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971.
Heart failure is a syndrome of huge and growing importance worldwide. It is widely accepted that the energy status of the myocardium in heart failure is impaired, irrespective of etiology. Agents which modify cardiac substrate utilisation have the potential to ameliorate this energy deficiency by increasing cardiac mechanical efficiency. This may represent a new therapeutic paradigm in heart failure. In this review we discuss existing and new agents that alter cardiac substrate use and summarise the data on clinical efficacy. 相似文献
972.
Julian D. Marshall Michael Brauer Lawrence D. Frank 《Environmental health perspectives》2009,117(11):1752-1759
Background
The built environment may influence health in part through the promotion of physical activity and exposure to pollution. To date, no studies have explored interactions between neighborhood walkability and air pollution exposure.Methods
We estimated concentrations of nitric oxide (NO), a marker for direct vehicle emissions), and ozone (O3) and a neighborhood walkability score, for 49,702 (89% of total) postal codes in Vancouver, British Columbia, Canada. NO concentrations were estimated from a land-use regression model, O3 was estimated from ambient monitoring data; walkability was calculated based on geographic attributes such as land-use mix, street connectivity, and residential density.Results
All three attributes exhibit an urban–rural gradient, with high walkability and NO concentrations, and low O3 concentrations, near the city center. Lower-income areas tend to have higher NO concentrations and walkability and lower O3 concentrations. Higher-income areas tend to have lower pollution (NO and O3). “Sweet-spot” neighborhoods (low pollution, high walkability) are generally located near but not at the city center and are almost exclusively higher income.Policy implications
Increased concentration of activities in urban settings yields both health costs and benefits. Our research identifies neighborhoods that do especially well (and especially poorly) for walkability and air pollution exposure. Work is needed to ensure that the poor do not bear an undue burden of urban air pollution and that neighborhoods designed for walking, bicycling, or mass transit do not adversely affect resident’s exposure to air pollution. Analyses presented here could be replicated in other cities and tracked over time to better understand interactions among neighborhood walkability, air pollution exposure, and income level. 相似文献973.
Reasons for non-adherence to vaccination at mother and child care clinics (MCCs) in Lambaréné, Gabon
Norbert G. Schwarz Marjolein Gysels Christopher Pell Julian Gabor Meike Schlie Saadou Issifou Bertrand Lell Peter G. Kremsner Martin P. Grobusch Robert Pool 《Vaccine》2009
The aim of this paper is to explore attitudes of mothers towards childhood vaccinations and reasons for non-attendance and non-adherence to mother–child clinics (MCCs). Forty in-depth interviews with mothers of children under 5 years of age revealed positive attitudes towards vaccination that seem at odds with the region's observed low vaccination coverage. Important reasons for MCC non-attendance included distance to the MCC, transport costs, negative experiences at MCCs (such as interactions with unfriendly staff) and mothers’ feeling of shame provoked by different, often poverty-associated reasons such as attending the clinic with a dirty or poorly clothed child. 相似文献
974.
Julian Little Julian P.T. Higgins John P.A. Ioannidis David Moher France Gagnon Erik von Elm Muin J. Khoury Barbara Cohen George Davey-Smith Jeremy Grimshaw Paul Scheet Marta Gwinn Robin E. Williamson Guang Yong Zou Kim Hutchings Candice Y. Johnson Valerie Tait Miriam Wiens Jean Golding Cornelia van Duijn Nick Birkett 《Journal of clinical epidemiology》2009,62(6):597-608.e4
975.
Roitberg BZ Hardman J Urbaniak K Merchant A Mangubat EZ Alaraj A Mlinarevich N Watson KS Ruland S 《Neurosurgery》2008,63(1):115-20; discussion 120-1
976.
Gharavi AG Moldoveanu Z Wyatt RJ Barker CV Woodford SY Lifton RP Mestecky J Novak J Julian BA 《Journal of the American Society of Nephrology : JASN》2008,19(5):1008-1014
IgA nephropathy (IgAN) is a complex trait determined by genetic and environmental factors. Most IgAN patients exhibit a characteristic undergalactosylation of the O-glycans of the IgA1 hinge region, which promotes formation and glomerular deposition of immune complexes. It is not known whether this aberrant glycosylation is the result of an acquired or inherited defect, or whether the presence of aberrant IgA1 glycoforms alone can produce IgAN. A newly validated lectin enzyme-linked immunosorbent assay (ELISA) was used to determine the serum level of galactose-deficient IgA1 (Gd-IgA1) in a cohort of 89 IgAN patients and 266 of their relatives. High Gd-IgA1 levels (> or =95th percentile for controls) were observed in all 5 available patients with familial IgAN, in 21 of 45 (47%) of their at-risk relatives (assuming autosomal dominant inheritance), and in only 1 of 19 (5%) of unrelated individuals who married into the family. This provides evidence that abnormal IgA1 glycosylation is an inherited rather than acquired trait. Similarly, Gd-IgA1 levels were high in 65 of 84 (78%) patients with sporadic IgAN and in 50 of 202 (25%) blood relatives. Heritability of Gd-IgA1 was estimated at 0.54 (P = 0.0001), and segregation analysis suggested the presence of a major dominant gene on a polygenic background. Because most relatives with abnormal IgA1 glycoforms were asymptomatic, additional cofactors must be required for IgAN to develop. The fact that abnormal IgA1 glycosylation clusters in most but not all families suggests that measuring Gd-IgA1 may help distinguish patients with different pathogenic mechanisms of disease. 相似文献
977.
Iophendylate (Pantopaque or Myodil) was commonly used from the 1940s until the late 1980s for myelography, cisternography, and ventriculography. Although such instances are rare, several different long-term sequelae have been described in the literature and associated with intrathecal iophendylate. The authors describe an unusual case of arachnoiditis caused by residual thoracic iophendylate imitating an expansile intramedullary lesion on magnetic resonance images obtained 30 years after the initial myelographic injection. 相似文献
978.
Lymphangioma is a benign congenital tumor rarely experienced in the upper extremity. There are few reports of the outcomes of treatment of this tumor to guide treatment when it occurs in the finger. Treatment of this disease is challenging. This report presents two cases of lymphangioma in the fingers of children. 相似文献
979.
Effects of spinal cord injury on semen parameters 总被引:1,自引:0,他引:1
OBJECTIVE/BACKGROUND: Neurogenic reproductive dysfunction in men with spinal cord injury (SCI) is common and the result of a combination of impotence, ejaculatory failure, and abnormal semen characteristics. It is well established that the semen quality of men with SCI is poor and that changes are seen as early as 2 weeks after injury. The distinguishing characters of poor quality are abnormal sperm motility and viability. In the majority of the men with SCI, the sperm count is not abnormal. We elaborate on the effects of the SCI on semen parameters that may contribute to poor motility and poor viability. METHODS: Review. DESIGN: PubMed and MEDLINE databases were searched using the following key words: spinal cord injuries, fertility, sexual dysfunction, and spermatogenesis. All literature was reviewed by the team of authors according to the various stages of sperm development and transport in the male reproductive cycle. FINDINGS: The cause of asthenozoospermia appears to be multifactorial. CONCLUSION: Current literature does not support the preeminence of a single factor relating to neurogenic reproductive dysfunction in men with SCI. After SCI, there is ample evidence of disturbance of sperm production, maturation and storage, and transport due to an abnormal neuroendocrine milieu. Semen quality seems to be primarily affected by changes to the seminal plasma constituents, type of bladder management, and the neurogenic impairment to the ejaculatory function. Further focused and structured studies are required. 相似文献
980.
Bustin J Rapoport MJ Krishna M Matusevich D Finkelsztein C Strejilevich S Anderson D 《International journal of geriatric psychiatry》2008,23(5):497-503
INTRODUCTION: Electroconvulsive therapy (ECT) is an effective, yet controversial treatment. Most patients receiving ECT have depression and it is likely that the majority having this treatment are older adults. However, attitudes towards ECT and knowledge of ECT in this population have never been studied in relation to the patients' cultural background. OBJECTIVE: To compare the attitudes and knowledge of ECT among older adults depressed patients across three culturally different populations and to explore the relationship between culture, knowledge and attitudes. METHODS: The study was conducted in one centre in each country. A semi-structured survey was used which included three sections: demographics characteristics, attitudes towards and knowledge of ECT. RESULTS: A total of 75 patients were recruited in this study: 30 patients from England; 30 patients from Argentina; and 15 patients from Canada. There was a significant difference in knowledge about ECT across the three countries. No significant difference was found in terms of attitudes. Knowledge was poor in all three countries. The most influential factor shaping subjects' attitudes and knowledge of ECT differed for the three countries. A weak correlation was found between knowledge of and attitudes towards ECT across all patients from the three different countries. CONCLUSION: Attitudes towards ECT are a very complex phenomenon. We could not find evidence that a particular cultural background affects attitudes towards ECT. Generalising the results of our study is restricted by the fact that this was a pilot study that suffered from limitations including small sample size and number of settings. 相似文献