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81.
Nasser M. Al‐Daghri Omar S. Al‐Attas Majed S. Alokail Khalid M. Alkharfy Hossam M. Draz 《Pediatrics international》2010,52(4):551-556
Background: Association of resistin with insulin resistance (IR) in humans is still controversial and few studies have investigated the association of plasminogen activator inhibitor‐1 (PAI‐1) with IR in children. The purpose of the present study was therefore to evaluate serum levels of resistin and active PAI‐1 (aPAI‐1) in Saudi children and their association with the various obesity‐related complications. Methods: In this cross‐sectional study, 73 boys and 77 girls with varying body mass index (BMI) were recruited. They were assessed for anthropometric measures and fasting serum levels of glucose, insulin, lipid profile, resistin, angiotensin II (ANG II) and aPAI‐1. Results: Resistin was positively correlated with hips (r = 0.33, P < 0.01), waist (r = 0.23, P < 0.05) and BMI (r = 0.33, P < 0.01). The association of resistin with the markers of obesity was also significant in girls but lost significance in boys. aPAI‐1 was positively correlated with total cholesterol (r = 0.24; P < 0.01), triglycerides (r = 0.2, P < 0.05), HOMA‐IR (r = 0.26, P < 0.01) and insulin (r = 0.26, P < 0.01). The significant association of aPAI‐1 with IR was also true in girls but lost significance in boys. Conclusion: Resistin is not correlated with IR and further studies are needed to explore the role of resistin especially in childhood obesity. In contrast, increased levels of PAI‐1 may contribute to the risk of cardiovascular diseases related to obesity and insulin resistance in children. The observed gender‐related differences in the association between resistin, aPAI‐1 with obesity markers and IR could be attributed to sexual dimorphism in body fat distribution. 相似文献
82.
Zellos L Jaklitsch MT Al-Mourgi MA Sugarbaker DJ 《Seminars in thoracic and cardiovascular surgery》2007,19(4):355-359
Extrapleural pneumonectomy (EPP) is a technically demanding operation that includes two body cavities within the operative field. Avoidance of postoperative deaths requires an experienced team that can identify common morbidities. The ability to recognize and intervene correctly in the early phases of postoperative complications can avoid deaths. Although our group has experienced only 20 deaths following 496 EPPs (4% mortality), there were 328 patients (66%) who suffered morbidity. We have drawn upon our single-institution experience to describe the most common source of morbidity following EPP and to offer successful interventions. 相似文献
83.
PURPOSE: To assess whether the presence and duration of air leaks after lobectomy are associated with an increased incidence of cardiopulmonary complications. METHODS: Propensity score analysis was used on 726 patients undergoing pulmonary lobectomy from 1995 through 2004 to form three well-matched pairs of patients: patients with prolonged air leak (PAL) [> 7 days] and without air leak; patients with short air leak (SAL) [< or = 7 days] and without air leak; and patients with SAL and PAL. These matched groups were then compared to assess postoperative hospital stay and early outcome. RESULTS: Patients with SAL had a longer postoperative hospital stay compared to patients without air leak (8.6 days vs 7.8 days, respectively; p < 0.0001) but had similar morbidity and mortality. Patients with PAL had a longer postoperative hospital stay compared to patients without air leak (16.2 days vs 8.3 days, respectively; p < 0.0001) and with SAL (16.9 days vs 9 days, respectively; p < 0.0001), but similar cardiopulmonary complications were noted between the groups. Patients with PAL had a higher rate of empyema compared to patients without air leak and with SAL (8.2% vs 0%, p = 0.01 and 10.4% vs.1.1%, p = 0.01, respectively). CONCLUSIONS: The presence of air leak was not associated with an increased incidence of cardiopulmonary morbidity but was associated with an increased risk of empyema. Future prospective studies are needed to confirm safety of fast track in patients with air leak. 相似文献
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86.
Yassir Turki Suha Saleh Shatha Albaik Yasmeen Barham Dorien van de Vrie Yousef Shahin Majed Hababeh Akihiro Seita 《Lancet》2019
Background
Mental health is a major public health priority, particularly among refugees worldwide. The United Nations Relief and Works Agency for Palestine Refugees (UNRWA) started to integrate mental health and psychosocial support (MHPSS) into its primary health-care services in Jordan in late 2017. This baseline study aimed to assess the knowledge, attitudes, practices, and perceived barriers among UNRWA health staff regarding the implementation of the MHPSS programme.Methods
The UNRWA Health Programme conducted a cross-sectional study of a sample of 220 out of the 390 male and female doctors, dentists, nurses, and midwives who work at 16 of the 25 UNRWA health centres in Jordan during November, 2017. Individuals on duty at the health centres on the day of the survey were included. The 16 health centres were selected based on their size and accessibility to surveyors (reflecting proximity to Amman, and the size of population served). Of the selected health centres, seven were large, seven were medium, and two were small according to the UNRWA classification of health centres (based on the number of medical doctors). A validated self-administered questionnaire was used. Ethics approval was granted by the UNRWA Health Programme ethics committee, and informed written consent was obtained from all participants. Data analysis was performed using SPSS (version 22).Findings
Of the participants, 73% (161 of 220) believed that their knowledge of MHPSS programmes was insufficient, with no significant difference (p=0·116) between different categories of staff. Furthermore, 88% (194 of 220) said that they needed more training, 67% (147 of 220) reported that the number of mental health cases is increasing, and 50% (110 of 220) that dealing with these cases is difficult. Reflecting on the past 12 months, 31% of staff (69 out of 220) reported meeting between one and ten children, and 45% (100 out of 220) reported meeting between one and ten adults suspected of having mental illnesses. The most suspected condition was depression (84%; 150 of 220), followed by epilepsy (64%; 140 of 220). The main perceived barriers to implementation included the limited availability of MHPSS policies (87%; 192 of 220), MH professionals (86%; 190 of 220), resources (86%; 189 out of 220), and lack of privacy (14%; 31 out of 220).Interpretation
Most health staff had positive attitudes towards MHPSS programme implementation but felt they lacked the required knowledge. There is a need for training and clear technical guidelines. Perceived barriers to MHPSS programme implementation need to be tackled with a structured plan of action.Funding
The UNRWA Health Programme, UNRWA Headquarters, Amman, Jordan. 相似文献87.
88.
Jumanah Alshenaifi Nour Ewida Shams Anazi Hanan E. Shamseldin Nisha Patel Sateesh Maddirevula Tarfa Al-Sheddi Rana Alomar Eman Alobeid Niema Ibrahim Mais Hashem Firdous Abdulwahab Minnie Jacob Amal Alhashem Hamad I. Alzaidan Mohammed Z. Seidahmed Nadia Alhashemi Rifaat Rawashdeh Wafaa Eyaid Zuhair N. Al-Hassnan Zuhair Rahbeeni Abdulrahman Alswaid Adnan Hadid Alya Qari Dia A. Mohammed Heba Y. El Khashab Majid Alfadhel Mohammad Abanemai Rawda Sunbul Saeed Al Tala Salwa Alkhalifi Turki Alkharfi Mohamed Abouelhoda Dorota Monies Nada Al Tassan Saud H. AlDubayan Wesam Kurdi Mohammed Al-Owain Majed J. Dasouki Amal Y. Kentab Suha Atyani Nawal Makhseed Eissa Faqeih Ranad Shaheen Fowzan S. Alkuraya 《Clinical genetics》2019,95(2):310-319
Defects in the peroxisomes biogenesis and/or function result in peroxisomal disorders. In this study, we describe the largest Arab cohort to date (72 families) of clinically, biochemically and molecularly characterized patients with peroxisomal disorders. At the molecular level, we identified 43 disease-causing variants, half of which are novel. The founder nature of many of the variants allowed us to calculate the minimum disease burden for these disorders in our population ~1:30 000, which is much higher than previous estimates in other populations. Clinically, we found an interesting trend toward genotype/phenotype correlation in terms of long-term survival. Nearly half (40/75) of our peroxisomal disorders patients had documented survival beyond 1 year of age. Most unusual among the long-term survivors was a multiplex family in which the affected members presented as adults with non-specific intellectual disability and epilepsy. Other unusual presentations included the very recently described peroxisomal fatty acyl-CoA reductase 1 disorder as well as CRD, spastic paraparesis, white matter (CRSPW) syndrome. We conclude that peroxisomal disorders are highly heterogeneous in their clinical presentation. Our data also confirm the demonstration that milder forms of Zellweger spectrum disorders cannot be ruled out by the “gold standard” very long chain fatty acids assay, which highlights the value of a genomics-first approach in these cases. 相似文献
89.
Majed B Moreau T Senouci K Salmon RJ Fourquet A Asselain B 《Breast cancer research and treatment》2008,111(2):329-342
Background Breast cancer and obesity represent important public health issues in most western countries. A number of studies found a negative prognosis effect of obesity or excess of weight in woman breast cancer. However, to date, this issue remains controversial. The objectives of this study were to confirm the prognosis role of obesity on a large cohort of patients and to investigate a potential independent effect. Materials and methods We constituted a cohort of 14,709 patients who were recruited and treated at the Curie Institute (Paris) from 1981 to 1999. These patients were followed prospectively for a first unilateral invasive breast cancer without distant metastasis. Obesity was defined by a Body Mass Index (BMI) above 30 kg/m(2) according to the World Health Organization recommendations. Results Obese patients (8%) presented more extended tumors at diagnosis time suggesting a delayed breast cancer diagnosis. However, obesity appeared as a negative prognosis factor for several events in respectively univariate and multivariate survival analysis: metastasis recurrence (HR = 1.32[1.19-1.48]; HR = 1.12[1.00-1.26]), disease free interval (1.20[1.08-1.32]; 1.10[0.99-1.22]), overall survival (1.43[1.28-1.60]; 1.12[0.99-1.25]) and second primary cancer outcome (1.57[1.19-2.07]; 1.43[1.09-1.89]). Even if obese patients presented more advanced tumors at diagnosis time, multivariate analysis showed that there was a relevant independent effect. Other BMI codings, distinguishing overweight patients or using BMI as a continuous variable, showed a consistent correlation between BMI's value and prognosis effect. Interaction analysis revealed a more important obesity effect in the presence of tumor estrogen receptors and among limited extent tumors. Conclusions This survey confirms the prognosis role of obesity on one of the largest cohort by investigating several prognosis events. While independent obesity effect linked to hormonal disorders appeared consistent as obesity's mechanism, we stress that obesity prognosis effect was also related to breast cancer presentation at diagnosis time. 相似文献
90.