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PubMedDate not supplied

Attitude of women of NWFP towards antenatal care.

BACKGROUND: A safe motherhood initiative is a global effort to reduce maternal mortality and morbidity. This aims to ensure improvement in the quality and safety of lives of women through adoption of health and non-health strategies. Antenatal care is a branch of preventive medicine dealing with prevention and early detection of pregnancy disorders. It is the key to modern obstetrics. METHODS: It was a descriptive type of study to find out the attitude of the women towards utilization of antenatal care facility at a newly commissioned hospital, Hayatabad Medical Complex, Peshawar, Pakistan in the first year of its working. RESULTS: We recorded 980 patients. All of them were married. Monthly attendance showed increasing trend. In this study 72.44% of the women were of 25-35 year of age while 11.42% were teenager. Multiparity was recorded in 38.97% and 12.14% had more then nine pregnancies. Six hundred and fifty patients were living near the hospital. 2.24% patients visited more than six times and 63.26% had one visit only, with the rest visiting for 2-5 times. Thirty patients had medical disorders. Obstetrical diseases were detected in 194 patients. Pregnancy losses contributed to 146 women and 3 women had more then 6 losses. 254 women selected hospital delivery. Out of then 160 women were booked in the 3rd trimester. Caesarean section rate among those women was 16.4%. CONCLUSIONS: The conclusion drawn was that the women living near the hospital used the facility. Antenatal care should be provided to the women at the doorstep of their house. There is a system of lady health workers that should be expanded to cover all areas. Basic health units must be fully equipped and staffed. Communication system should be improved. There is a need to include health education in the curricula of primary education.

Attitude to Health↗
PubMed2004

State of the science in brain tumor classification.

OBJECTIVES: To review the incidence of metastatic and primary brain tumors and the most widely used brain tumor classification systems, and to discuss discoveries advancing the understanding, classification, and grading of selected brain tumor histologies. DATA SOURCES: Journal articles, text books, epidemiologic and statistical reports. CONCLUSION: Recent advances in understanding the molecular biology of brain tumors have shown that molecular and genetic signatures may predict brain tumor behavior and may soon guide tumor classification, diagnosis, and tumor-specific treatment strategies. IMPLICATIONS FOR NURSING PRACTICE: Understanding recent advances in the molecular biology of brain tumors is important because these advances may soon guide treatment decisions. New tumor-specific therapeutic opportunities may improve outcomes as well as the care of persons with brain tumors.

Astrocytoma↗
PubMedDate not supplied

Betelnut chewing: a contributing factor to the poor glycaemic control in diabetic patients attending Port Moresby General Hospital, Papua New Guinea.

This descriptive study was conducted in the Diabetes Clinic of the Port Moresby General Hospital for 6 months, from July to December 2002. The aim was to document the usage and effects of betelnut chewing in diabetic patients. 210 patients were randomly selected from the list of patients in the appointment book, using a random number table. Betelnut chewing caused hyperglycaemia and diabetes mellitus in animal models. It was significantly associated with high fasting capillary blood glucose and was an independent risk factor for type 2 diabetes mellitus. In this study, the majority of patients with diabetes were in the older age group (> or = 45 years) and many of them were overweight or obese. The majority of patients had lived in the city of Port Moresby for many years before their diagnosis. 74% of diabetic patients chewed betelnut before their diagnosis and had continued the habit while undergoing treatment for diabetes. The majority (80%) of patients had poor glycaemic control as indicated by the high mean of their most recent blood glucose, which was 13.0 mmol/l in male and 13.1 mmol/l in female patients; these levels were not much lower than those at diagnosis. The mean follow-up of patients in the clinic was 6.2 years. On the balance of evidence, betelnut is a contributing factor to the poor glycaemic control in diabetic patients attending Port Moresby General Hospital.

Age Factors↗
PubMed1991

Paraphilias in U.S. pornography titles: "pornography made me do it" (Ted Bundy).

In 1986, the U.S. Commission on pornography reviewed 3,050 separate magazine and book titles sold in "adults only" pornographic outlets randomly selected in Washington, DC; Baltimore, MD; Miami, FL; Philadelphia, PA; New York, NY; and Boston, MA. Of these, 746 titles could be assigned to a DSM III-R paraphilia category (513 titles if the category partialism is excluded). Incest was listed as a category separately from pedophilia. Thus, 16.8 percent of the titles could be assigned to a paraphilia category (24.4% of all titles, if partialism is included as a category). Paraphilia distribution is discussed. Sadomasochism was by far the most common paraphilia (49.9%) while incest titles comprised 21.4 percent of the perversions. The frequency distribution for the U.S. material is compared with titles reviewed by the Victoria (Australia) State Classification of Publications Board and previously reported by the author.

Erotica↗
PubMed1995

Motor proteins 1: kinesins.

Progress regarding the kinesins is now being made at a rapid and accelerating rate. The in vivo-functions, and biophysical and enzymatic properties of kinesin itself are being explored at ever increasing levels of detail. The kinesin-related proteins now number several dozen, and although more is known about primary structure than function for most of the proteins, this trend is already reversing. For example, knowledge about the kinesin-related protein, ncd, is expanding rapidly, and more is already known about its three-dimensional structure than is known for kinesin heavy chain. This volume presents a comprehensive review of the major published works on kinesin and kinesin-related proteins. Hopefully, this manuscript will complement other recent review articles [17, 20, 25, 37, 60-62, 67, 69, 75, 85-88, 231, 233, 238, 244, 269-271, 281, 282, 292] or books [49, 227, 293] that have focused on more selective aspects of the kinesin family, or have been aimed more generally at MT motor proteins. In line with the stated purpose of the Protein Profile series, annual updates of the review on the kinesins are planned for at least the next few years.

Animals↗
PubMed1998

Dysafferentation: a novel term to describe the neuropathophysiological effects of joint complex dysfunction. A look at likely mechanisms of symptom generation.

BACKGROUND AND OBJECTIVES: Since the founding of the chiropractic profession, very few efforts have been made to thoroughly explain the mechanism(s) by which joint complex dysfunction generates symptoms. Save for a few papers, only vague and physiologically inconsistent descriptions have been offered. The purpose of this article is to propose a precise and physiologically sound mechanism by which symptoms may be generated by joint complex dysfunction. DATA SOURCES: The data was accumulated over a period of years by reviewing contemporary articles and books, and subsequently retrieving relevant papers. Articles were also selected from volumes 1-4 of the Chiropractic Research Archives Collection. The Nexus, published by the David D. Palmer Health Sciences Library, and In Touch, published by Logan College of Chiropractic Library, were reviewed and relevant articles were retrieved. Medline searches were found to be ineffective because appropriate key indexing terms were difficult to identify. DATA SYNTHESIS: The symptoms generated by joint complex dysfunction, such as pain, nausea and vertigo, are probably caused by increased nociceptive input and/or reduced mechanoreceptive input. CONCLUSIONS: Joint complex dysfunction should be included in the differential diagnosis of pain and visceral symptoms because joint complex dysfunction can often generate symptoms which are similar to those produced by true visceral disease.

Afferent Pathways↗
PubMed1992

A process-oriented approach. Selecting a nursing model for psychiatric nursing.

The nursing literature is replete with articles and books that describe nursing conceptual frameworks and models and encourage their use in clinical, education, and research activities. Although much information exists on the content of nursing models, less has been written about how a model is to be chosen and the process that may facilitate the choice of a model. This article reviews potential benefits and limitations of nursing models and conceptual frameworks and describes a three-phase process for selecting a model for psychiatric nursing practice.

Choice Behavior↗
PubMed1983

A comparison of low-risk pregnant women booked for delivery in two systems of care: shared-care (consultant) and integrated general practice unit. II. Labour and delivery management and neonatal outcome.

A random sample of low-risk pregnant women were equally divided into four groups of 63 nulliparae and multiparae each booked for care in a integrated general practice unit (GPU) and a shared-care (consultant) system. Selection criteria included only women who were admitted because they were in spontaneous labour or thought they were. Nulliparous women booked for shared-care came into hospital at a less advanced state of cervical dilatation than those booked for the GPU and spent longer (11 compared with 8 h) in hospital before delivery; the comparable durations in multiparae were 6 and 4 h. Both the first and second stages of labour were longer in the GPU-booked women but they received less pethidine and fewer had epidural analgesia; they received less electronic fetal monitoring, augmentation and forceps delivery, and fetal distress was diagnosed less often. The 1-min Apgar score was less than or equal to 6 in 17.5% of infants of nulliparae booked for the shared-care system compared with 1.6% of those booked for the GPU. The intubation rate of infants of nulliparae was 11% in the shared-care system compared with no intubations in the GPU. These comparisons demonstrate the simplicity and safety of delivery of low-risk women in the GPU as compared with deliveries of similar women in a shared-care (consultant) unit.

Adolescent↗
PubMed2000

Psychological therapies for sickle cell disease and pain.

BACKGROUND: Sickle cell disease comprises of a group of genetic blood disorders, and occurs when the sickle cell haemoglobin gene is inherited from both parents. The effects of the condition are: varying degrees of anaemia which if severe reduce the capacity for mobility; predisposition to obstruction of small blood capillaries causing pain in muscle and bone known as "crises"; damage to major organs such as the spleen, liver, kidneys, and lungs; and increased vulnerability to severe infections. There are both medical and non-medical complications, and treatment is usually symptomatic and palliative in nature. Psychological intervention for individuals with sickle cell disease seems viable in complementing current medical treatment, and studies examining their efficacy appear to have also yielded encouraging results. OBJECTIVES: To examine the evidence that in patients with sickle cell disease, psychological treatment improves the ability to cope with the condition. SEARCH STRATEGY: The Cochrane Cystic Fibrosis and Genetic Disorders Group specialist trials register which comprises references from comprehensive electronic database searches, handsearching relevant journals and handsearching abstract books of conference proceedings. Also, searches on the Internet were performed. SELECTION CRITERIA: All randomised or quasi-randomised controlled trials comparing the use of psychological intervention to no (psychological) intervention in patients with sickle cell disease. DATA COLLECTION AND ANALYSIS: The following outcomes were assessed: pain, mood, coping, health service utilisation, general health, quality of life, and life satisfaction. MAIN RESULTS: Four trials which reported results were all found to be unsuitable for inclusion at the present time, owing to incomplete data in the published papers. REVIEWER'S CONCLUSIONS: Psychological approaches are commonly used in an attempt to improve coping ability in patients with sickle cell disease. No conclusions can be made about the use of specific psychological therapies in sickle cell disease from the information currently available. This systematic review has clearly identified the need for well designed, adequately-powered, multicentre, RCTs assessing the effectiveness of specific interventions in sickle cell disease.

Adaptation, Psychological↗
PubMed1997

Controversies surrounding estrogen use in postmenopausal women.

OBJECTIVE: To provide an overview of controversies regarding the use of estrogen in postmenopausal women. DATA SOURCES: A MEDLINE search was conducted to identify pertinent literature published since 1990. Recently published textbooks devoted to the subjects of menopause and women's health were also reviewed, particularly their bibliographies. The bibliographies of selected review articles were also reviewed. STUDY SELECTION: Due to the vast amount of literature, only the most relevant published studies were reviewed. Review articles and book chapters authored by researchers of international reputation were also reviewed. DATA EXTRACTION: Identified studies from the primary literature and selected reviews were carefully reviewed. Information regarding the use of estrogen in postmenopausal women was extracted. Particular attention was given to areas of controversy commonly dealt with in the lay media. DATA SYNTHESIS: The number of postmenopausal women in the US will approach 60 million in the next decade. Despite numerous potential benefits, many women elect to not take estrogen due to fear of cancer or poor understanding of the long-term consequences of menopause and the beneficial effects of estrogen replacement therapy. Many women rely on the news media for information about hormone therapy and subsequently become confused regarding the benefits and risks. Estrogen relieves climacteric symptoms such as hot flushes and symptoms related to genitourinary tissue atrophy. Outcomes from controlled clinical trials are lacking, but numerous epidemiologic studies document clinically significant decreases in cardiovascular disease and osteoporotic morbidity and mortality. Unopposed estrogen increases the risk for endometrial cancer, but addition of a progestin for at least 10 days per cycle effectively reduces this risk to that of women who do not take estrogen. The association between postmenopausal estrogen use and breast cancer remains controversial, despite the results of numerous observational studies. This uncertainty regarding estrogen replacement and breast cancer risk can actually be reassuring when placed in proper perspective. CONCLUSIONS: Until some of the controversies surrounding postmenopausal hormone use are resolved, an objective discussion with a knowledgeable healthcare professional regarding the potential benefits and risks will help women make informed decisions regarding estrogen replacement therapy in the postmenopausal years.

Aged↗
PubMed1998

A comparative study of routine versus selective fetal anomaly ultrasound scanning.

OBJECTIVES: To evaluate the cost-benefit of changing from selective (high risk) to routine ultrasound screening for fetal anomaly. SETTING: Women booked by general practitioners for primary antenatal care at their local hospital. METHODS: Prospective study of the 12 months before and after introduction of routine second trimester ultrasound for fetal anomaly at our institution. All congenital abnormalities, mode of detection, and outcome were recorded and a cost analysis of the programme attempted. RESULTS: In the 12 months of selective (high risk) ultrasound policy, detailed second trimester scans were performed in 1007 (26%) pregnancies. In the 12 months of routine ultrasound anomaly screening, scans were performed in 3529 (93%) pregnancies. Routine ultrasound was the sole method of detection for 11 major and 18 less severe congenital abnormalities found in low risk pregnancies which would not previously have qualified for high risk ultrasound. In seven of these cases the parents opted for termination of pregnancy, with estimated savings on treatment and long term care of 1,015,546 pounds. The financial cost of providing the ultrasound screening service at our hospital for 12 months was calculated at 57,573 pounds and the resulting financial benefit for the year was estimated at 957,973 pounds. CONCLUSION: Although it is recognised that many of the emotional and psychological costs and benefits of the service are difficult to evaluate, routine fetal anomaly ultrasound would seem to be economically justifiable. The financial savings achieved at our hospital would translate into a potential annual saving for the National Health Service of nearly 170 million pounds if screening were offered in all hospitals in England and Wales.

Cohort Studies↗
PubMed2000

Antifungal therapies for allergic bronchopulmonary aspergillosis in people with cystic fibrosis.

BACKGROUND: Allergic Bronchopulmonary Aspergillosis (ABPA) is an allergic reaction to colonisation of the lungs with the fungus Aspergillus fumigatus and affects around 10% people with cystic fibrosis. ABPA is associated with an accelerated decline in lung function. Corticosteroids, in high doses, are the main treatment for ABPA although the long-term benefits are not clear and their many side effects are well documented. A group of compounds, the azoles, have activity against Aspergillus fumigatus and have been proposed as an alternative treatment for ABPA. Of this group, Itraconazole is the most active. A separate antifungal compound, Amphotericin B has been employed in aerosolised form to treat invasive infection with Aspergillus fumigatus, and may have potential for the treatment of ABPA. Antifungal therapy for ABPA in cystic fibrosis needs to be evaluated. OBJECTIVES: The review tested the hypotheses that antifungal interventions for the treatment of ABPA in cystic fibrosis: 1. improve clinical status compared to placebo or standard therapy (no placebo); 2. do not have unacceptable adverse effects. If benefit was demonstrated, the optimal type, duration and dose of antifungal therapy was assessed. SEARCH STRATEGY: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group specialist trials register which comprises references identified from comprehensive electronic database searches, handsearching relevant journals and handsearching abstract books of conference proceedings. In addition, pharmaceutical companies were approached. SELECTION CRITERIA: Randomised controlled trials, published or unpublished, where antifungal treatments have been compared to either placebo or no treatment, or where different doses of the same treatment have been used in the treatment of ABPA in patients with cystic fibrosis. DATA COLLECTION AND ANALYSIS: No completed randomised controlled trials were identified. MAIN RESULTS: No completed randomised controlled trials were identified. REVIEWER'S CONCLUSIONS: At present, there are no randomised controlled trials to evaluate the use of antifungal therapies for the treatment of ABPA in people with cystic fibrosis. Trials with clear outcome measures are needed to properly evaluate this potentially useful treatment for cystic fibrosis.

Adult↗
PubMed2005

Prophylactic cranial irradiation for preventing brain metastases in patients undergoing radical treatment for non-small cell lung cancer.

BACKGROUND: In non-small cell lung cancer (NSCLC), there is a relatively high incidence of brain metastases following radical treatment. At present, the role of prophylactic cranial irradiation (PCI) in this group of patients is not clear. OBJECTIVES: To investigate whether PCI has a role in the management of patients with NSCLC treated with radical intent. SEARCH STRATEGY: The electronic databases MEDLINE, EMBASE and Cancerlit, along with handsearching of journals, relevant books, and review articles used to identify potentially eligible trials. SELECTION CRITERIA: Randomised controlled trials (RCTs) comparing PCI with no PCI in NSCLC patients treated with radical intent. DATA COLLECTION AND ANALYSIS: Four RCTs were reviewed. Due to the small patient numbers, and variations in radiotherapy (RT) dose, no meta-analysis was attempted. MAIN RESULTS: PCI may reduce the incidence of brain metastases, but there is no evidence of a survival benefit. There is no evidence that any regimen is superior, and the effect of PCI on quality of life (QOL) is not known. AUTHORS' CONCLUSIONS: There is insufficient evidence to support the use of PCI in clinical practice. Where possible, patients should be offered entry into a clinical trial.

Brain Neoplasms↗
PubMed1998

[Surgery of the supratentorial and ventral spine: view-point of the surgeon].

The prone position for posterior fossa and cranio-spinal surgery is becoming the standard posture for neurosurgical teams. We analyze the reasons of such a change and specify indications of this posture. Thereafter, the procedure for optimal positioning is considered and the benefits of the prone position for the neurosurgeon and the anaesthetist are discussed. The selected references originate from Medline search (1991-1997), the Year Book of Neurology and Neurosurgery and the major neurosurgical review articles published between 1980 and 1996.

Humans↗
PubMedDate not supplied

The diet-induced proinflammatory state: a cause of chronic pain and other degenerative diseases?

BACKGROUND: It is the rare physician who includes diet therapy and nutritional supplements in patient care. Perhaps this is because chiropractic and medical schools devote very few classroom hours to nutrition. It is also possible that physicians are under the misconception that a detailed biochemical understanding of each individual disease is required before nutritional interventions can be used. OBJECTIVE: The purpose of this article is two-fold: (1) to demonstrate that chronic pain and other degenerative conditions encountered in clinical practice have similar biochemical etiologies, such as a diet-induced proinflammatory state, and (2) to outline a basic nutritional program that can be used by all practitioners. DATA SOURCES: The data were accumulated over a period of years by reviewing contemporary articles and books and subsequently by retrieving relevant articles. Articles were also selected through MEDLINE and manual library searches. RESULTS: The typical American diet is deficient in fruits and vegetables and contains excessive amounts of meat, refined grain products, and dessert foods. Such a diet can have numerous adverse biochemical effects, all of which create a proinflammatory state and predispose the body to degenerative diseases. It appears that an inadequate intake of fruits and vegetables can result in a suboptimal intake of antioxidants and phytochemicals and an imbalanced intake of essential fatty acids. Through different mechanisms, each nutritional alteration can promote inflammation and disease. CONCLUSION: We can no longer view different diseases as distinct biochemical entities. Nearly all degenerative diseases have the same underlying biochemical etiology, that is, a diet-induced proinflammatory state. Although specific diseases may require specific treatments, such as adjustments for hypomobile joints, beta-blockers for hypertension, and chemotherapy for cancer, the treatment program must also include nutritional protocols to reduce the proinflammatory state.

Antioxidants↗
PubMed2005

Genomic profiling of neutrophil transcripts in Asian Qigong practitioners: a pilot study in gene regulation by mind-body interaction.

BACKGROUND AND OBJECTIVES: The great similarity of the genomes of humans and other species stimulated us to search for genes regulated by elements associated with human uniqueness, such as the mind-body interaction. DNA microarray technology offers the advantage of analyzing thousands of genes simultaneously, with the potential to determine healthy phenotypic changes in gene expression. The aim of this study was to determine the genomic profile and function of neutrophils in Falun Gong (FLG, an ancient Chinese Qigong) practitioners, with healthy subjects as controls. SUBJECTS AND DESIGN: Six (6) Asian FLG practitioners and 6 Asian normal healthy controls were recruited for our study. The practitioners have practiced FLG for at least 1 year (range, 1-5 years). The practice includes daily reading of FLG books and daily practice of exercises lasting 1-2 hours. Selected normal healthy controls did not perform Qigong, yoga, t'ai chi, or any other type of mind-body practice, and had not followed any conventional physical exercise program for at least 1 year. Neutrophils were isolated from fresh blood and assayed for gene expression, using microarrays and RNase protection assay (RPA), as well as for function (phagocytosis) and survival (apoptosis). RESULTS: The changes in gene expression of FLG practitioners in contrast to normal healthy controls were characterized by enhanced immunity, downregulation of cellular metabolism, and alteration of apoptotic genes in favor of a rapid resolution of inflammation. The lifespan of normal neutrophils was prolonged, while the inflammatory neutrophils displayed accelerated cell death in FLG practitioners as determined by enzyme-linked immunosorbent assay. Correlating with enhanced immunity reflected by microarray data, neutrophil phagocytosis was significantly increased in Qigong practitioners. Some of the altered genes observed by microarray were confirmed by RPA. CONCLUSION: Qigong practice may regulate immunity, metabolic rate, and cell death, possibly at the transcriptional level. Our pilot study provides the first evidence that Qigong practice may exert transcriptional regulation at a genomic level. New approaches are needed to study how genes are regulated by elements associated with human uniqueness, such as consciousness, cognition, and spirituality.

Adult↗
PubMed2004

Low concentrations of maternal thyroxin during early gestation: a risk factor of breech presentation?

OBJECTIVE: To evaluate the relation between breech position at term (>37 weeks of gestation) and low maternal fT4 levels during gestation in women not suffering from overt thyroid dysfunction. DESIGN: A prospective cohort study of pregnant women. SETTING: Community-based study. POPULATION/SAMPLE: At random selected pregnant women of the general population. METHODS: At antenatal booking, based on thyroid function assessed at 12 weeks of gestation in a large cohort of pregnant women, two groups of participants were defined: women with low fT4 levels-below the 10th centile (n= 135) and women with fT4-between the 50th and 90th centiles at 12 weeks of gestation (n= 135). Women with clinical thyroid dysfunction (fT4 and TSH outside reference range) at 12 weeks of gestation were excluded. Maternal thyroid function (fT4 and TSH) was subsequently assessed at 24 and 32 weeks of gestation. Analysis refers to 204 women who met the inclusion and exclusion criteria and in whom all thyroid parameters were assessed. MAIN OUTCOME MEASURES: Fetal presentation (cephalic-breech) at delivery in women with term gestation (>37 weeks of gestation) in relation to maternal thyroid function at 12, 24 and 34 weeks of gestation. RESULTS: Breech presentation at term delivery was independently related to fT4 levels <10th centile at 12 weeks of gestation (OR = 4.7, 95% CI 1.1-19 [but not to an fT4 level below the 10th centile at 24 and 32 weeks of gestation]) as well as primiparity (OR = 4.7, 95% CI 1.3-15). CONCLUSIONS: Women with hypothyroxinaemia (fT4 level at the lowest 10th centile) during early gestation but without overt thyroid function are at risk for fetal breech presentation at term (>37 weeks of gestation).

Biomarkers↗