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排序方式: 共有108条查询结果,搜索用时 15 毫秒
1.
Balasubramanian P Desire S Panetta JC Lakshmi KM Mathews V George B Viswabandya A Chandy M Krishnamoorthy R Srivastava A 《Bone marrow transplantation》2012,47(9):1178-1185
CY in combination with BU is a widely used conditioning regimen for haematopoietic SCT (HSCT). The aim of this study was to evaluate the pharmacokinetics (PK) of CY and its major metabolite 4-hydroxyCY (HCY) in patients with thalassemia undergoing HSCT. A total of 55 patients received BU (16 mg/kg) followed by CY (160-200 mg/kg) both over 4 days before HSCT. A population PK model was developed to describe the disposition of CY and HCY and the inter-individual (IIV) and inter-occasion variability (IOV). The model was also used to determine the effects covariates including: demographics, Lucarelli classification and polymorphisms in enzymes involved in the metabolism or biotransformation of CY had on CY and HCY disposition. Overall, 17-114% IIV and 12-103% IOV in CY and HCY PK parameters were observed. Body weight and age were the main covariates, which explained the largest portion of the IIV. In addition, CYP2C9*2 explained a significant portion of the IIV in the clearance (P<0.002) and thus the area under the concentration curve (P<0.05) of CY. This covariate model may be used to design and plan targeted dose therapy in this group of pediatric patients, if clinical outcome association with CY PK are proved and target range established. 相似文献
2.
Taruffi F Bernini M Pantalone D Paolucci R Panichi S Andreoli F 《Chirurgia italiana》2002,54(6):819-827
The paper evaluates the results of the surgical therapy of primary inguinal hernia in adult subjects performed in our Institution from 1994 to 2000. The Trabucco and Lichtenstein procedures were compared. Two hundred and fifteen patients--123 Trabucco and 92 Lichtenstein--were enrolled in the study. A file was created for each patient with details of personal data, procedures, anaesthesia and postoperative course. A form regarding the present state of each patient was filled in, mainly by phone, but sometimes by physical examination, if patients complained of problems. The results were evaluated statistically using the Fisher f and X2 tests. Only four parameters showed significant differences: wound swelling, constipation and days off work were less frequent with the Trabucco procedure, while there was less loss of the foreign body sensation in the Lichtenstein patients (6.7% vs. 18.3%). No recurrences were detected. The results of the two procedures can be considered comparable. 相似文献
3.
Tubach F Ravaud P Beaton D Boers M Bombardier C Felson DT van der Heijde D Wells G Dougados M 《The Journal of rheumatology》2007,34(5):1188-1193
The concepts of minimal clinically important improvement (MCII) and patient acceptable symptomatic state (PASS) could help in interpreting results of trials involving patient-reported outcomes by translating the response at the group level (change in mean scores) into more clinically meaningful information by addressing the patient level as "therapeutic success (yes/no)." The aims of the special interest group (SIG) at OMERACT 8 were to discuss specific issues concerning the MCII and PASS concepts, especially the wording of the external anchor questions used to determine the MCII and PASS estimates, and to move toward a consensus for the cutoff values to use as the MCII and PASS in the different outcome criteria. The purpose of this SIG at OMERACT 8 was to inform participants of the MCII and PASS concepts and to agree on MCII and PASS values for pain, patient global assessment, and functional impairment. 相似文献
4.
Arribas B Rodríguez-Cabezas ME Comalada M Bailón E Camuesco D Olivares M Xaus J Zarzuelo A Gálvez J 《The British journal of nutrition》2009,101(1):51-58
The preventative effects of the probiotic Lactobacillus fermentum CECT5716 were evaluated in the lipopolysaccharide (LPS) model of septic shock in mice. The probiotic was administered suspended in drinking water at the final concentration of 108 colony-forming units/ml for 2 weeks before the induction of an endotoxic shock by an intraperitoneal injection of LPS (400 microg/200 microl per mouse). Blood and different organs were collected after 24 h to evaluate the severity of the endotoxic shock and the preventative effects of the probiotic. L. fermentum reduced TNF-alpha levels in blood, which promotes the major alterations observed during septic shock, as well as the infiltration of activated neutrophils into the lungs. Furthermore, free radical overproduction and oxidative stress were associated with a significant decrease in hepatic glutathione levels in septic mice, and with an excessive NO production attributed to the induction of the inducible isoform of NO synthase (iNOS). In fact, hepatic glutathione levels were significantly increased in the group of mice receiving the probiotic, and the increased iNOS expression both in the colon and lungs was down-regulated in those mice treated with L. fermentum. Finally, pre-treatment with L. fermentum may also exert its protective action modulating the expression of different cytokines in splenocyte-derived T cells such us IL-2, IL-5, IL-6 or IL-10. In conclusion, pre-treatment with L. fermentum may exert its protective action against LPS-induced organ damage in mice by a combination of several actions including its antioxidant properties and by reduction of the synthesis of the pro-inflammatory TNF-alpha and IL-6. 相似文献
5.
Phanzu DM Ablordey A Imposo DB Lefevre L Mahema RL Suykerbuyk P Meyers WM Portaels F 《The American journal of tropical medicine and hygiene》2007,77(6):1099-1102
We report a case of a four-year-old Angolan boy with the edematous form of Buruli ulcer on the face and scalp, who was treated at a rural hospital in the Bas-Congo Province, Democratic Republic of Congo. Treatment consisted of a series of surgical interventions and antimycobacterial chemotherapy (rifampin and ciprofloxacin) for two months. This case demonstrates the diagnostic and management difficulties of an edematous lesion of BU on the face and suggests an enhancement of healing and limitation of extent of excision by specific antibiotherapy. The outcome in this patient also underscores the importance of prompt referral of suspected cases and training of health professionals in the early diagnosis of BU. 相似文献
6.
The Personal Health Scale is a concise instrument for comprehensive culture-informed and self-rated assessment of general health status and well-being. It is composed of 10 questions that appraise different health dimensions collated from the international literature, including aspects ranging from somatic and psychological domains to social functioning and insight. PURPOSE: In this investigation, results of a study conducted in Southern Brazil to test and validate the Portuguese version of the Personal Health Scale (PHS-Pt) are presented. Method: This study analyzes data from a sample of 120 Brazilian volunteers (90 patients and 30 health care professionals). All patients completed the Portuguese version of the Personal Health Scale under a minimal guidance by trained examiners, who followed standardized instructional procedures. RESULTS: The internal consistency of the PHS-Pt attained a Cronbach's a of 0.75 among patients and of 0.69 among health care professionals. The test-retest reliability correlation coefficient yielded a score of 0.82. Furthermore, the PHS-Pt was able to detect a significant discriminating validity between the 2 evaluated samples (P < .001). CONCLUSIONS: The original English version of the Personal Health Scale was successfully adapted to Portuguese as methodologically demonstrated herein. The PHS-Pt constitutes a reliable and trustworthy research instrument for evaluating health status in Brazil, since it is appropriately designed to distinguish different groups of volunteers regarding their health status. 相似文献
7.
8.
Fox LM Furness BW Haser JK Desire D Brissau JM Milord MD Lafontant J Lammie PJ Beach MJ 《The American journal of tropical medicine and hygiene》2005,73(1):115-121
This randomized, placebo-controlled trial investigated the tolerance, efficacy, and nutritional benefit of combining chemotherapeutic treatment of intestinal helminths and lymphatic filariasis. Children were infected with Ascaris (30.7%), Trichuris (53.4%), and hookworm (9.7%) with 69.9% having more than one of these parasites. A total of 15.8% of the children had Wuchereria bancrofti microfilariae. Children were randomly assigned treatment with placebo, albendazole (ALB), diethylcarbamazine (DEC), or combined therapy. The combination of DEC/ALB reduced microfilarial density compared with placebo, ALB, or DEC (P < or = 0.03). Albendazole and DEC/ALB reduced the prevalence of Ascaris, Trichuris, and hookworm more than placebo or DEC (P < or = 0.03). Among Trichuris-infected children, those receiving ALB and DEC/ALB demonstrated greater gains in weight compared with placebo (P < or = 0.05). Albendazole and DEC/ALB were equally efficacious in treating intestinal helminths and for children with W. bancrofti microfilaremia, DEC/ALB was more effective than DEC, with no increase in severity of adverse reactions. 相似文献
9.
Clinician Burden and Depression Treatment: Disentangling Patient- and Clinician-Level Effects of Medical Comorbidity 下载免费PDF全文
Dickinson LM Dickinson WP Rost K DeGruy F Emsermann C Froshaug D Nutting PA Meredith L 《Journal of general internal medicine》2008,23(11):1763-1769
Background Efforts to improve primary care depression treatment have assessed strategies across heterogeneous groups of patients, but
few have examined clinician-level influences on depression treatment.
Objective To examine clinician characteristics that affect depression treatment in primary care settings, using multilevel ordinal regression
modeling to disentangle patient- from clinician-level effects.
Design Secondary analysis from the Quality Improvement in Depression Study dataset.
Participants The participants were 1,023 primary care patients with depression who reported on treatment in the 6-month follow-up and whose
clinicians (n = 158) had at least 4 patients in the study.
Measurements Primary outcome variable was depression treatment intensity, derived from assessment of concordance with AHCPR depression
treatment guidelines based on patient-reported data on their treatment. Primary independent variable was clinical practice
burden for treating depression, derived from patient- and clinician-reported composite measures tested for significant association
with clinician-reported practice burden.
Results Clinicians who treat patients with more chronic medical comorbidities perceive less burden from treating depressed patients
in their practice (Spearman’s rho = −.30, p < .05). Clinicians who treat patients with more chronic medical comorbidities
also provide greater intensity of depression treatment (adjusted OR = 1.44, p = .02), even after adjusting for the effects
of patient-level chronic medical comorbidities (adjusted OR = 0.95, p = .45).
Conclusions Clinicians who provide more chronic care also provide greater depression treatment intensity, suggesting that clinicians who
care for complex patients can integrate depression care into their practice. Targeting interventions to these clinicians to
enhance their ability to provide guideline-concordant depression care is a worthwhile endeavor and deserves further investigation.
Electronic supplementary material The online version of this article (doi:) contains supplementary material, which is available to authorized users. 相似文献
10.
Salamun Desire Poonkuzhali Balasubramanian Ashish Bajel Biju George Auro Viswabandya Vikram Mathews Alok Srivastava Mammen Chandy 《Medical oncology (Northwood, London, England)》2010,27(4):1046-1049
Functional polymorphisms in the thiopurine methyl transferase (TPMT) gene have been associated with varying levels of enzyme
activity and the occurrence of toxicity related to thiopurines. A total of 98 patients (66 pediatric and 32 adults) with precursor
B acute lymphoblastic leukemia (Pre-B ALL) were evaluated for TPMT gene polymorphisms. The inability to tolerate 6-mercaptopurine
(6-MP) at conventional doses was considered as a surrogate marker of hematologic toxicity. The allele frequency of TPMT*2,
*3A, *3B and *3C in the study population was 0.5, 0, 0 and 2.6%, respectively, similar to the frequency observed in other
Asian populations. Five patients were heterozygous for TPMT*3C variant allele, and one of these patient’s was compound heterozygous
with TPMT*2 variant as the other allele. The impact of TPMT polymorphisms on the toxicity and treatment outcome was assessed
in 66 pediatric patients only, as there was no variant TPMT detected in the adult patients. Three of the 5 patients (60%)
heterozygous for TPMT*2 or TPMT*3C polymorphisms and 12/61 patients (20%) with wild type TPMT genotype had more than 10% of
reduction of 6-MP dose (P = 0.07). The presence of TPMT polymorphisms did not seem to completely explain the variation in 6-MP toxicity in this small
group of patients. Other novel variants in TPMT or variations in the genes involved in transport and biotransformation of
6-MP need to be evaluated in the Indian population. 相似文献