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1.
Eur Phys J A Hadron Nucl ; 59(10): 232, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37860634

RESUMO

The target asymmetry T, recoil asymmetry P, and beam-target double polarization observable H were determined in exclusive π0 and η photoproduction off quasi-free protons and, for the first time, off quasi-free neutrons. The experiment was performed at the electron stretcher accelerator ELSA in Bonn, Germany, with the Crystal Barrel/TAPS detector setup, using a linearly polarized photon beam and a transversely polarized deuterated butanol target. Effects from the Fermi motion of the nucleons within deuterium were removed by a full kinematic reconstruction of the final state invariant mass. A comparison of the data obtained on the proton and on the neutron provides new insight into the isospin structure of the electromagnetic excitation of the nucleon. Earlier measurements of polarization observables in the γp→π0p and γp→ηp reactions are confirmed. The data obtained on the neutron are of particular relevance for clarifying the origin of the narrow structure in the ηn system at W=1.68GeV. A comparison with recent partial wave analyses favors the interpretation of this structure as arising from interference of the S11(1535) and S11(1650) resonances within the S11-partial wave.

2.
Phys Rev Lett ; 126(16): 162501, 2021 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-33961478

RESUMO

We report the first measurement of the average of the electron-proton and positron-proton elastic scattering cross sections. This lepton charge-averaged cross section is insensitive to the leading effects of hard two-photon exchange, giving more robust access to the proton's electromagnetic form factors. The cross section was extracted from data taken by the OLYMPUS experiment at DESY, in which alternating stored electron and positron beams were scattered from a windowless gaseous hydrogen target. Elastic scattering events were identified from the coincident detection of the scattered lepton and recoil proton in a large-acceptance toroidal spectrometer. The luminosity was determined from the rates of Møller, Bhabha, and elastic scattering in forward electromagnetic calorimeters. The data provide some selectivity between existing form factor global fits and will provide valuable constraints to future fits.

3.
Eur Phys J A Hadron Nucl ; 57(1): 40, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33551676

RESUMO

A measurement of the double-polarization observable E for the reaction γ p → π 0 p is reported. The data were taken with the CBELSA/TAPS experiment at the ELSA facility in Bonn using the Bonn frozen-spin butanol (C 4 H 9 OH) target, which provided longitudinally-polarized protons. Circularly-polarized photons were produced via bremsstrahlung of longitudinally-polarized electrons. The data cover the photon energy range from E γ = 600 to 2310 MeV and nearly the complete angular range. The results are compared to and have been included in recent partial wave analyses.

4.
Phys Rev Lett ; 125(15): 152002, 2020 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-33095637

RESUMO

Data on the beam asymmetry Σ in the photoproduction of η mesons off protons are reported for tagged photon energies from 1130 to 1790 MeV (mass range from W=1748 MeV to W=2045 MeV). The data cover the full solid angle that allows for a precise moment analysis. For the first time, a strong cusp effect in a polarization observable has been observed that is an effect of a branch-point singularity at the pη^{'} threshold [E_{γ}=1447 MeV (W=1896 MeV)]. The latest BnGa partial wave analysis includes the new beam asymmetry data and yields a strong indication for the N(1895)1/2^{-} nucleon resonance, demonstrating the importance of including all singularities for a correct determination of partial waves and resonance parameters.

5.
Phys Rev Lett ; 118(9): 092501, 2017 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-28306315

RESUMO

The OLYMPUS Collaboration reports on a precision measurement of the positron-proton to electron-proton elastic cross section ratio, R_{2γ}, a direct measure of the contribution of hard two-photon exchange to the elastic cross section. In the OLYMPUS measurement, 2.01 GeV electron and positron beams were directed through a hydrogen gas target internal to the DORIS storage ring at DESY. A toroidal magnetic spectrometer instrumented with drift chambers and time-of-flight scintillators detected elastically scattered leptons in coincidence with recoiling protons over a scattering angle range of ≈20° to 80°. The relative luminosity between the two beam species was monitored using tracking telescopes of interleaved gas electron multiplier and multiwire proportional chamber detectors at 12°, as well as symmetric Møller or Bhabha calorimeters at 1.29°. A total integrated luminosity of 4.5 fb^{-1} was collected. In the extraction of R_{2γ}, radiative effects were taken into account using a Monte Carlo generator to simulate the convolutions of internal bremsstrahlung with experiment-specific conditions such as detector acceptance and reconstruction efficiency. The resulting values of R_{2γ}, presented here for a wide range of virtual photon polarization 0.456<ε<0.978, are smaller than some hadronic two-photon exchange calculations predict, but are in reasonable agreement with a subtracted dispersion model and a phenomenological fit to the form factor data.

6.
Clin Obes ; 5(5): 237-44, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26222044

RESUMO

Weight loss is associated with improved quality of life in some, but not all, weight loss trials. We evaluated changes at 56 weeks in quality of life, measured by the Impact of Weight on Quality of Life-Lite (IWQOL-Lite) questionnaire, in a pooled analysis of patient-level data from four randomized controlled Phase 3 studies of naltrexone/bupropion (NB32 or Contrave®). The total number of subjects was 3362 (NB32 = 2043; placebo = 1319; mean body mass index = 36.3 kg m(2); mean age = 46). Improvements in IWQOL-Lite Total Score were greater in subjects treated with NB32 (11.9 points [SE 0.3]) vs. placebo (8.2 points [SE 0.3]; P < 0.001), corresponding to weight reductions of 7.0% (SE 0.2) and 2.3% (SE 0.2), respectively. Greater improvements were also observed for NB32 vs. placebo on all five subscale scores of the IWQOL-Lite. Fifty per cent of NB32-treated subjects achieved clinically meaningful improvements in IWQOL-Lite Total Score vs. 32.3% of placebo-treated subjects (odds ratio, 95% confidence interval; 2.09, 1.79-2.44). Subjects losing the most weight (≥ 15% of baseline weight) experienced the greatest improvement in IWQOL-Lite Total Score (19.3 points [SE 0.7] for NB32 and 18.7 points [SE 1.3] for placebo; P = 0.624). Improved quality of life was associated with weight reduction and was achieved in more subjects treated with NB32 than placebo.


Assuntos
Fármacos Antiobesidade/uso terapêutico , Bupropiona/uso terapêutico , Naltrexona/uso terapêutico , Obesidade/tratamento farmacológico , Obesidade/psicologia , Qualidade de Vida , Adulto , Idoso , Combinação de Medicamentos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Redução de Peso , Adulto Jovem
7.
Phys Rev Lett ; 113(6): 062001, 2014 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-25148317

RESUMO

New data on the polarization observables T, P, and H for the reaction γp→pπ(0) are reported. The results are extracted from azimuthal asymmetries when a transversely polarized butanol target and a linearly polarized photon beam are used. The data were taken at the Bonn electron stretcher accelerator ELSA using the CBELSA/TAPS detector. These and earlier data are used to perform a truncated energy-independent partial wave analysis in sliced-energy bins. This energy-independent analysis is compared to the results from energy-dependent partial wave analyses.

8.
Br J Anaesth ; 100(2): 256-62, 2008 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18079431

RESUMO

BACKGROUND: Cyclooxygenase inhibitor treatment is viewed increasingly critical because of safety considerations, and there are several open questions on their optimal use. METHODS: In a randomized placebo-controlled study in 320 patients undergoing discectomy, we administered parecoxib 40 mg either perioperatively (before operation and after operation), after operation (first dose given in the evening after surgery), or before operation (single parecoxib dose given 45 min before surgery). We measured the main outcome variables: average pain score, morphine consumption, and opioid-related symptom distress at 25, 49, and 73 h after surgery. RESULTS: Perioperative parecoxib significantly (i) improved the pain score compared with both placebo and postoperative parecoxib, (ii) decreased morphine consumption, and (iii) reduced the opioid-related symptom distress score. Neither a single preoperative dose nor postoperative parecoxib (first dose given in the evening after surgery) significantly improved morphine's analgesic effectiveness. CONCLUSIONS: Perioperative parecoxib compared with postoperative parecoxib improves post-discectomy pain and results in a reduction in adverse effects associated with opioid therapy. Postoperative parecoxib, or a single pre-incisional parecoxib dose, does not significantly improve post-discectomy pain or opioid side-effects up to 3 days after surgery.


Assuntos
Analgésicos não Narcóticos/administração & dosagem , Inibidores de Ciclo-Oxigenase/administração & dosagem , Discotomia , Isoxazóis/administração & dosagem , Dor Pós-Operatória/prevenção & controle , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Analgésicos Opioides/administração & dosagem , Método Duplo-Cego , Esquema de Medicação , Humanos , Pessoa de Meia-Idade , Morfina/administração & dosagem , Medição da Dor/métodos , Assistência Perioperatória/métodos , Cuidados Pós-Operatórios/métodos , Medicação Pré-Anestésica , Estudos Prospectivos
9.
Clin Nephrol ; 68(1): 10-7, 2007 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-17703830

RESUMO

AIMS: This 1-year double-blind, placebo-controlled, multicenter study evaluated the long-term safety and efficacy of cinacalcet for the treatment of secondary hyperparathyroidism in patients receiving hemodialysis. METHOD: Patients were randomly assigned in a 1:1 ratio to cinacalcet or control treatment groups. The initial dose of cinacalcet (or matching placebo) was 30 mg. Doses were titrated every 3 or 4 weeks based on the intact parathyroid hormone (iPTH) response and safety profile. Sequential doses included 30, 60, 90, 120 and 180 mg/d. Phosphate binders and vitamin D sterols were adjusted per protocol as needed to control levels of calcium and phosphorus. Efficacy and safety were compared between treatment groups among patients who completed the study (52 total weeks of treatment). Reasons for withdrawal are presented for patients who did not complete the study. RESULTS: A total of 210 patients completed 52 weeks of double-blinded treatment with cinacalcet (n = 99) or placebo (n = 111). Over the last 6 months of the study, a greater proportion of patients in the cinacalcet group than the control group achieved an iPTH level < or = 250 pg/ml (61.6 vs. 9.9%, p < 0.001) or a > or = 30% decrease in iPTH from baseline (81.8 vs. 21.6%, p < 0.001). Mean iPTH levels decreased by -47.8% in the cinacalcet group and increased by +12.9% in the control group. Mean percentage changes in other laboratory values in the cinacalcet and control groups included the following: serum calcium -6.5 vs. +0.9% (p < 0.001), serum phosphorus -3.6 vs. -1.1% (p = 0.465), and Ca x P -9.9 vs. -0.3% (p = 0.006). The most commonly reported adverse events related to study drug by the investigators included nausea (13% cinacalcet, 5% control), investigator-reported hypocalcemia (11% cinacalcet, 1% control), vomiting (9% cinacalcet, 2% control), dyspepsia (5% cinacalcet, 4% control), and diarrhea (5% cinacalcet, 2% control). CONCLUSIONS: Treatment with cinacalcet is a safe and effective therapy for long-term control of secondary hyperparathyroidism. 1-year therapy with cinacalcet was associated with sustained, clinically significant reductions in calcium, Ca x P and iPTH which allowed a greater percentage of patients to achieve NKF-KDOQI target goals for PTH and Ca x P.


Assuntos
Hiperparatireoidismo Secundário/tratamento farmacológico , Naftalenos/uso terapêutico , Diálise Renal , Cinacalcete , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo
10.
J Clin Endocrinol Metab ; 92(10): 3803-8, 2007 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17666472

RESUMO

BACKGROUND: Management of inoperable parathyroid carcinoma presents a challenge because until recently, effective medical therapy was not available. Morbidity and mortality result primarily from severe hypercalcemia. We assessed the ability of the calcimimetic cinacalcet HCl to reduce serum calcium in patients with parathyroid carcinoma as well as its effect on PTH concentrations, bone turnover markers, safety, and health-related quality of life variables. METHODS: Twenty-nine patients with parathyroid carcinoma were enrolled in this open-label, single-arm study consisting of titration and maintenance phases. Cinacalcet doses were titrated (30 mg twice daily to 90 mg four times daily) for 16 wk or until serum calcium was no more than 10.0 mg/dl. The study endpoint was the proportion of patients with at least a 1 mg/dl reduction in serum calcium at the end of the titration phase (responders). RESULTS: Mean (+/- se) serum calcium (14.1 +/- 0.4 mg/dl) and PTH (697 +/- 94 pg/ml) were markedly elevated at baseline. At the end of the titration period, serum calcium was reduced by at least 1 mg/dl in 62% of patients (mean decline to 12.4 +/- 0.5 mg/dl). In the 18 responders, serum calcium fell from 15.0 +/- 0.5 to 11.2 +/- 0.3 mg/dl (P < 0.001). The greatest reductions in serum calcium were observed in patients with highest baseline calcium levels. PTH levels decreased, but not significantly, to 635 +/- 73 pg/ml (-4.6%). Adverse events included nausea, vomiting, headache, and fracture. CONCLUSIONS: Cinacalcet effectively reduces hypercalcemia in approximately two thirds of patients with inoperable parathyroid carcinoma and may represent an important new treatment option for these patients.


Assuntos
Cálcio/sangue , Hipercalcemia/tratamento farmacológico , Hiperparatireoidismo Primário/tratamento farmacológico , Naftalenos/administração & dosagem , Neoplasias das Paratireoides/tratamento farmacológico , Adulto , Idoso , Cinacalcete , Feminino , Humanos , Hipercalcemia/sangue , Hiperparatireoidismo Primário/sangue , Masculino , Pessoa de Meia-Idade , Naftalenos/efeitos adversos , Hormônio Paratireóideo/sangue , Neoplasias das Paratireoides/sangue , Qualidade de Vida , Resultado do Tratamento
12.
Cienc. enferm ; 12(2): 53-62, dic. 2006. tab
Artigo em Espanhol | LILACS, BDENF - Enfermagem | ID: lil-444623

RESUMO

Estudio descriptivo relacional, destinado a conocer la autoestima y el funcionamiento social de los ancianos según roles sociales, desde su visión y la de sus cuidadores y la percepción del funcionamiento familiar. Se incluyó a 300 ancianos y sus cuidadores familiares, de los consultorios de atención primaria de Concepción. Se aplicó una encuesta en domicilio, con tres escalas: Groningen Social Disabilities Schedule; Escala de Funcionamiento Familiar de Smilkeinstein y el Test de Autoestima de Rosenberg. Resultados: el 51 por ciento de los ancianos reportan una alta autoestima. La percepción de funcionamiento familiar de éstos se ubica en un 84 por ciento, lo que corresponde a la más alta categoría de esta variable. No se encontró diferencia estadísticamente significativa en la evaluación de la percepción de funcionamiento social, entre la autoevaluación del anciano y la evaluación que hace el cuidador respecto del anciano. Es importante destacar una alta consistencia entre ambas mediciones, correlación de un 74 por ciento. Respecto a la relación entre las mediciones del autorreporte de funcionamiento social de los ancianos y la escala de autoestima, se encontró una correlación positiva, a mejor funcionamiento social obtenido del autorreporte, mayor autoestima. Lo mismo ocurre entre las variables autorreporte de Funcionamiento social de los ancianos y la Escala de Percepción de funcionamiento familiar-Apgar. Los resultados de esta investigación podrán ser considerados por los profesionales de salud para que en el trabajo con ancianos y sus familias se fomente la independencia, la funcionalidad y la calidad de vida.


Relational descriptive study aimed to asses elderly self esteem and social functioning according to the social roles, through their personal and caregiver perceptions and the family functional perception. The sample included 300 elders and the caregivers from Primary Care Centers in the city of Concepción, Chile. It was applied an inquest at home with 3 scales: the Groningen Social Disabilities Schedule; the Smilkeinstein Family Functioning scale and the Rosenberg self esteem test. Results: 51 percent of elders and 84 percent report a high self esteem. The functioning familiar perception of them is at 84 percent, that corresponds to a high level of perception. It was not found estatistically significant difference in social functioning perception between self esteem of elder and the evaluation made by the caregiver. It is important to say that is a high consistence between both measures. Correlation of 74 percent. About the relation between the self social function report of elders and self esteem scale, it was founded a positive correlation. The better the social functioning in the self report, the better the self esteem. The same phenomenon was observed between the elders self reporting social functioning and the APGAR family functioning perception scale. The results of this study could be considered by health professionals so that in working with elders and theirs families, the independence, the functioning and quality of life, could be increased.


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Qualidade de Vida , Autoimagem , Família , Cuidadores , Interação Social , Atenção Primária à Saúde , Epidemiologia Descritiva , Inquéritos e Questionários
13.
Kidney Int ; 69(11): 2094-100, 2006 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-16732194

RESUMO

Prior studies observing greater mortality in for-profit dialysis units have not captured information about benchmarks of care. This study was undertaken to examine the association between profit status and mortality while achieving benchmarks. Utilizing data from the US Renal Data System and the Centers for Medicare & Medicaid Services' end-stage renal disease (ESRD) Clinical Performance Measures project, hemodialysis units were categorized as for-profit or not-for-profit. Associations with mortality at 1 year were estimated using Cox regression. Two thousand six hundred and eighty-five dialysis units (31,515 patients) were designated as for-profit and 1018 (15,085 patients) as not-for-profit. Patients in for-profit facilities were more likely to be older, black, female, diabetic, and have higher urea reduction ratio (URR), hematocrit, serum albumin, and transferrin saturation. Patients (19.4 and 18.6%) in for-profit and not-for-profit units died, respectively. In unadjusted analyses, profit status was not associated with mortality (hazard ratio (HR)=1.04, P=0.09). When added to models with profit status, the following resulted in a significant association between profit status (for-profit vs not-for-profit) and increasing mortality risk: URR, hematocrit, albumin, and ESRD Network. In adjusted models, patients in for-profit facilities had a greater death risk (HR 1.09, P=0.004). More patients in for-profit units met clinical benchmarks. Survival among patients in for-profit units was similar to not-for-profit units. This suggests that in the contemporary era, interventions in for-profit dialysis units have not impaired their ability to deliver performance benchmarks and do not affect survival.


Assuntos
Benchmarking , Falência Renal Crônica/terapia , Avaliação de Resultados em Cuidados de Saúde , Setor Privado , Setor Público , Diálise Renal/mortalidade , Diálise Renal/normas , Instituições de Assistência Ambulatorial , Feminino , Seguimentos , Unidades Hospitalares de Hemodiálise , Humanos , Masculino , Pessoa de Meia-Idade
14.
Kidney Int ; 69(11): 2087-93, 2006 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-16641921

RESUMO

Hemodiafiltration (HDF) is used sporadically for renal replacement therapy in Europe but not in the US. Characteristics and outcomes were compared for patients receiving HDF versus hemodialysis (HD) in five European countries in the Dialysis Outcomes and Practice Patterns Study. The study followed 2165 patients from 1998 to 2001, stratified into four groups: low- and high-flux HD, and low- and high-efficiency HDF. Patient characteristics including age, sex, 14 comorbid conditions, and time on dialysis were compared between each group using multivariate logistic regression. Cox proportional hazards regression assessed adjusted differences in mortality risk. Prevalence of HDF ranged from 1.8% in Spain to 20.1% in Italy. Compared to low-flux HD, patients receiving low-efficiency HDF had significantly longer average duration of end-stage renal disease (7.0 versus 4.7 years), more history of cancer (15.4 versus 8.7%), and lower phosphorus (5.3 versus 5.6 mg/dl); patients receiving high-efficiency HDF had significantly more lung disease (15.5 versus 10.2%) and received a higher single-pool Kt/V (1.44 versus 1.35). High-efficiency HDF patients had lower crude mortality rates than low-flux HD patients. After adjustment, high-efficiency HDF patients had a significant 35% lower mortality risk than those receiving low-flux HD (relative risk=0.65, P=0.01). These observational results suggest that HDF may improve patient survival independently of its higher dialysis dose. Owing to possible selection bias, the potential benefits of HDF must be tested by controlled clinical trials before recommendations can be made for clinical practice.


Assuntos
Hemodiafiltração , Diálise Renal/mortalidade , Europa (Continente) , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco
15.
Psychol Assess ; 13(1): 118-26, 2001 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-11281033

RESUMO

The specificity of phallometric testing for pedophilia has been calculated using sex offenders against adult women. Does the offender's actual number of prior sexual contacts with women affect such estimates? To answer this, the authors' studied 82 male sex offenders against adult women, 172 offenders against unrelated children, and 70 offenders against their own biological children or stepchildren. Phallometric testing included visual and auditory depictions of prepubescent, pubescent, and adult males and females. The results for offenders against women showed that those who had had sexual contact with the greatest number of women (consenting or nonconsenting) had the lowest probability of being diagnosed as pedophilic. Specificity, calculated for those who had sexual contact with the most women and thus the most evidence of attraction to them, was 96%. Sensitivity, calculated analogously for men with the most offenses against children, was 61%.


Assuntos
Pedofilia/diagnóstico , Pênis/fisiologia , Delitos Sexuais , Adolescente , Adulto , Humanos , Masculino , Pletismografia/métodos , Sensibilidade e Especificidade
16.
Am J Clin Nutr ; 73(3): 647-52, 2001 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-11237944

RESUMO

BACKGROUND: Plasma free amino acid patterns in health and disease have been reported. However, amino acid concentrations in adult populations in developing countries and in patients with dengue, as a model for an acute infectious viral disease endemic to the tropics, have not been reported. OBJECTIVE: The purpose of this study was to determine the amino acid profile in both healthy Guatemalan adults from different socioeconomic backgrounds and at 3 time points during the course of classic dengue. DESIGN: The study was carried out in Guatemala and included measurement of plasma free amino acids in 22 healthy control subjects (14 low income, 8 middle class) and 17 febrile patients. Measurements of amino acids were repeated within a 48-h interval in 20 of the healthy Guatemalans. In 9 patients with dengue, amino acids were assayed 3 times: on admission to a local hospital in the coastal plain of Guatemala, on hospital discharge, and 7 d after hospital discharge. RESULTS: Branched-chain amino acid concentrations in healthy adults and dengue patients in Guatemala were lower than normal values reported in the literature for healthy Swedish adults. With the exception of increased phenylalanine concentrations and an increased ratio of phenylalanine to tyrosine, all amino acids as well as the Fischer molar ratio were decreased in the acute phase of dengue. CONCLUSIONS: Healthy Guatemalans have different amino acid patterns than do Swedish subjects independent of socioeconomic status. The systemic viral disease dengue is associated with changes in the plasma free amino acid pattern, reflecting infection-related alterations in amino acid metabolism.


Assuntos
Aminoácidos/sangue , Dengue/sangue , Adulto , Aminoácidos/metabolismo , Estudos de Casos e Controles , Dengue/metabolismo , Feminino , Glicina/sangue , Guatemala , Humanos , Masculino , Fenilalanina/sangue , Fatores Socioeconômicos , Suécia , Tirosina/sangue , Valina/sangue
17.
Semin Dial ; 13(6): 399-403, 2000.
Artigo em Inglês | MEDLINE | ID: mdl-11130265

RESUMO

The end-stage renal disease (ESRD) program has a significant overrepresentation of racial and ethnic minority groups. The increased susceptibility of nonwhite populations to ESRD has not been fully explained and probably represents a complex interplay of genetic, cultural, and environmental influences. Because the program delivers care under a uniform health care payment system, it represents a unique environment in which to explore variation in health care delivery. A number of disparities in outcomes and delivery of ESRD care have been noted for racial minority participants. These include possible overdiagnosis of hypertensive nephrosclerosis, decreased provision of renal replacement therapy, limited referral for home dialysis modalities, underprescription of dialysis, increased use of synthetic grafts rather than fistulas as permanent angioaccess, and delayed wait-listing for renal transplantation. Transplantation inequities mean that black patients are likely to remain on dialysis relatively longer, so that their susceptibility to less than optimal processes of care increases disproportionately. Improved survival and quality of life (QOL) for blacks with ESRD may have encouraged provider complacency about racial disparities in the ESRD program and in particular about referral for transplantation. It is also apparent that minority ESRD patients may, similar to their non-ESRD counterparts, be referred less frequently for invasive cardiovascular (CV) procedures. Despite these observations of inequality in ESRD care, the adjusted mortality for minority participants in the ESRD program are better than for the majority population. This seeming paradox may define an opportunity to improve outcomes for minorities with ESRD even more.


Assuntos
Negro ou Afro-Americano , Falência Renal Crônica/terapia , Padrões de Prática Médica , Diálise Renal , Nefropatias Diabéticas/diagnóstico , Nefropatias Diabéticas/genética , Nefropatias Diabéticas/terapia , Humanos , Falência Renal Crônica/diagnóstico , Falência Renal Crônica/genética , Diálise Renal/estatística & dados numéricos , Estados Unidos
18.
Arch Sex Behav ; 29(5): 463-78, 2000 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-10983250

RESUMO

Whether homosexual pedophiles have more older brothers (a higher fraternal birth order) than do heterosexual pedophiles was investigated. Subjects were 260 sex offenders (against children age 14 or younger) and 260 matched volunteer controls. The subject's relative attraction to male and female children was assessed by phallometric testing in one analysis, and by his offense history in another. Both methods showed that fraternal birth order correlates with homosexuality in pedophiles, just as it does in men attracted to physically mature partners. Results suggest that fraternal birth order (or the underlying variable it represents) may prove the first identified universal factor in homosexual development. Results also argue against a previous explanation of the high prevalence of homosexuality in pedophiles (25% in this study), namely, that the factors that determine sexual preference in pedophiles are different from those that determine sexual preference in men attracted to adults. An alternative explanation in terms of canalization of development is suggested.


Assuntos
Ordem de Nascimento , Pedofilia/epidemiologia , Comportamento Sexual , Adolescente , Adulto , Criança , Homossexualidade Masculina/psicologia , Humanos , Masculino , Pedofilia/psicologia , Ereção Peniana/fisiologia , Fatores Sexuais
19.
Ann N Y Acad Sci ; 904: 163-70, 2000 May.
Artigo em Inglês | MEDLINE | ID: mdl-10865731

RESUMO

The effects of an episode of acute classical dengue fever on extracellular water (ECW), intracellular water (ICW), and total body water (TBW) were measured in nine patients using conventional dilution techniques; and the findings were compared with the outcome variables from whole body impedance spectroscopy (BIS), extracellular fluid resistance (Recf), and intracellular fluid resistance (Ricf). The patients were assessed on admission with febrile presentation (DI), at discharge after the defervescence of the fever cycle at about five days postadmission (DII), and seven days thereafter (DIII). As a reference group, 15 persons without acute or chronic illness were enrolled. Total body water was unaltered during the course of disease and was not different from that in normal healthy subjects. However, body water shifted from the intracellular to the extracellular compartment in patients from the acute phase to convalescence, as reflected in the ratios of ECW/TBW and ECW/ICW. These ratios were significantly higher in convalescent dengue patients (DIII) than in the reference group (p < 0.05). Increasing ECW, from the acute phase of the disease to convalescence, was associated with a significant decrease in Recf (719 +/- 95, 693 +/- 89, 643 +/- 81 omega; p < 0.0001) and in Recf/Ricf (p < 0.01). Recf and Recf/Ricf were higher in the acute phase (DI) of dengue fever compared to controls (p < 0.05). We conclude that dengue fever is characterized by a relative expansion of ECW during the course of disease and convalescence. BIS was sensitive in determining the hydrational profile in dengue fever patients.


Assuntos
Composição Corporal , Dengue/fisiopatologia , Impedância Elétrica , Equilíbrio Hidroeletrolítico , Doença Aguda , Adulto , Idoso , Estatura , Índice de Massa Corporal , Peso Corporal , Espaço Extracelular/química , Humanos , Líquido Intracelular/química , Pessoa de Meia-Idade , Monitorização Fisiológica/métodos
20.
Ann N Y Acad Sci ; 904: 205-9, 2000 May.
Artigo em Inglês | MEDLINE | ID: mdl-10865740

RESUMO

Bioelectrical impedance spectroscopy (BIS) can provide estimates of body composition for both whole body (WB) and body segments (BS). In normal, healthy subjects, BS measurements may be expected to serve as surrogates for WB indices; however, very little is known about this correspondence in people suffering from acute illnesses. The aim of this study was to evaluate the degree of this correspondence in patients with an acute, systemic illness, such as classical dengue fever. Ten adult patients were examined upon admission to the community hospital on the Pacific Coast of Guatemala and after clinical recovery about two weeks later, and compared with a group of healthy subjects living in the same region. BIS was measured with a Xitron 4000B analyzer (Xitron Technologies Inc., San Diego, CA, USA). BS measurements were carried out using Organ et al.'s approach. The BIS data were modeled with the manufacturer's software: extra- (Recf) and intracellular- (Ricf) resistances, and the Recf/Ricf ratio. BIS BS measurements correlate closely with WB in both the acute and the recovery stages of dengue fever, with the leg showing the highest degree of correspondence and the trunk the lowest. Recf indices, per se, generally showed higher correspondence than Ricf or the Recf/Ricf ratio.


Assuntos
Composição Corporal , Dengue/fisiopatologia , Impedância Elétrica , Adulto , Seguimentos , Guatemala , Humanos , Valores de Referência , Fatores de Tempo
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