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21.
Carlos Calderón Rafael Rotaeche Arritxu Etxebarria Mercé Marzo Rosa Rico Marta Barandiaran 《BMC health services research》2006,6(1):138-11
Background
The GRADE method represents a new approach to grading the quality of evidence and strength of recommendations in the preparation of Clinical Practice Guidelines (CPG). In the context of a pilot study to assess the implementability of the system in Spain, we considered it relevant to gain an insight into the significance of the perceptions and attitudes expressed by the actual experts participating in the system try-out. 相似文献22.
Marta Padilla Castillo Yaiza Machado RyderManuel Cazorla Betancor Rocío Acebes TostiMargarita Medina Castellano Rosa Rodríguez-Mano 《Progresos de Obstetricia y Ginecología》2006
Heterotopic pregnancy is the combination of intrauterine and ectopic pregnancy. This potentially fatal condition rarely occurs in spontaneous conception cycles and consequently its diagnosis requires a high index of suspicion. We report a case of heterotopic pregnancy in a 30-year old primipara with no known risk factors who presented with acute abdominal pain due to a spontaneous heterotopic pregnancy. The ectopic pregnancy was resected via laparoscopy. After surgery, the intrauterine pregnancy was uneventful. 相似文献
23.
Delvys Rodríguez-Abreu Marta Llanos Muñoz Mariano Provencio Pulla Antonio Rueda Domínguez Dolores Isla Casado 《Clinical & translational oncology》2010,12(11):760-764
Follicular lymphoma (FL) is the second most common subtype of non-Hodgkin’s lymphoma (NHL) in the Western world. FL constitutes the most frequent indolent lymphoma, well characterized by its clinical presentation related to nodal involvement and its morphologic and biologic features. It is often managed as an incurable disease. However, several active therapeutic approaches from the ‘wait and watch” strategy to the allogeneic transplantation are available for management of patients with FL and clearly have changed the natural history of this disease, achieving a long-term disease-free survival. Therapeutic decision is mostly conditioned by patient’s characteristics, stage, histological grade, tumor burden, and risk-predicting factors. This article try to summarizes the diagnosis and treatment of this heterogeneous group of patients. 相似文献
24.
Marta Feldmesser 《Medical mycology》2005,43(7):571-587
Invasive aspergillosis is a disease of immunocompromised hosts and the pathogenesis of this disorder is heavily dependent upon the defect within a given host. Consequently, vaccine development is limited by our understanding of effective host responses and by limitations in our knowledge of fungal molecules that elicit protective immunity. Nonetheless, the past few years have witnessed advances in our understanding both of the immune response to this organism and in the relationship between antigenicity and the ability to confer protection. Manipulations that promote the development of T(H)1-associated responses correlate with increased resistance to disease, at least partly because of consequent enhancement of innate cellular effector function. Two areas of investigation most actively being pursued include the search for adjuvants that will allow products of Aspergillus fumigatus to become effective vaccine candidates, regardless of the form of immunity they ordinarily induce, and the identification of the specific antigens that will most effectively elicit beneficial responses. Strategies using antigen-exposed dendritic cells as adjuvants appear to be particularly promising. Though we currently are far away from a candidate that is applicable for human trials, recent progress is encouraging. 相似文献
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Daniel Hryhorczuk Irina Dardynskaia Elena Lukyanova Marta Matwyshyn-Fuoco Lee Friedman Zoreslava Shkiryak-Nizhnyk Alexander Zvinchuk Natalia Chislovska Yuri Antipkin 《Paediatric and perinatal epidemiology》2009,23(4):346-351
The prevalence of wheezing in children varies widely around the world. The reasons for this geographic variability remain unclear but may be related in part to exposures in the home environment during pregnancy and early childhood. We investigated the prenatal and early childhood risk factors for wheezing symptoms among 2127 children aged 6–8 years who were participants in the Ukrainian component of the European Longitudinal Study of Pregnancy and Childhood (ELSPAC). Cases included the 169 children whose parents answered yes to the International Study of Asthma and Allergy in Children (ISAAC) question: 'Has your child had wheezing or whistling in the chest in the past 12 months' during the ELSPAC assessment of the children at age 7. These were compared with the 1861 children in the cohort whose parents answered 'no' to this question.
Factors significantly associated with increased risk of wheezing illness at age 7 in adjusted analyses included mother's asthma [adjusted odds ratio (OR) 3.46, 95% confidence interval (CI) 1.22, 9.85]; mother's allergy problems (OR 1.43, [1.00, 2.05]); rarely playing with other children at age 3 (OR 1.84, [1.09, 3.11]); water intrusion (OR 1.62, [1.09, 2.39]) and inadequate heating of the home (OR 1.52, [1.06, 2.16]) during pregnancy. Factors protective of wheezing at age 7 included being first-born (adjusted OR 0.70, 95% CI 0.50, 0.98); living in the city of Dniprodzerzynsk as compared with Kyiv (OR 0.36, [0.24, 0.54]) and weekly contact with furry animals (OR 0.44, [0.20, 0.97]) before age 3. The constellation of risk factors for wheezing in Ukrainian children is similar to that of children in other parts of the world. Known risk factors do not account for the significant between-city variability of wheezing in Ukrainian children. 相似文献
Factors significantly associated with increased risk of wheezing illness at age 7 in adjusted analyses included mother's asthma [adjusted odds ratio (OR) 3.46, 95% confidence interval (CI) 1.22, 9.85]; mother's allergy problems (OR 1.43, [1.00, 2.05]); rarely playing with other children at age 3 (OR 1.84, [1.09, 3.11]); water intrusion (OR 1.62, [1.09, 2.39]) and inadequate heating of the home (OR 1.52, [1.06, 2.16]) during pregnancy. Factors protective of wheezing at age 7 included being first-born (adjusted OR 0.70, 95% CI 0.50, 0.98); living in the city of Dniprodzerzynsk as compared with Kyiv (OR 0.36, [0.24, 0.54]) and weekly contact with furry animals (OR 0.44, [0.20, 0.97]) before age 3. The constellation of risk factors for wheezing in Ukrainian children is similar to that of children in other parts of the world. Known risk factors do not account for the significant between-city variability of wheezing in Ukrainian children. 相似文献
28.
Pilot study to enhance HIV care using needle exchange-based health services for out-of-treatment injecting drug users 总被引:2,自引:0,他引:2
Altice Frederick L. Springer Sandra Buitrago Marta Hunt David P. Friedland Gerald H. 《Journal of urban health》2003,80(3):416-427
The introduction of highly active antiretroviral therapy (HAART) has resulted in marked reductions in mortality and acquired
immunodeficiency syndrome (AIDS) incidence across all risk groups; however, the proportionate decrease among injecting drug
users (IDUs) has been less impressive. Much of the disparity in benefit to IDUs has been a consequence of decreased access
to and receipt of potent antiretroviral combinations. Strategies to increase access to and utilization of HAART have included
entry into drug treatment and abstinence. Unfortunately, as few as 15%–20% of active drug users in the United States, and
in many other countries, are in drug treatment at any one time. We report a pilot project among out-of-drug treatment IDUs
infected with human immunodeficiency virus (HIV); HIV therapy was successfully provided to active heroin injectors using the
Community Health Care Van (CHCV) at sites of needle exchange. Subjects were willing to initiate, but were not receiving, recommended
HIV therapy and were not interested in formal drug treatment. Antiretroviral therapy regimens were selected and linked to
heroin injection timing. Weekly visits were scheduled by CHCV staff to assess adverse side effects and encourage adherence.
Of the 13 participants, the mean baseline HIV-1 RNA level and CD4 lymphocyte count were 162,369 (log 5.21) copies per milliliter
and 265 cells per milliliter, respectively. By 6 months, the proportion whose HIV-1 RNA was below the limits of detection
(<400 copies/mL) was 85% (N=11); 77% (N=10) had nondetectable levels by 9 months. By 12 months, 54% (N=7) had a persistently
nondetectable viral load, and the net increase in CD4 lymphocyte count was 150 cells per milliliter. As an additional and
unintended benefit of this pilot project, 9 (69%) subjects chose to enter drug treatment after achieving a nondetectable viral
load. Entry into drug treatment was associated with durability of viral suppression. This small pilot study suggests that
health services based on needle exchange may enhance access to HAART among out-of-treatment HIV-infected IDUs. In addition,
it demonstrates that this population can benefit from this therapy with the support of a nontraditional, community-based health
intervention. 相似文献
29.
L. Guillermo Palacio Ivan Jimnez H. Hugo Garcia Marta E. Jimnez Jorge L. Snchez John Noh IlLisa Ahn Ofelia Mora Margarita Giraldo Victor C. W. Tsang 《Epilepsia》1998,39(12):1334-1339
Summary: Purpose: A prospective series of 643 persons with epilepsy attending a reference neurologic center in Medellin, Colombia, was examined by computed tomography (CT scan) or serology or both with the enzyme-linked immunoelectrotransfer blot assay (EITB) to assess the prevalence of Taenia solium cysticercosis. Methods: All presenting patients were consecutively enrolled in the study. Five hundred forty-six persons underwent cerebral CT scans; 376 of them also had serum EITB performed. Results: Prevalence of neurocys@ercosis by CT scan was 13.92%. Overall prevalence of T. solium antibodies with EITB was 9.82%, but for those with late-onset epilepsy (onset after age 30 years), prevalence increased to 17.5% and 19% for those who originated from outside urban Medellin. Seroprevalence in individuals with mixed lesions (cysts and calcifications) was 88.2% and 64.10% in those with live cysts. Conversely, only 2.72% of persons with CT findings not related to neurocysticercosis had positive EITB tests. Conclusions: Our study shows that an important proportion of individuals with epilepsy have radiologic or serologic evidence of T. solium infection, suggesting that neurocysticercosis is an important etiology for epilepsy in Colombia. 相似文献
30.