The Sami people who are the natives of Scandinavia are not a homogeneous group. They consist of different groups of Sami populations of which the South Sami population are one small group. For the South Sami this mean...The Sami people who are the natives of Scandinavia are not a homogeneous group. They consist of different groups of Sami populations of which the South Sami population are one small group. For the South Sami this means a problem;they have to struggle against a general ignorance about the Sami people and culture, which also may affect received home nursing care. The aim of this study is to describe individual South Sami experiences of being old and receiving home nursing care. A sample of 10 older persons with South Sami background was chosen for this study. Narrative interviews were conducted and qualitative content analysis was used to identify and categorize primary patterns in data. The experience of being an old person with South Sami background who receives home nursing care was understood through the use of the following four themes developed from the informants’ own narratives: “Experience of losses in life”;“Feelings of being less valued”;“Feelings of gratitude”;and “Experience of meaning in daily life as old”. The main finding is that the South Sami population still is exposed to an ongoing subtle colonisation. Therefore, it is important to prepare and teach nurses who work in the South Sami area in cultural care, traditional values and beliefs specific to the South Sami population.展开更多
AIM: To determine if the severity of gastroesophageal reflux disease is dependent on the size of a hiatus hernia. METHODS: Seventy-five patients with either a small(n = 25), medium(n = 25) or large(n = 25) hiatus hern...AIM: To determine if the severity of gastroesophageal reflux disease is dependent on the size of a hiatus hernia. METHODS: Seventy-five patients with either a small(n = 25), medium(n = 25) or large(n = 25) hiatus hernia(assessed by high resolution esophageal manometry) were investigated using 24-h esophageal monitoring and a self-assessed symptom questionnaire. The questionnaire comprised the following items, each graded from 0 to 3 according to severity: heartburn; pharyngeal burning sensation; acid regurgitation; and chest pain. RESULTS: The percentage total reflux time was significantly longer in the group with hernia of 5 cm or more compared with the group with a hernia of < 3 cm(P < 0.002), and the group with a hernia of 3 to < 5 cm(P < 0.04). Pharyngeal burning sensation, heartburn and acid regurgitation were more common with large hernias than small hernias, but the frequency of chest pain was similar in all three hernia groups. CONCLUSION: Patients with a large hiatus hernia are more prone to have pathological gastroesophageal reflux and to have more acid symptoms than patients with a small hiatus hernia. However, it is unlikely that patients with an absence of acid symptoms will have pathological reflux regardless of hernia size.展开更多
AIM To consolidate the present evidence of effectiveness in renal functioning and graft survival following early introduction of mammalian target of rapamycin(m TOR) inhibitors with or without calcineurin inhibitors(C...AIM To consolidate the present evidence of effectiveness in renal functioning and graft survival following early introduction of mammalian target of rapamycin(m TOR) inhibitors with or without calcineurin inhibitors(CNIs) in renal transplant recipients.METHODS We analysed the current literature following PROSPERO approval describing the role of immunosuppressive agent, m TOR inhibitors as an alternative to CNI within six months of renal transplant by searching the Pub Med, EMBASE, Cochrane, Crossref, and Scopus using Me SH terms. RESULTS Six articles of early withdrawal of CNI and introduction of m TOR-inhibitors within six months of renal transplantation were sought. Glomerular filtration rate(GFR) and serum creatinine were significantly better in m TOR inhibitor group with equivalent survival at 12 mo, even though Biopsy Proven Acute rejection was significantly higher in m TOR-inhibitor group. CONCLUSION The evidence reviewed in this meta-analysis suggests that early introduction m TOR-inhibitors substantial CNI minimization. The m TOR inhibitors such as everolimus and sirolimus, due to their complementary mechanism of action and favourable nephrotoxicity profile; better glomerular filtration, lower serum creatinine with equivalent survival. Having said that, due to the higher rejection rate, may influence the use of these regimens to patients with moderate to high immunological risk patients.展开更多
Objective: To evaluate the performance of the vaginal touch in the diagnosis of vertex presentation in posterior variety. Materials Populations and Methods: Transversal analytical study conducted during 4 months (Nove...Objective: To evaluate the performance of the vaginal touch in the diagnosis of vertex presentation in posterior variety. Materials Populations and Methods: Transversal analytical study conducted during 4 months (November 2017 - February 2018) at the University Hospital of Brazzaville. This study included parturients with a living foetus in term and in vertex presentation.? The membranes were broken with less than 6 cm of vaginal dilatation. In each case the ultrasound was associated to verify the accuracy of the results of vaginal examination. The statistical tests used were: sensitivity, specificity, positive and negative predictive values, and Youden’s index. Results: One hundred and twenty-two vertex presentations were recorded, of which 31 (25.4%) had a posterior variety diagnosed successively with vaginal examination and ultrasound, while 23 (42.6%) were only on ultrasound. Parturients with foetuses in the posterior and anterior variety were similar in median age (30 [25.5 - 33.5] vs 27.5 [24 - 34], p > 0.05) and parity (2 [1.5 - 3.5] vs 2 [1 - 3], p > 0.05). Vaginal touch had: sensitivity of 57.4% [44.4 - 70.4], specificity of 94.1% [86.7 - 99.3], and Youden’s index of 0.52. The positive and negative predictive values were respectively 88.5% and 73.5%. The vaginal examination was influenced by: examiner (OR = 2.7 [1.21 - 6.07];p 25 kg/m2 (OR = 3.4 [1.07 - 11.07], p Conclusion: The vaginal touch is not very effective in the diagnosis of the vertex presentation in posterior variety.展开更多
Background and Objectives: Pyelo-Ureteral Junction Syndrome (PUJS) is the most common obstructive malformation of the upper urinary tract in children and adults. The standard treatment is open pyeloplasty using the Ku...Background and Objectives: Pyelo-Ureteral Junction Syndrome (PUJS) is the most common obstructive malformation of the upper urinary tract in children and adults. The standard treatment is open pyeloplasty using the Kuss-Anderson technique. Because of the minimally invasive nature of the laparoscopic approach, it has become the approach of choice for the management of this pathology. We present the results of laparoscopic transperitoneal pyeloplasty used in the management of PUJS. Materials and Methods: This was a retrospective study from 2015 to 2020, including 26 patients who underwent laparoscopic transperitoneal pyeloplasty for PUJS. Results: Twenty-six patients, including 18 (69.2%) men and 6 (30.8%) women, with a mean age of 35.42 ± 13.62 years, were treated. Renal colic was the primary symptom in the majority of the cases (22, 84.6%)). The diagnosis was confirmed in all patients through an abdominal CT scan, which revealed that all 26 patients had hydronephrosis. Half of the patients (50.0%) were classified as Valayer-Cendron Type II, and eight (30.8%) patients had associated stones. Seventeen (65.4%) patients had pathologies on the left side, and all patients were treated using the Kuss-Anderson technique with a median operating time of 108.5 (90.0 - 136.0) minutes. The uncrossing of lower pole vessels was performed in 10 patients. The average duration of hospitalisation was 2.23 ± 0.82 days. No conversion was observed, and after an average follow-up of 53.69 days, the success rate was 92.3%. Conclusion: Laparoscopic pyeloplasty is a minimally invasive technique of choice for the treatment of pyelo-ureteral junction obstruction. It is dependable, repeatable, and produces good functional outcomes that are equal to those of traditional surgery.展开更多
文摘The Sami people who are the natives of Scandinavia are not a homogeneous group. They consist of different groups of Sami populations of which the South Sami population are one small group. For the South Sami this means a problem;they have to struggle against a general ignorance about the Sami people and culture, which also may affect received home nursing care. The aim of this study is to describe individual South Sami experiences of being old and receiving home nursing care. A sample of 10 older persons with South Sami background was chosen for this study. Narrative interviews were conducted and qualitative content analysis was used to identify and categorize primary patterns in data. The experience of being an old person with South Sami background who receives home nursing care was understood through the use of the following four themes developed from the informants’ own narratives: “Experience of losses in life”;“Feelings of being less valued”;“Feelings of gratitude”;and “Experience of meaning in daily life as old”. The main finding is that the South Sami population still is exposed to an ongoing subtle colonisation. Therefore, it is important to prepare and teach nurses who work in the South Sami area in cultural care, traditional values and beliefs specific to the South Sami population.
文摘AIM: To determine if the severity of gastroesophageal reflux disease is dependent on the size of a hiatus hernia. METHODS: Seventy-five patients with either a small(n = 25), medium(n = 25) or large(n = 25) hiatus hernia(assessed by high resolution esophageal manometry) were investigated using 24-h esophageal monitoring and a self-assessed symptom questionnaire. The questionnaire comprised the following items, each graded from 0 to 3 according to severity: heartburn; pharyngeal burning sensation; acid regurgitation; and chest pain. RESULTS: The percentage total reflux time was significantly longer in the group with hernia of 5 cm or more compared with the group with a hernia of < 3 cm(P < 0.002), and the group with a hernia of 3 to < 5 cm(P < 0.04). Pharyngeal burning sensation, heartburn and acid regurgitation were more common with large hernias than small hernias, but the frequency of chest pain was similar in all three hernia groups. CONCLUSION: Patients with a large hiatus hernia are more prone to have pathological gastroesophageal reflux and to have more acid symptoms than patients with a small hiatus hernia. However, it is unlikely that patients with an absence of acid symptoms will have pathological reflux regardless of hernia size.
文摘AIM To consolidate the present evidence of effectiveness in renal functioning and graft survival following early introduction of mammalian target of rapamycin(m TOR) inhibitors with or without calcineurin inhibitors(CNIs) in renal transplant recipients.METHODS We analysed the current literature following PROSPERO approval describing the role of immunosuppressive agent, m TOR inhibitors as an alternative to CNI within six months of renal transplant by searching the Pub Med, EMBASE, Cochrane, Crossref, and Scopus using Me SH terms. RESULTS Six articles of early withdrawal of CNI and introduction of m TOR-inhibitors within six months of renal transplantation were sought. Glomerular filtration rate(GFR) and serum creatinine were significantly better in m TOR inhibitor group with equivalent survival at 12 mo, even though Biopsy Proven Acute rejection was significantly higher in m TOR-inhibitor group. CONCLUSION The evidence reviewed in this meta-analysis suggests that early introduction m TOR-inhibitors substantial CNI minimization. The m TOR inhibitors such as everolimus and sirolimus, due to their complementary mechanism of action and favourable nephrotoxicity profile; better glomerular filtration, lower serum creatinine with equivalent survival. Having said that, due to the higher rejection rate, may influence the use of these regimens to patients with moderate to high immunological risk patients.
文摘Objective: To evaluate the performance of the vaginal touch in the diagnosis of vertex presentation in posterior variety. Materials Populations and Methods: Transversal analytical study conducted during 4 months (November 2017 - February 2018) at the University Hospital of Brazzaville. This study included parturients with a living foetus in term and in vertex presentation.? The membranes were broken with less than 6 cm of vaginal dilatation. In each case the ultrasound was associated to verify the accuracy of the results of vaginal examination. The statistical tests used were: sensitivity, specificity, positive and negative predictive values, and Youden’s index. Results: One hundred and twenty-two vertex presentations were recorded, of which 31 (25.4%) had a posterior variety diagnosed successively with vaginal examination and ultrasound, while 23 (42.6%) were only on ultrasound. Parturients with foetuses in the posterior and anterior variety were similar in median age (30 [25.5 - 33.5] vs 27.5 [24 - 34], p > 0.05) and parity (2 [1.5 - 3.5] vs 2 [1 - 3], p > 0.05). Vaginal touch had: sensitivity of 57.4% [44.4 - 70.4], specificity of 94.1% [86.7 - 99.3], and Youden’s index of 0.52. The positive and negative predictive values were respectively 88.5% and 73.5%. The vaginal examination was influenced by: examiner (OR = 2.7 [1.21 - 6.07];p 25 kg/m2 (OR = 3.4 [1.07 - 11.07], p Conclusion: The vaginal touch is not very effective in the diagnosis of the vertex presentation in posterior variety.
文摘Background and Objectives: Pyelo-Ureteral Junction Syndrome (PUJS) is the most common obstructive malformation of the upper urinary tract in children and adults. The standard treatment is open pyeloplasty using the Kuss-Anderson technique. Because of the minimally invasive nature of the laparoscopic approach, it has become the approach of choice for the management of this pathology. We present the results of laparoscopic transperitoneal pyeloplasty used in the management of PUJS. Materials and Methods: This was a retrospective study from 2015 to 2020, including 26 patients who underwent laparoscopic transperitoneal pyeloplasty for PUJS. Results: Twenty-six patients, including 18 (69.2%) men and 6 (30.8%) women, with a mean age of 35.42 ± 13.62 years, were treated. Renal colic was the primary symptom in the majority of the cases (22, 84.6%)). The diagnosis was confirmed in all patients through an abdominal CT scan, which revealed that all 26 patients had hydronephrosis. Half of the patients (50.0%) were classified as Valayer-Cendron Type II, and eight (30.8%) patients had associated stones. Seventeen (65.4%) patients had pathologies on the left side, and all patients were treated using the Kuss-Anderson technique with a median operating time of 108.5 (90.0 - 136.0) minutes. The uncrossing of lower pole vessels was performed in 10 patients. The average duration of hospitalisation was 2.23 ± 0.82 days. No conversion was observed, and after an average follow-up of 53.69 days, the success rate was 92.3%. Conclusion: Laparoscopic pyeloplasty is a minimally invasive technique of choice for the treatment of pyelo-ureteral junction obstruction. It is dependable, repeatable, and produces good functional outcomes that are equal to those of traditional surgery.
