Primaire biliaire cirrhose met sclerodermie en hypothyreoidie

Contains fulltext : 4297.pdf (publisher's version ) (Open Access

Shigellosis and AIDS : Report of a case and brief review of the literature

Contains fulltext : 4491.pdf (publisher's version ) (Open Access

Non-radioactive in situ hybridization for the detection of cytomegalovirus infections

Contains fulltext : 4468.pdf (publisher's version ) (Open Access

Локальные элиминационные алгоритмы обработки запросов в базах данных

Рассмотрено использование локальных элиминационных алгоритмов (ЛЭА) для обработки запросов в реляционных базах данных. Обсуждаются особенности реализации локального алгоритма, использующего лишь прямую часть.Розглянуто використання локальних елімінаційних алгоритмів (ЛЕА) для обробки запитів в реляційних базах даних. Обговорюються особливості реалізації локального алгоритму, що використовує лише пряму частину.The applying local elimination algorithms (LEA) for processing queries in relational databases is considered. The special features of realization of local algorithm using only a forward part are discussed

A patient perspective on information provision during the care path of Lentigo Maligna

Patients sometimes experience complex diagnostic and treatment procedures. During these processes, they need to rely on the information provided by the care providers. In particular, if they would like to play an active role in the shared decision-making process, it is important that this information is accessible, complete and understandable. A patient with Lentigo Maligna on the nose has been followed during the process of diagnosis, shared decision-making and treatment. Using the autoethnographical methodology, it was evaluated which sources of information available to the patient contributed to a better understanding, a more active role in the treatment process and a positive experience. Possible improvements are suggested. Experience Framework This article is associated with the Quality & Clinical Excellence lens of The Beryl Institute Experience Framework (https://www.theberylinstitute.org/ExperienceFramework). Access other PXJ articles related to this lens. Access other resources related to this lens

Cardiac foetal reprogramming:a tool to exploit novel treatment targets for the failing heart

As the heart matures during embryogenesis from its foetal stages, several structural and functional modifications take place to form the adult heart. This process of maturation is in large part due to an increased volume and work load of the heart to maintain proper circulation throughout the growing body. In recent years, it has been observed that these changes are reversed to some extent as a result of cardiac disease. The process by which this occurs has been characterized as cardiac foetal reprogramming and is defined as the suppression of adult and re-activation of a foetal genes profile in the diseased myocardium. The reasons as to why this process occurs in the diseased myocardium are unknown; however, it has been suggested to be an adaptive process to counteract deleterious events taking place during cardiac remodelling. Although still in its infancy, several studies have demonstrated that targeting foetal reprogramming in heart failure can lead to substantial improvement in cardiac functionality. This is highlighted by a recent study which found that by modulating the expression of 5-oxoprolinase (OPLAH, a novel cardiac foetal gene), cardiac function can be significantly improved in mice exposed to cardiac injury. Additionally, the utilization of angiotensin receptor neprilysin inhibitors (ARNI) has demonstrated clear benefits, providing important clinical proof that drugs that increase natriuretic peptide levels (part of the foetal gene programme) indeed improve heart failure outcomes. In this review, we will highlight the most important aspects of cardiac foetal reprogramming and will discuss whether this process is a cause or consequence of heart failure. Based on this, we will also explain how a deeper understanding of this process may result in the development of novel therapeutic strategies in heart failure

Interference of circulating azathioprine but not methotrexate or sulfasalazine with measurements of interleukin-6 bioactivity

Contains fulltext : 4779.pdf (publisher's version ) (Open Access

Trust in Dutch intensive care networks:the results of a survey

Introduction: Dutch ICUs have been enrolled in network organisations since the Quality Standard of 2016. In networks, intensivists have to cooperate to provide a high quality of care for all patients in their network. Trust is essential to cooperate effectively in a network. It is unknown what the degree of trust is in Dutch ICU networks. Methods: A survey was composed using the questionnaire by Cummings, measuring the experience of trust, and the questionnaire by Currall, measuring the willingness to show behaviour that is consistent with trust. Two overall questions concerning the feeling of being part of the network and the overall level of trust were added. All questions were answered on a 7-point Likert scale. Network managers passed the questionnaire to intensivists in the network. Results: The overall level of trust showed a mean of 5.5 (SD 1.2), similar to the mean of the Cummings questionnaire (5.3; SD 0.9). Academic intensivists had a significantly higher level of trust than intensivists from other hospitals (5.9 vs 5.0 and 5.3; p=0.009). The questions covering `surveillance', which measures the need for control, scored lowest with 3.8 (SD 1.3). Intensivists feel the need to make formal agreements and they experience a relatively intense need to control these agreements. Conclusion: Intensivists experience a reasonable level of trust within their network. However, intensivists feel the need to make formal agreements and they experience a relatively intense need to control these agreements. This suggests that the actual trust is conditional. Academic intensivists showed the highest level of trust

Trust in Dutch intensive care networks:the results of a survey

Introduction: Dutch ICUs have been enrolled in network organisations since the Quality Standard of 2016. In networks, intensivists have to cooperate to provide a high quality of care for all patients in their network. Trust is essential to cooperate effectively in a network. It is unknown what the degree of trust is in Dutch ICU networks. Methods: A survey was composed using the questionnaire by Cummings, measuring the experience of trust, and the questionnaire by Currall, measuring the willingness to show behaviour that is consistent with trust. Two overall questions concerning the feeling of being part of the network and the overall level of trust were added. All questions were answered on a 7-point Likert scale. Network managers passed the questionnaire to intensivists in the network. Results: The overall level of trust showed a mean of 5.5 (SD 1.2), similar to the mean of the Cummings questionnaire (5.3; SD 0.9). Academic intensivists had a significantly higher level of trust than intensivists from other hospitals (5.9 vs 5.0 and 5.3; p=0.009). The questions covering `surveillance', which measures the need for control, scored lowest with 3.8 (SD 1.3). Intensivists feel the need to make formal agreements and they experience a relatively intense need to control these agreements. Conclusion: Intensivists experience a reasonable level of trust within their network. However, intensivists feel the need to make formal agreements and they experience a relatively intense need to control these agreements. This suggests that the actual trust is conditional. Academic intensivists showed the highest level of trust