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521.
Teague R Mijch A Fairley CK Sidat M Watson K Boyd K Chen MY 《International journal of STD & AIDS》2008,19(3):200-202
This study compares the testing rates of bacterial sexually transmitted infections (STIs) among HIV-positive men who have sex with men (MSM) attending two HIV clinics in Melbourne. Data on STI testing over a 12-month period were obtained for all HIV-positive MSM who attended the clinics between January and March 2006. Screening rates for bacterial STIs were significantly higher at a sexual health clinic (n = 254) compared with an infectious diseases clinic (n = 351), whether this was measured according to: at least one STI test being performed for chlamydia, gonorrhoea or syphilis (69% vs. 38%, P < 0.01); serological testing for syphilis alone (67% vs. 34%, P < 0.01); or 'complete' STI screening for pharyngeal gonorrhoea, urethral chlamydia, anal gonorrhoea, anal chlamydia and syphilis (41% vs. 6%, P < 0.01). Substantial differences in STI testing rates among HIV-positive MSM may exist between HIV clinical services depending on the measures in place that promote STI screening. 相似文献
522.
Elahi M Mahmood M Shahbaz A Malick N Sajid J Asopa S Matata BM 《Current Cardiology Reviews》2010,6(2):104-111
The pathophysiology of several conditions including heart failure is partly attributable to a failure of the cell energy metabolism. Studies have shown that exercise training (ET) improves quality of life (QOL) and is beneficial in terms of reduction of symptoms, mortality and duration of hospitalization. Increasingly, ET is now achieving acceptance as complimentary therapy in addition to routine clinical practice in patients with chronic heart failure (CHF). However, the mechanisms underlying the beneficial effects of ET are far less understood and need further evaluation. Evidence suggests that while CHF induces generalized metabolic energy depletion, ET largely enhances the overall function of the heart muscle. Hence, research efforts are now aiming to uncover why ET is beneficial as a complimentary treatment of CHF in the context of improving endothelial function and coronary perfusion, decreasing peripheral resistance, induction of cardiac and skeletal muscle cells remodeling, increasing oxygen uptake, substrate oxidation, and resistance to fatigue. Here we discuss the current evidence that suggest that there are beneficial effects of ET on cardiac and skeletal muscle cells oxidative metabolism and intracellular energy transfer in patients with CHF. 相似文献
523.
Enrique Reyes-Muñoz Thozhukat Sathyapalan Paola Rossetti Mohsin Shah Min Long Massimo Buscema Gaetano Valenti Valentina Lucia La Rosa Stefano Cianci Salvatore Giovanni Vitale 《Advances in therapy》2018,35(11):1805-1815
Polycystic ovary syndrome (PCOS) affects 6–10% of women and could be considered one of the most common endocrine alterations in women of reproductive age. The syndrome is characterized by several hormonal and metabolic alterations, including insulin resistance and hyperandrogenism, which play a severe detrimental role in the patient’s fertility. We aimed to offer an overview about drug metabolism in the PCOS population. Nevertheless, we did not find any study that directly compared drug metabolism between PCOS and healthy women. We therefore decided to summarize briefly how hormonal and insulin sensitizer drugs act differently in healthy and PCOS women, who show altered steroidogenesis by theca cells and metabolic imbalance, focusing especially on assisted reproductive techniques. To date, data about drug metabolism in the PCOS population appears to be extremely limited. This important gap could have significant implications for therapeutic approaches and future perspectives: the dosage of drugs commonly used for the treatment of PCOS women should be tailored according to each patient’s characteristics; we should implement new clinical trials in order to identify the best pharmacologic strategy for PCOS patients undergoing in vitro fertilization (IVF); it would be advisable to create an international expert panel to investigate the drug metabolism in the PCOS population. 相似文献
524.
Treatment of diffuse large B‐cell lymphoma with secondary central nervous system involvement: encouraging efficacy using CNS‐penetrating R‐IDARAM chemotherapy 下载免费PDF全文
Paul Maciocia Mohsin Badat Simon Cheesman Shirley D'Sa Rahul Joshi Jonathan Lambert Sajir Mohamedbhai Martin Pule David Linch Kirit Ardeshna 《British journal of haematology》2016,172(4):545-553
Diffuse large B‐cell lymphoma with secondary involvement of the central nervous system (SCNS‐DLBCL) is a rare condition carrying a poor prognosis. No optimal therapeutic regimen has been identified. We retrospectively analysed 23 patients with SCNS‐DLBCL treated with R‐IDARAM (rituximab 375 mg/m2 IV day 1; methotrexate 12·5 mg by intrathecal injection day 1; idarubicin 10 mg/m2/day IV days 1 and 2; dexamethasone 100 mg/day IV infusion over 12 h days 1–3; cytosine arabinoside 1000 mg/m2/day IV over 1 h days 1 and 2; and methotrexate 2000 mg/m2 IV over 2 h day 3. Ten out of 23 (44%) patients had CNS involvement at initial presentation (‘new disease’), 10/23 (44%) had relapsed disease and 3/23 (13%) had primary refractory disease. 14/23 (61%) of patients responded ‐ 6 (26%) complete response, 8 (35%) partial response. Grade 3–4 haematological toxicity was seen in all cycles, with no grade 3–4 or long‐term neurological toxicity. Median follow‐up for surviving patients was 49 months. At 2 years, estimated progression‐free survival (PFS) was 39% and overall survival (OS) was 52%. Encouraging outcomes were reported in patients with new disease, with 5‐year estimated PFS of 50% and OS 75%. R‐IDARAM is a well‐tolerated regimen with encouraging efficacy in patients with SCNS‐DLBCL, although patients with relapsed or refractory disease continue to fare poorly. 相似文献
525.
A decade has passed since the introduction of highly active antiretroviral therapy (HAART) as standard of care for HIV/AIDS patients. The success of HAART is largely dependent on almost 100% adherence to it. In this study our primary aim was to understand from patients' own perspectives and experiences what resulted in them having 100% adherence to HAART. Thus, we purposefully recruited for in-depth interviews 10 participants (7 men and 3 women) with 100% adherence to HAART (>/=6 months previous to the interviews). All interviews were transcribed verbatim and analyzed by using Giorgi's phenomenological analysis approach. The following issues emerged from the analysis: readiness to go on HAART; HAART viewed as a life-line; maintenance of 100% adherence related with willingness to live longer and healthier; optimal ongoing patient-physician relationship, better coping and/or lack of perceived side effects; and improvements in clinical condition as well as in CD4 T-cells count and viral load reinforced the motivation to continue 100% adherence. The study findings should be helpful for health professionals caring for HIV-infected individuals on HAART. 相似文献
526.
Global AIDS programs such as the US President's Emergency Plan for AIDS Relief (PEPFAR) face a challenging health care management transition. HIV care must evolve from vertically-organized, externally-supported efforts to sustainable, locally controlled components that are integrated into the horizontal primary health care systems of host nations. We compared four southern African nations in AIDS care, financial, literacy, and health worker capacity parameters (2005 to 2009) to contrast in their capacities to absorb the huge HIV care and prevention endeavors that are now managed with international technical and fiscal support. Botswana has a relatively high national income, a small population, and an advanced HIV/AIDS care program; it is well poised to take on management of its HIV/AIDS programs. South Africa has had a slower start, given HIV denialism philosophies of the previous government leadership. Nonetheless, South Africa has the national income, health care management, and health worker capacity to succeed in fully local management. The sheer magnitude of the burden is daunting, however, and South Africa will need continuing fiscal assistance. In contrast, Zambia and Mozambique have comparatively lower per capita incomes, many fewer health care workers per capita, and lower national literacy rates. It is improbable that fully independent management of their HIV programs is feasible on the timetable being contemplated by donors, nor is locally sustainable financing conceivable at present. A tailored nation-by-nation approach is needed for the transition to full local capacitation; donor nation policymakers must ensure that global resources and technical support are not removed prematurely. 相似文献
527.
Teresa Tsakok Tom Marrs Mahrose Mohsin Susannah Baron George du Toit Stephen Till Carsten Flohr 《Lancet》2017
Background
Atopic dermatitis is the commonest chronic inflammatory disorder of the skin, affecting more than 20% of children in industrialised countries and up to 5% of adults. This condition is often associated with other atopic diseases, such as IgE-mediated food allergy (FA). Food allergen recognition via antigen-presenting cells in eczematous skin has been suggested to act as an important mediator of food sensitisation and FA. This would have important implications for prevention and treatment. We aimed to review the association between atopic dermatitis and FA; the effect of FA on atopic dermatitis severity, chronicity, and age of onset; and whether there was a temporal association between atopic dermatitis and FA.Methods
A systematic search of Medline and Embase, with no language limits imposed, from inception until Nov 30, 2014, was supplemented by a hand search of the literature. Two authors independently screened abstracts for suitability, resulting in 164 articles that were read in full. Article selection for further analysis was based on specific inclusion and exclusion criteria. We extracted data from selected articles using a predefined proforma. Since we did not consider formal meta-analysis to be either feasible or appropriate, we assigned a quality score to each article.Findings
66 studies were identified. 18 were population based, eight used high-risk cohorts, and 40 comprised patients with either established atopic dermatitis or FA. In population-based studies, the likelihood of food sensitisation was up to six times higher in patients with atopic dermatitis than in healthy controls at 3 months of age (odds ratio 6·18, 95% CI 2·94–12·98; p<0·001). Studies that included only patients with established atopic dermatitis reported food sensitisation prevalences of up to 66%, with challenge-proven FA prevalences up to 81%. Results from 16 studies suggested that FA is associated with a more severe atopic dermatitis phenotype. Six studies indicated that atopic dermatitis of earlier onset or increased persistence is particularly associated with FA. Finally, results of one study indicated that atopic dermatitis preceded the development of FA.Interpretation
We confirm a strong and dose-dependent association between atopic dermatitis, food sensitisation, and FA. Atopic dermatitis of increased severity and chronicity is particularly associated with FA. Atopic dermatitis appeared to precede the development of FA, in keeping with a causal association. This evidence provides further support for skin barrier repair, early proactive treatment for atopic dermatitis, and reduction of environmental food allergen exposure in the prevention of food sensitisation and allergy.Funding
None. 相似文献528.
Masri MA Haberal MA Shaheen FA Stephan A Ghods AJ Al-Rohani M Mousawi MA Mohsin N Abdallah TB Bakr A Rizvi AH 《Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation》2004,2(2):217-220
During the seventies, sporadic renal transplants were performed in few MESOT-region countries, mainly Turkey, Iran, Egypt, and Lebanon. Since the introduction of cyclosporine in the early eighties, transplantation has become the preferred therapeutic modality for end-stage renal failure. In 1986, the Islamic theologians (Al Aloma) issued what became known as the Amman declaration, in which they accepted brain death and retrieval and transplantation of organs from living and cadaveric donors. Based on this and similar declarations, all Middle Eastern countries except Egypt passed laws that allow cadaveric transplantation and regulate live donations. Iran, Turkey, Saudi Arabia, Kuwait, Tunisia, Jordan, and Lebanon all have current active cadaveric programs and perform liver, heart, pancreas, and lung transplants. More than 5088 renal transplants/year are performed in the region with Iran leading with 1600. The cumulative number of renal transplant patients is now nearly 60,000. With a 2003 population of 600,682,175, the rate/million for renal transplantation in the MESOT region is a mere 9/million. Rates of renal transplantation range from 31/million in some countries to 0 in others. The major obstacle in establishing an accurate number of transplants is "tourist transplantation," in which the same transplanted patients are registered in different countries. Although cadaveric programs have been active for more than 10 years, live-related and nonrelated transplants account for nearly 85% of the total transplants. The data presented were collected from MESOT representatives in the region and from publications. For proper compilation of the registry, a format is being proposed that will be presented at the Congress for review and adaptation. Even with the limited resources in the region, immunosuppressive drugs for induction and maintenance therapy are available and are used. Costs for transplantation and immunosuppressive therapy are either totally or heavily supported by governmental agencies. 相似文献
529.
Steven C. Rose William C. Meyers Mohsin Saeed Jerome M. Feldman 《Cardiovascular and interventional radiology》1989,12(3):131-135
Mesenteric ischemia associated with carcinoid tumors often presents with nonspecific abdominal pain and is usually due to
mesenteric branch artery occlusion caused by elastic vascular sclerosis. Mesenteric ischemia was defined by the operative
findings of cyanosis or infarction. Eleven patients with intraabdominal metastatic carcinoid tumor were evaluated by angiography.
Angiographic narrowing and occlusion of multiple peripheral jejunal and ileal intramesenteric branch arteries was present
in 3 patients with mesenteric ischemia, but also occurred in 5 of 8 patients without mesenteric ischemia. Other angiographic
abnormalities included staining of the primary tumor (5) or metastases (6), tenting of small mesenteric vessels (5), and occlusion
of draining mesenteric veins (2). We conclude that in patients with midgut carcinoid tumors, angiographic narrowing and occlusion
of peripheral mesenteric arteries most likely represents elastic vascular sclerosis, is indicative of mesenteric invasions
of tumor, but correlates poorly with the presence of ischemia in the subtended bowel. Alternatively, a normal selective arteriogram
should exclude mesenteric ischemia as the cause of abnormal pain. 相似文献
530.