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72%), third (257, 72.39%) and second (351, 72.82%).
This study shows patients from the most deprived areas are over-represented in burns incidence and are less likely to perform first aid. We feel this should be highlighted in burns prevention and education strategies.
This study shows patients from the most deprived areas are over-represented in burns incidence and are less likely to perform first aid. We feel this should be highlighted in burns prevention and education strategies.
Hypoxic exposure should be considered as a continuum, the effects of which depend on the dose and individual response to hypoxia. Hypoxic conditioning (HC) represents an innovative and promising strategy, ranging from improved human performance to therapeutic applications.
With the aim of improving sports performance, the effectiveness of hypoxic exposure, whether natural or simulated, is difficult to demonstrate because of the large variability of the protocols used. In therapeutics, the benefits of HC are described in many pathological conditions such as obesity or cardiovascular pathologies. If the HC benefits from a strong preclinical rationale, its application to humans remains limited.
Advances in training and acclimation will require greater personalization and precise periodization of hypoxic exposures. For patients, the harmonization of HC protocols, the identification of biomarkers and the development and subsequent validation of devices allowing a precise control of the hypoxic stimulus are necessary steps for the development of HC.
From the athlete to the patient, HC represents an innovative and promising field of research, ranging from the improvement of human performance to the prevention and treatment of certain pathologies.
From the athlete to the patient, HC represents an innovative and promising field of research, ranging from the improvement of human performance to the prevention and treatment of certain pathologies.Although autoimmunity and autoimmune disease (AID) are relatively common, the repertoire of autoantigens is paradoxically very limited. Highly enriched in this autoantigen repertoire are nucleic acids and their binding proteins, which together form large macromolecular structures. Most of these complexes are of ancient evolutionary origin, with homologs throughout multiple kingdoms of life. Why and if these nucleic acid-protein particles drive the development of autoimmunity remains unresolved. Recent advances in our understanding of the microbiome may provide clues about the origins of autoimmunity - and the particular puzzle of why the autoantigen repertoire is so particularly enriched in ribonucleoprotein particles (RNPs). We discuss the possibility that autoimmunity to some RNPs may arise from molecular mimicry to microbial orthologs.In this study, 3-D non-linear ultrasound simulations and experimental measurements were used to estimate the range of in situ pressures that can occur during transcutaneous abdominal imaging and to identify the sources of error when estimating in situ peak rarefaction pressures (PRPs) using linear derating, as specified by the mechanical index (MI) guideline. Using simulations, it was found that, for a large transmit aperture (F/1.5), MI consistently over-estimated in situ PRP by 20%-48% primarily owing to phase aberration. For a medium transmit aperture (F/3), the MI accurately estimated the in situ PRP to within 8%. For a small transmit aperture (F/5), MI consistently underestimated the in situ PRP by 32%-50%, with peak locations occurring 1-2 cm before the focal depth, often within the body wall itself. The large variability across body wall samples and focal configurations demonstrates the limitations of the simplified linear derating scheme. The results suggest that patient-specific in situ PRP estimation would allow for increases in transmit pressures, particularly for tightly focused beams, to improve diagnostic image quality while ensuring patient safety.
The diagnosis of psychogenic non-epileptic seizures (PNES) can often be challenging. When video-electroencephalography (EEG) is not conclusive, single-photon emission computed tomography (SPECT) can be useful by quantifying changes in regional cerebral blood flow (rCBF).
We conducted a retrospective case-control study in adult patients with pharmacoresistant temporal lobe epilepsy (TLE). Those patients with an ictal SPECT obtained during an event finally diagnosed as PNES were included as cases (PNES+). The control group consisted of patients with TLE without PNES (PNES-). Clinical episodes were analysed and classified according to PNES subtypes. Subtraction ictal SPECT coregistered to MRI (SISCOM) analysis was performed for the detection of areas with significant changes in perfusion compared to individual interictal studies. Group comparisons in SPM12 included paired t-tests of ictal vs. interictal studies in each group of temporal lobe seizures and PNES events.
Ten patients with TLE and PNES were included. We found no patterns of regional hyperperfusion typical of TLE seizures during the PNES events. In two of these cases, an ictal SPECT during a confirmed epileptic seizure was also obtained, showing antero-mesial temporal lobe hyperperfusion. Group comparisons between ictal and interictal SPECTs showed increased rCBF in the temporal lobe with reduced perfusion in the default mode network areas and cerebellum during temporal lobe seizures in PNES- patients and decreased perfusion restricted to the posterior parietal cortex without significant rCBF increases in PNES events.
Ictal SPECT can be a helpful tool to characterize rCBF changes in PNES and for differential diagnosis with seizures in TLE patients.
Ictal SPECT can be a helpful tool to characterize rCBF changes in PNES and for differential diagnosis with seizures in TLE patients.Mesial temporal lobe epilepsy (MTLE) is one of the most common types of focal epilepsy in the adult population. MTLE is frequently associated with a specific histopathological lesion in the medial temporal structures, namely hippocampal sclerosis (HS). A significant proportion of patients with MTLE+HS have severe epilepsy, which is often resistant to clinical treatment. For these patients, surgical resection of the epileptogenic lesion can be performed. Our understanding of the underlying mechanisms leading to MTLE+HS has improved significantly over the past few decades. In this review, we aim to present and discuss the most recent findings regarding the genetic determinants of MTLE+HS. Furthermore, we will address studies about transcriptomics, proteomics, metabolomics, and epigenomic signatures of the tissue that is surgically removed from patients with refractory MTLE+HS and animal models of the disorder. We expect to provide an overview and a critical discussion of the findings, limitations, new approaches, and future directions for multi-omics studies in MTLE+HS.
This article aims to update nurses on the incidence, diagnosis, and treatment of neutropenic sepsis and septic shock.
A search of electronic databases, including PubMed and CINAHL, and e-books was performed, as was a search of clinically focused and point-of-care resources from the National Cancer Institute and UpToDate until December 2020.
Neutropenic sepsis and septic shock are oncological emergencies and can be fatal for patients undergoing anticancer treatment. Prompt and targeted treatment based on clinical signs is necessary to minimize further sequela, including morbidity and mortality.
The oncology nurse must possess an understanding of the risk factors, presenting signs, and initial management of a neutropenic fever, sepsis, and septic shock. Early identification and initiation of treatments in patients in sepsis and septic shock will allow the oncology nurse to intervene with speed, skill, and confidence while working within the multidisciplinary team to provide the best outcome based on current evidence.
The oncology nurse must possess an understanding of the risk factors, presenting signs, and initial management of a neutropenic fever, sepsis, and septic shock. Early identification and initiation of treatments in patients in sepsis and septic shock will allow the oncology nurse to intervene with speed, skill, and confidence while working within the multidisciplinary team to provide the best outcome based on current evidence.
To develop and evaluate the psychometric properties of an instrument assessing beliefs in physical activity based on the integration of the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB) among (pre)frail older adults.
A literature review and semi-structured interviews were conducted to generate the initial item pool of the instrument. Selleck Daporinad A rural sample of 611 (pre)frail older adults was enrolled to examine the validity and reliability of the instrument.
The exploratory factor analysis extracted eight factors for this instrument, explaining 71.3% of the variance in beliefs in physical activity. The confirmatory factor analysis confirmed the eight-factor structure. Linear regression models found that the integrated HBM-TPB constructs explained 65.9% of the variance in physical activity intention and 13.6% in physical activity. The Cronbach's alpha coefficients for the factors ranged from 0.80 to 0.98, and ICCs ranged from 0.71 to 0.85.
This instrument has satisfactory construct validity, predictive validity, internal consistency reliability and test-retest reliability, and it can be used in (pre)frail older adults to measure beliefs in physical activity.
This instrument may help health care providers understand beliefs in physical activity and facilitate targeted interventions among (pre)frail older adults.
This instrument may help health care providers understand beliefs in physical activity and facilitate targeted interventions among (pre)frail older adults.
Poor patient-provider communication, among other reasons, is a notable barrier to contraceptive decision-making among Latinas. Patient-centered approaches to contraceptive counseling that optimize communication align with shared decision-making (SDM) -which is associated with satisfaction and continued contraceptive use among various populations.
To examine associations of patient-provider communication and importance of SDM tenets with consistent contraceptive use among a population of Latinas.
Formative work for this study included prior qualitative and quantitative research with Latinas who expressed the importance of patient-provider communication during contraceptive counseling and therefore were instrumental in problem definition.
Cross-sectional surveys were administered to Latinas ages 15-29 years. Patient-provider communication, patient-reported importance of specific SDM tenets, and consistent contraception use were measured and analyzed for associations.
103 Latinas (mean age=21.4) particng techniques such as SDM as they seek to provide patient-centered care during contraceptive counseling for this patient population.
Results from this research demonstrate that patient-centered communication is highly valued by Latina study participants and is an important consideration in their contraceptive counseling. Clinicians should consider employing techniques such as SDM as they seek to provide patient-centered care during contraceptive counseling for this patient population.
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