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1.
Verhaak CM Smeenk JM Evers AW van Minnen A Kremer JA Kraaimaat FW 《Journal of behavioral medicine》2005,28(2):181-190
The predictive value of a comprehensive model with personality characteristics, stressor related cognitions, coping and social support was tested in a sample of 187 nonpregnant women. The emotional response to the unsuccessful treatment was predicted out of vulnerability factors assessed before the start of the treatment. The results indicated the importance of neuroticism as a vulnerability factor in emotional response to a severe stressor. They also underlined the importance of helplessness and marital dissatisfaction as additional risk factors, and acceptance and perceived social support as additional protective factors, in the development of anxiety and depression after a failed fertility treatment. From clinical point of view, these results suggest fertility-related cognitions and social support should receive attention when counselling women undergoing IVF or ICSI treatment. 相似文献
2.
Outcome of surgical treatment for early adenocarcinoma of the esophagus or gastro-esophageal junction 总被引:10,自引:0,他引:10
Westerterp M Koppert LB Buskens CJ Tilanus HW ten Kate FJ Bergman JJ Siersema PD van Dekken H van Lanschot JJ 《Virchows Archiv : an international journal of pathology》2005,446(5):497-504
Adenocarcinoma of the esophagus, or GEJ, has a poor prognosis. Early lesions [i.e. high grade dysplasia (HGD) or T1-carcinoma] are potentially curable. Local endoscopic therapies are promising treatment options for superficial lesions; however, for deeper lesions, surgical resection is considered to be the treatment of choice. To contribute to therapeutic decision-making, we retrospectively analysed the outcome of transhiatal esophagectomy in 120 patients with pathologically proven HGD (n=13) or T1-adenocarcinoma (n=107) of the distal esophagus or gastro-esophageal junction (GEJ). Tumors were subdivided into six different depths of invasion (T1-mucosal m1-m3, T1-submucosal sm1-sm3), and the frequency of lymphatic dissemination and time to locoregional and/or distant recurrence were analysed. Only one of the 79 T1m1-3/sm1 tumors (1%) showed lymph node metastases as compared with 18 out of 41 T1sm2-3 tumors (44%). There was a significant difference in recurrence-free period between T1m1-m3/sm1 versus T1sm2-sm3 tumor patients (P log rank <0.0001), with 5-year recurrence-free percentages of 97% and 57%, respectively. In multivariate analysis including age, gender, tumor differentiation grade, N-stage and depth of invasion, only N-stage was an independent prognostic factor for recurrence-free period (hazard rate=5.9, 95% CI 1.7–20.7). However, if N-stage was excluded from analysis, only depth of invasion (T1sm2-3 versus T1m1-m3/sm1) was an independent prognostic factor for recurrence-free period (hazard rate=7.5, 95% CI 2.0–27.7). These data indicate that T1m1-m3/sm1 adenocarcinomas of esophagus or GEJ show a very low risk of lymphatic dissemination and are therefore eligible for local endoscopic therapy. After transhiatal surgical resection, almost half of the patients with T1sm2-sm3 lesions develop recurrent disease within 5 years, and therefore need additional therapy to improve survival. 相似文献
3.
Vieira-de-Abreu A Assis EF Gomes GS Castro-Faria-Neto HC Weller PF Bandeira-Melo C Bozza PT 《American journal of respiratory cell and molecular biology》2005,33(3):254-261
Eosinophils are an important source of leukotriene (LT)C(4), which can be synthesized within lipid bodies-cytoplasmic organelles where eicosanoid formation may take place. Allergy-driven lipid body formation and function have never been investigated. Here, we studied the in vivo induction and role of lipid bodies within eosinophils recruited to sites of allergic inflammation. Using two murine models of allergic inflammation (asthma and pleurisy), we verified that parallel to the eosinophil influx, allergic challenge also induced lipid body formation within recruited eosinophils. Neutralizing antibodies to eotaxin/CCL11, RANTES/CCL5, or CCR3 partially inhibited lipid body formation within recruited eosinophils in the allergic pleurisy model. Likewise, intrapleural administration of RANTES or eotaxin also induced significant influx of eosinophils loaded with lipid bodies. By immunolabeling, we detected the presence of a key enzyme involved in the leukotriene metabolism-5-lipoxygenase-within eosinophil lipid bodies formed in vivo after allergen challenge. Furthermore, specific immunolocalization of newly formed LTC(4) demonstrated that lipid bodies were the sites of formation of this eicosanoid within infiltrating eosinophils. Therefore, allergic inflammation triggers in vivo formation of new lipid bodies within infiltrating eosinophils, a phenomenon largely mediated by eotaxin/RANTES acting via CCR3 receptors. Such in vivo allergen-driven lipid bodies function as intracellular compartments of LTC(4) synthesis. 相似文献
4.
Julia C. Phillippi Jennifer K. Doersam Jeremy L. Neal Christianne L. Roumie 《Journal of obstetric, gynecologic, and neonatal nursing : JOGNN / NAACOG》2018,47(4):529-534
Methods to obtain informed consent digitally or electronically may increase the participation of racially and geographically diverse pregnant women in prospective research, which is essential to improve the evidence base for maternity care. We evaluated the feasibility and utility of e-consent in the first year of a multiyear clinical trial involving pregnant women. Of the 86 women screened, 71 were eligible, 65 (93% of eligible) agreed to review the e-consent form, and 61 (86% of eligible) completed the e-consent process. Of the interested women who were sent the e-consent link, all were able to complete the e-consent process, even those who reported low health literacy. Women of all racial and ethnic groups were equally likely to consent, and the sample of women who consented was consistent with practice demographics. E-consent is feasible and easy to use with pregnant women and may expedite enrollment of a representative sample. 相似文献
5.
6.
Cesar Vargas-Serafin Aldo A. Acosta-Medina Irvin Ordonez-Gonzalez Deborah Martínez-Baños Christianne Bourlon 《Clinical Lymphoma, Myeloma & Leukemia》2021,21(3):182-187
BackgroundOutcomes of newly diagnosed multiple myeloma (NDMM) in developing regions have not paralleled those in developed settings. Economic disadvantage, comorbidities, and aggressive disease behavior play competing roles on defining outcomes. Our aim was to analyze the impact of socioeconomic characteristics and comorbidities on therapy initiation, drug selection, and survival outcomes of NDMM in a resource-constrained setting.Patients and MethodsThis retrospective single-center cohort included ≥ 18-year-old NDMM patients from January 2006 to December 2018.ResultsA total of 245 patients were included with a median age of 62 years, Eastern Cooperative Oncology Group performance status ≤ 2 in 70.2%, International Staging System score ≥ 2 in 89.4%, and high-risk disease in 31.6%. Comorbidities were reported in 69.4%, and Charlson comorbidity index (CCI) was ≥ 2 in 64.1%. A total of 87.4% (n = 214) received thalidomide-, alkylating-, and bortezomib-based induction in 67.8%, 18.2%, and 13.1%. Patient-related factors including performance status, comorbidities, and CCI, but not myeloma-related factors, were associated with a decreased likelihood of initiating induction therapy. On multivariate analysis, CCI ≥ 2 remained statistically significant (odds ratio, 5.81; P = .005). Overall survival was 44 months. Although both patient- and myeloma-related factors were associated with a decreased overall survival, only International Staging System score > 2 (hazard ratio, 3.53; P = .004) and induction without bortezomib-based regimens (hazard ratio, 4.45; P < .001) were statistically significant on multivariate analysis.ConclusionMyeloma- and treatment-related factors are the main determinants of survival in NDMM induction-eligible patients. Patient-related factors play a pivotal role determining access to therapy and survival outcomes. Comorbidity index and performance status were determinant on defining therapy initiation in this real-world population, which emphasizes the need to improve health baseline conditions in resource-constrained settings. 相似文献
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8.
Stephanie M. Mazerolle Christianne M. Eason Elizabeth M. Ferraro Ashley Goodman 《Journal of Athletic Training》2015,50(2):170-177
Context:Female athletic trainers (ATs) tend to depart the profession of athletic training after the age of 30. Factors influencing departure are theoretical. Professional demands, particularly at the collegiate level, have also been at the forefront of anecdotal discussion on departure factors.Objective:To understand the career and family intentions of female ATs employed in the collegiate setting.Design:Qualitative study.Setting:National Collegiate Athletic Association Division I.Results:Our participants indicated a strong desire to focus on family or to start a family as part of their personal aspirations. Professionally, many female ATs were unsure of their longevity within the Division I collegiate setting or even the profession itself, with 2 main themes emerging as factors influencing decisions to depart: family planning persistence and family planning departure. Six female ATs planned to depart the profession entirely because of conflicts with motherhood and the role of the AT. Only 3 female ATs indicated a professional goal of persisting at the Division I setting regardless of their family or marital status, citing their ability to maintain work-life balance because of support networks. The remaining 17 female ATs planned to make a setting change to balance the roles of motherhood and AT because the Division I setting was not conducive to parenting.Conclusions:Our results substantiate those of previous researchers, which indicate the Division I setting can be problematic for female ATs and stimulate departure from the setting and even the profession.Key Words: retention, attrition, work-life balance
Key Points
- Female athletic trainers decided to depart the Division I setting because the required hours of the job limited the time available for parenting.
- Female athletic trainers working in the Division I setting who were able to persist after having a family credit strong support networks and the development of effective work-life balance strategies.
9.
Christianne Velozo Luiz Ricardo Nogueira Luiz Ricardo Nogueira Filho Anderson Capistrano Diana Santana de Albuquerque 《Dental traumatology》2021,37(3):521-530
This case report demonstrates the possibility of functional and aesthetic rehabilitation using an interdisciplinary approach in a child following avulsion of a tooth. Autotransplantation after the development of calcific metamorphosis of the pulp and acute apical periodontitis provided satisfactory repair after root canal treatment. A 7-year-old white boy avulsed the right maxillary central incisor (tooth 11). The extra-alveolar time exceeded 60 minutes, and this triggered external replacement resorption of the avulsed tooth. At 11 years of age, the child underwent tooth autotransplantation. After 4 years of follow-up, intraoral clinical and radiographic examination led to the diagnosis of calcific metamorphosis of the pulp and acute apical periodontitis. The patient had minimally invasive root canal treatment, orthodontic treatment and esthetic rehabilitation with a porcelain crown. Control periapical radiography and tomography of the autotransplanted tooth after 7 years revealed bone repair in the periapical region. This case report indicates that tooth autotransplantation can be used to replace anterior teeth after avulsion followed by replacement resorption. Interdisciplinary management helped to maintain the esthetics and function of the rehabilitated area. 相似文献
10.
Christianne M. Eason Stephanie M. Mazerolle Ashley Goodman 《Journal of Athletic Training》2014,49(4):532-539
Context:
One of the greatest catalysts for turnover among female athletic trainers (ATs) is motherhood, especially if employed at the National Collegiate Athletic Association Division I level. The medical education literature regularly identifies the importance of role models in professional character formation. However, few researchers have examined the responsibility of mentorship and professional role models as it relates to female ATs'' perceptions of motherhood and retention.Objective:
To evaluate perceptions of motherhood and retention in relation to mentorship and role models among female ATs currently employed in the collegiate setting.Design:
Qualitative study.Setting:
Female athletic trainers working in National Collegiate Athletic Association Division I.Patients or Other Participants:
Twenty-seven female ATs employed in the National Collegiate Athletic Association Division I setting volunteered. Average age of the participants was 35 ± 9 years. All were full-time ATs with an average of 11 ± 8 years of clinical experience.Data Collection and Analysis:
Participants responded to questions by journaling their thoughts and experiences. Multiple-analyst triangulation and peer review were included as steps to establish data credibility.Results:
Male and female role models and mentors can positively or negatively influence the career and work–life balance perceptions of female ATs working in the Division I setting. Female ATs have a desire to see more women in the profession handle the demands of motherhood and the demands of their clinical setting. Women who have had female mentors are more positive about the prospect of balancing the rigors of motherhood and job demands.Conclusions:
Role models and mentors are valuable resources for promoting perseverance in the profession in the highly demanding clinical settings. As more female ATs remain in the profession who are able to maintain work–life balance and are available to serve as role models, the attitudes of other women may start to change.Key Words: role models, retention, quality of lifeKey Points
- Role models and mentors are being identified by female athletic trainers working in the Division I setting.
- Perceptions of work–life balance can be positively affected by how role models and mentors maintain balance within their own lives. Conversely, those individuals who cannot maintain balance can negatively affect their proteges'' perceptions of work–life balance.
- Female athletic trainers working in the Division I setting desire more female role models who are effectively balancing the multiple responsibilities of their personal and professional lives.