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1.
Acta Anaesthesiol Scand ; 64(5): 635-640, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31889298

RESUMO

BACKGROUND: To document the evolution of the Peripherally Inserted Central Catheter service at Princess Margaret Hospital, now Perth Children's Hospital. METHODS: Between January 2012 and June 2013 patients referred to Anaesthesia for a Peripherally Inserted Central Catheter were prospectively followed up. A repeat audit was conducted between January 2015 and June 2016, following the introduction of a number of measures aimed at improving the service. RESULTS: Audit 1: A total of 200 Peripherally Inserted Central Catheter insertions were attempted in 138 patients. Successful placement occurred in 86% of cases (172/200). The median age of patients was 7.71 years (range 0-20). The percentage of Peripherally Inserted Central Catheters remaining in situ for the predicted duration was 49/172 (28.5%). Complications were documented in 78/172 (45.4%) of cases. Audit 2: A total of 310 Peripherally Inserted Central Catheter placements were attempted in 244 patients. Successful insertion rate was 95.5% (296/ 310). The median age of patients was 5.3 years (range 0.0-18.72). The percentage remaining in situ for the predicted duration was 145/296 (49%). Complications were documented in 67/296 (22.6%) of cases. CONCLUSION: The evolution of the Peripherally Inserted Central Catheter service at our free standing Tertiary Paediatric Hospital is well documented following these 2 audits. The introduction of a dedicated Anaesthesia led Peripherally Inserted Central Catheter service at our centre has resulted in improved insertion success rates and a reduction in complications.

3.
J Paediatr Child Health ; 55(6): 690-694, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30315622

RESUMO

AIM: Bacteraemia episodes were assessed to calculate a hospital-wide central line-associated blood stream infection (CLABSI) rate per 1000 catheter-days. Secondary objectives were to describe risk factors, microbiology and outcomes of children with CLABSI. METHODS: A retrospective study was conducted at an Australian tertiary paediatric hospital in children <18 years who had blood culture sampling during the 2-year period, 2014-2015. All blood culture results were extracted from the hospital's laboratory information system. National Healthcare Safety Network Centres for Disease Control and Prevention definitions for bacteraemia classification were used. Central venous access device (CVAD) insertion and removal dates were obtained from a surgical electronic database and anaesthetic records and then manually validated. RESULTS: Of 11 774 processed blood culture bottles, 207 episodes of blood stream infection were observed. Eighty-five (41%) episodes were community-acquired bacteraemia (CA-B) and 122 (59%) health care-associated bacteraemia (HA-B), of which 73 (35%) were CLABSI. The hospital-wide CLABSI rate was 0.62 per 1000 catheter-days (95% confidence interval: 0.49-0.77). Conditions associated with CLABSI were malignancy (n = 45, 62%) and gastrointestinal failure (n = 6, 8%). Thirty-three (45%) CLABSI episodes developed in an outpatient setting. CONCLUSIONS: HA-B has a significant impact on child health, exceeding the number of CA-B at our hospital. Children with CVADs are vulnerable in both the inpatient and outpatient settings. Collecting robust data for a hospital-wide CLABSI rate is important to understand the full spectrum of paediatric CLABSI. The value of validating data using both electronic and manual methods is demonstrated.

4.
Conf Proc IEEE Eng Med Biol Soc ; 2018: 5767-5770, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-30441646

RESUMO

Spontaneous kicking in infants is one of the earliest displays of motor skills. Abnormalities observed in these displays are an important indicator of later abnormal neuromotor function. However, these abnormalities are not well defined and difficult to detect outside of direct clinical observation. To allow for extended, non-clinical observation of spontaneous kicking, IMU sensors are attached to the limb segments of the infant's legs. An activity detection algorithm is then used to quantify kicking activity derived from collected measurement data. This paper presents our method in detail and discusses results from kicking data acquired from term and low-risk preterm infants.


Assuntos
Recém-Nascido Prematuro , Monitorização Fisiológica/instrumentação , Atividade Motora , Dispositivos Eletrônicos Vestíveis , Algoritmos , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Destreza Motora
5.
Artif Cells Nanomed Biotechnol ; 46(sup3): S661-S670, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30307317

RESUMO

Hepatocellular carcinoma (HCC) is one of the greatest public health problems worldwide, and chemotherapy remains the major approach for the HCC treatment. Doxorubicin (DOX) is one of the anthracycline antibiotics but its clinical use is limited due to its severe cardiotoxicity. In this study, novel hybrid nanoparticles by self-assembling based on pectin-doxorubicin conjugates (PDC-NPs) were fabricated for HCC treatment. The stabilized structure of the PDC-NPs was characterized by methylene blue absorption, the size, zeta potential and the morphology, which was investigated by Zetasizer nanoparticle analyzer and transmission electron microscope (TEM), of nanoparticles. The PDC-NPs achieved a sustained and prolonged release ability, which was illustrated with in vitro drug release profiles, anti-cell proliferation study, cellular uptake assay and in vivo pharmacokinetics analysis. Biocompatibility of the PDC-NPs was assessed with bovine serum albumin (BSA) adsorption test, hemolysis activity examination and viability evaluation of human umbilical vein endothelial cells. Importantly, in vivo studies of the PDC-NPs, which were performed in the athymic BALB/c nude mice, demonstrated that the PDC-NPs significantly reduced the lethal side effect of DOX. Additionally, the H&E staining and serum biochemistry study further confirmed the excellent biological security of the PDC-NPs.


Assuntos
Carcinoma Hepatocelular , Doxorrubicina , Neoplasias Hepáticas , Nanopartículas , Pectinas , Animais , Carcinoma Hepatocelular/tratamento farmacológico , Carcinoma Hepatocelular/metabolismo , Carcinoma Hepatocelular/patologia , Preparações de Ação Retardada/química , Preparações de Ação Retardada/farmacocinética , Preparações de Ação Retardada/farmacologia , Doxorrubicina/química , Doxorrubicina/farmacocinética , Doxorrubicina/farmacologia , Células Hep G2 , Humanos , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/metabolismo , Neoplasias Hepáticas/patologia , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Nus , Nanopartículas/química , Nanopartículas/uso terapêutico , Pectinas/química , Pectinas/farmacocinética , Pectinas/farmacologia , Ensaios Antitumorais Modelo de Xenoenxerto
6.
Case Rep Gastroenterol ; 12(1): 63-68, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29515346

RESUMO

Gastrointestinal histoplasmosis (GIH) without pulmonary and bone marrow involvement is very rare worldwide. It can be misdiagnosed as intestinal tuberculosis or Crohn's disease. There are just few case reports of GIH in patients with a positive HIV antibody test. Here, we report a patient who presented to our hospital with repeated intestinal obstruction. The suspicious diagnosis was intestinal tuberculosis or Crohn's disease due to unspecific clinical manifestations and radiologic images. Our patient's HIV antibody test was negative. She had no medical prescriptions. Therefore, our differential diagnosis needed to include ileum histoplasmosis besides intestinal lymphoma, intestinal tuberculosis, and Crohn's disease. Finally, the patient was diagnosed with ileum histoplasmosis due to surgical resection. It is important to be aware of potential infectious diseases, such as ileum histoplasmosis, when making a differential diagnosis. Moreover, surgical resection might be the final approach for small-intestine stricture with fibrosis.

7.
Arch Dis Child ; 103(2): 165-169, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-28847879

RESUMO

OBJECTIVE: Despite the many benefits of paediatric Outpatient Parenteral Antimicrobial Therapy (OPAT) programmes, there are risks associated with delivering inpatient-level care outside of hospital. There is a paucity of evidence defining how best to mitigate these risks. We examined the impact of introducing a dedicated medical team to OPAT, to define the role of increased medical oversight in improving patient outcomes in this cohort. DESIGN: A prospective 24-month pre-post observational cohort study. SETTING: The Hospital in the Home (HiTH) programme at Princess Margaret Hospital (PMH) for Children, Western Australia. PATIENTS: All OPAT admissions to HiTH, excluding haematology/oncology patients. INTERVENTIONS: PMH introduced a dedicated OPAT medical support team in July 2015 to improve adherence to best-practice guidelines for patient monitoring and review. MAIN OUTCOME MEASURES: Duration of OPAT, adherence to monitoring guidelines, drug-related and line-related adverse events and readmission to hospital. RESULTS: There were a total of 502 OPAT episodes over 24 months, with 407 episodes included in analyses. Following the introduction of the OPAT medical team, adherence to monitoring guidelines improved (OR 4.90, 95% CI 2.48 to 9.66); significantly fewer patients required readmission to hospital (OR 0.45, 95% CI 0.24 to 0.86) and there was a significant reduction in the proportion of patients receiving prolonged (≥7 days) OPAT (OR 0.67, 95% CI 0.45 to 0.99). CONCLUSION: The introduction of a formal medical team to HiTH demonstrated a positive clinical impact on OPAT patients' outcomes. These findings support the ongoing utility of medical governance in a nurse-led HiTH service.


Assuntos
Antibacterianos , Fidelidade a Diretrizes , Hospitais Pediátricos , Infusões Parenterais , Antibacterianos/administração & dosagem , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pacientes Ambulatoriais , Guias de Prática Clínica como Assunto , Estudos Prospectivos , Resultado do Tratamento , Austrália Ocidental
8.
J Clin Nurs ; 26(23-24): 5133-5142, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28880461

RESUMO

AIMS AND OBJECTIVES: To explore couples' perceptions of the effects of perinatal loss on their marital relationship, social support and grief 1 year postloss, and analyse what factors changed the severity of their grief. BACKGROUND: Perinatal losses are traumatic events in the lives of families and can have serious long-term consequences for the psychological health of parents and any subsequent children. DESIGN: A prospective follow-up study. METHODS: We recruited, at a teaching hospital in southern Taiwan, a convenience sample of 30 couples whose babies either miscarried or were stillborn. At 1 month (T1), 3 months (T2), 6 months (T3) and 1 year (T4) after the pregnancy loss, all participants completed four questionnaires. To analyse the changing status of their grief and its related factors, we used a generalised estimating equation (GEE) to account for correlations between repeated observations. RESULTS: Postbereavement grief levels fell over the four time-points. Mothers reported feeling more grief than did the fathers. Couples with a history of infertility, no religious beliefs or no living children before the loss felt more grief from a perinatal miscarriage or stillbirth. Furthermore, couples reported more grief if their marital satisfaction level was low, if their socioemotional support from husband's parents was low or if they had never participated in a ritual for their deceased baby. CONCLUSIONS: Six months postloss is the crucial period for bereaved parents after a perinatal loss. Being a mother, having no previous living children and low-level socioemotional support from the husband's parents are significant high-risk factors for a high level of grief 1 year after perinatal death. RELEVANCE TO CLINICAL PRACTICE: We recommend that health professionals increase their ability to identify the factors that psychologically affect postloss grief. Active postloss follow-up programmes should focus on these factors to offer specific support and counselling.


Assuntos
Aborto Espontâneo/psicologia , Pesar , Pais/psicologia , Cônjuges/psicologia , Natimorto/psicologia , Adulto , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Gravidez , Estudos Prospectivos , Fatores de Risco , Apoio Social , Inquéritos e Questionários , Taiwan , Fatores de Tempo , Adulto Jovem
9.
Biomed Res Int ; 2017: 8738924, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28706951

RESUMO

The number of patients with knee osteoarthritis has increased in tandem with population aging. Consequently, the number of knee arthroplasties has also risen. The postoperative pain is the biggest challenge faced by patients soon after knee arthroplasty; therefore, this study is among different methods for post-knee arthroplasty pain control. A prospective longitudinal research design was employed; 177 adult patients who proposed for primary knee arthroplasty were enrolled and recruited. The patients were divided into conventional Group 1 (n = 120) and patient-controlled analgesia (PCA) Group 2 (n = 57) according to the treatment methods they received. All patients experience the highest pain level on the day of their surgery; women complained of higher pain levels than men did, while the PCA group had lower postoperative pain. Meanwhile, patients with general anesthesia experienced more pain than those with spinal anesthesia in postoperative period. Patients with a higher postoperative pain index have a smaller optimal knee flexion angle. The PCA group had lower postoperative pain; all patients experienced the highest pain level on the day of their surgery. The results of this study could serve as a reference for nurses where PCA ensures a better postoperative pain control and therefore facilitates recovery and improves the quality of nursing.


Assuntos
Artroplastia do Joelho/efeitos adversos , Osteoartrite do Joelho/tratamento farmacológico , Manejo da Dor , Dor Pós-Operatória/tratamento farmacológico , Adulto , Idoso , Analgesia Epidural , Analgesia Controlada pelo Paciente , Analgésicos Opioides/administração & dosagem , Raquianestesia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Morfina/administração & dosagem , Osteoartrite do Joelho/etiologia , Osteoartrite do Joelho/fisiopatologia , Dor Pós-Operatória/etiologia , Dor Pós-Operatória/fisiopatologia
10.
Sci Rep ; 7(1): 3272, 2017 06 12.
Artigo em Inglês | MEDLINE | ID: mdl-28607370

RESUMO

Cervical oesophageal cancer (CEC) is a relatively uncommon malignancy. The biological behaviour and treatment have not been well studied. This retrospective study reviewed the clinicopathological features of 28 patients with CEC who underwent surgical resection to investigate the biological behaviour, treatment and prognosis of CEC. The long-term outcomes of these patients were compared with those of the CEC patients who received definitive chemoradiotherapy and those of thoracic or abdominal oesophageal cancer patients who underwent surgery. The study group contained 21 men and 7 women, ranging in age from 41 to 67 years (median: 56.5 years). The median survival time and the 1-, 3-, and 5-year overall survival rates were 25.0 months, 83.8%, 48.8%, and 41.9%, respectively. Only salvage surgery was found to affect the overall survival (P = 0.007). The long-term outcomes for CEC patients who underwent surgery were significantly better than those who received definitive chemoradiotherapy (P = 0.045) but were similar to those of thoracic or abdominal oesophageal cancer patients. In summary, CEC is an uncommon and aggressive malignancy. The malignant potential of CEC is similar to that of thoracic or abdominal oesophageal cancer. Surgical resection is an important therapeutic strategy and may be associated with better survival rates than definitive chemoradiotherapy.


Assuntos
Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/cirurgia , Adulto , Idoso , Neoplasias Esofágicas/mortalidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Metástase Neoplásica , Estadiamento de Neoplasias , Terapia de Salvação , Análise de Sobrevida , Resultado do Tratamento , Carga Tumoral
11.
Hu Li Za Zhi ; 63(3): 52-61, 2016 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-27250959

RESUMO

BACKGROUND: Perinatal losses are traumatic events for women and may have serious long-term consequences for the psychological health of women and subsequent pregnancies. Therefore, it is important to explore the psychological adaptation process of subsequent pregnancy after loss in order to understand the overall phenomenon of perinatal loss. PURPOSE: To explore the childbearing experiences of women who have experienced a prior stillbirth. METHODS: This qualitative descriptive study targeted a purposive sample of 15 women who had prior personal experiences with stillbirth. A total of 22 in-depth interviews were conducted in order to ensure data saturation. Women who had experienced stillbirth at one of two teaching hospitals in southern Taiwan were recruited. Data were analyzed using content analysis. RESULTS: Three themes were identified that captured the complex feelings of participants regarding their subsequent childbearing experiences: (1) looking forward to another pregnancy but afraid of being hurt again, (2) treading on thin ice, and (3) bearing another child helps heal the loss of the stillborn. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The empirical data gathered in the present study helps build a more complete understanding of the process of recovery that women undergo following a stillbirth experience. In addition, the results suggest that healthcare professionals should be aware of and accept the worries and reactions of women during their subsequent pregnancy in order to help these women achieve a positive subsequent childbearing experience.


Assuntos
Pesquisa Qualitativa , Natimorto/psicologia , Adulto , Feminino , Humanos , Gravidez
12.
Res Sports Med ; 24(3): 157-70, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27248716

RESUMO

A 12-week Wheelchair Tai Chi 10 Form (WTC10) intervention was conducted among elderly with disability to examine the effect of this WTC10 intervention on selected physical and mental health variables. Thirteen (age 87.23 ± 6.71) in the WTC10 intervention group and 15 (age 89.73 ± 6.31) in the control group completed the study. Independent t-tests and paired t-tests were employed to examine the differences between groups and within groups, respectively, at pretest and post-test. The WTC10 intervention group showed significant improvements in systolic and diastolic blood pressure, shoulder external rotation, left trunk rotation and total trunk rotation after the intervention. A 12-week WTC10 intervention had positive effects on blood pressure, range of motion at the shoulder and trunk, physical activity, and mental health among the elderly with disability. WTC10 is a feasible and safe exercise for the elderly with disability.


Assuntos
Pessoas com Deficiência/psicologia , Exercício Físico/fisiologia , Saúde Mental , Tai Ji , Cadeiras de Rodas , Idoso de 80 Anos ou mais , Pressão Sanguínea , Feminino , Nível de Saúde , Humanos , Masculino , Amplitude de Movimento Articular , Rotação , Articulação do Ombro/fisiologia , Tai Ji/psicologia , Tronco/fisiologia
13.
J Child Neurol ; 31(7): 858-63, 2016 06.
Artigo em Inglês | MEDLINE | ID: mdl-26733505

RESUMO

Idiopathic toe walking treatments are not conclusively effective. This study investigated the effects of walking surface on gait parameters in children with idiopathic toe walking. Fifteen children with idiopathic toe walking and 15 typically developing children aged 4 to 10 years completed the study, which included a barefoot gait exam over three 4-m walkways. Each of the walkways was covered with a different surface: vinyl tile, carpet, and pea gravel. Temporal-spatial parameters were recorded along with a measure of early heel rise (HR32). Children with idiopathic toe walking and typically developing children shared similarly changed gait patterns on each surfaces. Only HR32 was significantly different between the groups (P < .001). Children with idiopathic toe walking showed significantly less toe-walking on the gravel walkway (P < .001). Walking surface plays a significant role in altering gait patterns in both children with idiopathic toe walking and typically developing children. Walking on a gravel surface should be further explored for idiopathic toe walking.


Assuntos
Marcha , Transtornos dos Movimentos , Fenômenos Biomecânicos , Criança , Pré-Escolar , Feminino , Marcha/fisiologia , Humanos , Masculino , Transtornos dos Movimentos/fisiopatologia , Propriedades de Superfície
14.
Dev Neurorehabil ; 19(1): 64-71, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-24724587

RESUMO

OBJECTIVE: To systematically examine the effects of robotic therapy on upper extremity (UE) function in children with cerebral palsy (CP). METHODS: A systematic literature search was conducted in Pubmed, CINAHL, Cochrane, PsychInfo, TRIP, and Web of Science up to July 2013. Studies of children with CP, using robotic therapy and measures of UE were included. RESULTS: Nine articles using three different robotic systems were included. Of these, seven were case studies. Overall, robotic therapy showed the potential effects as all studies reported at least one positive outcome: a moderate effect in improving reaching duration, smoothness, or decreased muscle tone, and a small to large effect in standardized clinical assessment (e.g. Fugl-Meyer). CONCLUSION: This review confirms the potential for robotic therapy to improve UE function in children with CP. However, the paucity of group design studies summons the need for more rigorous research before conclusive recommendations can be made.


Assuntos
Paralisia Cerebral/reabilitação , Destreza Motora , Modalidades de Fisioterapia , Robótica/métodos , Extremidade Superior/fisiopatologia , Paralisia Cerebral/fisiopatologia , Criança , Humanos , Resultado do Tratamento
15.
J Cancer Res Clin Oncol ; 142(1): 277-86, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26328915

RESUMO

PURPOSE: The role of adjuvant radiotherapy in patients with esophageal squamous cell carcinoma (ESCC) remains controversial. This retrospective study was designed to analyze the impact of adjuvant radiotherapy in patients with T3 stage ESCC after radical resection. METHODS: Data of a single-center cohort of 692 patients with T3 stage ESCC who underwent radical resection, with or without adjuvant radiotherapy, were reviewed. Univariate and multivariate analyses were performed to compare overall survival (OS) and locoregional recurrence-free survival (LRFS). RESULTS: Two hundred and forty-six patients received adjuvant radiotherapy (S + R group), and 446 patients underwent surgery alone (S group). The median survival time and 5-year OS rate were 40.0 months and 40.9 % for the entire population, 50.0 months and 45.6 % for the S + R group and 38.0 months and 38.3 % for the S group (P = 0.114 for S + R group vs. S group). The 5-year LRFS rate for the S + R group was significantly higher than that for S group (50.8 vs. 35.9 %, P < 0.001). In subgroup analyses, adjuvant radiotherapy was found to improve the 5-year OS in the subgroups of tumor length >5 cm, pN0 and pN1 categories, pTNM stage IIa, IIb and IIIa (P < 0.005). CONCLUSIONS: Adjuvant radiotherapy is effective in local control of radically resected T3 stage ESCC and may improve the overall survival in certain subgroups, such as the patients with tumor length >5 cm, pN0 and pN1 categories, pTNM stage IIa, IIb and IIIa. Further studies are required to confirm our results.


Assuntos
Carcinoma de Células Escamosas/radioterapia , Neoplasias Esofágicas/radioterapia , Esofagectomia/mortalidade , Recidiva Local de Neoplasia/radioterapia , Radioterapia Adjuvante/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Terapia Combinada , Neoplasias Esofágicas/mortalidade , Neoplasias Esofágicas/patologia , Neoplasias Esofágicas/cirurgia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/mortalidade , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/cirurgia , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida
16.
J Rehabil Res Dev ; 52(4): 421-30, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26360645

RESUMO

We hypothesized that the effects of immediate video feedback (IVF) on training ramp, wheelie, and curb wheelchair skills for persons with spinal cord injury (SCI) would be equivalent to or better than the traditional wheelchair skill training. Participants were manual wheelchair users with recent SCI (thoracic 1-lumbar 1) who were matched (9 pairs) on motor function level, age, and sex and randomly assigned to a control group (conventional training) or an experimental group (IVF training). Participants learned three wheelchair skills and then went through the wheelchair skill competency test, retention test, and transfer test. Paired t-tests were used to examine the differences in training time (minutes), spotter intervention needed (counts), and successful rate in performance between the two groups. A 2 (groups) x 3 (skills) x 3 (tests) repeated-measures analysis of variance and Bonferroni adjustment test were used to examine differences between groups on wheelchair skills and tests. No differences were found between two groups in training times (minutes) on three wheelchair skills (experimental vs control: ramp 14.92 +/- 5.80 vs 11.69 +/- 7.85; wheelie 17.79 +/- 6.03 vs 19.92 +/- 13.42; and curb 38.35 +/-23.01 vs 48.59 +/- 15.21). This study demonstrated that IVF for training manual wheelchair skills may produce similar results as the conventional training and may be an alternative training method for wheelchair skills.


Assuntos
Retroalimentação Sensorial , Feedback Formativo , Atividade Motora/fisiologia , Traumatismos da Medula Espinal/reabilitação , Cadeiras de Rodas , Adolescente , Adulto , Fatores Etários , Idoso , Feminino , Humanos , Vértebras Lombares , Masculino , Pessoa de Meia-Idade , Traumatismos da Medula Espinal/fisiopatologia , Traumatismos da Medula Espinal/psicologia , Vértebras Torácicas , Adulto Jovem
17.
World J Gastroenterol ; 21(24): 7514-21, 2015 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-26139998

RESUMO

AIM: To analyze a modified staging system utilizing lymph node ratio (LNR) in patients with esophageal squamous cell carcinoma (ESCC). METHODS: Clinical data of 2011 patients with ESCC who underwent surgical resection alone between January 1995 and June 2010 at the Cancer Hospital of Shantou University Medical College were reviewed. The LNR, or node ratio (Nr) was defined as the ratio of metastatic LNs ompared to the total number of resected LNs. Overall survival between groups was compared with the log-rank test. The cutoff point of LNR was established by grouping patients with 10% increment in Nr, and then combining the neighborhood survival curves using the log-rank test. A new TNrM staging system, was constructed by replacing the American Joint Committee on Cancer (AJCC) N categories with the Nr categories in the new TNM staging system. The time-dependent receiver operating characteristic curves were used to evaluate the predictive performance of the seventh edition AJCC staging system and the TNrM staging system. RESULTS: The median number of resected LNs was 12 (range: 4-44), and 25% and 75% interquartile rangeswere8 and 16. Patients were classified into four Nr categories with distinctive survival differences (Nr0: LNR = 0; Nr1: 0% < LNR ≤ 10%; Nr2: 10% < LNR ≤ 20%; and Nr3: LNR > 20%). From N categories to Nr categories, 557 patients changed their LN stage. The median survival time (MST) for the four Nr categories (Nr0-Nr3) was 155.0 mo, 39.0 mo, 28.0 mo, and 19.0 mo, respectively, and the 5-year overall survival was 61.1%, 41.1%, 33.0%, and 22.9%, respectively (P < 0.001). Overall survival was significantly different for the AJCC N categories when patients were subgrouped into 15 or more vs fewer than 15 examined nodes, except for the N3 category (P = 0.292). However, overall survival was similar when the patients in all four Nr categories were subgrouped into 15 or more vs fewer than 15 nodes. Using the time-dependent receiver operating characteristic, we found that the Nr category and TNrM stage had higher accuracy in predicting survival than the AJCC N category and TNM stage. CONCLUSION: A staging system based on LNR may have better prognostic stratification of patients with ESCC than the current TNM system, especially for those undergoing limited lymphadenectomy.


Assuntos
Carcinoma de Células Escamosas/secundário , Neoplasias Esofágicas/patologia , Linfonodos/patologia , Estadiamento de Neoplasias/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Área Sob a Curva , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/cirurgia , Neoplasias Esofágicas/mortalidade , Neoplasias Esofágicas/cirurgia , Carcinoma de Células Escamosas do Esôfago , Esofagectomia , Feminino , Humanos , Estimativa de Kaplan-Meier , Excisão de Linfonodo , Linfonodos/cirurgia , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Curva ROC , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento
18.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 23(2): 420-4, 2015 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-25948197

RESUMO

OBJECTIVE: To analyse the clinical featuers, prognositic factors and treatment outcomes of primary bone lymphoma(PBL). METHODS: The clinical data of 13 patients with PBL in our hospital from 2005 to 2014 were analysed retrospectively. RESULTS: The median age of these patients was 40 (25-71) years old, ostealgia was the initial symptom(100%). The main histologic type was diffuse large B cell lymphoma (DLBCL) (11/13, 84.6%), and among other 2 cases 1 case was anaplastic large cell lymphoma(ALCL) and other 1 case was B lymphoblastic lymphoma. All 13 cases were treated with chemotherapy, 6 cases got complete remission(46.2%) and 7 cases got partial remission(53.8%). There was no statistical relation of age, sex, stage, ß2-MG level, LDH level, pathological type and the application of rituximab with the complete remission rate (P>0.05). After the median follow up of 12 (3-72) months, 3 cases died of diease progression and 6 cases maintained in complete remission, the median progression-free survival was 13 (2-72) months. CONCLUSION: The most common histologic type is DLBCL, its main treatment method is the combined chemical therapy, but the role of rituximab in treatment is not clear, thus larger clinical trial is necessary.


Assuntos
Neoplasias Ósseas , Linfoma Difuso de Grandes Células B , Adulto , Idoso , Intervalo Livre de Doença , Humanos , Pessoa de Meia-Idade , Indução de Remissão , Estudos Retrospectivos , Resultado do Tratamento
19.
J Mark Res ; 52(4): 453-466, 2015 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-27065490

RESUMO

Considerable attention has been given to the notion that there exists a set of human-like characteristics associated with brands, referred to as brand personality. Here we combine newly available machine learning techniques with functional neuroimaging data to characterize the set of processes that give rise to these associations. We show that brand personality traits can be captured by the weighted activity across a widely distributed set of brain regions previously implicated in reasoning, imagery, and affective processing. That is, as opposed to being constructed via reflective processes, brand personality traits appear to exist a priori inside the minds of consumers, such that we were able to predict what brand a person is thinking about based solely on the relationship between brand personality associations and brain activity. These findings represent an important advance in the application of neuroscientific methods to consumer research, moving from work focused on cataloguing brain regions associated with marketing stimuli to testing and refining mental constructs central to theories of consumer behavior.

20.
J Child Neurol ; 30(8): 1010-6, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25260915

RESUMO

The effectiveness of idiopathic toe walking treatments is not conclusive. The study investigated the use of vibration as a therapeutic/treatment method for children with idiopathic toe walking. Fifteen children with idiopathic toe walking and 15 typically developing children, aged 4 to 10 years, completed the study. The study included a barefoot gait examination and a vibration perception threshold test before and after standing on a whole body vibration machine for 60 seconds. Temporal-spatial parameters were recorded along with HR32, a calculation designed to distinguish on aspects of the toe-walking pattern. No significant gait pattern differences were found between children with idiopathic toe walking and typically developing children after one bout of vibration intervention. HR32 was found to be a means to identify the toe-walking pattern (P < .001). Hypersensitivity to vibration of children with idiopathic toe walking was not found in the current study (P = .921).


Assuntos
Transtornos Neurológicos da Marcha/fisiopatologia , Transtornos Neurológicos da Marcha/reabilitação , Limiar Sensorial/fisiologia , Dedos do Pé , Vibração , Caminhada/fisiologia , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Resultado do Tratamento
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