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21.
Yasar Kucukardali Oral Oncul Saban Cavuslu Mehmet Danaci Semra Calangu Hakan Erdem Ayse Willke Topcu Zuhal Adibelli Murat Akova Emel Azak Karaali Ahmet Melih Ozel Zahit Bolaman Bulent Caka Birsen Cetin Erkan Coban Oguz Karabay Cagla Karakoc Mehmet Akif Karan Selda Korkmaz Gulsen Ozkaya Sahin Alaaddin Pahsa Fatma Sirmatel Emrullah Solmazgul Namik Ozmen Ilyas Tokatli Cengiz Uzun Gulsen Yakupoglu Bulent Ahmet Besirbellioglu Hanefi Cem Gul 《International journal of infectious diseases》2008,12(1):71-79
OBJECTIVE: The purpose of this trial was to determine the spectrum of diseases with fever of unknown origin (FUO) in Turkey. METHODS: A prospective multicenter study of 154 patients with FUO in twelve Turkish tertiary-care hospitals was conducted. RESULTS: The mean age of the patients was 42+/-17 years (range 17-75). Fifty-three (34.4%) had infectious diseases (ID), 47 (30.5%) had non-infectious inflammatory diseases (NIID), 22 (14.3%) had malignant diseases (MD), and eight (5.2%) had miscellaneous diseases (Mi). In 24 (15.6%) of the cases, the reason for high fever could not be determined despite intensive efforts. The most common ID etiologies were tuberculosis (13.6%) and cytomegalovirus (CMV) infection (3.2%). Adult Still's disease was the most common NIID (13.6%) and hematological malignancy was the most common MD (7.8%). In patients with NIID, the mean duration of reaching a definite diagnosis (37+/-23 days) was significantly longer compared to the patients with ID (25+/-12 days) (p=0.007). In patients with MD, the mean duration of fever (51+/-35 days) was longer compared to patients with ID (37+/-38 days) (p=0.052). CONCLUSIONS: Although infection remains the most common cause of FUO, with the highest percentage for tuberculosis, non-infectious etiologies seem to have increased when compared with previous studies. 相似文献
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Mitchell G. Spring Aaron Caccamise Elizabeth A. Panther Bethany M. Windsor Karan R. Soni Jayme R. McReynolds Daniel S. Wheeler John R. Mantsch Robert A. Wheeler 《The Journal of neuroscience》2021,41(11):2428
Chronic stress impairs the function of multiple brain regions and causes severe hedonic and motivational deficits. One brain region known to be susceptible to these effects is the PFC. Neurons in this region, specifically neuronal projections from the prelimbic region (PL) to the nucleus accumbens core (NAcC), have a significant role in promoting motivated approach. However, little is known about how activity in this pathway changes during associative learning to encode cues that promote approach. Less is known about how activity in this pathway may be altered by stress. In this study, an intersectional fiber photometry approach was used in male Sprague Dawley rats engaged in a Pavlovian autoshaping design to characterize the involvement of the PL-NAcC pathway in the typical acquisition of learned approach (directed at both the predictive cue and the goal), and its potential alteration by stress. Specifically, the hypothesis that neural activity in PL-NAcC would encode a Pavlovian approach cue and that prior exposure to chronic stress would disrupt both the nature of conditioned approach and the encoding of a cue that promotes approach was tested. Results of the study demonstrated that the rapid acquisition of conditioned approach was associated with cue-induced PL-NAcC activity. Prior stress both reduced cue-directed behavior and impaired the associated cortical activity. These findings demonstrate that prior stress diminishes the task-related activity of a brain pathway that regulates approach behavior. In addition, the results support the interpretation that stress disrupts reward processing by altering the incentive value of associated cues.SIGNIFICANCE STATEMENT Chronic stress causes hedonic and motivational deficits and disrupts the function of the PFC. A specific projection from the prelimbic region of the PFC to the nucleus accumbens core (PL-NAcC) promotes approach behavior and is a strong candidate for contributing to stress-induced disruptions in motivation. However, it is not known how activity in this pathway encodes cues that promote approach, and how this encoding may be altered by stress. Here we show that the rapid acquisition of conditioned approach is associated with cue-induced activity in the PL-NAcC pathway. Prior stress both reduces cue-directed behavior and impairs the associated cortical activity. These findings demonstrate that stress diminishes task-related activity in a brain pathway that regulates approach behavior. 相似文献
24.
Karan R. Chhabra Kathryn I. Pollak Stephanie J. Lee Anthony L. Back Roberta E. Goldman James A. Tulsky 《Patient education and counseling》2013
Objective
To characterize practices in subspecialist physicians’ communication styles, and their potential effects on shared decision-making, in second-opinion consultations.Methods
Theme-oriented discourse analysis of 20 second-opinion consultations with subspecialist hematologist-oncologists.Results
Physicians frequently “broadcasted” information about the disease, treatment options, relevant research, and prognostic information in extended, often-uninterrupted monologs. Their communicative styles had one of two implications: conveying options without offering specific recommendations, or recommending one without incorporating patients’ goals and values into the decision. Some physicians, however, used techniques that encouraged patient participation.Conclusions
Broadcasting may be a suboptimal method of conveying complex treatment information in order to support shared decision-making. Interventions could teach techniques that encourage patient participation.Practice implications
Techniques such as open-ended questions, affirmations of patients’ expressions, and pauses to check for patient understanding can mitigate the effects of broadcasting and could be used to promote shared decision-making in information-dense subspecialist consultations. 相似文献25.
Chhaya V Verma Rachna D Arora Hetal M Mistry Swati V Kubal Nandini S Kolwankar Pranali C Patil Anushka A Dalvi Sonal A Vichare Akhila Natesan Anagha N Mangaonkar Dolly D Kanakia Gayatri S Jere Karan Y Bansode Madhura R Patil Rajvi D Sheth Sandhya D Dudhavade Sayali D Mhatre Suresh K Patel Akanksha G Mohite Ankita N Bhavsar Jessica E Alfonso Maryam NA Syed Nidhi P Savla Riya N Rajgond Rutuja A Bute Samiksha M Mane Shubham R Jaiswal Vibhawari A Parab Abhiram M Kasbe Mohan A Joshi Ramesh N Bharmal 《Indian Journal of Critical Care Medicine》2021,25(3):317
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Background:Many pediatric forearm fractures can be treated in plaster following closed reduction. The cast index (CI, a ratio of anteroposterior to lateral internal diameters of the cast at the fracture site) is a simple, reliable marker of quality of molding and a CI of >0.8 correlates with increased risk of redisplacement. Previously, CI has been applied to all forearm fractures. We hypothesize that an acceptable CI is more difficult to achieve and does not predict outcome in fractures of the proximal forearm.Results:The mean CI was 0.77. Remanipulation was required in five cases (6%), all distal half fractures – mean CI 0.79. CI was higher in proximal half forearm fractures (0.83 vs. 0.76, P = 0.006), nonetheless these fractures did not re-displace more than distal fractures.Conclusion:Cast index is useful in predicting redisplacement of manipulated distal forearm fractures. We found that in proximal half forearm fractures it is difficult to achieve a CI of <0.8, but increased CI does not predict loss of position in these fractures. We therefore discourage the use of CI in proximal half forearm fractures. 相似文献
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Shruti Anand Siddhi Tripathi Anubhav Chopra Karan Khaneja Swatantra Agarwal 《Journal of Indian Prosthodontic Society》2015,15(2):125-130