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Narcı H. Acute pulmonary edema due to excessive water intake in pyschiatric patient. Iran Red Crescent Med J 2013; 15:375-6. [PMID: 24083018 PMCID: PMC3785919 DOI: 10.5812/ircmj.2228] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/04/2011] [Revised: 02/03/2012] [Accepted: 02/08/2012] [Indexed: 11/16/2022]
Affiliation(s)
- Hüseyin Narcı
- Baskent University, Emergency Department, Konya, Turkey
- Corresponding author: Hüseyin Narcı, Başkent Üniversitesi, Hoca Cihan mah. Saray Cad. No. 1 Selçuklu/ Konya, Turkey, Tel: +90-5063053233, Fax: +90-332257063, E-mail:
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1052
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Oche MO, Adamu H. Determinants of patient waiting time in the general outpatient department of a tertiary health institution in north Western Nigeria. Ann Med Health Sci Res 2013; 3:588-92. [PMID: 24380014 PMCID: PMC3868129 DOI: 10.4103/2141-9248.122123] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The amount of time a patient waits to be seen is one factor which affects utilization of healthcare services. Patients perceive long waiting times as barrier to actually obtaining services and keeping patients waiting unnecessarily can be a cause of stress for both patient and doctor. AIM This study was aimed at assessing the determinants of patients' waiting time in the general outpatient department (GOPD) of a tertiary health institution in northern Nigeria. SUBJECTS AND METHODS This descriptive cross-sectional study was carried out among new patients attending the GOPD of the Usmanu Danfodiyo University Teaching Hospital, Sokoto, North Western Nigeria. A structured questionnaire was used to elicit information from 100 patients who were recruited into the study using a convenience sampling method. Data collected were entered and analyzed using Statistical Package for Social Sciences version 17; Chi-square test was used to compare differences between proportions with the level of statistical significance set at 5% (P < 0.05). RESULTS Sixty-one percent (59/96) of the respondents waited for 90-180 min in the clinic, whereas 36.1% (35/96) of the patients spent less than 5 min with the doctor in the consulting room. The commonest reason for the long waiting time in the GOPD was the large number of patients with few healthcare workers. CONCLUSION There is an urgent need to increase the number of health workers in the GOPDs which serves as the gate way to the hospital if the aims of the Millennium Development Goals are to be realized.
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Affiliation(s)
- MO Oche
- Department of Community Health, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - H Adamu
- Department of Community Health, Usmanu Danfodiyo University, Sokoto, Nigeria
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1053
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Fischmeister FPS, Höllinger I, Klinger N, Geissler A, Wurnig MC, Matt E, Rath J, Robinson SD, Trattnig S, Beisteiner R. The benefits of skull stripping in the normalization of clinical fMRI data. Neuroimage Clin 2013; 3:369-80. [PMID: 24273720 PMCID: PMC3814956 DOI: 10.1016/j.nicl.2013.09.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Revised: 09/11/2013] [Accepted: 09/23/2013] [Indexed: 11/24/2022]
Abstract
Establishing a reliable correspondence between lesioned brains and a template is challenging using current normalization techniques. The optimum procedure has not been conclusively established, and a critical dichotomy is whether to use input data sets which contain skull signal, or whether skull signal should be removed. Here we provide a first investigation into whether clinical fMRI benefits from skull stripping, based on data from a presurgical language localization task. Brain activation changes related to deskulled/not-deskulled input data are determined in the context of very recently developed (New Segment, Unified Segmentation) and standard normalization approaches. Analysis of structural and functional data demonstrates that skull stripping improves language localization in MNI space — particularly when used in combination with the New Segment normalization technique. First investigation of the possible effects of skull-stripping with clinical fMRI data. Comparison of standard and most recent normalization approaches. Skull stripping improves language localization in MNI space.
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Affiliation(s)
- F Ph S Fischmeister
- Study Group Clinical fMRI, Department of Neurology, Medical University of Vienna, Austria ; High Field MR Center, Medical University of Vienna, Austria
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1054
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Abstract
BACKGROUND The concept of caring is important to both patients and nurses. If patients and nurses perceive caring behaviours differently, patients may not have their needs met or will be dissatisfied with the nursing. AIM This study conducted in mainland China compared the perceptions of nurses and patients concerning nurses' caring behaviours. METHODS From November 2011 to June 2012, 680 patients and 540 of their nurses in five hospitals in southern, central and eastern China were invited to complete a descriptive comparative survey with four subcategories, the Caring Behaviors Inventory-24. Respondents scored each of the 24 items on the survey from 1 (low) to 6 (high). Of those invited, 595 patients (87.50%) and 445 (82.41%) nurses completed the survey. RESULTS The mean item score on the Caring Behaviors Inventory-24 was 4.32 and 4.96 for patients and nurses, respectively. The subcategory with the highest mean score for both groups was knowledge and skills (4.73, 5.25), and the lowest for both groups was positive connectedness (3.98, 4.51). Nurses' scores were significantly higher than those of patients for all four subcategories (P < 0.001). CONCLUSIONS The gap between the two groups indicates that nurses need to improve their understanding and response to patients' actual and perceived needs and expectations. In China, patients require more support from nurses of their psychological needs. STUDY LIMITATIONS Participants came from a limited number of hospitals in three cities. A larger sample from different hospitals in mainland China could have increased the power of the study.
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Affiliation(s)
- T He
- Department of Nursing, People's Hospital of Zhongshan City, Zhongshan, Guangdong, China
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1055
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Lauvergeon S, Burnand B, Peytremann-Bridevaux I. [Implementation of a diabetes disease management program in Switzerland: patients' and healthcare professionals' point of view]. Rev Epidemiol Sante Publique 2013; 61:475-84. [PMID: 24035386 DOI: 10.1016/j.respe.2013.05.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Revised: 09/18/2012] [Accepted: 05/10/2013] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND A reorganization of healthcare systems is required to meet the challenge of the increasing prevalence of chronic diseases, e.g. diabetes. In North-America and Europe, several countries have thus developed national or regional chronic disease management programs. In Switzerland, such initiatives have only emerged recently. In 2010, the canton of Vaud set up the "Diabetes Cantonal Program", within the framework of which we conducted a study designed to ascertain the opinions of both diabetic patients and healthcare professionals on the elements that could be integrated into this program, the barriers and facilitators to its development, and the incentives that could motivate these actors to participate. METHODS We organized eight focus-groups: one with diabetic patients and one with healthcare professionals in the four sanitary areas of the canton of Vaud. The discussions were recorded, transcribed and submitted to a thematic content analysis. RESULTS Patients and healthcare professionals were rather in favour of the implementation of a cantonal program, although patients were more cautious concerning its necessity. All participants envisioned a set of elements that could be integrated to this program. They also considered that the program could be developed more easily if it were adapted to patients' and professionals' needs and if it used existing structures and professionals. The difficulty to motivate both patients and professionals to participate was mentioned as a barrier to the development of this program however. Quality or financial incentives could therefore be created to overcome this potential problem. CONCLUSION The identification of the elements to consider, barriers, facilitators and incentives to participate to a chronic disease management program, obtained by exploring the opinions of patients and healthcare professionals, should favour its further development and implementation.
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Affiliation(s)
- S Lauvergeon
- Institut universitaire de médecine sociale et préventive (IUMSP), centre hospitalier universitaire Vaudois et université de Lausanne, Biopôle 2, route de la Corniche 10, 1010 Lausanne, Suisse
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1056
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Bol N, Smets EMA, Rutgers MM, Burgers JA, de Haes HCJM, Loos EF, van Weert JCM. Do videos improve website satisfaction and recall of online cancer-related information in older lung cancer patients? Patient Educ Couns 2013; 92:404-412. [PMID: 23820196 DOI: 10.1016/j.pec.2013.06.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Revised: 04/22/2013] [Accepted: 06/10/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVE This study investigated the effects of personalized audiovisual information in addition to text on website satisfaction and recall of cancer-related online information in older lung cancer patients. METHODS An experiment using a 3 (condition: text only vs. text with nonpersonalized video vs. text with personalized video) by 2 (age patient: younger [<65 yrs] vs. older [≥65 yrs]) between-subjects factorial design was conducted. Patients were randomly assigned to one of the three information conditions stratified by age group. RESULTS Patients were more satisfied with the comprehensibility, attractiveness, and the emotional support from the website when information was presented as text with personalized video compared to text only. Text with personalized video also outperformed text with nonpersonalized video regarding emotional support from the website. Furthermore, text with video improved patients' recall of cancer-related information as compared to text only. Older patients recalled less information correctly than younger patients, except when we controlled for Internet use. CONCLUSION Text with personalized audiovisual information can enhance website satisfaction and information recall. Internet use plays an important role in explaining recall of information. PRACTICE IMPLICATIONS The results of this study can be used to develop effective health communication materials for cancer patients.
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Affiliation(s)
- Nadine Bol
- Amsterdam School of Communication Research/ASCoR, University of Amsterdam, Amsterdam, The Netherlands.
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1057
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Adib Hajbaghery M, Moradi T. Quality of care for patients with traction in shahid beheshti hospital in 2012. Arch Trauma Res 2013; 2:85-90. [PMID: 24396800 PMCID: PMC3876554 DOI: 10.5812/atr.9127] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Revised: 04/18/2013] [Accepted: 04/20/2013] [Indexed: 11/16/2022]
Abstract
Background With increasing incidence of traumatic fractures, the use of orthopedic intervention
such as traction has increased. Inappropriate traction care may cause substantial
morbidity and delay the patient rehabilitation. Objectives This study was conducted to evaluate the quality of care for patients with traction in
the orthopedic unit of Kashan's Shahid Beheshti Hospital, Kashan, Iran. Patients and Methods This observational study was conducted on 100 patients with traumatic fractures of hip
and femur bones who were admitted to Kashan Shahid-Beheshti Hospital during the first 6
months of 2012, and for whom skeletal or skin traction was performed. Data were
collected using a checklist including questions about the personal characteristics and
23 items related to care for patients with tractions. These items were in three domains
including caring while establishing traction, recording care and patient’s education.
Descriptive statistics were calculated and data were analyzed using the independent
sample t-test and Pearson correlation coefficient. Results The mean age of patients was 51.16 ± 23.28 years and 66% of them were male. In
total, 47% of the patients were treated by skin traction and 53% by skeletal traction.
The overall mean score of quality of care was 10.20 ± 2.64. Quality of establishing
traction was good in 55% of patients, but the quality of care was poor in the domains of
recording care (88%) and patient education (96%). Total mean of quality of care was
significantly different between male and female patients (P < 0.02). Conclusions The quality of care of patients with traction was not optimal. Therefore it is
necessary to improve measures in this area.
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Affiliation(s)
- Mohsen Adib Hajbaghery
- Trauma Nursing Research Center, Kashan University of
Medical Sciences, Kashan, IR Iran
- Corresponding author: Mohsen Adib Hajbaghery, Trauma
Nursing Research Center, Kashan University of Medical Sciences. Kashan, IR Iran. Tel.:
+98-3615550021, Fax: +98-3615556633, E-mail:
| | - Tayebeh Moradi
- Student Research Committee, Faculty of Nursing and
Midwifery, Kashan University of Medical Sciences, Kashan, IR Iran
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1058
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Egyir B, Guardabassi L, Nielsen SS, Larsen J, Addo KK, Newman MJ, Larsen AR. Prevalence of nasal carriage and diversity of Staphylococcus aureus among in patients and hospital staff at Korle Bu Teaching Hospital, Ghana. J Glob Antimicrob Resist 2013; 1:189-193. [PMID: 27873611 DOI: 10.1016/j.jgar.2013.05.006] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Revised: 05/21/2013] [Accepted: 05/31/2013] [Indexed: 11/28/2022] Open
Abstract
There is a paucity of data on Staphylococcus aureus epidemiology in Africa. Prevalence of nasal carriage and genetic diversity of S. aureus were determined among hospital staff (HS) and inpatients (IP) at the largest hospital in Ghana. In total, 632 nasal swabs were obtained from 452 IP and 180 HS in the Child Health Department (CHD) and Surgical Department (SD). S. aureus carriage prevalences were 13.9% in IP and 23.3% in HS. The chance of being a carrier was higher in HS (P=0.005) and IP staying ≤7 days in hospital (P=0.007). Resistance to penicillin (93%), tetracycline (28%) and fusidic acid (12%) was more common than for other agents (<5%). A higher chance of multidrug-resistant S. aureus carriage was observed among IP compared with HS (P=0.01). High genetic diversity was shown by spa typing, with 55 spa types found among 105 isolates; the predominant spa types were t355 (10%) and t084 (10%). MRSA was detected in six IP with an overall carriage prevalence of ca. 1.3%, but not in HS. All three MRSA isolates from SD belonged to ST88-SCCmec IV, and two of them displayed the same spa type and antibiograms; three MRSA isolates from CHD belonged to distinct lineages (ST88-SCCmec IV, ST8-SCCmec V and ST72-SCCmec V). Altogether, these data indicate a high diversity of S. aureus, low levels of MRSA carriage, and a higher chance of nasal carriage of multidrug-resistant S. aureus among IP compared with HS in this hospital.
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Affiliation(s)
- Beverly Egyir
- Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark; Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Bacteriology Department, Noguchi Memorial Institute for Medical Research, Accra, Ghana.
| | - Luca Guardabassi
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Søren Saxmose Nielsen
- Department of Large Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Jesper Larsen
- Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark
| | - Kennedy Kwasi Addo
- Bacteriology Department, Noguchi Memorial Institute for Medical Research, Accra, Ghana
| | | | - Anders Rhod Larsen
- Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark
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1059
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Bright MG, Murphy K. Reliable quantification of BOLD fMRI cerebrovascular reactivity despite poor breath-hold performance. Neuroimage 2013; 83:559-68. [PMID: 23845426 PMCID: PMC3899001 DOI: 10.1016/j.neuroimage.2013.07.007] [Citation(s) in RCA: 117] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 06/11/2013] [Accepted: 07/02/2013] [Indexed: 11/28/2022] Open
Abstract
Cerebrovascular reactivity (CVR) can be mapped using BOLD fMRI to provide a clinical insight into vascular health that can be used to diagnose cerebrovascular disease. Breath-holds are a readily accessible method for producing the required arterial CO2 increases but their implementation into clinical studies is limited by concerns that patients will demonstrate highly variable performance of breath-hold challenges. This study assesses the repeatability of CVR measurements despite poor task performance, to determine if and how robust results could be achieved with breath-holds in patients. Twelve healthy volunteers were scanned at 3 T. Six functional scans were acquired, each consisting of 6 breath-hold challenges (10, 15, or 20 s duration) interleaved with periods of paced breathing. These scans simulated the varying breath-hold consistency and ability levels that may occur in patient data. Uniform ramps, time-scaled ramps, and end-tidal CO2 data were used as regressors in a general linear model in order to measure CVR at the grey matter, regional, and voxelwise level. The intraclass correlation coefficient (ICC) quantified the repeatability of the CVR measurement for each breath-hold regressor type and scale of interest across the variable task performances. The ramp regressors did not fully account for variability in breath-hold performance and did not achieve acceptable repeatability (ICC<0.4) in several regions analysed. In contrast, the end-tidal CO2 regressors resulted in "excellent" repeatability (ICC=0.82) in the average grey matter data, and resulted in acceptable repeatability in all smaller regions tested (ICC>0.4). Further analysis of intra-subject CVR variability across the brain (ICCspatial and voxelwise correlation) supported the use of end-tidal CO2 data to extract robust whole-brain CVR maps, despite variability in breath-hold performance. We conclude that the incorporation of end-tidal CO2 monitoring into scanning enables robust, repeatable measurement of CVR that makes breath-hold challenges suitable for routine clinical practice.
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Affiliation(s)
- Molly G Bright
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, CF10 3AT Cardiff, UK.
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1060
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Hachesu PR, Ahmadi M, Alizadeh S, Sadoughi F. Use of data mining techniques to determine and predict length of stay of cardiac patients. Healthc Inform Res 2013; 19:121-9. [PMID: 23882417 PMCID: PMC3717435 DOI: 10.4258/hir.2013.19.2.121] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Revised: 03/28/2013] [Accepted: 04/01/2013] [Indexed: 11/23/2022] Open
Abstract
Objectives Predicting the length of stay (LOS) of patients in a hospital is important in providing them with better services and higher satisfaction, as well as helping the hospital management plan and managing hospital resources as meticulously as possible. We propose applying data mining techniques to extract useful knowledge and draw an accurate model to predict the LOS of heart patients. Methods Data were collected from patients with coronary artery disease (CAD). The patient records of 4,948 patients who had suffered CAD were included in the analysis. The techniques used are classification with three algorithms, namely, decision tree, support vector machines (SVM), and artificial neural network (ANN). LOS is the target variable, and 36 input variables are used for prediction. A confusion matrix was obtained to calculate sensitivity, specificity, and accuracy. Results The overall accuracy of SVM was 96.4% in the training set. Most single patients (64.3%) had an LOS ≤5 days, whereas 41.2% of married patients had an LOS >10 days. Moreover, the study showed that comorbidity states, such as lung disorders and hemorrhage with drug consumption have an impact on long LOS. The presence of comorbidities, an ejection fraction <2, being a current smoker, and having social security type insurance in coronary artery patients led to longer LOS than other subjects. Conclusions All three algorithms are able to predict LOS with various degrees of accuracy. The findings demonstrated that the SVM was the best fit. There was a significant tendency for LOS to be longer in patients with lung or respiratory disorders and high blood pressure.
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Affiliation(s)
- Peyman Rezaei Hachesu
- Department of Health Information Management, School of Health Management and Information Sciences, Tehran University of Medical Sciences, Tehran, Iran
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1061
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Clark NA, Will MA, Moravek MB, Xu X, Fisseha S. Physician and patient use of and attitudes toward complementary and alternative medicine in the treatment of infertility. Int J Gynaecol Obstet 2013; 122:253-7. [PMID: 23820030 DOI: 10.1016/j.ijgo.2013.03.034] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Revised: 03/16/2013] [Accepted: 05/28/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine use of and attitudes toward complementary and alternative medicine (CAM) among infertility patients and subspecialty physicians. METHODS Infertility patients were asked to complete anonymous written surveys at an academic infertility practice; members of the Society for Reproductive Endocrinology and Infertility were electronically surveyed. Both groups were assessed regarding their use of and attitudes toward CAM. RESULTS The response rate was 32.1% (115/358) among patients and 22.6% (225/995) among physicians (P<0.05). In total, 105 (91.3%; 95% confidence interval [CI], 85.8-96.2) patients used CAM, and 84 (73.0%; 95% CI, 64.9-81.1) regarded it as beneficial to their fertility treatment. However, only 30 (26.1%; 95% CI, 18.0-34.0) patients reported CAM use to physicians, with the most common reason being that they were "never asked." Overall, 202 (89.8%; 95% CI, 85.9-93.8) physicians reported inquiring about CAM. CONCLUSION Significant discrepancies exist between subfertile patients and physicians in attitudes toward the use of CAM. The current prevalence of CAM use among infertility patients requires greater physician attention and justifies further study on the risks and benefits of integrating CAM into the biomedical treatment of infertility.
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Affiliation(s)
- Natalie A Clark
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Michigan, Ann Arbor, USA.
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1062
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Hutton B, Morretto P, Emmenegger U, Mazzarello S, Kuchuk I, Addison CL, Crawley F, Canil C, Malone S, Berry S, Fergusson D, Clemons M. Bone-targeted agent use for bone metastases from breast cancer and prostate cancer: A patient survey. J Bone Oncol 2013; 2:105-9. [PMID: 26909279 DOI: 10.1016/j.jbo.2013.05.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Accepted: 05/27/2013] [Indexed: 11/22/2022] Open
Abstract
Background In order to design studies assessing the optimal use of bone-targeted agents (BTAs) patient input is clearly desirable. Methods Patients who were receiving a BTA for metastatic prostate or breast cancer were surveyed at two Canadian cancer centres. Statistical analysis of respondent data was performed to establish relevant proportions of patient responses. Results Responses were received from 141 patients, 76 (53.9%) with prostate cancer and 65 (46.1%) with breast cancer. Duration of BTA use was <3 months (15.9%) to >24 months (35.2%). Patients were uncertain how long they would remain on a BTA. While most felt their BTA was given to reduce the chance of bone fractures (77%), 52% thought it would slow tumour growth. Prostate patients were more likely to receive denosumab and breast cancer patients, pamidronate. There was more variability in the dosing interval for breast cancer patients. Given a choice, most patients (49–57%) would prefer injection therapy to oral therapy (21–23%). Most patients (58–64%) were interested in enrolling in clinical trials of de-escalated therapy. Conclusion While there were clear differences in the types of BTAs patients received, our survey showed similarity for both prostate and breast cancer patients with respect to their perceptions of the goals of therapy. Patients were interested in participating in trials of de-escalated therapy. However, given that patients receive a range of agents for varying periods of time and in different locations (e.g. hospital vs. home), the design of future trials will need to be pragmatic to reflect this.
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1063
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Abstract
Objective The aim of this study was to explore Jordanian patients’ perceptions toward generic medicines and to evaluate their opinions regarding generic substitution. Method A cross-sectional descriptive study involving Jordanian patients was undertaken, using a self-administrated anonymous questionnaire. The response rate was 80% (n=400/500). Results The study showed that cost of medicines is high according to 83% of the patients. Most patients (92%) preferred to be prescribed the cheapest medicine. Majority of patients (79%) believed that cost should be considered before a drug is prescribed. Most patients (78%) accepted generic substitution and believed that it can provide significant saving. Surveyed patients (78%) agreed that they should have the option of choosing between generic and originator and 74% believed that physicians should give them that choice. These results showed a significant statistical correlation with the monthly income of the patient, percentage cost they pay and number of medicines prescribed (P<0.05). Conclusion The high cost of medicines in Jordan is believed to be the main driver for choosing generic medicines Furthermore; patients have positive attitudes towards generic medicines. The involvement of patients in the treatment decision would result in more adherence and improvement in health. The insights gained from patients in this study will be useful to health organisations and policy makers to design a robust generic policy to use medicines cost-effectively in Jordan.
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Affiliation(s)
- Faris El-Dahiyat
- Pharmacy Department, Kingston University, Penrhyn Road, Kingston upon Thames, KT1 2EE, United Kingdom
| | - Reem Kayyali
- Pharmacy Department, Kingston University, Penrhyn Road, Kingston upon Thames, KT1 2EE, United Kingdom
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1064
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Sanei B, Mahmoudieh M, Talebzadeh H, Shahabi Shahmiri S, Aghaei Z. Do patients with penetrating abdominal stab wounds require laparotomy? Arch Trauma Res 2013; 2:21-5. [PMID: 24396785 PMCID: PMC3876513 DOI: 10.5812/atr.6617] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Revised: 02/23/2013] [Accepted: 03/07/2013] [Indexed: 11/16/2022]
Abstract
BACKGROUND The optimal management of hemodynamically stable asymptomatic patients with anterior abdominal stab wounds (AASWs) remains controversial. The goal is to identify and treat injuries in a safe cost-effective manner. Common evaluation strategies are local wound exploration (LWE), diagnostic peritoneal lavage (DPL), serial clinical assessment (SCAs) and computed tomography (CT) imaging. Making a decision about the right time to operate on a patient with a penetrating abdominal stab wound, especially those who have visceral evisceration, is a continuing challenge. OBJECTIVES Until the year 2010, our strategy was emergency laparotomy in patients with penetrating anterior fascia and those with visceral evisceration. This survey was conducted towards evaluating the results of emergency laparotomy. So, better management can be done in patients with penetrating abdominal stab wounds. PATIENTS AND METHODS This retrospective cross-sectional study was performed on patients with abdominal penetrating trauma who referred to Al- Zahra hospital in Isfahan, Iran from October 2000 to October 2010. It should be noted that patients with abdominal blunt trauma, patients under 14 years old, those with lateral abdomen penetrating trauma and patients who had unstable hemodynamic status were excluded from the study. Medical records of patients were reviewed and demographic and clinical data were collected for all patients including: age, sex, mechanism of trauma and the results of LWE and laparotomy. Data were analyzed with PASW v.20 software. All data were expressed as mean ± SD. The distribution of nominal variables was compared using the Chi-squared test. Also, diagnostic index for LWE were calculated. A two-sided P value less than 0.05 was considered to be statistically significant. RESULTS During the 10 year period of the study, 1100 consecutive patients with stab wounds were admitted to Al-Zahra hospital Isfahan, Iran. In total, about 150 cases had penetrating traumas in the anterior abdomen area. Sixty-three (42%) patients were operated immediately due to shock, visceral evisceration or aspiration of blood via a nasogastric tube on admission. Organ injury was seen in 78% of patients with visceral evisceration. Among these 87 cases, 29 patients' (33.3%) anterior fascia was not penetrated in LWE. So, they were observed for several hours and discharged from the hospital without surgery. While for the remaining 58 patients (66.6%), whose LWE detected penetration of anterior abdominal fascia, laparotomy was performed which showed visceral injuries in 11 (18%) cases. CONCLUSIONS All in all, 82 percent of laparotomies in patients with penetrated anterior abdominal fascia without visceral evisceration, who had no signs of peritoneal irritation, were negative. So, we recommended further evaluation in these patients. However, visceral evisceration is an indication for exploratory laparotomy, since in our study; the majority of patients had organ damages.
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Affiliation(s)
- Behnam Sanei
- Department of Surgery, Isfahan University of Medical Sciences, Isfahan, IR Iran
| | - Mohsen Mahmoudieh
- Department of Surgery, Isfahan University of Medical Sciences, Isfahan, IR Iran
| | - Hamid Talebzadeh
- Department of Surgery, Isfahan University of Medical Sciences, Isfahan, IR Iran
- Corresponding author: Hamid Talebzadeh, Department of Surgery, Isfahan University of Medical Sciences, Isfahan, IR Iran. Tel: +98-3112255838, Fax: +98-3112335030, E-mail:
| | | | - Zahra Aghaei
- Department of Surgery, Isfahan University of Medical Sciences, Isfahan, IR Iran
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1065
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Arens R, van Hall T, van der Burg SH, Ossendorp F, Melief CJM. Prospects of combinatorial synthetic peptide vaccine-based immunotherapy against cancer. Semin Immunol 2013; 25:182-90. [PMID: 23706598 DOI: 10.1016/j.smim.2013.04.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Revised: 04/10/2013] [Accepted: 04/19/2013] [Indexed: 01/15/2023]
Abstract
The insight that the immune system is involved in tumor resistance is gaining momentum and this has led to the development of immunotherapeutic strategies aiming at enhancement of immune-mediated tumor destruction. Although some of these strategies have moderate clinical benefit, most stand-alone therapies fail to significantly affect progressive disease and survival or do so only in a minority of patients. Research on the mechanisms underlying the generation of immune responses against tumors and the immune evasion by tumors has emphasized that various mechanisms simultaneously prevent effective immunity against cancer including inefficient presentation of tumor antigens by dendritic cells and induction of negative immune regulation by regulatory T-cells (Tregs) and myeloid derived suppressor cells (MDSCs). Thus the design of therapies that simultaneously improve effective tumor immunity and counteract immune evasion by tumors seems most desirable for clinical efficacy. As it is unlikely that a single immunotherapeutic strategy addresses all necessary requirements, combinatorial strategies that act synergistically need to be developed. Here we discuss the current knowledge and prospects of treatment with synthetic peptide vaccines that stimulate tumor-specific T-cell responses combined with adjuvants, immune modulating antibodies, cytokines and chemotherapy. We conclude that combinatorial approaches have the best potency to accomplish the most significant tumor destruction but further research is required to optimize such approaches.
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Affiliation(s)
- Ramon Arens
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands.
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1066
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Latif A, Boardman HF, Pollock K. Understanding the patient perspective of the English community pharmacy Medicines Use Review (MUR). Res Social Adm Pharm 2013; 9:949-57. [PMID: 23506650 DOI: 10.1016/j.sapharm.2013.01.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Revised: 01/17/2013] [Accepted: 01/17/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND Health policy-makers and pharmacy's representative bodies seek to better utilize the skill of community pharmacists so as to support patients' use of medicines and associated health care outcomes. The English Medicines Use Review (MUR) is an NHS-funded community pharmacy service that aims to improve patients' knowledge of medicines and their use. MURs represent an opportunity for patients to gain additional help with their medicines as well as fostering inter-professional collaboration between pharmacists and general practitioners (GPs). OBJECTIVE To describe patients' perspective of the MUR service and their understanding of the value that they derive from it. METHODS This study employed a qualitative approach involving 10 weeks of ethnographic observation in two English community pharmacies. It employed observations of 54 patient-pharmacist MURs consultations and subsequent interviews with 34 patients. A thematic approach was used to analyze the data. RESULTS All patients reported feeling comfortable speaking with the pharmacist, who they saw as a knowledgeable expert on medicines. They appreciated the time spent with them in a private consultation. The MUR provided patients with reassurance about their medicines, that they were "doing the right thing." Despite these positive views, when asked to describe the purpose of their MUR, patients provided ambivalent accounts and reported that the consultation did little to improve their knowledge of medicines or affect how they used them. CONCLUSIONS Patients' accounts of MURs suggested they held broadly positive views about the service. However, evidence that MURs were fulfilling their formal policy aims and intentions was limited. Policy-makers and those seeking to promote community pharmacy's professional agenda should note the patients' perspective, assessment and perceived value of MURs in order to develop services, which are better tailored to patient need.
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Affiliation(s)
- Asam Latif
- Division of Social Research in Medicines and Health, School of Pharmacy, University of Nottingham, East Drive, University Park, Nottingham NG7 2RD, United Kingdom.
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1067
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Agostinho A, Renzi G, Haustein T, Jourdan G, Bonfillon C, Rougemont M, Hoffmeyer P, Harbarth S, Uçkay I. Epidemiology and acquisition of extended-spectrum beta-lactamase-producing Enterobacteriaceae in a septic orthopedic ward. Springerplus 2013; 2:91. [PMID: 23539506 PMCID: PMC3604582 DOI: 10.1186/2193-1801-2-91] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Accepted: 02/27/2013] [Indexed: 11/10/2022]
Abstract
Wards cohorting infected orthopaedic patients may be particularly prone to transmitting extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E). We analyze their epidemic pattern by performing molecular typing of ESBL-E isolated from patients and healthcare workers (HCW) from our septic ward. Between March 2010 and November 2011, 186 patients were admitted. Among 565 anal swabs, ESBL-E were detected in 204 samples from 45 patients, suggesting prolonged carriage in affected patients. Among 25 cases with identical ESBL-E species and positive epidemiological links, only 9 were really attributable to our service. We also screened 41 healthcare workers (HCW) on 49 occasions during the study period. Six samples (13%) were positive. None of the ESBL-E detected in HCW were related to any of the patient isolates. Among 60 environmental samples taken at the peak of the epidemic none revealed ESBL-E. We conclude that HCW also were anal carriers of ESBL-E, however the ESBL- strains from the HCW were not the same strains isolated from patients in the septic ward. Moreover, the epidemiological attribution of ESBL by simple vicinity, timing, and species identification might grossly overestimate transmission within a given unit.
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Affiliation(s)
- Americo Agostinho
- Infection Control Program, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
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1068
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Heydari AA, Fata A, Mojtabavi M. Chronic cutaneus mucormycosis in an immunocompetent female. Iran Red Crescent Med J 2013; 15:254-5. [PMID: 23984008 PMCID: PMC3745757 DOI: 10.5812/ircmj.1953] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2011] [Revised: 07/14/2012] [Accepted: 01/08/2013] [Indexed: 11/25/2022]
Abstract
Introduction Cutaneous infection is an uncommon presentation of mucormycosis, usually seen after trauma, at the site of surgical drains or after occlusive dressings. The involved area is erythematous and painful, with varying degree of central necrosis. We report the case of chronic coetaneous infection of one year duration and without apparent necrosis in an immunocompetant patient. Case presentation A 32-year-old immunocompetent woman presented with a large unilateral firm infiltrative plaque resembling cancer lesions, disfiguring the eyelids, nose and lips. The punch biopsy and then surgical debridement was done and the diagnosis of cutaneous mucormycosis was confirmed on histologic examinations with granulomatous reaction and characteristic broad, nonseptate, pale-staining hyphae. Conclusions Mucomycosis should be in differncial diagnosis of any chronic infiltrative lesions even without visible necrosis and normal immune status of the patient.
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Affiliation(s)
- Ali Akbar Heydari
- Imam Reza Hospital. Mashad University of Medical Sciences, Mashad, IR Iran
- Corresponding author: Ali Akbar Heydari, Imam Reza Hospital, Mashad University of Medical Sciences, Mashad, IR Iran. Tel/ Fax: +98-5118412351, E-mail:
| | - Abdolhamid Fata
- Imam Reza Hospital. Mashad University of Medical Sciences, Mashad, IR Iran
| | - Maryam Mojtabavi
- Imam Reza Hospital. Mashad University of Medical Sciences, Mashad, IR Iran
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1069
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Abbasinazari M, Sahraee Z, Mirahmadi M. The Patients' Adherence and Adverse Drug Reactions (ADRs) which are Caused by Helicobacter pylori Eradication Regimens. J Clin Diagn Res 2013; 7:462-6. [PMID: 23634397 DOI: 10.7860/jcdr/2013/4673.2799] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2012] [Accepted: 12/04/2012] [Indexed: 01/25/2023]
Abstract
BACKGROUND Helicobacter pylori is a major cause of upper gastrointestinal disorders. The eradication of H. pylori has been recommended for the treatment of different gastrointestinal diseases. Notwithstanding, a combination therapy is needed for Helicobacter pylori eradication, but using these medications can be the cause, the incidence risk of patients' adherence to treatment regimens reduction and probably increase risk of Adverse Drug Reactions (ADRS), so, it is seem that evaluation the out come of combination therapy is need more than the past. AIM The aim of present study was to determine the patients' adherence to the treatment and the ADRs with five eradiation regimens. SETTING AND DESIGN A cross sectional study was done in a well known referral clinic of gastrointestinal disorders in Tehran, Iran. METHODS AND MATERIALS Ninety patients were evaluated the study (18 in each of the five regimens). The adherence to the treatment and the ADRs of the patients were asked during the treatment, twice, by doing telephone assays. STATISTICAL ANALYSIS USED The data were analyzed by using the SPSS, 17 software and the statistical significance was accepted for the P values of 0.05. RESULTS 81% of the patients had a good adherence and there was no significant difference between the types of regimens (triple or quadruple therapy) and the adherence to the treatment regimens by the patients (p=0.6). Also, we found that there was no significant relationship between the types of regimens and the sex (p=0.99), education level (p=0.99), accommodation (p=0.93), an existence of underlying disease (p=0.86) and the concurrent use other medications (p=0.93). But there was a significant relationship between the patients' age and adherence to the treatment regimens (p=0.008). The most reported ADRs belonged to gastrointestinal (GI) disorders (an abnormal taste had the most prevalence (36.6%) among the GI disorders). There was no significant relationship between the regimen type and the GI ADRs, (p=0.48). CONCLUSION The findings of this study showed that the patients' adherence to the treatment regimens and the ADRs did not have a significant relationship with the various eradication regimens for H. pylori. It seems that the type of H. pylori eradication regimen may not be an important factor in the patients' adherence to the treatment regimens and the ADRs.
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Affiliation(s)
- Mohammad Abbasinazari
- Department of Clinical Pharmacy, Shahid Beheshti University of Medical Sciences , Tehran, Iran
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1070
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Fernández Alemán JL, Hernández I, Sánchez García AB. [Opinion survey on the use of personal health records in the Region of Murcia (Spain)]. Gac Sanit 2013; 27:454-8. [PMID: 23332377 DOI: 10.1016/j.gaceta.2012.12.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Revised: 12/03/2012] [Accepted: 12/04/2012] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To identify the opinions of patients of the Murcia Health Service on the adoption of personal health records (PHRs) and the factors associated with these opinions. METHODS A cross sectional and descriptive study was performed by personal survey of a sample of individuals (N=156) aged between 14 and 80 years old in five public health facilities of districts VI and VII of the Health Service of Murcia. RESULTS A total of 87.8% of the population stated they would use PHRs. Respondents aged 24-33 years old were 13.15 times more willing to use PHRs (95% CI: 1.09-157.42) than people over 63 years old. A lower probability of using PHRs was found in people who did not use the Internet, with an odds ratio of 0.31 (95% CI: 0.07-1.29); this difference was not statistically significant. CONCLUSIONS Most of the patients surveyed had never heard of PHRs but most would be willing to use them.
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1071
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Cuadrado-Cenzual MÁ, García-Saenz JÁ, López Palacios S, de Pedro Moro JA, Díaz-Rubio E. [New strategies to improve accessibility to laboratory tests in cancer patients]. Rev Calid Asist 2013; 28:217-23. [PMID: 23298729 DOI: 10.1016/j.cali.2012.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Revised: 11/15/2012] [Accepted: 11/16/2012] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To develop models to improve accessibility of performing laboratory tests on chronic oncology patients, as well as a more flexible choice of sample collection in both primary and specialized care. MATERIAL AND METHODS Circuit analysis of cancer patients. Patient survey to study access to laboratory tests. High Resolution Consultation Development Model (MCAR) and Patient Access Analytical Model (MAAP). RESULTS The percentage of cancer patients on treatment has increased by 8.76% in the past two years. There was a 32% increased in the use of the MAAP model in the two years of its implementation, and has been the choice of 74% due to greater accessibility, with 8% of the patients having used both models to suit their needs. CONCLUSIONS The implementation of optimized and preferred care systems has shown that both models improve accessibility and flexibility of the diagnostic testing laboratory in the patients studied.
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1072
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Hafez AA, Tavassoli E, Hasanzadeh A, Reisi M, Javadzade SH, Imanzad M. Quality of life in peptic ulcer patients referring to Al-Zahra hospital of Isfahan, Iran. Gastroenterol Hepatol Bed Bench 2013; 6:S87-92. [PMID: 24834294 PMCID: PMC4017537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/28/2013] [Accepted: 06/08/2013] [Indexed: 10/25/2022]
Abstract
AIM The purpose of this study was to determine quality of life in peptic ulcer patients referring to Al-Zahra hospital of Isfahan. BACKGROUND Peptic ulcer disease (PUD) is one of the most prevalent diseases. Its prevalence is 6-15% and about 10% of people experience its symptom in their life. PUD can have a considerable impact on patients' quality of life (QOL). PATIENTS AND METHODS This descriptive- analytic survey was done on 93 randomly patients referred to Al-Zahra hospital of Isfahan city in Iran. Data gathering was done via questionnaire including five domains: physical, psychological, social, behavioral and economical. For data analysis, t-test, Pearson correlation and ANOVA test were used. RESULTS 93 patients with mean age of 38.54 years, including 43 (46.2%) women and 54 (53.8%) men, were studied. There was a negative significant between quality of life and age and between disease duration and psychological, economical domains and between the mean of QOL scores in physical and social domains with the number of cigarette per day, also there was significant relation between social domain and gender, and physical, psychological and behavioral domains with marital status; Physical, social domains with smoking. Also there was a negative significant between physical, social and behavioral domains with years of smoking. CONCLUSION Study results showed that quality of life is in a relatively good level among patients, thus some diseases such as peptic ulcer can effect on quality of life. So, treatment and prevention of these diseases may improve their quality of life.
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Affiliation(s)
- Asghar Ashrafi Hafez
- Proteomics Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elahe Tavassoli
- The Student's Research Committee, Department of Public Health, Faculty of Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Akbar Hasanzadeh
- Department of Biostatistics, Faculty of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahnoush Reisi
- Department of Health Education, Bushehr University of Medical Sciences, Bushehr, Iran
| | | | - Masoumeh Imanzad
- Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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1073
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Ghafarinezhad A, Rajabizadeh G, Shahriari V. Relationships of dissociative disorders and personality traits in opium addicts on methadone treatment. Addict Health 2013; 5:21-6. [PMID: 24494154 PMCID: PMC3905559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Accepted: 10/21/2012] [Indexed: 11/03/2022]
Abstract
BACKGROUND Drug abuse is a major public health problem. Some believe that when dissociation fails to defend against emotional, physical, or sexual trauma, the person will find relief from unpleasant thoughts and emotions in opium use. On the other hand, personality disorders are considered as important predictors of treatment outcomes in drug abusers. Due to lack of adequate research in this regard, we evaluated dissociative disorders and personality traits of opium addicts on methadone treatment. METHODS This cross-sectional analytic study included 111 non-psychotic subjects on methadone treatment (case group) and 69 non-addicts (control group). After recording demographic characteristics, Dissociative Experiences Scale (DES) and Millon Multiaxial Inventory III were applied to assess dissociative symptoms and clinical personality patterns of all participants. FINDINGS Dissociative symptoms were significantly more common in the case group than in the control group (P = 0.044). While hysterionic personality disorder was more frequent in the control group (P = 0.008), sadistic, antisocial, and schizotypal personality disorders were significantly more common in the case group (P = 0.008, 0.002, and 0.023, respectively). CONCLUSION We found relations between history of drug dependence, dissociative symptoms, and personality disorders. Therefore, the mentioned disorders need to be kept in mind while planning addiction treatment modalities and identifying high risk groups.
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Affiliation(s)
- Alireza Ghafarinezhad
- Associate Professor, Department of Psychiatry, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Ghodratollah Rajabizadeh
- Associate Professor, Department of Psychiatry, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Vahid Shahriari
- Resident, Department of Psychiatry, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran,Correspondence to: Vahid Shahriari MD,
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1074
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Twigg MJ, Poland F, Bhattacharya D, Desborough JA, Wright DJ. The current and future roles of community pharmacists: views and experiences of patients with type 2 diabetes. Res Social Adm Pharm 2012; 9:777-89. [PMID: 23127392 DOI: 10.1016/j.sapharm.2012.10.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Revised: 10/07/2012] [Accepted: 10/08/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND The current UK government agenda is for community pharmacists to assume greater responsibility for medication management in patients with chronic conditions. This agenda may require a significant change in the way patients currently interact with their community pharmacist. OBJECTIVES To explore the experiences and views of patients with type 2 diabetes regarding the current and proposed future role of community pharmacists. METHODS This study used focus groups to collect experiences and views of patients with type 2 diabetes. A National Health Service (NHS) ethics committee approved this study. Pharmacists identified all patients with type 2 diabetes to whom they provided an information sheet and a consent form which included a request to supply basic demographic details. Focus group members were purposively sampled to gain a diverse range of opinions. Two researchers independently coded and thematically analyzed the transcripts. The researchers discussed the emergent themes to ensure all valid themes had been identified. RESULTS Twenty-five participants attended one of 4 focus groups. Two broad themes were identified: the place of pharmacy in the wider primary care team and pharmacy as a healthcare destination. Participants who had been living with diabetes for a long time and those who felt they had received a lower level of care from the medical practice were more likely to acknowledge contributions of pharmacists in their care for advice on side effects, drug interactions and supply than participants with a good relationship with their general practitioner (GP) or practice nurse and whose diabetes was well controlled. CONCLUSIONS Participants with type 2 diabetes identified a role for pharmacists in their care linked to their perceived expertise on medicines. However, the extent to which they would engage with the pharmacist depended on the quality of relationship with their GP or practice nurse.
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Affiliation(s)
- Michael J Twigg
- School of Pharmacy, University of East Anglia, Norwich NR4 7TJ, UK.
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1075
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Shabestari AA, Akhlaghpoor S, Tayebivaljozi R, Fattahi Masrour F. Prevalence of Congenital Coronary Artery Anomalies and Variants in 2697 Consecutive Patients Using 64-Detector Row Coronary CTAngiography. Iran J Radiol 2012; 9:111-21. [PMID: 23329976 PMCID: PMC3522371 DOI: 10.5812/iranjradiol.8070] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2011] [Revised: 08/01/2012] [Accepted: 08/11/2012] [Indexed: 12/15/2022]
Abstract
BACKGROUND Coronary artery anomalies are not common, but could be very serious. OBJECTIVES This study determines the frequency of coronary anomalies and normal variants by multi-detector-row computed tomography (MDCT). PATIENTS AND METHODS The results of cardiac MDCT study in 2697 consecutive patients were analyzed retrospectively. Acquisition was performed by a 64-detector row CT machine. Imaging results were assessed by experienced radiologists. RESULTS Myocardial bridging was by far the most frequent coronary variant (n = 576, 21.3%). Eighty-three subjects (3.1%) showed other coronary anomalies and variants. Anomalies of origination and course of the left main coronary artery (LMCA) were detected in 1.09% of the subjects. The frequency of these anomalies in the right coronary artery (RCA), left circumflex artery (LCx), left anterior descending artery (LAD), posterior descending artery (PDA) and obtuse marginal (OM) artery were 1.24%, 0.33%, 0.1%, 0.07% and 0.03%, respectively. The single coronary pattern was seen in 0.18% and coronary fistulas in 0.07%. CONCLUSION Based on the fact that coronary CT-angiography using MDCT can display different coronary anomalies, this study shows similar results to other reports on the subject. Future advances in the performance of CT machines will further improve the quality of CT-based cardiac imaging.
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Affiliation(s)
- Abbas Arjmand Shabestari
- Cardiac CT Department, Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- CT Department, Noor Medical Imaging Center, Tehran, Iran
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran
| | - Shahram Akhlaghpoor
- CT Department, Noor Medical Imaging Center, Tehran, Iran
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran
- Radiology Department, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Tayebivaljozi
- Cardiac CT Department, Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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1076
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Pascual-Guardia S, Árbol F, Sánchez E, Casadevall C, Merlo V, Gea J, Barreiro E. [Inflammation and oxidative stress in respiratory and limb muscles of patients with severe sepsis]. Med Clin (Barc) 2012; 141:194-200. [PMID: 22841463 DOI: 10.1016/j.medcli.2012.05.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Revised: 05/11/2012] [Accepted: 05/17/2012] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND OBJECTIVE Oxidative stress and inflammation contribute to the diaphragm contractile dysfunction observed in animal models of sepsis and endotoxemia. In septic patients, molecular events have never been explored in their respiratory muscles. Levels of oxidative stress and inflammation were evaluated in a respiratory muscle, the external intercostal, and a limb muscle, the vastus lateralis, of patients with sepsis. PATIENTS AND METHODS Levels of oxidized and nitrated proteins, protein adducts of malondialdehyde and hydroxinonenal, antioxidant enzymes catalase and Mn-superoxide dismutase, tumor necrosis factor (TNF)-α, TNF-α receptors i and ii, interleukin (IL)-1 and IL-6, the panleukocyte marker CD18, and fiber type composition were explored using immunoblotting, real time-polymerase chain reaction, and immunohistochemistry in the external intercostal and vastus lateralis of patients with severe sepsis and/or septic shock. RESULTS Compared to the controls, in septic patients, levels of oxidized and nitrated proteins were increased in the vastus lateralis, but not in the external intercostal, while those of the antioxidant enzymes did not differ, and the proportions and sizes of the muscle fibers were not significantly different in any muscle between patients and controls. CONCLUSIONS Differences in activity between the respiratory and limb muscles may account for the differential pattern of oxidative stress and inflammation observed among patients with severe sepsis. These findings may have relevant implications for the clinical and therapeutic management of these patients.
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Affiliation(s)
- Sergio Pascual-Guardia
- Unidad de Investigación en Músculo y Aparato Respiratorio, Servicio de Neumología, Instituto Municipal de Investigación Médica (IMIM)-Hospital del Mar, Parc de Salut Mar, Departamento de Ciencias Experimentales y de la Salud, Universitat Pompeu Fabra, Parc de Recerca Biomèdica de Barcelona (PRBB), Barcelona, España
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1077
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Aghadoost D, Fazel MR, Aghadoost HR. Pattern of pediatric ocular trauma in kashan. Arch Trauma Res 2012; 1:35-7. [PMID: 24719840 PMCID: PMC3955939 DOI: 10.5812/atr.5302] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2011] [Revised: 10/22/2011] [Accepted: 02/28/2012] [Indexed: 12/26/2022]
Abstract
Background: Ocular trauma is a significant health problem in pediatric patients. Objectives: The aim of this study was to analyze the characteristics of ocular-trauma-related hospitalization of children in Kashan. Patients and Methods: This descriptive, cross-sectional study included 131 children aged less than 16 years with ocular trauma, who were admitted to the Matini Hospital at the Kashan University of Medical Sciences between April 2006 and March 2009. After admission, detailed ocular examination was performed, and their ocular trauma was classified according to the International Ocular Trauma Classification and Birmingham Eye Trauma Terminology systems. Results: Mean age of the patients was 7.8 ± 2.2 years (age range, 0–16 years), and male to female ratio 5:1. The most common cause of admission was hyphema (38.1%), followed by corneoscleral laceration (27.5%). Ocular trauma most commonly occurred at home (43%), and 69% of the patients presented to the emergency room within 24 h of injury. In 30% of the patients, initial visual acuity at the time of presentation was less than 20/200 (Figure 1). Conclusions: Ocular trauma is a major cause of unilateral blindness, especially in young boys, and hence, preventive measures and education is required.
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Affiliation(s)
- Davood Aghadoost
- Trauma Research Centre, Kashan University of Medical Sciences, Kashan, IR Iran
- Department of Ophthalmology, Kashan University of Medical Sciences, Matini Hospital, Kashan, IR Iran
- Corresponding author: Davood Aghadoost, Trauma Research Center, Kashan University of Medical Sciences, Matini Hospital, Amirkabir Avenue, Kashan, IR Iran, Tel: +98-9131613628, Fax: +98-3615332900, E-mail:
| | - Mohammad Reza Fazel
- Trauma Research Centre, Kashan University of Medical Sciences, Kashan, IR Iran
| | - Hamid Reza Aghadoost
- Department of surgery, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
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1078
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Weder P, Schumacher TNM, Spits H, Luiten RM. Testing for HLA/peptide tetramer-binding to the T cell receptor complex on human T lymphocytes. Results Immunol 2012; 2:88-96. [PMID: 24371571 DOI: 10.1016/j.rinim.2012.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Revised: 04/27/2012] [Accepted: 04/27/2012] [Indexed: 10/28/2022]
Abstract
HLA/peptide tetramers are frequently used for ex vivo monitoring of disease- or vaccine-induced T cell immune responses and for T cell epitope identification. However, when low-levels HLA/peptide tetramer-positive T cell populations are encountered, it is difficult to ascertain whether this represents a true T cell receptor (TCR)-mediated interaction or background signal. To address this issue, we have developed a method for both HLA class I and class II tetramer assays to confirm tetramer-binding to the TCR/CD3 complex. Preincubation of T cells with anti-CD3 mAb SPV-T3b and subsequent crosslinking interferes with the binding of HLA/peptide tetramers to the TCR/CD3 complex and thereby indicates to what extent HLA/peptide tetramer binds through interaction with TCR/CD3 complex. SPV-T3b pretreatment results in a 2- to 10-fold decrease in tetramer-binding intensity to antigen-specific CD8+ or CD4+ T cells, whereas background reactivity of HLA/peptide tetramers containing HIV-derived peptide in HIV-negative donors remained unchanged. SPV-T3b pretreatment forms a valuable tool to verify tetramer-based detection of antigen-specific T cells during the monitoring of immune responses in clinical studies.
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Affiliation(s)
- Pauline Weder
- Division of Immunology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Ton N M Schumacher
- Division of Immunology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Hergen Spits
- Tytgat Institute for Liver and Instestinal Research, Academic Medical Center, University of Amsterdam, The Netherlands
| | - Rosalie M Luiten
- Dept. of Dermatology and The Netherlands Institute for Pigment Disorders, Academic Medical Center, University of Amsterdam, The Netherlands
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1079
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Einollahi B. Therapy for HBV Infection in Hemodialysis Patients: Is it Possible? Hepat Mon 2012; 12:153-7. [PMID: 22550522 PMCID: PMC3339414 DOI: 10.5812/hepatmon.834] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/25/2011] [Revised: 01/12/2012] [Accepted: 01/29/2012] [Indexed: 01/09/2023]
Affiliation(s)
- Behzad Einollahi
- Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Behzad Einollahi, Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Ground Floorof Baqiyatallah Hospital, Mollasdra Ave., Vanak Sq., Tehran, IR Iran. Tel.: +98-2181262073, Fax: +98-2181262073, E-mail:
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1080
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Polly DWJ. Commentary on: Quality-of-Life Evaluation of Patients Undergoing Lumbar Discectomy Using Short Form 36. Anesth Pain Med 2012; 1:199-200. [PMID: 24904795 PMCID: PMC4018685 DOI: 10.5812/kowsar.22287523.3459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2011] [Revised: 11/10/2011] [Accepted: 11/12/2011] [Indexed: 11/16/2022] Open
Affiliation(s)
- David W. Jr Polly
- Department of Orthopaedic Surgery, University of Minnesota, Minnesota, USA
- Corresponding author: David W. Jr Polly, Department of Orthopaedic Surgery, University of Minnesota, Minnesota, USA. Tel: +1-6122737991, Fax: +1-6122737959. E-mail:
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1081
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Geramizadeh B. Author's Reply: HFE Gene Mutations (C282Y and H63D) in a Group of Patients With Cryptogenic Cirrhosis. Hepat Mon 2012; 12:50. [PMID: 22451846 PMCID: PMC3298878 DOI: 10.5812/kowsar.1735143x.821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/04/2012] [Revised: 01/09/2012] [Accepted: 01/14/2012] [Indexed: 12/11/2022]
Affiliation(s)
- Bita Geramizadeh
- Department of Pathology, Shiraz University of Medical Science, Shiraz, IR Iran
- Corresponding author: Bita Geramizadeh, Department of Pathology, Shiraz University of Medical Science, Shiraz, IR Iran. Tel.: +98-7116125854, Fax: +98-7116473105, E-mail:
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1082
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Abstract
BACKGROUND A comprehensive preoperative evaluation is critical for providing anesthetic care for patients from the intensive care unit (ICU). There has been no preoperative evaluation form specific for ICU patients that allows for a rapid and focused evaluation by anesthesia providers, including junior residents. In this study, a specific preoperative form was designed for ICU patients and evaluated to allow residents to perform the most relevant and important preoperative evaluations efficiently. METHODS The following steps were utilized for developing the preoperative evaluation form: 1) designed a new preoperative form specific for ICU patients; 2) had the form reviewed by attending physicians and residents, followed by multiple revisions; 3) conducted test releases and revisions; 4) released the final version and conducted a survey; 5) compared data collection from new ICU form with that from a previously used generic form. Each piece of information on the forms was assigned a score, and the score for the total missing information was determined. The score for each form was presented as mean ± standard deviation (SD), and compared by unpaired t test. A P value < 0.05 was considered statistically significant. RESULTS Of 52 anesthesiologists (19 attending physicians, 33 residents) responding to the survey, 90% preferred the final new form; and 56% thought the new form would reduce perioperative risk for ICU patients. Forty percent were unsure whether the form would reduce perioperative risk. Over a three month period, we randomly collected 32 generic forms and 25 new forms. The average score for missing data was 23 ± 10 for the generic form and 8 ± 4 for the new form (P = 2.58E-11). CONCLUSIONS A preoperative evaluation form designed specifically for ICU patients is well accepted by anesthesia providers and helped to reduce missing key preoperative information. Such an approach is important for perioperative patient safety.
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Affiliation(s)
- Katherine Chuy
- Department of Anesthesiology and Critical Care, Perelman School of Medicine at the University of Pennsylvania, USA
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1083
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Kamar N. Hepatitis e virus infection in Iranian kidney-transplant patients. Hepat Mon 2011; 11:927-8. [PMID: 22308159 PMCID: PMC3269063 DOI: 10.5812/kowsar.1735143x.791] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/23/2011] [Revised: 11/06/2011] [Accepted: 11/12/2011] [Indexed: 12/11/2022]
Affiliation(s)
- Nassim Kamar
- Department of Nephrology, Dialysis and Organ Transplantation, CHU Rangueil, Toulouse, France
- Corresponding author at: Nassim Kamar, Department of Nephrology, Dialysis and Organ Transplantation, CHU Rangueil, TSA 50032,31059,Toulouse Cedex 9, France. Tel.: +33561322335, Fax: +33561323989, E-mail:
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1084
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Fallahi A, Pooyan M, Ghanaati H, Oghabian MA, Khotanlou H, Shakiba M, Jalali AH, Firouznia K. Uterine segmentation and volume measurement in uterine fibroid patients' MRI using fuzzy C-mean algorithm and morphological operations. Iran J Radiol 2011; 8:150-6. [PMID: 23329932 PMCID: PMC3522330 DOI: 10.5812/kmp.iranjradiol.17351065.3142] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2010] [Revised: 07/26/2011] [Accepted: 08/02/2011] [Indexed: 11/25/2022]
Abstract
BACKGROUND Uterine fibroids are common benign tumors of the female pelvis. Uterine artery embolization (UAE) is an effective treatment of symptomatic uterine fibroids by shrinkage of the size of these tumors. Segmentation of the uterine region is essential for an accurate treatment strategy. OBJECTIVES In this paper, we will introduce a new method for uterine segmentation in T1W and enhanced T1W magnetic resonance (MR) images in a group of fibroid patients candidated for UAE in order to make a reliable tool for uterine volumetry. PATIENTS AND METHODS Uterine was initially segmented using Fuzzy C-Mean (FCM) method in T1W-enhanced images and some morphological operations were then applied to refine the initial segmentation. Finally redundant parts were removed by masking the segmented region in T1W-enhanced image over the registered T1W image and using histogram thresholding. This method was evaluated using a dataset with ten patients' images (sagittal, axial and coronal views). RESULTS We compared manually segmented images with the output of our system and obtained a mean similarity of 80%, mean sensitivity of 75.32% and a mean specificity of 89.5%. The Pearson correlation coefficient between the areas measured by the manual method and the automated method was 0.99. CONCLUSIONS The quantitative results illustrate good performance of this method. By uterine segmentation, fibroids in the uterine may be segmented and their properties may be analyzed.
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Affiliation(s)
- Alireza Fallahi
- Department of Biomedical Engineering, Hamedan University of Technology, Hamedan, Iran
| | - Mohammad Pooyan
- Department of Biomedical Engineering, Shahed University, Tehran, Iran
| | - Hossein Ghanaati
- Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Oghabian
- Department of Medical Physics, Research Center for Science and Technology in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Hassan Khotanlou
- Department of Computer Engineering, Bu Alisina University, Hamedan, Iran
| | - Madjid Shakiba
- Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Hossein Jalali
- Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Kavous Firouznia
- Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
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1085
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Moradi Moghaddam O. Probiotics in critically ill patients. Anesth Pain Med 2011; 1:58-60. [PMID: 25729656 PMCID: PMC4335740 DOI: 10.5812/kowsar.22287523.2291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2011] [Revised: 09/15/2011] [Accepted: 09/18/2011] [Indexed: 11/16/2022] Open
Affiliation(s)
- Omid Moradi Moghaddam
- Department of Anesthesiology and Critical Care, Rasoul-Akram Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Corresponding author: Omid Moradi Moghaddam, Department of Anesthesiology and Critical Care, Rasoul-Akram Medical Center Tehran University of Medical Sciences, Tehran, Iran. Tel: +98-9391244560, Fax: +98-2166509059, E-mail:
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1086
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Tezel A, Karabulutlu E, Şahin Ö. Depression and perceived social support from family in Turkish patients with chronic renal failure treated by hemodialysis. J Res Med Sci 2011; 16:666-73. [PMID: 22091290 PMCID: PMC3214379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2011] [Accepted: 05/09/2011] [Indexed: 11/10/2022]
Abstract
BACKGROUND Dialysis patients experience psychosocial problems, such as anxiety, depression, social isolation, loneliness, helplessness, and hopelessness. All of these psychosocial problems can increase patients' need for holistic care, including attention to the person's environment and receiving support from family. If dialysis patients are better supported and cared for, these negative consequences might be prevented or at least decreased. This study was performed to determine the perceived social support from family and depression level of hemodialysis patients. METHODS In this study, descriptive design was used. Data were collected during structured interviews in an outpatient clinic using a questionnaire. The questionnaire aimed to determine the patients' descriptive characters and the scores of Beck Depression Inventory and Perceived Social Support from Family Scales. In data evaluation, descriptive statistics, Student's t tests, Kruskal Wallis tests, Mann-Whitney U tests and Pearson product moment correlations were used. RESULTS The mean depression score was very high (23.2 ± 10.5). Significant differences were found between employment status and level of depressive symptoms. The mean level of perceived social support from family was 15.23 ± 5.37. There were no statistically significant differences between all the variables for the level of perceived social support from family. Perceived social support from family was negatively correlated with depression. CONCLUSIONS The results of this study indicate that Turkish hemodialysis patients experience depression. However, patients who were dissatisfied with their social relationships had higher depression scores.
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Affiliation(s)
- Ayfer Tezel
- Associate Professor, Ankara University, Faculty of Health Sciences, Nursing Department, Ankara, Turkey
| | - Elanur Karabulutlu
- Assistant Professor, Atatürk University, Faculty of Health Sciences, Nursing Department, 25070, Erzurum, Turkey,
Corresponding Author: Elanur Karabulutlu E-mail:
| | - Özlem Şahin
- Research Assistant, Atatürk University, Faculty of Health Sciences, Nursing Department, 25070, Erzurum, Turkey
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1087
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Wu S, Liang J, Zhu X, Liu X, Miao D. Comparing the treatment effectiveness of body acupuncture and auricular acupuncture in preoperative anxiety treatment. J Res Med Sci 2011; 16:39-42. [PMID: 21448381 PMCID: PMC3063431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2010] [Accepted: 08/27/2010] [Indexed: 11/23/2022]
Abstract
BACKGROUND Preoperative anxiety has become more frequent in preoperative patients and can bring negative impact on operation outcomes. Many studies have reported the effect of body acupuncture in reducing anxiety syndromes. The aim of this study is to compare the treatment effect of body acupuncture and auricular acupuncture in preoperative patients with preoperative anxiety. METHODS Thirty five elective ambulatory surgery patients were selected in the randomized and blinded trial. Subjects were randomly categorized in two intervention groups, the body acupuncture group who received acupuncture in the special points of body, and the auricular acupuncture group who received ear acupuncture. Zung Self-Rating Anxiety Scale (SAS) was used before and after the study. RESULTS For the auricular acupuncture group, the mean score of SAS was 57.57 ± 8.22 before the intervention and 46.32 ± 6.37 afterward. For the body acupuncture group, the SAS score was 55.39 ± 5.41 and 44.82 ± 6.76 before and after the intervention, respectively. For both groups, the difference between pre- and post-treatment scores reached the significant level (p = 0.00). CONCLUSIONS Both auricular and body acupuncture treatment methods were effective in decreasing anxiety in preoperative patients.
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Affiliation(s)
- Shengjun Wu
- Department of Psychology, School of Aerospace Medicine, Fourth Military Medical University, Xi'an, China
| | - Jie Liang
- State Key Laboratory of Cancer Biology and Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China
| | - Xia Zhu
- Department of Psychology, School of Aerospace Medicine, Fourth Military Medical University, Xi'an, China
| | - Xufeng Liu
- Department of Psychology, School of Aerospace Medicine, Fourth Military Medical University, Xi'an, China
| | - Danmin Miao
- Department of Psychology, School of Aerospace Medicine, Fourth Military Medical University, Xi'an, China,Corresponding Author:
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1088
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Park JS, Ryu JS, Lee SM, Yim JJ, Yoo CG, Kim YW, Han SK, Shim YS, Yang SC. Influence of additional post-bronchoscopy visit on patient satisfaction after flexible bronchoscopy. Korean J Intern Med 2010; 25:392-8. [PMID: 21179277 PMCID: PMC2997968 DOI: 10.3904/kjim.2010.25.4.392] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2010] [Revised: 05/03/2010] [Accepted: 05/04/2010] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIMS Many patients undergoing a flexible bronchoscopy (FB) experience anxiety and discomfort during the procedure. We assessed whether an additional patient visit after a FB would improve patient satisfaction. METHODS The study patients were randomly assigned to a control and post-visit groups. The physicians who were scheduled to perform the FB visited the study patients. The control group had one visit before the FB and the post-visit group had a before and after FB visit. The post-visit group received additional information and support during the second visit. Twenty-four hours after the FB, the participants completed questionnaires about discomfort and satisfaction with the procedure. RESULTS The control and post-visit groups included 151 and 153 patients, respectively. The post-visit group reported having more information after the FB than the control group. The additional post-bronchoscopy visit improved the general patient tolerability of the procedure. The willingness to return for another FB was not affected by the post-bronchoscopy patient visit. CONCLUSIONS The post-bronchoscopy visit improved patient satisfaction and general tolerability to the procedure. Subjective patient tolerability with the FB may be improved through a post-bronchoscopy visit by providing more information and emotional support to patients.
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Affiliation(s)
- Jong Sun Park
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute of Medical Research Center, Seoul National University College of Medicine, Seoul, Korea
| | - Jeong-Seon Ryu
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea
| | - Sang-Min Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute of Medical Research Center, Seoul National University College of Medicine, Seoul, Korea
| | - Jae-Joon Yim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute of Medical Research Center, Seoul National University College of Medicine, Seoul, Korea
| | - Chul-Gyu Yoo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute of Medical Research Center, Seoul National University College of Medicine, Seoul, Korea
| | - Young Whan Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute of Medical Research Center, Seoul National University College of Medicine, Seoul, Korea
| | - Sung Koo Han
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute of Medical Research Center, Seoul National University College of Medicine, Seoul, Korea
| | - Young-Soo Shim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute of Medical Research Center, Seoul National University College of Medicine, Seoul, Korea
| | - Seok-Chul Yang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute of Medical Research Center, Seoul National University College of Medicine, Seoul, Korea
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1089
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Sharifi Z, Shooshtari MM, Kermani FR. Identification of HCV genotypes in HCV infected blood donors. Indian J Microbiol 2010; 50:275-9. [PMID: 23100841 DOI: 10.1007/s12088-010-0059-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2008] [Accepted: 10/15/2008] [Indexed: 12/17/2022] Open
Abstract
HCV infection is a leading cause of chronic liver disease, including cirrhosis of the liver. There are at least six major genotypes and more than 50 subtypes of HCV. The prevalence and distribution of HCV genotypes depend on geographical location. The aim of this study was to identify and compare the HCV genotypes in HCV infected blood donors and patients. In this cross-sectional study, 167 serum samples from 103 blood donors and 64 patients with hepatitis C were investigated for HCV genotypes. HCV genotyping was carried out using type-specific primers from the core region of the viral genome. The highest frequency was for genotype 1a, with 53 and 34 (51.5% versus 53.1%) of subjects in blood donors and patients respectively. Genotype 3a and 1b were the other frequent genotypes with 4 and 16 (3.9% versus 25%) and 39 and 10 (37.9% versus 15.6%) subjects, respectively. There was not any statistical significant association between the place of infection of the patients and genotype. The results of this study indicate that the distribution of genotypes in the two populations was similar. The dominant HCV genotypes between blood donors and patients were 1a, 3a and 1b respectively.
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Affiliation(s)
- Zohreh Sharifi
- Research center, Iranian Blood Transfusion Organization (IBTO), Tehran, Iran
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1090
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Abstract
The Clinical Documentation Project was piloted at one site in Greater Southern Area Health Service (GSAHS) in New South Wales; it aimed to improve the standard of clinical documentation by 50% between March and August 2005. The main intervention was the use of a Self Directed Documentation Learning Package (SDDLP). Results achieved a 75% improvement in clinical documentation within six months and a 46.5% improvement in clinicians' confidence in their level of knowledge on documentation requirements.
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Affiliation(s)
- Ann Stewart
- Ann Stewart, RGN, RM, GradCertQI, FLECcert, ImmuCert, Acting Director Clinical Governance, Greater Southern Area Health Service, 34 Lowe Street, Queanbeyan NSW 2620, AUSTRALIA, Tel: +61 2 6124 9820
| | - Tony Robben
- Tony Robben, RGON, AdvDipN, BSci, GradCertMgt, GradCertQI, Acting Professional Practice Manager, Greater Southern Area Health Service, 34 Lowe Street, Queanbeyan NSW 2620, AUSTRALIA, Tel: +61 2 4475 1647
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1091
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Cummings E, Turner P. Patients at the centre: methodological considerations for evaluating evidence from health interventions involving patients use of web-based information systems. Open Med Inform J 2010; 4:188-94. [PMID: 21594007 PMCID: PMC3096889 DOI: 10.2174/1874431101004010188] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2009] [Revised: 01/08/2010] [Accepted: 01/12/2010] [Indexed: 11/22/2022] Open
Abstract
Building an evidence base for healthcare interventions has long been advocated as both professionally and ethically desirable. By supporting meaningful comparison amongst different approaches, a good evidence base has been viewed as an important element in optimising clinical decision-making and the safety and quality of care. Unsurprisingly, medical research has put considerable effort into supporting the development of this evidence base, and the randomised controlled trial has become the dominant methodology. Recently however, a body of research has begun to question, not just this methodology per se, but also the extent to which the evidence it produces may marginalise individual patient experiences, priorities and perceptions.Simultaneously, the widespread adoption and utilisation of information systems (IS) in health care has also prompted initiatives to develop a stronger base of evidence about their impacts. These calls have been stimulated both by numerous system failures and research expressing concerns about the limitations of information systems methodologies in health care environments. Alongside the potential of information systems to produce positive, negative and unintended consequences, many measures of success, impact or benefit appear to have little to do with improvements in care, health outcomes or individual patient experiences.Combined these methodological concerns suggest the need for more detailed examination. This is particularly the case, given the prevalence within contemporary clinical and IS discourses on health interventions advocating the need to put the 'patient at the centre' by engaging them in their own care and/or 'empowering' them through the use of information systems.This paper aims to contribute to these on-going debates by focusing on the socio-technical processes by which patients' interests and outcomes are measured, defined and evaluated within health interventions that involve them using web-based information systems. The paper outlines an integrated approach that aims to generate evidence about the impact of these types of health interventions that are meaningful at both individual patient and patient cohort levels.
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Affiliation(s)
- Elizabeth Cummings
- eHealth Services Research Group, School of Computing and Information Systems, University of Tasmania, Hobart, Australia
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1092
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Tajudeen Nuhu F, Jika Yusuf A, Akinbiyi A, Oluyinka Fawole J, Joseph Babalola O, Titilope Sulaiman Z, Oyeniran Ayilara O. The burden experienced by family caregivers of patients with epilepsy attending the government psychiatric hospital, Kaduna, Nigeria. Pan Afr Med J 2010; 5:16. [PMID: 21293743 PMCID: PMC3032618 DOI: 10.4314/pamj.v5i1.56176] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2010] [Accepted: 05/24/2010] [Indexed: 11/26/2022] Open
Abstract
Background Caring for patients with chronic medical and psychiatric disorders is associated with significant burden. However little is known about the burden experience by caregivers of patients with epilepsy in Nigeria. The objective of this study, therefore, was to assess the level and correlates of burden among caregivers of patients with epilepsy. Methods It was a cross-sectional study carried out among 231 eligible caregivers of patients with epilepsy attending the psychiatric clinic of government psychiatric hospital in Kaduna, Northern Nigeria. Sociodemographic/clinical characteristics of patients and socio-demographic characteristics of caregivers were recorded, and the Zarit Burden Interview administered to caregivers to assess their experience of burden. Results The mean age of the caregivers was 43.6 ±9.5 years, 52.4% lived outside Kaduna and the mean seizure-free period for the patients was 26.4 ±36.5 weeks. One hundred and twenty (51.9%) caregivers had high burden. High burden was significantly associated with patients aged less than20 years, patient’s unemployment, long duration of epilepsy, short seizure-free period, family history of epilepsy and living outside Kaduna (p value<0.05). Conclusion Caregivers of patients with epilepsy experience significant burden while caring for their relatives and this is mainly associated with patient’s factors and location of residence. Therefore efforts should be made control seizure and make health care available and affordable to all citizens irrespective of where they live.
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1093
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Peltzer K, Mngqundaniso N. Patients consulting traditional health practioners in the context of HIV/AIDS in urban areas in KwaZulu-Natal, South Africa. Afr J Tradit Complement Altern Med 2008; 5:370-379. [PMID: 20161959 PMCID: PMC2816585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The purpose of this study is to assess patients consulting full-time traditional health practitioners (THPs) and the practice of THPs after they had been trained on Human Immunodeficiency Virus (HIV)/ Sexually Transmitted Infections (STI) prevention and care. The sample included 222 patients interviewed when exiting a THP's practice (n=17) in purposefully chosen two urban sites in KwaZulu-Natal. Results indicate that at post training evaluation the majority of the THPs were involved in HIV/STI management and most had low levels of HIV risk practices at the workplace. Major self-reported reasons for consulting the THP included a complex of supernatural or psychosocial problems, chronic conditions, acute conditions, generalized pain, HIV and other STIs. Overall, patients including HIV positive (n=18) patients had moderate knowledge of Antiretroviral Therapy (ART). A number of HIV positive patients were using traditional medicine and ART concurrently, dropped out of ART because of side effects and were using traditional medicine for HIV.
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Affiliation(s)
- Karl Peltzer
- Social Aspects of HIV/AIDS and Health, Human Sciences Research Council, Pretoria, South Africa.
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1094
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Wang XB, Yang LT, Zhang ZW, Guo JM, Cheng XD. Pancreaticoduodenectomy for advanced gastric cancer with pancreaticoduodenal region involvement. World J Gastroenterol 2008; 14:3425-9. [PMID: 18528942 PMCID: PMC2716599 DOI: 10.3748/wjg.14.3425] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To characterize the factors of the improved survival following combined pancreaticoduodenectomy (PD) and gastrectomy for the treatment of advanced gastric cancer with pancreaticoduodenal region involvement.
METHODS: From 1995 to 2004, 53 patients with primary gastric cancer were diagnosed with synchronous (n = 44) or metachronous (n = 9) pancreaticoduodenal region involvement. Of these, 17 patients (32%) underwent total gastrectomy (TG) or distal subtotal gastrectomy (SG) combined with PD simultaneously. The preoperative demographic, clinical information, clinicopathologic features and the surgical results of these 17 patients were considered as factors influencing survival and were analyzed by the Kaplan-Meier method with log-rank comparison.
RESULTS: The actual 1- and 3-year survival rates of these 17 patients after resection were 77% and 34%, respectively, and three patients survived for more than 5 years after surgery. The tumor-free resection margin (P = 0.0174) and a well-differentiated histologic type (P = 0.0011) were significant prognostic factors on univariate analysis. No mortality occurred within one mo after operation, postoperative weight loss of different degree was present in all the patients with TG and 12 cases had other complications. There were 9 (53%) cases of recurrence in 5-48 mo after operation. The survival rate in the palliative and explorative group was significantly (P = 0.0064) lower than in the combined PD group.
CONCLUSION: Judicious use of en bloc PD and gastrectomy and strictly preventing postoperative complications may improve the long-term survival for advanced gastric cancer patients with pancreati-coduodenal region involvement. Well-differentiated histology and negative resection margin are the most important predictors of long survival.
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1095
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Abstract
The whole concept of abnormal Pap smears and cervical cancer being due to an STI poses enormous challenges to the healthcare provider. The psychological and psychosocial sequelae of misinformation are potentially damaging both to the woman and her partner. There is a clear responsibility for the information around this to be simple, relevant, reassuring and comprehensible. Written information is invaluable.
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