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61.
62.
Uwe Wollina Marco Burroni Rocco Torricelli Stefano Gilardi Giordana Dell''Eva Cathrine Helm Wolfgang Bardey 《Skin research and technology》2007,13(2):133-142
BACKGROUND: Early detection of cutaneous melanoma is the most important step to improve prognosis. In recent years objective techniques have been developed to improve diagnostics of pigmented lesions superior to the naked eye. Digital dermoscopy offers several advantages such as independence from the investigator, format ready for teledermatology and image storage, and comparability. SETTING: In a routine setting including three centres in Europe, i.e. Lugano and Locarno in Switzerland, and Dresden in Germany, the usefulness of digital dermoscopy in daily routine has been evaluated. PATIENTS AND METHODS: Digital dermoscopy was performed with the DB-MIPS system in 1308 patients, and 3544 pigmented lesions were evaluated. A total of 466 pigmented lesions were surgically removed and classified by histopathology. Among those 52 melanomas and 299 dysplastic, naevi could be identified. DB-MIPS system evaluated 35 variables of geometrics, colour, colour distribution and texture. Lesion identification is realized by clustering. Another important part of the analysis was to study the decision making, i.e. removal or follow-up of lesions. The tendency to follow-up was defined as the ratio of (number of suspicious lesions-removed lesions)/suspicious lesions. The interventism is defined as the ratio of the number of removed lesions to the number of suspicious lesions. RESULTS: The DB-MIPS system was robust and easy in handling in daily routine. The data analysis and digital imaging were realized in real time. Fifty-two melanomas could be identified including eight in situ melanomas and 33 T1a melanomas (thinner than 1 mm). Sensitivity of digital dermoscopy varied between 90% and 95% between the three centres. Specificity varied between 79.6% and 93.3%. The centres differed in the patient population, the mean diameter of pigmented lesions and decisions. Interventism varied between 36.3% and 76.0%, follow-up varied from 24% to 63%. Higher levels of clinician's false positive were associated with a higher percentage of interventism. CONCLUSIONS: Digital dermoscopy offers advantages for daily routine in detection of early melanoma. Sensitivity and specificity for early melanomas is high and thereby, the experienced dermatologist can be easily supported in daily routine of a pigment lesion clinic to improve diagnostics and hopefully prognosis in cutaneous melanoma. 相似文献
63.
Cathrine Hildingh RN BNSc Bengt Fridlund RN PhD Kerstin Segesten RN PhD 《Journal of advanced nursing》1995,22(5):921-928
Self-help groups are lay, mutual support groups in which people who share some long-term existential problems in their lives meet regularly to support each other empathetically These groups can be viewed as supplementary sources of support outside patients' existing social networks As such, it is of importance to be aware of them when planning nursing care The aim of this study was to examine cardiac nurses' preparedness to use self-help groups as a support strategy A qualitative research method was used and 12 registered nurses from two coronary care units were interviewed The findings showed that nurses' knowledge of social support, self-help groups and of patients' social circumstances as well as their attitudes to their own roles as nurses were of importance in their preparedness to use self-help groups as a support strategy Lack of knowledge of social support and self-help groups affected the nurses attitudes towards lay care and was probably the reason for not using self-help groups as a support strategy Most of the nurses were well informed about their patients' social circumstances, they had an explicit family nursing approach and were not at all against further expansion of their nursing role However, there is a need for education in innovative ways of working that respond to and interact with informal support networks if nurses are to be able to contribute to empowerment of their patients 相似文献
64.
Staff AC Braekke K Harsem NK Lyberg T Holthe MR 《European journal of obstetrics, gynecology, and reproductive biology》2005,122(1):33-39
OBJECTIVE: We hypothesized that umbilical vein serum soluble fms-like tyrosine kinase 1 (sFlt1) concentration was augmented in pre-eclampsia. We also explored a possible association between fetal and maternal concentrations of sFlt1. STUDY DESIGN: At cesarean delivery, maternal serum samples from pre-eclamptic (n=38) and uncomplicated (n=32) pregnancies were obtained, as well as umbilical vein serum and amniotic fluid samples. ELISA for human sFlt1, vascular endothelial growth factor (VEGF) and placental growth factor (PlGF) were performed. RESULTS: Median sFlt1 concentrations were elevated in pre-eclampsia compared to uncomplicated pregnancy, in umbilical venous serum (246 and 163 pg/mL, P=0.04), in maternal serum (9932 and 3417 pg/mL, P<0.001), as well as in amniotic fluid (51,040 and 33,490 pg/mL, P=0.03). A positive association between the fetal and maternal serum levels of sFlt1 was found in the pre-eclampsia group. Median PlGF concentration in the maternal serum was significantly lower in the pre-eclampsia group compared to the control group (82 pg/mL and 169 pg/mL, P<0.001). CONCLUSIONS: sFlt1 concentration is elevated in the fetal circulation in pre-eclampsia, but at a much lower level than in the maternal circulation. The results of our study do not support a substantial fetal contribution to the elevated circulating maternal sFlt1 protein concentration in pre-eclampsia. 相似文献
65.
Individually Modified Saliva Delivery Changes the Perceived Intensity of Saltiness and Sourness 总被引:1,自引:0,他引:1
Individuals vary largely in their salivary flow and composition, and given the importance of saliva on perception of taste, this might influence how the tastant stimuli are perceived. We therefore hypothesise that altering the individual salivary flow rates has an impact on the perceived taste intensity. In this study, we investigated the role of saliva amount on the perceived taste intensity by excluding parotid saliva and adding artificial saliva close to the parotid duct at preset flow rates. Significant decreases in perception with increasing salivary flow rates were observed for citric acid and sodium chloride. This can partially be explained by a dilution effect which is in line with previous studies on detectable concentration differences. However, since the bitterness and sweetness remained unaffected by the salivary flow conditions and the dilution effect was comparable to that of saltiness, further explanation is needed. Furthermore, we investigated whether the suppression of taste intensity in binary mixtures (taste-taste interactions) could possibly be caused by the increased salivary flow rate induced by an additional taste attribute. The results show, however, that suppression of taste intensity in binary mixtures was not affected by the rate of salivation. This was more likely to be explained by psychophysics. 相似文献
66.
67.
68.
Jackerott M Lee YC Møllgård K Kofod H Jensen J Rohleder S Neubauer N Gaarn LW Lykke J Dodge R Dalgaard LT Søstrup B Jensen DB Thim L Nexø E Thams P Bisgaard HC Nielsen JH 《Endocrinology》2006,147(12):5752-5759
Trefoil factors (TFFs) 1, 2, and 3 are expressed in mucosal epithelia. TFFs are particular abundant in the intestine in which they play a crucial role in maintenance and restitution of the epithelium. Because pancreas developmentally arises from the primitive foregut, we explored the expression of TFFs in the pancreas in man and rat. Immunocytochemical staining of adult human pancreas showed abundant TFF3 immunoreactivity in pancreatic islets and some duct cells, whereas weak TFF1 and no TFF2 staining were detected. In the islets TFF3 localized to most insulin and some glucagon and pancreatic polypeptide-producing cells. TFF3 immunoreactivity was colocalized with insulin and glucagon in distinct cell clusters in human fetal pancreas at wk 14 and in the newborn rat pancreas. In isolated human and rat islets, TFF3 and TFF1 mRNA was identified by RT-PCR, and TFF3 protein was detected in human pancreas and islets by ELISA. Exposure of neonatal rat islets or insulinoma cells to GH, a known beta-cell growth factor, resulted in markedly increased TFF3 but decreased TFF1 mRNA levels. The effect of GH on TFF3 expression was confirmed by Western blot. Culture of neonatal rat islets in the presence of TFF3 resulted in attachment and migration of the islet cells, but no effects on proliferation, insulin secretion or cytokine-induced apoptosis were seen. These data demonstrate expression of TFFs in the endocrine pancreas, but their possible functions remain unknown. 相似文献
69.
Transition to adulthood is a period in life when women encounter conflicts, ambiguities and rapidly expanding roles that may be stressful and difficult to manage. The aim of this study was to compare stress in daily life, health complaints and self-confidence in 26-year old women in two different cultures. A health survey study was performed among Swedish women (n = 386) and American women (n = 201) living in urban areas at the West coast of Sweden and in Minnesota. Both Swedish and American women reported stress in their everyday life, with higher figures for the Americans. Overall health was rated lower by the Swedish women and they reported more health complaints such as headache, general tiredness, irritability, depression and sleeping disorders. There was a difference between groups in self-confidence with higher figures for excellent self-confidence among American women. However, low self-confidence was reported by more American than Swedish women. A good work situation predicted self-confidence in Swedish women and financial confidence in American women. Physical fitness was associated with self-confidence in both groups. Young women in both cultures experienced high level of stress but health related complaints were more common among Swedish women. High stress and health complaints must be taken seriously and interventions to support young women in the midst of transition to adulthood should contain stress reduction as well as empowerment performed in a more effective way than today in different health care settings and at place of work. 相似文献
70.
Johansson I Hildingh C Wenneberg S Fridlund B Ahlström G 《Journal of advanced nursing》2006,56(5):463-471
This paper reports the development of a theoretical model of relatives' coping approaches during the patient's intensive care unit stay and subsequent recovery at home by performing an analysis of concepts generated from two empirically grounded, theoretical studies in this area. BACKGROUND: When supporting relatives of intensive care unit patients, it is important that nurses have access to evidence-based knowledge of relatives' coping approaches during the period of illness and recovery. METHOD: Simultaneous concept analysis was used to refine and combine multiple coping concepts into a theoretical model of coping. The concepts were generated in two previous empirical studies of relatives' coping approaches during mechanically ventilated patients' intensive care unit stays and recovery at home. FINDINGS: The theoretical model was developed in 2004-2005 and illustrates the effectiveness of different coping approaches in relation to each other and to social support. Definitions summarizing each coping approach and containing the knowledge gained through the simultaneous concept analysis method were also formulated. CONCLUSION: This middle-range theory of relatives' coping approaches may make a valuable contribution to international intensive care unit nursing practice, especially as it is based on empirical studies and may therefore serve as a basis for the development of future clinical guidelines. However, the theoretical model needs to be empirically validated before it can be used. 相似文献