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Regarding pain, studies have found a reduction of this symptom in the neck, shoulders, back, masseter, and larynx. In the perceptual analysis, an improvement was verified in the parameters of tension, breathiness, roughness, instability, and asthenia. In addition, different types of vocal symptoms such as pain, burning, lump in the throat and effort to speak were reduced after TENS. CONCLUSION Although the studies included in this review indicate that there were changes related to the reduction of vocal symptoms, reduction of pain and improvement of vocal quality after the application of TENS in dysphonic patients, studies with a higher level of evidence and rigorous assessments of methodological quality are necessary so that findings are more robust and replicable in clinical practice. The aim of this study is to compare the relatively new CO2 laser microlaryngeal surgery and conventional cold dissection method in treatment of minimal associated pathological lesions of vocal folds. Eighty patients aged 20-70 years old were randomly divided into two groups, group A (40 patients) was treated by the conventional method and group B (40 patients) was treated with CO2 laser microlaryngeal surgery. Assessment procedures included GRBAS scale, stroboscopic examination, and Arabic version of voice handicap index. Results stated that improvement of quality of voice after surgery in both techniques had no significant difference. The significant difference was in operative time and bleeding because laser had less time and bleeding. Both techniques had no recurrence within 3-months follow-up. BACKGROUND There are only scarce data on treatment of elderly patients with nab-paclitaxel for metastatic breast cancer, especially from the real-world setting. Here we present data from the noninterventional study NABUCCO with special focus on taxane-induced peripheral neuropathy (TIPN) in younger and elderly patients. PATIENTS AND METHODS A total of 407 patients with HR-positive/HER2-negative metastatic breast cancer were enrolled between April 2012 and April 2015 into the prospective, multicenter, noninterventional study NABUCCO. Details on effectiveness, tolerability, and safety of nab-paclitaxel were evaluated for younger ( less then 70 years) and elderly (≥70 years) patients. RESULTS Neither median time to progression (TTP, younger 6.0 months, 95% confidence interval [CI], 5.5-7.1; elderly 6.9 months, 95% CI, 5.5-8.6) nor median overall survival (younger 16.4 months, 95% CI, 14.2-18.1; elderly 14.5 months, 95% CI, 11.9-17.4) differed by age group, also not in view of prior treatments. A multivariate regression model revealed that age did not significantly influence the TTP. TIPN was reported by 49.0% younger (44.3% common terminology criteria for adverse events [CTCAE] grade 1/2, 4.7% grade 3/4) and 45.8% elderly patients (41.1% CTCAE grade 1/2, 4.7% grade 3/4). The cumulative nab-paclitaxel dose did not correlate with the severity/grading of TIPN. CONCLUSION Treatment with nab-paclitaxel in first- or further-line of metastatic HR-positive/HER2-negative breast cancer resulted in similar effectiveness and safety, irrespective of age. Therefore, nab-paclitaxel is a valid treatment option for elderly and partially heavily pretreated patients. However, incidence of TIPN is high, influencing the patients' quality of life. A close monitoring and awareness for early TIPN symptoms is warranted. Bull fertility is crucial for efficient, profitable, and sustainable agriculture of cattle. Despite the fact that the uses of sperm from low fertility bulls cause millions of dollars economic losses, conventional methods available to accurately predict bull fertility are still of limited use. Although breeding bulls produce billions of sperm mostly with normal motility and morphology, some bulls are afflicted with poor fertility due to molecular or cellular defects in the sperm. Sperm functional genome including transcriptome, proteome, and metabolome influence bull fertility. Through high throughput screening methods of metabolomics, specific small molecules have been described both for seminal plasma and sperm. Compared to sperm, seminal plasma contains much higher numbers and levels of metabolites. Although the identities and functions of many of these metabolites are known, such knowledge is still yet to be generated for a greater number of metabolites of sperm and seminal plasma. Once validated as fertility markers, sperm, and seminal plasma metabolites can be used to evaluate semen quality and predict bull fertility, and/or used in assisted reproductive technologies. This review describes the possibility to use small molecules (in the review called metabolites) as fertility predictors. V.INTRODUCTION Individuals with intellectual disabilities (ID) are more likely to visit the emergency department (ED) more frequently than their counterparts without ID. Nurses play an integral role in caring for all patients in the ED, including those with ID, although training to work with this population is limited. The aim of this study was to examine the self-perceived knowledge, skills, and comfort of ED nurses when caring for a patient with ID. selleck inhibitor METHODS Questionnaires were returned from 151 nurses from a total of six EDs within Ontario, Canada. The questionnaire contained fourteen items related to knowledge, comfort, practice and skills, readiness for change, prior exposure to patients with ID, and awareness of strategies to identify patients in this population. RESULTS Although the majority of nurses reported an interaction with a patient with a suspected ID in the past year, only 28% of respondents reported awareness of strategies to help identify if a patient may have an ID, and only half reported feeling skilled in adapting their communication and approach. DISCUSSION ED nurses are the first point of contact in caring for patients with ID, thus it is crucial that they understand how to provide accessible and inclusive care for this population. INTRODUCTION As a supplement, beta-glucan has various therapeutic healing effects generated by the immune cells. It has been scientifically approved and proven to be a biological defense modifier. The aim of this study was to investigate the effects of beta-glucan on treatments administered in an acute otitis media model OBJECTIVES This study investigated the effect of beta-glucan on the treatment of acute otitis media in an acute otitis media -induced animal model. Efficacy was evaluated both immunologically and histologically. METHODS The study sample comprised 35 adult rats, randomly separated into 5 groups of 7 Group 1 (control), Group 2 (acute otitis media, no treatment), Group 3 (acute otitis media+antibiotic), Group 4 (acute otitis media+beta-glucan) and Group 5 (acute otitis media+beta-glucan+antibiotic). Analyses were made of the histopathology and immunology examination results in respect of thickening of the tympanic membrane, epithelium damage, inflammation, and sclerosis. In all groups the serum levels of TNF-α, IL-4, IL-6 and IL-1β were evaluated.

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