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This report reviews the evidence for the types of human rights violations experienced by people with mental and psychosocial disabilities in low-income and middle-income countries as well as strategies to prevent these violations and promote human rights in line with the UN Convention on the Rights of Persons with Disabilities (CRPD). The article draws on the views, expertise, and experience of 51 people with mental and psychosocial disabilities from 18 low-income and middle-income countries as well as a review of English language literature including from UN publications, non-governmental organisation reports, press reports, and the academic literature.
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Comparative Study
Insulin-treated diabetes in Tasmania: population-based clinical characteristics and their possible implications for diabetic health care in Australia.
The Tasmanian Insulin-treated Diabetes Register recruited 1233 eligible (treatment with insulin on May 1, 1984) subjects with insulin-treated diabetes, which enabled the description of a population-based profile of clinical characteristics. Approximately one-third of both the male and female subjects who were recruited was considered to have insulin-dependent diabetes mellitus. As would be expected, subjects with insulin-dependent diabetes mellitus were considerably younger, had a longer average duration of disease, and had had fewer hospital admissions compared with subjects with non-insulin-dependent diabetes mellitus. ⋯ More than 90% of subjects with insulin-dependent diabetes mellitus and approximately half the subjects with non-insulin-dependent diabetes mellitus were hospitalized at diagnosis; an absence of a secular trend in diabetes-stabilization practices was noted, which suggested a low utilization of facilities for ambulatory stabilization in Tasmania to date. To monitor metabolic control, approximately half the subjects performed self-monitoring of their blood glucose levels exclusively, which indicated the widespread acceptance of this form of evaluation (which has been introduced into Australia only within the past decade). Approximately one-quarter of the subjects continued to perform urine testing exclusively and a small proportion of subjects did not monitor their metabolic control in any way.
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Chinese Med J Peking · Jun 2004
Case ReportsClinical phenotypes, ALK1 gene mutation and level of related plasma proteins in Chinese hereditary hemorrhagic telangiectasia.
We determined the diagnosis of hereditary hemorrhagic telangiectasis (HHT) in a suspected HHT family, identified ALK1 gene mutation and established a gene diagnosis method of HHT. The level of related plasma proteins (transforming growth factor beta and thrombomodulin) were also analyzed. ⋯ Chinese HHT individuals have mutant ALK1 gene, a C1231T variation on exon 8 of ALK1 is responsible for HHT clinical phenotypes in this family. ALK1 gene analysis, together with special clinical phenotypes and family history, provides a reliable method in diagnosing HHT. In affected HHT subjects, plasma TGFbeta levels were not obviously different from those of normal subject; while plasma TM concentration was significantly lower than that in normal subjects. The significance and mechanism remain to be elucidated.
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After disruption of the descending respiratory pathways induced by unilateral cervical spinal cord injury (SCI) in rats, the inactivated ipsilateral (ipsi) phrenic nerve (PN) discharge may partially recover following some specific experimental procedures [such as contralateral (contra) phrenicotomy (Phx)]. This phrenic reactivation involves normally silent contra pathways decussating at the level of the phrenic nucleus, but the mechanisms of this crossed phrenic activation are still poorly understood. The present study investigates the contribution of sensory phrenic afferents to this process by comparing the acute effects of ipsi and contra Phx. ⋯ This ipsi phrenic activity was enhanced immediately after contra Phx and was completely suppressed by an acute contra cervical section, indicating that it is triggered by crossed phrenic pathways located laterally in the contra spinal cord. Ipsi phrenic activity was also abolished immediately after ipsi Phx that interrupts phrenic sensory afferents, an effect prevented by prior acute ablation of the cervical dorsal root ganglia, indicating that crossed phrenic activation depends on excitatory phrenic sensory afferents but also putatively on inhibitory non-phrenic afferents. On the basis of these data, we propose a new model for crossed phrenic activation after partial cervical injury, with an essential role played by ipsi-activating phrenic sensory afferents.
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Klebsiella pneumoniae is once thought to be a less common cause of brain abscess in adults and is mainly hospital-acquired. Community-acquired CNS infection (brain abscess and meningitis) caused by K pneumoniae without other metastatic septic abscesses is exceedingly rare. Therefore, we present a rare adult patient with invasive cerebral abscess and meningitis without other invasive abscesses related to K pneumoniae. ⋯ Despite the progress of modern neurosurgical techniques, new antibiotics, and modern imaging techniques, brain abscesses are still a potentially fatal infection. Streptococci are common organisms that result in brain abscesses. Nevertheless, Klebsiella species, once thought to be a less common cause of brain abscess in adults, has become an increasingly important cause of brain abscess, especially in Asia.