Diagnosis.and.Management.of.Breast.Tumors.A.Practical.[taliem.ir]

Diagnosis and Management of Breast Tumors

Although the feld of radiology as a whole is subject to many levels of regulation and accreditation, breast imaging, and specifcally mammography, is a subspecialty subject to rigorous standards of care that are legally mandated in the United States. Two major entities collaboratively regulate breast imaging in the interests of quality and safety. Responding to issues and inconsistencies in matters pertaining to patient care and image quality, the American College of Radiology (ACR) developed the Mammography Accreditation Program in the late 1980’s as a means of periodic peer review and feedback from experts for improvement . Secondly, the Mammography Quality Standards Act (MQSA) was enacted by Congress in the 1990’s to set national quality standards through specifc regulatory requirements that were established by the Food and Drug Administration (FDA) for mammography . Under MQSA, all facilities that provide mammography services in the United States must be inspected by the FDA every year, earn accreditation by an FDA approved body (which includes the ACR, and the states of Arkansas, Iowa, and Texas) every 3 years, and be certifed by Health and Human Services every 3 years. Mammography facilities under the Department of Veterans Affairs, while not included in MQSA, undergo accreditation by the ACR to maintain the same standards of care.
Crohn's.Disease.and.Ulcerative.Colitis.From.[taliem.ir]

Crohn’s Disease and Ulcerative Colitis

The occurrence of IBD has been increasing in Western Europe and North America over several decades after the Second World War. It has been assumed that socioeconomic factors represent the most important explanation for this increase . A part of this increase may have been related to more awareness and recognition of the diseases, as well as generally better registration in all countries. It is important to realize that the general acceptance of endoscopy as the main internationally accepted diagnostic procedure is quite young, and that we may divide the history into a pre-endoscopic area before 1970, an early endoscopic period between 1970 and 1990 characterized by a relatively large heterogeneity among studies, and a post-endoscopic period from around 1990, whereafter a widespread distribution of equipment and skills of endoscopy enabled all countries to perform uniform diagnostic procedures (Table 1.1). Moreover, after this point in time, most international studies have been performed according to generally accepted definitions and criteria of diagnosis. However, even if we generally include only endoscopy-based studies, the heterogeneity of even the Western materials is striking and difficult to compare, regarding incidence, prevalence, and subtypes. One important reason for this is the selection of cohorts in the different countries. In most centers, the registration of IBD has been hospital based, by which the type of recorded patients were depending on the level of each hospital in the healthcare system of each country, including access to health care. Additionally, great variations exist in the recording systems, both between hospitals and between countries, and in how well the patients were characterized on the basis of first or later admissions .
Contemporary.Liver.Transplantation.The.Successful.Liver.[taliem.ir]

Contemporary Liver Transplantation

In the late 1950s, transplant models were developed in dogs for all of the intra-abdominal organs (Fig. 1). The most fruitful of these efforts involved the liver (Table 1) (Starzl TE (1969a) In: Starzl TE (ed) Experience in hepatic transplantation. WB Saunders, Philadelphia). In addition to its direct clinical application, the research in liver transplantation yielded new information about the metabolic interrelations of the intraabdominal viscera in disease and health; a more profound understanding of the mechanisms of organ alloengraftment; and the addition of new nontransplant procedures to the treatment armamentarium against gastrointestinal diseases.
Congenital.Vascular.Malformations.A.[taliem.ir]

Congenital Vascular Malformations

Mild as well as severe vascular anomalies have been described in ancient documents by authors such as Hippocrates , Ambrose Pare , Galen , and others. Some anomalies have been named after those who first described them, such as the KlippelTrenaunay, Maffucci, Servelle, Martorell, and Parkes Weber syndromes. Others have been named after Greek or Roman mythological monstrosities. As we review the features and names of some of the congenital vascular anomalies heretofore described, we cannot avoid but to notice the striking relationship with creatures and myths of the Greek and Roman mythology. It is fascinating to review the Pantheon of Greek and Roman gods and realize that the monstrous aspect and names of some of the congenital vascular anomalies that we observe in our clinics were often inspired by mythological creatures. The cirsoid aneurysm of the scalp, an arteriovenous malformation, resembles Medusa’s head where the hair was replaced by a nest of snakes , and the caput medusae, a net of paraumbilical veins, is formed in patients with portal hypertension due to liver cirrhosis. The sirenomelia, a severe and often fatal congenital anomaly, received its name by its resemblance to the Sirens mythological creatures . Let’s review the reasons behind these names.
The-secret-of-making-money- in- history(www.panteashop.ir).[taliem.ir]

بزرگترین راز پول درآوردن در تاریخ

قدرت بخشش: سال ها پیش بود. روز بسیار گرم تابستانی. من به سمت مغازه ی خواروبارفروشی می رفتم تا دو قلم از چیزهایی را که می خواستم تهیه کنم. در آن روزها، مدام برای خرید به مغازه می رفتم چرا که هیچوقت پول کافی نداشتم تا هفته ای یکبار مواد غذایی مورد نیازم را تهیه کنم. چند ماه قبل همسر جوانم را پس از یک نبرد غم انگیز با سرطان از دست داده بودم. هیچ بیمه ای هزینه را تقبل نمی کرد. فقط من مانده بودم و مخارج فراوان و کوهی از صورتحساب ها، یک کار پاره وقت به دست آورده بودم، که با پولش به سختی می توانستم غذای دو فرزندم را تهیه کنم. همه چیز بد بود، واقعا بد. و آنروز با قلبی سنگین و درحالی که 4دلار در جیبم داشتم، راهی مغازه شدم تا یک گالن شیر و یک قرص نان بخرم. بچه ها گرسنه بودند و من باید چیزی برای خوردن تهیه می کردم. همانطور که پشت چراغ قرمز منتظر بودم، توجهم به سمت راستم جلب شد که یک مرد و زن جوان ویک بچه روی چمن ها نشسته بودند. آفتاب نیم روز بی رحمانه بر آن ها می تابید در دست مرد کاغذی مقوایی بود که رویش نوشته شده بود: «ما غذا می خواهیم کمک مان کنید». زن در کنار او نشسته بود. او فقط به ماشین هایی که پشت چراغ بودند نگاه می کرد. بچه که احتمالا 2ساله بود، روی چمن ها نشسته و عروسک یک دستش را در آغوش گرفته بود. من در مدت سی ثانیه ای که چراغ سبز شد متوجه همه ی این ها شدم با تمام وجود می خواستم چند دلاری به آن ها بدهم، اما در این صورت، پول کافی برای خرید شیر و نان نداشتم. همانطور که چراغ سبز شد، برای آخرین بار نگاهی به آن ها انداختم در حالی که پر از حس گناه (به خاطر کمک نکردن به آن ها) و ناراحتی (به خاطر نداشتن پول کافی که با آن ها تقسیم کنم) بودم.
saheran-servat(www.panteaco.com).[taliem.ir]

ساحران ثروت

کیفیت زندگی انسان و اتفاقاتی که در طول عمر خود آنها را تجربه می کند هرگز از قبل برایش تعیین نشده است بلکه طبق اثبات علوم فیزیک کوانتوم همه ی اتفاقات خوب و بد از جمله ثروت و فقر به فرکانس هایی برمی گردد که از ذهن شخص به مجموعه کائنات ارسال می شود و قانون دقیق هستی هم جنس آن فرکانس را در قالب ایده ها – شرایط – اتفاقات و افراد به سوی او برمی گرداند مثلا شخص اندیشه های ضد پول تولید میکند مانند بیکاری در جامعه اوج گرفته و قیمت محصولات هر روز افزایش می یابد کاملا مشخص است که این اندیشه همراه با حس ترس – نا امیدی افسردگی – و غم همراه است و با سرعتی بالاتر از سرعت نور در کیهان پخش میشود و دقیقا هم جنس همین احساسات را در قالب اتفاقات زندگی به او برمیگرداند یعنی شرایطی برایش پیش خواهد که او را بیکار می کند و اتفاقاتی رقم می خورد که توانایی خرید مایحتاج زندگی خود را نخواهد داشت و عصبی – غمگین – و نا امید می شود و مطمئن باشید این پروسه دقیقا پروسه ساز و کار جهان هستی است و هیچ ربطی به تقدیر – شانس – و اقبال ندارد. دوستان هر یک از ما انسانها با توجه به اندیشه هایی که در طول شبانه روز در مغزمان تولید می کنیم در حال خلق اتفاقات زندگی خودمان هستیم در بدن هر یک از ما برق وجود دارد که می تواند یک لامپ کوچک را روشن کند لذا دقیقا اندیشه ها توسط مغز ما دارای یک ارتعاش الکترومغناطیسی هستند که با سرعت فوق سرعت نور به کیهان ارسال می شوند و یقین داشته باشید جای هیچ شک و گمانی نیست که اتفاقات زندگی خودتان را خود شما به سوی خوتان دعوت می کنید و در مدار آن اتفاقات و شرایط می چرخید به همین جهت است می بینیم بیش از 97درصد مردم جهان تا آخر عمر کیفیت زندگی خود را نمی توانند بالا ببرند و همان اتفاقات گذشته برایشان تکرار می شود چون جنس اندیشه خود را تغییر نداده اند لذا همان فرکانس های قبلی را تولید می کند و در مدار همان شرایط گذشته می چرخد.
elm-servatmand-shodan(panteashop.ir).[taliem.ir]

علم ثروتمند شدن يا موفقيت مالي از طريق تفكر خلاق

اين كتاب يك كتاب فلسفي نيست در عوض يك كتاب عملي است. يك رساله عملي است و يك مقاله تئوريكي نيست و براي مردان و زناني طراحي شده است كه نياز مبرمي به پول دارند؛ كساني كه ميخواهند اول ثروتمند شوند و بعد از آن به دنبال علم و فلسفه بروند. اين كتاب براي كساني است كه تا به حال وقت، ابزار و فرصت كافي براي مطالعه عميق متافيزيك نداشته اند ولي در عوض به دنبال نتيجهاند و ميخواهند از علم به عنوان پايه اي براي فعاليتها، نتيجه بگيرند بدون اينكه وارد فرآيندهايي شوند كه آن نتايج بدست ميآيند. از خواننده انتظار ميرود كه به مطالب اساسي اين كتاب به عنوان واقعيت بنگرد همان طور كه به مطالب مرتبط به قانون الكتريسيته مينگرد كه توسط ماركوني يا اديسون منتشر شده است و طوري به مطالب ايمان داشته باشد كه انگار اين ايمان را از طريق عمل كردن به آنها بدون شك و ترديد به دست آورده است. هر مرد يا زني كه اين كار را انجام دهد بدون شك ثروتمند ميشود. زيرا علمي كه در اين باره به كار ميرود يك علم دقيق است و شكست در آن غيرممكن است. با اين وجود براي اطمينان بيشتر كساني كه ميخواهند از طريق بررسي تئوريكي و علمي، پايه اي منطقي براي اعتقاد خود به وجود آورند، در اينجا برخي از مسائل اساسي را بيان خواهم كرد.
Histiocytic.Disorders.[taliem.ir]

Histiocytic Disorders

The “histiocytoses” have been a collective description of tissue proliferations of the hematopoietic-derived cells that compose both the monocyte-macrophage and the dendritic cell families. Our understanding of histiocytic disorders has evolved from the frst classifcation published by the Histiocyte Society (HS) Working Group in 1987 that included disorders of Langerhans cells (LC), non-Langerhans cell related, and the malignant histiocytoses (MH) . A more contemporary classifcation was laid out in 1997 by the World Health Organization (WHO) Committee on Histiocytic/Reticulum Cell Proliferations and the Histiocyte Society Reclassifcation Working Group (Table 1.1) . These classifcations were based on biologic behavior and histopathology, including dendritic cell related (e.g., Langerhans cell histiocytosis (LCH), juvenile xanthogranuloma (JXG) family), macrophage related (e.g., hemophagocytic syndromes, Rosai-Dorfman disease (RDD)), and malignant disorders, typically grouped by their most common morphologic/immunophenotypic counterpart. The histology together with the clinical features and stage of involvement had resulted in a unifying clinicopathologic diagnosis in most cases . However, the feld of histiocytic disorders is now within an era of “molecular enlightenment.” New molecular data are emerging that support the theory that LCH and Erdheim-Chester disease (ECD) (and possibly also systemic JXG lesions with gain of function mutations) are best classifed as inflammatory myeloid neoplasms .
A.Treatise.on.Topical.Corticosteroids.in.Dermatology.[taliem.ir]

A Treatise on Topical Corticosteroids in Dermatology

Corticosteroids are the steroidal compounds derived from the adrenal gland or prepared synthetically. Topical corticosteroids are mainly glucocorticoids. The frst use of corticosteroids was in the form of adrenal extracts which was reported in 1930 by Swingle et al. In the same year, Tadeus Reichstein in Zurich; Edward Kendall at the Mayo Clinic, USA; and Oskar Wintersteiner at Columbia had been able to isolate small amount of active steroid from the adrenal gland. Systemically it was used successfully to treat rheumatoid arthritis in 1948. Reichstein, Kendall and Hench received a ‘Nobel Prize’ for their work with adrenal steroids. The frst successful use of topical hydrocortisone in human dermatoses was reported in 1952 by Sulzberger and Witten. This landmark event opened up the avenue for the search of newer molecules with more potency and desirable properties. Gradually, the fluorinated compounds like flumethasone, flurandrenolone and triamcinolone were developed by early 1960. All these preparations were more potent than cortisone and hydrocortisone. The third generation of topical corticosteroids, betamethasone, beclomethasone or fluocinolone, found their places in the early 1960s which gradually extended their presence from systemic to topical therapy. Betamethasone, a remarkable one, after primarily systemic use, was placed successfully in the topical world in 1964. Betamethasone valerate was prepared by 1967 by esterifcation which further added to the potency of the parent compound.
Coloproctology.(European.Manual.[taliem.ir]

Coloproctology

In most European countries, colorectal surgery is not a certifed subspecialty. However, many countries have colorectal societies and annual meetings that focus on colorectal disease (Table 1.1). A survey among national representatives of the European Society of Coloproctology (ESCP) showed that formal fellowships in colorectal surgery exist in only 10 countries (Czech Republic, Denmark, Germany, Ireland, Israel, Italy, Netherlands, Russia, Sweden, United Kingdom), and 6 countries have board certifcation in colorectal surgery (Czech Republic, Denmark, Germany, Ireland, Israel, Russia). Five countries have a formal examination (Czech Republic, Ireland, Israel, Romania, Russia), including oral (in four countries), multiple choice (in three), and practical sections (in two). As much as the health care systems and hospital organizations vary among European countries, so too does colorectal training. Therefore, because colorectal subspecialization is becoming increasingly common, addressing the challenge of standardization is in the best interests of all of practitioners in the feld.