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991.
预知性健康教育对减轻经尿道膀胱肿瘤电切术后膀胱痉挛的效果观察 总被引:1,自引:1,他引:0
目的:探讨术前预知性健康教育对减少和预防膀胱电切术后膀胱痉挛的影响。方法:将71例患者按改进健康教育方法前、后分为对照组和实验组。在一般术前准备和健康教育外对实验组患者增加预知性健康知识给予。结果:分析两组患者的病历和护理记录,发现膀胱痉挛发作时频次、疼痛程度和发作时对护理指导的依从性均明显不同,实验组优于对照组。结论:膀胱电切术前给予预知性教育,减轻焦虑恐惧情绪,可避免或减轻膀胱痉挛发作,增加对术后护理的依从性。 相似文献
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Arterburn DE McDonell MB Hedrick SC Diehr P Fihn SD 《The American journal of medicine》2004,117(10):738-746
PURPOSE: We hypothesized that obese adults with coronary heart disease, obstructive lung disease, or depression would report greater impairments in health-related quality of life owing to their angina, dyspnea, or depressive symptoms as compared with persons with normal body weight. METHODS: We analyzed cross-sectional data from the Ambulatory Care Quality Improvement Project, a multicenter study of veterans enrolled in general internal medicine clinics. Health-related quality of life was assessed using the Medical Outcomes Study Short Form-36, the Seattle Angina Questionnaire, the Seattle Obstructive Lung Disease Questionnaire, and the Hopkins Symptom Checklist for Depression. RESULTS: Compared with patients of normal weight (body mass index: 18.5 to 24.9 kg/m2), underweight patients (body mass index <18.5 kg/m2) reported health-related quality-of-life scores that were at least 5% lower (worse) in all 15 quality-of-life domains examined. Patients with class III obesity (body mass index > or =40 kg/m2) reported quality-of-life scores that were at least 5% lower than those of normal weight patients in eight domains. Scores of overweight patients (body mass index: 25 to 29.9 kg/m2) were higher (better) than those of normal weight patients in 11 domains. CONCLUSION: Body mass index was strongly associated with generic- and condition-specific health-related quality of life. Our results suggest that, when considering health-related quality-of-life outcomes among veterans, the optimal body mass index may be above the "normal" range. Further research should test the validity of the 1998 National Institutes of Health body mass index categories as predictors of health outcomes among veterans. 相似文献
996.
The effects of acetylcholine on the spontaneous activity of the AV node of dog hearts were studied by recording transmembrane potentials of its fibers. Action potentials of most nodal fibers were characterized by prominent phase 4 depolarization and a smooth transition from phases 4 to 0. On the isolated AV nodes, acetylcholine at 1.0 μg/m1 suppressed the rate of phase 4 depolarization and increased the amplitude of the maximum diastolic potential, resulting in a slowing of spontaneous activity. At 2.0 μg/m1, spontaneous activity was completely suppressed. In comparison, spontaneous activity of the isolated His bundle was relatively insensitive to the suppressive effect of acetylcholine at the same concentrations. In the AV node-His bundle preparations in which the AV node was the pacemaker, acetylcholine decreased spontaneous activity by suppressing the phase 4 depolarization of the nodal fibers and shifted the pacemaker of the preparation to the His bundle. The findings provide a basis for predicting that under strong vagal influence, the automaticity of the AV node will be suppressed and the pacemaker of the junctional rhythm will be located at the His bundle. 相似文献
997.
Jenny Chan Marcos Perini Michael Fink Mehrdad Nikfarjam 《HPB : the official journal of the International Hepato Pancreato Biliary Association》2018,20(6):487-496
Background
Central hepatectomy (CH) is a relatively uncommon liver resection technique. It is generally perceived as a more complex operation than extended hepatectomies (EH), with potentially higher associated morbidity. The outcomes of CH compared with EH is not well defined and there is a need to reassess.Methods
A systematic literature search was conducted in PubMed, MEDLINE, EMBASE and Web of Science according to PRISMA guidelines for studies on the treatment of liver tumours with CH published from 1972 until February 2017. Outcomes of patients undergoing CH were assessed and compared to those undergoing EH.Results
18 publications including 1380 CH were included for analysis. Mortality rates after CH ranged from 0 to 9%. There were 20 (1.4%) deaths after CH and the most common cause of death was post-hepatectomy liver failure (PHLF). Morbidity rates varied between 12 and 61% and 316 (23%) post-operative events were reported. Analysis of five comparative studies showed similar mortality between CH and EH groups (OR: 0.64, 95% CI = 0.24–1.70, p = 0.37). There were significantly fewer overall post-operative complications in the CH group (OR: 0.38, 95% CI = 0.28–0.51, p < 0.001) and reduced PHLF was found in the CH group compared to EH (OR: 0.53, 95% CI = 0.29–0.98, p = 0.04). The rates of post-hepatectomy biliary complications were similar between groups (OR: 0.98, 95% CI = 0.51–1.88, p = 0.96). Mean length of stay (days) was shorter in the CH group (MD: ?2.67, 95% CI = ?4.93 to ?0.41, p = 0.02).Conclusion
CH appears to have similar post-operative mortality rates compared to EH but is associated with fewer post-operative complications, including PHLF and shorter overall length of stay. 相似文献998.
F.Andrew Gaffney Jui-Chin Lin Ronald M. Peshock Larry Bush L.Maximilian Buja 《The American journal of cardiology》1983,52(5):607-609
Several agents are used as echocardiographic contrast agents, but their unreliability discourages routine clinical use. Studies from the early 1960s suggest that dilute hydrogen peroxide (H2O2) is a safe intravascular agent. Its use was evaluated in contrast echocardiography. To obtain dense opacification reliably, H2O2 (3%) was passed through a sterile 0.2 μ Millipore filter and diluted with heparinized saline solution to make a 0.1 to 0.2% solution. A drop of blood was withdrawn from an indwelling peripheral venous needle into a syringe containing 0.5 to 2.0 ml of the dilute H2O2 and the contents injected. Studies in dogs, normal adults and 36 patients with noncyanotic congenital and acquired cardiac disorders produced dense opacification with no complications. In vitro mixture of H2O2 (0.3%) with leukocyte-poor blood or plasma produced only a few microbubbles, while addition to whole blood or buffy coat produced many, suggesting a role for leukocyte peroxidase. H2O2 contrast echocardiography is simple, inexpensive, and reliably provides dense, sustained opacification. This study and previous studies suggest that intravenous injection of 0.2% H2O2 can be done safely. Great caution should be exercised in patients with severe pulmonary hypertension or large right-to-left shunts because little clinical experience with H2O2 is available. 相似文献
999.
Sheila Oliveira Angelo Ravelli Angela Pistorio Esteban Castell Clara Malattia Anne Marie Prieur Claudia Saad‐Magalhães Kevin J. Murray Sang‐Cheol Bae Rik Joos Ivan Foeldvari Carolina Duarte‐Salazar Nico Wulffraat Pekka Lahdenne Pavla Dolezalova Jaime de Inocencio Florence Kanakoudi‐Tsakalidou Michael Hofer Irina Nikishina Huri Ozdogan Philip J. Hashkes Jeanne M. Landgraf Alberto Martini Nicolino Ruperto 《Arthritis care & research》2007,57(1):35-43
Objective
To investigate the proxy‐reported health‐related quality of life (HRQOL) and its determinants in patients with juvenile idiopathic arthritis (JIA).Methods
In this multinational, multicenter, cross‐sectional study, HRQOL of patients with JIA was assessed through the Child Health Questionnaire (CHQ) and was compared with that of healthy children of similar age from the same geographic area. Potential determinants of HRQOL included demographic data, physician's and parent's global assessments, measures of joint inflammation, Childhood Health Assessment Questionnaire (CHAQ), and erythrocyte sedimentation rate.Results
A total of 6,639 participants (3,324 with JIA and 3,315 healthy) were enrolled from 32 countries. The mean ± SD physical and psychosocial summary scores of the CHQ were significantly lower in patients with JIA than in healthy children (physical: 44.5 ± 10.6 versus 54.6 ± 4.0, P < 0.0001; psychosocial: 47.6 ± 8.7 versus 51.9 ± 7.5, P < 0.0001), with the physical well‐being domain being most impaired. Patients with persistent oligoarthritis had better HRQOL compared with other subtypes, whereas HRQOL was similar across patients with systemic arthritis, polyarthritis, and extended oligoarthritis. A CHAQ score >1 and a pain intensity rating >3.4 cm on a 10‐cm visual analog scale were the strongest determinants of poorer HRQOL in the physical and psychosocial domains, respectively.Conclusion
We found that patients with JIA have a significant impairment of their HRQOL compared with healthy peers, particularly in the physical domain. Physical well‐being was mostly affected by the level of functional impairment, whereas the intensity of pain had the greatest influence on psychosocial health. 相似文献1000.
目的:探讨健康急进高原者纤溶系统的变化。方法:总共50名青年男性入选本试验,均为从四川省(海拔400m)招募的新兵。在乘飞机从四川进入拉萨(海拔3658m)之前及之后3d,测定血凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fg)、纤溶酶原(Plg)、纤溶酶抑制物、D-二聚体(DD)含量。结果:进入高原后,PT、TT、APTT、DD比在平原时增高,FIB、Plg、纤溶酶抑制物降低(P〈0.05)。结论:健康人急进高原后纤溶系统变化显著。 相似文献