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1.
Diabet Med ; 37(11): 1854-1860, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-32614482

RESUMEN

AIM: To examine the feasibility and acceptability of a brief self-compassion intervention for adolescents with type 1 diabetes and disordered eating behaviour. METHODS: Twenty-seven adolescents with type 1 diabetes were recruited and randomized to receive the brief (two 2.5-h sessions) self-compassion intervention, either in the intervention group (n=11) or in a waitlist control group (n=8). The intervention was adapted from the standardized eight-session 'Making Friends with Yourself' programme, and sessions were delivered 1 week apart. Acceptability was assessed through qualitative questionnaires and feasibility was assessed based on session attendance and recruitment metrics. Possible changes to disordered eating behaviour, self-care behaviours, diabetes-related distress, self-compassion, stress and glycaemic control were also assessed. RESULTS: Nineteen participants completed the study, and they reported an increased sense of common humanity (acknowledging that we are not alone), mindfulness, and coping resources. In terms of feasibility, recruitment took longer than expected (8 months) and not all participants were able to attend both sessions (nine could only attend one of the two sessions). CONCLUSIONS: While self-compassion is a strong conceptual fit for the issues of type 1 diabetes and disordered eating behaviour in adolescence, and the intervention content appears acceptable, feasibility issues were such that brief self-compassion programmes will probably need to be adapted into digital interventions for future research. (Trial registration number: ANZCTR 12619000541101).


Asunto(s)
Diabetes Mellitus Tipo 1/psicología , Empatía , Trastornos de Alimentación y de la Ingestión de Alimentos/psicología , Atención Plena , Aceptación de la Atención de Salud , Autoimagen , Adaptación Psicológica , Adolescente , Niño , Diabetes Mellitus Tipo 1/terapia , Estudios de Factibilidad , Trastornos de Alimentación y de la Ingestión de Alimentos/terapia , Femenino , Humanos , Masculino , Nueva Zelanda , Selección de Paciente , Distrés Psicológico , Autocuidado , Estrés Psicológico/psicología
2.
Rev Laryngol Otol Rhinol (Bord) ; 125(2): 127-31, 2004.
Artículo en Inglés | MEDLINE | ID: mdl-15462174

RESUMEN

OBJECTIVE: The aim of this retrospective study was to analyse the data of patients with rhino-orbital-cerebral mucormycosis for predisposing factors, diagnosis, treatment and survival rate. The role of frozen section in early diagnosis and use of nasal endoscopy in diagnosis, treatment and follow-up of patients has also been examined. DESIGN: Retrospective case series. SETTING: University Teaching Hospital. METHODS: The case notes of 9 patients with diagnosis of mucormycosis who presented from 1973 to 2001 were examined. The data for predisposing factors, signs/symptoms, histological diagnosis, radiological intervention, medical and surgical treatment and final outcome was analysed. RESULTS: There were 9 patients with mucormycoses. Early diagnosis was made by endoscopic examination and frozen section in 5 patients, which was later confirmed by histology. Treatment included parental and/or local amphotericin, hyperbaric oxygen and debridement either by endoscopic or external approach, with or without orbital exenteration. This resulted in an overall survival of 5 patients. CONCLUSION: Frozen section diagnosis allows for early therapy since successful treatment depends on systemic amphotericin, surgical debridement and treatment of underlying predisposing factors. Nasal endoscopy is useful in diagnosis, endoscopic debridement and follow up of patients.


Asunto(s)
Encefalopatías/microbiología , Encefalopatías/terapia , Mucormicosis/microbiología , Mucormicosis/terapia , Enfermedades Nasales/microbiología , Enfermedades Nasales/terapia , Enfermedades Orbitales/microbiología , Enfermedades Orbitales/terapia , Adulto , Anciano , Anciano de 80 o más Años , Anfotericina B/uso terapéutico , Antifúngicos/uso terapéutico , Encefalopatías/diagnóstico , Desbridamiento , Endoscopía , Femenino , Humanos , Oxigenoterapia Hiperbárica , Masculino , Persona de Mediana Edad , Mucormicosis/diagnóstico , Enfermedades Nasales/diagnóstico , Enfermedades Orbitales/diagnóstico , Estudios Retrospectivos
3.
BJU Int ; 93(1): 36-41, 2004 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-14678364

RESUMEN

OBJECTIVE: To report an interim clinical evaluation of combined external beam irradiation (EBRT) and interstitial or regional hyperthermia in the treatment of locally advanced prostate cancer. PATIENTS AND METHODS: From 1997 to 2001, 26 patients with T3-4/NX/0M0 prostate carcinoma were treated with a combination of conformal EBRT and hyperthermia. Fourteen patients received five weekly regional hyperthermia treatments within an optimization (phase II) study, using the coaxial transverse electrical magnetic system. Twelve patients received one interstitial hyperthermia treatment within a feasibility study (phase I), using the multi-electrode current source system. Irradiation was delivered using a conformal three-field technique, administering 70 Gy in 2-Gy fractions in 7 weeks. RESULTS: The mean initial prostate-specific antigen level was 26 ng/mL. Three patients had a T4 and 23 a T3 tumour; the tumours were classified as well (four), moderately (16) and poorly (six) differentiated. The mean follow-up was 36 months. In the combined treatments there was no toxicity of more than grade 2. In regional hyperthermia the mean index temperature (T90 and T50, i.e. exceeded by 90% and 50% of the measurements) was 40.2 degrees C and 40.8 degrees C, and for interstitial hyperthermia 39.4 degrees C and 41.8 degrees C, respectively. All patients survived; seven patients had a biochemical relapse (27%), three in the regional and four in the interstitial group. The actuarial probability of freedom from biochemical relapse was 70% at 36 months for all patients together, 79% for regional and 57% for interstitial. No factors were found that could be used to predict relapse. CONCLUSIONS: The clinical outcome in these patients with advanced localized prostate cancer seems to compare favourably with most series using irradiation alone, and the treatment caused no severe complications.


Asunto(s)
Hipertermia Inducida/métodos , Neoplasias de la Próstata/terapia , Anciano , Terapia Combinada/métodos , Supervivencia sin Enfermedad , Estudios de Factibilidad , Estudios de Seguimiento , Humanos , Hipertermia Inducida/efectos adversos , Masculino , Persona de Mediana Edad , Neoplasias de la Próstata/radioterapia , Resultado del Tratamiento
4.
Médecine Tropicale ; 64(5): 478-481, 2004. tab
Artículo en Francés | AIM | ID: biblio-1266684

RESUMEN

Dans le cadre d'une étude sur le statut sanitaire des pasteurs nomades et de leur bétail exécutée en étroite colla-boration entre les services de santé publique et vétérinaire tchadiens,le taux de rétinol sérique humain a été analysé en cor-rélation avec celui contenu dans le lait du bétail. Parmi les femmes examinées (n = 99),43% (IC95% 33 - 54 %) étaient défi-c i t a i resen rétinol (tauxde0,35µmol/Là0,7µmol/L) et 17% (IC95% 10 -26%) sévèrement défi c i t a i resen rétinol (tauxinféri e u rà0,35µmol/L). Aucunedesfemmesinterrogées(n=87)n'indiquaituneconsommation defruitset seulesdeux avaientconsommédeslégumesfraisau coursdesdern i è res 24 heures. Lelait était donc pratiquement la seule source devitamineA pour ces popu-lations. Parmi le bétail,les chèvres (n=6) avaient les taux moyens de rétinol les plus élevés dans leur lait (329 ± 84 µg/kg),sui-vies des bovins (n=25; 247 ± 32 µg/kg) et des dromadaires (n=12; 120 ± 18 µg/kg). Les concentrations de rétinol dans le sérumhumain dépendaient de manière significative de la concentration de rétinol dans le lait du bétail (pente partielle 0,23; inter-valle de confiance de 95% 0,008 - 0,47). Notre étude confirme que le lait de chèvre et de vache est une source importante devitamine A chez les pasteurs nomades. Par ailleurs,la promotion de la consommation de légumes verts,de fruits et de sup-pléments vitaminés reste nécessaire pour lutter contre les carences en vitamine A


Asunto(s)
Bovinos , Chad , Cabras
5.
Int J Hyperthermia ; 19(4): 402-13, 2003.
Artículo en Inglés | MEDLINE | ID: mdl-12850926

RESUMEN

INTRODUCTION: The aim of this prospective study was to describe quality of life (QoL) in patients with locally advanced prostate carcinoma treated with conventional radiotherapy and to evaluate the influence of adding regional or interstitial hyperthermia. MATERIALS AND METHODS: All patients were irradiated using a CT-planned conventional three field technique, administering 70 Gy to prostate and vesicles. In two different phase I studies, hyperthermia was added to the radiotherapy. Twelve patients were treated with one interstitial hyperthermia treatment, lasting 60 min. Fourteen patients have been treated with five regional hyperthermia treatments, lasting 75 min each. In both hyperthermia studies, the body, bladder and rectum temperatures remained below safety limits. Patients treated with radiotherapy alone (n = 58) or combined with regional (n = 8) or interstitial hyperthermia (n = 12) completed the European Organization for Research and Treatment of Cancer (EORTC) core questionnaire (C30 + 3), the EORTC prostate cancer module (PR25) and the Rand 36 health survey before treatment and 1 and 6 months after completion of treatment. Analysis of Variance (ANOVA) for repeated measurements has been performed to describe the data. RESULTS: All patient groups were comparable concerning patient characteristics. No significant interaction or difference in QoL has been noticed between the two hyperthermia patient groups and the patient group without hyperthermia. Therefore, all groups were analysed together (n = 78) to detect QoL changes in time. A deterioration of QoL has been measured from baseline to 1 month after treatment. Fatigue, pain, urinary symptoms, bowel symptoms and financial difficulties increased significantly. Social, physical and role functioning worsened significantly. No differences in QoL were measured 6 months after treatment compared to the baseline measurement, except for a decrease in sexual activity. CONCLUSIONS: After radiotherapy with or without hyperthermia only a temporary deterioration of QoL occurs, concerning social, psychological and disease related symptoms. Additional hyperthermia does not seem to decrease QoL.


Asunto(s)
Hipertermia Inducida , Neoplasias de la Próstata/fisiopatología , Neoplasias de la Próstata/terapia , Calidad de Vida , Radioterapia , Anciano , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Estudios Prospectivos , Neoplasias de la Próstata/patología , Neoplasias de la Próstata/psicología , Encuestas y Cuestionarios
6.
Brain Res Cogn Brain Res ; 11(3): 377-85, 2001 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-11339987

RESUMEN

Recent studies have indicated a role for the thalamus in attention, arousal and the capacity to perform tasks of speeded information processing. The present study evaluated the role of the thalamus in age-related cognitive decline by investigating the correlations between thalamic volume, cognition and age. This was done in 57 healthy subjects ranging from 21 to 82 years of age. All subjects underwent neurocognitive testing with information processing tests and structural magnetic resonance imaging. A significant decrease in volume of the thalamus with increasing age was found, relatively stronger than and independent of the decrease of total brain volume. The decrease of thalamic volume was apparent before the onset of loss of volume of the total brain. Over the age-span studied, the thalamic decrease in volume correlated with the diminished performance on tests of cognitive speed. Additionally, in young and middle-aged, but not in old subjects, the size of the thalamus predicted performance on tasks that require cognitive speed.


Asunto(s)
Envejecimiento/fisiología , Envejecimiento/psicología , Cognición/fisiología , Imagen por Resonancia Magnética , Tálamo/anatomía & histología , Tálamo/fisiología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Tiempo de Reacción/fisiología , Valores de Referencia
7.
Am J Physiol ; 271(1 Pt 1): C312-20, 1996 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-8760060

RESUMEN

Migration of neutrophils (polymorphonuclear leukocytes; PMN) across polarized epithelia is asymmetrical: basolateral-to-apical (physiologically directed) migration is far more efficient than migration in the reverse direction, suggesting the presence of luminal retention signal(s). Following pilot observations, we used polarized intestinal epithelial monolayers (T84) to examine whether asymmetrical constraint of migration afforded by the epithelial cytoskeleton might underlie such retention signals. Rearrangement of epithelial cortical F-actin accompanied PMN transepithelial migration (in either direction) and was prevented by preloading monolayers with the F-actin stabilizing agent phallacidin. Although phallacidin preloading did not influence physiologically directed PMN transepithelial migration, such treatment greatly enhanced migration in the reverse direction (i.e., effective loss of luminal retention signal). 1,2-Bis(2-aminophenoxy)ethane-N,N,N',N'-tetraacetic acid (BAPTA) preloading also prevented epithelial cortical actin rearrangements and selectively resulted in loss of luminal retention signal(s). BAPTA preloading did not influence resistance or forskolin-induced Cl- secretion, and phallacidin preloading did not influence resistance or carbachol-induced Cl- secretion, suggesting that barrier function and surface polarity were maintained under these conditions. These and supplementary data suggest that epithelial actin (but not microtubule) cytoskeletal reordering asymmetrically influences PMN migration and underlies, at least in part, the observed signal that biases for retention of PMN in the luminal space.


Asunto(s)
Citoesqueleto/fisiología , Mucosa Intestinal/fisiología , Neutrófilos/fisiología , Actinas/metabolismo , Movimiento Celular/efectos de los fármacos , Ácido Egtácico/análogos & derivados , Ácido Egtácico/farmacología , Humanos , Mucosa Intestinal/efectos de los fármacos , Microtúbulos/efectos de los fármacos , Nocodazol/farmacología , Paclitaxel/farmacología , Péptidos Cíclicos/farmacología
8.
Int J Hyperthermia ; 4(5): 479-95, 1988.
Artículo en Inglés | MEDLINE | ID: mdl-3292667

RESUMEN

Blood flow in tumours and healthy tissue determines the ability of obtaining satisfactory temperature distributions in clinical hyperthermia, as well as the success of hyperthermia and radiation treatment. During the hyperthermia treatment, diagnostic data related to tissue blood flow can be determined by analysing the relationship between the amount of power absorbed in the tissue and the resulting temperature rise. The interpretation of the perfusion data (PERF) is highly complicated by the lack of an adequate theory to describe the heat transport in vascularized tissues. In vascularized breast tissues about 10 times as much power is needed to maintain therapeutic temperatures as is necessary in a stationary breast phantom. This large difference in maintenance power levels indicates the extreme importance of blood flow in tissue heat transport. PERF has been determined in 23 patients with advanced breast tumours. In this series (a) perfusion typically did not change during the stationary part of the individual hyperthermic sessions, (b) minimum tumour PERF was not related to tumour volume, and (c) there was no relation between tumour PERF and the ability to heat tumours. PERF can both increase and decrease after successful hyperthermia.


Asunto(s)
Neoplasias de la Mama/irrigación sanguínea , Quimioterapia del Cáncer por Perfusión Regional , Hipertermia Inducida , Absorción , Temperatura Corporal/efectos de la radiación , Neoplasias de la Mama/clasificación , Neoplasias de la Mama/metabolismo , Neoplasias de la Mama/terapia , Ensayos Clínicos como Asunto , Femenino , Humanos , Hipertermia Inducida/métodos , Matemática , Microondas/uso terapéutico , Flujo Sanguíneo Regional
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