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排序方式: 共有468条查询结果,搜索用时 15 毫秒
1.
G W Arana S Reichlin R Workman R Haaser R I Shader 《The American journal of psychiatry》1988,145(6):707-711
The authors sought to determine whether the performance of the dexamethasone suppression test (DST) could be enhanced by expressing cortisol as a function of dexamethasone. Because cortisol concentration is a function of the reciprocal of dexamethasone concentration, this relationship was approximated by calculating the product of cortisol and dexamethasone as a dexamethasone suppression index. Preliminary assessment of test performance measures (sensitivity, specificity, and predictive power) showed that use of the dexamethasone suppression index was an improvement over the use of cortisol levels alone. Factoring dexamethasone levels into post-dexamethasone cortisol level measures may enhance the utility of neuroendocrine assessment in psychiatry. 相似文献
2.
Circulating antibodies to peripheral nerve in American trypanosomiasis (Chagas' disease). 总被引:12,自引:4,他引:12 下载免费PDF全文
E L Khoury V Ritacco P M Cossio R P Laguens A Szarfman C Diez R M Arana 《Clinical and experimental immunology》1979,36(1):8-15
An antibody reacting with Schwann sheaths of myelinated somatic and unmyelinated autonomic peripheral nerve was found in sixty-one out of seventy-one chronic, and nine out of ten acute, Chagas' disease sera. Indirect immunofluorescence (IFL) was carried out on rat, mouse and human somatic nerves and rat sympathetic nerves with initial serum dilutions of 1 : 10, and the staining reached a final titre of 1 : 320 in some cases. The antibodies fixed complement and were absorbed out by lyophilized epimastigotes of T. cruzi. Lipid extraction of the tissue sections enhanced the staining of myelinated nerve, whereas unfixed unmyelinated sympathetic nerve was strongly reactive. Central nervous tissue did not display any positive staining on neurons, glial cells or periaxonal sheaths. Furthermore, by using a double-labelled IFL technique, it was possible to show that a rabbit antiserum raised against guinea-pig spinal cord and the chagasic anti-nerve antibodies reacted with different structures in the rat sciatic nerve. These findings suggest that the reactive antigen(s) could be located on Schwann cells. The majority, but not all, of the chagasic individuals with anti-nerve antibodies also showed the sarcolemmal and endothelial staining (EVI) previously described in Chagas' disease. The possible recognition of Schwann cell antigens by circulating antibodies in Chagas' disease could be relevant, since an autonomic denervation has been postulated as a pathogenic mechanism of cardiomyopathy and megaviscera in this condition. 相似文献
3.
E L Khoury P M Cossio A Szarfman J C Marcos O García Morteo R M Arana 《American journal of clinical pathology》1978,69(1):62-65
One hundred fifty-six of 1,250 sera from patients with presumed connective tissue and related diseases showed vascular staining on mouse liver cryostat sections when they were routinely checked for antinuclear factor by the indirect immunofluorescence test. In a third of the cases, the vascular immunofluorescent pattern was given by the EVI antibody reacting with the plasma membrane of striated muscle fibers and endothelial cells, as has been recently described to occur in Chagas' disease. This led to the detection of previously unsuspected Trypanosoma cruzi infection in 67.8% of the serum samples in which the EVI antibody was detected after observation of a positive vascular pattern with mouse liver cryostat sections. On the other hand, no significant relationship between Chagas infection and sera with other anti-striated-muscle immunofluorescent patterns that also showed a vascular staining on mouse liver cryostat sections was established. Consideration of the vascular pattern observed with the EVI antibody on mouse liver cryostat sections can be helpful in detection of previously ignored T. cruzi infection in patients who have connective-tissue diseases and related conditions. This is of interest in view of the fact that anergic immunodepressive therapy, often used in these patients, significantly alters the host-parasite relationship and may lead to severe dissemination of the parasite. 相似文献
4.
A review of inpatient satisfaction data for MUSC provides both comfort and cause for additional study. Although overall satisfaction rates of 89 and 88 during the period of organizational change indicate stable patient perceptions, one must reflect upon these scores in greater detail. For example, although survey response rates in the 36 percent to 28 percent range appear customary for this type of survey, absolute numbers of discharge responses averaged 496 for the four quarters reported. Some confidence can be taken in the fact that overall survey scores were highly consistent in the 89 to 88 range for the entire reporting period. Moreover, the fact that workforce performance variables such as medication errors and patient occurrence reports did not change indicates that patient care did not deteriorate during this period. Although one could argue that in a time of workforce reduction, employees may work more diligently in order to ensure job security, and that work deterioration may be more apparent over a longer period of observation, this limited view suggests that, at least in the acute phase, work performance was maintained. Future studies should review the relative effectiveness of the specific strategies adopted by MUSC management to ensure high levels of patient care. For example, although MUSC adopted a fairly comprehensive communications effort, it is difficult to discern whether timeliness, variety, or repetition contributed more to the effectiveness of the communications program. Such information could help managers develop focused change implementation strategies. It appears from the inpatient survey data collected by UHC and from the two work performance monitors that MUSC's approach to change management has been able to preserve acceptable levels of patient satisfaction in the face of significant organizational change. Furthermore, these strategies may have been helpful in countering the turbulence caused by large scale change or, at the very least, insulating the care site from potentially negative effects. 相似文献
5.
Oliveira EA Diniz JS Cabral AC Leite HV Colosimo EA Oliveira RB Vilasboas AS 《Pediatric nephrology (Berlin, Germany)》1999,13(9):859-864
With the increasing use of obstetric echography fetal hydronephrosis has been reported more frequently. The purpose of this
study was to identify prognostic factors associated with adverse outcome, such as renal failure and death, in fetal hydronephrosis.
One hundred and forty-eight children with fetal hydronephrosis were admitted, submitted to a systematic protocol, and prospectively
followed. Prognostic factors associated with fetal echography and clinical and laboratory findings on admission were studied.
The median follow-up was 39 months. The analysis was conducted in two steps. In a univariate analysis, variables associated
with adverse outcome were identified by the Kaplan-Meier method. The variables that were significantly associated with adverse
outcome were then included in a multivariate analysis. This analysis, using the multivariate Cox’s model, was performed to
identify variables that were independently associated with a worse prognosis. Only variables that remained independently associated
with adverse outcome were included in the final model. After final adjustment by Cox’s multivariate model, three variables
were identified as independent predictors of adverse outcome: oligohydramnios, prematurity, and glomerular filtration rate
lower than 20 ml/min. Thus, in the presence of oligohydramnios, prematurity, and abnormal renal function, the medical team
must plan appropriate follow-up for infants at health centers prepared to investigate and treat uropathies in newborns.
Received: 24 August 1998 / Revised: 7 December 1998 / Accepted: 11 December 1998 相似文献
6.
Shameel Shafqat Evelyn Arana Chicas Areez Shafqat Shahrukh K. Hashmi 《The Journal of clinical investigation》2022,132(13)
Recent improvements in cancer treatment have increased the lifespan of pediatric and adult cancer survivors. However, cancer treatments accelerate aging in survivors, which manifests clinically as the premature onset of chronic diseases, such as endocrinopathies, osteoporosis, cardiac dysfunction, subsequent cancers, and geriatric syndromes of frailty, among others. Therefore, cancer treatment–induced early aging accounts for significant morbidity, mortality, and health expenditures among cancer survivors. One major mechanism driving this accelerated aging is cellular senescence; cancer treatments induce cellular senescence in tumor cells and in normal, nontumor tissue, thereby helping mediate the onset of several chronic diseases. Studies on clinical monitoring and therapeutic targeting of cellular senescence have made considerable progress in recent years. Large-scale clinical trials are currently evaluating senotherapeutic drugs, which inhibit or eliminate senescent cells to ameliorate cancer treatment–related aging. In this article, we survey the recent literature on phenotypes and mechanisms of aging in cancer survivors and provide an up-to-date review of the major preclinical and translational evidence on cellular senescence as a mechanism of accelerated aging in cancer survivors, as well as insight into the potential of senotherapeutic drugs. However, only with time will the clinical effect of senotherapies on cancer survivors be visible.Cancer survival times have increased annually owing to advances in early detection and treatment that prolong patient survival. However, increasing survivorship has underscored the observation that cancer survivors develop age-related diseases prematurely, which cause significant morbidity, health expenditures, and mortality. Many cancer survivors have been exposed to chemotherapy, radiotherapy, or both; despite eradicating cancer cells, these therapies also damage normal cells to accelerate biologic aging, such that a discrepancy exists between their biologic and chronologic age (1). Considerable data exist regarding the phenotypes of accelerated aging. However, mechanical and molecular uncertainties have limited the study of these manifestations in a clinical context. Our Review discusses accelerated aging phenotypes in cancer survivors and the cellular mechanisms underpinning these phenomena. We then discuss the translational evidence on how accelerated aging phenotypes, mainly related to senescence, are being targeted while highlighting areas of uncertainty for future research to address. 相似文献
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Helen Sawaya Kevin Johnson Matthew Schmidt Ashley Arana George Chahine Mia Atoui David Pincus Mark S. George Jaak Panksepp Ziad Nahas 《The international journal of neuropsychopharmacology / official scientific journal of the Collegium Internationale Neuropsychopharmacologicum (CINP)》2015,18(6)