600 research outputs found
Recombinant factor XIII A-subunit in a patient with factor XIII deficiency and recurrent pregnancy loss
No full textEssentials Inherited factor XIII deficiency is a very rare bleeding disorder. We used recombinant factor XIII-A in a pregnant patient with factor XIII-A subunit deficiency. The patient had a successful pregnancy outcome with no pregnancy related complications. The dose of recombinant factor XIII-A was minimized by using frequent trough level monitoring. Summary: Inherited factor XIII deficiency is a very rare bleeding disorder, and is one of the causes of recurrent pregnancy loss. The use of plasma-derived FXIII to improve pregnancy outcomes has been reported. We report a 26-year-old woman with FXIII A-subunit (FXIII-A) deficiency who was treated with recombinant FXIII-A and had a successful pregnancy outcome with no pregnancy-related complications. Our case illustrates that the dose of recombinant FXIII-A can be minimized and adjusted on the basis of frequent trough level monitoring
Deferasirox (Exjade®) significantly improves cardiac T2* in heavily iron-overloaded patients with β-thalassemia major
No full textNoninvasive measurement of tissue iron levels can be assessed using T2* magnetic resonance imaging (MRI) to identify and monitor patients with iron overload. This study monitored cardiac siderosis using T2* MRI in a cohort of 19 heavily iron-overloaded patients with β-thalassemia major receiving iron chelation therapy with deferasirox over an 18-month period. Overall, deferasirox therapy significantly improved mean ± standard deviation cardiac T2* from a baseline of 17.2±10.8 to 21.5±12.8 ms (+25.0percent; P=0.02). A concomitant reduction in median serum ferritin from a baseline of 5,497 to 4,235 ng-mL (-23.0percent; P=0.001), and mean liver iron concentration from 24.2±9.0 to 17.6± 12.9 mg Fe-g dry weight (-27.1percent; P=0.01) was also seen. Improvements were seen in patients with various degrees of cardiac siderosis, including those patients with a baseline cardiac T2* of 10 ms, indicative of high cardiac iron burden. These findings therefore support previous observations that deferasirox is effective in the removal of myocardial iron with concomitant reduction in total body iron. © The Author(s) 2009.Anderson LJ, 2006, ACTA HAEMATOL-BASEL, V115, P106, DOI 10.1159-000089475; Anderson LJ, 2001, EUR HEART J, V22, P2171, DOI 10.1053-euhj.2001.2822; Borgna-Pignatti C, 2004, HAEMATOLOGICA, V89, P1187; BRITTENHAM GM, 1994, NEW ENGL J MED, V331, P567, DOI 10.1056-NEJM199409013310902; Cappellini MD, 2006, BLOOD, V107, P3455, DOI 10.1182-blood-2005-08-3430; Daar S, 2009, HAEMATOL-HEMATOL J, V94, P140, DOI 10.3324-haematol.13845; ELEFTHERIOU P, 2006, HAEMATOLOGICA S1, V91, P999; Garbowski M, 2008, BLOOD, V112, P116; Kolnagou A, 2006, HEMOGLOBIN, V30, P219, DOI 10.1080-03630260600642542; Noetzli LJ, 2008, BLOOD, V112, P2973, DOI 10.1182-blood-2008-04-148767; PENNELL D, 2008, BLOOD, V112, P3874; Pennell DJ, 2008, BLOOD, V112, P3873; Porter J, 2008, EUR J HAEMATOL, V80, P168, DOI 10.1111-j.1600-0609.2007.00985.x; St Pierre TG, 2005, BLOOD, V105, P855, DOI 10.1182-blood-2004-01-0177; Taher A, 2009, EUR J HAEMATOL, V82, P458, DOI 10.1111-j.1600-0609.2009.01228.x; Vichinsky E, 2007, BRIT J HAEMATOL, V136, P501, DOI 10.1111-j.1365-2141.2006.06455.x; Westwood M, 2003, J MAGN RESON IMAGING, V18, P33, DOI 10.1002-jmri.10332; Wood JC, 2004, BLOOD, V104, p111A; Wood JC, 2008, BLOOD, V112, P3882; Wood JC, 2006, TRANSL RES, V148, P272, DOI 10.1016-j.trsl.2006.05.005; ZURLO MG, 1989, LANCET, V2, P2719222
A review of mental health policies from Commonwealth countries
No full textBackground: The burden of disease related to mental disorders across the world is substantial. However, there remains inequality between funding for clinical and research activities between physical illness and mental illness in almost all countries. Aims: One way of reducing this inequality is to ensure that mental health policies reflect this. We were interested in looking at the policies of members of Commonwealth. Method: We decided to survey 52 member countries of the Commonwealth to explore whether mental health policies existed and whether there was equity between physical and mental health services funding. Using World Health Organization (WHO) data sets and other sources when indicated, we looked at the existence and contents of mental health policies. Results: We found that less than half of the countries had a mental health policy. Deinstitutionalization was not seen as a priority in many countries and there was no equity between physical and mental health funding. Although integration between physical and mental health care was recommended in many countries, there was a clear gap. Conclusion: It is apparent that there is still a long way to go in terms of equity between physical and mental health in terms of funding in member states of the Commonwealth. These findings confirm earlier observations of discrimination against people with mental illness. We suggest that there must be mechanisms in place to facilitate and support change wherever required
Prevalence and experience of harassment of people with mental health problems living in the community
No full text<i>Declaration</i> <i>of</i> <i>interest</i>: This study was funded by the Communities Fund and was the result of a partnership between the Nuffield Centre for Community Care Studies, University of Glasgow, the National Schizophrenia Fellowship (Scotland) and the Scottish users' network.
<i>Background</i>: The levels and experiences of harassment of people with mental health problems in the community compared with those of the general population have not been explored.
<i>Aims</i>: To measure the levels and experience of harassment experienced by people with mental health problems in the community in Scotland and compare them with the general population.
<i>Method</i>: Experiences of harassment were collected by interviewing 165 individuals with mental health problems and a control group of 165 people from the general population.
<i>Results</i>: Harassment in the community was found to be twice as common for individuals with mental health problems (41%) than for those in the general population (15%). The harassment commonly involved verbal abuse referring to the individual's mental health problems and was committed primarily by teenagers and neighbours.
<i>Conclusions</i>: Harassment has a significantly higher prevalence among individuals with mental health problems living in the community and is believed to have a detrimental effect on mental health
Legislative provisions related to marriage and divorce of persons with mental health problems: a global review
No full textRealization of right to marry by a person is an exercise of personal liberty, even if concepts of marriage and expectations from such commitment vary across cultures and societies. Once married, if an individual develops mental illness the legal system often starts to discriminate against the individual. There is no doubt that every individual's right to marry or remain married is regulated by their country's family codes, civil codes, marriage laws, or divorce laws. Historically mental health condition of a spouse or intending spouse has been of interest to lawmakers in a number of ways from facilitating divorce to helping the individual with mental illness. There is no doubt that there are deeply ingrained stereotypes that persons with mental health problems lack capacity to consent and, therefore, cannot enter into a marital contract of their own free will. These assumptions lead to discrimination both in practice and in law. Furthermore, the probability of mental illness being genetically transmitted and passed on to offspring adds yet another dimension of discrimination. Thus, the system may also raise questions about the ability of persons with mental health problems to care, nurture, and support a family and children. Internationally, rights to marry, the right to remain married, and dissolution of marriage have been enshrined in several human rights instruments. Domestic laws were studied in 193 countries to explore whether laws affected the rights of people with mental illness with respect to marriage; it was found that 37% of countries explicitly prohibit marriage by persons with mental health problems. In 11% (21 countries) the presence of mental health problems can render a marriage void or can be considered grounds for nullity of marriage. Thus, in many countries basic human rights related to marriage are being flouted
Right to property, inheritance, and contract and persons with mental illness
No full textDiscrimination against people with mental illness is rife across the globe. Among different types of discrimination is the policy in many countries where persons with mental illness are forbidden to inherit property, and they are not able to enter into a contract in a large number of countries. Using various databases, legislations dealing with law of contract, law of succession/inheritance, and law relating to testamentary capacity (wills) of all UN Member states (193 countries) were studied. With respect to federal countries, the laws of the most populous state as a representative state in the respective country were studied. Only 40 Member States (21%) recognize/allow persons with mental health problems to enter into contracts. Of these, however, only 16 Member States (9%) recognize the right of persons with mental health problems to enter into a contract without any restrictions. The remaining 24 Member States (12%) allow a contract entered into by a person with mental health problems to be invalidated under certain conditions. These countries also make the validity of the contract subject to the capacity to consent or based on the level of understanding of the person with mental health problems. They may allow persons with mental health problems to enter into contracts only for transactions of an insignificant nature or of personal rights. Only 9% of the countries allow people with mental illness to enter into contracts in an unrestricted way. Furthermore, there remain variations between high income and low income states. In spite of international laws in many countries, laws remain discriminatory
HGV-HCV/HBV co-infection in India: A pilot study
No full textBackground: Hepatitis G virus (HGV) is newly identified virus, transmitted by infected blood and blood products. Effect of HGV infection on liver diseases is not well known. Aims: Co-infection of HGV with hepatitis B virus (HBV) and hepatitis C virus (HCV) infection has been reported however; very limited data is available from India. Therefore, we have performed a pilot study for the presence of co-infection of HGV in chronic liver disease patients. Setting and Design: The study was performed in research laboratory at P.D. Hinduja National hospital and Medical research center, Mahim, Mumbai. Prospective study was designed. Methods and Materials: Forty HBV, HCV related chronic liver disease patients were studied. Forty randomly selected voluntary healthy blood donors visiting our blood bank were included as controls. Serum bilirubin, alanine aminotransferase (ALT), Aspartate aminotransferase (AST) and alkaline phosphatase (ALP) were estimated. HGV infection was detected by using reverse transcriptase molony murine leukemia virus (M-MLV) with the help of HGV 340/625IC kit (Sacace, Italy). Results and Conclusion: One HCV positive patient had infection with HGV among 40 HBV/HCV chronic liver disease patients
Legal protection of the right to work and employment for persons with mental health problems: a review of legislation across the world
No full textThe right to work and employment is indispensable for social integration of persons with mental health problems. This study examined whether existing laws pose structural barriers in the realization of right to work and employment of persons with mental health problems across the world. It reviewed disability-specific, human rights legislation, and labour laws of all UN Member States in the context of Article 27 of the UN Convention on the Rights of Persons with Disabilities (CRPD). It wes found that laws in 62% of countries explicitly mention mental disability/impairment/illness in the definition of disability. In 64% of countries, laws prohibit discrimination against persons with mental health during recruitment; in one-third of countries laws prohibit discontinuation of employment. More than half (56%) the countries have laws in place which offer access to reasonable accommodation in the workplace. In 59% of countries laws promote employment of persons with mental health problems through different affirmative actions. Nearly 50 years after the adoption of the International Covenant on Economic, Social, and Cultural Rights and 10 years after the adoption of CRPD by the UN General Assembly, legal discrimination against persons with mental health problems continues to exist globally. Countries and policy-makers need to implement legislative measures to ensure non-discrimination of persons with mental health problems during employment
- …
