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71.
Abstract: This article integrates theory and research related to boundary ambiguity in parents of children with a chronic health condition. We propose that boundary ambiguity is a risk factor for psychological distress in these parents. Clinical applications and a case example highlight how boundary ambiguity can be assessed and managed in clinical settings by professionals working with parents with chronically ill children. Questions are provided for assessing boundary ambiguity in clinical and research settings, and implications for research are discussed. 相似文献
72.
M. F. Gagnadoux J. L. Bacri M. Broyer R. Habib 《Pediatric nephrology (Berlin, Germany)》1989,3(1):50-55
Over a 15-year period we observed seven children (four girls, three boys) who presented within the first months of life with severe renal failure and acidosis, associated with hypertension in five patients and polyuria in four. In addition, one patient had a severe cholestatic liver disease. In two families, a similarly affected sibling had died previously. Four patients were referred with the clinical diagnosis of polycystic kidney disease because of moderate enlargement of kidneys, but renal imaging (intravenous pyelography and ultrasonography) did not confirm this diagnosis. A renal biopsy, performed in all patients, showed similar features characterized by a diffuse chronic tubulo-interstitial nephritis (TIN) and particularly by the presence of microcystic dilatation of proximal tubules and Bowman's space. Liver pathology was normal in two patients, including one with hepatomegaly. However, in the patient with cholestasis there was inflammatory portal fibrosis with mild duct proliferation. Progression of the renal disease was extremely rapid and all patients reached end-stage renal failure (ESRF) before the age of 2 years (11–22 months). Two children had successful renal transplants. Although this chronic TIN shares some features with nephronophthisis, we suggest that it represents a distinct entity both on clinical and morphological grounds. The specific clinical features of this disease are its early onset and rapid progression to ESRF. Pathologically, it differs from nephronophthisis by the absence of medullary cysts and thickened tubular basement membranes and by the presence of cortical microcysts. 相似文献
73.
Amir Tejani Ping Leung Ho Lea Emmett Donald M Stablein 《American journal of transplantation》2002,2(2):142-147
Chronic rejection accounted for 32% of all graft losses in 7123 pediatric transplants. In a previous study acute, multiple acute and late acute rejections were risk factors for the development of chronic rejection. We postulated that the recent decrease in acute rejections would translate into a lower risk for chronic rejection among patients with recent transplants. We reviewed our data on patients transplanted from 1995 to 2000, and using multivariate analysis and a proportional hazards model developed risk factors for patients whose grafts had failed due to chronic rejection. A late initial rejection increased the risk of chronic rejection graft failure 3.6-fold (p < 0.001), while a second rejection resulted in further increase of 4.2-fold (p < 0.001). Recipients who received less than 5 mg/kg of cyclosporine at 30 days post-transplant had a relative risk (RR) of 1.9 (p = 0.02). Patients transplanted from 1995 to 2000 had a significantly lower risk (RR = 0.54, p < 0.001) of graft failure from chronic rejection than those who received their transplants earlier (1987-94). Since we were able to demonstrate that there is a decreased risk of chronic rejection graft failure in our study cohort, we would conclude that the goal of future transplants should be to minimize acute rejections. 相似文献
74.
This study sought to measure the effect of pulmonary function testing (PFT) data on the decisions made by generalist physicians
in the management of chronic obstructive pulmonary disease (COPD). 148 physicians were randomly assigned to two groups, both
of which were asked to manage two identical fictitious but representative cases of COPD, which included history, physical,
x-ray, and laboratory results. The experimental group received PFT results in addition. No significant difference was noted
between the two groups in management based on availability of PFT data. The optimum utility of PFT data in the management
of COPD may be exaggerated and has yet to be determined.
Received from the Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, Milwaukee,
Wisconsin.
Presented at the Annual Scientific Meeting of the American College of Chest Physicians, October 28, 1992, Chicago, Illinois. 相似文献
75.
结肠回肠反流与回肠黏膜结肠化相关性的实验研究 总被引:2,自引:0,他引:2
目的探讨结肠回肠反流后回肠末端黏膜结肠化的机制.方法取SD大鼠60只,均为雄性,体重25¨3∞g,随机分为实验组和对照组,分别进行末端回肠-盲肠侧侧吻合术或回肠末端手术缝线,2个月后处死动物并取组织进行观察.结果实验组术后一般状况良好.大体形态学观察:实验组回肠末端黏膜表现为绒毛萎缩、间距增宽、沟变浅、光滑性增强.病理组织学:实验组表现为黏膜绒毛萎缩、间距增宽、沟变浅、上皮细胞变短、杯状细胞增多.电镜观察:实验组可见绒毛变小、变短或脱落;微绒毛变短、分布不均匀;杯状细胞数目在非坏死区增多.结论结肠-回肠反流后可导致回肠末端黏膜结肠化的变化,它可能是慢性末端回肠炎的发病基础或前期表现. 相似文献
76.
慢性前列腺炎相关危险因素的调查报告 总被引:8,自引:1,他引:7
目的:探索不良生活习惯、精神、心理等相关因素与慢性前列腺炎发病的关系. 方法:对600例慢性前列腺炎患者进行流行病学调查,采用单因素及多因素条件Logistic回归法进行统计分析,判断危险因素.结果:多因素Logistic回归分析发现引起慢性前列腺炎的可能因素为尿道炎、无节制的性生活、频繁的手淫、固定体位(尤其长时间骑跨、坐位)、酗酒、生活方式改变、长时间憋尿、紧张焦虑心理等.结论:本研究结果对慢性前列腺炎的预防、治疗及防止复发具有参考价值. 相似文献
77.
R. N. Smith T. Kawai S. Boskovic O. Nadazdin D. H. Sachs A. B. Cosimi R. B. Colvin 《American journal of transplantation》2006,6(8):1790-1798
The pathogenesis of late renal allograft loss is heterogeneous and difficult to diagnose. We have analyzed renal allografts in nonhuman primates to determine the relationship between alloantibodies and the graft pathology of late graft loss. Seventeen Cynomolgus monkeys were chosen from among those on several protocols for renal allotransplantation with mixed chimerism induction so that animals with and without alloantibodies were included. All animals received transient CD154 blockade and short-term cyclosporine treatment until day 28. Serial blood samples were tested for alloantibodies. Protocol biopsies and autopsy kidneys were scored for pathology and C4d deposition. Group 1, defined by complete lack of C4d deposition (24 tissue samples; 8 recipients), had no detectable alloantibodies (33 serum samples; 1-7 samples per recipient) and no evidence of chronic rejection. Three survived greater than 2 years with normal function and histology. Group 2, defined as having C4d deposition in peritubular capillaries, all made alloantibodies (100%), and most grafts later showed chronic allograft glomerulopathy (89%), and/or arteriopathy (89%). All grafts in Group 2 failed (3-27 months). Pathologic lesions of typical of chronic rejection in humans develop in monkeys, correlate with antecedent alloantibodies/C4d deposition and predict chronic rejection rather than durable accommodation. 相似文献
78.
BN Akay† P Ekmekci† H Sanli† G Celik‡ M Bozdayi§ 《Journal of the European Academy of Dermatology and Venereology》2006,20(4):442-445
A patient with hepatitis C virus (HCV) infection was diagnosed with cutaneous, pulmonary and hepatic sarcoidosis following interferon alpha therapy. There are only a few cases of sarcoidosis associated with this treatment. This is the first case who not only developed sarcoidosis, but also autoimmune hypothyroidism and thrombocytopenia during interferon alpha therapy due to the immunomodulatory effects of the drug. 相似文献
79.
本文观察了15例慢性肾功能衰竭病人透析前后的血浆心钠素浓度改变.患者透析前血浆心钠素浓度较正常人明显增高(P相似文献
80.