Thèses sur le sujet « Intermal medicine »
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Dodd, Will. « Adolescent Medicine ». Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/8913.
Texte intégralPatel, Vaishal J. « MGH Internal Medicine Associates : primary care redesign ». Thesis, Massachusetts Institute of Technology, 2015. http://hdl.handle.net/1721.1/99015.
Texte intégralThesis: S.M., Massachusetts Institute of Technology, Engineering Systems Division, 2015. In conjunction with the Leaders for Global Operations Program at MIT.
Cataloged from PDF version of thesis.
Includes bibliographical references (pages 105-107).
Internal Medicine Associates (IMA) is the largest primary care practice at Massachusetts General Hospital (MGH) with over 40 attending physicians, 60 residents, and 80 support staff that deliver care to more than 30,000 patients. The IMA is structured into seven pods that act independently to serve patients. Each pod consists of patient care providers and support staff that work collaboratively in a team structure. In particular, providers and medical assistants work closely together during the clinical session to meet patient needs. A lack of standardization in the practice's operations has contributed to inefficiencies that add to a sense of overload and burnout with the medical assistant staff A detailed study of providers' clinical schedules revealed that individual clinical sessions are highly variable in terms of the number of concurrent clinical sessions per pod, session length, and number of patient appointments booked during this time. Providers in the IMA are part-time and create their clinical schedules based on personal preference and coordination with their other MGH related commitments. Variability in the schedule arises from many systematic, predictable, and unpredictable sources. Additionally, as part of a teaching hospital, IMA supports the educational training of over 60 Internal Medicine residents who hold a varying number of clinical sessions per week, depending on specific requirements of their residency program. Coordinating and supporting provider presence consumes many resources, impacts medical assistant workload, and adds to variability within the practice. The project develops an optimization model to level-load the expected workload on medical assistants and other members of the medical care team by determining the clinic schedules of providers. The expected workload is measured by the number of concurrent sessions and expected number of patient visits per hour. The project has developed an optimization model to suggest changes to the clinic schedule. Specifically in Pod 2/3, by strategically shifting 19.5% of provider sessions, we can achieve an 83% improvement in variability, as measured by the difference between maximum and minimum expected workload. Similar results are modeled for all pods in the IMA. The team has identified a pilot pod to test the model and is
by Vaishal J. Patel.
M.B.A.
S.M.
Dodd, Will. « Pediatric Emergency Medicine ». Digital Commons @ East Tennessee State University, 2020. https://dc.etsu.edu/etsu-works/8915.
Texte intégralDi, Girolamo Nicola <1987>. « Method-Comparison and Reference Interval Determination in Animal Medicine ». Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2016. http://amsdottorato.unibo.it/7650/2/Tesi_dottorato_Definitiva.pdf.
Texte intégralDi, Girolamo Nicola <1987>. « Method-Comparison and Reference Interval Determination in Animal Medicine ». Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2016. http://amsdottorato.unibo.it/7650/.
Texte intégralKallis, Constantinos. « Construction and assessment of risk models in medicine ». Thesis, University of Warwick, 2005. http://wrap.warwick.ac.uk/79266/.
Texte intégralMendes, Georges. « Tradução de um capítulo do Harrison’s principles of internal medicine ». Master's thesis, Universidade de Aveiro, 2015. http://hdl.handle.net/10773/14876.
Texte intégralNo âmbito do Mestrado em Tradução Especializada, vertente Saúde e Ciências da Vida, este projeto procura explorar a metodologia e a problemática associada à atividade tradutológica, através da realização de uma tradução de um capítulo da obra Harrison’s Principles of Internal Medicine, subordinado ao tema da Aterosclerose, explorando a patogenia, prevenção e tratamento daquela que é uma das principais causas de mortalidade nos países ocidentais. Além da tradução, este projeto consiste também na análise de todos os processos ultrapassados antes de se iniciar a tradução, durante e após a sua completação.
In the context of Specialised Translation, this project seeks to explore the methodology and problems associated with the translational activity, through the translation of a chapter from Harrison’s Principles of Internal Medicine, under the subject of Atherosclerosis, exploring the patogeny, prevention and treatment of one of the leading causes of death in western countries. Additionally to the translation, this project also includes the analysis of all processes undergone before, during and after the translation was completed.
Braun, Sarah. « Determinants of Stress and Effects on Performance in Internal Medicine Residents ». VCU Scholars Compass, 2015. http://scholarscompass.vcu.edu/etd/3799.
Texte intégralChasapis, Emmanouil. « Small animal internal medicine and surgery - Osteosarcoma in ex-racing greyhounds ». Master's thesis, Universidade de Évora, 2017. http://hdl.handle.net/10174/22912.
Texte intégralObua, Uche Gerard. « Strategies for Reducing Medication Errors in an Outpatient Internal Medicine Clinic ». ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6638.
Texte intégralWang, Ling, et Shunbin Ning. « Viral and Cellular MicroRNAs in Regulation of EBV Latency and Oncogenesis ». Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/6543.
Texte intégralCegelka, Derek S. « End-of-Life Training in US Internal Medicine Residency Programs : A National Study ». University of Toledo / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1461679801.
Texte intégralNing, Shunbin, et Ling Wang. « Identification of PP1 as the First Phosphatase for IRF7 ». Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/6527.
Texte intégralSerrão, Mariana Rafael Pedro. « Patologia e clínica de equinos ». Master's thesis, Universidade de Évora, 2015. http://hdl.handle.net/10174/18045.
Texte intégralSetshedi, Mashiko. « Impairments in signaling cascades mediating the progression of liver disease from chronic hepatitis to hepatocellular carcinoma in animal and human models ». Doctoral thesis, University of Cape Town, 2011. http://hdl.handle.net/11427/11788.
Texte intégralGina, Ntombenhle Phindile. « Early morning urine collection to improve the sensitivity of LAM in hospitalised TB/HIV co-infected patients ». Master's thesis, University of Cape Town, 2016. http://hdl.handle.net/11427/20834.
Texte intégralViljoen, Charle André. « Audit of the quality and cost of acute inpatient stroke care in the general medical wards at Groote Schuur Hospital ». Master's thesis, University of Cape Town, 2016. http://hdl.handle.net/11427/21377.
Texte intégralWasserman, Sean. « Early outcomes of thrombolysis for acute ischaemic stroke in a South African tertiary care centre ». Master's thesis, University of Cape Town, 2012. http://hdl.handle.net/11427/3493.
Texte intégralIncludes bibliographical references.
Stroke is an important cause of death and disability in sub-Saharan Africa. Recombinant tissue plasminogen activator (tPA) thrombolysis is effective in treating acute ischaemic stroke, but may not be a viable option in developing countries. This prospective observational study was designed to assess the short-termoutcomes and safety of tPA for the treatment of stroke at Groote Schuur Hospital.Data was collected from January 2000 to February 2012, and included patients witha clinical diagnosis of acute stroke with onset of stroke symptoms within 4.5 hours ofreceiving thrombolysis. Exclusion criteria were based on the National Institute ofNeurological Disorders and Stroke (NINDS) rt-PA trial protocol (upper age limit was 75 years). Primary outcomes were the proportion of patients achieving significant early neurological recovery defined as an improvement of 4 or more points on the National Institutes of Health stroke scale (NIHSS) score and functional independence defined as a modified Rankin score of 2 or less at discharge. The primary safety measures were the rates of symptomatic intracranial haemorrhage (SICH) and death. From January 2000 to February 2011 42 patients were thrombolysed, with a mean time to tPA infusion of 160 minutes (standard deviation (SD) 50; range 60 - 270). By discharge the median NIHSS score fell from 14 (interquartile range (IQR) 10.5 - 17) to 7.5 (IQR 1 - 15); 28 (66.7%) achieved significant neurological improvement, and 17 (40.5%) were functionally independent. Two patients (4.8%) suffered SICH and there were 3 (7.1%) deaths. Thrombolysis in routine clinical practice in a South African setting has similar safety and early efficacy outcomes to controlled trials and open-label studies in developing and developed countries.
Nzeale, Jean Jacques Noubiap. « Prevalence of dyslipidaemia among adults in Africa : a systematic review and meta-analysis ». Master's thesis, Faculty of Health Sciences, 2019. http://hdl.handle.net/11427/31183.
Texte intégralRush, Colin James. « The effect of structured reflection on the diagnostic accuracy of postgraduate trainees during real patient encounters ». Master's thesis, University of Cape Town, 2016. http://hdl.handle.net/11427/22819.
Texte intégralPoulet, Erma. « Implementation of the JAK2V617F mutation analysis in the pathway of suspected myeloproliferative neoplasms in Groote Schuur Hospital ». Master's thesis, University of Cape Town, 2016. http://hdl.handle.net/11427/23660.
Texte intégralMARTINS, Geraldo. « Calliphoridae (Insecta, Diptera) associados às fases de decomposição de carcaças de suínos (Sus scrofa Linnaeus, 1758) em área de caatinga no estado da Paraíba ». Universidade Federal Rural de Pernambuco, 2013. http://www.tede2.ufrpe.br:8080/tede2/handle/tede2/5666.
Texte intégralMade available in DSpace on 2016-10-11T13:34:12Z (GMT). No. of bitstreams: 1 Geraldo Martins.pdf: 2758105 bytes, checksum: 4e586fcda70973bcd0b330ad69b0e52c (MD5) Previous issue date: 2013-02-21
The objective of this study was to identify and analyze the abundance of dipteran family Calliphoridae present along the decomposing carcass of pigs in the Cariri, Paraiba State, Brazil, in two periods: rainy and dry. The study was conducted in Reserva Particular do Patrimônio Natural (RPPN) Fazenda Almas, in São José dos Cordeiros-PB. We used two pig carcasses (Sus scrofa) by period, protected from scavengers by a metal cage inside trap like "Shannon". Samples were collected daily, twice a day, for eleven days in both periods. The meteorological data of precipitation were obtained at the Centro de Previsão e Estudos Climáticos do INMET and temperature and relative humidity were obtained in situ using a digital hygrometer. The insects collected were placed in the laboratory of entomology of UFPB and identified as well. We collected 8.811 individuals of the family Calliphoridae, belonging to six species (Chrysomya albiceps (Wiedemann, 1819), Cochliomyia macellaria (Fabricius, 1775), Chrysomya putoria (Wiedemann, 1818), Chloroprocta idioidea (Robineau-Devoidy, 1830), Chrysomya megacephala (Fabricius, 1794) e Lucilia eximia (Wiedemann, 1818)), which were presented the in both the periods, although a relative abundance of species was higher in the rainy period (4.706). We measured the abundance of species per period, where C. albiceps was the most abundant in the dry period (3.244/36, 81%) and C. idioidea in the rainy period (2.860/32, 45%). There were five stages of decomposition: fresh, chromatic, emphysematous, coliquative and skeletonization stage. The emphysematous was the stage where we most collected Calliphoridae (3.923/44, 52%), followed by skeletonization (3.458/39, 25%), chromatic (726 / 8.24%), coliquative (627/7, 12%) and fresh (77/0, 87%). It was also found that the highest abundance of C. idioidea occurred on the highest elevation of relative humidity and rainfall. This study is the first survey of the region of Caatinga in Paraiba state using active collecting, these results will serve to enrich the data to local forensic entomology and will contribute to the understanding the fauna of the region carrion flies.
Objetivou-se com este estudo inventariar e analisar a abundancia de dípteros da família Calliphoridae presentes ao longo da decomposição da carcaça de suínos na região do Cariri, estado da Paraíba, Brasil, em dois períodos: chuvoso e seco. O estudo foi desenvolvido na Reserva Particular do Patrimônio Natural (RPPN) na Fazenda Almas, no município de São José dos Cordeiros-PB. Foram utilizadas duas carcaças de suíno (Sus scrofa) por período, protegidas de animais carniceiros por uma gaiola metálica no interior de armadilha do tipo “Shannon”. As coletas foram realizadas diariamente, duas vezes ao dia, durante onze dias em ambos os períodos. Os dados meteorológicos de precipitação foram obtidos no Centro de Previsão de Tempo e de Estudos Climáticos do INMET e a temperatura e umidade relativa do ar foram obtidas in loco utilizando-se um termohigrômetro digital. Os insetos coletados foram encaminhados mediante autorização ao laboratório de entomologia da UFPB e posteriormente identificados e parte deles depositada na coleção de referencia. Foram coletados 8.811 indivíduos da família Calliphoridae, pertencentes a seis espécies: Chrysomya albiceps (Wiedemann, 1819), Cochliomyia macellaria (Fabricius, 1775), Chrysomya putoria (Wiedemann, 1818), Chloroprocta idioidea (Robineau-Devoidy, 1830), Chrysomya megacephala (Fabricius, 1794) e Lucilia eximia (Wiedemann, 1818), as quais estiveram presentes em ambos os períodos, porém a abundância relativa de espécies foi maior no período chuvoso (4.706/53,4%). Verificou-se a abundância de algumas espécies por período, onde a C. albiceps foi a espécie mais abundante no período seco (3.244/36,81%) e C. idioidea no período chuvoso (2.860/32,45%). Observaram-se cinco fases de decomposição: fresca, cromática, enfisematosa, coliquativa e esqueletização. A enfisematosa foi a fase onde mais se coletou Calliphoridae (3.923/44,52%), seguida pela esqueletização (3.458/39,25%), cromática (726/8,24%), coliquativa (627/7,12%) e fresca (77/0,87%). Constatou-se também que a maior abundancia de C. idioidea ocorreu no dia de maior elevação da umidade relativa e precipitação. Este é o primeiro estudo de levantamento realizado com coleta ativa em região de Caatinga paraibana, cujos resultados permitirão enriquecer os dados da entomologia forense local e contribuirão para o entendimento da fauna de dípteros necrófagos da região.
KATSUMATA, YOSHINAO, MASAYOSHI TERASHIMA, TATSURO OHTA, TAMOTSU OKADA et KAZUO KATSUMATA. « Incidence of Sleep Apnea Syndromes in General Patients at a Hospital for Internal Medicine ». Nagoya University School of Medicine, 1986. http://hdl.handle.net/2237/17491.
Texte intégralAjudua, Emmanuel Enuagwuna. « Profile of diabetic complications amongst diabetics attending internal medicine outpatient department and family medicine outpatient department in Dora Nginza Hospital, PE hospital complex ». Thesis, Stellenbosch : University of Stellenbosch, 2015. http://hdl.handle.net/10019.1/97196.
Texte intégralENGLISH ABSTRACT: Introduction: Diabetes is the most prevalent endocrinology problem encountered in primary care practice. If recent trends showing a dramatic increase in prevalence (believed to be a consequence of a decline in physical activity and excessive caloric intake) continue, then the condition will soon affect nearly 20 million people in the U.S a reflection of the global trend. Effective management requires care that is thoughtful and meticulous, incorporating intensive patient education. Euglycemic control, with the level of glycosylated haemoglobin (HbA1c) kept below 7.0mmol/L, has emerged as a major treatment objective because of its association with a marked reduction in the risk for micro vascular complications. The primary physician is in the unique position to provide comprehensive care to the diabetic patient. Setting: The aim of this study is to evaluate the profile of complications arising due to diabetes mellitus among adult diabetics attending internal medicine outpatient department and family medicine/primary care outpatient department in the Dora Nginza hospital, PE hospital complex. Method: The study is a descriptive retrospective study in which names of patients were collated from clinic records of both clinics, files sought at the records department covering the period between Jan 2007 and Jan 2008 inclusive. Prevalence of statistical variables was generated using frequency tables, bar graphs, cross tabulations and chi square test. Results: Hyperglycemia was the major complication which predominantly was associated with high haemoglobin A1c (HbA1c) levels. However, some hyperglycaemic cases were also found to be associated with normal HbA1c. Complications were found to be more in type 2 diabetics. Patients with hypertension, obesity, smoking and alcohol use were observed to have a higher risk of developing diabetic complications. The findings on retinopathy in this study was inconclusive in view of the fact that patients sent for fundoscopy did not return with documented results from the sister hospital PE provincial hospital. Family Medicine outpatient department overall did better in patient care compared to the Internal Medicine outpatient department. Conclusion: The challenge for the primary care physician is to design a therapeutic program that is safe practical and acceptable to the patient. The ultimate goal of therapy is the prevention of micro vascular and macro vascular complications, consequence of diabetes that makes the condition a major risk factor for cardiovascular disease, stroke, visual impairment, renal failure, impotence, peripheral neuropathy, limb loss and ultimately death. These can be averted through appropriate education of both hospital staff, patients and their care givers. The recommendations made are based on the findings of the study.
AFRIKAANSE OPSOMMING: Nie beskikbaar.
Ning, Shunbin. « Interferon Regulatory Factors and Autoimmune Diseases ». Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/6542.
Texte intégralNossum, Vibeke. « The effect of vascular bubbles on endothelial function ». Doctoral thesis, Norwegian University of Science and Technology, Department of Circulation and Medical Imaging, 2003. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-347.
Texte intégralThe purpose of the study was to:
• Study the effect of vascular gas bubbles on the brain and lung
• Study changes in the endothelial function caused by gas bubbles
• Study the preventive effects of monoclonal anti-C5a antibody on functional changes caused by gas bubbles
It is important to reveal any changes in the function of the endothelium caused by gas bubbles, as the endothelium probably plays an important role in the development of decompression sickness (DCS). Furthermore, we followed up previous studies using monoclonal anti-C5a antibody trying to prevent damages caused by gas bubbles. In order to prevent damages causes by gas bubbles and maybe prevent DCS, the mechanisms behind have to be revealed. This thesis is part of an ongoing project that for several years has tried to bring to light the “secrets” of DCS.
Qvigstad, Elisabeth. « Effects of fatty acids and over-stimulation on insulin secretion in man ». Doctoral thesis, Norwegian University of Science and Technology, Faculty of Medicine, 2003. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-414.
Texte intégralPressemelding:
Behandling av type 2 diabetes har trolig best effekt i en tidlig fase av sykdommen. Dette skriver assistentlege Elisabeth Qvigstad (36) fra Grimstad i doktoravhandlingen sin ved Norges teknisk-naturvitenskapelige universitet NTNU. Arbeidet kan bidra til at det utvikles nye medisiner mot diabetes.
Avhandlingen tar utgangspunkt i type 2 diabetes, som rammer 105-120 000 nordmenn. Tidligere forskning i form av celle- og dyreforsøk har vist at vedvarende høye nivåer av fettsyrer i blodet og langvarig stimulering av insulinfrigjøring kan svekke funksjonen til de insulinproduserende beta-cellene i bukspyttkjertelen. Avhandlingen ville teste om lignende forhold er til stede hos mennesker og om korrigerende tiltak ville bedre insulinfrigjøringen ved type 2 diabetes.
Nivået av frie fettsyrer hos personer med type 2 diabetes er oftest forhøyet. Langvarig faste hos friske gir også forhøyet fettsyrenivå og kan ses på som en modellsituasjon for type 2 diabetes. Qvigstad fant redusert insulinfrigjøring hos friske forsøkspersoner etter 58 timer faste.
Fettsyrenivået i blod under testing ble senket ved hjelp av et nikotinsyrederivat hos friske personer og personer med type 2 diabetes. Hos friske påvirket ikke medikamentet insulinfrigjøring eller -følsomhet. Imidlertid virket behandlingen positivt på insulinfrigjøring hos de diabetikerne som hadde best blodsukker-kontroll. Derimot, når type 2 diabetikere reduserte fett i kosten, ga dette ingen utslag på insulinfrigjøringen, men noe nedsatt insulinfølsomhet. Nivået av fettvevshormoner (leptin, adiponectin) ble redusert. Den egne insulinfrigjøringen ble hemmet med medikamentet diazoxid, og insulininjeksjoner ble brukt som erstatning. Insulinfrigjøringen økte uten å endre insulinbehov eller blodsukkerkontroll sammenliknet med placebo. Disse resultatene tyder på at "betacelle-hvile" er gunstig ved type-2 diabetes.
Qvigstads doktorgradsarbeid bidrar til økt forståelse av betydningen av fettsyrer for insulinfrigjøring og insulinfølsomhet hos friske og ved type 2 diabetes. I tillegg støtter funnene betydningen av "betacelle-hvile», som kan bidra til utvikling av nye medisiner mot diabetes.
http://www.ntnu.no/doktorgrader/dr.med/02.03/qvigstad.htm
Wibe, Arne. « Rectal cancer treatment in Norway - standardisation of surgery and quality assurance ». Doctoral thesis, Norwegian University of Science and Technology, Faculty of Medicine, 2003. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-420.
Texte intégralThe main purpose of the present work was to evaluate the efforts taken by the Norwegian surgical community in order to promote and enhance the standards of rectal cancer treatment on a national level, in particular:
- to examine the outcome of rectal cancer surgery following implementation of total mesorectal excision as the standard rectal resection technique
- to explore the prognostic impact of the circumferential resection margin on local recurrence, distant metastases and overall survival following mesorectal excision
- to evaluate the oncological outcomes following mesorectal excision of cancer of the lower rectum, particularly the rates of local recurrence and overall survival for patients with tumours in this areas
- to illustrate the influence of a rectal cancer registry as a quality control instrument on outcome of rectal treatment, and furthermore, to investigate the rates of postoperative mortality, anastomic leakage, local recurrence (LR) and overall survival related to hospital caseload among Norwegian hospitals during implementation of mesorectal excision.
Steinsbekk, Aslak. « Homeopathy in the prevention of upper respiration tract infections in children ». Doctoral thesis, Norwegian University of Science and Technology, Department of Public Health and General Practice, 2005. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-521.
Texte intégralThe aim of this thesis is to explore why parents bring their children to homeopaths and to investigate the effect of homeopathic treatment for prevention of upper respiratory tract infections (URTI) in children. The reason for doing studies on this is that there has been a nearly threefold increase in the proportion of children among patients visiting Norwegian homeopaths. This raised the question of why it is so. Furthermore, recurrent respiratory complaints are a main reason why child patients consult homeopaths. This raised the question of the effect of homeopathic treatment in this patient group, because there is very little research on this. The thesis builds on four different studies conducted between August 2002 and June 2004.
Parents of nine children that recently had been to a homeopath for the first time were interviewed to explore why parents take their children to homeopaths. All parents had been to a medical doctor before consulting the homeopath. It was the experiences with conventional medical treatment that led the parents to look for alternatives. The reasons were that 1) the parents did not want to give the medication prescribed by the doctor, 2) they wanted treatment while waiting for a problem to be assessed, 3) they did not want to continue to use the prescribed medication, 4) they stopped taking conventional medication due to side effects or 5) they were not offered any treatment by the medical doctor. The parents would consult a medical doctor if they felt insecure about the health conditions of the child and would visit a homeopath when they felt that the situation was clarified. There are parents who take their child to homeopaths despite not understanding or having belief in whether ultramolecular homeopathic medicines can have effects.
One hundred and sixty-one children who had been diagnosed with an URTI by a medical doctor were recruited to participate in a trial on the effect of treatment by homeopaths for prevention of URTI in children. The children were randomly allocated to two groups. One group received an appointment immediately with one of five homeopaths who treated the patients as they do in their everyday practice. The other group (control) got such treatment after three months. The occurrence of URTI judged by the parents were significantly lower among those treated immediately by homeopaths (median 8 days in three months) compared to the control group who used self-selected conventional health care (median 13 days) (p=0.006).
Homeopathic medicines are frequently used for self-treatment (over the counter-OTC). It is not known if the choice of the patient is the same, as a homeopath would have prescribed. A study was therefore conducted to explore if there can be developed indications for homeopathic medicines that facilitate that parents can chose the same medicine as a homeopath would prescribe for children with URTI. Firstly, data from a survey was used to find three medicines Calcarea carb, Pulsatilla and Sulphur that accounted for 60% of all prescription made by Norwegian homeopaths for children with URTI. Simplified constitutional indications for these medicines were developed and tested by comparing the choices of 70 parents with the prescription of eleven homeopaths. The parents were able to choose the same homeopathic medicine as homeopaths prescribed for 55% of the children.
Two hundred and fifty-nine children who had been diagnosed with an URTI by a medical doctor were recruited to participate in a trial on the effect of one of three self-selected ultramolecular homeopathic medicines for prevention of URTI in children. The indications developed were used. The children was randomly allocated to receive either ultramolecular homeopathic medicine (C-30) or placebo. There was no difference in the occurrence of URTI judged by the parents among getting ultramolecular homeopathic medicine compared to those getting placebo (median 9 days in three months for both groups) (p=0.531).
Hensikten med denne avhandlingen er å undersøke hvorfor foreldre tar sine barn med til homøopat og å undersøke effekten av homøopatisk behandling i forebygging av øvre luftveisinfeksjoner (ØLI) hos barn. Bakgrunnen for de undersøkelsene som er gjort, er at det nesten er en tredobling i andelen barn blant pasienter hos homøopat. Dette utløste spørsmål om hvorfor det er slik. Videre er gjentatte luftveisplager en hovedårsak til at barn oppsøker homøopat. Fordi det er lite forskning på dette temaet ble spørsmålet om effekten av homøopatisk behandling i denne pasientgruppen også utløst. Avhandlingen bygger på fire ulike undersøkelser som er gjennomført mellom august 2002 og juni 2004.
Foreldre til ni barn som nylig hadde vært hos homøopat for første gang ble intervjuet for å undersøke hvorfor foreldre tar sine barn med til homøopat. Alle foreldrene hadde vært hos lege før de kontaktet homøopaten, og det var erfaringer med legebehandlingen som fikk foreldrene til å søke alternativer. Årsakene var at foreldrene 1) ikke ønsket å gi den behandlingen lege foreskrev til barnet, 2) ønsket behandling mens barnet ventet på å bli ferdig utredet, 3) ønsket å avslutte bruken av de medisinene legen hadde foreskrevet for barnet, 4) opplevde at barnet fikk bivirkninger av behandlingen legen hadde gitt og 5) ikke ble tilbudt noen behandling hos legen. Foreldre oppsøker først lege når de er usikre eller bekymret for barnets helsetilstand. De oppsøker homøopat for behandling når dette er avklart. Det er foreldre som oppsøker homøopat med sine barn selv om de ikke forstår eller tror på effekten av homøopatiske medisiner (som kan være svært fortynnet).
Ett hundre og sekstini barn som hadde vært til lege på grunn av en øvre luftveisinfeksjon ble rekruttert til å være med på en undersøkelse av effekten av behandling hos homøopat i forebyggingen av ØLI hos barn. Barna ble tilfeldig fordelt i to grupper. Barna i den ene gruppen fikk time med en gang hos en av fem homøopater som foreskrev homøopatisk behandling på vanlig måte. Den andre gruppen fikk slik behandling etter 3 måneder. Forekomsten av ØLI Hensikten med denne avhandlingen er å undersøke hvorfor foreldre tar sine barn med til homøopat og å undersøke effekten av homøopatisk behandling i forebygging av øvre luftveisinfeksjoner (ØLI) hos barn. Bakgrunnen for de undersøkelsene som er gjort, er at det nesten er en tredobling i andelen barn blant pasienter hos homøopat. Dette utløste spørsmål om hvorfor det er slik. Videre er gjentatte luftveisplager en hovedårsak til at barn oppsøker homøopat. Fordi det er lite forskning på dette temaet ble spørsmålet om effekten av homøopatisk behandling i denne pasientgruppen også utløst. Avhandlingen bygger på fire ulike undersøkelser som er gjennomført mellom august 2002 og juni 2004. Foreldre til ni barn som nylig hadde vært hos homøopat for første gang ble intervjuet for å undersøke hvorfor foreldre tar sine barn med til homøopat. Alle foreldrene hadde vært hos lege før de kontaktet homøopaten, og det var erfaringer med legebehandlingen som fikk foreldrene til å søke alternativer. Årsakene var at foreldrene 1) ikke ønsket å gi den behandlingen lege foreskrev til barnet, 2) ønsket behandling mens barnet ventet på å bli ferdig utredet, 3) ønsket å avslutte bruken av de medisinene legen hadde foreskrevet for barnet, 4) opplevde at barnet fikk bivirkninger av behandlingen legen hadde gitt og 5) ikke ble tilbudt noen behandling hos legen. Foreldre oppsøker først lege når de er usikre eller bekymret for barnets helsetilstand. De oppsøker homøopat for behandling når dette er avklart. Det er foreldre som oppsøker homøopat med sine barn selv om de ikke forstår eller tror på effekten av homøopatiske medisiner (som kan være svært fortynnet).
Ett hundre og sekstini barn som hadde vært til lege på grunn av en øvre luftveisinfeksjon ble rekruttert til å være med på en undersøkelse av effekten av behandling hos homøopat i forebyggingen av ØLI hos barn. Barna ble tilfeldig fordelt i to grupper. Barna i den ene gruppen fikk time med en gang hos en av fem homøopater som foreskrev homøopatisk behandling på vanlig måte. Den andre gruppen fikk slik behandling etter 3 måneder. Forekomsten av ØLI var signifikant lavere hos de som fikk behandling hos homøopat med én gang (median 8 dager på tre måneder) sammenlignet med den andre gruppen som brukte standard behandling ved behov mens de ventet (median 13 dager) (p=0,006).
Homøopatisk medisin brukes internasjonalt i stor grad til selvbehandling. Man vet ikke om pasientens eget valg av homøopatisk
medisin er lik det en homøopat ville foreskrevet. Det ble derfor gjennomført en undersøkelse av om det kan utvikles beskrivelser for indikasjoner for homøopatiske medisiner som gjør at foreldre kan velge samme medisin som en homøopat foreskriver for barn med ØLI. Først ble det funnet fram til tre medisiner, Calcarea carb, Pulsatilla og Sulphur som homøopater i Norge foreskriver til 60% av barn med ØLI. Så ble det utviklet indikasjoner for disse tre medisinene som ble testet ut ved at valgene til 70 foreldre ble sammenlignet med foreskrivingen til 11 homøopater. Foreldrene valgte samme medisin som homøopaten for 55% av barna.
To hundre og femtien barn som hadde vært til lege på grunn av en øvre luftveisinfeksjon ble rekruttert til å være med på en undersøkelse av effekten av en av tre selvvalgte homøopatiske medisiner i forebyggingen av ØLI hos barn. Indikasjonene som ble utviklet ble brukt. Barna ble tilfeldig fordelt til enten å få homøopatisk medisin eller placebo. Det var ingen signifikant forskjell i forekomsten av ØLI mellom de som fikk homøopatisk medisin sammenlignet med de som fikk placebo (median 9 dager på tre måneder i begge grupper) (p=0,531).
Bråthen, Geir. « The classification and clinical diagnosis of Alcohol-related seizures ». Doctoral thesis, Norwegian University of Science and Technology, Faculty of Medicine, 2001. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-533.
Texte intégralThe aims of this dissertation were to investigate alcohol-related seizures in clinical neurological practice. We wanted to assess the extent of this problem, to classify the seizures, and to investigate methods to improve the clinical diagnosis of such seizures. We propose an arbitrary but simple and reproducible way of diagnosing alcohol-related seizures and alcohol withdrawal seizures. Papers I and II relate to seizure classification and the extent of the problem in relation to the level and weekly pattern of alcohol use. Paper III investigates the performance of various biological markers as aids in the diagnosis of alcohol-related seizures. Paper IV explores pitfalls in the result interpretation for two methods for detection of CDT in patients with neurological disorders. Paper V investigates the utility of standard EEG for the identification of alcohol-related seizures.
Even though the general alcohol consumption in our region is low, every third patient with an epileptic seizure leading to hospitalisation had hazardous alcohol consumption.
Evidence of focal lesions or focal seizure start was found in a high proportion of alcohol-related seizures. All such seizures were secondarily generalized and thus, we challenge the establishment impression that the vast majority of alcohol-related seizures are primarily generalized. Binge drinking (more than six drinks for men or four drinks for women, in a single drinking occasion) was common, but had little influence on seizure susceptibility or timing of seizures. In contrast to prior knowledge, we found that in some patients there was no time lag from cessation of drinking to the occurrence of a seizure, but falling intake levels prior to withdrawal seizures were demonstrated. This indicates that a state of relative withdrawal while still drinking may be sufficient to induce a seizure. Carbohydrate-deficient transferring (CDT) is the most accurate biomarker for alcohol use and good adjunct to the diagnosis of alcohol-related seizures, but its accuracy does not compete with a good clinical investigation. Generally poor accuracy should be expected for fertile women. Women on enzyme-inducing antiepileptic drugs who drink no or little alcohol seem to be at risk of having false positive CDT. Other variables associated with increased CDT were low body mass index, or having total transferring levels outside normal range. A definitely abnormal EEG suggests epilepsy or symptomatic seizures unrelated to alcohol use. The predictive value of a normal EEG is limited, but the typical post-ictal finding in alcohol-related seizures is nevertheless a normal low-amplitude EEG record.
The best method for identification of alcohol-related seizures is a clinical work-up based on a thorough medical history. The Alcohol Use Disorders Identification Test (AUDIT) provides a reliable measure of drinking habits. CDT is a good supplement to the clinical diagnosis when there is doubt, if factors associated with false-positive values are appreciated. The diagnostic value of EEG is limited.
Kurtze, Nanna. « The significance of anxiety and depression in fatique and patterns of pain among individuals dagnosed with fibromyalgia : Relations with quality of life, functional disability, lifestyle, employment status, co-morbidity and gender ». Doctoral thesis, Norwegian University of Science and Technology, Faculty of Medicine, 2001. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-561.
Texte intégralThe main purpose of the theses is to explore the significance of anxiety and depression in patterns of pain, fatigue, quality of life. Lifestyle, functional disability, co-morbidity and gender among individuals given the diagnosis of fibromyalgia by their doctor.
Svensson, Maria. « Metabolic aspects on diabetic nephropathy ». Doctoral thesis, Umeå University, Public Health and Clinical Medicine, 2003. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-79.
Texte intégralDiabetic nephropathy (DN) is associated with morbidity and mortality due to cardiovascular disease and renal failure. This study focused on the impact of glycemic control on the development of DN and the metabolic consequences of DN. The euglycemic hyperinsulinemic clamp technique was used to assess insulin sensitivity and insulin clearance. Two different registries, the Diabetes Incidence Study in Sweden (DISS) and the Swedish Childhood Diabetes Registry, as well as questionnaires and data from medical records were used to study diabetic complications in population-based cohorts.
Microalbuminuria is an early marker of DN and may also be associated with impaired insulin sensitiv-ity in diabetic and non-diabetic subjects. We studied the relationship between insulin sensitivity and the degree of albuminuria in patients with type 1 diabetes and micro- or macroalbuminuria but normal glomerular filtration rate (GFR). We did not find a direct quantitative association between the degree of albuminuria and insulin resistance, arguing against a cause-effect relationship.
With progression of DN, a decline in GFR is seen. Patients with severe renal failure have both im-paired insulin sensitivity and insulin clearance. We studied insulin sensitivity and insulin clearance in type 1 diabetes patients with three different degrees of renal involvement (none, only albuminuria, and slightly reduced GFR, ~40-70 ml/min/1.73 m2, respectively). A clear reduction in insulin sensitivity in vivo, but not in insulin clearance, was seen in the group with reduced GFR, and concomitant changes in the levels of PTH, IGF-1, IL-6 and TNF-α were found. In parallel, cellular insulin sensitivity and insulin degradation were examined in vitro, in subcutaneous fat cells but no differences were found between the three groups of patients.
To study the occurrence of renal involvement in patients with modern diabetes treatment we moni-tored a cohort of young adults from the DISS-registry with onset of diabetes in 1987-88 at age 15-34 years. We found that ~7% of the patients had signs of renal involvement, i.e. incipient nephropathy (5%) and overt nephropathy (2%), after a median follow-up of ~9 years and the strongest risk markers were poor glycemic control (HbA1c) and high blood pressure. Patients with type 2 diabetes were most prone to have renal involvement in this age group.
Retrospectively, we studied 94 patients diagnosed with type 1 diabetes in 1981-1992 at age 0-14 years at the Umeå University Hospital. Incipient nephropathy and background retinopathy occurred in 18 and 45%, respectively, of the patients, during ~12 years of follow-up. Glycemic control, also during the first five years of diabetes, was a strong risk marker. Young age at onset of diabetes prolonged the time to development of microvascular complications.
Conclusion: Despite modern diabetes treatment some patients with diabetes develop renal involvement within the first ten years. Inadequate glycemic control, also early in the disease, is a risk marker as well as type 2 diabetes and high blood pressure. In patients with type 1 diabetes and diabetic neph-ropathy a slightly reduced GFR, but not albuminuria, is associated with insulin resistance. Concomi-tant changes in insulin-antagonistic hormones and cytokines may be involved.
Grootboom, Wandisile M. « Prescribing patterns in adult patients with meningitis in internal medicine wards, Dr George Mukhari Hospital ». Thesis, University of Limpopo (Medunsa Campus), 2010. http://hdl.handle.net/10386/219.
Texte intégralBackground Information regarding disease epidemiology, treatment options and emerging infections and resistance constantly challenge the knowledge of the health care practitioner. Antibiotic prescribing patterns was identified by the Dr George Mukhari hospital antibiotics committee as an area of concern. Due to this concern it was decided to investigate the prescribing patterns in adult patients with meningitis admitted to the internal medicine wards at Dr George Mukhari hospital. Objectives To determine the current antimicrobial prescribing patterns in adult patients diagnosed with meningitis, to record the causative organisms and sensitivity patterns, to record the outcom e, cost and length of treatment. Method Patient and prescriptions data were recorded prospectively on specially designed data sheets from five internal medicine wards for four months (May to August 2008). Patients were followed until discharged. Results Sixty-six patients were enrolled; 41 recovered, 22 died, 2 refused treatment and 1 absconded. Ceftriaxone was prescribed the most frequently and was administered to 58 patients; four patients with confirmed cryptococcal meningitis received amphotericin B IVI, three patients were started on iv Rifafour® for suspected tuberculosis meningitis and one was started on cefuroxime. Specimens from only 22 patients were sent for culture and sensitivity tests; ten were positive for yeast-like organisms, three for S pneumoniae and one for N meningitides and tuberculosis respectively. The average duration of treatment of patients with meningitis was 9.2days. The total cost of antiinfectives used for treatment of meningitis amounted to R111, 292.53 and the average cost per patient was R1 686.25. The cost of all medicines prescribed for the 66 patients amounted to R116, 490.43. Conclusion Ceftriaxone was used frequently as empiric therapy. Specimens for culture and sensitivity were not sent routinely. Therefore it was difficult to monitor and observe any resistance patterns and to contain cost of treatment.
Panchal, Hemang B., Kalpit Devani, Shimin Zheng, Eunice Mogusu, Sukhdeep Bhogal, Abdul Ahad Khan, Syed Imran Zaidi, Thomas Helton, Nirat Beohar et Timir K. Paul. « Impact of Chronic Kidney Disease on Guideline Directed Interventions Among Patients Admitted With Acute ST-Elevation Myocardial Infarction : A Nationwide Inpatient Sample 2012-2014 ». Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/6305.
Texte intégralWang, Ling, et Shunbin Ning. « "Toll-Free" Pathways for Production of Type I Interferons ». Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/6540.
Texte intégralFraga, Cecília Archer de Menezes Castro. « Medicina da produção leiteira : estudos de relação entre o desempenho reprodutivo e as mastites ». Master's thesis, Universidade de Lisboa, Faculdade de Medicina Veterinária, 2018. http://hdl.handle.net/10400.5/15046.
Texte intégralO impacto das mastites na eficiência reprodutiva dos bovinos leiteiros, tem sido estudado ao longo dos últimos anos, por diversos autores. O objetivo do presente estudo, foi analisar a possível associação causal entre a ocorrência de mastites subclínicas e a alteração do desempenho reprodutivo. Recorrendo a uma base de dados de contraste leiteiro, na qual existiam registos provenientes de 9 explorações nacionais, introduzidos entre 1996 e 2016, procedeu-se à análise da relação da contagem de células somáticas, com o intervalo parto-conceção. Os resultados obtidos demonstraram que, à medida que aumenta a contagem de células somáticas, aumenta o intervalo parto-conceção. Tais resultados foram estatisticamente significativos e mais pronunciados para os dados relativos à segunda lactação. Observou-se ainda que, para cada aumento do número de eventos, cuja contagem de células somáticas se encontra acima do limiar de distinção entre infetado e saudável, o intervalo parto-conceção aumenta 28,7 dias para a primeira lactação e 27,9 dias para a segunda. Tais resultados, sugerem a hipótese de haver uma relação da cronicidade da infeção, com a fertilidade. Assim, à semelhança do reportado por autores anteriores, os resultados obtidos apontam a existência de uma relação entre as mastites subclínicas e o desempenho reprodutivo dos bovinos leiteiros.
ABSTRACT - Dairy Production Medicine: studies of the relationship between reproductive performance and mastitis - The impact of mastitis on reproductive performance of dairy cattle has been studied throughout the last years, by several authors. The objective of this study was to evaluate the possible causal association between the occurrence of subclinical mastitis and altered reproductive performance. Through the analysis of a database, in which there was access to milk recording data from 9 national dairy farms, introduced from 1996 to 2016, the relationship between the somatic cell count and the calving-to-conception interval was analyzed. The obtained results showed that, as the somatic cell count increases, the calving-to-conception interval increases. These results were statistically significant and more pronounced on the second lactation. Furthermore, it was observed that, with increases in the number of mastitis episodes, in which somatic cell counts were above the considered threshold between infected and healthy, the calving-to-conception interval progressively increased 28,7 days for the first lactation and 27,9 days for the second. These results support the existence of a relationship between the chronicity of the episodes and fertility. As such, similarly to results presented by previous authors, this study supports the existence of a direct relationship between mastitis and the reproductive performance of dairy cattle.
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Carlin, Christopher M. « The effects of statins on hypoxia-induced proliferation and cell signalling pathways in pulmonary artery fibroblasts ». Thesis, University of Glasgow, 2010. http://theses.gla.ac.uk/1484/.
Texte intégralNeisius, Ulf. « Proteomic, circulating and functional biomarkers of cardiovascular disease ». Thesis, University of Glasgow, 2013. http://theses.gla.ac.uk/4740/.
Texte intégralMartin, Steven Carl. « Homocysteine and vascular disease ». Thesis, University of Glasgow, 2003. http://theses.gla.ac.uk/30939/.
Texte intégralStevenson, Judith L. « An investigation of attitudes and attentional biases in trichotillomania ». Thesis, University of Glasgow, 2018. http://theses.gla.ac.uk/31012/.
Texte intégralShaw, Aaron Robert James. « Sleep, anxiety and the effects on cognition ». Thesis, University of Warwick, 2018. http://wrap.warwick.ac.uk/114458/.
Texte intégralSpooner, Joshua. « People's experiences of living with severe health conditions ». Thesis, University of Warwick, 2018. http://wrap.warwick.ac.uk/114471/.
Texte intégralEddowes, Peter John. « The role of MRI in stratifying and evaluating chronic liver disease ». Thesis, University of Birmingham, 2018. http://etheses.bham.ac.uk//id/eprint/8126/.
Texte intégralRedgrave, Liam Stephen. « The role of supercoiling in altering chromosome structure, gene expression and antibiotic resistance in bacteria ». Thesis, University of Birmingham, 2017. http://etheses.bham.ac.uk//id/eprint/7912/.
Texte intégralDinsdale, Robert Jonathon. « Production and impaired regulation of neutrophil extracellular traps following severe thermal injury, implications for sepsis and multiple organ failure ». Thesis, University of Birmingham, 2017. http://etheses.bham.ac.uk//id/eprint/7958/.
Texte intégralWard, Lewis Stuart Corey. « Interactions of mesenchymal stromal cells with their microenvironment ». Thesis, University of Birmingham, 2018. http://etheses.bham.ac.uk//id/eprint/8278/.
Texte intégralDominguez, Medina Carmen Coral. « Investigation of how antibody to the outer membrane porin D from Salmonella typhimurium binds and protects against infection ». Thesis, University of Birmingham, 2018. http://etheses.bham.ac.uk//id/eprint/8572/.
Texte intégralRedzuan, Adyani Md. « Sodium-dietary intake, awareness and clinical outcomes in treated hypertensive patients ». Thesis, University of Glasgow, 2012. http://theses.gla.ac.uk/4418/.
Texte intégralMcElroy, Daniel. « Elucidating the functions of fibroblast growth factor 9 in multiple sclerosis ». Thesis, University of Glasgow, 2018. http://theses.gla.ac.uk/30798/.
Texte intégralLiu, Hui-Hsuan. « Investigation of the role of nutrients for protection against acute kidney injury ». Thesis, University of Nottingham, 2017. http://eprints.nottingham.ac.uk/44162/.
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