RESUMEN
OBJECTIVES: Several concepts on collaboration between patients and healthcare systems have emerged in the literature but there is little consensus on their meanings and differences. In this study, "patient participation" and related concepts were studied by focusing on the dimensions that compose them. This review follows two objectives: (1) to produce a detailed and comprehensive overview of the "patient participation" dimensions; (2) to identify differences and similarities between the related concepts. METHODS: A scoping review was performed to synthesize knowledge into a conceptual framework. An electronic protocol driven search was conducted in two bibliographic databases and a thematic analysis was used to analyse the data. RESULTS: The search process returned 39 articles after exclusion for full data extraction and analysis. Through the thematic analysis, the dimensions, influencing factors and expected outcomes of "patient participation" were determined. Finally, differences between the included concepts were identified. CONCLUSION: This global vision of "patient participation" allows us to go beyond the distinctions between the existing concepts and reveals their common goal to include the patient in the healthcare system. PRACTICE IMPLICATIONS: This scoping review provides useful information to propose a conceptual model of "patient participation", which could impact clinical practice and medical training programs.
Asunto(s)
Participación del Paciente , HumanosRESUMEN
A 3-year-old boy presented with a history of intermittent abdominal pain and vomiting from the age of 1 year. Raised serum amylase and lipase levels supported a diagnosis of acute pancreatitis. Subsequent investigation confirmed coeliac disease. This is the youngest patient to be reported with this combination.
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Enfermedad Celíaca/diagnóstico , Enfermedad Celíaca/patología , Pancreatitis Aguda Necrotizante/diagnóstico , Pancreatitis Aguda Necrotizante/patología , Dolor Abdominal/etiología , Amilasas/sangre , Preescolar , Diagnóstico Diferencial , Humanos , Lipasa/sangre , Masculino , Suero/químicaRESUMEN
BACKGROUND: This study was conducted to explore the use of cisapride in the treatment of chronic idiopathic constipation in children. METHODS: Seventy-nine children were screened. Seventy-three of them met the selection criteria that included clinical, laboratory, radiologic, and histopathologic investigations. These patients entered a week-long phase I of disimpaction using lactulose. Four of them were noncompliant and thus were excluded from the next phase. In phase II sixty-nine patients were assigned to two treatment groups: 0.3 mg/kg cisapride four times a day versus matching placebo for 8 weeks in a double-blind study. The two groups that completed phase II were similar in age and duration of symptoms, confirmed by statistical analysis. Stool frequency was assessed weekly, beginning at the end of the disimpaction phase and continuing for 9 weeks. Total gastrointestinal transit time was measured twice, on completion of phase I and 9 weeks later. Transit time is the time required for a carmine marker taken orally after overnight fast to appear in the stool. RESULTS: There was a significant difference between stool frequency per week before and after cisapride treatment, stool frequency per week at the end of phase II with cisapride versus placebo, and total gastrointestinal transit time before and after treatment with cisapride (p < 0.05 for all values). No such difference was demonstrated when comparing stool frequency per week or total gastrointestinal transit time before and after placebo (p > 0.05 for both). CONCLUSIONS: Cisapride may have a role in the management of chronic idiopathic constipation in children.
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Cisaprida/uso terapéutico , Estreñimiento/tratamiento farmacológico , Fármacos Gastrointestinales , Adolescente , Niño , Preescolar , Enfermedad Crónica , Estreñimiento/fisiopatología , Método Doble Ciego , Impactación Fecal/terapia , Femenino , Motilidad Gastrointestinal , Humanos , Lactulosa/uso terapéutico , Masculino , PlacebosRESUMEN
This is a report of spherocytosis presenting unusually early with choledocholithiasis secondary to low grade haemolysis.
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Cálculos Biliares/etiología , Esferocitosis Hereditaria/diagnóstico , Colangiopancreatografia Retrógrada Endoscópica , Femenino , Ácido Fólico/uso terapéutico , Cálculos Biliares/cirugía , Humanos , Lactante , Fragilidad Osmótica , Esferocitosis Hereditaria/complicaciones , Esferocitosis Hereditaria/tratamiento farmacológico , UltrasonografíaRESUMEN
Recurrent hyperbilirubinaemia was described as a feature of familial Mediterranean fever in the 1950s and early 1960s. However, over the last 33 years only one case has been published. We present a 12-year-old Arab boy who developed recurrent hyperbilirubinaemia in the course of familial Mediterranean fever. His response to colchicine was excellent. Review of the literature reveals that hyperbilirubinaemia of familial Mediterranean fever has a distinct clinical picture characterized by concurrent peritonitis, minimal jaundice and short duration. Factors contributing to the paucity of reports in recent literature are discussed.
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Fiebre Mediterránea Familiar/complicaciones , Hiperbilirrubinemia/etiología , Niño , Colchicina/uso terapéutico , Fiebre Mediterránea Familiar/tratamiento farmacológico , Supresores de la Gota/uso terapéutico , Humanos , Hiperbilirrubinemia/tratamiento farmacológico , Masculino , RecurrenciaRESUMEN
Successful parasitization by Cryptosporidium parvum requires multiple disruptions in both host and protozoan cell membranes as cryptosporidial sporozoites invade intestinal epithelial cells and subsequently develop into asexual and sexual life stages. To identify cryptosporidial proteins which may play a role in these membrane alterations, hemolytic activity was used as a marker to screen a C. parvum genomic expression library. A stable hemolytic clone (H4) containing a 5.5-kb cryptosporidial genomic fragment was identified. The hemolytic activity encoded on H4 was mapped to a 1-kb region that contained a complete 690-bp open reading frame (hemA) ending in a common stop codon. A 21-kDa plasmid-encoded recombinant protein was expressed in maxicells containing H4. Subclones of H4 which contained only a portion of hemA did not induce hemolysis on blood agar or promote expression of the recombinant protein in maxicells. Reverse transcriptase-mediated PCR analysis of total RNA isolated from excysted sporozoites and the intestines of infected adult mice with severe combined immunodeficiency demonstrated that hemA is actively transcribed during the cryptosporidial life cycle.
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Cryptosporidium parvum/genética , Genes Protozoarios , Proteínas Hemolisinas/genética , Secuencia de Aminoácidos , Animales , Secuencia de Bases , Southern Blotting , Cryptosporidium parvum/patogenicidad , Proteínas Hemolisinas/biosíntesis , Datos de Secuencia Molecular , Proteínas Protozoarias/biosíntesis , Ovinos , Transcripción GenéticaRESUMEN
In a placebo-controlled, randomized, cross-over study, 16 patients (10 males, 6 females; 50.6 +/- 10.4 years; body weight of 74.5 +/- 8.9 kg; mean +/- SD) with arterial hypertension (WHO stages I and II) were administered single oral doses of placebo, 80 mg of propranolol, as well as 50 and 100 mg of brefanolol (a beta-adrenergic blocking agent with vasodilating properties) in order to determine the resulting hemodynamic effects. Blood pressure, heart rate, and various hemodynamic parameters were assessed noninvasively by mechano- and impedance cardiography as well as by venous occlusion plethysmography before and 2, 4, 6, 10, and 24 h after drug administration. Treatment with propranolol resulted in the typical hemodynamic changes induced by a beta-adrenergic blocking agent characterized by a significant reduction in blood pressure, heart rate, cardiac output, stroke volume, and an increase in total peripheral resistance. A dose of 100 mg of brefanolol also led to comparable hemodynamic effects. Similar significant decreases in blood pressure, heart rate, and cardiac output also occurred with 50 mg of brefanolol, but stroke volume and reactive hyperemia increased. Thus, in this phase of drug development, dose titration with 50 and 100 mg of brefanolol indicates that the lower dose gives rise to a more balanced relationship between its beta-adrenergic blocking and vasodilating properties.