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1.
S. P. Luby P. N. Kazembe S. C. Redd C. Ziba O. C. Nwanyanwu A. W. Hightower C. Franco L. Chitsulo J. J. Wirima M. A. Olivar 《Bulletin of the World Health Organization》1995,73(4):477-482
Anaemia is a serious and common problem among young children in sub-Saharan Africa. As a first step towards developing guidelines for its recognition and treatment, we conducted a study to evaluate the ability of health workers to use clinical findings to identify children with anaemia. Health care workers examined a total of 1104 children under 5 years of age at two hospital-based outpatient clinics in rural Malawi. Blood samples were taken to determine haemoglobin concentrations. Pallor of the conjunctiva, tongue, palm or nail beds was 66% sensitive and 68% specific in distinguishing children with moderate a anaemia (haemoglobin concentration, 5-8 g/dl) and 93% sensitive and 57% specific in distinguishing those with severe anaemia (haemoglobin concentration, < 5 g/dl). Even without laboratory support, which is often unavailable in rural Africa, clinical findings can identify the majority of children with anaemia. 相似文献
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To determine the efficacy of oral vitamin D [25(OH)D] in patients with active rheumatoid arthritis (RA) who are in methotrexate (MTX) therapy, patients receiving stable doses of MTX were randomized to one of two dose groups and received 12?weeks of double-blind vitamin D[25(OH)D] (50,000?IU per week) or matching placebo. The moderate and major efficacy measure was the proportion of patients with >0.6 and >1.2 improvement in RA based on the Disease Activity Score 28(DAS 28) at 12?weeks. Safety measures included adverse events and laboratory assessments. On a background of MTX, the percentage of patients with a moderate/major DAS 28 response at week 12 in the vitamin D groups (76/44%) was not significantly different from placebo (64.6/33.4%). Adverse events were typically mild and included small hepatic enzyme elevation; we did not have any undesirable events resulting in discontinuation of study drug. In patients with active RA receiving stable doses of MTX, vitamin D showed non-significant improvement in efficacy outcomes compared to placebo. 相似文献
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Khodayar Golabchi Ali Salehi Hamidreza Jahanbani-Ardakani Sara Ghaffari Ziba Farajzadegan 《Cutaneous and ocular toxicology》2018,37(1):9-14
Purpose: The aim of this study is to compare the effect of smoking in corneal endothelial cell number and morphology by specular microscopy on a non-smoker population.Methods: Our cross-sectional study was performed on 150 participants from a non-smoker population. Non-contact specular microscopy (Tomey Corporation Inc., Nagoya, Japan) was performed in the center of the cornea of all subjects. The cell density (CD), average cell size (AVG), percent of hexagonality (HEX%) and central corneal thickness (CCT) were calculated and compared in both groups.Results: Totally, 76 eyes of 76 smokers and 74 eyes of 74 non-smokers were enrolled in the study from 2015 to 2016. The mean age of smokers and non-smokers were 48.61?±?17.04 and 46.39?±?13.02, respectively. The mean number of pack/year among the smokers was 17.36?±?14.68. Also, the mean values of AVG and CD were significantly different for these two groups (p?=?0.011 and p?=?0.039, respectively). Other corneal endothelial variables did not show a significant difference between smokers and non-smokers (p?>?0.05). However, smokers with severe nicotine dependency had significantly greater AVG and lower CD in comparison with the non-smokers (p?=?0.004 and p?=?0.013, respectively).Conclusion: Our study showed that smoking can cause significant changes in some of the corneal endothelial variables, but not all of them. 相似文献
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Farnaz Khalili Asad VaisiRaygani Ebrahim Shakiba Maryam Kohsari Maryam Dehbani Rozita Naseri Soheila Asadi Ziba Rahimi Mehrali Rahimi Zohreh Rahimi 《Journal of clinical laboratory analysis》2022,36(1)
IntroductionChronic hyperglycemia activates the inflammatory pathways and oxidative stress mechanisms with consequent damage to nerve tissue and retina. The Keap1‐Nrf2 pathway acts as one of the most important antioxidant pathways of the organism. Variants of Keap1 could affect susceptibility to diabetes and its complications.MethodsIn a case‐control study, 400 individuals included type 2 diabetes mellitus (T2DM) patients without complication, with neuropathy, with retinopathy, and healthy individuals were investigated. The levels of glutathione (GSH), glutathione peroxidase (GPx), malondialdehyde (MDA), and total antioxidant capacity (TAC) were measured using chemical methods. Using the PCR‐RFLP method, the Keap1 (rs11085735) variants were identified.ResultsNeuropathic patients had significantly lower levels of GSH, GPx, and TAC and higher levels of total oxidative status (TOS), MDA, and oxidative stress index (OSI) compared to T2DM patients without complication and controls. Lower levels of GSH and GPx and a higher level of MDA were observed in patients with retinopathy compared with controls. Obesity was associated with significantly lower GPx activity and higher TOS. A significantly higher Keap1 AA genotype was found in patients with neuropathy than T2DM without complication and controls. The presence of Keap1 AA genotype correlated with lower GPx activity compared to CC genotype.ConclusionsOur study suggests the role of reduced antioxidant system and Keap1 variants in the pathogenesis of T2DM and its complications of neuropathy and retinopathy and also obesity in enhanced oxidative stress. Monitoring oxidative stress parameters in diabetic patients, especially those with complication and their treatment with antioxidants is suggested. 相似文献
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Cardiomyocyte apoptosis has been associated with the pathogenesis of heart failure as well as ischemic and inflammatory myocardial conditions. The aim of this study is to give a critical synopsis of cardiomyocyte apoptosis and identify methods to prevent or attenuate apoptosis in patients undergoing cardiac surgery. Clinical conditions and agents associated with decreased apoptotic index are early repair or replacement of valvular pathology before deterioration of ventricular function, afterload reduction with medication or intraaortic balloon pulsation in patients with acute increase in afterload or in hemodynamically compromised patients, decreasing catecholamine-induced cardiotoxicity by using β-blockers, phosphodiesterase inhibitors, or early insertion of intraaortic balloon pulsation or ventricular assist device. Prompt coronary revascularization, which reduces myocardial ischemia time, is the most effective antiapoptotic therapy. Reduction of myocardial apoptosis associated with cardiopulmonary bypass and aortic cross-clamping are other therapeutic targets. Some investigational therapies include ischemic preconditioning and use of antiapoptotic medication such as the caspase inhibitors, antioxidants, calcium-channel blockers, the insulin-like growth factor-1, and the poly-adenosine diphosphate-ribose-synthetase inhibitors. Most of the therapeutic implications in reducing cardiomyocyte apoptosis are still in the experimental phase. Some options are already incorporated in the clinical practice of the cardiovascular surgeon. New therapeutic considerations include avoiding sustained and long-term use of catecholamines and reducing or avoiding cardiopulmonary bypass—when clinically feasible. Noncatecholamine inotropes should be preferred for patients undergoing heart failure surgery and for patients with low output syndrome after open-heart surgery. The lessons learned from apoptosis research reinforce more liberal and early insertion of intraaortic balloon pulsation or ventricular assist device in clinical low output states. 相似文献
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n-6 Docosapentaenoic acid is not a predictor of low docosahexaenoic acid status in Canadian preschool children 总被引:1,自引:0,他引:1
BACKGROUND: The n-3 fatty acid docosahexaenoic acid (DHA; 22:6n-3) is important for neural and visual functional development. In animals, 22:6n-3 deficiency is accompanied by increased docosapentaenoic acid (DPA; 22:5n-6), which suggests that the ratio of 22:6n-3 to 22:5n-6 could be a useful biochemical marker of low n-3 fatty acid status. The n-3 fatty acid status of preschool children has not been described, and data are lacking on whether low 22:6n-3 is accompanied by high 22:5n-6 in humans. OBJECTIVE: We determined n-3 fatty acid status and investigated the relation between 22:6n-3 and 22:5n-6 in children. DESIGN: In Canadian children aged 18-60 mo (n = 84), the n-3 and n-6 fatty acid status of erythrocyte phosphatidylethanolamine was measured, and dietary fat intake was estimated by using a food-frequency questionnaire. RESULTS: The mean (+/- SEM) 22:6n-3 concentration in erythrocyte phosphatidylethanolamine among children was 3.06 +/- 0.13 g/100 g fatty acids (5th-95th percentiles: 1.43-5.79 g/100 g fatty acids). Concentrations of 22:5n-6 increased with increasing 22:6n-3 concentrations in erythrocyte phosphatidylethanolamine (P < 0.01). Mean intakes of linoleic acid (18:2n-6), linolenic acid (18:3n-3), and trans fatty acids were 3.6 +/- 0.2%, 0.7 +/- 0.5%, and 2.0 +/- 1.3%, respectively. Phosphatidylethanolamine 22:6n-3 and 22:5n-3 concentrations were inversely related to the intakes of 18:2n-6 and trans fatty acids, but not to those of total fat or n-3 fatty acids. CONCLUSIONS: The concentration of 22:5n-6 is not a useful biochemical marker of low n-3 fatty acid intake or status in the membrane phosphatidylethanolamine of preschool children. High intakes of 18:2n-6 and trans fatty acids could compromise the incorporation of 22:6n-3 into membrane phospholipids. 相似文献
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Comparison of contrast sensitivity,visual acuity,and Humphrey visual field testing in patients with glaucoma 总被引:4,自引:0,他引:4
BACKGROUND: Despite their normal or near-normal Snellen visual acuity, patients with glaucoma often complain of "poor" vision. OBJECTIVE: To investigate the relationship between large-letter contrast sensitivity, high-contrast visual acuity, and visual field defects in patients with glaucoma who have 20/40 or better visual acuity. DESIGN :Prospective, cross-sectional case series. PATIENTS AND METHODS: We evaluated 250 eyes of 144 subjects from the Glaucoma Service at the University of Illinois at Chicago College of Medicine. Subjects with a diagnosis of glaucoma, suspected glaucoma, or ocular hypertension who met the 20/40 or better vision requirement were recruited. Visual acuity was measured using the rear-illuminated Lighthouse Visual Acuity Chart at 4 m. Contrast sensitivity was measured using the Pelli-Robson Chart in a front-illuminated box with even luminance across the chart. Visual fields of the patients were measured using the 24-2 full-threshold program on the Humphrey Visual Field Analyzer. RESULTS: A significant correlation (r = 0.57, P < 0.001, n = 127) was found between the visual field mean deviations and the contrast sensitivity scores. The correlation (r = -0.322, P < 0.001, n = 127) was less between the visual field mean deviation and the log MAR visual acuity values, as was the correlation between the contrast sensitivity scores and log MAR visual acuity values (r = -0.370, P < 0.001, n = 127). In the subgroup of patients with chronic open-angle glaucoma, the correlation between the mean visual field deviation and the contrast sensitivity score was higher at 0.689 (P < or = 0.001, n = 62). CONCLUSIONS: Reduced contrast sensitivity is significantly correlated with visual field losses in patients with glaucoma and a visual acuity of 20/40 or better. The study data support the conclusion that, compared with visual acuity, the disease process preferentially affects contrast sensitivity. In our previous work, contrast sensitivity was shown to be more related than visual acuity to real-world function in patients with early glaucomatous changes. 相似文献
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Mike Gray Ziba Rajaei‐Dehkordi Marilyn Ewan Richard Wysocki 《The International journal of pharmacy practice》2002,10(Z1):R34-R34
Evidence‐based patient‐completed questionnaires were used to assess patients' risk of osteoporosis Community pharmacists significantly increased patient bone health knowledge which was sustained over a 10‐week period; pharmacists significantly contributed to increasing patients' daily calcium intake in line with national recommendations Patients at high‐risk of osteoporosis were identified, appropriately managed in the pharmacy or referred to GPs and followed‐up Patients indicated satisfaction with the programme and felt they had become more aware of bone health All the programme standards were met and gave a mandate for the roll‐out of revised and improved community‐pharmacy based programmes that could meet the bone health needs of patients 相似文献