocyte globulin can cure up to 90% of patients

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  • Randomized studies comparing standard-dose therapy to high-dose melphalan therapy (HDT) with hematopoietic stem cell support have shown that HDT can achieve high overall response rates and prolonged progression-free and overall survival; however, few, if any, patients are cured.

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  • Rare patients with localized early stage mycosis fungoides can be cured with radiotherapy, often total-skin electron beam irradiation. More advanced disease has been treated with topical glucocorticoids, topical nitrogen mustard, phototherapy, psoralen with ultraviolet A (PUVA), electron beam radiation, interferon, antibodies, fusion toxins, and systemic cytotoxic therapy. Unfortunately, these treatments are palliative. Adult T Cell Lymphoma/Leukemia Adult T cell lymphoma/leukemia is one manifestation of infection by the HTLV-I retrovirus.

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  • Myelodysplasia: Treatment The therapy of MDS has been unsatisfactory. Only stem cell transplantation offers cure: survival rates of 50% at 3 years have been reported, but older patients are particularly prone to develop treatment-related mortality and morbidity. Results of transplant using matched unrelated donors are comparable, although most series contain younger and more highly selected cases.

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  • Uterine Cancer Incidence and Epidemiology Carcinoma of the endometrium is the most common female pelvic malignancy. Approximately 39,080 new cases are diagnosed yearly, although in most (75%), tumor is confined to the uterine corpus at diagnosis, and therefore most can be cured. The 7400 deaths yearly make uterine cancer only the eighth leading cause of cancer death in females.

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  • Screening In contrast to patients who present with advanced disease, patients with early ovarian cancers (stages I and II) are commonly curable with conventional therapy. Thus, effective screening procedures would improve the cure rate in this disease. Although pelvic examination and CA-125 can occasionally detect early disease, these are relatively insensitive screening procedures. Transvaginal sonography is often used, but significant false-positive results are noted, particularly in premenopausal women.

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  • Stages I and II Seminoma Inguinal orchiectomy followed by retroperitoneal radiation therapy cures ~98% of patients with stage I seminoma. The dose of radiation therapy (2500– 3000 cGy) is low and well tolerated, and the in-field recurrence rate is negligible. About 2% of patients relapse with supradiaphragmatic or systemic disease. Surveillance has been proposed as an option, and studies have shown that about 15% of patients relapse. The median time to relapse is 12–15 months, and late relapses (5 years) may be more frequent than with nonseminoma.

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  • Harrison's Internal Medicine Chapter 92. Testicular Cancer Testicular Cancer: Introduction Primary germ cell tumors (GCTs) of the testis, arising by the malignant transformation of primordial germ cells, constitute 95% of all testicular neoplasms. Infrequently, GCTs arise from an extragonadal site, including the mediastinum, retroperitoneum, and, very rarely, the pineal gland. This disease is notable for the young age of the afflicted patients, the totipotent capacity for differentiation of the tumor cells, and its curability; about 95% of newly diagnosed patients are cured.

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  • Metastatic Disease The primary goal of treatment for metastatic disease is to achieve complete remission with chemotherapy alone or with a combined-modality approach of chemotherapy followed by surgical resection of residual disease, as is done routinely for the treatment of germ cell tumors. One can define a goal in terms of cure or palliation on the basis of the probability of achieving a complete response to chemotherapy using prognostic factors, such as Karnofsky Performance Status (KPS) (...

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  • Most recurrences after a surgical resection of a large-bowel cancer occur within the first 4 years, making 5-year survival a fairly reliable indicator of cure. The likelihood for 5-year survival in patients with colorectal cancer is stagerelated (Fig. 87-3). That likelihood has improved during the past several decades when similar surgical stages have been compared. The most plausible explanation for this improvement is more thorough intraoperative and pathologic staging.

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  • Screening The rationale for colorectal cancer screening programs is that earlier detection of localized, superficial cancers in asymptomatic individuals will increase the surgical cure rate. Such screening programs are important for individuals having a family history of the disease in first-degree relatives. The relative risk for developing colorectal cancer increases to 1.75 in such individuals and may be even higher if the relative was afflicted before age 60.

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  • Gastric Adenocarcinoma: Treatment Complete surgical removal of the tumor with resection of adjacent lymph nodes offers the only chance for cure. However, this is possible in less than a third of patients. A subtotal gastrectomy is the treatment of choice for patients with distal carcinomas, while total or near-total gastrectomies are required for more proximal tumors. The inclusion of extended lymph node dissection in these procedures appears to confer an added risk for complications without enhancing survival.

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  • Head and Neck Cancer: Treatment Patients with head and neck cancer can be categorized into three clinical groups: those with localized disease, those with locally or regionally advanced disease, and those with recurrent and/or metastatic disease. Comorbidities associated with tobacco and alcohol abuse can affect treatment outcome and define long-term risks for patients who are cured of their disease. Localized Disease Nearly one-third of patients have localized disease; that is, T1 or T2 (stage I or stage II) lesions without detectable lymph node involvement or distant metastases.

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  • Clinical Characteristics There are four types of cutaneous melanoma (Table 83-2). In three of these—superficial spreading melanoma, lentigo maligna melanoma, and acral lentiginous melanoma—the lesion has a period of superficial (so-called radial) growth during which it increases in size but does not penetrate deeply. It is during this period that the melanoma is most capable of being cured by surgical excision. The fourth type—nodular melanoma—does not have a recognizable radial growth phase and usually presents as a deeply invasive lesion, capable of early metastasis.

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