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To describe glucose status changes in patients with acromegaly receiving somatostatin analog lanreotide as primary treatment. This retrospective, single-center study conducted during 1996-2008, included acromegalic patients receiving primary lanreotide treatment. Baseline and last follow-up visit assessments included glucose status (according to American Diabetes Association criteria), growth hormone (GH), and insulin-like growth factor-1 (IGF-1) levels. Glucose control was considered improved when fasting plasma glucose or antidiabetic treatments were reduced, and deteriorated if fasting glucose was the same/higher but with increased antidiabetic treatments. 42 patients (median age 50?years; range 29-75?years) were included. At baseline, 26 (62%) were normoglycemic, eight (19%) had impaired glucose tolerance/fasting glycemia, and eight (19%) had diabetes mellitus; family history of diabetes mellitus was significantly associated with abnormal glucose status. At final visit, the mean (SE) lanreotide dose was 108 (21) mg/month. Median treatment duration was 23?months, range 3-138?months, and 74% of patients received the 120-mg dose. Median GH levels decreased significantly (baseline, 12 [5-20] μg/l; final visit, 2.1 [1.0-4.7] μg/l; P?0.0001); IGF-1 levels were age- and sex-normalized in 33% of patients. Glucose control deteriorated in seven patients (17%) and improved from abnormal levels in 10 (24%). Deterioration was associated with smaller GH decreases (median change, -3.4?μg/l vs. -10.7?μg/l, P?=?0.014) and improvement with trend to lower BMI and younger age. During primary lanreotide treated acromegalic patients 60% had no change, 24% had an improvement and 17% had a worsening of glucose status. Deterioration was significantly associated with smaller GH decreases during primary lanreotide treatment. 相似文献
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Comparison of Adding Treatment of PTSD During and After Shelter Stay to Standard Care in Residents of Battered Women's Shelters: Results of a Randomized Clinical Trial
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Dawn M. Johnson Nicole L. Johnson Sara K. Perez Patrick A. Palmieri Caron Zlotnick 《Journal of traumatic stress》2016,29(4):365-373
This study explored the acceptability, feasibility, and initial efficacy of an expanded version of a PTSD treatment developed for residents of battered women's shelters, Helping to Overcome PTSD through Empowerment (HOPE) in women who received standard shelter services (SSSs). A Phase I randomized clinical trial comparing HOPE + SSSs (n = 30) to SSSs (n = 30) was conducted. Primary outcome measures included the Clinician‐Administered PTSD Scale (Blake et al., 1995) and the Revised Conflict Tactic Scales (Straus, Hamby, Boney‐McCoy, & Sugarman, 1996 ). Participants were followed at 1‐week, and 3‐ and 6‐months posttreatment. Only 2 women dropped out of HOPE + SSS treatment. Latent growth curve analyses found significant treatment effects for PTSD from intimate partner violence (IPV) (β = ?.007, p = .021), but not for future IPV (β = .002, p = .709) across follow‐up points. Significant effects were also found for secondary outcomes of depression severity (β = ?.006, p = .052), empowerment (β = .155, p = .022), and resource gain (β = .158, p = .036). Additionally, more women in HOPE + SSSs were employed at 3‐ and 6‐month follow‐up compared to those in SSSs only. Results showed the acceptability and feasibility of adding IPV‐related treatment to standard services. They also suggested that HOPE may be a promising treatment for residents of battered women's shelters. Further research with a larger sample, utilizing more diverse shelter settings and a more rigorous control condition, is needed to confirm these findings. 相似文献
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Prevalence of Symptomatic and Asymptomatic Thrombosis in Pediatric Oncology Patients With Tunneled Central Venous Catheters
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![点击此处可从《Pediatric blood & cancer》网站下载免费的PDF全文](/ch/ext_images/free.gif)
Reineke A. Schoot MD PhD Marianne D. van de Wetering MD PhD Theo Stijnen PhD Wim J.E. Tissing MD PhD Erna Michiels MD PhD Floor C.H. Abbink MD PhD Martine F. Raphael MD Hugo A. Heij MD PhD Michel Zwaan MD PhD Jan A. Lieverst MSc Hubert N. Caron MD PhD Heleen van Ommen MD PhD 《Pediatric blood & cancer》2016,63(8):1438-1444
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Griffith J Caron CD Desrosiers J Thibeault R 《Canadian journal of occupational therapy. Revue canadienne d'ergothérapie》2007,74(2):78-90
BACKGROUND: In the Canadian Model of Occupational Performance, meaningful occupation involves interaction between spirituality and environment. However little research exists on the process of giving meaning to occupation. PURPOSE: This study explored both meaningful occupation and the definition of spirituality from the perspective of community-dwelling older adults with autonomy loss. METHOD: Using a qualitative approach, grounded theory method of Glaser and Strauss (1967), eight cognitively intact persons were interviewed individually. RESULTS: The process of giving meaning to occupation involves an intrinsic link between identity and meaningful occupation, with identity being central to the person. Following autonomy loss, a process of adjusting identity, involving social, psychological and spiritual aspects, occurs over time. Spirituality is defined in terms of its close links to religion and belief in a benevolent greater power. IMPLICATIONS OF RESEARCH: This study contributes to the discussion of the concepts of spirituality, identity and meaning in occupational therapy. 相似文献
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BACKGROUND: We have previously shown that tubulin, the major protein of microtubules, is posttranslationally modified by palmitoylation. In addition, we demonstrated that palmitoylation of tubulin is inhibited in vitro by stoichiometric levels of the chemotherapeutic drug, vinblastine. Here, we sought to determine whether a clinically relevant dose of vinblastine inhibits palmitoylation of tubulin in vivo. METHODS: Human CEM leukemic lymphocytes were incubated with [3H]palmitate in the presence and absence of a low, clinically relevant dose of vinblastine. [3H]palmitoylated tubulin was identified by two-dimensional PAGE and autoradiography. RESULTS: We found, first, that tubulin was palmitoylated in CEM cells. Second, the clinically relevant dose of vinblastine inhibited palmitoylation of tubulin in vivo in CEM cells. In addition, microtubules were disassembled and cells became apoptotic. CONCLUSION: This study identifies a previously unknown mechanism of action of vinblastine, the depalmitoylation of tubulin, and suggests that depalmitoylation of tubulin may be a target for new chemotherapeutic drugs. 相似文献
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