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1.
Despite common experiences of identity damage, decline, and deterioration, many brain injury survivors succeed in reconstructing robust identities in the wake of injury. Yet, while this accomplishment greatly benefits survivors’ quality of life, little is known about how positive identity work might be facilitated or enhanced in therapeutic institutions. Drawing on data from a women’s self-help group, we argue that an egalitarian, reflective, strength-focused, and gender-segregated environment can provide female ABI (acquired brain injury) survivors with a fertile scene for identity enhancement and offer unique opportunities for collective identity development. Sociolinguistic interactional analysis revealed four types of positive identity work undertaken within the group: constructing competent selves; tempering the threat of loss and impairment; resisting infantilisation and delegitimisation; and asserting a collective gender identity. This identity work was facilitated by specific programme attributes and activities and contributed to the global project of decentring disability and destigmatising impairments and losses. We call for increased attention to identity issues in brain injury rehabilitation and argue that gender-segregated programming can provide a unique space for female survivors to construct empowering individual and collective identities after injury. 相似文献
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With some, but not all, types and intensities of exercise, lactate accumulates in the blood and in the muscles engaged in the exercise. A great deal of attention has been directed towards attempting to understand the dynamics of lactate production and removal at the onset of exercise, during exercise, and during the recovery process following exercise. It has been hoped that an unravelling of these events would provide a key to understanding cellular metabolism and its regulation during exercise. The purpose of this introductory paper to a symposium on lactate is to present a brief overview of some of the conditions that influence the rate and magnitude of lactate accumulation during exercise. It is pointed out that many conditions influence the rate and magnitude of the accumulation of lactate in blood and muscles. Included are diet, state of physical fitness, and the type and duration of the exercise. We have cautioned against trying to evaluate the state of oxygen delivery to muscle and the state of tissue oxygenation from the appearance of lactate in blood. We have pointed out the positive aspects of lactate production based on how it augments the cellular supply of ATP, thereby allowing for high intensity exercise, and also the negative aspects that develop as a result the reduction in pH which adversely influences many cellular processes essential for muscular activity. 相似文献
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B G Lowman L A Queral W A Holbrook J T Estes B Bayly F J Dagher 《The American surgeon》1983,49(11):621-624
Transluminal angioplasty is being extensively utilized to dilate arteriosclerotic lesions. However, this technique has not been widely used for the treatment of cerebrovascular insufficiency. This report describes the application of transluminal angioplasty to relieve cerebral ischemia secondary to extracranial arterial stenosis. A total of 10 patients presented with symptoms of vertebrobasilar insufficiency. Bilateral upper extremity pressures were measured prior to the performance of arteriography on all patients. Significant stenoses were found in the subclavian artery (9) and in the innominate artery (1). Dilating catheters were passed retrograde through surgically exposed brachial and common carotid arteries. Transluminal angioplasty under fluoroscopic control was attempted. Anatomic correction of all lesions was achieved without hemorrhagic or embolic complications. The mean increase in brachial systolic pressure was 38.2 mm Hg postdilatation. Initial symptomatic relief was total in seven patients, partial in two, and absent in one. It is believed that associated small vessel brain stem disease accounted for the less than total relief of symptoms of these three patients. Average follow-up for all patients was 13 months with one recurrent subclavian artery stenosis occurring at three months postangioplasty. Preliminary results suggest that some patients with cerebral ischemia secondary to extracranial arterial stenosis can be treated safely by transluminal angioplasty. 相似文献
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Bayly PJ 《British journal of anaesthesia》2004,92(4):598-599
Editor The conclusion reached by Stone and colleagues1is correct as far as it goes, but is misleading when consideringthe question they sought to answer: does the addition of dopexamineto intraoperative volume expansion confer added benefit? Theconclusion reached was that they were unable to demonstratesuch a benefit. This is not surprising given the study design,and should not be interpreted as meaning that a benefit doesnot exist. It is possible that the authors 相似文献
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Simon R Bayly Robert C King Davina J Honess Peter J Barnard Helen M Betts Jason P Holland Rebekka Hueting Paul D Bonnitcha Jonathan R Dilworth Franklin I Aigbirhio Martin Christlieb 《Journal of nuclear medicine》2008,49(11):1862-1868
A water-soluble glucose conjugate of the hypoxia tracer 64Cu-diacetyl-bis(N4-methylthiosemicarbazone) (64Cu-ATSM) was synthesized and radiolabeled (64Cu-ATSE/A-G). Here we report our initial biological experiments with 64Cu-ATSE/A-G and compare the results with those obtained for 64Cu-ATSM and 18F-FDG. METHODS: The uptake of 64Cu-ATSE/A-G and 64Cu-ATSM into HeLa cells in vitro was investigated at a range of dissolved oxygen concentrations representing normoxia, hypoxia, and anoxia. Small-animal PET with 64Cu-ATSE/A-G was performed in male BDIX rats implanted with P22 syngeneic carcinosarcomas. Images of 64Cu-ATSM and 18F-FDG were obtained in the same model for comparison. RESULTS: 64CuATSE/A-G showed oxygen concentration-dependent uptake in vitro and, under anoxic conditions, showed slightly lower levels of cellular uptake than 64Cu-ATSM; uptake levels under hypoxic conditions were also lower. Whereas the normoxic uptake of 64Cu-ATSM increased linearly over time, 64Cu-ATSE/A-G uptake remained at low levels over the entire time course. In the PET study, 64CuATSE/A-G showed good tumor uptake and a biodistribution pattern substantially different from that of each of the controls. In marked contrast to the findings for 64Cu-ATSM, renal clearance and accumulation in the bladder were observed. 64Cu-ATSE/A-G did not display the characteristic brain and heart uptake of 18F-FDG. CONCLUSION: The in vitro cell uptake studies demonstrated that 64Cu-ATSE/A-G retained hypoxia selectivity and had improved characteristics when compared with 64Cu-ATSM. The in vivo PET results indicated a difference in the excretion pathways, with a shift from primarily hepatointestinal for 64Cu-ATSM to partially renal with 64Cu-ATSE/A-G. This finding is consistent with the hydrophilic nature of the glucose conjugate. A comparison with 18F-FDG PET results revealed that 64Cu-ATSE/A-G was not a surrogate for glucose metabolism. We have demonstrated that our method for the modification of Cu-bis(thiosemicarbazonato) complexes allows their biodistribution to be modified without negating their hypoxia selectivity or tumor uptake properties. 相似文献
9.
Nabeela Z. Mian MD Robert Bayly MD David M. Schreck MD Eva B. Besserman DO David Richmond MD 《Academic emergency medicine》1997,4(12):1118-1121
Objective : To determine in adult medical patients the incidence of deep venous thrombosis (DVT) resulting from femora] venous catheterization (FVC).
Methods : A prospective, observational study was performed at a 420-bed community teaching hospital. Hep-arin-coated 7-Fr 20-cm femoral venous catheters were inserted unilaterally into a femoral vein. Each contra-lateral leg served as a control site. Age, gender, number of FVC days. DVT risk factors, administration of DVT prophylaxis, and DVT formation and site were tabulated for each patient. Venous duplex sonography was performed bilaterally on each patient within 7 days of femoral venous catheter removal.
Results : Catheters were placed in 29 men and 13 women. Femoral DVT was identified by venous duplex sonography in 11 (26.2%) of the FVC legs and none (0%) in the control legs. Posterior tibial and popliteal DVT was identified in both the FVC and control legs of 1 patient. DVT formation at the site of FVC insertion was highly significant (p = 0.005). There were no statistically significant associations with age (p = 0.42), gender (p = 0.73), number of DVT risk factors (p = 0.17), number of FVC days (p = 0.89), or DVT prophylaxis (p — 099).
Conclusion : Placement of femoral catheters for central venous access is associated with a significant incidence of femoral DVT as detected by venous duplex sonography criteria at the site of femoral venous catheter placement. Physicians must be aware of this risk when choosing this vascular access route for adult medical patients. Further studies to assess the relative risk for DVT and its clinical sequelae when using the femoral vs other central venous catheter routes are indicated. 相似文献
Methods : A prospective, observational study was performed at a 420-bed community teaching hospital. Hep-arin-coated 7-Fr 20-cm femoral venous catheters were inserted unilaterally into a femoral vein. Each contra-lateral leg served as a control site. Age, gender, number of FVC days. DVT risk factors, administration of DVT prophylaxis, and DVT formation and site were tabulated for each patient. Venous duplex sonography was performed bilaterally on each patient within 7 days of femoral venous catheter removal.
Results : Catheters were placed in 29 men and 13 women. Femoral DVT was identified by venous duplex sonography in 11 (26.2%) of the FVC legs and none (0%) in the control legs. Posterior tibial and popliteal DVT was identified in both the FVC and control legs of 1 patient. DVT formation at the site of FVC insertion was highly significant (p = 0.005). There were no statistically significant associations with age (p = 0.42), gender (p = 0.73), number of DVT risk factors (p = 0.17), number of FVC days (p = 0.89), or DVT prophylaxis (p — 099).
Conclusion : Placement of femoral catheters for central venous access is associated with a significant incidence of femoral DVT as detected by venous duplex sonography criteria at the site of femoral venous catheter placement. Physicians must be aware of this risk when choosing this vascular access route for adult medical patients. Further studies to assess the relative risk for DVT and its clinical sequelae when using the femoral vs other central venous catheter routes are indicated. 相似文献
10.
L.M. Dibbens PhD R. Michelucci MD A. Gambardella MD F. Andermann MD G. Rubboli MD M.A. Bayly BBTech T. Joensuu PhD D.F. Vears BSc S. Franceschetti MD L. Canafoglia MD R. Wallace PhD A.G. Bassuk MD PhD D.A. Power MD PhD C.A. Tassinari MD E. Andermann MD PhD A.E. Lehesjoki MD PhD S.F. Berkovic MD FRS 《Annals of neurology》2009,66(4):532-536