RESUMO
OBJECTIVES: Type 2 diabetes is a major public health concern because of its prevalence, the severity of complications and the financial implications. Compliance and patient's autonomy in medications intake play key roles in the success of treatment. Pharmacists' interviews ensure an optimized and individual follow-up. Type 2 diabetes is not one of the targeted diseases to perform pharmacists' interviews on under Health Insurance. We thus judged useful to contribute to their development. METHODS: We applied a cross-disciplinary methodological process in order to define the specifications of the follow-up form useful to conduct the pharmacist's interview 1 by focusing on the identification of a non-compliance and its origins. A feasibility study was carried out in order to check its workability to the pharmacy practice. RESULTS: The follow-up form, associated with a pharmacist practical guide, includes 3 parts: (1) General informations, (2) Survey establishing patient's knowledge, (3) Summary including a level of knowledge assessment grid. Outcomes provide a long but appropriate-felt duration, few difficulties to conduct the interview and a proven usefulness in 90% of all cases that make the follow-up form suitable to the pharmacy practice. CONCLUSIONS: This tool could serve as a model for the pharmacist to conduct his future interviews for the type 2 diabetes patients, thus improving patient care, together with other health professionals.
Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Custos de Medicamentos , Autonomia Pessoal , Seguimentos , Humanos , Pacientes/psicologia , Assistência Farmacêutica , Farmácias , FarmacêuticosRESUMO
BACKGROUND: Mesh integration is a key parameter for reliable and safe hernia repair. So far, its assessment is based on histology obtained from rare second-look operations or experimental research. Therefore, non-invasive high-resolution imaging techniques would be of great value. Ultrasound biomicroscopy (UBM) and scanning acoustic microscopy (SAM) have shown potential in the imaging of hard and soft tissues. This experimental study compared the detection of mesh integration, foreign body reaction and scar formation in UBM/SAM with standard histology. MATERIALS AND METHODS: Ten titanized polypropylene meshes were implanted in rats in a model of onlay repair. 17 days postoperative animals were killed and samples were paraffin embedded for histology (H&E, Cresyl violet) or processed for postmortem UBM/SAM. The observation period was uneventful and meshes appeared well integrated. RESULTS: Relocation of neighboring cross-sectional levels could easily be achieved with the 40-MHz UBM and granulation tissue could be distinguished from adjacent muscle tissue layers. The spatial resolution of approximately 8 µm of the 200-MHz UBM system images was comparable to standard histology (2.5-5× magnification) and allowed a clear identification of mesh fibers and different tissue types, e.g., scar, fat, granulation, and muscle tissues, as well as vessels, abscedations, and foreign body giant cell clusters. CONCLUSION: This pilot study demonstrates the potential of high-frequency ultrasound to assess hernia mesh integration non-invasively. Although the methods lack cell-specific information, tissue integration could reliably be assessed. The possibility of conducting UBM in vivo advocates this method as a guidance tool for the indication of second-look operations and subsequent elaborate histological analyses.
Assuntos
Reação a Corpo Estranho/diagnóstico , Herniorrafia , Microscopia Acústica , Telas Cirúrgicas , Cicatrização , Animais , Cicatriz/diagnóstico , Modelos Animais de Doenças , Masculino , Projetos Piloto , Polipropilenos , Ratos , Ratos Sprague-Dawley , TitânioRESUMO
A semiquantitative evaluation of potential bacterial pathogens was correlated to the severity of lesions during an outbreak of bovine necrotic vulvovaginitis (BNVV) on an Israeli dairy herd. Bacteriologic examination of 287 vaginal swabs from 104 post-calving heifers showed a highly significant correlation between Porphyromonas levii colony forming unit numbers and the clinical scores of the lesions, when assessed by an ordinal regression statistical model. No such correlation was found for the other bacteria included in the study. Nineteen samples taken for virological examinations resulted negative for bovine herpes viruses 1, 2, 4 and 5. Thus the results of this study substantiate the essential role of P. levii in the etiology of BNVV and indicate that BHV4 is not required as a predisposing factor to the syndrome.
Assuntos
Doenças dos Bovinos/microbiologia , Surtos de Doenças/veterinária , Vulvovaginite/veterinária , Animais , Bovinos , Doenças dos Bovinos/epidemiologia , Feminino , Herpesvirus Bovino 1/isolamento & purificação , Herpesvirus Bovino 2/isolamento & purificação , Herpesvirus Bovino 4/isolamento & purificação , Herpesvirus Bovino 5/isolamento & purificação , Necrose/microbiologia , Porphyromonas/isolamento & purificação , Vulvovaginite/epidemiologia , Vulvovaginite/microbiologiaRESUMO
A method proposed herein allows simultaneous selection for several production traits, taking into consideration their marginal economic values (i.e. the economic value of a trait's additional unit). This economic index-marker assisted selection (EI-MAS) method is based on the calculation of the predicted economic breeding value (BV), using information on DNA markers that have previously been found to be associated with relevant quantitative trait loci. Based on the proposed method, results with real birds showed that sire progeny performance was significantly correlated with expected performance (r = 0.61-0.76; P = 0.03-0.01). Simulation analysis using a computer program written specifically for this purpose suggested that the relative advantage of EI-MAS would be large for traits with low heritability values. As expected, the response to EI-MAS was higher when the map distance between the marker and the quantitative trait gene was small, and vice versa. A large number of distantly located markers, spread 10 cM apart, yielded higher response to selection than a small number of closely located markers spread 3 cM apart. Additionally, the response to EI-MAS was higher when a large number (ca.150) of progeny was used for the prediction equation.
Assuntos
Criação de Animais Domésticos/economia , Galinhas/genética , Locos de Características Quantitativas , Criação de Animais Domésticos/métodos , Animais , Cruzamento/economia , Cruzamento/métodos , Galinhas/crescimento & desenvolvimento , Mapeamento Cromossômico , Simulação por Computador , Marcadores Genéticos , Repetições de MicrossatélitesRESUMO
In this study of 162 third graders in New York City public schools, we found that slightly over half of the children in special education were males who had Medicaid coverage at birth and mothers with medical conditions or adverse health habits noted on the birth certificate; two thirds of the children with this combination of characteristics actually were placed in special education. These findings suggest that newborns at risk for later learning disabilities can be targeted to receive preventive interventions.
Assuntos
Educação Inclusiva/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Deficiências da Aprendizagem/epidemiologia , Triagem Neonatal/métodos , Declaração de Nascimento , Peso ao Nascer , Educação Inclusiva/legislação & jurisprudência , Avaliação Educacional , Feminino , Idade Gestacional , Indicadores Básicos de Saúde , Humanos , Recém-Nascido , Deficiências da Aprendizagem/etiologia , Modelos Lineares , Masculino , Idade Materna , Medicaid/estatística & dados numéricos , Registro Médico Coordenado , Mães/educação , Triagem Neonatal/normas , Cidade de Nova Iorque/epidemiologia , Paridade , Projetos Piloto , Dinâmica Populacional , Gravidez , Complicações na Gravidez/epidemiologia , Cuidado Pré-Natal/normas , Grupos Raciais , Estudos Retrospectivos , Fatores Sexuais , Pais Solteiros/estatística & dados numéricos , Estados UnidosRESUMO
Despite the fact that circumcision of the new-born male has been practiced for at least 6,000 years, the procedure remains controversial. Circumcision rates in the United States remain among the highest of any nation in the industrialized world, yet there is little descriptive data on the demographic characteristics of newborns who are circumcised. New York State's hospital discharge data were used to examine demographic patterns for the procedure for the period 1980-1986. Circumcision was less common in New York City than in other areas of New York State, and was more common in private hospitals than in public hospitals. Whites had the highest rate of circumcision (70%), while Hispanics had the lowest (25%). Newborns under Medicaid coverage were more likely to be circumcised in voluntary hospitals than in public hospitals (45% vs 33%). We conclude that circumcision rates vary depending on a variety of factors, some of which may be attributable to the physician and others to family and society.