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At least 883 records · Page 49Linked to original sources
PubMed1993

Treatment of end-stage renal disease due to lupus nephritis: comparison of six patients treated with both peritoneal and hemodialysis.

End-stage renal disease (ESRD) is one of the most significant complications of systemic lupus erythematosus (SLE). Previous investigators have evaluated the morbidity and mortality of different renal replacement treatment modalities in these patients. Earlier reports have suggested that the systemic manifestations of SLE diminish, or "burn out," once ESRD occurs. These investigators also suggested that vascular access complications were a significant cause of morbidity and mortality in these patients treated with hemodialysis (HD). A retrospective review of the records of 6 patients with ESRD from lupus nephritis (LN), who received both HD and peritoneal dialysis (PD), was performed to determine if there was a difference in disease activity between treatment modalities, using patients as self-controls. The number of SLE flares was determined by clinical and/or serologic studies, and prednisone dosages compared for each treatment modality. Four of the 6 patients continued to have active SLE after renal replacement therapy was begun. There were no significant differences in the number of SLE flares or prednisone dosages while receiving either treatment modality. While PD eliminates problems associated with vascular access, both HD and PD were effective forms of renal replacement therapy. Most patients in this study continued to have active SLE after commencement of dialysis, with no differences in disease activity noted during HD or PD.

Adolescent↗
PubMed1993

Behavioural techniques to reduce self-injurious behaviour in children with autism.

This paper is part of a special section on 'self-injurious behaviour and autism' and concentrates on behavioural treatment techniques available and useful to reduce self-injurious behaviour in children with autism (e.g. extinction, time-out, differential reinforcement, alternative forms of stimulation, sensory deprivation, physical restraint, crisis management, environmental modifications). It has become increasingly evident that the successful treatment of self-injurious behaviour requires, first, a systematic and detailed (functional) analysis of the variables associated with the behaviour and, second, a hypothesis-testing approach on an individual, naturalistic basis to increase the acquisition of alternative skills and self-control.

Autistic Disorder↗
PubMed1994

[Optimal structure of the multienzyme system of the tricarboxylic acid cycle of E. coli during growth on various carbon sources].

The optimal structure (stoichiometry) of the tricarboxylic acid cycle multienzyme system of E. coli has been computed using experimental data for the E. coli biomass monomeric content and the results of the steady-state metabolic fluxes calculation. The calculation was performed for the cases of E. coli growth on acetate, glycolate, glycerate, glutamate, glucose, gluconate and pyruvate as carbon sources. The possible self-control mechanisms make it possible to optimize the cellular multienzyme system structure for each of the carbon sources under study. The relationship between the optimal structure and the maximal specific rate of the cell growth is discussed.

Carbon↗
PubMed1994

[The importance of CAPD in kidney replacement therapy].

Continuous ambulatory peritoneal dialysis (CAPD) a method suitable for self-treatment by patients with chronic renal failure, was introduced for clinical use at the end of the seventies. It was rapidly accepted and used worldwide. Based upon a ten-year-old clinical experience at the renal unit of the Stadtspital Waid, Zürich, and on data of a cohort of 113 unselected patients treated by this method, this report aims at the importance of CAPD for renal replacement therapy. Experiences with developments of materials, techniques and measures preventing complications, collected during an observation period, from 1979 to 1989 were analyzed and data from three arbitrarily fixed consecutive periods compared. The Tenckhoff catheter, primarily used for dialysis, has been replaced by the Oreopoulos-Zellermann catheter because of a reduced complication rate. The number of patients treated with CAPD doubled within these ten years. The survival rate for different methods was similar in the three time periods investigated. In accordance with other centers, peritonitis was found to be the most frequent cause for a drop-out and was equally the most frequent complication whose incidence, however, declined over the observation periods. Compared to other centers, incidence of peritonitis was already low before at the renal unit of SWZ. 41% of the patients died, most of them because of cardiovascular problems. Infections of the catheter tunnels were less frequent, but their rate could not be influenced in the course of the ten-year period. Clinical experiences of the first ten years with CAPD at the renal unit of SWZ yielded positive results: 1. CAPD represents a simple and effective method for dialysis therapy of equal value compared to hemodialysis. 2. Success of the CAPD program depends crucially on amelioration of the CAPD materials and techniques as well as on an optimal education of the patient by the nursing staff and the physician. 3. Obviously, the significant decline of the rate of peritonitis in the Stadtspital Waid was due to the introduction of a simple microbiologic method for self-control (so-called dialysate-digest medium tube-method) and to the prophylaxis for fungal peritonitis with Nystatin per os accompanying every antibiotic therapy. 4. A future challenge is seen in increased attention and better prevention of the second most common complication of CAPD, catheter-tunnel infection.

Adult↗
PubMed1994

[The influence of blood oxygen tension on the glucose level measured by a handy blood glucose analyzer (Toecho Super)].

A handy blood glucose analyzer (Toecho Super), using disposable enzyme electrodes, is widely used not only for the self-control of diabetes but also for critical care settings such as the ICU or the operating room. Recently we reported that the measured glucose value was lower compared with the true reference data, when oxygen tension was high. We investigated the interaction between the blood glucose levels and oxygen tension in vitro using 5 levels of glucose and 5 levels of oxygen tension. Measured glucose value decreased linearly as oxygen tension rose with a high correlation factor (0.816-0.996). The measured glucose level (mg.dl-1) could be estimated by the reference data minus one tenth of oxygen tension (in mmHg). Therefore we conclude that the measured glucose value is dependent only on oxygen tension but not on the range of glucose level. The reference glucose value can be estimated when oxygen tension is available.

Blood Chemical Analysis↗
PubMed1994

Aberrant behaviors of young boys with fragile X syndrome.

To determine whether aberrant behaviors described in boys with fragile X syndrome distinguish them from other boys with developmental disabilities, we asked the primary caregivers of 55 boys with fragile X and 57 matched controls to complete five behavioral questionnaires. Twenty-one items distinguished the groups. Principal components analysis (PCA) yielded five behavioral clusters: abnormal language, tactile defensiveness, poor self-control, poor eye contact/shyness, and hand flapping. Boys with fragile X were found times more likely to have both tactile defensiveness and abnormal language. The presence of these abnormal behaviors in boys with developmental delays warrants further assessment for fragile X.

Autistic Disorder↗
PubMed1976

[Hygiene in medical practice (author's transl)].

Ideas and suggestions for hygiene in medical practice ought to be a stimulus for colleagues in active practice in town and country and also for specialists. Within the scope of a reviw, neither rules, standards nor checklists should be given, because self-determination and self-control- with the help of these stimuli too-are preferable to bureaucratic control. Order and cleanliness are part of the picture of a good doctor. The aspects of hygiene in their many branches, not only for defense against infection, ought to contribute in fact and psychologically to the benefit of the patient.

Communicable Disease Control↗
PubMed1993

Clinical results with Taleum in the treatment of extrinsic bronchial asthma.

Taleum inhalation aerosol, produced by EGIS Pharmaceuticals Works, was examined in an 8-week open cross-over self-controlled study in 50 patients suffering from extrinsic bronchial asthma. Intal powder capsule inhaled with the aid of a spinhaler was used as a reference drug. Changes in subjective complaints and symptoms were continuously recorded on a score scale in the patients' diary. The alterations in respiratory parameters were measured. Laboratory parameters were monitored. On the basis of the results Taleum spray was found to be effective in the prevention of bronchial asthma. It proved to be a well tolerated drug form of simple use.

Administration, Inhalation↗
PubMedDate not supplied

Coping in spouses of patients with acute myocardial infarction in Taiwan.

OBJECTIVE: The purpose of this study was to determine the usage and perceived effectiveness of coping strategies of spouses of patients with acute myocardial infarction in Taiwan, the Republic of China, during the acute phase of the illness. DESIGN: Survey. SETTING: Visitors room for a coronary care unit in Taiwan, the Republic of China. SUBJECTS: Twenty-one female and 10 male spouses of patients with acute myocardial infarction. OUTCOME MEASURES: The Revised Ways of Coping Scale was modified to assess both frequency of use and perceived effectiveness of coping strategies. It was also translated into Chinese. RESULTS: Seeking Social Support was the most frequently used coping strategy, whereas Confrontive Coping was used the least. There were significant positive relationships between the extent of usage of coping strategies and their perceived effectiveness. Men used Planful Problem-Solving more often and found it be more effective than did women; they also found the Self-Controlling and Accepting Responsibility strategies to be more effective than did women. Older spouses reported the Planful Problem-Solving strategy to be more effective than did younger subjects. The more family members living with a spouse, the less Accepting Responsibility was used as a coping strategy. CONCLUSIONS: Spouses of patients with acute myocardial infarction in Taiwan, the Republic of China, report using a variety of coping strategies. Those used most often are perceived to be the most effective.

Adaptation, Psychological↗
PubMed1994

[Results of 5-year activity in a program for pregnant diabetics in south-eastern Poland. I. Methodology of a unified program and evaluation of the degree of diabetes compensation in pregnant women].

A model of diabetic-obstetrical management in pregnant diabetics from the south-eastern Poland realized in Cracow has been described. It consists in education, intensive insulin therapy and self-control with borrowed glucose meters. The study included 102 pregnant women enrolled from 1987-1991. It was found that the patients in general with poorly normalized diabetes mellitus referred late to a special unit. It was shown that with experience normoglycemia was achieved with lower insulin doses in four injections. A characteristic feature was a very small number (4) of the patients who had thought of diabetes normalization before pregnancy. Coordinated care provides a possibility of reducing failures in pregnancy, nevertheless it is necessary to develop comprehensive care both before and during pregnancy in diabetic women.

Adult↗
PubMed1993

Gender differences in AIDS-relevant condom attitudes and condom use.

Two studies, conducted approximately one year apart, examined gender differences in AIDS-relevant condom attitudes, condom use behaviors, and relationships among attitudes and condom use behaviors. Subjects (N = 248, N = 528) were undergraduates, primarily heterosexual. Females reported more favorable attitudes, with the exception of greater inhibition about buying and possessing condoms. Men engaged in preliminary condom use behaviors (carrying and keeping condoms at home) substantially more often than did women. Preliminary condom use behaviors predicted past and intended condom use more consistently for men than for women. Relationships between condom attitudes and condom use behaviors were generally similar for both sexes, with poorer self-control explaining the most variance in past and intended condom use. These results, interpreted from the perspective of Eagly's (1987) gender role theory, suggest that although females may indirectly influence condom use decisions, providing condoms is the expected role of males, infusing them with greater control over the interpersonal process.

Acquired Immunodeficiency Syndrome↗
PubMed1993

The efficacy of intranasal DDAVP therapy in children with nocturnal enuresis.

This prospective self-controlled study was designed to evaluate the safety and efficacy of Desmopressin (DDAVP) in the treatment of childhood primary nocturnal enuresis (PNE) and the diurnal variation of ADH secretion and urine excretion/concentration in these children. Twenty-three children (15M,8F), aged 5-16 years, who wet their beds at least 3 nights per week were enrolled in the study. After a four-week observation period, they were hospitalized for one day to monitor intake, output, renal sonography, plasma ADH, urine and serum osmolality. Intranasal DDAVP treatment at a dose of 15-30 micrograms at bedtime was started with a 4-week titration period followed by a 3 to 6-month full dose treatment period. Subsequently the dose was tapered off for one to two months, and the patients were followed for at least two months to observe any recurrence. The results showed no diurnal difference of ADH level in these children (p > 0.05); serum osmolality decreased slightly during sleep (p < 0.01); urine production decreased, and urine osmolality increased, during sleep. Seventeen children (81%) responded with a more than 50% reduction in frequency of enuresis: 11 were excellent responders, 6 were partial responders, while 4 failed. After completion of therapy, four (19%) remained dry and were considered cured; the rest had much less frequent recurrence. There were no subjective complaints other than mild local discomfort; laboratory test results remained normal. It was concluded that intranasal DDAVP is a safe and effective treatment for PNE which usually works promptly. Given the spontaneous annual remission rate of 14%, the cure rate of 19% in this study was not satisfactory.

Administration, Intranasal↗
PubMed1994

Going through the motions.

The benefits of exercise to a person's health and self-esteem are well recognized. Yet, for the institutionalized elderly person, exercise can be a rarity. Unfortunately, too many gerontological nurses struggle to enhance their patients' quality of life and to reduce the risk of physical and mental deterioration while ignoring this basis nursing measure. Range-of-motion (ROM) exercise is one simple activity that can have unqualified results. It can strengthen an elderly person's quality of life by increasing self-control, self-functioning, independence and, thus, self-esteem.

Aged↗
PubMed1993

Management of abusive behaviour in a hemodialysis unit.

Occasionally in hemodialysis units there are situations where registered nurses are unable to assist an individual whose behaviour is abusive or escalating in that direction, and the person cannot re-establish self-control and appropriate behaviour. Such abusive behaviour may arouse concern for the physical and psychological safety or security of the nurse and that of other patients and visitors. Interdisciplinary conferences were held to develop a policy document and guidelines to aid caregivers should abusive situations occur. These were the result of collaboration between physicians, nurses, social workers, a dietician and the clinical nurse specialist from psychiatry. The policy statement and guidelines include nursing actions, physician interventions and recommendations for follow-up conferences.

Dangerous Behavior↗
PubMed1993

Coping with AIDS and AIDS-risk reduction efforts among gay men.

Because AIDS has been identified as a major source of stress among gay men, coping models may contribute to an understanding of factors related to changes in and failure to change sexual behavior. Gay men in Long Beach, California, were surveyed to determine whether appraisal and coping are factors in efforts to reduce transmission risk for the human immunodeficiency virus (HIV). Factor analysis of the appraisal and coping items yielded factor structures similar to those reported by earlier coping investigators and that were differentially associated with reported reductions in risk for HIV transmission and with reported intent to engage in high- and low-risk sexual behaviors. Risk-reduction efforts and intent were associated with health-threat (to self or to partner) primary appraisals, secondary appraisals that respondents could change or do something about AIDS, and the coping factors of self-control, seeking social support, and confrontive coping (expression of anger). In addition, intent to engage in relatively high-risk behavior was associated with passive coping (acceptance). These results are discussed in terms of their relevance for risk-reduction education programs and for future research.

Acquired Immunodeficiency Syndrome↗
PubMed1993

[Utilization of pacifiers: distribution, causes and sequelae].

UNLABELLED: A survey of 293 children in a pediatric practise showed that in 80% a pacifier was used. This spread is the result of a distribution in the hospital at birth on the one hand and appreciation of its tranquilizing effect by the parents on the other hand. According to the parents, the use of a pacifier is a habit. A sucking child can, thus, restore its emotional equilibrium. This self-control reappears in certain situations. With time the child learns to control its behavior by other means. Only few children have difficulties in giving up this habit. Children using an alternative to the pacifier have more dental and jaw deformations than those using a pacifier. Dental pacifiers cause far less deformations than the other types. CONCLUSIONS: 1. Children who suck their fingers should be given a pacifier. 2. One should give a pacifier to babies with emotional problems up to the age of 6 months. Later on, an object harmless to the teeth should be given. 3. A pacifier should only be used if really necessary.

Child Behavior↗
PubMed1993

[Diabetes and sports].

Through better understanding of the physiology of physical exercise in normal and diabetic subjects we can more closely define the significance of regular physical exercise in the treatment of diabetes. Although patients with type I and type II diabetes can obtain different advantages from regular physical exercise, this activity is in turn connected with different risks. The introduction of self-monitoring of blood glucose has though considerably eased management in relation to physical activity by type I diabetics. Essentially the risk to type I diabetics is that of developing hypoglycemia during or after exercise as well as the danger of a worsening of metabolic levels with the development of ketoacidosis. In type II diabetics the risk of hypoglycemia is less pronounced and in patients treated solely by dietary means the regulation of blood glucose presents no great problem. With these individuals regular physical activity can be implemented as a further therapeutic tool towards the normalisation of body weight and an improvement in insulin sensitivity. With appropriate training and self-control the potential hypoglycemia in type I diabetic patients can easily be avoided. For this reason regular physical exercise can be recommended as a cornerstone of therapy, both in the management of type I as well as type II diabetes. The positive effect of exercise is significantly better defined in regard to type II diabetics than with type I diabetics. In particular, regular physical exercise can be implemented as a supplement to caloric restriction for weight reduction and as a means to improve insulin sensitivity in the obese insulin-resistant individual.

Blood Glucose↗