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61.
P. Morales A. Rastogi M.L. Bez S.M. Akintorin S. Pyati S.M. Andes R.S. Pildes 《Pediatric cardiology》1998,19(3):225-229
Patent ductus arteriosus (PDA) is believed to be a contributing factor in the etiopathogenesis of bronchopulmonary dysplasia
(BPD). We studied the effects of early dexamethasone therapy on persistent ductal patency and the role of PDA in the etiopathogenesis
of BPD during the course of a randomized double-blind trial of dexamethasone to prevent BPD. Infants, who weighed between
700 and 999 g, had severe RDS, and had been given surfactant, were randomized to receive a 12-day course of dexamethasone
(n= 13) or placebo (n= 17) starting within the first 12 hours of postnatal life. The diagnosis of PDA was made clinically and was confirmed by
cardiac ultrasound. The incidence of clinically significant ductus in infants who weighed less than 1000 g was 23% in the
dexamethasone-treated group, as compared with 59% in infants who were given placebo. This difference was marginally significant,
p= 0.05, odds ratio 0.21, 95% confidence interval 0.04–1.05. None of the infants in the dexamethasone group had recurrence
of PDA after indomethacin therapy as compared with three infants in the placebo group. Dexamethasone significantly reduced
the number of days infants required ventilator and supplemental oxygen as compared with infants who received placebo. Dexamethasone,
as compared with placebo, also reduced the incidence of BPD, p= 0.025, odds ratio 0.08, 95% confidence interval 0.01–0.58. Dexamethasone may reduce the incidence of PDA in premature infants
who weigh less than 1000 g at birth and thereby reduce the incidence of BPD. 相似文献
62.
本文讨论了以分层法进行中药药效评价时权重设立的问题,主要由以下几部分组成:1.建立递阶层次结构;2.构造两两比较判断矩阵;3.计算单一准则下元素的相对权重;4.计算各层元素的组合权重。由于中药作用具有多途径、多靶点的特性,因此评价过程中权重的设立就占有重要位置。它直接影响对被评价对象药效作用的评判。全面解决中药作用多途径、多靶点药效学评价的数学方法,客观量化的评价中药的综合药效,是中药现代化进程中一个值得研讨的命题。 相似文献
63.
Chiun-Fang Chiou Marcia R Weaver Michelle A Bell Todd A Lee James W Krieger 《International journal for quality in health care》2005,17(1):23-30
OBJECTIVE: To develop a multi-attribute outcome measure for children with asthma that allows for the calculation of quality-adjusted life years in cost-effectiveness studies and can also be used to assign preference weights to asthma-symptom-free days. STUDY DESIGN: A literature review and two interviewer-administered surveys. SETTING: Homes or community centers of participants in Seattle, United States. MAIN MEASURE: Visual analog scale (VAS), standard gamble (SG), and relative risk attitude equation techniques were used to estimate two sets of preference weights for 10 health states. The PAHOM was used to record health states of pediatric asthma patients. RESULTS: A total of 94 subjects provided complete responses without any illogical ratings to VAS questions and 101 provided the same to SG questions. The VAS preference weights of the health states range from a maximum of 1 for perfect health to a minimum of 0.03 for severe asthma symptoms, emotional problems, and activity limitations. Those based on the relative risk attitude equation constructed with both VAS and SG preference weights range from 1 to 0.06. The mean PAHOM scores of pediatric asthma patients based on VAS and converted SG preference weights were 0.70 and 0.83, respectively. CONCLUSIONS: The PAHOM calendar can be used to identify asthma patients' health outcomes, to calculate the preference weights of asthma patients' health states, and to estimate the number of symptom-free days. These factors make the PAHOM a promising instrument for use in effectiveness and cost-effectiveness studies in children with asthma. 相似文献
64.
Research on the contribution of CRH receptor stimulation to energy homeostasis has focused on forebrain substrates. In this study, we explored the effects of caudal brainstem administration of the CRH receptor agonist, urocortin, on food intake and body weight, and on plasma glucose and corticosterone (CORT) in non-deprived rats. Urocortin (0, 0.3, 1, 3 microg) delivered, respectively, to the fourth and lateral ventricles yielded substantial suppression of food intake measured 2, 4 and 24 h later. A significant but more modest anorexia was observed between 24 and 48 h after injection. Intake responses did not differ between the injection sites, but body weight loss measured 24 h after lateral-i.c.v. injection was substantially greater than that after fourth-i.c.v. injection. Fourth-i.c.v. urocortin administration (3 microg) produced substantial elevations in plasma glucose and CORT that were not distinguishable in magnitude and duration from responses to lateral-i.c.v. delivery. Unilateral microinjection of urocortin into the dorsal vagal complex significantly reduced 24-h food intake at a dose (0.1 microg) that was subthreshold for the response to ventricular administration, suggesting that fourth-i.c.v. effects are mediated in part by stimulation of CRH receptors in this region of the caudal brainstem. The results indicate that similar effects can be obtained from stimulation of anatomically disparate populations of CRH receptors, and that interactions between forebrain and hindbrain structures should be considered in the evaluation of CRH contributions to food intake and body weight control. 相似文献
65.
66.
围生因素与新生儿肺透明膜病发病关系的探讨 总被引:1,自引:0,他引:1
目的探讨围生因素与新生儿肺透明膜病(HMD)发病的关系。方法对481例早产儿围生因素进行Logistic回归分析,筛选出与HMD有关的因素,列出回归方程,然后对其进行率的比较及卡方检验。结果HMD危险因素的主效应模型是logit(p)=6.254-0.204胎龄-1.556出生体重 0.834窒息/宫内窘迫 1.635胎膜早破。对于有围生期合并症的早产儿,其胎龄越小,HMD发病率越高。结论30周以下早产儿HMD发病主要与胎龄、出生体重关系密切,而30周以上早产儿HMD发病除与胎龄、出生体重有关外,还与围生因素密切相关,其发病机制有待进一步研究。 相似文献
67.
Recent advances in modern perinatal and neonatal intensive care have led to an increase in the survival of premature infants. This increased survival, unfortunately, has not been accompanied by an improvement in neurodevelopmental outcomes. Premature infants, especially those with an extremely low birth weight (less than 1000 g) or those born at less than 28 weeks’ gestation, are at increased risk of major disabilities and complex, ‘low severity’ dysfunctions that have significant, lasting effects on their school function, academic performance and behaviour, as well as on family function. Neonatal follow-up programs provide a number of functions to centres providing neonatal intensive care, including quality assurance and audits, research and follow-up clinical care to neonatal intensive care unit survivors and their families. The challenge for neonatal follow-up programs is to meet the often competing objectives of providing clinical services to children and their families while providing quality assurance and audits, and high-quality long-term outcome research components, given the available resources. There is also a need for ongoing research to develop and evaluate effective postdischarge intervention programs to improve the long-term outcome of prematurity and other neonatal complications. Developmental paediatricians – with their background and training in the provision of specialized health care to children and their care-givers with respect to developmental and psychosocial well-being, and in conducting developmental and behavioural disabilities research – play a valuable role in the follow-up assessment and care of neonatal intensive care unit graduates, and strengthen the multidisciplinary research groups necessary to assess long-term outcomes and the effects of perinatal and postdischarge interventions. 相似文献
68.
69.
The obesity epidemic has serious implications for women of reproductive age; its rising incidence is associated not just with health implications for the mother but also has transgenerational ramifications for the offspring. Increased incidence of diabetes, cardiovascular disease, obesity, and kidney disease are seen in both the mothers and the offspring. Animal models, such as rodent studies, are fundamental to studying maternal obesity and its impact on maternal and offspring health, as human studies lack rigorous controlled experimental design. Furthermore, the short and prolific reproductive potential of rodents enables examination across multiple generations and facilitates the exploration of interventional strategies to mitigate the impact of maternal obesity, both before and during pregnancy. Given that obesity is a major public health concern, it is important to obtain a greater understanding of its pathophysiology and interaction with reproductive health, placental physiology, and foetal development. This narrative review focuses on the known effects of maternal obesity on the mother and the offspring, and the benefits of interventional strategies, including dietary intervention, before or during pregnancy on maternal and foetal outcomes. It further examines the contribution of rodent models of maternal obesity to elucidating pathophysiological pathways of disease development, as well as methods to reduce the impact of obesity on the mothers and the developing foetus. The translation of these findings into the human experience will also be discussed. 相似文献
70.