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991.
Sheila Mortimer‐Jones Paul Morrison Ahmed Munib Francesco Paolucci Sonia Neale Amanda Hellewell Jumiati Sinwan Catherine Hungerford 《International journal of mental health nursing》2019,28(4):971-979
In recent years, there has been a move away from the medical model of care for people with borderline personality disorder, as hospital admission comes with a number of risks and potential adverse consequences. Although long‐term outpatient‐based therapy is successful, this may not be an option for those whose condition is in need of stabilisation. Brief admission for crisis intervention has been successful and is now widely used; however, research that examines both the staff and clients’ perceptions of a dedicated programme is lacking. Open Borders is a residential recovery‐oriented programme that provides brief admission, respite, and phone coaching for people with borderline personality disorder who are heavy users of the public mental health system. In this paper, the authors report the perspectives of clients and staff of the Open Borders programme obtained through semi‐structured interviews. Thematic analysis of client and staff perspectives identified four common themes: ‘Benefits of the programme’, ‘Enhanced client outcomes’, ‘Impact of the physical environment’, and ‘Ways of enhancing service delivery’. In addition, analysis of the staff perspectives included the theme ‘Emotional impact on staff’. Benefits of the programme included the small supportive team approach, flexibility of the staff to spend time with the clients to tailor care, and the relaxed, welcoming environment. Enhanced client outcomes included a reduction in self‐harming and hospitalization and an increase in self‐efficacy. These results support the move away from the medical model and the empowerment of clients to self‐manage their symptoms while fostering hope and self‐determination. 相似文献
992.
Heitham Awadalla Sufian K. Noor Wadie M. Elmadhoun Sarra O. Bushara Ahmed O. Almobarak Amel Abdalrhim Sulaiman Mohamed H. Ahmed 《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2018,12(6):961-964
Background
Diabetes mellitus (DM) is a major health problem in Sudan and is a leading cause of morbidity and mortality. Dyslipidemia is a major complication of diabetes and an important risk factor for cardiovascular disease (CVD). The objective of this study was to determine the prevalence of dyslipidemia and its co-relation with the glycemic control in individuals with diabetes in River Nile State, Sudan.Methods
Individuals with diabetes attended, Naserudin Karamalla Diabetic (NKDM) Centre, in Atbara teaching hospital during study period, who volunteered to participate were included. Only those on treatment for DM for at least one year were included. Venous samples were collected for cholesterol, triglycerides, HDL, LDL, blood glucose and Glycosylated hemoglobin. Participants were interviewed using standardized pretested questionnaire to record medical history and sociodemographic characteristics. Blood pressure, body mass index (BMI) and waist circumference were measured.Results
A total of 188 individuals were included. The mean age was 49.5?+?13.9 and (128) 68.1% were females. Most patients were having DM for at least 3–5 years 69 (36.7%). Poor diabetes control (HbA1c >7) was recorded in 87.2%, hypercholesterolemia, hypertriglyceridemia and high LDL were identified in 36.6%, 27.7% and 26.6% respectively. In addition, HDL was low in 61.2% of patients.Conclusion
Low HDL is a prominent feature in two thirds of individuals with diabetes, while high cholesterol and high triglyceride were seen in over one quarter. 相似文献993.
PURPOSE: Digital pressure on the perineum was reported to result in an increase of the rectal tone. This effect has been related to a reflex action named perineorectal reflex but was not verified. The mechanism of action of perineal pressure on the rectal tone was studied. METHODS: Eighteen healthy volunteers (mean age +/- standard deviation, 39.7 +/- 11.8 years; 10 males) were studied. The barostat system used consisted of a polyethylene balloon connected to a strain gauge and a computer-controlled, air-injection system. The balloon was introduced into the rectum, and the rectal tone was assessed by recording the balloon volume variations in response to digital pressure on the perineum. The test was repeated after individual anesthetization of perineum and rectum. It was performed again using normal saline instead of Xylocaine. RESULTS: During perineal pressure, all the volunteers exhibited rectal tone increase with a mean decrease in the balloon volume of 72.3 +/- 14.7 percent. There was no significant difference (P > 0.05) in the rectal tone response between females and males nor between young and elderly patients. The mean latency was 17.3 +/- 1.8 ms. Perineal pressure 20 minutes after individual anesthetization of perineum and rectum effected no significant rectal tone changes. The response returned after the anesthetic effect had waned. The rectal tone response after saline administration was similar to that before administration. CONCLUSION: The study has shown that rectal tone increase during digital perineal pressure represents most probably a reflex action. This was evidenced by absence of rectal tone response on individual anesthetization of the assumed two arms of the reflex arc: perineum and rectum. The perineorectal reflex may be of diagnostic significance in rectal motor disorders and has the potential to be used as an investigative tool, provided further studies are performed to prove these points. 相似文献
994.
El-Zayadi AR Selim O Hamdy H El-Tawil A Moustafa H 《The American journal of gastroenterology》2002,97(5):1264-1265
995.
Jafary FH Arham AZ Waqar F Raza A Ahmed H 《Journal of thrombosis and thrombolysis》2008,26(2):147-149
There is paucity of outcomes data on patients receiving fibrinolytic therapy (FT) for acute ST-elevation myocardial infarction
(STEMI) in Indo-Asians. We conducted this study to determine survival as well as correlates of mortality in this population.
Hospital charts of 230 patients receiving FT for acute STEMI between January 2002 and December 2004 were reviewed. Primary
outcome variable was total mortality. Cox proportional hazards regression models were constructed. At a median follow-up of
717 days, 13.5% died, majority (23) during the in-hospital period. Multivariate predictors of mortality included (adjusted
hazards ratio [HR], 95% confidence interval [CI]) age (HR 1.06, 95% CI 1.01–1.13), ejection fraction (HR 0.93, 95% CI 0.89–0.97),
admission white cell count (HR 1.02, 95% CI 1.01–1.04) and change in ST-segment elevation (HR 0.96, 95% CI 0.92–0.99). We
conclude that patients receiving FT for acute STEMI in Pakistan are a relatively high-risk group with a 10% in-hospital mortality
and high frequency of recurrent events. Comparison data with primary angioplasty as an alternative strategy are needed. 相似文献
996.
Bolad A Nebié I Cuzin-Ouattara N Traore A Esposito F Berzins K 《The American journal of tropical medicine and hygiene》2003,68(6):728-733
Antibody-mediated inhibition of Plasmodium falciparum parasites in vitro reflects the potential parasite-neutralizing activity of the antibodies in vivo. In this study, immunoglobulins and P. falciparum isolates were collected from children with asymptomatic malaria in Burkina Faso. We demonstrate a significantly lower in vitro growth inhibitory activity against the P. falciparum field isolates by autologous host immunoglobulin compared with that of immunoglobulin from other individuals. To gain further insight to possible mechanisms for the diverse sensitivity observed, analyses of consecutive isolates taken 14 days apart were performed with regard to polymerase chain reaction-based genotyping and sensitivity to growth inhibition in vitro. All the asymptomatic infections were composed of multiple, genotypically distinct parasite clones, and at least one new parasite clone appeared in most of the day 14 isolates compared with the corresponding day 0 isolates. Apparently persisting parasite clones, present in both the day 0 and day 14 isolates from the same person, were also frequently observed. The day 14 isolates were more effectively inhibited by autologous day 14 immunoglobulin than by the corresponding day 0 immunoglobulin in 57% of the cases. However, the frequent presence of persisting parasite clones in asymptomatic children indicates that the parasite may develop a relative resistance to neutralizing immune responses. 相似文献
997.
Abozguia K Phan TT Shivu GN Maher AR Ahmed I Wagenmakers A Frenneaux MP 《European journal of heart failure》2008,10(7):652-657
AIM: We used Near Infrared Spectrophotometry (NIRS) during arterial occlusion to measure resting skeletal muscle oxygen consumption in chronic heart failure (CHF) patients and in age-matched healthy volunteers (HVs). METHODS: Fifteen CHF patients (ten males) and eleven HVs (six males) had echocardiographic evaluation followed by measurement of the oxygen consumption of the brachioradialis muscle using NIRS. This involved continuous measurement of the oxygenated haemoglobin concentration ([Oxy-Hb]) and deoxy-haemoglobin concentration ([Deoxy-Hb]) with an Oxiplex TS NIRS probe first under basal overnight fasted resting conditions followed by 1 min of forearm arterial occlusion. A linear decline was observed in [Oxy-Hb-Deoxy-Hb] during the arterial occlusion and the oxygen consumption rate was calculated from the initial slope observed. RESULTS: CHF patients were 59+/-2.8 years old with Left Ventricular Ejection Fraction (LVEF) 31%+/-2.2 and the HVs were 52+/-4.8 years old with LVEF 62%+/-2.5. The resting muscle oxygen consumption rate was significantly reduced in CHF patients versus HVs (0.04+/-0.01 mlO(2)/min/100 g versus 0.07+/-0.01 mlO(2)/min/100 g) p<0.005. CONCLUSIONS: There is a significant reduction in resting oxygen consumption per gram of tissue in skeletal muscle of patients with CHF. 相似文献
998.
Cesar J. Lopez Angel Edward A. Pham Huixun Du Francesco Vallania Benjamin J. Fram Kevin Perez Thai Nguyen Yael Rosenberg-Hasson Aijaz Ahmed Cornelia L. Dekker Philip M. Grant Purvesh Khatri Holden T. Maecker Jeffrey S. Glenn Mark M. Davis David Furman 《Proceedings of the National Academy of Sciences of the United States of America》2021,118(14)
999.
Dina El-Dahshan Doaa Bahy Ahmed Wahid Amr E. Ahmed Amro Hanora 《Arab Journal Of Gastroenterology》2018,19(3):106-115
Background and study aims
The double-stranded RNA dependent protein kinase (PKR) plays a vital role in the immune system. During HCV infection, PKR has antiviral effect by inhibition of protein synthesis of the HCV. The functional single nucleotide polymorphisms (SNPs) in PKR promoter region might have a relation to HCV disease outcome and response to treatment. The objective of the present work was threefold. First, it proposed an optimized protocol for PCR amplification of PKR promoter. Second, it screened the promoter region of PKR gene in HCV Egyptian patients to detect the possible SNPs’ function. Third, to study the association between the detected SNPs and the response to treatment.Patients and methods
The functional SNPs in PKR promoter region were detected using DNA sequencing in 40 HCV infected patients; 20 sustained virologic response (SVR) patients and 20 nonresponse (NR) patients after combined interferon/ribavirin therapy. Twenty healthy subjects were included as a control.Results
Two functional SNPs were detected: rs62133148T>G and rs12992188C>T within our target PKR promoter region. In rs62133148 polymorphism, there is a significant difference between patients and control subjects for TT and TG genotypes (p?<?0.0001). In addition, the G allele is more predominant in HCV patients. In rs12992188 polymorphism, the CC genotype is significantly different between patients and healthy control subjects (OR/95% CI: 0.033/0.006–0.172, p?<?0.0001). The presence of C allele was significantly associated with the NR patients (OR/95%CI: 0.25/0.097–0.643, p?=?0.006). The TT genotype is significantly different between SVR and NR (OR/95%CI: 8.5/1.54–46.871, p?=?0.014).Conclusion
This study is a pioneer clinical study on these two functional SNPs (rs62133148T>G and rs12992188 C>T). The rs62133148 polymorphism does not show any association with response to treatment. The TT genotype in rs12992188 polymorphism shows association with response to treatment. Therefore, patients with TT genotypes were more likely to achieve SVR. 相似文献1000.
Major histocompatibility complex haplotype studies in Ashkenazi Jewish patients with pemphigus vulgaris.
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A R Ahmed E J Yunis K Khatri R Wagner G Notani Z Awdeh C A Alper 《Proceedings of the National Academy of Sciences of the United States of America》1990,87(19):7658-7662
Of 26 Ashkenazi Jewish patients with pemphigus vulgaris, 24 (92.3%) carried the major histocompatibility complex (MHC) class II alleles HLA-DR4, DQw3, of which all were of the subtype DR4, DQw8. From studies of the patients and their families, haplotypes were defined. It was found that, of the patients who carried HLA-DR4, DQw8, 75% carried one or the other (and in one case, both) of two haplotypes [HLA-B38, SC21, DR4] or HLA-B35, SC31, DR4. The former is a known extended haplotype among normal Jews, with a frequency of 0.102, and the latter may also be an extended haplotype in this ethnic group, with a frequency of 0.017 among normal haplotypes from Jews. Of the remaining DR4-positive patients, all but one had a presumed D-region segment (defined as SC21, DR4, DQw8 or SC31, DR4, DQw8 with variable HLA-B) of these haplotypes. Only one patient had DR4, DQw8 without any other markers of the extended haplotypes. The number of homozygotes and heterozygotes for DR4, DQw8 was consistent with dominant but not recessive (P less than 0.01) inheritance of a class II or a class II-linked susceptibility gene for the disease. Since the disease is entirely attributable to the presence of an antibody to an intraepidermal intercellular cement substance, it is likely that the class II susceptibility gene (on [HLA-B38, SC21, DR4, DQw8], HLA-B35, SC31, DR4, DQw8, or their segments, in Jewish patients) controls the production of the antibody as a dominantly expressed immune response gene. 相似文献