Social networks and service utilisation in patients with severe mental illness.
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Humans↗
Biomedical subjects
T Becker
Publications and source records attributed to T Becker.
The influence of citrate concentration on the quality of plasma obtained by automated plasmapheresis: a prospective study.
BACKGROUND: There is a need for more comprehensive work dealing with the quality of plasma collected by automated plasmapheresis using different final concentrations of citrate anticoagulant. A prospective study was performed to examine the influence of three concentrations of sodium citrate on the levels of clotting factors and markers of activated hemostasis and fibrinolysis. STUDY DESIGN AND METHODS: Fifty-one experienced plasma donors were recruited for subsequent 750-mL plasmapheresis procedures using 4-percent (wt/vol) sodium citrate. Anticoagulant-to-blood ratios of 1:16.6, 1:14.2, and 1:12.5 were used, corresponding to sodium citrate concentrations of 6 percent, 7 percent, and 8 percent (vol/vol), respectively. Between two plasmapheresis procedures, there was a washout period of 7 days. Determinations were made of the plasma levels of fibrinogen and factors V, VII, VIII, and IX, as well as antithrombin, tissue-type plasminogen activator, and several markers of activated hemostasis and fibrinolysis: activated factor VII, prothrombin splits products, D-dimers, and beta-thromboglobulin. RESULTS: The plasma samples anticoagulated with 6-percent citrate contained significantly higher levels of factors V, VIII, and IX than the samples anticoagulated with 8-percent citrate (p<0.0001, p< or =0.0001 and p = 0.009, respectively). The citrate concentration had no influence on the levels of fibrinogen, factor VII, antithrombin, or tissue-type plasminogen activator. There was no evidence that the plasma samples containing lower citrate concentrations were more prone to activation of hemostasis or fibrinolysis. CONCLUSION: A reduction in the final citrate concentration of plasma collected by automated plasmapheresis results in higher yields of factors V, VIII, and IX without activation of hemostasis. More comprehensive studies should confirm previous work dealing with the establishment of the lowest citrate concentration acceptable in plasma used as therapeutic fresh-frozen plasma or as starting material for the manufacture of plasma derivatives.
Adult↗
Women behind bars: health needs of inmates in a county jail.
OBJECTIVES: This study was performed to assess the prevalence of behavioral risk factors and correlates of poor self-reported health among incarcerated women in a county jail in Oregon. METHODS: The authors collected self-reported data from recently incarcerated women at a county jail, focusing on prevalence of high-risk health behaviors, history of health care use, history of physical and sexual abuse, and health care coverage. The authors assessed factors associated with poor self-reported health using logistic regression techniques. RESULTS: More than half of the participants reported a history of intravenous drug use, 67% reported a history of sexual abuse, 79% reported a history of physical abuse, and 43% stated that they had a history of trading sex for money or drugs. Two factors were associated with poor self-reported health: history of physical assault (odds ratio [OR] = 2.7; 95% confidence interval [CI] 1.4, 5.2) and use of heroin during the month prior to arrest (OR = 2.9; 95% CI 1.3, 6.6). CONCLUSIONS: The high prevalence of health risk behaviors among the inmates suggests a number of areas for intervention. These findings may also be used to guide topics addressed during intake interviews of new inmates, and to help identify inmates that require additional medical or social services.
Adult↗
Validity of a novel biopsy urease test (HUT) and a simplified 13C-urea breath test for diagnosis of Helicobacter pylori infection and estimation of the severity of gastritis.
This prospective study was designed to validate a novel biopsy urease test as well as a simplified 13C-urea breath test for the detection of Helicobacter pylori. In addition, the hypothesis was tested that both the reaction velocity of the urease test and the 13CO2 excess of the urea breath test may allow a prediction of the severity of gastritis. Seventy dyspeptic patients with unknown H. pylori status were included. The H. pylori status was assessed by means of culture and histology after Warthin and Starry stain. One antral and one body biopsy specimen were separately analyzed by the novel biopsy urease test (HUT). Also, a 13C-urea breath test using 75 mg 13C-labelled urea and orange juice as test meal was performed in all patients. Forty-seven patients (67%) were H. pylori positive as judged from histology and culture. In 46 patients, H. pylori infection was also detected by the novel biopsy urease test and by the urea breath test as well (sensitivity 97.9%). False-positive results were not observed by either method (specificity 100%). Both the reaction velocity of the urease test and the 13CO2 excess of the breath test significantly correlated with H. pylori density and grade and activity of gastritis. The determination coefficients, however, indicated that both methods allow a reliable prediction of the severity of gastritis only in about 40-50% of the patients. In conclusion, the novel biopsy urease test and the simplified 13C-urea breath test proved to be highly accurate in diagnosing H. pylori infection. Despite a significant correlation, neither the reaction velocity of the urease test nor the 13CO2 excess of the breath test are clinically useful for the prediction of the severity of gastritis.
Adolescent↗
Intestinal crypt lesions associated with protein-losing enteropathy in the dog.
Six dogs were diagnosed with protein losing enteropathy (PLE). There was no evidence of inappropriate inflammatory infiltrates or lymphangiectasia in multiple mucosal biopsies of the small intestine of 4 of the dogs. The 5th and 6th dogs had obvious lymphangiectasia and a moderate infiltrate of inflammatory cells in the intestinal mucosa. All 6 dogs had a large number of dilated intestinal crypts that were filled with mucus, sloughed epithelial cells, and/or inflammatory cells. Whether PLE occurs in these dogs because of protein lost from the dilated crypts into the intestinal lumen or whether the dilated crypts are a mucosal reaction due to another undetermined lesion that is responsible for alimentary tract protein loss is unknown. However, when large numbers of dilated intestinal crypts are present, they appear to be associated with PLE even if there are no other remarkable lesions in the intestinal mucosa.
Animals↗
[The role of health insurance in mental health care in Germany].
An outline of the German system of mental health care is given. A description of its organization, funding streams and service set-up is provided. Strengths and weaknesses are highlighted, and the system is contrasted with the organisation of mental health care in England and Wales.
Germany↗
[Surgery in the aged--status and consequences].
Surgery in advanced age is encumbered with hazards for the patient ensuing above all from his polymorbidity. Accordingly, postoperative mortality may be up to 30 per cent and, in special cases (ileus), may even be as high as 80 per cent. Although many operations are performed and excellent results can be presented, alternatives to the prevailing attitude of taking the present situation for granted are feasible. Such alternatives are offered by a specific prophylaxis focussing in the younger patient on conditions which will require on operation anyway and which, as experience shows, will lead to serious complications in old age. If these consequences are taken into account, old people can be spared many an operation.
Aged↗