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Integrating a Unique Leg Strengthening Device (S-Press) into Physiotherapy Rehabilitation Practice, a Qualitative Examination

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Advances in Aging Research 2025年第1期14卷 1-21页

作者： Kate Walker Chris Griffiths Bharath Lakkappa Research and Innovation Department Northamptonshire Healthcare NHS Foundation Trust Northampton UK consultant/clinical Director Community/CECS Northamptonshire Healthcare NHS Foundation Trust Northampton UK

Muscle deconditioning due to hospitalisation is problematic, causing delayed discharges, more nursing, carer, or social service support following discharge, and possible discharge to a care home rather than the patient’s own home. Muscle deconditioning is associated with increased mortality, infections, depression, and reductions in patient mobility and ability to engage in their activities of daily living. Preserving muscle strength and function should form part of patients’ rehabilitation plans. Progressive resistance training (PRE) offers the most cost-effective way of preserving muscle strength and function;however, it is not routinely carried out in hospitals. A leg strengthening device (the S-Press) has been developed with the aim of improving access to effective PRE for adults. Using a qualitative approach, thematic analysis of interviews with physiotherapists, patients, and relative carers about their experience of using the S-Press provided insight into integrating PRE into patients’ rehabilitation, what promoted or prevented its use, and the outcomes associated with its use. Four overall themes emerged from the data. “Experience of Users” described that the S-Press was accessible, convenient, time efficient, portable, and manoeuvrable, and it provided an objective measure of progress. “Facilitators” included findings around how the S-Press was easy to use, motivational, and comfortable when in use. “Barriers” comprised the inability of some patients to use the S-Press independently and the identification of obstacles that prevented consistent use. “Impact and Benefits” represented the perceptions of increased leg strength and psychological benefits. The S-Press is beneficial for patients’ rehabilitation by offering PRE that is simple and easy to use, acceptable to both patients and professionals, and can be integrated as part of patients’ rehabilitation plans.

关键词： Physiotherapy Rehabilitation Strength Training Deconditioning Resistance Training

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Efficacy and safety of ranibizumab for wet age-related macular degeneration in Chinese patients

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International Journal of Ophthalmology(English edition) 2017年第1期10卷 91-97页

作者： Hui-Jun Qi Xiao-Xin Li Jun-Yan Zhang Ming-Wei Zhao Department of Ophthalmology People's HospitalPeking UniversityBeijing 100044China clinical Study consultant Bothwin Pte.Ltd.Shanghai 200232China Branch of clinical Epidemiology and Evidence-Based Medicine Shanghai Medical AssociationShanghai 200240China

AIM： To evaluate the clinical efficacy and safety of ranibizumab for wet age-related macular degeneration （wAMD） in Chinese patients and to determine the mean number of injections administered over one year of follow-up. METHODS： This single centre, retrospective observational case series study included data from 121 patients with wAMD （121 eyes） who were diagnosed by indirect ophthalmoscopy, fluorescence fundus angiography （FFA）, indocyanine green angiography, and optical coherence tomography. Ranibizumab was injected into the vitreous cavities once per month for 3mo and as needed afterwards. Changes in visual acuity and central foveal thickness （CFT） during the follow-up period were compared, and the mean number of injections over the year was calculated. Patients with one or more adverse events related to the drugs and injections were recorded for further adverse events ***： The study population included 70 males and 51 females aged between 50 and 87y （mean： 71.32±9.41y）. The mean number of injections over the first year was 5±1 （range： 3-9）. The mean best-corrected visual acuity by Early Treatment Diabetic Retinopathy Study increased from 43.2±19.3 （95%CI： 39.8-46.7） at baseline to 51.7±20.1 （95%CI： 48.1-55.3）, and central foveal thickness （CFT） decreased from 526.5±277.0 μm （95%CI： 476.6-576.4） to 258.2±161.6 μm （95%CI： 229.2-287.3） at 12mo. The differences were statistically significant （P〈0.001）. Visual acuity significantly improved in 34.1% of the patients （38 eyes）, stabilized in 66.1% of the patients （80 eyes）, and significantly decreased in 2.5% of the patients （3 eyes）. CFT at baseline was an independent risk factor of decreased CFT and increased visual acuity. None of the patients had severe adverse events during the follow-up ***： Ranibizumab can effectively control disease progression and improve visual acuity in patients with wAMD. The disease conditions of most patients stabilized after a one-year treatment with an average

关键词： antiangiogenic drug ranibizumab wet age-relatedmacular degeneration fluorescence fundus angiography indocyanine green angiography optical coherence tomography visual acuity central foveal thickness

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A Case of Pelvic Migraine

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Open Journal of Obstetrics and Gynecology 2015年第11期5卷 672-675页

作者： Conor O’Brien consultant clinical Neurophysiologist National Maternity Hospital Dublin Ireland

A 62-year-old woman presented with an 8-year history of chronic persisting pelvic pain. She described constant throbbing, stabbing vaginal pain. A pelvic floor neurophysiological assessment of the pudendal nerve was performed by performing a needle EMG to the left and right external anal sphincter assessing for insertional activity and recruitment pattern. A quantitative assessment of the motor unit action potentials [MUAPs] was also performed. Tests confirmed a left pudendal neuropathy with chronic denervation in the left external anal sphincter, with reasonable muscle function, with a recruitment pattern of 65% - 70% of normal. The CAR showed an elevated sensory threshold with a normal distal latency. All other conventional pudendal nerve treatments including oral antiepileptic medication, neuromodulation and pudendal nerve blocking injections had failed, and the patient was exacerbated by the persisting pain and discomfort. In this case, 30 international units (iu) of botulinum toxin type A in 10 divided doses of 3 iu were injected along the nerve. Four days later the patient reported a significant improvement in the pain symptoms. She was reviewed 3 weeks later and for the first time in 8 years had made the 70 mile journey to the clinic as a passenger in her husband’s car. This case highlights a new therapeutic option of botulinum toxin type A injection, along the nerve length, for this common painful condition. It seems to have clinical veracity as unlike other therapeutic option the affect lasts for 3 or 4 months.

关键词： Pudendal Neuropathy Vaginal Birth Pelvic Pain Migraine Pelvic Migraine Botulinum Toxin Injection Pelvic Floor Neurophysiology

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Acute liver failure following levetiracetam therapy for seizure prophylaxis in traumatic brain injury

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Case Reports in clinical Medicine 2012年第2期1卷 42-45页

作者： Aasim Ali Syed Christopher D. Adams clinical Specialist Brigham and Women’s Hospital Boston USA Registered pharmacist CVS Pharmacy Suffern USA

This case report investigates an uncommon occurrence of drug induced acute liver injury directly associated with the administration of levetiracetam in a patient following traumatic brain injury.

关键词： Levetiracetam Liver Failure Seizure Prophylaxis Traumatic Brain Injury Adverse Drug Reaction

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ONCOLOGY PHARMACY PRACTICE——The Singapore Experience

ONCOLOGY PHARMACY PRACTICE——The Singapore Experience

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规范静脉输液混合调配学术研讨会

作者： LIM SIEW WOON MSc In clinical Pharmacy Pancipal pharmacist Cancer Centre Pharmacy National University Hospital SINGAPORE

＜正＞Top 5 causes of death in Singapore Fresentation in （?） ,China June 2006 SINGAPORE Hospitals -Public （NUH, TTSH, NCC, SGH, KKH） -Private （John-Hopkins International Medical Centre, Mount Elizabeth, Gleneagle...

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Supporting Skin Structure and Its Barrier Functions with Evidence-Based Skin Care Ingredients

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Journal of Cosmetics, Dermatological Sciences and Applications 2024年第2期14卷 200-210页

作者： Marsha Tharakan Lori Lonczak Scientific and clinical consultant Denver CO USA Lori Lonczak Consulting LLC Fair Haven NJ USA

The epidermis, and in particular its outermost layer, the stratum corneum, contributes much of the barrier function of the skin and is a readily visible representation of skin health. Maintaining the health of the skin barrier has arguably become more important than ever in the modern world, in which a large majority of people are exposed to environmental insults. These external factors can damage the integrity of the skin barrier and prematurely age the skin. Therefore, it has become increasingly important to maintain and protect the stratum corneum. Here, we briefly review the complex, multilayered structure of the skin and relate it to clinically translatable function, with an emphasis on the stratum corneum. In the context of epidermal structure and function, the formulation and clinical data for Phelityl® Reviving Cream will be reviewed. Phelityl Reviving Cream was shown to be associated with improvements in both immediate- and long-term parameters, including a significant positive effect on the skin barrier and immediate and long-lasting hydration.

关键词： Skin Structure Skin Barrier Stratum Corneum Phelityl Reviving Cream Phelityl Complex

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Perception and Attitude of Employers towards Employees with AUD in an Emerging Economy: A Qualitative Enquiry

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Open Journal of Psychiatry 2021年第2期11卷 107-123页

作者： Eugene Kobla Dordoye Lilian Ama Afun Thelma Mpoku Alalbila consultant Psychiatrist Senior Lecturer & Head Department of Psychological Medicine and Mental Health School of Medicine University of Health and Allied Sciences Ho Ghana clinical Psychologist Lecturer and PhD Candidate. Accra Psychiatric Hospital Accra Ghana pharmacist Lecturer and Head Department of Pharmacy Practice School of Pharmacy University of Health and Allied Science Ho Ghana

Background: The disease, addiction to chemical substances or drugs such as alcohol (ethanol, C2H5OH) is still not accepted as a diagnostic nosology by many in Ghana. Many consider addiction as a moral challenge, rather than a medical condition. This perception is propagated even in the Ministry of Health’s Occupational Health and Safety (OHS) policy document which punishes symptoms of substance use disorders. This study seeks to explore the perception and attitude of employers towards employees with alcohol use disorders (AUD) and to ascertain the level at which employee assistance programs (EAPs) are implemented in organizations. Methods: To infer outcomes, the study adopted the qualitative approach. In-depth interviews and observations which describe the perceived attitudes of employers (using HR managers as proxy) towards employees with AUD of some selected hospitals (private and public) in the Greater-Accra Metropolis. The interview was conducted face-to-face using an interview guide, which included open-ended questions. The structure of the guide helped the researchers to observe the participants and the conversations were also audio-taped after seeking the consent of the participants. On average, the interview lasted between 45 and 60 minutes. Results: Findings from the 10 interviews revealed that a number of factors such as biological, environmental, social and psychological accounted for AUD among employees regardless of the nature of their work. Although the HR managers had knowledge on the possible causes of AUD, some of them explained that they could not identify alcohol use in their organisations. The few that admitted to AUD at their workplace reported that alcohol use did not have any effect on their productivity and most of these workers were temporal or causal workers, hence were not perceived as permanent staff. In spite of preval

关键词： Perception Attitude Alcohol Use Disorder (AUD) Employee Assistance Programs (EAPs)

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Risk profile and outcomes of aortic valve replacement in octogenarians

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World Journal of Cardiology 2011年第11期3卷 359-366页

作者： Sujatha Kesavan Aamer Iqbal Yusra Khan Jonathan Hutter Katie Pike Chris Rogers Mark Turner Mandie Townsend Andreas Baumbach Academic Tutor and Research Fellow in Car-diology University of Bristol and Bristol Heart Institute Medical students University of Bristol clinical Lead and consultant Cardiothoracic Surgeon University of Bristol and the Bristol Heart Institute clinical Trials Evaluation Unit Bris-tol Heart Institute consultant Cardiologist University of Bristol and the Bristol Heart Institute Honorary Reader in Cardiology and consultant Cardiologist Bristol Heart Institute and University of Bristol

AIM: To investigate the patient characteristics, relationship between the Logistic EuroSCORE (LES) and the observed outcomes in octogenarians who underwent surgical aortic valve replacement (AVR). METHODS: Two hundred and seventy three octogenarians underwent AVR between 1996 and 2008 at Bristol Royal Inf irmary. Demographics, acute outcomes,length of hospital stay and mortality were obtained. The LES was calculated to characterize the predicted operative risk. Two groups were def ined: LES ≥ 15 (n = 80) and LES < 15 (n = 193). RESULTS: In patients with LES ≥ 15, 30 d mortality was 14% (95% CI: 7%-23%) compared with 4% (95% CI: 2%-8%) in the LES < 15 group (P < 0.007). Despite the increase in number of operations from 1996 to 2008, the average LES did not change. Only 5% of patients had prior bypass surgery. The LES identifi ed a low risk quartile of patients with a very low mortality (4%, n = 8, P < 0.007) at 30 d. The overall surgical results for octogenarians were excellent. The low risk group had an excellent outcome and the high risk group had a poor outcome after surgical AVR. CONCLUSION: It may be better treated with transcatheter aortic valve implantation.

关键词： Aortic valve replacement Transcatheter aortic valve implantation Logistic EuroSCORE Coronary artery bypass grafting

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Diabetes and COVID-19:Role of insulin resistance as a risk factor for COVID-19 severity

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World Journal of Diabetes 2021年第9期12卷 1550-1562页

作者： Charitha Gangadharan Rupa Ahluwalia Alben Sigamani Department of clinical Research Narayana Hrudayalaya LimitedBangalore 560099KarnatakaIndia consultant in Diabetes and Endocrinology Norfolk and Norwich University Hospitals NHS Foundation TrustNorwich NR47UYUnited Kingdom Chief Scientific Officer Numen HealthBangalore 560095KarnatakaIndia

Patients with diabetes are more susceptible to coronavirus disease 2019(COVID-19),and as a consequence,develop more severe form of *** is partly due to a systemic inflammatory state and pro thrombotic milieu seen in metabolic *** this review,we attempt to explore the pathogenetic links between insulin resistance and COVID-19 disease *** resistance is an underlying condition for metabolic syndromes,including type 2 diabetes,which impairs insulin signaling pathways affecting metabolic and cardiovascular homeostasis.A high concentration of circulating insulin shifts the balance to mitogen activated protein kinase(MAPK)-dependent signaling and causes endothelial cell *** phosphatidylinositol 3 kinase and MAPK dependent signaling pathways maintain a balance between nitric oxide-dependent vasodilator and endothelin-1 dependent vasoconstriction actions of *** smooth muscle cell dysfunction is responsible for inflammation and blood coagulation leading to microvascular and macrovascular complications in *** in renin-angiotensin system is implicated in development of islet oxidative stress and subsequentβ-cell dysfunction,as it alters the islet blood *** deleterious effects of insulin resistance involving altered blood pressure,vascular dysfunction,and inflammation could be associated with increased severity in COVID-19 *** conclude that clinical and/or biochemical markers of insulin resistance should be included as prognostic markers in assessment of acute COVID-19 disease.

关键词： Insulin resistance Renin-angiotensin system Blood flow measurements Inflammation Thrombosis Severity of COVID-19

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China and monkeypox: Correspondence

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Animal Models and Experimental Medicine 2022年第5期5卷 485-486页

作者： Amnuay Keebayoon Rujittika Mungmunpuntipantip Viroj Wiwanitkit Private Academic consultant SamraongCambodia Private Academic consultant BangkokThailand Department of Biological Science Joseph Ayobbabalola UniversityIkeji-ArakejiNigeria

To the editor,We would like to share our feedback on the publication“Is China ready for monkeypox?”.1 Wei documented the wide range of clinical prob-lems associated with *** mentioned that it is necessary to strengthen the prevention method against ***,in addition to a fever,the patient with monkeypox has a skin problem,usually vesicula ***,it is possible that neither a fever nor a skin lesion is present in a patient with monkeypox.2 According to a recent report by Benites-Zapata et al.,the meta-analysis results showed that rash occurs in 93%and fever in 72%of patients with mon-keypox.3 Without the atypical appearance of lesions,the doctor can fail to identify the issue and incorrectly diagnose the disease.4 In addition,the general laboratory inquiry is commonly based on the evaluation of crust or vesicle clinical ***,it is clear that skin lesion is considered to be a typical clinical problem in almost all published *** is important to recognize that some patients display only odd symptoms,such as gastrointestinal and neurological conditions.

关键词： prevention clinical doctor

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