Falloposcopy is a transvaginal microendoscopic technique to explore the
human Fallopian tube from the uterotubal ostium to the fimbrial end.
Falloposcopy provides a unique possibility to visualize endotubal disease
and may be used therapeutically for removal of debris and for cutting down
filmy intraluminal adhesions. To assess the clinical performance of
falloposcopy as part of an infertility investigation, a total of 43 women
scheduled for laparoscopy as part of an investigation of infertility had a
falloposcopy performed in conjunction with the laparoscopy. All women were
investigated at Danderyd Hospital, Stockholm and Akademiska Hospital,
Uppsala, during 1995 and 1996. Images from the endosalpinx were obtained in
26 of 43 women (60.5%). In 10 women (23.3%), it was possible to obtain
images from both tubes. No images were of sufficient quality to describe
the entire tubal mucosa in detail. Falloposcopy represents a unique tool
for visualization of endotubal disease and may provide a valuable
instrument for in-vivo exploration of tubal physiology. However, certain
technical problems limit the usefulness of this method in routine clinical
practice. These technical problems have to be solved before falloposcopy
can achieve a central position in investigation and treatment of tubal
disease.
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Thalidomide, clinically used as an antiinflammatory and antitumoral drug, inhibited sponge-induced angiogenesis when administered systemically (100 mg/kg–1) in mice. However, it failed to inhibit solid Ehrlich tumor in the same mouse strain. We have used functional, biochemical and histological parameters to assess neovascularization and fibrovascular tissue infiltration of the mice sponge granuloma. The neovascularization growth as detected by development of blood flow and hemoglobin content extracted from the implants showed that thalidomide inhibited fibrovascular tissue formation by 40%. The functional and biochemical parameters correlated well with the histological study. Thalidomide had no inhibitory effect in the development of Ehrlich tumor. The detection of this selective action using the same animal strain bearing two different processes, supports the hypothesis that rather than species specificity, thalidomide is tissue specific. This approach may be used to identify the specificity of other therapeutic agents against distinct angiogenesis-dependent diseases. 相似文献
Interstitial chromosomal deletions at 22q11.2 and 7q11.23 are detected in
the vast majority of patients affected by CATCH 22 syndromes and the
Williams-Beuren syndrome, respectively. In a group of 15 Williams- Beuren
patients, we have shown previously that a large number of 7q11.23 deletions
occur in association with an interchromosomal rearrangement, indicative of
an unequal crossing-over event between the two homologous chromosomes 7. In
this study, we show that a similar mechanism also underlies the formation
of the 22q11.2 deletions associated with CATCH 22. In eight out of 10
families with a proband affected by CATCH 22, we were able to show that a
meiotic recombination had occurred at the critical deleted region based on
segregation analysis of grandparental haplotypes. The incidences of
crossovers observed between the closest informative markers, proximal and
distal to the deletion, were compared with the expected recombination
frequencies between the markers. A significant number of recombination
events occur at the breakpoint of deletions in CATCH 22 patients (P =
2.99x10(-7)). The segregation analysis of haplotypes in three- generation
families was also performed on an extended number of Williams-Beuren cases
(22 cases in all). The statistically significant occurrence of meiotic
crossovers (P = 4.45x10(-9)) further supports the previous findings. Thus,
unequal meiotic crossover events appear to play a relevant role in the
formation of the two interstitial deletions. The recurrence risk for
healthy parents in cases where such meiotic recombinations can be
demonstrated is probably negligible. Such a finding is in agreement with
the predominantly sporadic occurrence of the 22q11.2 and 7q11. 23
deletions. No parent-of-origin bias was observed in the two groups of
patients with regard to the origin of the deletion and to the occurrence of
inter- versus intrachromosomal rearrangements.
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Prevention Science - The world youth population is the largest ever and the levels of problem behavior will influence future global health. Recognition of these issues raises questions as to... 相似文献
ObjectivesQuantify how observable characteristics contribute to influenza vaccination disparities among White, Black, and Hispanic nursing home (NH) residents.DesignRetrospective cohort.Setting and ParticipantsShort- and long-stay U.S. NH residents aged ≥65 years.MethodsWe linked Minimum Data Set (MDS) and Medicare data to LTCFocUS and other facility data. We included residents with 6-month continuous enrollment in Medicare and an MDS assessment between October 1, 2013, and March 31, 2014. Residents were classified as short-stay (<100 days in NH) or long-stay (≥100 days in NH). We fit multivariable logistic regression models to assess the relationships between 27 resident and NH-level characteristics and receipt of influenza vaccination. Using nonlinear Oaxaca-Blinder decomposition, we decomposed the disparity in influenza vaccination between White versus Black and White versus Hispanic NH residents. Analyses were repeated separately for short- and long-stay residents.ResultsOur study included 630,373 short-stay and 1,029,593 long-stay residents. Proportions vaccinated against influenza included 67.2% of White, 55.1% of Black, and 54.5% of Hispanic individuals among short-stay residents and 84.2%, 76.7%, and 80.8%, respectively among long-stay residents. Across 4 comparisons, the crude disparity in influenza vaccination ranged from 3.4 to 12.7 percentage points. By equalizing 27 prespecified characteristics, these disparities could be reduced 37.7% to 59.2%. Living in a predominantly White facility and proxies for NH quality were important contributors across all analyses. Characteristics unmeasured in our data (eg, NH staff attitudes and beliefs) may have also contributed significantly to the disparity.Conclusions and ImplicationsThe racial/ethnic disparity in influenza vaccination was most dramatic among short-stay residents. Intervening on factors associated with NH quality would likely reduce these disparities; however, future qualitative research is essential to explore potential contributors that were unmeasured in our data and to understand the degree to which these factors contribute to the overall disparity in influenza vaccination. 相似文献
BackgroundVancomycin is often used as antimicrobial prophylaxis in patients undergoing total hip or knee arthroplasty. Vancomycin requires longer infusion times to avoid associated side effects. We hypothesized that vancomycin infusion is often started too late and that delayed infusion may predispose patients to increased rates of surgical site infections and prosthetic joint infections.MethodsWe reviewed clinical data for all primary total hip arthroplasty (THA) and total knee arthroplasty (TKA) patients at our institution between 2013 and 2020 who received intravenous vancomycin as primary perioperative gram-positive antibiotic prophylaxis. We calculated duration of infusion before incision or tourniquet inflation, with a cutoff of 30 minutes defining adequate administration. Patients were divided into two groups: 1) appropriate administration and 2) incomplete administration. Surgical factors and quality outcomes were compared between groups.ResultsWe reviewed 1047 primary THA and TKA patients (524 THAs and 523 TKAs). The indication for intravenous vancomycin usage was allergy (61%), methicillin-resistant staphylococcus aureus colonization (17%), both allergy and colonization (14%), and other (8%). 50.4% of patients began infusion >30 minutes preoperatively (group A), and 49.6% began infusion <30 minutes preoperatively (group B). Group B had significantly higher rates of readmissions for infectious causes (3.6 vs 1.3%, P = .017). This included a statistically significant increase in confirmed prosthetic joint infections (2.2% vs 0.6%, P = .023). Regression analysis confirmed <30 minutes of vancomycin infusion as an independent risk factor for PJI when controlling for comorbidities (OR 5.22, P = .012).ConclusionLate infusion of vancomycin is common and associated with increased rates of infectious causes for readmission and PJI. Preoperative protocols should be created to ensure appropriate vancomycin administration when indicated. 相似文献
The current study examined the relevance of relationship functioning to partners’ agreement or consensus about joint effort surrounding COVID-19 prevention. Interdependence theory has been widely used to understand how relationship partners influence health behavior, including how sexual minority male (SMM) couples regulate HIV risk. Couples with better relationship functioning tend to be more successful at negotiating joint (shared) goals and subsequently accomplishing them. The study recruited 134 cis-male, SARS-CoV-2 negative adults in relationships with cis-male partners from phone-based social networking applications. Participants completed an online survey assessing relationship functioning (Perceived Relationship Components Questionnaire), COVID-19 prevention behaviors, and risk perceptions. Partners’ consensus around joint COVID-19 prevention effort was assessed using an adapted version of the Preferences for Sexual Health Outcomes scale. Path analyses indicated that consensus for joint prevention effort predicted social distancing (B?=?0.23; p?=?.001) and the number of other COVID-19 prevention behaviors engaged in (B?=?0.17; p?=?.003) above and beyond perceived risk and relationship functioning. Relationship satisfaction predicted higher levels of consensus for joint COVID-19 prevention effort (B?=?0.40; p?=?.029). Findings suggest that the theoretical foundations of successful HIV prevention interventions that utilize joint goal formation may generalize to the prediction of COVID-19 prevention behavior and may be leveraged to mitigate the risk of SARS-CoV-2 infection among SMM in relationships. Interventions that overlook the potential for dyadic regulation of health behavior may miss opportunities to capitalize on shared coping resources and fail to address relational barriers to prevention.
The objective of this study was to determine nitric oxide (NO) and superoxide anion release (O
2–
) by neutrophils (PMNs) in the septic multiple organ dysfunction syndrome (MODS) and to compare them with the response of normal cells to lipopolysaccharide (LPS) and cytokines. NO production was measured by the release of nitrites in the medium, its maximal production rate by a modified oxyhemoglobin assay and O
2–
by standard methods. Normal cells were incubated with LPS, gamma interferon (IFN-), or tumor necrosis factor (TNF-) alone or in combination. Results showed that PMN release of both NO and O
2–
was reduced in septic samples; in contrast, an association of LPS, IFN-, and TNF- promoted maximal NO release by normal cells (40–50%). We conclude that while interaction of normal PMNs with cytokines increases NO and O
2–
release, progression of sepsis to a multiple organ dysfunction impairs these responses in both functions. 相似文献