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81.
J Smail 《Nursing times》1987,83(29):44-45
Clinicians conducted a study of 154 women who presented themselves at a health center of the University of Wales College of Medicine with symptoms of vaginitis. A nurse examined the vagina with a speculum to note the appearance of the cervix, the color and amount of discharge, and the presence of odor and inquired about soreness during the examination. The nurse took 3 endocervical swabs and 2 high vaginal swabs. Upon microscopic examination, any vaginal discharge with epithelial cells stippled with small coccobacilli indicated a possible Gardnerella vaginalis infection. Laboratory personnel identified G. vaginalis either alone or in combination with other organisms in 53% of the women. Those with G. vaginalis alone or in combination with anaerobes reported more symptoms than those women who had negative cultures. In addition, women with G. vaginalis alone and those G. vaginalis in combination with other organisms had more discharge, described as yellow and runny, than those with negative cultures. 77% of the women infected with G. vaginalis had a high cheese or fishy odor. 75% of the women with G. vaginalis came to the health center between 2-4 weeks or even longer after they 1st noticed symptoms. On the other hand, women who were infected with C. albicans presented to the health center within a week of the start of the symptoms. Clinicians had previously treated erroneously many of the women with G. vaginalis with an antifungal agent. These women should be treated with metronidazole or, if a yeast infection is also present, with an antifungal agent and metronidazole. All women who present themselves to a nurse or physician with vaginal symptoms should have a history taken, an examination, and vaginal discharge samples taken and evaluated in the laboratory. 相似文献
82.
Ben Smail D Hugeron C Denys P Bussel B 《Archives of physical medicine and rehabilitation》2005,86(3):494-497
OBJECTIVES: To determine the frequency of pruritus after intrathecal baclofen (ITB) withdrawal and to study the pathophysiology of this symptom. DESIGN: Retrospective cohort study. SETTING: Rehabilitation department of a general hospital. PARTICIPANTS: Patients (N=102) implanted with an ITB pump who had been followed up since 1988. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Incidence of pruritus after withdrawal. We studied the relation between pruritus and daily dose, concentration and mode of infusion of baclofen, and cause of the central nervous system lesion inducing spasticity. RESULTS: Pruritus was observed in 10 of 23 cases of ITB withdrawal. It never occurred during the first 3 months after pump implantation. It seems likely that the segmental spinal action of baclofen is responsible for pruritus. There was no statistically significant difference between patients with ITB deprivation who did and did not experience pruritus in their daily infused dosage or in concentration and mode of infusion. Surprisingly, no pruritus was observed in patients with multiple sclerosis. CONCLUSIONS: Pruritus is a frequent symptom after ITB withdrawal. Its occurrence is probably subsequent to chronic blocking of the liberation of substance P by baclofen at the spinal level. This symptom is a good clinical predictor of baclofen withdrawal, in contrast to an isolated increase of spasticity that may be due to drug tolerance or irritant factors. Pruritus requires investigation of a possible dysfunction of the infusion system. 相似文献
83.
Mooney JA Helms PJ Jolliffe IT Smail P;Scottish Study Group for the Care of Diabetes in the Young 《Archives of disease in childhood》2004,89(10):970-973
Background: Diagnoses of type 1 insulin dependent diabetes mellitus are generally more common in winter, although this seasonal pattern has not been observed in children of preschool age (0–4 years) or in all countries. Aims: To confirm the persistence of seasonality and the influence of age, holidays, and weekends. Methods: We extracted data on date of birth, date of presentation, age, and sex of children diagnosed with diabetes and registered with the Scottish Study Group for the Care of Diabetes in the Young. Cosinor analysis was applied to monthly and mid-monthly data. Two sample Z tests were used to compare the epochs 1984–1992 and 1993–2001. Results: Some 4517 children between 0 and 14 years of age (2407 male and 2110 female) presented with IDDM between 1 January 1984 and 31 December 2001. Seasonality was evident in children above 4 years of age with amplitudes of 19.5–25.7% and peaks between mid December and mid January. Presentation was strongly influenced by weekends and holiday periods, with reduced presentations in December compared with November and January, and with the lowest presentations in July (the main Scottish holiday month). Using mid-month to mid-month data did not change the overall seasonality but did improve the fits for cosinor analysis. Mondays and Fridays were the most common days for presentation. Conclusion: Initial presentation of IDDM in Scotland follows a stable seasonal pattern in all but the youngest children with lower rates of presentation in holiday periods and at weekends for all age groups. 相似文献
84.
Minville V Pianezza A Asehnoune K Cabardis S Smail N 《European journal of anaesthesiology》2006,23(7):594-597
BACKGROUND AND OBJECTIVE: Out-of-hospital intravenous line placement is used daily. All available studies take place using paramedics, e.g. US-American emergency medical system. The aim of this study was to assess the intravenous line placement feasibility (time and success rate) in the French emergency medical system. METHODS: A prospective observational study was performed by a French out-of-hospital team during 3-month assessing the timing and success rates for intravenous line placement. All patients were enrolled at the emergency medical service of a university hospital in France. Six hundred and sixty-nine consecutive patients were included, 388 (58%) had at least one intravenous line placement in the out-of-hospital setting. RESULTS: Success rate was 76% at the first attempt and 98% at the second attempt. The overall success rate for intravenous line placement was 99.7% (only one failure), and the average successful intravenous line time was 4.4+/-2.8 min. Attempts ranged from 1 to 8. The time for intravenous line placement with blood sampling (58% of patients) is statistically longer than without (4.6+/-2.5 vs. 4.3+/-3 min, P<0.05). Seventeen of the enrolled patients were trauma patients, and 83% were non-trauma patients. Four hundred and twenty-seven intravenous lines were placed, intravenous 10% had more than one intravenous line. Seventy-one percent of the intravenous lines were used to infuse drugs, the others were security intravenous. No significant difference was noticed between trauma and non-trauma patients in regard to the success rate and the time to place the intravenous line. CONCLUSION: The out-of-hospital team was skilled at intravenous line placement (success rate=99.7%), and the time required to performed intravenous line access was short. 相似文献
85.
86.
The photosensitivity of freshly dissociated R3230AC mammary adenocarcinoma cells was examined by measurement of the activities of selected intracellular enzymes after treatment with hematoporphyrin derivative (Hpd) and exposure to light in vitro. Enzymes selected as representative of the cytosolic cell compartment showed no loss in activity, whereas malate dehydrogenase, located in the mitochondrial matrix, displayed a modest decrease (approximately 15%) in activity. In contrast, cytochrome c oxidase and succinate dehydrogenase, enzymes associated with the mitochondrial membrane, demonstrated a very rapid and more marked inhibition of activities, approximately 45% and 25%, respectively. The time-course of inhibition of these mitochondrial membrane enzymes preceded the loss of cell viability, which displayed slower kinetics as seen by a more gradual and progressive pattern of loss in viability. These data suggest that the mitochondria are an early-affected and important intracellular site for Hpd photosensitization. 相似文献
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