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At least 1,081 records · Page 60Linked to original sources
PubMed2002

[Diabetes mellitus in the elderly].

The prevalence of diabetes increase in the elderly. Ageing is one of the most important factors contributing to development of glucose intolerance (insuline resistance). NHANES II data showed that in the poppulation over 65 years 18.7% has got overt diabetes and 22.8% glucose intolerance. Similar data were obtained among ageing inhabitants of the city of Bialystok (downtown). The criteria of diagnosis of diabetes in the elderly are the same like in the younger population. However, in the elderly the clinical symptoms are not characteristic and scanty (limited). The period without symptoms is long. Very often, the diabetes is diagnosed for the first time in patient with the heart infarct, brain stroke, diabetic foot or even hyperosmolar coma. There may occur two critical situations in the elderly diabetic persons, namely non-ketotic hyperosmolar coma and hypoglycameia. The non-ketotic hyperosmolar coma is a result of a considerable elevation in the blood concentration of glucose, sodium and urea. This, in turn, is a consequence of osmotic diuresis which is non balanced by elevation in the volume of water intake. Factors facilitating development of the coma include: nontreated diabetes, infirmity, inadequate care, diuretics, stroke, hyperthermia. Hypoglycaemia in the elderly is a very serious problem. It can cause arrhythmia, a rise in the blood pressure, unconsciousness, falls and injuries. The most often reason of hypoglycaemia in the elderly are: long-acting derivatives of sulphonylurea, treatment with insulin and irregular meals. The major aims of treatment of diabetes in the elderly are: reduction of hyperglycaemia, reduction in the development of complications and minimizing of the risk of hypoglycaemia. An elderly patient with diabetes should have each year a check-up which would include examination of the eyes, kidneys, feet. The elderly patient with diabetes is often crippled, indolent and lives often alone. Therefore, such a patient should be taken care of by a team of people. The most important role in the team should be played by a family physician and a social nurse.

Adipose Tissue↗
PubMed1979

Preliminary report on long term cure of schistosomiasis using metrifonate (Bilarcil/Dipterex)--a new antischistosomal drug.

Twenty patients aged between 7 and 19 years with confirmed vesical schistosomiasis due to Schistosoma haematobium were treated with Metrifonate (Dipterex, Bilarcil) orally on a single dose of 7.5 mg/kg body weight repeated at fortnightly intervals until egg excretion ceased. This was achieved with a maximum of three doses. No symptoms of toxicity or significant side effects were observed. Four patients remained symptom free of the infection for up to three years after the initial treatment. These results suggest that Metrifonate (Bilarcil), a cheap, relatively non-toxic, orally administered and effective drug against Schistosoma haematobium, can be used successfully in the management of this crippling infection. They also suggest that, provided there is no re-exposure, the subjects can remain free of symptoms for more than three years.

Adolescent↗
PubMedDate not supplied

Namibia: HIV and pre-employment testing.

In May 2000, the Namibian Labour Court ruled that the Namibian Defense Force (NDF) is not entitled to exclude people from recruitment on the grounds of their HIV status. Acting Judge Harold Levy had ruled that excluding a person from employment purely on the basis of being HIV positive was unfair labor practice and constituted discrimination. However, this will not be the end of the matter. Defense Minister Erkki Nghimtina said that an appeal would be lodged against the judgement in the interest of ensuring that Namibia had a healthy and strong military. AIDS Law Unit Lawyer, Michaela Figueira, lauded the judgement as a brilliant breakthrough, which put Namibia law on HIV/AIDS in the forefront of legal developments in the field internationally. "We will appeal", Nghimtina commented, when approached at the National Assembly. The judgement, he added, was tantamount to allowing for the recruitment into the NDF of blind and crippled people. Nghimtina said he still stood by statements he had made in the National Assembly 2 weeks before, when the Minister told fellow Parliamentarians that the NDF could not recruit HIV positive people because they were ill, and the country could not be defended by ill persons. "We need a strong (defense) force--a healthy force", he said. "We have to have physically strong, healthy people, who can carry out hard tasks. This, we cannot compromise". Commenting on the unanimous testimony from both sides in the Labor Court case, that an HIV positive status, did not necessarily mean that a person was in any way physically unfit for military duty. Nghimtina answered that the NDF needed to recruit members for the long term. People with HIV, he added, could be employed elsewhere, but not in the NDF.

Acquired Immunodeficiency Syndrome↗
PubMed2001

Endemic fluorosis in Rajasthan.

Chronic fluoride (F) toxicity in the form of osteo-dental fluorosis was observed in both sexes of children and adults from ten villages viz., Bhavanpura, Dovada, Genhuwara, Gokulpura, Hathai, Kahela, Mandav, Nalwara, Pratappura and Samota located in the vicinity of alive F mines of Dungarpur district (Rajasthan) where F concentration in drinking waters varied from 1.2 to 8.9 ppm. At 1.7 and 6.1 mean F concentrations, 70.6% and 100.0% of children (< 18 years) and 68.0% and 100.0% adults, respectively, were found to be affected with dental fluorosis of varying grades. No much sex difference was seen in prevalence of dental fluorosis. Both prevalence and severity of dental mottling were found to be increased with increasing of F concentration and were found maximum in the 17-22 years age group. At these same F concentrations, 7.4% and 37.7% adults (> 21 years) were showing evidence of skeletal fluorosis, respectively. Although, skeletal fluorosis was also found in children with low prevalence (5.2%) but at high F concentration (4.8 ppm). The prevalence of skeletal fluorosis was relatively higher in males and increased with higher F level and age. Deformities such as crippling, kyphosis, invalidism and genu-varum were observed frequently in higher age group subjects (> 48 years) at a F concentration of 3.3 ppm. None of fluorotic individuals revealed evidence of genu-valgum syndrome and goitre (thyroidism). Radiological findings of other deformities in fluorotic subjects were also found. The distribution of F and endemic fluorosis in different districts of Rajasthan state have also been reviewed.

Adolescent↗
PubMed2002

[Legal developments--from taboo to sexual self-determination for handicapped patients?].

The author describes the development in German law regarding the protection of sexual self-determination of disabled persons. Her analysis encompasses the last twenty years, starting from the "cripple-tribunal 1981", where disabled women first raised the subject in German public. As the main legal reforms for disabled persons in Germany, the author analysis the Thirty-First-Criminal-Law-Change-Act and the Sixth-Act-To-Reform-Criminal-Law of 1997/98 as well as the Ninth-Social-Law-Code of 2001. The author welcomes these legislative reforms but points to the fact that the judiciary has yet failed to implement particularly the criminal law reform. In addition she shows that the new criminal law does not fill all former protection gaps. She demands further reforms in other areas of law. Finally she emphasizes that comprehensive information and education for all those who are concerned by the subject are necessary.

Adolescent↗
PubMed1999

[Costs directly related to acute lower respiratory tract infections in the pediatric hospital milieu].

The purpose of this retrospective study carried out by 1997 in two paediatric units of Antananarivo: paediatric unit of the General hospital of Befelatanana (Marfan) and paediatric unit of the Hospital Center of Soavinandriana (CI), was to evaluate direct service costs for an hospitalization of a child affected by lower acute airway diseases. In the first unit, there is partial charge, in the second, there is full charge. Direct services were continued by complementary tests, therapy and meals. The length of the hospitalization changes according to the cause and the severity of diseases. Average direct service costs were of 19 and 38 US$ respectively. Maximum direct service costs were of 77 and 154 US$ respectively. Amounts of direct service costs were crippled especially by inappropriate use of antibiotics.

Acute Disease↗
PubMed2002

C. Scott Harrison, MD. Healing bodies + souls.

C. Scott Harrison, an orthopedic surgeon, discovered a need for his services while serving a humanitarian mission in Africa. As a witness to the deplorable treatment of children with deformities, he founded Crippled Children's United Rehabilitation Effort International (CURE) and has successfully operated on thousands of children. Dr. Harrison has built three hospitals in third world nations and is in the process of completing the fourth.

Africa South of the Sahara↗
PubMed2001

Factors preventing African Americans from seeking early intervention in the treatment of ischemic strokes.

The most widely advocated drug that has been developed to decrease and possibly reverse the crippling effect of stroke is recombinant tissue plasminogen activator (rt-PA). In the treatment of ischemic stroke, rt-PA must be administered within the first 3 hr after the onset of symptoms for optimal efficacy and avoidance of life-threatening cerebral hemorrhage. This study sought to determine whether African-American stroke victims presented for treatment within the first 3 hr. In the study, we identified some of the more common reasons for the lack of prompt presentation. A prospective survey of 103 randomly selected acute stroke patients was performed. We found that less than half of this population sought assistance in the emergency department in time to take advantage of rt-PA therapy. When confronted with symptoms that were consistent with acute stroke, many patients either chose to ignore them or thought that they were experiencing transient phenomena. Three factors were identified as possible reasons for the lack of prompt response: (a) a lack of information about available treatment options; (b) the inability to recognize the early warning signs of an impending stroke; and (c) denial of illness. This study may help to evolve strategies that must be instituted to better educate the community about the early recognition of stroke and available treatment alternatives.

Acute Disease↗
PubMed2002

Telehealth policy: looking for global complementarity.

Telehealth is gaining acceptance as a tool for bridging the local and global health-care divides. However, integrating telehealth into existing health infrastructures presents a daunting challenge for governments, policy makers, telehealth advocates and health-care workers. The development of specific inter-jurisdictional telehealth policies will significantly improve the ability to meet this challenge. In the policy context, one 'success' is the increasing number of jurisdictions addressing policy issues. However, policy decisions have largely been taken in isolation, within individual health institutions, regions, provinces/states or countries. This represents a failure of the current approach. Telehealth, by its very nature, has the ability to transgress existing geo-political boundaries. As a consequence, policy in any single jurisdiction may hamper or even cripple the ability of telehealth to fulfil its potential. Commonality--or at least complementarity--of approach to telehealth policy must be encouraged. To achieve this, it is essential to understand the current or anticipated regulatory constraints that may affect telehealth. We have begun a preliminary study of country-specific policy issues.

Global Health↗
PubMed1976

Splenic abscess.

A review of autopsy files and clinical case reports demonstrates two categories of splenic abscess. First, the abscesses discovered at postmortem usually are multiple, small manifestations of widespread, lethal infection in immunologically crippled hosts. A clinical diagnosis seldom is made. Second, the splenic abscesses encountered by the clinician are usually solitary, large, and challenge his diagnostic skills. Recognition is of vital importance, for therapy can be highly successful. Left untreated, the mortality rate is very high. The features, clinical management, and pathogenesis of splenic abscesses are discussed.

Abscess↗
PubMed2003

Anopheles gambiae genome: perspectives for malaria control.

Malaria, a disease that infects 300 million people throughout the world and kills more than a million people, mostly children in sub-Saharan Africa, involves three organisms. The human host where the disease is seen, the protozoan Plasmodium parasite and the mosquito. The parasite is transmitted to humans only by the mosquito vector, which in sub-Saharan regions is generally Anopheles gambiae. Malaria along with AIDS and tuberculosis are killing large numbers of people and crippling the economies of the affected African countries. Though an enormous effort has been made during the past twenty years to develop vaccines to block malaria in humans, the incidence of the disease is increasing in Africa. The reasons for this development include a breakdown in mosquito control related to increased insecticide resistance, as well as increased parasite resistance to antimalarial drugs. It is clear that new methods of Anopheles mosquito control are needed to ameliorate the medical and economic situation in sub-Saharan Africa. As a step toward new malaria control methods, the international Plasmodium falciparum and Anopheles gambiae consortia have carried out the full genome sequencing of the most deadly malaria parasite and the most efficient vector. These, combined with the human genome sequence, provide the genomic infrastructure for a better understanding of the complex interactions within the malaria triad. This essay discusses possible strategies as to how the Anopheles genome can contribute to malaria control.

Animals↗
PubMed1992

[Role of echography in septic arthritis of the hip in the newborn].

Pyogenic arthritis of the hip in neonates remains a serious problem. The sequelae of delay in diagnosis and treatment can be crippling. Five hips, in four neonates, with a presumed diagnosis of septic arthritis were examined with ultrasonography. In two hips ultrasonography found intracapsular effusion. In the remaining three hips there were no pathological findings. In the two hips with joint effusion an arthrotomy was performed, dislodging pus in both cases. Follow-up radiographs and ultrasonographies of the five hips showed normal joint anatomy. In neonates, ultrasonography provides an early and reliable evaluation of hips in which septic arthritis is suspected.

Arthritis, Infectious↗
PubMed2003

Quality of life and functional status of patients with hip fractures in Thailand.

Measurement of quality of life and functional status provides important additional information for priority setting in health policy formulation and resource allocation. Hip fracture has been a concern in health planning in developing countries due to an increasing trend, as reported in several studies. Ironically, in developing countries, studies of the impacts of hip fracture on quality of life and functional status are rare. This prompted our team to seek evidence of the impacts using a longitudinal follow-up approach in a Thai setting. In this study, health-related quality of life (HRQOL) before and after hip fractures was evaluated in 250 Thai patients. Measurement of HRQOL was based on a modified SF-12 questionnaire, which was developed with a realization of the following demands: 1) cultural sensitivity of measurement tools; 2) disease-specific HRQOL measurement and 3) feasibility of conducting field work. Functional status was measured using an adapted version of the Index of Activity of Daily Living (ADL), which was previously developed in another setting in Thailand. Mild, moderate and severe deficits in quality of life were found in 36%, 60%, and 4% respectively, of surviving patients. The number of patients with physical functioning dependency, as measured by the ADL, also increased significantly in all 10 activities assessed. Comorbidities were associated with deficits in health-related quality of life but age, sex, income, education level, and surgery were not. Our findings indicate that hip fracture could lead to crippling consequences, with a pronounced effect on the quality of life of Thai patients. Further studies using control groups and longitudinal design are needed to validate the results of this study.

Activities of Daily Living↗
PubMed1956

Emotional factors in physically handicapped children.

The staff of the Reiss-Davis Clinic for Child Guidance has been concerned with the emotional factors in physically handicapped or chronically ill children. It is felt by the staff that work with these children must include not only the known procedures to improve or correct their physical condition, but also efforts directed toward preventing or removing any evidence of emotional or psychological crippling. The symbolic or unconscious meaning of the disability is of great importance in this work. Attitudes of the parents may seriously interfere with the handicapped child's ability to develop his maximum level of functioning and adjustment. Individual and group psychotherapy was found of value in helping these parents.

Adaptation, Psychological↗
PubMed1992

Chronic rheumatic heart disease in India: a reappraisal of pathologic changes.

Rheumatic heart disease contributes to significant cardiac morbidity and mortality in India. The disease predominantly affects the valvular endocardium culminating in crippling valvular deformities, preferentially involving the mitral valve which may be severely affected in children and young adults. This appears to be unique to India and has been termed juvenile mitral stenosis. It is characterized by cardiomegaly, refractory congestive heart failure, and marked by elevated pulmonary vascular pressures and a progressive, fulminant clinical course. Autopsies of patients dying of rheumatic heart disease revealed that the mitral valve was most commonly afflicted either alone or in combination with the aortic and tricuspid valves in 31.6% and 52.8%, respectively. Organic involvement of the tricuspid valve was documented in 38.4% of cases. The extent and severity of the disease process was most marked in the mitral valve, followed by the aortic and tricuspid valves. Mitral valves showed various degrees of calcification, moderate or severe calcification being observed in 36.4%. Chronic inflammatory cell infiltration was observed in both calcified and non-calcified valves. The phenotypic profile of the inflammatory cells by immunohistochemical staining revealed a significant number to be T-helper/inducer lymphocytes. Lungs from cases of mitral stenosis exhibited prominent vascular and parenchymal changes. Pulmonary vessels revealed moderate to marked medial hypertrophy of the medium sized branches of the pulmonary artery. Dilatation lesions were also seen in a few cases. The most striking parenchymal change was the prominent smooth muscle in the bronchoalveolar walls. The extent and severity of the vascular and parenchymal changes were more marked in juvenile patients. The presence of inflammatory cells in cases of chronic heart disease reflects a possible ongoing insult/injury to some persistent antigenic stimulus by beta hemolytic streptococcal antigens that have primed the various target tissues. Further study of surface characteristics of various mesenchymal cells may help in understanding the nature and pathogenesis of this serious cardiac problem.

Adolescent↗
PubMed1957

Management of juvenile rheumatoid arthritis; the problem of long-term rehabilitation.

A program for the management of juvenile rheumatoid arthritis should permit the child an optimal developmental experience despite the persistence of potentially crippling inflammatory disease. Drugs are useful, although no more than palliative, and all are significantly toxic. Physical measures should be directed toward the improvement of joint alignment and mobility and the restoration of muscular strength. The emotional, social and educational needs of a child with such a chronic disability deserve the most thoughtful attention.

Arthritis, Juvenile↗
PubMed1959

Injuries of the hand and forearm; treatment of damaged soft tissues.

Successful primary repair of soft tissue injuries of the hand and forearm holds the ultimate disability to a minimum. The kinds of trauma and the resultant soft tissue damage may be classified. Attention to details and technique in carrying out the primary reparative operation on the injured hand largely obviates a crippling deformity or the need for much reconstruction later.

Forearm↗
PubMed1992

Myosin light chain-2 luciferase transgenic mice reveal distinct regulatory programs for cardiac and skeletal muscle-specific expression of a single contractile protein gene.

To examine the relationship between the cardiac and skeletal muscle gene programs, the current study employs the regulatory (phosphorylatable) myosin light chain (MLC-2) as a model system. Northern blotting, primer extension, and RNase protection studies documented the high level expression of the cardiac MLC-2 mRNA in both mouse cardiac and slow skeletal muscle (soleus). Transgenic mouse lines harboring a 2100- or a 250-base pair rat cardiac MLC-2 promoter/luciferase fusion gene were generated, demonstrating high levels of luciferase activity in cardiac muscle, and only background luminescence in slow skeletal muscle and non-muscle tissues. As assessed by in situ hybridization, immunofluorescence, and luminescence assays of luciferase reporter activity in various regions of the heart, both the endogenous MLC-2 gene and the MLC-2 luciferase fusion gene were expressed exclusively in the ventricular compartment, with expression in the atrium at background levels. Point mutations within the conserved regulatory sites HF-1a and HF-1b significantly cripple ventricular muscle specificity, while mutation of the single E-box site was without effect, suggesting that ventricular muscle-specific expression occurs through an E-box-independent pathway. This study provides direct evidence that the cis regulatory sequences in the cardiac/slow twitch MLC-2 gene which confer cardiac and skeletal muscle-specific expression can be clearly segregated, suggesting that distinct regulatory programs may have evolved to control the tissue-specific expression of this single contractile protein gene in cardiac and skeletal muscle.

Amino Acid Sequence↗