We investigated the prevalence and risk factors of anemia and iron deficiency in 389 [corrected] rural Amazonians aged 5-90 years in Acre, Brazil. Anemia and iron deficiency were diagnosed in 16% and 19% of the population, respectively. Anemia was likely to have multiple causes; although nearly half of anemic school children and women had altered iron status indicators, only 19.7% of overall anemia was attributable to iron deficiency. Geo-helminth infection and a recent malaria episode were additional factors affecting iron status indicators in this population. 相似文献
Chronic nausea occurs in most patients with advanced cancer. This study was done to assess the antiemetic effects of dexamethasone in patients with chronic nausea refractory to metoclopramide. Secondary outcomes included appetite, fatigue, and pain. Fifty-one patients who had nausea (> or = 3/10 on a 0-10 scale) for > or = 2 weeks despite 48 hours of oral metoclopramide therapy (40-60 mg/day) were enrolled. Patients received 20 mg/day dexamethasone (DM) orally (n = 25) or placebo (n = 26) for severe nausea in addition to metoclopramide (60 mg/day orally). At baseline the mean nausea intensity ratings in the DM and placebo groups were 8.0 and 7.4. At Day 8 they were 2.1 and 2.0, respectively. At Day 3 and Day 8, the mean difference in nausea intensity for the DM and placebo groups was 4.5 and 2.9 (P = 0.16) and 5.9 and 5.7 (P = 0.85), respectively. Improvement in appetite and fatigue were observed on Day 3 and Day 8 in both groups as compared with the baseline. Pain, vomiting, well-being, and quality of life remained unchanged in both groups at both times. We conclude that DM was not superior to placebo in the management of chronic nausea in our patients with advanced cancer. 相似文献
Aim: Our aim was to evaluate the correlation and concordance measures between clinical, endoscopic and histologic remission in Crohn’s disease (CD) under treatment.
Method: Twenty-four patients with CD under treatment were included in a prospective consecutive cross-sectional study from January to September 2018. Clinical activity was assessed by Crohn’s Disease Activity Index (CDAI). All of the patients were submitted an ileocolonoscopy with biopsy and classified by Simple Endoscopic Score (SES-CD). Histologic activity was assessed by Global Histologic Activity Score (GHAS) modified. Remission was considered with CDAI <150; SES-CD ≤2 and GHAS ≤4.
Results: Clinical remission was established in 53%, however, only 50% had mucosal healing (MH) and 70% had inflammatory histologic activity. Correlation between endoscopic and histological measures was strong and positive (σ = 0.73, p?<?.0003). The concordance remission agreement between SES-CD and GHAS was weak with (κ) = 0.3 (IC 95%: ?0.09; 0.69). The greatest disparity arose when clinical activity (CDAI) was compared with histological measures (σ?=?0.20, p?=?.45), (κ)?=?0.26 (IC?=??0.03; 0.56).
Conclusion: The score SES-CD correlates well with histological score GHAS in CD under treatment, however, there is low concordance between both mainly in patients with anti-TNFs treatment. CDAI score had low correlation and concordance with histological score GHAS. In this sample, patients under treatment and without symptoms had low MH and histologic healing. 相似文献
A white female patient developed overlapping features of systemic lupus erythematosus (SLE) and systemic sclerosis (SSc) with severe pulmonary compromise. She was treated with steroids and azathioprine, which improved her clinical condition and spirometric status. In May 2002 she presented with continuous pain in her left ankle that continued even during rest and under treatment with nonsteroidal anti-inflammatory drugs (NSAIDs). Magnetic resonance imaging (MRI) showed multiple avascular necrosis (AVN). Rest and kinesitherapy were indicated for 1 year, and gradually an orthosis was introduced allowing the patient to walk normally. 相似文献
The authors conducted a systematic review and meta-analysis to determine whether arthrocentesis or arthroscopy combined with platelet-rich plasma (PRP) or platelet-rich growth factor (PRGF) injection compared with no injection or saline injection (control group) or hyaluronic acid (HA) injection reduced pain and increased maximum mouth opening (MMO) in patients with temporomandibular joint (TMJ) osteoarthritis (OA).
Types of Studies Reviewed
The authors used the Cochrane Library, Embase, PubMed, Web of Science, Google Scholar databases and hand searched reference lists through May 4, 2018, to identify randomized controlled trials and controlled trials including patients with TMJ OA receiving injections (PRP or PRGF versus other). The authors assessed the risk of bias according to the Cochrane guidelines.
Results
The authors screened 36 abstracts. They included 5 studies (3 randomized controlled trials and 2 controlled trials) with a total of 285 patients with TMJ OA in this review. The authors assessed all 5 studies as being at high risk of bias. The quality of evidence was very low owing to statistical heterogeneity, small sample size, or high risk of bias. Meta-analyses with 2 studies showed a visual analog scale pain improvement from baseline of ?2.778 units (0-10 scale, 0 = no pain, 10 = worst pain) favorable to PRP or PRGF compared with findings in control groups (95% confidence interval [CI], ?3.504 to ?2.052; P < .001) and an improvement of ?0.968 favorable to PRP or PRGF compared with findings in HA groups (95% CI, ?1.854 to ?0.082; P = .032). The authors found no significant increase in MMO in those receiving PRP or PRGF compared with that in the control or HA groups.
Conclusions and Practical Implications
Although the results of the included studies showed that arthrocentesis or arthroscopy with PRP or PRGF, saline, or HA injections all reduced pain and increased mouth opening, the evidence was of very low quality. Further studies are needed to confirm these preliminary results showing that PRP or PRGF with arthrocentesis or arthroscopy significantly improved pain but did not increase MMO compared with findings in the control or HA groups. 相似文献
This study has evaluated the pre and post perceptions of patients with ectodermal dysplasia (ED) who have been referred to Westmead Centre for Oral Health for treatment with dental implants.
Methods
Six patients with ED and hypodontia were treated with new maxillary complete dental prostheses or fixed implant prostheses, and a mandibular fixed dental prosthesis with implants. Patient perceptions were recorded with a 10 cm visual analogue scale (VAS). All patients were asked to draw a line on the VAS which best described their feelings regarding aesthetics, chewing, diet and speech.
Results
Improvement in aesthetics was reported for all patients with change scores ranging from +9 to +4 points. Similarly, all patients reported an improvement in chewing ability with +6 point changes in 2 patients, and +8, +3, +7 and +1 in the other 4 patients. Five out of 6 patients reported less dietary restriction with 3 patients each indicating a change of +6 points, +4 points, +3 points, and 2 patients reporting +1 point change. Speech improved by +1 point for 3 patients, whilst 1 patient improved by +6 points, a further 2 patients scored no change.
Conclusions
Patients with ED treated with dental implants reported encouraging outcomes post treatment after prostheses were fitted. Follow-up from 1.6 to 6.8 years has confirmed these improvements. 相似文献
ObjectiveTo analyze cytokine responses and the clinical course of septic neonates orally supplemented with docosahexaenoic acid as well as to evaluate fatty acid incorporation into leukocytes.MethodsA quasiexperimental study was conducted in neonates who developed sepsis following a surgical procedure. Selected neonates were randomly assigned to receive 100 mg docosahexaenoic acid (G-DHA) daily or olive oil (G-OO) as placebo for 14 d throughout a sepsis episode. At selection (baseline), blood samples were obtained to determine interleukin-1 (IL-1)β, interleukin-6 (IL-6), and tumor necrosis factor-α as well as the leucocyte fatty acid profile. Measurements were repeated at 7 (D7) and 14 d (D14) of follow-up. Within- and between-group comparisons were conducted with parametric statistics after logarithmic transformation. Repeated measurement analyses with a general linear model procedure were used, adjusting according to human milk intake, use of anti-inflammatory drugs, and nutritional status.ResultsSixty-three neonates were included: 29 in G-DHA group and 34 in G-OO group. Although decreases of cytokines during hospitalization were similar in both groups, there was a greater decrease of IL-1β in the G-DHA group than in the G-OO group after adjusting by confounders (P = 0.028). Leukocyte docosahexaenoic acid increased from 4.96 ± 2.96 at baseline to 5.52 ± 3.05 and 5.92 ± 2.8 at D7 and D14, respectively, in the G-DHA group (P = 0.044). Illness severity was inversely associated with the proportion of docosahexaenoic acid in leukocytes throughout follow-up (P = 0.034).ConclusionsOral supplementation with docosahexaenoic acid to neonates attenuates IL-1β response and the clinical course of sepsis. This may be an additional strategy to further benefit ill neonates even if they are not candidates for parenteral nutrition. 相似文献
We studied the effect of inhibition of platelet aggregation (obtained by omitting sample stirring and by the addition of ASA and GRGDS peptide) on ATP secretion and Ca(2+) movements. When collagen was the agonist, platelet aggregation stimulated release reaction and Ca(2+) movements in both the presence and absence of extracellular Ca(2+). When platelets were stimulated by thrombin, ATP release and Ca(2+) movements were largely independent of aggregation. Our data suggest that platelet aggregation stimulates Ca(2+) movement, and that this phenomenon of feedback amplification of platelet activation plays an important role in platelet function when collagen is the agonist, while it has little or no role when thrombin is the stimulus. 相似文献
Nothing is known about haemostasis in Xenarthra, a widely distributed Order of American mammalians. Chaetophractus villosus, a member of the Dasypodidae family of this group, which is easily adapted to captivity, is of growing interest for biomedical research. In this work, we studied platelet number, MPV, ultrastructure of the platelets by SEM and TEM, and aggregation responses to ADP and ristocetin in this species. Blood samples were obtained by cardiac puncture in 20 anaesthetised animals. Platelet count and MPV were evaluated at the beginning and at the end of a 3-year experimental period, to detect possible variations related to time of captivity. SEM and TEM were done by routine methods adapted to the material, and aggregation response to ADP and ristocetin were evaluated by the Born method. The parameters studied did not show any sex-related differences, nor did the platelet count change during captivity. Nevertheless, MPV decreased during this period. Platelets were ultrastructurally similar to those of other mammals and human beings and responded to proven agonists. Data provided in this study will contribute to the understanding of the haemostatic process in this species. 相似文献