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At least 1,531 records · Page 85Linked to original sources

PubMed2006

Making sense of apparently conflicting data: stress and immunity in swine and cattle.

Stress is generally considered to suppress the immune system and may lead to an increase in the occurrence of disease in the presence of a pathogen. The immune system is ordinarily brought back to a baseline response level after immune challenge through homeostatic processes, in part regulated by the hypothalamic-pituitary-axis. Often, findings reported from various studies investigating the effects of stress on the immune system are conflicting and difficult to reconcile into a cohesive and comprehensible set of universally applicable theories. These discrepancies may be partly explained by the types and durations of the stressors, the aspect(s) of immune system measured, genetics, and social status. A particular stressor may enhance cell-mediated immune responses while suppressing humoral responses or vice versa, thus disrupting the balance between these components of the immune system. How farm animals perceive their environment depends not only on traditional environmental stressors (e.g., heat, cold, humidity, pollutants), but also on aspects of their social environment. Dominant animals may have enhanced immune activation, whereas subordinates have suppression of the same immune component in response to the same stressor. This could explain why individual animals within a group respond differently to stressors and disease challenges. A better understanding of the consequences and complex interactions between social and environmental stressors for innate and adaptive immune traits must be developed so we can more fully understand the effects of stress on immunity in livestock. Once these complex relationships are better understood, more effective interventions can be designed to improve animal health and well-being.

Animals↗

PubMed1990

Reminiscence: an independent nursing intervention for the elderly.

The nursing literature states that reminiscence is an independent nursing intervention for elderly clients and patients. This paper is about the use of reminiscence by nurses in all settings. Nurses have not to date built a firm knowledge base. The paper discusses the need for knowledge about the phenomenon and life review versus reminiscence. The uses of reminiscence therapy in one-to-one interaction, in the group modality, and as a research tool are all important applications of the concept. In contrast to other disciplines, reminiscence therapy, as studied by nurses, focuses on interventions. Reminiscence is a fascinating, elusive, and complex phenomenon, but although nursing textbooks tout its usefulness, the research findings are less optimistic.

Aged↗

PubMedDate not supplied

Powered mobility and preschoolers with complex developmental delays.

OBJECTIVE: The purpose of this study was to explore the effects of a powered mobility riding toy on the participation behaviors of young children with complex developmental delays. METHOD: A single-subject withdrawal design was used to study the effects of powered mobility on child-initiated movement occurrences, initiation of contact with others, and affect. The participants were two young children with complex developmental delays, including spastic quadriplegia. The intervention consisted of having the children use a powered mobility riding toy in their school settings during gym class and outdoor recess. RESULTS: Primary findings were that use of the powered mobility riding toy (a) increased the number of self-initiated movement occurrences; (b) appeared to have some effect on initiation of contacts with adults and, for one child, negative adult initiations and positive peer initiations; and (c) did not have a clear impact on the amount of positive affect. CONCLUSION: For some young children with severe motor impairments and developmental delay, use of a powered mobility device may increase self-initiated movement occurrences during free play.

Child Behavior↗

PubMed1999

Phases of alcohol problem prevention research.

We build on precedents from other health research to present a phases model of research for alcohol problem prevention that accommodates the special characteristics of this research. We propose a five-level model, in which research moves along a series of relevant continua: from basic to more and more applied research; from descriptive hypothesis-generating pilot studies to full-fledged, methodologically sophisticated, hypothesis-testing studies; from smaller to larger samples for testing; from greater to lesser control of experimental conditions; from more artificial "laboratory" environments to real-world geographically defined communities; from testing the effects of single prevention strategies to more complex studies of multiple strategies integrated into intervention systems; and from research-driven outcome studies to "demonstration" projects that evaluate the capacity of various types of communities to implement prevention programs based on prior evaluations. The five phases of research are: (1) foundational research to define and determine the prevalence of specific alcohol-involved problems, establish causal factors and processes that yield the specific problems or increase the risk of a problem, and provide the foundations for the development of effective prevention interventions; (2) developmental (preliminary effectiveness) studies to develop and test the likely effectiveness, safety, and costs of new interventions or to assess the effectiveness, safety, and costs of an existing intervention; (3) efficacy studies to determine the effects, safety, and costs of an intervention under optimal conditions of implementation (or availability or enforcement) and acceptance (or adoption at the community, organizational, or group level; or participation, compliance, or adherence at the individual level); (4) effectiveness studies of the real-world effectiveness of preventive interventions with purposeful or natural variation in implementation and acceptance; and (5) demonstration studies of the effects of interventions when widely disseminated. The proposed phases model for alcohol problem prevention research presented herein differs in significant ways from the models established by other National Institutes of Health agencies. Greater emphasis is placed on natural experiments, on methods development along the whole research continuum, on collapsing or combining research phases when appropriate, on recognizing the critical importance of behavioral parameters early as well as late in the research sequence, and on extending the research continuum to embrace diffusion and dissemination (i.e., technology transfer) studies. We also include examples of phased research in existing alcohol studies and a discussion of relevant issues, including cost, special populations, methods, and dissemination. If systematically followed, this model has the potential to contribute to wider testing and dissemination of prevention interventions of known effectiveness.

Alcohol Drinking↗

PubMed1997

Managing the human side of change in VA's transformation.

Transformational change interventions often fail or short fall of their intended impact on organizations and systems. One main reason is that these interventions frequently do not strategically address the complex human dynamics of change. This happens despite awareness of and commitment to intervening at this level by top management and change leaders. The wisdom that "systems don't change; people change" is widely acknowledged but inadequately applied. These are exactly the conditions the U.S. Department of Veterans Affairs (VA) faces in deploying its new Veterans Integrated Services Networks (VISNs). Applying validated behavioral science strategies that address the human side of change will help VA implement VISNs effectively. Six strategies derived from many years of study and practice in the public and private sectors are discussed, along with suggestions for VISN managers about how to implement them.

Community Networks↗

PubMed1999

Abdominal pregnancy in a 67-year-old woman undetected for 37 years. A case report.

BACKGROUND: Abdominal pregnancy is an exceedingly rare occurrence, but even more unusual is prolonged retention of an advanced abdominal pregnancy with lithopedion formation. We present the case of prolonged retention of an advanced abdominal pregnancy in an elderly women. CASE: A 67-year-old, white woman presented to the emergency department with abdominal pain. An acute abdominal series revealed a fetal skeleton extending from the patient's pelvis to her lower costal margins. Pelvic examination revealed a normal postmenopausal uterus, and human chorionic gonadotropin was negative. On further questioning the patient reported that she had become pregnant 37 years earlier and was diagnosed as having a "missed" pregnancy. She refused intervention at that time but suffered no untoward consequences. She reported having had later a healthy intrauterine pregnancy, delivered vaginally at term. No attempt was made to remove the prior missed abdominal pregnancy. The acute pain episode resolved, and there was no surgical intervention. CONCLUSION: Abdominal pregnancies can have a complex course, and management decisions can be difficult. This case presents an unusual outcome of an advanced abdominal pregnancy and illustrates a unique approach to management.

Abdomen, Acute↗

PubMed2000

Review of programs for persons who are homeless and mentally ill.

Despite recent prosperity in the U.S., homelessness is still a widespread social problem. It is estimated that 25% of homeless persons have a serious mental illness. This article will review the literature evaluating prevention services and specialized outreach, treatment, and housing programs designed to reduce homelessness for individuals who are mentally ill. Although these interventions have been helpful in addressing the complex needs of the homeless mentally ill, it is difficult to measure how they have improved outcomes. It is even more challenging to determine whether the programs are cost-effective. Since public resources are used to maintain services for the homeless mentally ill, policy-makers must be informed about whether the best outcomes are achieved at the lowest possible cost. Following a discussion of the successes of the individual programs and the challenges they confront, several important questions are identified related to improving the efficiency of these programs. Although the establishment of such programs indicates that progress has been made toward alleviating the burdens facing people who are homeless and mentally ill, collaboration among all stakeholders-especially between the mental health community and consumer advocates-needs to be further enhanced. New research can be conducted in a way that improves how information is evaluated and used.

Adult↗

PubMedDate not supplied

[Simultaneous extracranial and intracranial otogenic complications].

INTRODUCTION: Chronic otitis media is the most common cause of otologic complications. A simultaneous occurrence of extracranial and intracranial otologic complications is rare in clinical practice. In this paper, we are presenting a patient with exacerbation of chronic otitis media and associated otologic complications: peripheral facial nerve palsy and subdural cerebral abscess. CASE REPORT: A patient aged 56 who has suffered from chronic otitis media during the past 37 years, was admitted at the Clinic of Otorhinolaryngology due to worsening of the underlying disease. The clinical examination revealed chronic otitis media with granulation in the external auditory canal, pulsatile discharge and extracranial otologic complication--facial nerve paralysis. The preoperative diagnostic procedure included: cochleovestibular investigations (hearing disorder of mixed type on the left side with normal labyrinthine function), temporal bone radiography (sclerotic cell alteration of mastoid on the left), topodiagnosis of facial nerve). The laboratory finding confirmed increased number of leukocytes (21.7 x 10(9)/l), increased erythrocyte sedimentation rate (25/58 mm/h), increased fibrinogen (5.0 g/l) and presence of protein in urine. Chest and heart X-ray findings were normal. Staphylococcus aureus was isolated from ear discharge by microbiological investigation. Signs of meningitis were negative, the liquor was colorless, slightly stirred up with total number of cells 384 x 10(6)/l, sugar 2.7 mmol/l and total proteins from 0.82 g/l. Bacteriological liquor culture was negative. The ophthalmologic examination confirmed normal finding of the eye fundus and absence of increased cranial pressure. For further diagnostics CT (computerized tomography) and MRI of head (magnetic resonance imaging) were performed. The findings confirmed subdural abscess and suspected encephalitic foci of the left cerebral lobe. According to findings, surgery involving radical trepanation of the temporal bone, decompression of facial nerve, denudation of sigmoid sinus dural sinus and angle area and incision of dura mater of the cranial fossa posterior with drainage of subdural abscess (meningitis surgery) was performed. CONCLUSION: A simultaneous occurrence of extracranial and intracranial otologic complications accompanied by subdural abscess is rare in clinical practice. The mechanism of development and spreading of subdural abscess is very interesting. In this case, subdural abscess caused the reaction of dura mater, which has prevented spreading of the disease by cerebrospinal liquid at the onset. However, there is a possibility of its further spreading by blood vessels into the brain white substance, where encephalitic foci may develop and later brain tissue abscesses as well. The clinical course of subdural abscess may be atypical, without headache and increased cranial pressure. This kind of disease demands a complex diagnostic procedure, sufficient otosurgical and neurosurgical interventions, cooperation with infectologist and administration of antibiotic therapy.

Brain Abscess↗

PubMed2001

Beyond infant colic.

Some of the most interesting cases in pediatric practice evolve through time. What may begin as a clear, well defined problem with a predictable natural history and an accepted intervention strategy may develop into a more complex, multi-faceted set of problems. It is these children who potentially provide clinicians with new insights into behaviors. This case of a colicky infant illustrates the wide spectrum of behavioral and physiological symptoms that emerge from a specific underlying behavioral phenomenon. It also emphasizes the significant benefit derived from a longitudinal perspective of developmental events.

Child↗

PubMed2001

[Rehabilitation of patients with asymmetrical maxillary deformations].

Observations of 31 patients aged 16-31 years (11 men and 20 women) with asymmetrical maxillary deformations showed that medical rehabilitation of this patient population requires a comprehensive orthodontic and surgical approach. Such an approach leads to good esthetic and functional results without relapses of the deformation. A modified method of maxillary osteotomy was used, taking into consideration the clinical manifestations of asymmetrical deformation. Effective surgical treatment implies thorough planning of the volume of intervention and reliable fixation of osteotomied maxillary complex, which helps rule out secondary deformations of facial skull. Purposeful timely orthodontic treatment essentially accelerates medical rehabilitation.

Adolescent↗

PubMedDate not supplied

[Special aspects of anesthesiology and intensive care in oncological operations with microsurgical autoplasty].

The efficiency of the most rational antithrombotic, rheological, and antiischemic agents was evaluated: low-molecular heparin fraxiparin, nonsteroid antiinflammatory drug ketoprofene (ketonal), perfluorane, and antikininogen contrycal. Twenty-eight patients divided into 3 groups were examined before, during, and after extensive interventions with simultaneous microsurgical plastic repair by complex autotissue grafts. Results of treatment of 17 patients, in whom therapeutic and prophylactic complex including fraxiparin, perfluorane, and contrycal was used, deserve special attention. Use of this drug complex according to the proposed protocol creates optimal conditions for maintaining blood supply and oxygenation of the transplant at the expense of deceleration of blood clotting, decrease of blood viscosity, and decrease of erythrocyte and platelet aggregation. Complete healing of transplants was attained in all patients, who were discharged with good plastic results.

Adult↗

PubMed2002

[Relations between military health services and humanitarian organizations--the point of view of the International Red Cross].

The classic definition of humanitarian action is any operation conducted for the purpose of helping to reduce human suffering. This concept can be expanded to include a notion of prevention. This expanded definition has opened a wide range of applications for humanitarian assistance. Military personnel are frequently involved in relief operations after natural disasters. Military logistic support is a key factor for coping with the massive needs of victims. However military intervention in humanitarian operations during wartime poses complex problems. The ICRC intervenes during military conflict and has, for several years, expressed its concern over the growing involvement of military forces in humanitarian operations. These considerations provide the backdrop for analysis of the relationship between Military Health Corps Services and the ICRC. The purpose of this article is to evaluate the need to make a clear-cut distinction between political and humanitarian objectives and thus between the actors associated with these goals. In this regard, the role of Military Health Corps Services will be presented in function of the principles underlying any humanitarian program. This article will also discuss areas of agreement and cooperation between the ICRC and Military Health Corps Services.

Altruism↗

PubMed2003

Posterior decompressive procedures for the cervical spine.

Cervical degenerative disease encompasses a complex array of pathologies. Before considering surgical intervention, the surgeon should have a complete understanding of the indications for surgery and should have conducted a thorough physical examination and evaluation of radiologic studies. In general, unless myelopathy is present, surgery should be the treatment of last resort, used only after conservative measures have failed. The indications for posterior cervical decompression include both radiculopathy and myelopathy. However, these conditions alone are not sufficient to indicate that a posterior procedure is appropriate. Other factors, such as bilaterality of symptoms, presence or absence of cervical lordosis, number of levels involved, and presence of axial neck pain, should also be considered when deciding whether an anterior procedure or posterior decompression is more appropriate.

Cervical Vertebrae↗

PubMed2002

[Chronic anastomosis fistula: special problem in anastomosis wound healing].

Chronic anastomotic fistulas represent a complex clinical problem following various surgical gastrointestinal interventions. The etiology of anastomotic fistula includes multiple factors. Risk factors include patient- and surgery-dependent factors and those that are influenced by pre- and perioperative therapeutic measures. Therapeutic strategies include optimization of concomitant risk factors, medical strategies to improve wound healing, and endoscopical or surgical interventions.

Anastomosis, Surgical↗

PubMedDate not supplied

The retinoid X receptor and its ligands: versatile regulators of metabolic function, cell differentiation and cell death.

Retinoid X Receptors (RXRs) consist of a family of nuclear receptors that target and regulate multiple signalling pathways. The early evolutionary emergence of RXRs in comparison to other nuclear receptors may have allowed for the development of unique properties as transcriptional regulators. Indeed, the complexity of these receptors is derived from their ability to activate transcription as homodimers or as obligate heterodimeric partners of a multitude of other nuclear receptors. In addition, RXRs can regulate gene expression in a ligand-dependent (forming permissive heterodimeric complexes) or - independent (forming non-permissive heterodimeric complexes) manner. Given that ligand binding is a critical component of RXR function, this review will focus on the ligand dependent functions of RXR. The remarkably conserved ligand binding domain of RXR is a multi-functional structure that in addition to ligand binding, serves as a homo- and heterodimeric interface, and a region to bind coactivactor and corepressor molecules. RXRs have a small ligand binding pocket and therefore bind their ligands (such as 9-cis RA) with both high affinity and specificity. In the presence of ligand, permissive RXR heterodimers bind coactivators, but nonpermissive complexes can bind coactivators or corepressors depending on the activation of the RXR's heterodimeric partner. Physiologically, the temporal and tissue specific pattern of RXRs as well as the presence of phenotypic abnormalities in receptor knockout studies (most severe in RXRa -/- animals) demonstrate the important role for these receptors both during development (morphogenesis) and in adult differentiated tissues (cell proliferation, cell differentiation, cell death). These receptors also play an important regulatory role metabolic signaling pathways (glucose, fatty acid and cholesterol metabolism), including metabolic disorders such as type 2 diabetes, hyperlipidemia and atherosclerosis. RXRs function as master regulators producing diverse physiological effects through the activation of multiple nuclear receptor complexes. RXRs represent important targets for pharmacologic interventions and therapeutic applications.

Animals↗

PubMed2004

[Simultaneous methods of surgical treatment of nose and accessory nasal sinuses pathology].

Among the servicemen the diseases of nose and accessory nasal sinus (ANS) are the predominant pathology of LOR-organs. The external causes of this pathology are the frequent viral affection of respiratory tracts, smoking, the effect of unfavorable factors of ecology and military work. The local causes are conditioned by congenital or acquired anatomical changes in the nose and ANS structures. The most frequent predisposing cause is the nasal septum curvature that influences on the nasal breathing. The surgical treatment of nose and ANS combined pathology can be conducted simultaneously or at several stages. The simultaneous operations have both positive and negative factors. The qualitative analysis based on the results of treatment of 230 servicemen with combined pathology of nose and ANS structures (divided into 5 most common combinations) permitted to propose the algorithm of surgical interventions, the adequate anesthesiology and postoperative treatment complex. All these would minimize the negative consequences of simultaneous operation on the nose and ANS structures. Some peculiarities of military service and requirements to servicemen' health make the simultaneous method of surgical treatment of nose and ANS pathology preferable.

Anesthesiology↗

PubMed1998

Update on antiobesity drugs.

The Society for Medicines Research organized a one-day meeting on antiobesity drugs on March 26, 1998, in London. Current environmental risks for obesity include an increase in the proportion of fat consumption--especially an increase in the fat-to-carbohydrate ratio--and an increase in a sedentary life-style without an appropriate lowering in food intake. Energy balance plays a pivotal role of in the control of body stores. Knowing the mechanisms of the control of energy intake and energy expenditure provides explanations for the incidence of obesity and also possible sites for drug intervention. The genetic basis for obesity is complex, with the probability of a number of interacting genes being involved (polygenic inheritance). Each of the main components of the energy balance relationship has a distinct genetic basis. The ob gene was first identified in 1994 by Friedman, and its product is leptin, which may well be a potential target for obesity treatment. Speakers at the meeting highlighted various targets that hold promise in developing pharmacological treatments for obesity: increasing the activity of satiety factors (CCK-8, GPL-1, ACTH, alphaMSH and 5-HT acting on 5-HT(2C) receptors); inhibiting orexigenic agents (NPY, MCH, galanin); targeting thermogenesis (beta(3)-adrenergic agonists and uncoupling proteins); targeting fat absorption; and targeting neuropeptides. Some of the compounds developed to act on these sites are now becoming available.

Journal Article↗

PubMed2005

[Prescription of psychotropic drugs for schizophrenic outpatients in Hungary].

UNLABELLED: The complexity of the acute and maintenance pharmacological interventions is a very important problem in the management of the schizophrenic patients. Antipsychotics are used as target therapy while anxiolytics, hypnotics, antidepressants, mood stabilizers can be given as adjunctive treatment. We have evidence based, experimental, anecdotal knowledge about the therapy of schizophrenia but we do not know the facts of the practice. The aim of my study was to evaluate the trends in the prescription of psychotropic drugs for schizophrenic outpatients in Hungary. METHOD: A questionnaire has been constructed and been sent to the psychiatrists. The study was blind to the investigator because nor the psychiatrists neither the patients were identified. The patients turned to psychiatrists from 9th to 20th June 2003 were included in the cross-sectional study. RESULTS: 147 questionnaires were evaluated. 30% of the patients take only one, 35% two and 23% three, 12% four or more kinds of psychotropic drugs simultaneously. Only 6 patients are not given any antipsychotic drugs. About 30% takes some kind of typical (first generation) while 80% atypical (new generation) form and about 15% is on antipsychotic combination therapy. The proportion of depot is 26%. The most frequently used antipsychotics are olanzapine, flupenthixole, clozapine and risperidone. The ranges of the doses show an optimal use. 45.6% of the patients is on anxiolytic, 19% on any kind of antidepressant and 11% on hypnotic drug and only 4.1% on any kind of mood stabilizers. The data of duration of therapy show that the rate of switch an antipsychotic to another for one year before the index time is low (30%) but about 8.8% of the patients are on the same antidepressant and 21.1% on the same anxiolytic drug in that period. There are no gender differences in the therapy. CONCLUSION: The results show the current trends of pharmacological treatment of schizophrenic outpatients in Hungary. The data of the study are comparable with international trends, professional expectation and the new evaluations in the future.

Adult↗