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Largest Cause (largest + cause)
Selected AbstractsGranular cell tumors of the esophagus: report of five cases and review of diagnostic and therapeutic techniquesDISEASES OF THE ESOPHAGUS, Issue 5 2007L. De Rezende SUMMARY., Granular cell tumors (GCT) of the esophagus are stromal lesions originating from the Schwann cells of the submucosal neuronal plexus. Although they are very infrequent, they constitute the second largest cause of non-epithelial tumors in the esophagus after leiomyomas. These tumors are generally benign, although a certain number of malignant, aggressive cases have been reported. Diagnosis requires that this possibility be ruled out before deciding on which course of therapeutic action to take as well as familiarization with the relevant indicators. GCT linked synchronically or metachronically to other malignant neoplasias of the esophagus have also been described, but the actual extent of this association is uncertain. This report describes five cases of GCT recently diagnosed as incidental findings following endoscopic exploration. All of these were benign and were treated conservatively. The article discusses new aspects relating to the diagnosis of these lesions and the role carried out by endoscopic ultrasonography in their characterization, both at preliminary diagnosis and monitoring levels. No standard therapeutic guidelines exist for the management of GCT, but endoscopic treatment without invading the muscularis propria layer would be used for symptomatic patients, creating histopathological doubts requiring research on the entire organ. Endoscopic therapeutic techniques are analyzed (resection with forceps or diathermy handles, yttrium-aluminum-garnet laser ablation, alcohol injection) in esophageal GCT, which have overtaken surgery in most cases due to their efficiency, greater safety and fewer complications. [source] Factors affecting nest predation on forest songbirds in North AmericaIBIS, Issue 2007FRANK R. THOMPSON III Nest predation is an important factor in the ecology of passerines and can be a large source of mortality for birds. I provide an overview of factors affecting nest predation of passerines in North America with the goal that it may provide some insight into the ecology and management of woodland birds in the United Kingdom. Although several factors influence productivity, nest success is perhaps the most widely measured demographic characteristic of open-cup-nesting birds, and nest predation is usually the largest cause of nest failure. The identity of predator species, and how their importance varies with habitat and landscape factors, must be known for managers and scientists to design effective conservation plans and place research on nest predation in the appropriate context. Recent studies using video surveillance have made significant contributions to our understanding of the relative importance of different predator taxa in North America. Spatial and temporal variation in nest predation can be better understood when landscapes are placed in a biogeographical context and local habitat and nest-site effects are placed in a landscape context. Low productivity resulting from high nest predation is one of several potential causes of bird population declines in North America and the UK. Although the ,forest fragmentation paradigm' from the eastern US may not apply directly to the UK, thinking about avian demographics from a multiscale perspective, and consideration of factors affecting nest predation with knowledge of the dominant predator species, may provide insight into population declines. [source] Consent and long-term neuroleptic treatmentJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 4 2002N. R. Harris phd bsc(hons) rmn The involvement of clients in the process of developing their care and treatment package is well established. If a genuine collaboration in treatment is achieved one of the fundamental bases of this process lies with ,informed consent'. Neuroleptic medication forms the basis of relapse prevention treatment for people suffering from schizophrenia with non-adherence to treatment seen as the largest cause of relapse. This paper reviews the complex and difficult issues in obtaining informed consent for this client group from within the context of the nurse's role and the problems that arise as a consequence of the blurring of professional boundaries. Throughout the paper reference is made to the expectations made by the UKCC, which provides clarification of nurses' practice in this area. [source] Translational Mini-Review Series on Immunology of Vascular Disease: Inflammation, infections and Toll-like receptors in cardiovascular diseaseCLINICAL & EXPERIMENTAL IMMUNOLOGY, Issue 3 2009J. R. Ward Summary Cardiovascular disease, in which atherosclerosis is the major underlying cause, is currently the largest cause of death in the world. Atherosclerosis is an inflammatory disease characterized by the formation of arterial lesions over a period of several decades at sites of endothelial cell dysfunction. These lesions are composed of endothelial cells, vascular smooth muscle cells, monocytes/macrophages and T lymphocytes (CD4+). As the lesions progress some can become unstable and prone to disruption, resulting in thrombus formation and possibly a myocardial infarction or stroke depending upon the location. Although the exact triggers for plaque disruption remain unknown, much recent evidence has shown a link between the incidence of myocardial infarction and stroke and a recent respiratory tract infection. Interestingly, many reports have also shown a link between a family of pattern recognition receptors, the Toll-like receptors, and the progression of atherosclerosis, suggesting that infections may play a role in both the progression of atherosclerosis and in inducing the more severe complications associated with the disease. [source] Human survivability in motor vehicle firesFIRE AND MATERIALS, Issue 4 2008K. H. Digges Abstract Automobile fires are consistently among the largest causes of fire death in the United States (about 500 annually) and the U.S. motor vehicle industry and others have spent a significant amount of money in recent years studying this problem. The authors of this review have analyzed the auto industry reports, the scientific literature, and statistical data, and conclude that measures should be taken to improve survivability in automobile fires. The U.S. Federal Motor Vehicle Safety Standard 302 (FMVSS 302) was introduced almost 40 years ago to measure the flammability of interior materials, but improvements in the crashworthiness of automobiles and their fuel tanks and the increased use of combustible materials have changed the motor vehicle fire scenario significantly. In particular, the primary threat has changed from ignition of a small quantity of combustible interior materials by a lit cigarette, in 1960, to ignition of a large quantity of combustible interior and exterior materials by an impact-induced fire, at present. The authors therefore suggest that FMVSS 302 is no longer relevant to automobile fire safety and recommend improved standards based on objective criteria for fire safety performance (fireworthiness) at the system/vehicle level as is routinely done for crashworthiness. Copyright © 2008 John Wiley & Sons, Ltd. [source] | ||||||||||