Academic literature on the topic 'Widal triad'

Zusammenfassung. Das Widal-Syndrom umfasst eine klinische Trias mit chroniquer Rhinosinusitis und nasalen Polypen, Asthma bronchiale und eine Unverträglichkeit auf Acetylsalicylsäure (Aspirin) und anderen nichtsteroidalen Entzündungshemmern (NSAID). Etwa 7 % der Asthmatiker und 10 % der Patienten mit chronischer Rhinosinusitis leiden darunter. Asthma und NSAID-Unverträglichkeit treten häufig mehrere Jahre nach Beginn der Rhinosinusitis auf, was zur Verzögerung der Diagnose führt. Zurzeit gibt es keine spezifischen Biomarker. Der Provokationstest mit Aspirin bleibt der Gold-Standard für die Diagnose, sollte aber wegen des Risikos eines schweren Asthmaanfalls nur durch den Spezialisten durchgeführt werden. Die Grundbehandlung beruht auf der Kombination topischer Kortikosteroide und Montelukast, sowie der Vermeidung von Hemmern der Zyklooxygenase-1. Therapierefraktäre Fälle können auf eine Desensibilisierung mit Aspirin oder neuerdings auf Biologika wie Mepolizumab ansprechen.

Eine chronische Rhinosinusitis ist häufig mit einem Asthma bronchiale verbunden. Kommt eine Analgetika­intoleranz hinzu, so spricht man auch vom Morbus Widal oder der Samter Trias. Vor allem die chronische Sinusitis mit Polyposis nasi ist bei diesen Patienten oft schwer zu behandeln. Es besteht meist aber ein hoher Leidensdruck. In diesem Artikel soll das Krankheitsbild vorgestellt werden unter besonderer Berücksichtigung der Therapie mit Acetylsalicylsäure (ASS), die dazu dient, eine Toleranz gegen ASS und NSAR zu erreichen (Desensibilisierung bzw. «adaptive Desaktivierung») und nachhaltig die Symptome der oberen Atemwege zu verbessern. Ergänzend wird noch eine Nachbeobachtungsstudie aus unserem eigenen Patientengut vorgestellt.

AbstractInjections of Baptisia tinctoria Ø (Wild Indigo) were administered i.m. to two healthy rabbits six times at weekly intervals. Blood samples were collected before, during and at the conclusion of the trial. Blood was analysed for antibodies against Salmonella typhosa, using the Widal reaction. A total leucocyte count was also carried out. A third rabbit was kept as control and was injected only with normal saline i.m. Its blood samples were also collected according to the above schedule. No formation of antibodies against Salmonella typhosa was observed in any experimental animal or control whereas marked leucopenia was observed in both experimental rabbits.

“Eyes wide shut”: On what there is and what cannot be seen in new Polish Second World War museumsMuseums have always been political institutions. Owing to this engagement, they are not neutral and they should not claim objectivity. Facts and artefacts at an exhibition exemplify the assumed hypotheses. This means that visitors are objects of manipulation. In case of the Warsaw Rising Museum, which was the first narrative museum in Poland, World War II was a trial, which the first victim of the German aggression — the Polish nation en bloc — underwent successfully. Th at was a time of heroes who should be imitated. The decision about the rising was right, even though the capital and its population were annihilated as a result of it. In contrast, in the Museum of World War II in Gdańsk, the war was a tragedy for the whole humanity and a hecatomb of the civilian population, with the presentation of the history of Poland nation as just one of many. If there were heroic deeds, they were individual and exceptional. Heroism was not only combat. Survival was the aim.This means that the first museum is about “men’s adventure”, which is fighting among faithful comrades — it’s a hymn of praise to the valour of the Poles under German occupation. The more innocent the victims, the higher the factor of heroism. By contrast, the other museum is a warning — every war is first of all a failure of humanity. These two interpretations of the events of World War II differ from each other as the target groups of both exhibitions are different. Supporters of the Warsaw Rising Museum do not accept the Museum of World War II and vice versa; they often voice opinions about something they did not have a chance or did not even feel like to see. These institutions are reflections of political disputes which divide Poles into supporters and opponents of certain historical policies which are pursued by making use of museums and in relation to them.

Streszczenie Utwory wapienia muszlowego (trias środkowy) zajmują ponad 70% obszaru Niżu Polskiego. Reprezentowane są przede wszystkim przez różne odmiany wapieni, dolomitów i margli. Stanowią jeden z mniej rozpoznanych poziomów wodonośnych formacji mezozoicznej na Niżu Polskim, dlatego wzbudzają duże zainteresowanie badawcze m.in. odnośnie do parametrów zbiornikowych. Jednoznaczną ocenę parametrów zbiornikowych, węglanowych utworów wapienia muszlowego, utrudnia obecność złożonej przestrzeni szczelinowej i porowej oraz brak wiedzy na temat szczelinowatości tych utworów. Niemniej jednak na podstawie analizy parametrów porowatości całkowitej i przepuszczalności wskazano rodzaj skały zbiornikowej oraz wytypowano obszar i ogniwo o najkorzystniejszym rozkładzie tych parametrów w utworach wapienia muszlowego. Zmiany własności petrofizycznych utworów wapienia muszlowego zależą przede wszystkim od rodzaju skały zbiornikowej oraz przebiegu stref dyslokacji. Analizując rozkład tych parametrów w obszarze całego zbiornika, widać ich wyraźną dwudzielność. Porowatością do 2% i przepuszczalnoćią poniżej 1 mD charakteryzują się głównie zbite niespękane wapienie oraz iłowce i margle. W obrębie całej formacji obserwuje się wartości przepuszczalności bliskie zera. Większość badanych prób zawiera się w przedziale przepuszczalności 0–0,1 mD. Najwyższe wartości parametrów petrofizycznych zaobserwowano przede wszystkim w wapieniach piankowych i wapieniach czystych, dolnego wapienia muszlowego, na głębokościach nieprzekraczających 2500 m p.p.t. Maksymalne wartości porowatości całkowitej wapieni wynoszą > 20% przy przepuszczalności dochodzącej do 340 mD. Obszar o najkorzystniejszych wartościach parametrów porowatości całkowitej i przepuszczalności rozciąga się na granicy monokliny przedsudeckiej i niecki łódzkiej, co zostało potwierdzone na podstawie porównania rozkładu parametru porowatości całkowitej z przebiegiem regionalnych stref tektonicznych.

The prevalence of ADHD children increases every year. Some researchers have shown that psychosocial behavior therapy (antecedents-consequences modification) was effective to decrease hyperactivity and increase attention to ADHD children. This study aims to find out the effectiveness of antecedents-consequences modification by parents and teachers to decrease hyperactivity and increase attention to a 6 years old boy with ADHD. The study was a single case experimental design. Psychosocial behavior therapy has been used with antecedents-consequences modification. The antecedents-consequences modification was applied by teacher at school and parents at home. Data were analyzed using Wilcoxon Signed Rank Test. Results showed that there’s a significant decrease of hyperactivity behavior and significant increase of doing his assignment both at school and also at home. Not only about the content of behavior therapy itself, but how to give the therapy is important. Parents and teacher should do the therapy consistently, immediately, specifically and saliency to reach the target of intervention. Keywords: ADHD Children, Antecedents, Consequences, Modification Reference: (APA), A. A. P. (2013). Diagnostic and Manual of Mental Disorder (5th ed.). Arlington: American Psychiatric Association. Amalia, R. (2018). Intervensi terhadap Anak Usia Dini yang Mengalami Gangguan ADHD Melalui Pendekatan Kognitif Perilaku dan Alderian Play Therapy. Jurnal Obsesi : Jurnal Pendidikan Anak Usia Dini, 2(1), 27. https://doi.org/10.31004/obsesi.v2i1.4 Anastopoulos, A.D; Farley, S. . (2003). A Cognitive Behavioural Training Program for Parents of Children with Attention-Deficit/Hyperactivity Disorder. In W. J. Kazdin, Alan E (Ed.), Evidence-based psychotherapies for children and adolescents (pp. 187–203). New York: Guildford Press. Barkley, Russell A; DuPaul, G.L ; McMurray, M. . (1990). 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Prospective follow-up of girls with attention-deficit/hyperactivity disorder into early adulthood: Continuing impairment includes elevated risk for suicide attempts and self-injury. Journal of Consulting and Clinical Psychology,80(6), 1041–1051. https://doi.org/10.1037/a0029451 Jackson, N. A. (2003). A Survey of Music Therapy Methods and Their Role in the Treatment of Early Elementary School Children with ADHD. Journal of Music Therapy, 40(4), 302–323. https://doi.org/10.1093/jmt/40.4.302 Johnston, Charlotte; Mash, E. J. (2001). Families of Children With Attention-Deficit/Hyperactivity Disorder : Review and Recommendations for Future Research. Clinical Child and Family Psychology Review, 4(3), 183–207. Jr, W. E. P., Fabiano, G. A., & Pelham, W. E. (2008). Evidence-Based Psychosocial Treatments for Attention- Deficit / Hyperactivity Disorder (Vol. 4416). https://doi.org/10.1080/15374410701818681 Kaiser, N. M., McBurnett, K., & Pfiffner, L. J. (2011). 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Introdução: A polipose nasal (PN) é considerada uma condição inflamatória crônica da mucosa da cavidade nasal e seios paranasais de etiologia não muito clara. Há poucos dados sobre alterações epiteliais em PN e sua relação com a ação dos radicais livres. Muitas doenças estão ligadas a danos causados por espécies reativas de oxigênio (ROS) e de nitrogênio (RNSS) e ocorrem de um desequilíbrio entre eles e antioxidantes, o que for maior atividade de espécies reativas, o que chamamos de estresse oxidativo. Objetivo: O objetivo principal deste estudo é avaliar o estresse oxidativo em pólipos removidos cirurgicamente em 3 grupos de pacientes com polipose nasal (com PN unicamente, PN associado à asma e PN associado à asma e intolerância ao ácido acetilsalicílico) a fim de elucidar possíveis diferenças no perfil redox nestes grupos. Material e Métodos: Cinquenta e nove pacientes com diagnóstico de polipose nasal foram divididos em três grupos clínicos: um grupo controle PN unicamente, um grupo asma (PN associado à asma) e um grupo Widal (PN associado à asma e intolerância ao ácido acetilsalicílico). Medição e Resultados Principais: Neste trabalho defesas enzimáticas (superóxido dismutase, consumo de peróxido de hidrogênio, glutationa peroxidase e glutationa S-transferase) e defesas não enzimáticas (glutationa total, nitritos e nitratos, vitamina C e E) foram analisados. Também foi realizada a medição de danos em lipídios (malondialdeído) e proteínas (carbonila). No grupo asma, o consumo de peróxido de hidrogênio, atividade da glutationa peroxidase, níveis de malondialdeído e vitamina E foram significativamente menores do que no grupo de controle. Também foi realizada a medição de danos em lipídios (malondialdeído) e proteínas (carbonila). No grupo Widal foram encontrados níveis significativamente maiores de glutationa e nitritos e nitratos em relação ao grupo controle. Não foram encontradas diferenças entre os grupos em relação ao nível de carbonila e glutationa, tamanho dos pólipos, atividades da superóxido dismutase e S-transferase. Conclusões: A classificação redox dos grupos de PN foi parcialmente alcançada. Os pólipos do grupo asma possuem alterações nas defesas enzimáticas relacionadas com o peróxido de hidrogênio e a peroxidação lipídica, enquanto pólipos do grupo Widal apresentaram alterações nos níveis de óxido nítrico e glutationa.
Introduction: Nasal polyposis (NP) is considered a chronic inflammatory condition of the mucosa of the nasal cavity and paranasal sinuses of etiology is not very clear. There are few data on epithelial changes in nasal polyposis and its relation to the action of free radicals. Many diseases are linked to damage caused by reactive oxygen species (ROS) and nitrogen (RNSs) and occur from an imbalance between them and antioxidants, whichever is greater activity of reactive species, what we call oxidative stress. Objective: The primary objective of this study is to evaluate oxidative stress in polyps surgically removed in 3 groups of patients with nasal polyposis, in order to elucidate possible differences in redox profile in these groups. Methods: Fifty nine patients diagnosed with nasal polyposis were divided into three groups: a control group, an asthma group (NP with asthma) and a Widal group (NP with asthma and aspirin intolerance) in which patients had an association of NP, asthma and aspirin intolerance. Measurement and main results: In this work enzymatic defenses (superoxide dismutase, hydrogen peroxide consumption, glutathione peroxidase and glutathione S-transferase) and non-enzymatic defenses (total glutathione, measurement of nitrites and nitrates, vitamin C and E) were analyzed. Also the measurement of damage in lipids (malondialdehyde) and proteins (carbonyl) was conducted. In the asthma group, hydrogen peroxide consumption, glutathione peroxidase activity, malondialdehyde, and vitamin E levels were significantly lower than in the control group. The Widal group showed significant higher glutathione levels, nitrite and nitrate levels than found in the control group. No differences were found among the groups regarding carbonyl level, polyp size, superoxide dismutase, and glutathione S-transferase activities. Conclusions: The redox classification of the groups of NP was partly achieved. Polyps of patients with asthma have changes in enzymatic defense pathways related to hydrogen peroxide and lipid peroxidation while polyps of patients with Widal triad present changes in nitric oxide and glutathione.

Objetivos. Revisar la temática y la literatura médica disponible con respecto a la convergencia de los tres ítems propuestos: Consumo de Sustancias, TDAH y Trauma Complejo, fundamentalmente a través de la presentación de un caso ilustrativo. Material y método. Comunicamos los resultados obtenidos a través del análisis pormenorizado del recorrido y la trayectoria existencial, diagnóstica y terapéutica del caso clínico que presentamos. Resultados y conclusiones. Hasta un 60% de los niños muestran patología neuropsiquiátrica asociada al TDAH (Biederman J et al., 1991). Los más frecuentes son: Trastorno Negativista Desafiante (40-60%), Trastornos Específicos del Aprendizaje (45%), Ansiedad (30-45%), depresión (4-30%), Trastorno de la Conducta Social (14-46%), Tics (9-11%). La comorbilidad de TDAH y Trastornos relacionados con Sustancias y Trastornos Adictivos consituye una de las asociaciones más preocupantes. Los pacientes con TDAH tienen un riesgo cuatro veces mayor de presentar esta problemática con respecto a la población general (Rodríguez PJ et al., Wigal SB et al., 2010). Un encuadre diagnóstico poco acertado va a condicionar seriamente la respuesta al tratamiento tanto farmacológico como no farmacológico así como la evolución del sujeto de estudio. Lo anterior queda ilustrado en el caso clínico que exponemos, el de una joven extutelada, en la que convergen las cirsunstancias descritas y en la que posteriormente se da la situación de que ingresa en un programa especialmente dirigido a tratar el denominado Trauma Complejo.