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31.
FRITZI KALLOP RN RS 《Journal of obstetric, gynecologic, and neonatal nursing : JOGNN / NAACOG》1973,2(3):36-41
The author believes that professional advice given the parents of a mongoloid infant determines their initial decision on institutionalization. Multidisciplinary counseling by the health team can help parents decide on a course of action that will prove satisfactory in the long run. Consultation should include health t e r n efforts to help parents work through the mourning process and presentation of a) an objective, comprehensive view of the child's condition, b) information on integrating a mongoloid into the family unit, and c) outside resources available to the parents. Deliberation with the parents to help them reach their own decision is essential. 相似文献
32.
33.
Background
The Rh blood system is one of the most polymorphic and immunogenic systems known to humans. The expression of Rh blood group antigen is complex. The Rh D antigen is the most important of the antigens that constitute the Rh antigen system. In most cases, D antigen can easily be detected. However, due to variability of expression, weak forms antigen are encountered. The reactivity of weak D with antisera is variable and presents as a problem in blood banking.Methods
A retrospective analysis for a five-year period was done. Blood samples that were negative for Rh D by immediate spin tube method were tested for weak D antigen by additional lab tests.Result
Of 34932 serial Rh grouping tests done in our Blood Bank, the incidence of weak D Rh antigen was 0.189%. All these were confirmed by the antiglobulin test.Conclusion
These patients present as a problem for the blood banker and a curiosity to the clinician. Although uncommon, all health care workers should be aware of this entity to avoid anti D alloimmunisation.Key Words: Weak D, Rh Blood Group 相似文献34.
35.
MJ McKinley RM McAllen GL Pennington A. Smardencas RS Weisinger BJ Oldfield 《Clinical and experimental pharmacology & physiology》1996,23(Z3):99-104
- 1 Autoradiographic binding studies have shown that the AT1 receptor is the predominant angiotensin II (AngII) receptor subtype in the central nervous system (CNS). Major sites of AT1 receptors are the lamina terminalis, hypothalamic paraventricular nucleus, the lateral parabrachial nucleus, rostral and caudal ventrolateral medulla, nucleus of the solitary tract and the intermediolateral cell column of the thoraco-lumbar spinal cord.
- 2 While there are differences between species, AT2 receptors are found mainly in the cerebellum, inferior olive and locus coeruleus of the rat.
- 3 Circulating AngII acts on AT1 receptors in the subfornical organ and organum vasculosum of the lamina terminalis (OVLT) to stimulate neurons that may have a role in initiating water drinking.
- 4 Centrally administered AngII may act on AT1 receptors in the median preoptic nucleus and elsewhere to induce drinking, sodium appetite, a sympathetic vasoconstrictor response and vasopressin secretion.
- 5 Recent evidence shows that centrally administered AT1 antagonists inhibit dipsogenic, natriuretic, pressor and vasopressin secretory responses to intracerebroventricular infusion of hypertonic saline. This suggests that an angiotensinergic neural pathway has a role in osmoregulatory responses.
- 6 Central angiotensinergic pathways which include neural inputs to the rostral ventrolateral medulla may use AT1 receptors and play a role in the function of sympathetic pathways maintaining arterial pressure.
36.
37.
RS de Vreeze D de Jong IH Tielen HJ Ruijter PM Nederlof RL Haas F van Coevorden 《Modern pathology》2009,22(2):223-231
Almost all primary retroperitoneal liposarcomas can be classified as well-/dedifferentiated liposarcoma. Rarely, however, primary retroperitoneal liposarcoma is classified as myxoid/round cell liposarcoma, based on the presence of myxoid areas and vascular crow's feet pattern, which has resulted in a debate on the classification of liposarcoma in the retroperitoneum. Genetically, myxoid/round cell liposarcoma and well-/dedifferentiated liposarcoma are different diseases. Myxoid/round cell liposarcoma is characterized by a translocation causing FUS-CHOP or EWSR1-CHOP fusion, whereas well-/dedifferentiated liposarcoma is characterized by an amplification of the 12q13-15 region, including MDM2 and CDK4 genes. As myxoid/round cell liposarcoma is highly radio- and chemosensitive, differentiation between subtypes is important to optimize treatment. We studied whether primary retroperitoneal liposarcomas diagnosed as myxoid/round cell liposarcoma represent molecularly true myxoid/round cell liposarcoma or are histopathological mimics and represent well-/dedifferentiated liposarcoma. Primary retroperitoneal myxoid/round cell liposarcoma (n=16) were compared to primary extremity myxoid/round cell liposarcoma (n=20). Histopathological and immunohistochemical features were studied. Amplification status of the 12q13-15 region was studied using a multiplex ligation-dependent probe amplification analysis, and FUS-CHOP or EWS-CHOP translocations were studied using RT-PCR. In primary retroperitoneal myxoid/round cell liposarcoma, MDM2 and CDK4 staining was both positive in 12 of 15 cases. In primary extremity myxoid/round cell liposarcoma, MDM2 was negative in 18/20 and CDK4 was negative in all cases. Multiplex ligation-dependent probe amplification showed the amplification of 12q13-15 region in 16/16 primary retroperitoneal myxoid/round cell liposarcomas and in 1/20 primary extremity myxoid/round cell liposarcomas. Translocation was present in all (18/18) primary extremity myxoid/round cell liposarcomas, but absent in all primary retroperitoneal myxoid/round cell liposarcomas. On the basis of immunohistochemical and molecular characteristics, apparent primary retroperitoneal myxoid/round cell liposarcoma can be recognized as well-/dedifferentiated liposarcoma with morphological features mimicking myxoid/round cell liposarcoma. In these cases, treatment should probably be specifically designed as for well-/dedifferentiated liposarcoma. Moreover, finding of myxoid/round cell liposarcoma translocations in a retroperitoneal localization is highly suggestive of metastasis and should prompt search for a primary localization outside the retroperitoneum. 相似文献
38.
39.
Anti-thrombotic therapy for non-rheumatic atrial fibrillation 总被引:1,自引:0,他引:1
Recent randomized trials of antithrombotic therapy in non-rheumatic atrial
fibrillation have helped to clarify the benefits of warfarin and aspirin.
Low-risk patients (normotensives aged <60 with normal left
ventricular function) have a small risk of thromboembolic events and are
unlikely to benefit significantly from anticoagulants, but may benefit from
aspirin with little increase in risk of bleeding. High-risk patients
(>75 years, impaired left ventricular function, previous
thromboembolism and/or associated conditions such as hypertension and
diabetes mellitus) have an increased risk of thromboembolism, and benefit
from long-term anticoagulant therapy to a greater degree than with aspirin,
although at a risk of increased bleeding complications.
相似文献
40.
Winning the battle but losing the war: methicillin-resistant Staphylococcus aureus (MRSA) infection at a teaching hospital 总被引:2,自引:0,他引:2
Farrington M; Redpath C; Trundle C; Coomber S; Brown NM 《QJM : monthly journal of the Association of Physicians》1998,91(8):539-548
A methicillin-resistant Staphylococcus aureus (MRSA) control policy, aimed
at eradication, was established at a 1000-bed hospital in 1985, applied
consistently for 10.5 years, and then relaxed. Its components included
screening of high-risk patients, transfer of carriers to exhaust-ventilated
isolation rooms, closure of wards to new admissions when local transmission
was detected, MRSA screening during outbreaks, and prospective collection
of clinical and epidemiological information. During the eradication policy
period, every 6 months, a mean of 5.1 patients (range 1-12) already
carrying MRSA were admitted, and a mean of 3.6 (range 0-16) acquired
carriage in the hospital. The largest outbreak comprised 11 patients
despite epidemic MRSA strain EMRSA-16 being introduced six times, and MRSA
did not become endemic. MRSA- positive admissions increased progressively
from 1993; nursing staff workload increased, areas available for
alternative patient accommodation were reduced, the resulting ward closures
interfered with clinical services, and hence the control policy was relaxed
in mid- 1995. Isolation facilities were overwhelmed with 622 new patient-
isolates in the next 18 months, and there were 67 clinical infections in
1996. The proportion of blood cultures positive for MRSA rose nearly
sevenfold by 1996 and 27-fold by 1997. Thus, repeated eradication of MRSA,
even epidemic strains, by use of a stringent policy, is possible given
sufficient resources, whereas flexible national guidelines designed to
control, but not eradicate, epidemic staphylococci, are currently unlikely
to be successful. The costs of eradication policies need to be weighed
against those of endemicity.
相似文献