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排序方式: 共有230条查询结果,搜索用时 250 毫秒
1.
Lauren Tingey Britta Mullany Rachel Chambers Ranelda Hastings Angelita Lee Anthony Parker 《AIDS care》2015,27(9):1087-1097
Potential for widespread transmission of HIV/AIDS among American Indian (AI) adolescents exists, yet no evidence-based interventions (EBIs) have been adapted and evaluated with this population. Intensive psychoeducation may improve knowledge and decision-making which could potentially translate to reductions in HIV risk behaviors. A peer group randomized controlled comparison of an adapted EBI vs. control was delivered over an eight-day summer basketball camp in one reservation-based tribal community to adolescents ages 13–19. Outcome data were gathered immediately post-camp and at 6 and 12 months follow-up. Self-selected peer groups were randomized to intervention (n = 138) or control (n = 129) conditions for a total sample of 267 participants (56.2% female), mean age 15.1 years (SD = 1.7). Intervention participants had better condom use self-efficacy post-camp (Adjusted Mean Difference [AMD] = ?0.75, p < 0.005) and at 6 (AMD = ?0.44, p < 0.005) and 12 months (AMD = ?0.23, p < 0.05) follow-up. Intervention participants also had higher HIV prevention and transmission knowledge (post-camp: AMD = 0.07, p < 0.01; 6 months: AMD = 0.06, p < 0.01) were more likely to believe condoms prevent sexually transmitted infections (post-camp: RR = 1.41, p < 0.005; 6 months: RR = 1.34, p < 0.05), to talk with an adult about HIV/AIDS (post-camp: RR=1.78, p < 0.005; 6 months: RR = 1.14, p < 0.005), had higher partner negotiation efficacy related to substance use during sex (post-camp: AMD = 0.37, p < 0.01), and were more likely to intend to use a condom (post-camp: RR = 1.39, p < 0.01). The adapted intervention had short- and medium-term impacts on AI adolescent risk for HIV/AIDS, but attenuated at 12 months. Intervention delivery through a community-based camp is feasible and acceptable with strong retention. Additional study is needed to evaluate the adapted intervention's impact on sexual risk behaviors and if booster sessions and parent involvement translate to long-term impacts. 相似文献
2.
Rodrigo O Perez Angelita Habr-Gama Igor Proscurshim Fábio G Campos Desiderio Kiss Joaquim Gama-Rodrigues Ivan Cecconello 《Journal of gastrointestinal surgery》2007,11(11):1431-8; discussion 1438-40
BACKGROUND: The role of local excision for pT2 distal rectal cancer has been challenged because of the observation of high rates of lymph node metastases and local failure. However, neoadjuvant chemoradiation therapy (CRT) has led to increased local disease control and significant tumor downstaging, possibly decreasing rates of lymph node metastases. In this setting, a possible role for local excision of ypT2 has been suggested. METHODS: A total of 401 patients with distal rectal cancer underwent neoadjuvant CRT. Tumor response assessment was performed after at least 8 weeks from CRT completion. One hundred and twelve patients with complete clinical response were not immediately operated on and were excluded from the study, and 289 patients with incomplete clinical response were managed by radical surgery. Patients with final pathological stage ypT2 were analyzed to determine the risk of unfavorable pathological features that could represent unacceptable risk for local failure after local excision. RESULTS: Eighty-eight (30%) patients had ypT2 rectal cancer. Final ypT status was not associated with pretreatment radiological staging (p = 0.62). ypT status was significantly associated with the risk of lymph node metastases, risk of perineural and vascular invasion, and recurrence (p = 0.001). Lymph node metastases were present in 19% of patients with ypT2 rectal cancer. The risk of lymph node metastases in ypT2 was associated with the presence of perineural invasion (47% vs 4%; p = <0.001), vascular invasion (59% vs 6%; p < 0.001), and decreased mean interval CRT surgery (12 vs 18 weeks; p < 0.001), but not with mean tumor size (3.2 vs 3.1 cm; p = 0.8). Disease-free and overall survival rates were significantly better for patients with ypT2N0 (p = 0.02 and 0.006, respectively). Fifty-five (63%) patients with ypT2 had at least one unfavorable pathological feature for local excision (lymph node metastases, vascular or perineural invasion, mucinous type or tumor size >3 cm). CONCLUSION: Lymph node metastases were present in 19% of patients with ypT2 and were significantly associated with poor overall and disease-free survival rates. The risk of lymph node metastases could not be predicted by radiological staging or tumor size. Radical surgery should be considered the standard treatment option for ypT2 rectal cancer after CRT. 相似文献
3.
Immediate and delayed cord clamping in infants born between 24 and 32 weeks: a pilot randomized controlled trial. 总被引:1,自引:0,他引:1
Judith S Mercer Margaret M McGrath Angelita Hensman Helayne Silver William Oh 《Journal of perinatology》2003,23(6):466-472
OBJECTIVE: This pilot study's aim was to establish feasibility of a protocol for delayed cord clamping (DCC) versus immediate cord clamping (ICC) at preterm birth and to examine its effects on initial blood pressure and other outcomes. STUDY DESIGN: A randomized controlled trial recruited 32 infants between 24 and 32 weeks. Immediately before delivery, mothers were randomized to ICC (cord clamped at 5 to 10 seconds) or DCC (30- to 45-second delay in cord clamping) groups. RESULTS: Intention-to-treat analyses revealed that the DCC group were more likely to have higher initial mean blood pressures (adjusted OR 3.4) and less likely to be discharged on oxygen (adjusted OR 8.6). DCC group infants had higher initial glucose levels (ICC=36 mg/dl, DCC=73.1 mg/dl; p=0.02). CONCLUSION: The research design is feasible. The immediate benefit of improved blood pressure was confirmed and other findings deserve consideration for further study. 相似文献
4.
Laparoscopic-assisted colonoscopic polypectomy 总被引:2,自引:0,他引:2
Background: The majority of colonic polyps found at endoscopy are suitable for diathermy snare excision via colonoscope. Due to location
or size, some are deemed unsafe to treat in this manner and therefore require colectomy. This study describes the technique
and early results of a laparoscopic-assisted colonoscopic polypectomy technique that can be used to manage such polyps and
thereby avoid laparotomy and colectomy.
Methods: Colonoscopy with simultaneous laparoscopy was utilized to locate the site of the polyp. The colon was mobilized, if required,
and the polyp resected by electrosurgical snare via the colonoscope while the serosal aspect of the colon was monitored laparoscopically.
Results: The technique has been tried successfully in six patients. Three polyps were in the cecum and three were within the left
colon. The size of the polyps ranged from 3 to 7 cm. All polyps were benign on histological examination. The patients were
discharged on the day following the procedure. There were no complications.
Conclusions: The combination of laparoscopy with colonoscopic resection of a select group of large polyps represents a safe alternative
to colonic resection.
Received: 18 March 1998/Accepted: 7 May 1998 相似文献
5.
6.
Paola Carpinetti Elisa Donnard Fabiana Bettoni Paula Asprino Fernanda Koyama Andrei Rozanski Jorge Sabbaga Angelita Habr-Gama Raphael B. Parmigiani Pedro A.F. Galante Rodrigo O. Perez Anamaria A. Camargo 《Oncotarget》2015,6(35):38360-38371
Neoadjuvant chemoradiotherapy (nCRT) followed by surgery is the mainstay treatment for locally advanced rectal cancer. Variable degrees of tumor regression are observed after nCRT and alternative treatment strategies, including close surveillance without immediate surgery, have been investigated to spare patients with complete tumor regression from potentially adverse outcomes of radical surgery. However, clinical and radiological assessment of response does not allow accurate identification of patients with complete response. In addition, surveillance for recurrence is similarly important for these patients, as early detection of recurrence allows salvage resections and adjuvant interventions. We report the use of liquid biopsies and personalized biomarkers for monitoring treatment response to nCRT and detecting residual disease and recurrence in patients with rectal cancer. We sequenced the whole-genome of four rectal tumors to identify patient-specific chromosomal rearrangements that were used to monitor circulating tumor DNA (ctDNA) in liquid biopsies collected at diagnosis and during nCRT and follow-up. We compared ctDNA levels to clinical, radiological and pathological response to nCRT. Our results indicate that personalized biomarkers and liquid biopsies may not be sensitive for the detection of microscopic residual disease. However, it can be efficiently used to monitor treatment response to nCRT and detect disease recurrence, preceding increases in CEA levels and radiological diagnosis. Similar good results were observed when assessing tumor response to systemic therapy and disease progression. Our study supports the use of personalized biomarkers and liquid biopsies to tailor the management of rectal cancer patients, however, replication in a larger cohort is necessary to introduce this strategy into clinical practice. 相似文献
7.
Angelita Paganin RN MSc Eneida Rejane Rabelo RN ScD 《International journal of nursing knowledge》2012,23(3):159-162
PURPOSE: To conduct a Fehring model‐based clinical validation of the defining characteristics of the nursing diagnosis of impaired physical mobility in a sample of 250 patients. METHOD: Cross‐sectional study. FINDINGS: Three of the 11 NANDA‐International defining characteristics assessed in this study were validated: limited range of motion, limited ability to perform gross motor skills, and difficulty turning. Although discomfort was not validated due to the rarity of occurrence, there was excellent interrater agreement as to its relevance (kappa coefficient). CONCLUSIONS: In this setting, three characteristics were validated. IMPLICATIONS FOR NURSING PRACTICE: Validation studies are important for advancing evidence‐based practice. 相似文献
8.
Aderson O.M.C. Damiao Aytan M. Sipahi Denise P. Vezozzo Patricia L. Goncalves Angelita Habr-Gama Magaly G. Teixeira Julia T. Fukushima Antonio A. Laudanna 《Digestive diseases and sciences》1997,42(2):259-264
In order to gain insight into the possiblemechanisms involved in gallstone formation incolectomized ulcerative colitis patients, we studiedgallbladder motility by means of ultrasonography inthree groups of subjects: controls (N = 40) and ulcerativecolitis patients without (N = 30) and with (N = 20)colectomy. Impaired gallbladder emptying after a liquidfatty meal stimulus was observed in ulcerative colitis patients with colectomy compared with thoseobtained in ulcerative colitis patients withoutcolectomy and controls (P = 0.001). The maximumpercentage of gallbladder emptying also, wassignificantly lower (59.8%) than those seen in ulcerative colitispatients without colectomy (74.5%) and controls (77.8%)(P = 0.001). Diminished gallbladder emptying withensuing stasis might be a contributory factor to the increased prevalence of gallstones incolectomized patients. 相似文献
9.
John M. Wentworth Tamishta Hensman Julie Playfair Cheryl Laurie Matthew E. Ritchie Wendy A. Brown Stewart Skinner Jonathan E. Shaw Paul E. O’Brien 《Diabetologia》2014,57(3):463-468
Aims/hypothesis
Obesity and dysglycaemia are major risk factors for type 2 diabetes. We determined if obese people undergoing laparoscopic adjustable gastric banding (LAGB) had a reduced risk of progressing from impaired fasting glucose (IFG) to diabetes.Methods
This was a retrospective cohort study of obese people with IFG who underwent LAGB. Weight and diabetes outcomes after a minimum follow-up period of 4 years (mean ± SD 6.1?±?1.7 years) were compared with those of Australian adults with IFG from a population-based study (AusDiab).Results
We identified 281 LAGB patients with baseline IFG. Their mean ± SD age and BMI were 46?±?9 years and 46?±?9 kg/m2, respectively. The diabetes incidence for patients in the lowest, middle and highest weight loss tertile were 19.1, 3.4 and 1.8 cases/1,000 person-years, respectively. The AusDiab cohort had a lower BMI (28?±?5 kg/m2) and a diabetes incidence of 12.5 cases/1,000 person-years. This increased to 20.5 cases/1,000 person-years when analysis was restricted to the 322 obese AusDiab participants, which was higher than the overall rate of 8.2 cases/1,000 person-years seen in the LAGB group (p?=?0.02). Multivariable analysis of the combined LAGB and AusDiab data suggested that LAGB was associated with ~75% lower risk of diabetes (OR 0.24 [95% CI 0.10, 0.57], p?=?0.004).Conclusions/interpretation
In obese people with IFG, weight loss after LAGB is associated with a substantially reduced risk of progressing to diabetes over ≥4 years. Bariatric surgery may be an effective diabetes prevention strategy in this population. 相似文献10.
L Tingey M Cwik N Goklish M Alchesay A Lee R Strom R Suttle J Walkup A Barlow 《The American journal of drug and alcohol abuse》2012,38(5):409-415
Background: Risk factors for binge substance use and non-suicidal self-injury (NSSI) are similar, suggesting the importance of exploring how binge substance use and self-injury interrelate. Objectives: To gain insight from a sample of American Indian (AI) adolescents regarding how binge drinking and drug use function in their lives, including as overlapping forms of self-injury, and to identify community-based ideas for dual prevention strategies. Methods: A total of N?=?58 White Mountain Apache (Apache) adolescents participated in ten mixed gender (n?=?33 males, 55.9%) focus group discussions. Results were interpreted and categorized by Apache researchers and compared to Nock's behavioral model of NSSI. Results: Participants reported substance use most commonly with "family" and "friends," "at a house," or "around the community." Substance use was not confined to a particular time of day, and often occurred "at school." Commonly endorsed reasons fell into two main categories: "to avoid problems" or "to reduce negative feelings," versus "to be cool" or "to feel part of a group." All adolescents but one thought that some youths use substances excessively as a way to harm/injure themselves (n?=?25 responses). Prevention approaches included encouraging healthy relationships, teaching about consequences of use, providing alternative recreation, and changing/enforcing laws on the reservation. Conclusion: Tribal-specific data support the idea that binge substance use sometimes functions as a form of self-injury. Home/school environments are critical prevention settings, in addition to improved law enforcement and increased recreation. Scientific Significance: Understanding possible shared root causes and functions of binge substance use and self-injury may advance integrated prevention approaches. 相似文献