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1.
Gynecol Endocrinol ; 35(5): 439-442, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30585507

RESUMO

A retrospective cohort study was performed to examine whether, in artificial endometrial preparation for frozen embryo transfer (FET) cycles, progesterone (P) levels the day prior to embryo transfer of euploid embryos have an impact on pregnancy outcomes. In a private university clinic, 244 FETs between January 2016 and June 2017 were analyzed. Endometrial preparation was achieved with estradiol valerate and vaginal micronized progesterone. Serum P and estradiol levels the day prior to embryo transfer were measured. A multivariable analysis to assess the relationship between serum P level and pregnancy outcomes was performed, adjusted for confounding variables. Mean P value was 11.3 ± 5.1 ng/ml. Progesterone levels were split in quartiles: Q1: ≤ 8.06 ng/ml; Q2: 8.07-10.64 ng/ml; Q3: 10.65-13.13 ng/ml; Q4: > 13.13 ng/ml. Patients included in the lower P quartile had a significantly higher miscarriage rate and significantly lower live birth rate (LBR) compared to the higher ones. A low serum P level (≤ 10.64 ng/ml) one day before FET is associated with a lower pregnancy and LBR following FET of euploid embryos.


Assuntos
Transferência Embrionária/métodos , Fertilização In Vitro , Resultado da Gravidez , Progesterona/sangue , Adulto , Coeficiente de Natalidade , Criopreservação , Feminino , Humanos , Nascimento Vivo , Gravidez , Estudos Retrospectivos , Fatores de Risco
2.
Trans R Soc Trop Med Hyg ; 105(11): 607-16, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21962292

RESUMO

Intermittent preventive treatment of malaria during pregnancy (IPTp) and insecticide-treated nets (ITN) are recommended malaria interventions during pregnancy; however, there is limited information on their efficacy in areas of low malaria transmission in sub-Saharan Africa. An individually-randomised placebo-controlled trial involving 5775 women of all parities examined the effect of IPTp, ITNs alone, or ITNs used in combination with IPTp on maternal anaemia and low birth weight (LBW) in a highland area of southwestern Uganda. The overall prevalence of malaria infection, maternal anaemia and LBW was 15.0%, 14.7% and 6.5%, respectively. Maternal and fetal outcomes were generally remarkably similar across all intervention groups (P>0.05 for all outcomes examined). A marginal difference in maternal haemoglobin was observed in the dual intervention group (12.57g/dl) compared with the IPTp and ITN alone groups (12.40g/dl and 12.44g/dl, respectively; P=0.04), but this was too slight to be of clinical importance. In conclusion, none of the preventive strategies was found to be superior to the others, and no substantial additional benefit to providing both IPTp and ITNs during routine antenatal services was observed. With ITNs offering a number of advantages over IPTp, yet showing comparable efficacy, we discuss why ITNs could be an appropriate preventive strategy for malaria control during pregnancy in areas of low and unstable transmission.


Assuntos
Antimaláricos/uso terapêutico , Mosquiteiros Tratados com Inseticida/estatística & dados numéricos , Malária/prevenção & controle , Complicações Parasitárias na Gravidez/prevenção & controle , Pirimetamina/uso terapêutico , Sulfadoxina/uso terapêutico , Adolescente , Adulto , Análise de Variância , Combinação de Medicamentos , Feminino , Visita Domiciliar , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Malária/tratamento farmacológico , Malária/epidemiologia , Pessoa de Meia-Idade , Gravidez , Complicações Parasitárias na Gravidez/tratamento farmacológico , Complicações Parasitárias na Gravidez/epidemiologia , Cuidado Pré-Natal , Uganda/epidemiologia , Adulto Jovem
3.
Homeopathy ; 91(1): 3-9, 2002 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-12371448

RESUMO

The objective of this review was to ascertain the incidence of childhood sexual abuse: to ascertain the long-term effects of childhood sexual abuse and to collate the experiences of homeopaths in caring for survivors. Childhood sexual abuse (CSA) is common with a high percentage of homeopathic patients giving a positive history. It is associated with many common clinical conditions, particularly pelvic pain. Survivors are more likely to present for medical help and to be hospitalised. Homeopaths have found work with such patients to be difficult, with cases being complex and multi-layered. New models for case-analysis have been developed.


Assuntos
Abuso Sexual na Infância/psicologia , Homeopatia/métodos , Transtornos de Estresse Pós-Traumáticos/terapia , Sobreviventes/psicologia , Adaptação Psicológica , Criança , Transtornos Dissociativos/diagnóstico , Transtornos Dissociativos/psicologia , Feminino , Doenças dos Genitais Femininos/etiologia , Doenças dos Genitais Femininos/psicologia , Humanos , Acontecimentos que Mudam a Vida , Transtornos de Estresse Pós-Traumáticos/complicações , Transtornos de Estresse Pós-Traumáticos/psicologia , Saúde da Mulher
4.
Homeopathy (Londres. 2002) ; 91(1): 3-9, jan. 2002.
Artigo em Inglês | HomeoIndex - Homeopatia | ID: hom-5919

RESUMO

The objetive of this review was to ascertain the incidence of childhood sexual abuse: to ascertain the long-term effects of childhood sexual abuse and to collate the experiences of homeopoaths in caring for survivors. Childhood sexual abuse (CSA) is common with a high percentage of homeopathic patients giving a positive history. It is associated with... (AU)


Assuntos
Relatos de Casos , Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Abuso Sexual na Infância , Homeopatia , Fadiga/terapia , Vaginite/terapia , Síndrome de Fadiga Crônica/terapia
5.
Health Care Manag Sci ; 2(3): 137-48, 1999 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-10934538

RESUMO

OBJECTIVES: This collaborative project between two community hospitals, a Metropolitan Home Care Program and the University, was designed to quantify the applicability (who is eligible for) and acceptability (who will likely comply with) Home Care services, provided through a Quick Response Program (QRP) initiative as compared to usual hospital care services, to patients, families and physicians. METHODS: During a 6 week period of sampling (5 days per week, 8 hours per day) in two Emergency Departments (ED) in moderately sized community hospitals in a major metropolitan city, all patients triaged to the urgent category were assessed for eligibility for QRP services by on-site Home Care Coordinators using specific criteria. Patients meeting the criteria initially were reviewed by the ED physician for approval for QRP services and then randomized to experimental and control conditions. Patients not meeting the eligibility criteria were managed by the usual ED services procedures. Demographic and clinical data were obtained on all urgent category patients at presentation to the ED. Additionally, the nature and cost of all health care services used by the ED patients during the ED event and 10 days follow up, were obtained through hospital and Home Care record abstraction and compared among the different sample groups. RESULTS: The QRP Initiative was applicable to 2% of the total ED patient population and 5% of the urgent category of patients triaged in the ED. It was acceptable to 97% of this eligible group. One hundred and fifty-five patients who initially qualified for QRP were excluded from eligibility at a subsequent assessment. Ninety of these patients were admitted to hospital and 65 were discharged home. In the total "exclusion" group, 37 refused Home Care services including the QRP. HEALTH CARE PRACTICE IMPLICATIONS: The sampling results raise important questions about broader system issues concerning the role of the hospital and community in providing health care services and the social value or utility that guides the allocation of health care funds. What level of applicability and acceptability would justify priority services for certain target groups. In the future, policy makers will need to be able to show that it is in the best interest of patients and society to prioritize mixtures of services to certain target groups.


Assuntos
Doença Crônica , Serviço Hospitalar de Emergência/organização & administração , Serviços de Assistência Domiciliar/estatística & dados numéricos , Relações Interinstitucionais , Encaminhamento e Consulta/estatística & dados numéricos , Adulto , Idoso , Definição da Elegibilidade , Serviço Hospitalar de Emergência/economia , Feminino , Hospitais Comunitários , Humanos , Masculino , Ontário , Avaliação de Programas e Projetos de Saúde
6.
Biochemistry ; 37(1): 417-23, 1998 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-9425063

RESUMO

Phycoerythrin 545 was isolated having an alpha2beta2 (dimer) protein structure at pH 6.0 and 2 g/L protein concentration with eight bilin chromophores. Monomers (alphabeta) were produced by lowering the protein concentration to 0.15 g/L and the pH to 4.5. Dimer dissociation was monitored by dynamic light scattering and gel-filtration column chromatography. Monomers were stable and had bilin optical spectra different from the alpha2beta2 dimers, although they have very similar protein secondary structures. The optical spectra of phycoerythrin 545 showed four types of behavior with temperature: 10-20 degrees C, dimers; 40-50 degrees C, dimers/monomers; 60 degrees C, nearly fully disordered; 70 degrees C, disordered alpha and beta polypeptides. At 40 degrees C, the protein dissociated partially to monomer, which could be totally reversed to dimers at 20-25 degrees C. The visible circular dichroism difference spectrum for the protein dimers minus monomers exhibited positive and negative bands--such spectra may indicate exciton splitting between closely-spaced bilins. Circular dichroism also revealed a spectrum suggesting exciton coupling for the second excited state of the bilins. Ultrafast fluorescence using a two-photon method showed the fastest time for protein dimers to be 2. 4 ps and monomers had a 39-ps lifetime. Phycocyanin 645 was found to have a 550-fs lifetime.


Assuntos
Pigmentos Biliares/química , Eucariotos/química , Ficoeritrina/química , Pigmentos Biliares/metabolismo , Sítios de Ligação , Cromatografia em Gel , Dicroísmo Circular , Dimerização , Transferência de Energia , Luz , Ficoeritrina/metabolismo , Espalhamento de Radiação , Espectrometria de Fluorescência , Temperatura
7.
J R Coll Surg Edinb ; 40(1): 55-8, 1995 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-7738901

RESUMO

The objective of this study was to compare an on call rota and partial shift working pattern for house surgeons in two hospitals. The study was conducted using a crossover trial of working both systems for 6 weeks each in two groups of newly appointed house surgeons. Assessment was by questionnaire to house surgeons, consultants, registrars, nursing staff and patients. The study took place at the departments of general surgery at Guy's and Lewisham Hospitals, London. A total of 12 house surgeons attached to four surgical firms and their consultants and registrars were the subject of our study. In addition the permanent nursing staff on designated general surgical wards and those patients of greater than 48 h stay on those wards on the day of assessment took part. Expectations of reduced fatigue levels using the partial shift system were not fulfilled. In contrast, this working pattern led to perceived disruption of the running of the surgical firms and demoralization of the house surgeons. Standards of patient care were, however, equally high using a rota or partial shift system. This comparison of a partial shift working pattern to an on call rota of similar average weekly hours demonstrated a marked preference for an on call rota from both medical and nursing staff although patients found both systems acceptable.


Assuntos
Hospitais de Ensino , Admissão e Escalonamento de Pessoal/organização & administração , Centro Cirúrgico Hospitalar , Tolerância ao Trabalho Programado , Estudos Cross-Over , Humanos , Londres , Corpo Clínico Hospitalar , Planejamento de Assistência ao Paciente , Inquéritos e Questionários , Recursos Humanos
8.
Ann R Coll Surg Engl ; 76(1): 22-5, 1994 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-8117013

RESUMO

All 338 lower limb amputees under the care of one disablement services centre were asked to assess phantom pain severity at different times after amputation. Of 212 (63%) replies, 13 had died, 22 were non-limb wearers and 22 were unable to complete the questionnaire. In all, 176 useful replies were received--96 below-knee, 74 above-knee and 6 through-knee. Of these, 98 amputations were performed for trauma and 78 for vascular disease. Below-knee amputees rehabilitated better than above-knee amputees (P < 0.05) and traumatic better than vascular amputees (P < 0.0001). Preoperative pain was worse in vascular amputees (P < 0.0005), but there was no significant difference in the amount of phantom-pain experienced by vascular and traumatic amputees. Phantom sensations were experienced by 82% and phantom pain by 78%. Phantom pain decreased with time, was present equally in traumatic and vascular amputees, and was related to the amount of preoperative pain (P < 0.005). Only 22% felt phantom pain had impaired their rehabilitation. Rehabilitation score was related to phantom pain severity at the time of questionnaire completion (P < 0.05), but not at other specified times after operation.


Assuntos
Amputação/reabilitação , Perna (Membro)/cirurgia , Medição da Dor , Membro Fantasma/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Amputação/efeitos adversos , Humanos , Perna (Membro)/irrigação sanguínea , Traumatismos da Perna/cirurgia , Pessoa de Meia-Idade , Membro Fantasma/fisiopatologia , Período Pós-Operatório , Fluxo Sanguíneo Regional , Coxa da Perna/cirurgia , Doenças Vasculares/cirurgia
10.
Oncogene ; 4(12): 1441-8, 1989 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-2687766

RESUMO

Three different Harvey-ras (Ha-ras) genes have been identified in the bovine genome by screening a lambda phage-bovine DNA library with the ras gene of the Harvey murine sarcoma virus. The genes have been characterized by hybridization and heteroduplex analysis with both the viral and human Ha-ras genes. Based on heteroduplex mapping, the putative direction of transcription and the approximate position of the coding regions of the bovine genes were established. Two genes, bovine Ha-ras 1 and 2, both show an arrangement of exons and introns typical of c-Ha-ras genes. However, they are distinct entities as they have different nucleotide sequences and physical maps, and heteroduplexes between them contain a region of non-homology upstream of exon 1. The third gene, c-Ha-ras 3, does not contain introns and is a pseudogene, analogous to human c-Ha-ras 2. The nucleotide sequence of both Ha-ras 1 and Ha-ras 2 has been determined and shows that Ha-ras 1 encodes a bona fide ras protein, whereas Ha-ras 2 has diverged considerably from a recognizably functional sequence.


Assuntos
Genes ras , Biblioteca Genômica , Sequência de Aminoácidos , Animais , Sequência de Bases , Bovinos , Clonagem Molecular/métodos , Humanos , Dados de Sequência Molecular , Hibridização de Ácido Nucleico , Proteínas Proto-Oncogênicas/genética , Proteínas Proto-Oncogênicas p21(ras) , Mapeamento por Restrição , Homologia de Sequência do Ácido Nucleico
11.
Biochem J ; 239(3): 699-704, 1986 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-2950851

RESUMO

A procedure has been developed for the purification of 3-dehydroquinase from Escherichia coli. Homogeneous enzyme with specific activity 163 units/mg of protein was obtained in 19% overall yield. The subunit Mr estimated from polyacrylamide-gel electrophoresis in the presence of sodium dodecyl sulphate was 29,000. The native Mr, estimated by gel permeation chromatography on Sephacryl S-200 (superfine) and on TSK G3000SW, was in the range 52,000-58,000, indicating that the enzyme is dimeric. The catalytic properties of the enzyme have been determined and shown to be very similar to those of the biosynthetic 3-dehydroquinase component of the arom multifunctional enzyme of Neurospora crassa.


Assuntos
Escherichia coli/enzimologia , Hidroliases/metabolismo , Cromatografia Líquida , Eletroforese em Gel de Poliacrilamida , Hidroliases/isolamento & purificação , Concentração de Íons de Hidrogênio , Cinética , Neurospora crassa/enzimologia
12.
Anticancer Res ; 6(4): 663-8, 1986.
Artigo em Inglês | MEDLINE | ID: mdl-3092725

RESUMO

We have determined the effect of fragments of the human IgC lambda region on the expression of a linked marker gene on transfection into heterologous LATK cells. No Ig fragment stimulated high expression of the bacterial chloramphenicol acetyl transferase gene under conditions where high activation by the Moloney MSV enhancer was observed. This suggests that there is not an element in this DNA fragment which behaves as a strong enhancer in fibroblast cells. Sequences localised within a 0.9 kb fragment 3' to the Ke-Oz- constant region gene showed low (four fold) stimulation of CAT activity. These results are discussed in relation to measuring gene activity by protein expression assays.


Assuntos
Regulação da Expressão Gênica , Cadeias Leves de Imunoglobulina/genética , Cadeias lambda de Imunoglobulina/genética , Acetiltransferases/genética , Animais , Cloranfenicol O-Acetiltransferase , Elementos Facilitadores Genéticos , Fibroblastos , Humanos , Camundongos , Plasmídeos , Transcrição Genética , Transfecção
13.
Nucleic Acids Res ; 12(17): 6647-61, 1984 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-6091030

RESUMO

We report the first isolation and characterisation of a human Ig V lambda gene. The gene was isolated from a recombinant phage library of human chromosome 22 using a mouse Ig lambda cDNA as probe. DNA sequence analysis predicts a short leader peptide interrupted by an intron of 88 nucleotides, and a mature polypeptide of 96-97 amino acids which shares 61% homology with mouse V lambda I chains. Comparison with the amino acid sequence of known human lambda chains of all six subgroups shows agreement at 22/25 low variance positions. However the maximum homology with human chains is 49%, so we conclude that this sequence represents a new IgV lambda subgroup. The coding region is followed by the conserved heptamer, CACAGTG, and nonamer, ACATAAACC, sequences which have been implicated in V-J segment recombination. This gene has the hallmarks of an active V lambda gene including recently identified transcriptional controlling sequences. Probing genomic DNA with the subcloned V lambda gene detects a family of about 10 cross hybridizing members at low stringency and 2 at high stringency. There is limited polymorphism of the V lambda locus.


Assuntos
Cromossomos Humanos 21-22 e Y , DNA Recombinante/isolamento & purificação , Genes , Região Variável de Imunoglobulina/genética , Sequência de Bases , Clonagem Molecular , DNA/sangue , Enzimas de Restrição do DNA , Humanos , Peso Molecular , Hibridização de Ácido Nucleico , Polimorfismo Genético
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