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Gender Dysphoria (GD, formerly known as transsexualism) describes distress and impairment in an individual caused by the incongruence between the experienced gender and the sex assigned at birth (Gender Incongruence GI). Transgender health care focusses on gender-affirmative treatments (e. g., hormone therapy) and associated needs (e. g., psychotherapy). Moreover, genital surgery is considered an effective treatment to reduce GI/GD and improve mental health and quality of life. Interdisciplinary cooperation between the associated medical facilities is regarded as evidence-based health care.

To date, THC is delivered in zwei different health care settings interdisciplinary and centralized from one medical institution vs. decentralized, spread over several medical institutions. In Germany, individuals with GI/GD access health care mostly in decentralized structures. The consequences of feminizing genital surgery carried out in centralized and decentralized health care structures in terms of quality and effectiveness have not been investigated so far. The goal of the TransCare study is to prospectively examine individuals with GI/GD seeking feminizing genital surgery regarding demographics and clinical characteristics as well as to analyze the influence of centralized and decentralized health care settings on the psychosocial and clinical outcome.

To recruit a valid and comprehensive sample, participants were questioned prospectively.

The results of the study should help gain new insights into the influence of centralized and decentralized health care settings carrying out feminizing genital surgery on psychosocial and clinical outcomes for the patients.

Based on the TransCare study, we suggest that health care should be improved according to individual patient needs.

Based on the TransCare study, we suggest that health care should be improved according to individual patient needs.The concept of mentalization has attracted broad clinical and scientific interest, particularly because of its high clinical and therapeutic relevance. To make this concept accessible for empirical research, the 8-item Reflective Functioning Questionnaire (RFQ-8) was developed, which comprises 2 subscales tapping into uncertainty about mental states (or hypomentalizing), and certainty about mental states (i. e. hypermentalizing). Although first psychometric examinations have evaluated the RFQ-8 positively, these findings must be interpreted with caution for methodological reasons. The aim of this study was the psychometric evaluation of the German version of the RFQ-8 in a large general population sample (n=2477). Various confirmatory and exploratory factor analyses indicated that the originally introduced 2-factor solution is mis-specified. Instead, the RFQ-8 seems to cover a unidimensional construct. Having excluded 2 items due to their insufficient psychometric qualities, the 6-item measure (RFQ-6) showed high internal consistency (McDonald's ω=0,88) as well as significant rank correlations with depression, anxiety and bodily complaints. Considering the psychometric limitations of the RFQ-8, its use in clinical routine and research should be viewed very critically, particularly with respect to its ability to assess hypermentalizing.

In Germany, waiting times for outpatient psychotherapy are on average 5 months long. Guided web-based interventions can be implemented to reduce depressive symptoms during waiting times. The study aims to explore how patients experience the usage of a web-based intervention for mood enhancement.

Patients on the waiting lists of cooperating outpatient clinics were invited to participate in the study and apply a web-based intervention for mood enhancement. Eleven participating patients were interviewed about their experiences with the intervention. The data was analyzed based on the Grounded-Theory methodology.

Three categories could be derived from the data prior expectations, experiences with the intervention and factors influencing adherence. The web-based intervention was experienced very differently and was associated with both positive and negative experiences. The participants could be grouped into 3 user types.

Not all patients report positive experiences with the intervention and some fail to adhere. In order to prepare patients adequately, they should be informed about the application and goals of the intervention in advance. Interventions should be implemented in accordance with the individual's need of support in order to enhance adherence and allow positive experiences.

Not all patients report positive experiences with the intervention and some fail to adhere. #link# In order to prepare patients adequately, they should be informed about the application and goals of the intervention in advance. Interventions should be implemented in accordance with the individual's need of support in order to enhance adherence and allow positive experiences.Infectious diseases are among the greatest threats to global health in the 21st century, and one critical concern is due to antibiotic resistance developed by an increasing number of bacterial strains. New resistance mechanisms are emerging with many infections becoming more and more difficult if not impossible to treat. This growing phenomenon not only is associated with increased mortality but also with longer hospital stays and higher medical costs. For these reasons, there is an urgent need to find new antibiotics targeting pathogenic microorganisms such as ESKAPEE bacteria. Most of currently approved antibiotics are derived from microorganisms, but higher fungi could constitute an alternative and remarkable reservoir of anti-infectious compounds. link2 For instance, pleuromutilins constitute the first class of antibiotics derived from mushrooms. However, macromycetes still represent a largely unexplored source. Publications reporting the antibacterial potential of mushroom extracts are emerging, but few purified compounds have been evaluated for their bioactivity on pathogenic bacterial strains. Therefore, the aim of this review is to compile up-to-date data about natural products isolated from fruiting body fungi, which significantly inhibit the growth of ESKAPEE pathogenic bacteria. When available, data regarding modes of action and cytotoxicity, mandatory when considering a possible drug development, have been discussed in order to highlight the most promising compounds.Pueraria mirifica is an endemic Thai plant that has been used for rejuvenation and in the relief of various aging diseases. Puerarin is one of the major isoflavones found in this plant and shows several pharmacological activities in relation to the Thai traditional use of P. mirifica. Therefore, comparative pharmacokinetics of pure puerarin alone and that in a P. mirifica extract in cynomolgus monkeys were conducted in order to investigate the pharmacokinetic profiles of the 2 preparations. To this end, puerarin and P. mirifica extract, at an equivalent dose of 10 mg/kg of puerarin, were orally dosed to adult female monkeys for 7 consecutive days. A single intravenous injection of puerarin at a dose of 1 mg/kg was also peformed. Serial blood samples and excreta were collected from 0 - 24 h and 0 - 48 h after dosing. Determination of the puerarin levels and its metabolites in biological samples was conducted by liquid chromatography tandem mass spectrometry. Plasma levels of aspartate aminotransferase, alanine aminotransferase, and creatinine fluctuated in the normal range, with no abnormal physical signs in the animal. The absolute oral bioavailability of puerarin was approximately 1% in both preparations. Accumulation of puerarin was found after oral dosing for 7 consecutive days in both groups. Major metabolites of puerarin found in monkeys were hydroxylation and deglycosylation products. this website of unchanged puerarin was detected in urine and feces. Pharmacokinetic profiles obtained from this study could help to design the prescribed remedy of puerarin and P. mirifica extract phytopharmaceutical products for human use.This study aims at determining the in vitro antitrypanosomal, antileishmanial, antioxidant, and anti-inflammatory-like activities of Terminalia mollis root crude extracts. The antitrypanosomal and antileishmanial activities on Trypanosoma brucei brucei (strain 427) and promastigotes of Leishmania mexicana mexicana (MHOM/BZ/84/BEL46) were evaluated in vitro. The methanolic root bark extract and standards were profiled by HPLC-PDA, and the majority of compounds identified using literature data. The in vitro antioxidant and anti-inflammatory-like activities were determined by evaluating the effect of crude extracts on reactive oxygen species produced by phorbol 12-myristate 13-acetate-stimulated equine neutrophils using lucigenin-enhanced chemiluminescence and on purified equine myeloperoxidase activity measured by specific immunological extraction followed by enzymatic detection. The methanolic, aqueous crude extract, and aqueous crude extract free of tannins exhibited good growth inhibition on Trypanosoma brucei brucei (IC50 3.72, 6.05, and 4.45 µg/mL respectively) but were inactive against Leishmania mexicana mexicana (IC50 > 100 µg/mL). Suramin (IC50 0.11 µg/mL) and amphotericin (IC50 0.11 µg/mL) were used as standard respectively for the antitrypanosomal and antileishmanial activity. Very interesting antioxidant and anti-inflammatory-like activities were observed with 50% hydroethanolic, aqueous crude extracts, and aqueous crude extract free of tannins as well as with pure punicalagin, gallic, and ellagic acid (IC50 0.38 - 10.51 µg/mL for 2,2'-azinobis-(3-ethylbenzothiazoline-6-sulfonic acid), chemiluminescence, and specific immunological extraction followed by enzymatic detection assays. The study results support traditional medicinal use of the plant for the treatment of parasitical disorders and revealed for the first time the antitrypanosomal potential, anti-inflammatory-like, and antioxidant activity of Terminalia mollis root.

This study aimed to describe the involvement of the lesser sigmoid notch in fractures to the coronoid process. We hypothesized that injuries to the lateral aspect of the coronoid process regularly involve the annular ligament insertion at the anterior lesser sigmoid notch.

Patients treated for a coronoid process fracture at our institution between 06/2011 and 07/2018 were included. We excluded patients < 18 years, patients with arthritic changes or previous operative treatment to the elbow, and patients with concomitant injuries to the proximal ulna. In patients with involvement of the lesser sigmoid notch, the coronoid height and fragment size (anteroposterior, mediolateral, and craniocaudal) were measured.

Seventy-two patients (mean age 47 years ± 17.6) could be included in the study. Twenty-one patients (29.2%) had a fracture involving the lateral sigmoid notch. The mean anteroposterior fragment length was 7 ± 1.6 mm. The fragment affected a mean of 43 ± 10.8% of the coronoid height. The mean mediolateral size of the fragment was 10 ± 5.0 mm, and the mean cranio-caudal size was 7 ± 2.7 mm.

Coronoid fractures regularly include the lesser sigmoid notch. link3 These injuries possibly affect the anterior annular ligament insertion which is important for the stability of the proximal radioulnar joint and varus stability of the elbow.

Coronoid fractures regularly include the lesser sigmoid notch. These injuries possibly affect the anterior annular ligament insertion which is important for the stability of the proximal radioulnar joint and varus stability of the elbow.

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