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排序方式: 共有923条查询结果,搜索用时 15 毫秒
1.
Ian Gooding Vicky Dondos Khin Ma Gyi Margaret Hodson David Westaby 《Liver transplantation》2005,11(12):1522-1526
Autopsy and imaging studies show that liver involvement is common in cystic fibrosis. However, complications of chronic liver disease including portal hypertension and variceal bleeding are infrequently encountered, and the degree to which variceal hemorrhage affects prognosis in cystic fibrosis is unclear. This uncertainty has lead to debate as to whether liver transplantation is indicated in these patients. We describe a case series of 18 patients and compare their survival with a control group of cystic fibrosis patients without liver disease. The median age at first bleed was 20.0 years (range 9.7-30.9). The median survival after first bleed was 8.4 years, compared to 13.0 years in the control group (P = 0.15). A total of 14 patients have died, 9 from respiratory disease with no discernable contribution from their liver disease. Liver disease contributed to 4 deaths. Only 1 patient suffered a fatal hemorrhage, which may have been either variceal or bronchial in origin. Long-term survival is a frequent occurrence in patients with cystic fibrosis who suffer variceal hemorrhage, and age at death is comparable to the general cystic fibrosis population. In conclusion, this suggests that liver transplantation is not indicated in these patients without additional features of liver decompensation. 相似文献
2.
Maximal static expiratory and inspiratory mouth pressures (PEmax and PImax) and quadriceps femoris muscle strength were measured in 25 patients aged 16-28 years with cystic fibrosis (mean FEV1 46% predicted). Mean (SD) PEmax was 64% (18%) predicted (below 75% predicted in 16 of the 25 patients), and PImax was 64% (24%) predicted (below 75% predicted in 14 patients). Quadriceps muscle strength was 68% (20%) predicted (below 75% predicted in 17 patients). The relatively small reduction in respiratory muscle strength in these patients was unlikely to have contributed appreciably to their respiratory problems. 相似文献
3.
A H Cohen R Soden S A Martin S Liss W L Hodson M Meyer 《Journal of the American Optometric Association》1987,58(5):386-389
As an essential element of the comprehensive rehabilitation efforts at Northport VA Medical Center, and as a service whose demand is projected to increase substantially with the expanding proportion of aging veterans, eye/vision care has become increasingly important. As a result, the administration of the Medical Center decided to heed the suggestions of Congress and the Director of Optometry in VA Central Office and reorganize the delivery of eye/vision services so the ever-increasing demand could be met more rationally, efficiently and effectively. In this paper, the Northport VA Medical Center's Comprehensive Eye/Vision Program, including the residency program in rehabilitative optometry, will be described and the benefits of the reorganization will be discussed. 相似文献
4.
Circannual variation in lymphocyte subsets, revisited 总被引:2,自引:0,他引:2
BACKGROUND: Circadian and circannual variations in lymphocyte subsets, especially CD8+ T-lymphocytes, have been reported. This study focuses on CD4+ T-lymphocyte seasonal variation over a 6-year 8-month period. STUDY DESIGN AND METHODS: Lymphocyte subsets were quantitated monthly for four healthy individuals from 1986 through 1992 as part of a flow cytometry quality-control program. RESULTS: In general, there were no significant seasonal changes in the total number of white cells or in total lymphocyte counts. The absolute numbers of CD4+ T-lymphocytes were lowest in summer when the CD8+ T-lymphocytes were highest. Mean CD4+ T-lymphocyte counts were 846, 967, 618, and 695 per microL for Subjects 1 through 4, respectively, in winter and 432, 670, 355, and 766 per microL, respectively, in summer. Two healthy subjects had CD4+ T-lymphocyte counts lower than 300 per microL on one or more occasions during the study period. In three of the four subjects, the percentage of B-lymphocytes in winter was almost double that in summer. In one of the four subjects, no circannual rhythm was observed in these lymphocyte subpopulations. CONCLUSION: The seasonal variation in CD4+ T- lymphocyte counts demonstrated in three healthy individuals over almost 7 years is again of interest in light of renewed consideration of using surrogate tests, such as CD4+ T-lymphocyte counts, to screen for AIDS- like diseases that may be in the blood supply. 相似文献
5.
6.
The family history in family practice: a questionnaire study 总被引:9,自引:7,他引:2
OBJECTIVES: Our aims were to investigate family medical history taking in
general practice, and to evaluate the value attached to the family medical
history as an aid to decision making in general practice. METHOD: A postal
questionnaire survey was conducted among all 291 GPs working within the
Calderdale and Kirklees Health Authority area. Each questionnaire was
followed by a reminder. The main outcome measures were answers to questions
on routine and opportunistic family history taking and a question about
transmitting knowledge about genetic risk to other members of the family.
Questions were also posed about the value attached to the family medical
history as an aid to decision making. RESULTS: A total of 193 GPs returned
the questionnaire (response rate 66.3%). On registration, 94.3% of GPs
indicated that enquiries were made about a family history of coronary heart
disease. Breast and colorectal cancer were specifically asked about by
48.4% and 30.7% of GPs, respectively. One-fifth of respondents indicated
that they asked a general question about family medical history. A little
over one-quarter of respondents indicated that they made opportunistic
enquiries about the family history or suggested that the patient should
inform other members of the family about possible risks. In the scenarios
highlighted in this study, the majority of respondents felt that the family
medical history had value as an aid to decision making. This was
particularly the case for checking a patient's cholesterol (92.1%) and for
initiating referrals in younger patients with possible cancer-related
symptoms (three-quarters of respondents). CONCLUSION: GPs value the family
medical history as an aid to decision making. Unfortunately, apart from
enquiries about coronary heart disease, routine or opportunistic family
history taking is not occurring in practice. Mechanisms need to be sought
to extract information from the family medical history so that it can be
more effectively used by GPs.
相似文献
7.
Georg H. Eifert Stephanie E. Hodson Doreen R. Tracey L. Seville Kumar Gunawardane 《Journal of behavioral medicine》1996,19(4):385-399
Psychological features and complaints of persons presenting to medical settings with heart-focused anxiety and noncardiac chest pain are poorly understood. Comparing 20 healthy heart-anxious patients to cardiac and surgical inpatients and nonpatient controls, we found that healthy heart-anxious patients (a) were as afraid of chest pain and heart palpitations as inpatients with heart disease, (b) were as incapacitated by symptoms and using medical services as much as both inpatient groups; and (c) reported higher levels of cardiac disease conviction, heart awareness, and behaviors designed to protect their heart than surgical patients and nonpatients. Compared to all other groups, healthy heart-anxious patients reported more panic and other anxiety disorders, hypochondriacal beliefs, physical symptoms, obsessive-compulsive concerns, and negative affect. Following a hyperventilation test, heart-anxious patients also indicated more distressing symptoms and thoughts, and felt less safe and in control than surgical patients and nonpatients. Results support efforts for a timely recognition, diagnosis, and behavioral treatment of persons with heart-focused anxiety. 相似文献
8.
The strain difference in the effect of mercuric chloride on antigen-triggered serotonin release from rat mast cells is not mediated via interferon-gamma. 下载免费PDF全文
Previous work has shown that in vitro exposure of Brown-Norway (BN) rat peritoneal mast cells to mercuric chloride (HgCl2) causes enhancement of subsequent mediator release induced by cross-linking of surface immunoglobulin E (IgE). This enhancing effect is seen significantly less often with peritoneal cells from Lewis rats. In addition HgCl2 has been shown to suppress interferon (IFN)-gamma production by BN but not Lewis splenocytes. Given that IFN-gamma is known to inhibit mediator release by mast cells, we hypothesized that the strain difference in the effect of HgCl2 on mediator release was mediated via a differential effect on IFN-gamma release from T cells in the mixed peritoneal cell population: IFN-gamma release would be suppressed in the case of the BN rat, releasing the mast cells from inhibition and resulting in the enhancing effect of HgCl2. The aim of the study was to test two predictions of this hypothesis. Exposure of BN rat mast cells to IFN-gamma inhibited subsequent antigen-induced mediator release but did not significantly reduce HgCl2-mediated enhancement of this release. Exposure of Lewis rat mast cells to blocking concentrations of anti-IFN-gamma did not reveal any HgCl2-mediated enhancement of mediator release. These observations provide strong evidence against the hypothesis that the differential effects of HgCl2 on BN and Lewis rat mast cells are mediated via IFN-gamma. In addition the results revealed that BN rat mast cells are significantly more sensitive than Lewis rat mast cells to the inhibitory effects of IFN-gamma on antigen-induced mediator release. 相似文献
9.
P L Haslam B Thompson I Mohammed P J Townsend M E Hodson E J Holborow M Turner-Warwick 《Clinical and experimental immunology》1979,37(3):381-390
Increased Clq binding levels have been obtained in serum from twenty-one (50%) of forty-two patients with cryptogenic fibrosing alveolitis (CFA) suggesting the presence of circulating immune complexes. There was a low frequency of positive results using a number of other tests for circulating immune complexes. The increased Clq binding levels were observed in six (35%) out of seventeen patients with lone lung involvement and in fifteen (60%) out of twenty-five patients with extrapulmonary connective tissue disorders. There was an especially close correlation between arthritis and elevated Clq binding. A strong correlation between Clq binding levels and levels of circulating rheumatoid factor (RF) and IgG, and enhancement in macrophage radiobioassay tests using RF-containing sera, suggested that RF might be involved in the circulating immune complexes in these patients. DNAase pre-treatment of sera did not influence the findings, and there was no correlation between Clq binding and levels of immunofluorescent ANA, C-reactive protein levels, or platelet counts. A weak correlation between Clq binding and erythrocyte sedimentation rates, and slightly lower binding levels in treated than untreated patients with 'lone' CFA suggested that binding levels may give some indication of disease activity and may in some instances be influenced by treatment. 相似文献
10.