European journal of internal medicine
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Eur. J. Intern. Med. · Jul 2009
ReviewThe concepts of professionalism and professional behaviour: conflicts in both definition and learning outcomes.
This article is the second in a series on professionalism in the European Journal of Internal Medicine. The current article will first focus on these different views and definitions that are currently adopted by the various researchers, and subsequently discuss the consequences for the training and assessment of professionalism and professional behaviour in medical education.
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Amyotrophic lateral sclerosis (ALS) is the most common rapidly progressive adult-onset neurodegenerative disorder. There have been great advances in the management of patients with ALS over the past decade. It starts with the giving of the diagnosis and continues to the terminal phase of the disease. This review will examine the impact of medical and non-medical interventions on improving survival and quality of life in these patients, emphasizing the importance of a multidisciplinary approach.
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Eur. J. Intern. Med. · Jul 2009
Risk assessment study of the pressure ulcers in intensive care unit patients.
In this research, we studied the incidence of pressure ulcer and risk factors and screening of the patients for pressure ulcers at intensive care unit on the first day of admission in 142 patients. All patients were evaluated according to National Pressure Ulcer Advisory Panel during the ICU period strictly. Pressure ulcer risk evaluation was performed according to Norton Scale. ⋯ Results of this study show us the PU incidence of ICU patients may be low if we perform PU screening all patients at the admission and put into practice NPUAP strictly. Age, low Norton score, hospitalization period, high APACHE-II score, hypotension, malnutrition and hypoalbuminemia were significant in patients with PU; however, BMI and hemoglobin were not significant. The studies focusing on the relation between the effect of optimization of these parameters from the first day of admittance and pressure ulcer are required.
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Eur. J. Intern. Med. · Jul 2009
Randomized Controlled TrialSerum levels of MMP-9 and TIMP-1 in primary hypertension and effect of antihypertensive treatment.
Matrix metalloproteinases, a family of proteolytic enzymes are thought to be involved in extracellular matrix accumulation during development of hypertensive target organ disease. The present study was designed to compare hypertensive patients with normotensive individuals with respect to serum levels of matrix metalloproteinase (MMP)-9 and tissue inhibitor of metalloproteinase (TIMP)-1 and to search for the effect of antihypertensive treatment on the serum enzyme levels. ⋯ In hypertensive patients, increased MMP-9 activity could result in increased degradation of elastin relative to collagen and non-elasticity, while decreased TIMP-1 activity could lead to accumulation of poorly cross-linked, immature and unstable fibril degradation products, which result in misdirected deposition of collagen. Our study is important for revealing the role of the MMP enzyme system in the pathogenesis of hypertensive target organ disease.
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Eur. J. Intern. Med. · Jul 2009
Effect of depression on health care utilization in patients with end-stage renal disease treated with hemodialysis.
Depression is regarded as the most common psychiatric abnormality in patients on hemodialysis (HD) for end-stage renal disease (ESRD). Although several studies have demonstrated a relationship between depression and utilization of health care in ESRD and other chronic illnesses in developing countries, such evidence from hemodialysis patients is lacking in Iran. This study aims to investigate the effect of depression on health care utilization among Iranian hemodialysis patients. ⋯ Depression in hemodialysis patients is associated with higher rate of hospital admission, and prospective studies should be conducted to assess whether treatment of depression will decrease health care utilization in these patients.