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1.
Cultur Divers Ethnic Minor Psychol ; 28(3): 361-369, 2022 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-34941283

RESUMEN

OBJECTIVES: The purpose of this study was to further understand the psychological process of migration through an interdisciplinary (psychology, history, and digital humanities) collaboration that examines the experiences of Somali refugees in the United States. METHOD: The sample consisted of 26 Somali American emerging adult and older adult refugees who created digital stories as part of the Immigrant Stories Project (https://immigrantstories.umn.edu/). Stories were analyzed through an examination of narrative structure and content. RESULTS: The structure of the authors' stories was primarily progressive or stable, with very few regressive stories. Although the distribution of these story structures did not differ for emerging adults and older adults, there were important variations in content. Emerging adults' stories reflected a struggle to find self-continuity across time and place, whereas older adults' stories indicated attempts to find meaning and optimally adapt to their current situations. Moreover, none of the stories took on a redemptive structure, a type of story that has been identified as culturally prevalent in U.S. culture but seldom examined across diverse populations. CONCLUSIONS: The findings highlight the varieties of paths toward successful immigration and the importance of taking a collaborative, participatory approach to understanding migration experiences. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Asunto(s)
Emigrantes e Inmigrantes , Refugiados , Anciano , Emigración e Inmigración , Humanos , Narración , Refugiados/psicología , Somalia , Estados Unidos
2.
Med J Aust ; 211(5): 224-229, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-31318068

RESUMEN

INTRODUCTION: Representatives appointed by relevant Australian medical societies used a systematic approach for adaptation of guidelines (ADAPTE) to formulate clinical consensus recommendations on assessment and management of bone health in women with oestrogen receptor-positive early breast cancer receiving endocrine therapy. The current evidence suggests that women receiving adjuvant aromatase inhibitors and pre-menopausal woman treated with tamoxifen have accelerated bone loss and that women receiving adjuvant aromatase inhibitors have increased fracture risk. Both bisphosphonates and denosumab prevent bone loss; additionally, denosumab has proven anti-fracture benefit in post-menopausal women receiving aromatase inhibitors for hormone receptor-positive breast cancer. MAIN RECOMMENDATIONS: Women considering endocrine therapy need fracture risk assessment, including clinical risk factors, biochemistry and bone mineral density measurement, with monitoring based on risk factors. Weight-bearing exercise and vitamin D and calcium sufficiency are recommended routinely. Anti-resorptive treatment is indicated in women with prevalent or incident clinical or morphometric fragility fractures, and should be considered in women with a T score (or Z score in women aged < 50 years) of < - 2.0 at any site, or if annual bone loss is ≥ 5%, considering baseline bone mineral density and other fracture risk factors. Duration of anti-resorptive treatment can be individualised based on absolute fracture risk. Relative to their skeletal benefits, risks of adverse events with anti-resorptive treatments are low. CHANGES IN MANAGEMENT AS RESULT OF THE POSITION STATEMENT: Skeletal health should be considered in the decision-making process regarding choice and duration of endocrine therapy. Before and during endocrine therapy, skeletal health should be assessed regularly, optimised by non-pharmacological intervention and, where indicated, anti-resorptive treatment, in an individualised, multidisciplinary approach.


Asunto(s)
Densidad Ósea , Neoplasias de la Mama/diagnóstico , Receptores de Estrógenos/genética , Inhibidores de la Aromatasa/uso terapéutico , Australia , Conservadores de la Densidad Ósea/uso terapéutico , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/genética , Femenino , Fracturas Óseas/prevención & control , Humanos , Nueva Zelanda , Sociedades Médicas , Vitamina D/uso terapéutico
3.
Clin Endocrinol (Oxf) ; 89(3): 280-296, 2018 09.
Artículo en Inglés | MEDLINE | ID: mdl-29741296

RESUMEN

To formulate clinical consensus recommendations on bone health assessment and management of women with oestrogen receptor-positive early breast cancer receiving endocrine therapy, representatives appointed by relevant Australian Medical Societies used a systematic approach for adaptation of guidelines (ADAPTE) to derive an evidence-informed position statement addressing 5 key questions. Women receiving adjuvant aromatase inhibitors and the subset of premenopausal woman treated with tamoxifen have accelerated bone loss and increased fracture risk. Both bisphosphonates and denosumab prevent bone loss; additionally, denosumab has proven antifracture benefit. Women considering endocrine therapy need fracture risk assessment, including clinical risk factors, biochemistry and bone mineral density (BMD) measurement, with monitoring based on risk factors. Weight-bearing exercise, vitamin D and calcium sufficiency are recommended routinely. Antiresorptive treatment should be considered in women with prevalent or incident clinical or morphometric fractures, a T-score (or Z-scores in women <50 years) of <-2.0 at any site, or if annual bone loss is ≥5%, considering baseline BMD and other fracture risk factors. Duration of antiresorptive treatment can be individualized based on absolute fracture risk. Relative to their skeletal benefits, risks of adverse events with antiresorptive treatments are low. Skeletal health should be considered in the decision-making process regarding choice and duration of endocrine therapy. Before and during endocrine therapy, skeletal health should be assessed regularly, optimized by nonpharmacological intervention and where indicated antiresorptive treatment, in an individualized, multidisciplinary approach. Clinical trials are needed to better delineate long-term fracture risks of adjuvant endocrine therapy and to determine the efficacy of interventions designed to minimize these risks.


Asunto(s)
Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/metabolismo , Receptores de Estrógenos/metabolismo , Anticuerpos Monoclonales/uso terapéutico , Anticuerpos Monoclonales Humanizados , Inhibidores de la Aromatasa/uso terapéutico , Conservadores de la Densidad Ósea/uso terapéutico , Neoplasias de la Mama/tratamiento farmacológico , Femenino , Humanos
4.
Vet Radiol Ultrasound ; 59(6): E66-E70, 2018 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-28419635

RESUMEN

A 6-year-old spayed female miniature schnauzer presented with generalized seizures and progressive multifocal intracranial neurologic disease. Thoracic radiographs and computed tomography (CT) revealed a large solitary pulmonary mass within the right cranial lung lobe. On brain magnetic resonance imaging (MRI), a solitary intraparenchymal mass within the left piriform lobe had a "target" appearance on both pre- and postcontrast sequences. Cerebrospinal fluid was unremarkable and histopathology indicated both masses represented histiocytic sarcoma. This case represents an uncommonly reported MRI appearance of histiocytic sarcoma in the canine brain and a large, solitary-appearing pulmonary histiocytic sarcoma in the same dog.


Asunto(s)
Neoplasias Encefálicas/veterinaria , Enfermedades de los Perros/diagnóstico por imagen , Sarcoma Histiocítico/veterinaria , Neoplasias Pulmonares/veterinaria , Imagen por Resonancia Magnética/veterinaria , Animales , Neoplasias Encefálicas/diagnóstico por imagen , Perros , Femenino , Sarcoma Histiocítico/diagnóstico por imagen , Neoplasias Pulmonares/diagnóstico por imagen , Radiografía Torácica/veterinaria , Tomografía Computarizada por Rayos X/veterinaria
5.
J Zoo Wildl Med ; 48(1): 232-236, 2017 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-28363038

RESUMEN

Baylisascaris procyonis larva migrans was diagnosed in two North American beavers ( Castor canadensis ) belonging to a zoological park in Clarke County, Georgia. Both beavers presented with neurological signs. One beaver died naturally and despite attempted treatment, the other beaver was euthanatized because of severe clinical signs and poor prognosis. Histologic evaluation of the beavers revealed evidence of parasitic migration characterized by several lesions, including eosinophilic granulomas in various organs, as well as necrotizing eosinophilic and lymphoplasmacytic to granulomatous polioencephalitis, leukoencephalitis and cervical leukomyelitis. This represents the first confirmed case of B. procyonis larva migrans in beaver and the first non-raccoon ( Procyon lotor ) host in the southeastern United States. This report highlights the need for clinicians and diagnosticians to consider baylisascariasis in animals with compatible clinical signs. Preventative measures should be considered for captive animals, because early diagnosis of B. procyonis is challenging, and treatment is often unrewarding.


Asunto(s)
Infecciones por Ascaridida/veterinaria , Ascaridoidea , Larva Migrans/veterinaria , Roedores , Animales , Animales de Zoológico , Infecciones por Ascaridida/diagnóstico , Infecciones por Ascaridida/parasitología , Resultado Fatal , Femenino , Larva Migrans/diagnóstico , Larva Migrans/parasitología , Masculino
6.
J Vet Intern Med ; 35(5): 2366-2373, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34476832

RESUMEN

BACKGROUND: Serum phosphorylated neurofilament-heavy chain (pNF-H) has not been longitudinally evaluated in dogs that develop progressive myelomalacia (PMM) after Type I intervertebral disc herniation (IVDH). OBJECTIVES: To determine if serum pNF-H concentrations would predict outcome of neuroligical disease in dogs with acute, severe thoracolumbar myelopathy secondary to Type I IVDH. ANIMALS: Thirty-nine client-owned dogs with thoracolumbar myelopathy secondary to IVDH. METHODS: Prospective controlled cohort study. Serum was collected from dogs undergoing hemilaminectomy at multiple timepoints. Final neurological status was established at 12 months and groups were stratified accordingly. Comparisons between outcome and pNF-H concentration at each timepoint was examined using Kruskal-Wallis analysis of variance on ranks and receiver operator characteristics curve analysis. RESULTS: Median serum pNF-H concentrations were not significantly different between deep pain negative dogs that did or did not recover at any timepoint (baseline: 0.37 ng/mL [0-0.9 ng/mL] vs 0 ng/mL [0-0.9 ng/mL], P > 1; 24 hours: 1.25 ng/mL [0.35-7.23 ng/mL] vs 1.53 ng/mL [0-11.94 ng/mL], P > 1; 48 hours: 1.22 ng/mL [0.63-6.62 ng/mL] vs 2.12 ng/mL [0-20.72 ng/mL], P > 1; 72 hours: 2.77 ng/mL [1.33-6.62 ng/mL] vs 16.69 ng/mL [4.02-40.12 ng/mL], P > 1). Dogs that developed PMM had significantly higher serum pNF-H concentrations after surgery compared to all other cohorts at 24 hours: 39.88 ng/mL (25.74-50.68 ng/mL); P < .05 and 72 hours: 223.9 ng/mL (155.4-263.7 ng/mL); P < .05. A serum pNF-H concentration ≥31.39 ng/mL was 83.33% sensitive and 100% specific for identifying PMM in this cohort. CONCLUSIONS AND CLINICAL IMPORTANCE: Serum pNF-H is a promising biomarker for antemortem diagnosis of PMM in dogs with acute, severe thoracolumbar myelopathy secondary to Type I IVDH.


Asunto(s)
Enfermedades de los Perros , Desplazamiento del Disco Intervertebral , Disco Intervertebral , Enfermedades de la Médula Espinal , Animales , Biomarcadores , Estudios de Cohortes , Enfermedades de los Perros/diagnóstico , Perros , Filamentos Intermedios , Desplazamiento del Disco Intervertebral/diagnóstico , Desplazamiento del Disco Intervertebral/veterinaria , Estudios Prospectivos , Enfermedades de la Médula Espinal/veterinaria
7.
Vet Med Sci ; 5(1): 5-18, 2019 02.
Artículo en Inglés | MEDLINE | ID: mdl-30394686

RESUMEN

Entotherapy an image-guided drug-eluting microcylinder platform, has the potential to bypass the limitations of systemic chemotherapy use in the treatment of canine brain tumours. Gliomas, which are common in dogs and also represent the majority of fatal brain tumours in humans, can be amenable to chemotherapy with temozolomide. Biopolymer microcylinders conjugated with temozolomide and gadolinium were implanted into partially resected tumours of four client-owned dogs with gliomas. All four dogs presented with generalized seizures and had mild to no neurologic deficits at the time of craniotomy. All dogs underwent craniotomy for implantation of the microcylinders into partially resected gliomas (glioblastoma multiforme {n = 1} or oligodendroglioma {n = 3}). All dogs recovered well from the craniotomy and implantation procedure. This novel procedure appears to be feasible and tolerated in tumour-bearing dogs. A future controlled clinical study can now aim to evaluate the microcylinder implantation for long-term efficacy.


Asunto(s)
Antineoplásicos Alquilantes/uso terapéutico , Neoplasias Encefálicas/veterinaria , Enfermedades de los Perros/economía , Glioma/veterinaria , Temozolomida/uso terapéutico , Animales , Antineoplásicos Alquilantes/administración & dosificación , Neoplasias Encefálicas/tratamiento farmacológico , Enfermedades de los Perros/tratamiento farmacológico , Enfermedades de los Perros/cirugía , Perros , Implantes de Medicamentos , Femenino , Glioma/tratamiento farmacológico , Glioma/cirugía , Masculino , Temozolomida/administración & dosificación
8.
Vet Clin North Am Small Anim Pract ; 46(2): 253-63, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-26704659

RESUMEN

Primary intracranial cystic or cyst-like lesions include intra-arachnoid, epidermoid, dermoid, and choroid plexus cysts. Differentiation of these cystic lesions can usually be accomplished by imaging studies alone; however, some cysts are similar in appearance and require histopathology for definitive diagnosis. Clinical signs often reflect the location of the cysts within the intracranial cavity rather than the type of cyst. If clinical signs are significant and progressive, surgical removal is warranted and may be successful, although cystic contents could be harmful if allowed to contact surrounding brain parenchyma or meninges.


Asunto(s)
Quistes Aracnoideos/veterinaria , Encéfalo/anomalías , Enfermedades de los Perros/congénito , Quiste Epidérmico/veterinaria , Animales , Quistes Aracnoideos/congénito , Quistes Aracnoideos/diagnóstico , Quistes Aracnoideos/fisiopatología , Encéfalo/diagnóstico por imagen , Neoplasias Encefálicas/congénito , Neoplasias Encefálicas/veterinaria , Enfermedades de los Perros/diagnóstico , Enfermedades de los Perros/fisiopatología , Perros , Quiste Epidérmico/congénito , Quiste Epidérmico/diagnóstico , Quiste Epidérmico/fisiopatología , Femenino , Imagen por Resonancia Magnética/veterinaria , Masculino , Factores Sexuales
9.
J Am Vet Med Assoc ; 243(9): 1310-5, 2013 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-24134582

RESUMEN

OBJECTIVE: To evaluate the occurrence of perianesthetic complications in dogs undergoing MRI for suspected intracranial disease and identify risk factors associated with observed complications. DESIGN: Retrospective case-control study. ANIMALS: 238 client-owned dogs undergoing MRI of the brain. PROCEDURES: Signalment, clinical signs, neurologic examination findings, presumptive diagnosis, anesthesia-related variables, whether CSF was collected and CSF analysis results, severe perianesthetic complications (need for a ventilator following anesthesia or perianesthetic death), and anesthetic recovery time were recorded. Selected factors were compared between dogs with and without intracranial lesions and dogs with and without perianesthetic complications (including severe complications and prolonged anesthetic recovery [> 20 minutes from the end of anesthesia to extubation]). RESULTS: 3 of 149 (2%) dogs with and 0 of 89 dogs without intracranial lesions required ventilation following anesthesia; the difference was nonsignificant. Recovery time was significantly longer in dogs with (median, 15 minutes) than in dogs without (10 minutes) intracranial lesions. Abnormal mentation prior to anesthesia was the only clinical sign that differed significantly between dogs with (15/26 [58%]) and without (70/212 [33%]) perianesthetic complications. A significantly larger proportion of dogs with perianesthetic complications had intracranial masses (13/26 [50%]), compared with dogs without these complications (56/212 [26%]). CONCLUSIONS AND CLINICAL RELEVANCE: Dogs with complications were more likely to have had intracranial lesions than were dogs without complications, but few dogs had severe complications. Abnormal mentation was more common in dogs with than in dogs without complications. Prospective studies to further evaluate perianesthetic risk factors and procedures for improving outcomes in these patients are warranted.


Asunto(s)
Anestesia/veterinaria , Anestésicos/efectos adversos , Encefalopatías/veterinaria , Enfermedades de los Perros/diagnóstico , Imagen por Resonancia Magnética/veterinaria , Neuroimagen/veterinaria , Anestesia/efectos adversos , Animales , Encefalopatías/inducido químicamente , Encefalopatías/diagnóstico , Estudios de Casos y Controles , Enfermedades de los Perros/inducido químicamente , Enfermedades de los Perros/patología , Perros , Femenino , Masculino , Estudios Retrospectivos , Factores de Riesgo
10.
J Am Vet Med Assoc ; 241(2): 227-32, 2012 Jul 15.
Artículo en Inglés | MEDLINE | ID: mdl-22765369

RESUMEN

OBJECTIVE: To identify erythrocyte-bound immunoglobulin (Ig) isotypes in dogs with primary immune-mediated hemolytic anemia (IMHA). DESIGN: Retrospective case series. Animals-54 dogs with IMHA. PROCEDURES: Medical records of dogs with IMHA diagnosed between January 2001 and April 2010 were examined. Immunoglobulin isotype (tested via direct immunofluorescence by flow cytometry to identify erythrocyte-bound Ig), Hct, serum bilirubin concentration, presence of autoagglutination, degree of spherocytosis, duration of hospitalization, and 90-day outcome were recorded. RESULTS: The Hct on admission was significantly lower in dogs with IgG and IgM isotypes bound to erythrocytes, compared with dogs with a single Ig isotype, and the degree of spherocytosis was greater in dogs with IgG and IgM bound to erythrocytes, compared with dogs that only had IgM. Dogs with only IgM were not more likely to have autoagglutination, compared with dogs that only had IgG on the erythrocyte surface. Although Ig isotype was not associated with survival time, initial serum total bilirubin concentration was higher in nonsurvivors. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that dogs with IMHA with ≥ 2 Ig isotypes bound to erythrocytes, particularly IgG and IgM, are likely to have a more severe degree of anemia, spherocytosis, and autoagglutination.


Asunto(s)
Anemia Hemolítica/veterinaria , Enfermedades de los Perros/inmunología , Eritrocitos/metabolismo , Inmunoglobulinas/metabolismo , Anemia Hemolítica/inmunología , Animales , Perros , Femenino , Inmunoglobulinas/clasificación , Inmunoglobulinas/inmunología , Masculino , Estudios Retrospectivos
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