Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 35
Filtrar
1.
J Pharm Bioallied Sci ; 16(Suppl 1): S415-S417, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38595357

RESUMO

Objective: Primary brain injuries, which are the result of severe head trauma and cannot be prevented, are always catastrophic and fatal. Yet, if diagnostic and therapeutic steps are taken promptly after a craniocerebral injury, further brain insults may be prevented and the victim's death can be avoided within 24 hours. Materials and Methods: Source of data, sample size, inclusion criteria, exclusion criteria, statistical methods. Results: One hundred individuals with confirmed cumputer tomography (CT) scan results of severe head trauma participated in this analysis. Seventy men and thirty women accounted for the total number of patients. The research included 70% men and 30% women. The M/F ratio is 2.3:1. Males between the ages of 21 and 30 (a total of 21 patients) had the highest rate of head injury in our analysis. Males had a lower incidence overall, with nine cases in the 0-10 age range, 11 cases in the 11-20 age range, five cases in the 41-50 age range, three cases in the 51-60 age range, and four cases in patients older than 61. Similarly, eight of the female patients were in the 21-30 age range. There were also four patients between the ages of 0 and 10, four between the ages of 11 and 20, two between the ages of 41 and 50, five between the ages of 51 and 60, and three among those older than 61. Summary and Conclusion: Men were more likely than women to sustain a head injury. The majority of the study population consisted of patients between the ages of 21 and 30 and 31 and 40. Injuries were found to most often occur in car crashes.

2.
Cureus ; 15(11): e48594, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-38090446

RESUMO

Congenital dyserythropoietic anemias are a group of rare hereditary conditions affecting erythropoiesis. These disorders are characterized by anemia, primarily caused by inefficient erythropoiesis, as well as distinctive morphological abnormalities observed in most erythroblasts in the bone marrow. congenital dyserythropoietic anemia type I (CDA-I) is a hereditary condition characterized by inefficient production of red blood cells and excessive accumulation of iron. It follows an autosomal recessive pattern of inheritance. There have been approximately 300 recorded cases of CDA-I documented on a global scale. CDA-I is a rarely documented condition in the Indian subcontinent. Therefore, we will be examining a case of CDA-I in the present article. A male infant, aged four months, who had signs of vomiting, weight loss, and failure to thrive, was diagnosed with CDA-I following a bone marrow aspiration. Our experience provides further evidence supporting the notion that the accurate diagnosis of CDA-I can be achieved by doing a comprehensive assessment of bone marrow aspiration.

3.
Asian Pac J Cancer Prev ; 24(7): 2347-2352, 2023 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-37505765

RESUMO

BACKGROUND: Breast cancer comprises a highly heterogeneous subset of tumours that respond well to Neoadjuvant Chemotherapy (NAC). Tumour Infiltrating Lymphocytes (TIL) act as a means to an end by shedding light on the treatment response as well as predictive factors to the clinicopathological features for the same. Therefore, this article attempts to shift the attention to the relevance of TIL in the aforementioned aspects by bringing to notice the contrasting traits displayed by them in the different immunohistochemical subtypes of breast carcinoma. MATERIALS AND METHODS: 75 triple-negative breast cancer (TNBC) patients, 25 human epidermal growth factor receptor (HER2BC) positive patients and 77 hormone receptor (HRBC) positive breast cancer patients were included in this study who received NAC before surgical excision of the tumour which was then stained using routine Haematoxylin and Eosin techniques. Standardised guidelines were used to evaluate TIL in the stroma and the tumour. RESULTS: In TNBC, a significant association between Intratumoural (IT) TIL (p=0.0288) and Intrastromal (IS) TIL (p=0.0250) with pathological complete response (pCR). IS TIL and age at operation (p=0.0494) showed significant values but no correlation was found with IT TIL. In HER2BC, IS TIL revealed a significant association with the tumour response(p=0.0229). A strong association was found between IT TIL and the age of menopause(p=0.0441). In HRBC, no significant associations were found between IT and IS TIL scores and the clinicopathological features. CONCLUSION: The predictive factors of TIL and complete response post-neoadjuvant chemotherapy can be a strong indicative factor for immunohistochemical markers. It also helps throw light on further studies which can be carried out to determine the clinicopathological features and TIL correlation in the various subtypes of breast carcinoma.


Assuntos
Neoplasias da Mama , Neoplasias de Mama Triplo Negativas , Feminino , Humanos , Neoplasias de Mama Triplo Negativas/patologia , Resultado do Tratamento , Terapia Neoadjuvante , Neoplasias da Mama/patologia , Linfócitos/patologia , Linfócitos do Interstício Tumoral , Receptor ErbB-2/metabolismo , Prognóstico
4.
J Eur Acad Dermatol Venereol ; 37(5): 945-950, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-36708077

RESUMO

BACKGROUND: Existing artificial intelligence for melanoma detection has relied on analysing images of lesions of clinical interest, which may lead to missed melanomas. Tools analysing the entire skin surface are lacking. OBJECTIVES: To determine if melanoma can be distinguished from other skin lesions using data from automated analysis of 3D-images. METHODS: Single-centre, retrospective, observational convenience sample of patients diagnosed with melanoma at a tertiary care cancer hospital. Eligible participants were those with a whole-body 3D-image captured within 90 days prior to the diagnostic skin biopsy. 3D-images were obtained as standard of care using VECTRA WB360 Whole Body 3-dimensional Imaging System (Canfield Scientific). Automated data from image processing (i.e. lesion size, colour, border) for all eligible participants were exported from VECTRA DermaGraphix research software for analysis. The main outcome was the area under the receiver operating characteristic curve (AUC). RESULTS: A total of 35 patients contributed 23,538 automatically identified skin lesions >2 mm in largest diameter (102-3021 lesions per participant). All were White patients and 23 (66%) were males. The median (range) age was 64 years (26-89). There were 49 lesions of melanoma and 22,489 lesions that were not melanoma. The AUC for the prediction model was 0.94 (95% CI: 0.92-0.96). Considering all lesions in a patient-level analysis, 14 (28%) melanoma lesions had the highest predicted score or were in the 99th percentile among all lesions for an individual patient. CONCLUSIONS: In this proof-of-concept pilot study, we demonstrated that automated analysis of whole-body 3D-images using simple image processing techniques can discriminate melanoma from other skin lesions with high accuracy. Further studies with larger, higher quality, and more representative 3D-imaging datasets would be needed to improve and validate these results.


Assuntos
Melanoma , Neoplasias Cutâneas , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inteligência Artificial , Dermoscopia , Melanoma/patologia , Projetos Piloto , Estudos Retrospectivos , Sensibilidade e Especificidade , Neoplasias Cutâneas/diagnóstico por imagem , Neoplasias Cutâneas/patologia
5.
Ann Med Surg (Lond) ; 80: 104308, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36045840

RESUMO

Background: The microenvironment of breast cancer plays a significant role in determining the prognosis of the disease. With the shifting paradigm on the predictive factors post-Neoadjuvant Chemotherapy (NAC), it was sought out that Tumour infiltrating lymphocytes (TILs) are of valuable use for the same. Yet, the delineation of the two types - Intrastromal and Intratumoural has seldom been facilitated. This study, therefore, aimed to evaluate, analyse and compare the two - to gauge the importance of the treatment outcome and clinicopathological features. Materials and methods: 180 breast cancer patients were included in this study who underwent NAC, and their post-surgically resected tumour specimens were sectioned and stained using routine Haematoxylin and Eosin techniques. The evaluation of TILs in the stroma and tumour was done based on the standardised guidelines. Results: Out of the 180 patients, 55 (i.e. 30.56%) displayed pathological complete resolution (pCR). Furthermore, Intratumoural TILs had a slight association with the pCR (p = 0.0335) whereas Intrastromal TILs had a significantly large association with pCR (p < 0.0001) dependent on the lymphocytic response. Backward regression revealed that - the age at operation, pCR, lymph node involvement and menopause highly contributed to predicting 68.2% of the total cases correctly with a sensitivity of 93.0% and specificity of 24.6% for Intratumoral TILs. Age at operation, pCR, lymph node involvement and tumour emboli highly contributed to predicting 71.5% of the total cases correctly with sensitivity of 71.6% and specificity of 71.4% for Intrastromal TILs. Conclusion: TILs and the prediction of NAC and pCR should be made standardised and reproducible so that they can be universally available to all patients with breast cancer. Through this study, further avenues of research have opened up for their relations with clinicopathological features mainly age at operation and menopausal status.

6.
Med J Malaysia ; 77(3): 374-383, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35638495

RESUMO

Abnormal uterine bleeding (AUB) is one of the commonest complaints of women in reproductive age and non-gravid state that brings them to the attention of the primary care doctor or the gynaecologist. Anovulation without any medical illness or pelvic pathology seems to be the common cause. Bleeding due to a wide variation in pathology both inside and outside the reproductive tract can be termed as anovulatory bleeding. Therefore, it is mandatory to elicit a focused menstrual history and appropriate evaluation followed by a pelvic examination. This includes a vaginal speculum examination to differentiate anovulatory bleeding from other causes of bleeding. In contrast, Heavy menstrual bleeding (HMB) is referred to as an ovulatory bleeding exceeding 8 days duration and is often caused by uterine fibroids or adenomyosis, a copper IUD or coagulation disorders. PALM-COEIN classification is a system designed by the Federation Internationale de Gynaecologie et d'Obstetrique to define the precise underlying causes of AUB. Aetiology of AUB can be classified as the following acronym "PALM-COEIN": Polyp, Adenomyosis, Leiomyoma, Malignancy and hyperplasia, Coagulopathy, Ovulatory dysfunction, Endometrial, Iatrogenic and Not yet classified. AUB describes a range of symptoms, such as HMB, intermenstrual bleeding (IMB) and a combination of both heavy and prolonged menstrual bleeding (MB). Dysfunctional uterine bleeding (DUB) and menorrhagia are now better described as AUB. Newborn girls sometimes spot for a few days after birth, due to placental oestrogenic stimulation of the endometrium in utero.


Assuntos
Adenomiose , Leiomioma , Menorragia , Adenomiose/complicações , Adenomiose/diagnóstico , Adenomiose/terapia , Feminino , Humanos , Recém-Nascido , Leiomioma/complicações , Menorragia/diagnóstico , Menorragia/etiologia , Menorragia/terapia , Placenta , Gravidez , Hemorragia Uterina/diagnóstico , Hemorragia Uterina/etiologia , Hemorragia Uterina/terapia
7.
Med J Malaysia ; 76(3): 390-394, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-34031339

RESUMO

INTRODUCTION: The debate surrounding the management of term breech presentation (BP) has resulted in the presence of a multitude of guidelines, reviews, and directives. The vaginal delivery of a breech baby requires sound obstetric skills since approximately 3-4% of babies at term are breech presentations. BP is the commonest of all malpresentations. However, expertise required to deliver breech babies vaginally has virtually disappeared. There is no convincing evidence that Caesarean Section (CS) is better than assisted vaginal delivery when conducted in appropriate settings, with experienced obstetricians and strict prevailing protocols. Unfortunately, planned vaginal breech delivery (VBD) is becoming an uncommon event. This has led to fewer opportunities for obstetric residents to master the skills of vaginal birth of breech presentations. MATERIALS AND METHODS: The BP has always been a challenge for obstetricians, due to special skills required to deliver the breech safely. In addition, the immediate perinatal outcome, in terms of APGAR scores and acid-base status of the breech babies is of great concern. Thus, in 2000, in order to provide more evidence-based data, the Term Breech Trial (TBT) was published which compared the outcome of VBD with planned CS. In their 2003 Clinical Guideline, the National Institute for Health and Clinical Excellence (NICE) recommended external cephalic version (ECV) for breech presentation at 36 weeks of gestation a ns elective CS if the procedure is declined or failed. The first edition, Green-top Guidelines by the Royal College of Obstetricians and Gynaecologists (RCOG) regarding the breech delivery was first published in 1999 and revised in 2001, 2006 (Nos. 20a and 20b) and March 2017. In 2020, the Guideline Committee meeting decided on a further revision and deferred the decision for further 3 years (2023). The aim of this Guideline is to aid decision making regarding the route of delivery and choice of various techniques used during delivery. In March 2005, the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) issued a formal statement concerning breech delivery at term. Through their Committee on Obstetric Practice, the American College of Obstetricians and Gynecologists (ACOG) issued a Committee Opinion paper on "Mode of term singleton breech delivery" in 2006. RESULTS: Almost immediately, the medical community all over the world embraced the conclusions of the trial highlighting the superiority of outcomes in planned CS compared to VBD in terms of maternal, neonatal mortality and morbidity. Clinicians, in consultation with their patients, must make the final decisions regarding mode of breech delivery in the light of the updated clinical guidelines and committee opinions for a rational choice for the mode of delivery. CONCLUSION: There is a place for planned VBD, the prerequisites are: strict case selection, operator skills and vigilant intrapartum monitoring. Provision of basic skills training by utilizing birthing pelvic models and mannikins, hands-on practice of External Cephalic Version (ECV) in clinical settings, may result in larger reduction in the risk of CS.


Assuntos
Apresentação Pélvica , Versão Fetal , Austrália , Cesárea , Parto Obstétrico , Feminino , Humanos , Recém-Nascido , Gravidez
8.
J Eur Acad Dermatol Venereol ; 35(5): 1111-1118, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33506523

RESUMO

BACKGROUND: Nevus-associated melanomas (NAM) account for 30% of all melanomas and are associated with younger age and with thinner Breslow thickness. Previous studies of NAM dermoscopy found conflicting results. OBJECTIVE: To compare the clinical and dermoscopic features of NAM and de novo melanomas (DNM), stratified by melanoma thickness, in a relatively large cohort of patients. METHODS: A cross-sectional study of all melanomas biopsied between 2004 and 2019 at a large cancer centre. Lesions were categorized as in situ and invasive NAM or DNM. Dermoscopic images were reviewed and annotated. Associations between melanoma subtype and dermoscopic features were analysed via logistic regression modelling. Bivariate analyses were conducted using non-parametric bootstrap and chi-squared methods. RESULTS: The study included 160 NAM (86 in situ and 74 invasive) and 218 DNM (109 in situ and 109 invasive). NAM were associated with younger age, greater likelihood of being present on the torso, and thinner Breslow thickness. NAM were 2.5 times more likely to show a negative pigment network than DNM. In situ NAM were 2.1 and two times more likely to display dermoscopic area without definable structures and tan structureless areas than DNM, respectively. In situ melanomas were more likely to present a pigment network, and invasive melanomas more commonly presented scar-like depigmentation and shiny white structures. Streaks, blotches and shiny white structures were associated with deeper Breslow depth. CONCLUSIONS: Even though the nevus component of NAM could not be identified dermoscopically in the current series, negative pigment network, tan structureless areas and areas without definable structures are dermoscopic clues for NAM.


Assuntos
Melanoma , Nevo , Neoplasias Cutâneas , Estudos Transversais , Dermoscopia , Humanos , Melanoma/diagnóstico por imagem , Estudos Retrospectivos , Neoplasias Cutâneas/diagnóstico por imagem
9.
J Eur Acad Dermatol Venereol ; 35(4): 892-899, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33205467

RESUMO

BACKGROUND: The presence of peripheral globules is associated with enlarging melanocytic lesions; however, there are numerous patterns of peripheral globules distribution and it remains unknown whether specific patterns can help differentiate enlarging naevi from melanoma. OBJECTIVE: To investigate whether morphological differences exist between the peripheral globules seen in different subsets of naevi and in melanoma. METHODS: A cross-sectional study of clinical notes that mentioned peripheral globules, in addition to all melanoma images with peripheral globules on the International Skin Imaging Collaboration archive. Dermoscopic images were reviewed and annotated. Associations between diagnosis and categorical features were measured with odds ratios. Non-parametric tests were used for continuous factors. RESULTS: 184 lesions with peripheral globules from our clinic were included in the analysis; only 6 of these proved to be melanoma. 109 melanomas with peripheral globules from the International Skin Imaging Collaboration archive were added to the analysis. Melanomas were more common on the extremities and among older individuals. Melanomas were more likely to display atypical, tiered and/or focal peripheral globules. Only 5% of melanomas lacked dermoscopic melanoma-specific structures compared to 48% of naevi. CONCLUSIONS: Melanocytic lesions with atypical or asymmetrically distributed peripheral globules, especially when located on the extremities, should raise suspicion for malignancy. Melanocytic lesions with typical and symmetrically distributed peripheral globules, and with no other concerning dermoscopic features, are unlikely to be malignant.


Assuntos
Melanoma , Nevo Pigmentado , Neoplasias Cutâneas , Estudos Transversais , Dermoscopia , Humanos , Melanoma/diagnóstico por imagem , Nevo Pigmentado/diagnóstico por imagem , Neoplasias Cutâneas/diagnóstico por imagem
10.
J Clin Diagn Res ; 8(4): FD09-10, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24959457

RESUMO

Endometriosis is presence of functioning endometrial tissue outside the uterine cavity, usually in the pelvis. However, its occurrence is very rare (0.03%-0.4%) in the scars which follow obstetrical and gynaecological surgeries. We are reporting two cases of scar endometriosis which occurred after caesarean sections. Both cases presented with abdominal pain at caesarean scar sites, one of which gave a cyclical history. Clinical examination revealed painful swellings in both cases, which were misdiagnosed as stitch granulomas. Wide surgical excisions were done and histopathology examination revealed a diagnosis of scar endometriosis. We are presenting these cases because of their rarity, their uncommon sites and difficulty in diagnosing the conditions clinically.

11.
Prostate Cancer Prostatic Dis ; 13(1): 94-6, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19918264

RESUMO

Fibroblast growth factor receptor 4 (FGFR4), a member of the fibroblast growth receptor family, was recently reported to be more abundantly expressed in malignant than benign prostate cells. A single nucleotide polymorphism at position 388 of the FGFR4 amino-acid sequence results in the substitution of glycine (Gly) with arginine (Arg) and higher frequency of the ArgArg genotype was previously found in prostate cancer patients. DNA was extracted from the blood drawn from 399 prostate cancer patients, 150 BPH patients and 294 healthy community controls. Polymerase chain reaction was carried out and single nucleotide polymorphisms of FGFR4 were identified by restriction enzyme digestion. No overall association is detectable between the Arg allele and increased prostate cancer risk. Subgroup analysis shows a higher incidence of the heterozygous ArgGly genotype in cancer cases than in the combined group of BPH and controls (P<0.05); this difference is statistically significant between cancer and BPH patients but not between cancer cases and community controls. The single nucleotide polymorphism Gly(388)Arg in FGFR4 is not associated with increased risk of prostate cancer in Scottish men. This observation is in contrast with results from two previous studies conducted in the USA and Japan.


Assuntos
Neoplasias da Próstata/genética , Receptor Tipo 4 de Fator de Crescimento de Fibroblastos/genética , Idoso , Estudos de Casos e Controles , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Hiperplasia Prostática/genética
12.
Hear Res ; 231(1-2): 84-9, 2007 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-17658231

RESUMO

Although it is generally accepted that endolymphatic hydrops is the cause of complaints in patients suffering from Menière's disease, it has not been possible up to now to prove the presence of an endolymphatic hydrops in living humans. This study evaluated the psychophysical method introduced by Mrowinski et al. [Mrowinski D., Gerull G., Nubel K., Scholz G., 1995. Masking and pitch shift of tone bursts and clicks by low-frequency tones. Hear. Res. 85, 95-102; Mrowinski D., Scholz G., Krompass S., Nubel K., 1996. Diagnosis of endolymphatic hydrops by low-frequency masking. Audiol. Neurootol. 1, 125-134] to diagnose endolymphatic hydrops. These authors used low frequency biasing to differentiate between individuals with and individuals without Menière's disease. In the present study no statistically significant differences in masking parameters could be found between a large number (n=91) of ears with Menière's disease and ears (n=52) with comparable sensorineural hearing losses, but without symptoms of Menière's disease. Our results support the idea that results deviating from normal in low frequency biasing measurements are not due to endolymphatic hydrops itself, but to other pathological changes of the inner ear. An explanation could be that with increasing hearing loss the gain of the cochlear amplifier decreases, leading to smaller modulation depths.


Assuntos
Audiometria de Resposta Evocada , Limiar Auditivo , Cóclea/patologia , Testes Auditivos/métodos , Doença de Meniere/diagnóstico , Doença de Meniere/patologia , Estimulação Acústica , Doenças Cocleares , Hidropisia Endolinfática/patologia , Estudos de Avaliação como Assunto , Auxiliares de Audição , Perda Auditiva/diagnóstico , Perda Auditiva/patologia , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/patologia , Humanos , Modelos Estatísticos , Emissões Otoacústicas Espontâneas
13.
J Phys Chem B ; 110(31): 15244-50, 2006 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-16884241

RESUMO

The internal structure of PbSe nanocrystals was deduced using synchrotron X-ray photoemission spectroscopy for three different sizes of nanocrystals. The photoemission data revealed the layered structure of PbSe nanocrystals with the crystalline PbSe core surrounded by a nonstoichiometric Pb(1-x)Se shell, finally passivated by a capping agent in the outermost layer. A detailed analysis of the experimental data yielded quantitative information on the thickness of three different layers, which is unavailable through any other technique; moreover, the overall sizes of the nanocrystals probed by transmission electron microscopy were in agreement with the corresponding quantity obtained in the present experiment. The present results provide a plausible explanation for the strong variation in the photoluminescence intensity with size observed for these nanocrystals.

14.
J Nanosci Nanotechnol ; 3(5): 392-400, 2003 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-14733149

RESUMO

We report the synthesis of fixed-size ZnS nanoclusters approximately 24 A in diameter with varying manganese concentrations. Various samples of Zn1-x MnxS, with x = 0, 0.02, 0.055, 0.09, and 0.13, have been prepared and characterized using X-ray diffraction, energy-dispersive analysis of X-rays, UV absorption, fluorescence emission and excitation, electron paramagnetic resonance (EPR), and magnetic susceptibility measurements. The manganese ions are found to substitute Zn randomly without giving rise to any clustering of Mn sites, as seen from EPR and magnetic susceptibility results. Our studies reveal that the band gap of the doped nanoclusters passes through a maximum as the manganese concentration is varied. Also, we observe orange emission from Mn2+ ions in the doped ZnS nanoclusters, apart from the blue emission characteristic of the ZnS defect states. The relative intensity of the orange emission compared with the blue varies with the manganese concentration in a nonmonotonic way. The inverse of susceptibility temperature plots can be plotted onto a universal curve by simple multiplicative constants, thus showing that the magnetic interactions between Mn2+ ions are weak.


Assuntos
Cristalização/métodos , Magnetismo/instrumentação , Manganês/química , Teste de Materiais/métodos , Nanotecnologia/instrumentação , Nanotubos/química , Óptica e Fotônica/instrumentação , Sulfetos/química , Compostos de Zinco/química , Conformação Molecular , Nanotecnologia/métodos , Nanotubos/efeitos da radiação , Nanotubos/ultraestrutura , Semicondutores , Sulfetos/efeitos da radiação , Propriedades de Superfície , Raios Ultravioleta , Compostos de Zinco/efeitos da radiação
15.
J Asthma ; 38(3): 253-60, 2001 May.
Artigo em Inglês | MEDLINE | ID: mdl-11392365

RESUMO

School nurses play an important role in identifying children with asthma and providing care during school hours. Educational programs designed to improve nurses' asthma knowledge and practices have concentrated on urban settings. The purpose of this investigation was to determine asthma-related practices and educational needs of rural school nurses. A survey about asthma was mailed to school nurses in all counties of the state of Maryland and in Washington, D.C. Responses were compared between rural Maryland counties and counties from the remainder of Maryland and Washington, D.C. The survey addressed attitudes and beliefs, function and roles, medication administration, and educational needs about asthma. We found that rural nurses used peak flow meters less often to assess and monitor asthma, requested fewer referrals for asthma, had fewer interactions with health room assistants, and had reduced access to asthma educational resources. Also, they provided less asthma education in the schools than other school nurses. These results suggest a need for comprehensive asthma educational programs in rural areas that are based on national guidelines, and that address the unique needs of rural school nurses. These programs should also emphasize the need for open communication between rural school nurses, health room assistants, primary care providers, and parents/caregivers.


Assuntos
Asma , Educação Continuada em Enfermagem , Saúde da População Rural , Serviços de Enfermagem Escolar , Adulto , Asma/epidemiologia , Atitude do Pessoal de Saúde , Coleta de Dados , District of Columbia/epidemiologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Maryland/epidemiologia , Pessoa de Meia-Idade
16.
Ann Allergy Asthma Immunol ; 86(5): 524-30, 2001 May.
Artigo em Inglês | MEDLINE | ID: mdl-11379803

RESUMO

BACKGROUND: Although asthma can be associated with significant airflow obstruction in those over the age of 65, it is often underdiagnosed and undertreated. OBJECTIVE: To describe severity of asthma, allergy skin test sensitivities, indoor allergen exposures, and the impact on quality of life (QOL) and health status in elderly persons with asthma. METHODS: A cross-sectional data analysis with 80 elderly persons with asthma recruited from medical, geriatric, and allergy/immunology tertiary care centers. Asthma severity was determined by symptoms and measurements of lung function. House dust specimens were collected from mattresses and bedroom carpets and analyzed separately for the major allergens of house dust, using monoclonal antibody-based immunoenzymetric assays. QOL was measured using Juniper's Asthma Quality of Life Questionnaire. Health status was measured using the Short Form Health Survey Medical Outcome Questionnaire which included Ferrans and Powers' Quality of Life Index subscales. RESULTS: Two-thirds of participants had either moderate or severe persistent asthma. Skin tests to a battery of common airborne allergens were positive to at least one allergen in 56 of the 75 participants tested (74.7%). Reservoir dust allergen levels were often high enough to place participants at risk of symptoms or at risk of developing sensitization. Increased asthma severity was associated with significantly lower QOL and a trend toward decreased health status. CONCLUSIONS: Asthma is a significant chronic problem in the elderly. Atopy was common. Asthma severity impacts on these participants' QOL and health status. Results support interventions aimed at identifying allergens precipitating attacks and reducing them in the home.


Assuntos
Asma/epidemiologia , Hipersensibilidade Imediata/epidemiologia , Idoso , Poluição do Ar em Ambientes Fechados/efeitos adversos , Poluição do Ar em Ambientes Fechados/análise , Alérgenos/efeitos adversos , Animais , Animais Domésticos , Antiasmáticos/uso terapêutico , Asma/tratamento farmacológico , Asma/etiologia , Asma/psicologia , Baltimore/epidemiologia , Roupas de Cama, Mesa e Banho , Gatos , Baratas/imunologia , Cães , Uso de Medicamentos/estatística & dados numéricos , Poeira , Exposição Ambiental , Indicadores Básicos de Saúde , Habitação , Humanos , Umidade , Hipersensibilidade Imediata/etiologia , Hipersensibilidade Imediata/psicologia , Proteínas de Insetos/efeitos adversos , Proteínas de Insetos/imunologia , Qualidade de Vida , Índice de Gravidade de Doença , Testes Cutâneos , Fumar/epidemiologia , Espirometria , População Urbana
17.
Chem Commun (Camb) ; (21): 2188-9, 2001 Nov 07.
Artigo em Inglês | MEDLINE | ID: mdl-12240105

RESUMO

A one-pot synthesis is reported of water-soluble cadmium sulfide nanoclusters capped with cysteine ester, with an average size of 2.0 nm and fluorescing in the blue region, establishing the possibility of using these as fluorescent biological probes.

18.
J Midwifery Womens Health ; 45(5): 384-91, 2000.
Artigo em Inglês | MEDLINE | ID: mdl-11089358

RESUMO

From October 1994 through September 1998, the American College of Nurse Midwives conducted a nationwide Domestic Violence Education Project. The project aimed to encourage universal screening for domestic violence among all women being seen for care. A four-pronged set of objectives was used, including policy, basic education, continuing education, and advocacy/activism. A description of the project and the results of the project evaluation, including replicable features, are presented. Process and outcome evaluations were performed using both quantitative and qualitative data. Surveys, interviews, and site visits formed the basis for the evaluation of the policy reform, education program, and advocacy components. Pretests and posttests of training participants formed the basis of the evaluation of the continuing education component. All project objectives were met. Policy reform occurred as expected. Changes were noted in education programs in both didactic content and clinical exposure. Changes in clinical behavior as assessed by the pretests and posttests look promising, although numbers of respondents at 12 and 24 months after training are small. Participants reported an increase in advocacy and activism. The Domestic Violence Education Project seems to be a successful and somewhat replicable model for changing attitudes about a health topic (among providers) with possible implications for clinical practice.


Assuntos
Violência Doméstica , Educação Continuada em Enfermagem/organização & administração , Enfermeiros Obstétricos/educação , Avaliação de Programas e Projetos de Saúde , Currículo , Feminino , Política de Saúde , Humanos , Defesa do Paciente , Saúde Pública
19.
Cancer Nurs ; 23(4): 277-85, 2000 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-10939175

RESUMO

Patients with breast cancer who undergo autologous bone marrow/peripheral blood stem cell transplantation (ABMT) cope not only with a life-threatening medical treatment, but also with multiple, interrelated symptoms including pain, fatigue, psychological distress, and nausea. The purpose of this study was to determine, in a randomized controlled clinical trial, whether a comprehensive coping strategy program (CCSP) was effective in significantly reducing pain, fatigue, psychological distress, and nausea in patients with breast cancer who underwent ABMT. The CCSP was composed of preparatory information, cognitive restructuring, and relaxation with guided imagery. Randomization placed 52 patients in the CCSP treatment group and 58 patients in the control group. The CCSP was found to be effective in significantly reducing nausea as well as nausea combined with fatigue 7 days after the ABMT when the side effects of treatment were most severe. These results are important given the high incidence of nausea and fatigue in the ABMT population. The CCSP-treated group experienced mild anxiety as compared with the control group who reported moderate anxiety. The greatest effectiveness of CCSP may correspond to the time of the greatest morbidity for patients with breast cancer who have undergone ABM.


Assuntos
Adaptação Psicológica , Transplante de Medula Óssea , Neoplasias da Mama/enfermagem , Neoplasias da Mama/psicologia , Adulto , Ansiedade/psicologia , Neoplasias da Mama/cirurgia , Fadiga/psicologia , Feminino , Humanos , Pessoa de Meia-Idade , Náusea/psicologia , Dor Intratável/psicologia
20.
J Natl Med Assoc ; 92(1): 22-8, 2000 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-10800283

RESUMO

The purpose of this study was to examine the socio-demographic and behavioral differences related to obesity between African-American men and women. Obesity was defined as a body mass index of greater than 27.3 kg/m2 for women and 27.8 kg/m2 for men. Data were collected from 661 African-Americans, 418 women and 243 men, residing in wards 7 and 8 in Washington, DC through telephone interviews. Obesity was prevalent among 38.3% of the women and 20.1% of the men (p < 0.01). For women age 55 or older, annual income over $20K, having less than a high school education, and alcohol and tobacco consumption were associated with being overweight in the initial bivariate analysis (p < 0.05). For men, being 35 years or older and unemployment were significant factors associated with obesity. Our final analysis, when known dietary risk factors were adjusted, revealed that in women, obesity was associated with age, hard liquor consumption and non use of tobacco. For men, older age was a primary association. We concluded that gender, with increasing age, plays a significant role in predicting obesity, as defined by concurrent national standards. African American men 55 years of age or older are the most likely group to be overweight even after predisposing and behavioral risk factors are considered.


Assuntos
População Negra , Obesidade/etnologia , Caracteres Sexuais , Adolescente , Adulto , Índice de Massa Corporal , Causalidade , Suscetibilidade a Doenças , District of Columbia/epidemiologia , Comportamento Alimentar/etnologia , Comportamento Alimentar/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/etiologia , Prevalência , Estudos Retrospectivos , Fatores Socioeconômicos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA