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101.
102.
Gilda Tonziello Marintonietta Pisaturo Antonello Sica Maria Giovanna Ferrara Caterina Sagnelli Giuseppe Pasquale Evangelista Sagnelli Salvatore Guastafierro Nicola Coppola 《Infection》2013,41(1):225-229
A female patient with non-Hodgkin lymphoma who tested positive for surface antigen of the hepatitis B virus and negative for hepatitis B core antibody experienced a reactivation of occult HBV infection 20 months after rituximab discontinuation despite lamivudine prophylaxis covering the 4 months of rituximab administration and the subsequent 12 months. 相似文献
103.
Oriol Roca Purificación Pérez-Terán Joan R. Masclans Lourdes Pérez Enrique Galve Arturo Evangelista Jordi Rello 《Journal of critical care》2013
Purpose
High flow nasal cannula (HFNC) may decrease preload being associated with beneficial hemodynamic and respiratory effects in adults with heart failure.Methods
This is a sequential intervention prospective study including 10 adults with New York Heart Association (NYHA) class III and left ventricle ejection fraction 45% or less. High flow gas was administered (fraction of inspired oxygen, 0.21) through nasal cannula (OptiflowTM; Fisher & Paykel, Auckland, New Zealand). Sequential echocardiographies were performed at baseline, using HFNC with 20 lpm and 40 lpm and post-HFNC. A reduction greater than 20% in the estimated inspiratory collapse of the inferior vena cava (IVC) from baseline was considered clinically significant.Results
Ten patients were included, with median age of 57 (44-65) years; 6 (60%) were female, and 8 (80%) had dilated cardiomyopathy. Median IVC inspiratory significantly (P < .05) decreased from baseline (37%) to HFNC with 20 lpm (28%) and HFNC with 40 lpm (21%), representing mean attributable reductions of 20% (95% confidence interval, 6-55) and 53% (95% confidence interval, 36-67) from baseline. Changes in the IVC inspiratory collapse were reversible after HFNC withdrawal. Respiratory rate was significantly reduced from 23 breaths per minute at baseline to 17 breaths per minute at HFNC with 20 lpm and 13 breaths per minute at HFNC with 40 lpm. In contrast, no significant changes in other echocardiographic or clinical variables were documented.Conclusion
These findings suggest that patients with NYHA class III heart failure may benefit with HFNC supportive therapy. 相似文献104.
Children with HIV are dependent on taking continuous medication and care, and family preparation is required when disclosing HIV. This study aimed to unveil families’ experiences with HIV disclosure to children under 13 years old. Eight family members who have disclosed HIV to seropositive children were interviewed in‐depth and individually. The fieldwork took place at a public paediatric outpatient hospital in Rio de Janeiro. The results showed that the family members’ discourse highlighted two ways of knowing their own condition and disclosing the condition of the children with HIV. First, they needed to address the communication of bad news and discover their own HIV status through their children's disease. Second, the disclosure was a process constituted by four stages: preparing for disclosure, identifying the time, deciding how and where to tell, and instilling silence after disclosure. They also recognized that nurses had a role in the process as part of an interprofessional team. Nurses can develop advocacy care and empower family members in the preparation of safe HIV disclosure. By systematizing and institutionalizing the care advocacy process, nurses may enable caretakers and children to participate in their therapeutic management, improving adherence to the treatment and self‐care with autonomy. 相似文献
105.
106.
William Froehlich Jip L. Tolenaar Kevin M. Harris Craig Strauss Thoralf M. Sundt Thomas T. Tsai Mark D. Peterson Arturo Evangelista Daniel G. Montgomery Eva Kline-Rogers Christoph A. Nienaber James B. Froehlich Eric M. Isselbacher Kim A. Eagle Santi Trimarchi 《The American journal of medicine》2018,131(3):300-306
Objectives
The purpose of this research is to analyze factors associated with delays to surgical management of Type A acute aortic dissection patients.Methods
Time from diagnosis to surgery and associated factors were evaluated in 1880 surgically managed Type A dissection patients enrolled in the International Registry of Acute Aortic Dissection.Results
The majority of patients were transferred (75.7% vs 24.3%). Patients who were transferred had a median delay from diagnosis to surgery of 4.0 hours (interquartile range 2.5-7.2 hours), compared with 2.3 hours (interquartile range 1.1-4.2 hours; P < .001) in nontransferred patients. Among patients who were transferred, those with worst-ever, posterior, or tearing chest pain those with severe complications, and those receiving transthoracic echocardiogram prior to a transesophageal echocardiogram or as the only echocardiogram were treated more quickly. Those undergoing magnetic resonance imaging, or who had prior cardiac surgery, had longer delays to surgery. Among nontransferred patients, those with coma were treated more quickly. In both groups, patients presenting with emergent conditions such as cardiac tamponade, hypotension, or shock had more rapid treatment. Among transferred patients, surviving patients had longer delays (4.1 [2.6-7.8] hours vs 3.3 [2.0-6.0] hours, P = .001). Overall mortality did not differ between patients who were transferred vs not (19.3% vs 21.1%, P = .416).Conclusion
Simply being transferred added significantly to the delay to surgery for Type A acute aortic dissection patients, but a number of factors affected its extent. Overall, signs and symptoms leading to a definitive diagnosis or indicating immediate life threat reduced time to surgery, while factors suggesting other diagnoses correlated with delays. 相似文献107.
Campos JM Evangelista LF Galvão Neto MP Ramos AC Martins JP dos Santos MA Ferraz AA 《Surgical laparoscopy, endoscopy & percutaneous techniques》2010,20(6):e215-e217
The erosion of a laparoscopic adjustable gastric band (LAGB) can cause pain that is not controlled by analgesics. In such cases, early endoscopic removal may be indicated, but only when gastric penetration is greater than 50%. We report the case of a patient with severe shoulder pain due to a small area of LAGB erosion, which was treated with early endoscopic removal through an incision in the gastric wall. The pain worsened after eating and gastroscopy revealed slight gastric erosion of the band under the cardia. The gastric wall covering the LAGB was incised using an endoscopic needle knife. In a second upper endoscopy performed 7 days later at the endoscopy suite, endoscopic scissors were used to cut the thread and part of the band lock. The open band was then removed orally. This novel endoscopic incision in the gastric wall hastened band erosion and avoided abdominal reoperation. 相似文献
108.
Genetic education,knowledge and experiences between nurses and physicians in primary care in Brazil: A cross‐sectional study
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Luís Carlos Lopes‐Júnior RN MS PhD candidate Paulo Marcondes Carvalho Júnior MD MS PhD Victor Evangelista de Faria Ferraz MD MS PhD Lucila Castanheira Nascimento RN MN PhD Marcia Van Riper RN FAAN PhD Milena Flória‐Santos RN MS PhD 《Nursing & health sciences》2017,19(1):66-74
Recent advances in genomics and related technologies have the potential to improve health care throughout the world. In this cross‐sectional study, we examine genetics education, knowledge, and genetics‐related experiences among the nurses and physicians who provide primary care in a Brazilian city. Fifty‐four healthcare professionals from family health units participated in the study (response rate: 90%). Data were collected using a structured 36‐item questionnaire divided into five axes: sociodemographic data and academic background; genetics education; genetics knowledge; genetics‐related experiences in family practice; and knowledge regarding the National Policy for Comprehensive Care in Clinical Genetics in the Unified Health System. Although most participants (85.2%) acknowledged receiving some genetic content during their undergraduate education, the majority (77.8%) advised that they did not feel prepared to deliver genomics‐based health care in primary care. The results suggest that nurses and physicians often lack the knowledge to provide genomics‐based health care in primary care. Therefore, continuing education in genetics/genomics should be provided to primary healthcare professionals in order to enhance family practice and compliance with national policies. 相似文献
109.
Spectroscopic techniques have been widely employed to analyze properties of macromolecules and dynamics of intracellular events on bulk preparations of cells. The development of computer controlled microspectrophotometers has made possible the study of the same events in single cells, often providing significant and unexpected results. This paper briefly reviews experimental works carried out in our laboratories on single red blood cells. Microspectrophotometric techniques were applied which make use of the fact that ligand binding to intracellular haemoglobin is associated with optical changes. Information on the relative abundance of different haemoglobin components inside single erythrocytes of trout blood was obtained from spectra of air equilibrated samples, taking advantage of the extreme pH sensitivity of one of the four haemoglobin components. The kinetics of oxygen and carbon monoxide binding to haemoglobin has been followed and demonstrated to correspond to a zero order process, with a rate much slower than that characteristic for haemoglobin in solution. These results demonstrate that the process is diffusion limited; computer simulations suggest that ligand uptake is limited by the time required for the diffusion from the extracellular space of enough ligand molecules for total saturation of intraerythrocytic haemoglobin. Finally, oxygen dissociation curves in single red blood cells can be obtained by means of particular flow cell, with promising results for the study of physiological and pathological processes (namely red cell sickling in drepanocytosis). 相似文献
110.
Previous studies have shown that 2,4-Dichlorophenoxyacetic butyl ester (2,4-D b.e.) causes hypomyelination in chicks born from eggs externally treated and alters the myelin chemical composition. In this paper the effect of 2,4-D b.e. on myelin phospholipid and fatty acid composition has been examined. The results of our investigations show significant variations in the phospholipid composition, with the phosphatidyl inositol content increased and sphingomyelin and phosphatidyl ethanolamine contents diminished. The fatty acid pattern of the individual myelin lipids is also significantly altered, with an important reduction of long chain fatty acids and an increase of saturated fatty acids. The observed changes in the chemical composition implicate alterations in the intrinsic properties of this membrane. 相似文献