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Medication beliefs predict medication adherence in ambulatory patients with decompensated cirrhosis

World Journal of Gastroenterology 2017年第40期23卷 7321-7331页

作者： Kelly l Hayward Patricia C Valery Jennifer H Martin antara Karmakar Preya J Patel leigh U Horsfall Caroline J Tallis Katherine A Stuart Penny l Wright David D Smith Katharine M Irvine Elizabeth E Powell W Neil Cottrell Pharmacy Department Princess Al-exandra Hospital The Centre for Liver Disease Research Translational Research Institute The University of Queensland Cancer and Chronic Disease Research Group QIMR Berghofer Medical Research Institute School of Medicine and Public Health The University of Newcastle The Centre for liver Disease Research Translational Research Institute The University of Queensland Department of Gastroenterology and Hepatology Princess Alexandra Hospital The Centre for Liver Disease Research Translational Research Institute The University of Queensland Department of Gastroenterology and Hepatology Princess Alexandra Hospital Statistics Unit QIMR Berghofer Medical Research Institute School of Pharmacy The University of Queensland

AIM To investigate the impact of medication beliefs, illness perceptions and quality of life on medication adherence in people with decompensated *** One hundred adults with decompensated cirrhosis completed a structured questionnaire when they attended for routine outpatient hepatology review. Measures of self-reported medication adherence(Morisky Medication Adherence Scale), beliefs surrounding medications(Beliefs about Medicines Questionnaire), perceptions of illness and medicines(Brief Illness Perception Questionnaire), and quality of life(Chronic liver Disease Questionnaire) were examined. Clinical data were obtained via patient history and review of medical records. least absolute shrinkage and selection operator and stepwise backwards regression techniques were used to construct the multivariable logistic regression model. Statistical significance was set at alpha = *** Medication adherence was " High " in 42 % o f participants, "Medium" in 37%, and "low" in 21%. Compared to patients with "High" adherence, those with "Medium" or "low" adherence were more likely to report difficulty affording their medications(P lower perception of treatment helpfulness(P = 0.003) and stronger medication concerns relative to medication necessity beliefs(P = 0.003). People with "low" adherence also experienced greater symptom burden and poorer quality of life, including more frequent abdominal pain(P = 0.023), shortness of breath(P = 0.030), and emotional disturbances(P = 0.050). Multivariable analysis identified having stronger medication concerns relative to necessity beliefs(Necessity-Concerns Differential ≤ 5, OR = 3.66, 95%CI: 1.18-11.40) and more frequent shortness of breath(shortness of breath score ≤ 3, OR = 3.87,95%CI: 1.22-12.25) as independent predictors of "low"*** The association between "low" adherence and patients having strong concerns or doubting the necessity or helpfulness of their medications should be explor

关键词： Medication adherence Medication beliefs Illness perceptions Quality of life liver cirrhosis

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千分之一效能白砷剂改善慢性砷中毒症状的初步临床观察(英文)

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中西医结合学报 2011年第6期9卷 596-604页

作者： Anisur Rahman Khuda-Bukhsh antara Banerjee Surjyo Jyoti Biswas Susanta Roy Karmakar Pathikrit Banerjee Surajit Pathak Bibhas Guha Saiful Haque Debarsi Das Arnab De Durba Das Naoual Boujedaini Department of Zoology Laboratory of Cytogenetics and Molecular BiologyUniversity of KalyaniKalyani 741235India Department of Surgical and Gastroenterological Science University of PadovaPadovaItaly Department of Zoology Netaji Subhas Open UniversityKolkata 700020India Boiron laboratory 20 rue de la LiberationSainte-Les-Foy-LyonLyonFrance

背景:全世界有数以百万计的人饮用砷污染的地下水,而目前尚未有缓解慢性砷中毒症状的有效制剂。文献报道白砷剂lM0/3作为一种顺势疗法强化制剂,对于砷中毒症状有一定的治疗作用。目的:本研究旨在验证白砷剂lM0/3对由于生活环境所致而长... 详细信息

背景:全世界有数以百万计的人饮用砷污染的地下水,而目前尚未有缓解慢性砷中毒症状的有效制剂。文献报道白砷剂lM0/3作为一种顺势疗法强化制剂,对于砷中毒症状有一定的治疗作用。目的:本研究旨在验证白砷剂lM0/3对由于生活环境所致而长期饮用砷污染水的人群的慢性砷中毒症状的缓解作用。设计、场所、对象和干预措施:本研究为双盲安慰剂对照研究,参加本研究的28名志愿者来自印度西孟加拉邦纳迪亚区一村落,该村无不含砷的饮用水可用,水井中的含砷量为55～95μg/ml。受试者分别服用药物或安慰剂,在参加试验前及2个月后试验结束时提供血、尿样本。另有18名来自无砷污染饮用水村的志愿者提供血、尿样本作为阴性对照。主要结局指标:测量受试者血、尿样本中的砷含量,各类中毒生物标记物及病理生理指标。结果:28名受试者中,14名愿意提供血、尿样本,其余14名退出试验。受试者的血、尿样本检测出砷的浓度升高,碱性磷酸酶及酸性磷酸酶水平升高,脂质过氧化反应及谷胱甘肽活性升高,血糖、三酰甘油、总胆固醇及低密度脂蛋白胆固醇水平升高,天门冬氨酸氨基转移酶及丙氨酸氨基转移酶水平、γ谷氨酰转移酶及葡萄糖6磷酸脱氢酶含量降低,高密度脂蛋白胆固醇水平及红细胞压积降低。2个月后,用药组的上述指标均有所改善,基质金属蛋白酶活性较安慰剂组有所降低。结论:在尚未有更好的医疗条件和治疗手段的情况下,使用白砷剂lM0/3在饮用水受砷污染地区作为暂时的治疗手段以缓解生活在这些地区的人们的慢性砷中毒症状有一定的可行性。

关键词：砷剂顺势疗法砷中毒生物学标记基质金属蛋白酶类临床试验

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皮肤阿米巴病的组织病理学

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世界核心医学期刊文摘（皮肤病学分册） 2005年第1期1卷 21-21页

作者： Maga.na M. Maga.na M.l. alc'antara A. P'erez-Martn M.A. 罗素菊冯义国 Viaducto miguel.a.eman 230 y Mineria M'exico D.F. 11800 Mexico Dr.

Cutaneous amebiasis (CA) is the manifestation in the skin and underlying soft tissues of the pathogenic properties of Entamoeba histolytica, which may be the only expression of the infection or may be associated with disease in other organs. So far, there have been only isolated case reports on this disease. We herein report the histopathologic findings on a series of seven cases, six adults and one child, of CA. Themost common findings include ulcers, areas of necrosis, mixed inflammatory infiltrates, and the presence of trophozoites, the invasive form of the parasite. CA is a very rare and severe disease, it is progressive and destructive; erythrophagocytosis, a microscopic sign of pathogenicity, is always seen in CA.

关键词：皮肤阿米巴病组织病理学滋养体溶组织阿米巴皮下软组织细胞吞噬混合感染侵入体

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