Patients with Gaucher type 1 (GD1) throughout Argentina were enrolled in the Argentine bone project to evaluate bone disease and its determinants. We focused on presence and predictors of bone lesions (BL) and their relationship to therapeutic goals (TG) with timing and dose of enzyme replacement therapy (ERT). A total of 124 patients on ERT were enrolled in a multi-center study. All six TG were achieved by 82% of patients: 70.1% for bone pain and 91.1% for bone crisis. However, despite the fact that bone TGs were achieved, residual bone disease was present in 108 patients on ERT (87%) at time 0. 16% of patients showed new irreversible BL (bone infarcts and avascular osteonecrosis) despite ERT, suggesting that they appeared during ERT or were not detected at the moment of diagnosis. We observed 5 prognostic factors that predicted a higher probability of being free of bone disease: optimal ERT compliance; early diagnosis; timely initiation of therapy; ERT initiation dose ≥45 UI/kg/EOW; and the absence of history of splenectomy. Skeletal involvement was classified into 4 major phenotypic groups according to BL: group 1 (12.9%) without BL; group 2 (28.2%) with reversible BL; group 3 (41.9%) with reversible BL and irreversible chronic BL; and group 4 (16.9%) with acute irreversible BL. Our study identifies prognostic factors for achieving best therapeutic outcomes, introduces new risk stratification for patients and suggests the need for a redefinition of bone TG. Am. J. Hematol. 91:E448-E453, 2016. © 2016 Wiley Periodicals, Inc.
Purpose The purpose of this study is to explore salesperson empathy and the moderating impact of positive/negative affect on a salesperson’s listening and adaptive selling behaviors. It also seeks to identify whether and how empathy influences performance. Design/methodology/approach The study’s hypothesis was analyzed using data collected from business-to-business salespeople working for a manufacturing firm. A partial least squares analysis was used to test the study’s proposed hypotheses. Findings The results of this study show that empathy and the moderating role of positive affect foster desirable sales behaviors (listening and adaptive selling behaviors) that subsequently enhance in-role (expected) and extra-role (discretionary) performance. Originality/value Contributions from the findings enhance the literature through its consideration of how the direct effect of empathy on sales behaviors (a salesperson’s listening and adapting selling behavior) is moderated by the salesperson’s positive and negative affect and how sales behaviors impact final sales outcomes (in-role and extra-role performance).
Resumen Introducción: Debido a la gran diversidad de patología quirúrgica de la glándula tiroides y su alta frecuencia en nuestro medio, creemos conveniente presentar nuestra experiencia en esta patología. Objetivos: Conocer la incidencia de la patología quirúrgica de la glándula tiroides, según diagnóstico anatomopatológico, en pacientes operados. Diseño: Estudio retrospectivo, observacional y descriptivo. Lugar: Servicio de cirugía de cabeza y cuello, Hospital Dos de Mayo, Lima, Perú, hospital de enseñanza médica. Participantes: Pacientes operados de la glándula tiroides. Intervenciones: Se revisó las historias clínicas de pacientes operados de la glándula tiroides, desde enero de 1997 hasta diciembre de 2006. Principales medidas de resultados: Resultados anatomopatológicos en los especímenes de glándula tiroides. Resultados: Hubo 274 casos operados, de los cuales 81,4% del total correspondió al sexo femenino; 56,9% de los casos provenía de fuera de Lima y Callao, con edades que fluctuaban desde los 30 y 59 años. El tumor fue el signo predominante en 97,8% de los casos. La operación realizada más frecuente fue la tiroidectomía total (39,8%). La patología benigna representó 58% de los casos, con el adenoma folicular como principal patología benigna (23%); dentro de las neoplasias malignas (42% del total), 23,7% era carcinoma papilar. Conclusiones: La patología tumoral tiroidea presentó un marcado predominio en el sexo femenino, principalmente en los grupos etáreos de la 4 a , 5 a y 6 a décadas. La patología glandular tiroidea fue en su mayoría benigna, y de la maligna, el carcinoma papilar. Con alto valor de especificidad (97,7%) y valor predictivo positivo (95,4%), la biopsia de aspiración por aguja fina de tiroides continúa siendo el examen auxiliar más importante en el estudio del paciente con patología tumoral tiroidea. Palabras clave: Patología quirúrgica; glándula tiroides; cirugía; neoplasias. AbstractIntroduction: Due to the great diversity and variety of thyroid surgical pathology in our country, we review our experience with this pathology. Objectives: To determine the incidence of thyroid gland surgical pathology in patients undergoing surgery. Design: Descriptive and retrospective study. Setting: Head and neck service, Hospital Dos de Mayo, Lima, Peru, a teaching hospital. Participants: Patients undergoing surgery of the thyroid gland. Interventions: Clinical histories and surgical reports involving the thyroid gland in the period January 1997 through December 2006 were reviewed. Main outcome measures: Pathology results of thyroid gland surgical specimens. Results: Two hundred and seventy four cases had thyroid surgery, 81,4% females; 56,9% of the cases corresponded to Lima, capital of Peru. Incidence was higher between 30 and 59 years of age. Growing tumor was the most frequent sign with 97,8%. Total thyroidectomy was the most frequent surgery (39,8%). Benign pathologies represented 58% of the cases, with follicular adenoma as the main pathology (23%); and for malignant tumors (42% from the total) ...
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