720 research outputs found
Tipps und Tricks in der Behandlung offener Handverletzungen in der Notfallpraxis
No full textTreatment of acute injuries of the hand Abstract. Injuries to the hand are a common presentation in primary care units. When accurately assessed, many open injuries may be handled in the emergency department without referral to a hand surgery specialist. We would like to give some recommendations on how to treat the most frequent injuries like lesions to the nail and nailbed, fingertip amputation as well as burns, infections and bites. But first, we highlight the different methods of local anesthesia and discuss the use of a tourniquet or vasoconstriction with adrenalin - WALANT - instead
Ranibizumab and Bevacizumab but Not Aflibercept Inhibit Proliferation of Primary Human Retinal Pigment Epithelium in vitro.
No full textAIM
Treatment of exudative age-related macular degeneration by using vascular endothelial growth factor (VEGF) antagonists is the gold standard today. So far, several bioactive molecules have been approved for therapeutic use. In this study, we investigate the effects of ranibizumab (Lucentis®), bevacizumab (Avastin®), and aflibercept (Eylea®) on primary human retinal pigment epithelial (hRPE) cells in vitro.
METHODS
hRPE cells were prepared from donor eyes and cultured under standard culture conditions. Scleral fibroblasts also prepared from donor tissue served as physiological controls. The impact of the anti-VEGF molecules on cell viability was investigated with the trypan blue exclusion assay, whereas proliferation was measured using the MTT assay. Biological activity of the molecules was quantified in a VEGF-enzyme-linked immunosorbent assay (ELISA).
RESULTS
All tested substances were biologically active in vitro. They displayed no cytotoxicity on RPE cells or scleral fibroblasts. However, proliferation of RPE cells was significantly decreased after treatment with ranibizumab or bevacizumab but not with aflibercept.
CONCLUSIONS
The humanized antibodies (fragments) interfered specifically with the RPE cells. The thereby measured inhibition of cell proliferation may indicate possible side effects on the physiology of RPE cells
Bone-Preserving Arthroplasty With Abductor Pollicis Longus Tenodesis for Trapeziometacarpal Osteoarthritis.
No full textPurpose
The objective of this study was to describe an original method of bone-preserving arthroplasty with abductor pollicis longus (APL) tenodesis and determine its safety and effectiveness as a treatment for early-stage osteoarthritis of the trapeziometacarpal joint.
Methods
Eleven patients underwent a trapezium-preserving arthroplasty with APL tenodesis for stage 1 and 2 osteoarthritis were retrospectively reviewed. This arthroplasty consisted of a distally-based APL tendon being passed through the trapeziometacarpal joint. The proximal end of the tendon was then pulled and passed through a drill hole made at the neck of the second metacarpal and sutured to itself. Thus, distraction of the first metacarpal and interposition of the tendon were created. Postoperative radiologic and clinical follow-up visits were performed at 4, 8, and 12 weeks. Range of motion and strength were assessed after surgery. Patient satisfaction and outcome were assessed, and the disabilities of the arm, shoulder, and hand (DASH) score was used.
Results
After a mean follow-up of 29.5 months (range, 16-43 months), the mean patient visual analog scale pain score improved from 7.1 to 2.3. The average DASH score of all patients at the follow-up examination was 18.3 ± 19.8. Patients' mean grip strength was 25.3 kg, which represented 102% of the value on the contralateral side. The key-pinch strength was 6.2 kg on the operated hand compared with 6.5 kg on the contralateral side. The mean thumb opposition Kapandji index was 9.4, which was similar to that of the contralateral side. Three patients were very satisfied with the postoperative outcome and 3 patients were satisfied. Two patients were lost to follow-up, 1 patient did not consent to share her data, and 2 patients had to undergo trapeziectomy.
Conclusions
Although a larger study population and a longer follow-up period are needed to draw conclusions, bone-preserving arthroplasty with APL tenodesis showed satisfying results in patients presenting with early-stage osteoarthritis. This method is technically simple and time-efficient, does not reduce the range of motion, and leaves open all other surgical options.
Type of study/level of evidence
Therapeutic IV, Case Series
Giedion and America: Repositioning the History of Modern Architecture
No full textSigfried Giedion (1888–1968), one of the main protagonists of the architectural avant-garde in Europe, paradoxically achieved this reputation in America, far from his homeland. Nearly all of Giedion’s books written after his initial stay at Harvard University were published in English long before they became available in his native German. Reto Geiser sheds new light on Giedion’s life and reassesses his work through the lens of cultural transformation and modernization processes. The author questions the unbroken line of developments portrayed in the historiography of modern architecture, and argues that Giedion’s position in between two cultural spheres not only caused ruptures and contradictions in his work but also productively shaped its reception on either side of the Atlantic
Reto y confrontación en el enfoque centrado en la persona
No full textIn this article the role of the challenge in the person centered approach is analized. With this aim the author has planned a small-scale research study using an open questionaire with a sample of 10 therapists and 15 clients. From this study it would appear that challenge, in terms of the opportunities and freedoms offered by the core conditions, is an integral part of the person centered approach.En este artículo la autora reflexiona sobre el papel que juegan el reto y la confrontación en el enfoque centrado en la persona. A este fin se plantea un estudio a pequeña escala a través de un cuestionario suministrado a una muestra reducida de diez terapeutas y quince clientes. Del análisis de sus resultados se deduce que reto y confrontación, en términos de nuevas oportunidades y alternativas son elementos nucleares del enfoque centrado en la persona
Farmacetiskā aprūpe un tās uzlabošanas iespējas Reto slimību pacientiem
No full textVeselības vadībaVeselības aprūpeHealth ManagementHealth CareFarmaceitiskā aprūpe un tās būtiskā nozīme pacientu veselības aprūpē ir jau gadiem aktuāla tēma farmaceitu darba ikdienā. Pieaugot reto slimību diagnostikai, pētniecībai un ārstēšanas iespējām, aptiekās pieaug arī medikamentu pieejamība šo slimību pacientiem. To, kādas ir farmaceitu zināšanas par reto slimību pacientiem, to diagnozēm un pielietojamo medikamentozo terapiju, pētīja darba autore.
Maģistra darba tēma ir “Farmaceitiskā aprūpe un tās uzlabošanas iespējas reto slimību pacientiem Latvijā”. Maģistra darba mērķis bija izpētīt farmaceitisko aprūpi reto slimību pacientiem un izstrādāt priekšlikumus tās pilnveidošanai Latvijā.
Pētījuma jautājumi:
1. Kādas konceptuālās pieejas pastāv un kāda ir starptautiskā prakse reto slimību pacientu farmaceitiskajā aprūpē?
2. Kāds ir reto slimību pacientu aprūpes un medikamentozās ārstēšanas nodrošinājums Latvijā?
3. Kāds ir farmaceitu pieejamās informācijas, zināšanu un profesionālās pieredzes līmenis par retajām slimībām un to medikamentozo ārstēšanu?
Hipotēze: Farmaceitiskā aprūpe reto slimību pacientiem būtiski atšķiras no tradicionālās farmaceitiskās aprūpes. Hipotēze tiek apstiprināta ar šādiem pētījuma secinājumiem:
1. 38% respondentu jeb 43 farmaceiti daļēji iztaujā pacientus par viņu diagnozēm un lietotajiem medikamentiem, savukārt 23% jeb 26 farmaceiti neuzdod pacientiem jautājumus par blakusslimībām vai lietotajiem medikamentiem, kā arī pacienti farmaceitiem neatklāj savas diagnozes, tādējādi neveidojas dialogs, kura laikā var tikt sniegta kvalitatīva farmaceitiskā aprūpe.
2. 70% jeb 80 farmaceitu uzskata, ka farmaceitiskās aprūpes plāns retu slimību pacientam ir nepieciešams, 83% jeb 5 eksperti uzskata, ka nav nepieciešams, kā arī 100% jeb visi 4 pacienti atbildēja, ka aptiekā nav nepieciešams farmaceitiskās aprūpes plāns reto slimību pacientiem.
Maģistra darbā ir 95 lappuses, 3 pielikumi, 22 tabulas, 14 attēli un 57 literatūras avoti.Pharmaceutical care and its essential role in patient health care has been a topical issue in the daily work of pharmacists for years. As the diagnosis, research and treatment options for rare diseases increase, so does the availability of medicines in pharmacies.
What is the knowledge of pharmacists about patients with rare diseases, their diagnoses and applicable drug therapy researched by the author of the paper.
Master's thesis topic Pharmaceutical care and its improvement opportunities for rare disease patients in Latvia.
The aim of the master's thesis is to study pharmaceutical care for patients with rare diseases and to develop proposals for its improvement in Latvia.
Research questions
1. What conceptual approaches exist and what is the international practice in pharmaceutical care for patients with rare diseases?
2. What is the provision of care and medical treatment for patients with rare diseases in Latvia?
3. What is the level of information, knowledge and professional experience available to pharmacists on rare diseases and their medical treatment?
Hypothesis: Pharmaceutical care for patients with rare diseases differs significantly from traditional pharmaceutical care. The hypothesis is confirmed by the following conclusions of the study:
1. 38% of respondents, or 43 pharmacists, partially ask patients about their diagnoses and medications, 23% or 26 pharmacists do not ask patients questions about co-morbidities or medications used, patients do not disclose their diagnoses to pharmacists, thus there is no dialogue during which quality pharmaceutical care can be provided.
2. 70% or 80 pharmacists believe that a pharmaceutical care plan for a rare disease patient is necessary, 83% or 5 experts believe that it is not necessary, as well as 100% or all 4 patients answered that a pharmacy does not need a pharmaceutical care plan for a rare disease patient.
Master's thesis consists of 95 Pages, 3 Appendice, 22 tables, 14 figures, and 57 literature sources
LA "SIEMBRA DEL PETRÓLEO": UN RETO PERENNE
No full textEl autor, desarrolla en este trabajo, la compleja y rica discusiva en torno a la industria del petróleo en Venezuela, destacando los aportes de paradigmas del pensamiento como Juan Pablo Pérez Alfonzo, ex- ministro de Energía y Minas en 1945 y 1958. La tesis de la "Siembra del Petróleo" expuesta por Arturo Uslar Pietri, y otros autores, se presenta como un reto permanente de las sociedades petroleras como la venezolana. Aunque comparte la orientación social de la actual política del gobierno del presidente Hugo Chávez, critica la voracidad del gasto fiscal. ABSTRACT The author develops in this work a rich and complex discussion about the oil industry in Venezuela emphasizing the contributions of paradigms of the thought like Juan Pablo Perez Alfonzo, ex- energy and mines minister in 1945 and 1958. The thesis of the sowing of oil (sembrar el petróleo) exposed by Arturo Uslar Pietri and other authors appears like a permanent challenge for oil societies like the Venezuelan. Although sharing the social direction of the current oil policy of president Chavez government, the author criticizes its voracity on the fiscal cost
Comunicación Global. El Reto Gerencial
No full textMax Römer PierettiLa responsabilidad de los gerentes en el ámbito de las comunicaciones de su empresa hace vital el conocimiento de las herramientas filosóficas y políticas que pueden mover a su e,presa hacia el camino del éxtio. Manejar las herramientas de la comunicación globla será el elemento diferenciador de las empresas en un futuro no muy lejano.Este artículo es una síntesis del libro Comunicación Global: el reto gerencial, el cual a su vez es un resumen de la tesis con el mismo nombre, que permitió al autor obtener su doctorado en Ciencias de la Información en la Universidad de La Laguna, Tenerife, España.AbstractThe responsability of the managers in the ambit of communications in their companies, make vital the knowledge of the philosophical and political tools that can move their enterprises towards the road of success. Handling the tools of global communication will be the differentiating element of enterprises in a not far away future.This article is a synthesis of the book Global Communications: The Managing Challenge, which is summary of the thesis with the same name that permitted the author obtain his doctorate in Sciences of the Information in the University of La Laguna, Tenerife, Spain
Markers for silent atrial fibrillation in esophageal long-term electrocardiography.
No full textPURPOSE
Paroxysmal atrial fibrillation (PAF) often remains undiagnosed. Long-term surface ECG is used for screening, but has limitations. Esophageal ECG (eECG) allows recording high quality atrial signals, which were used to identify markers for PAF.
METHODS
In 50 patients (25 patients with PAF; 25 controls) an eECG and surface ECG was recorded simultaneously. Partially A-V blocked atrial runs (PBARs) were quantified, atrial signal duration in eECG was measured.
RESULTS
eECG revealed 1.8‰ of atrial premature beats in patients with known PAF to be PBARs with a median duration of 853ms (interquartile range (IQR) 813-1836ms) and a median atrial cycle length of 366ms (IQR 282-432ms). Even during a short recording duration of 2.1h (IQR 1.2-17.2h), PBARs occurred in 20% of PAF patients but not in controls (p=0.05). Left atrial signal duration was predictive for PAF (72% sensitivity, 80% specificity).
CONCLUSIONS
eECG reveals partially blocked atrial runs and prolonged left atrial signal duration - two novel surrogate markers for PAF
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