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71.
Deciding when to wean neonates from extracorporal membrane oxygenation (ECMO) can be difficult. The usefulness of simple measurements of pulmonary mechanics e.g., dynamic compliance (Cdyn) has been questioned. We investigated the pulmonary mechanics of eight neonates using the interrupter technique, which allows the partitioning of pulmonary mechanics into compartments representing the conducting airways and more peripheral phenomena (viscoelastic properties and "pendelluft"). Three neonates required ECMO for a congenital diaphragmatic hernia (CDH), two for hyaline membrane disease (HMO), two for meconium aspiration syndrome (MAS), and one for pneumonia. All neonates with MAS, HMD, and pneumonia were successfully weaned from ECMO when their Cdyn was 0.3 mL/cmH2O/kg or greater [mean 0.34 +/- 0.06 (SEM)]. All three neonates with CDH died and their highest Cdyn was 0.21, 0.19, and 0.09 mL/cmH2O/kg respectively (mean, 0.16 +/- 0.037). The airway resistance (Raw) and the slower component of pressure change after interruption (delta Pdiff), a measure of the more peripheral phenomena of the lung, were not significantly different in those neonates who survived and those who did not. The values for delta Pdiff in all patients were higher than those in healthy neonates. However, the Raw was not different. This suggests that the major disturbance in pulmonary mechanics was distal to the conducting airways. Those neonates who were successfully weaned from ECMO had a significantly higher Cdyn 24-48 hours prior to decannulation. Considering the lung as a two-compartment model offers no advantages when compared to the one-compartment model for the prediction of the outcome of a neonate on ECMO. 相似文献
72.
儿童肥胖与颈动脉内膜-中层厚度及动脉扩张功能 总被引:6,自引:0,他引:6
为了解动脉粥样硬化疾病是否在儿童期即有开始,研究了肥胖儿童颈动脉内膜—中层厚度及动脉扩张功能。选择27例单纯性肥胖症儿童和16例正常对照儿童,通过家族史调查,生化分析法检测血脂、血液粘度以及超声测定颈动脉内膜—中层厚度及脓动脉舒缩顺应性。结果发现肥胖者在儿童期颈动脉内膜—中层的厚度已经开始增加,内皮依赖性动脉扩张功能降低,并可以合并高脂血症和高脂蛋白血症。提示儿童的肥胖、脂质代谢异常导致动脉血管壁损伤;动脉粥样硬化是小儿时期得病、成人发病的一种疾病。预防冠状动脉粥样硬化性心脏病,须从儿童期开始防治肥胖症,超声检查颈动脉内膜中层厚度简便、安全无创,可以作为早期发现冠心病一个良好的预报因子。 相似文献
73.
74.
We hypothesize that diabetic contact lens wearers may represent a special group displaying higher levels of compliance with their lens care regimens as a result of learned behaviour relating to maintenance of their diabetic condition. To test this hypothesis, a prospective, single centre, controlled, masked study was performed whereby 29 diabetic contact lens patients and 29 non-diabetic control subjects were issued with disposable hydrogel contact lenses and a multipurpose lens care regimen. All participants were given identical instruction on lens care and maintenance. Compliance levels were assessed at a 12-month aftercare appointment by demonstration and questionnaire. Twenty-four different aspects of compliance were scored, 12 by observation and 12 by questionnaire report, of which only two showed a significant difference between the diabetic and control groups. Although the combined population of contact lens wearers was generally compliant, there were examples of non-compliance in both groups. Neither the duration of diabetes nor the degree of metabolic control appeared to have a significant effect on compliance. The results suggest that eye care practitioners cannot assume that diabetic patients will be more compliant with contact lens care and maintenance than non-diabetic patients. 相似文献
75.
对患者用药依从性调查分析 总被引:2,自引:0,他引:2
任艳丽 《中国药物应用与监测》2004,1(3):12-14
目的:通过对患者用药依从性的调查,分析目前病人对医嘱的依从程度.方法:随机对门诊、住院患者及家属采用问卷的形式进行现场调查,以收回的完整问卷为有效问卷,共收回289份资料,内容包括性别、年龄、是否依从医嘱及不依从医嘱的原因.结果:289份问卷中,男女比例为139/150,年龄从5个月婴儿到79岁老人,依次分为幼儿组、少儿组、青少年组、青年组、中年组及老年组,其依从性由高到低是青年组、幼儿组、少儿组、中年组、青少年组及老年组,老年组的不依从比最高,达到31.82%.结论:通过分析患者不依从性的原因,结果发现不同年龄段的患者,依从性有较大程度的差异(P>0.05),为医务工作者更好地为患者服务提供参考. 相似文献
76.
77.
《HIV clinical trials》2013,14(2):168-172
AbstractPURPOSE: An important factor in adherence to antiretroviral therapy (ART) is the patient's commitment to follow the regimen, which suggests that therapy should be initiated only when the patient is ready to make such a commitment. Because there has been no research on patient readiness for ART, this study was undertaken to investigate factors that influence the decision of an HIV-positive person to seek medical care and to initiate ART. METHOD: The investigators surveyed 83 HIV-infected patients on ART. Participants completed a questionnaire that obtained information on the length of time from when they learned of their HIV-positive status to when they sought medical care, the length of time from when they learned of their HIV-positive status to when they were ready to initiate therapy, and psychological and social factors thought to be associated with readiness. RESULTS: Respondents had a mean age of 37 years, 71% were male, and 65% were African American. Only 42% said they sought medical care immediately upon learning their HIV diagnosis. Fifty percent were ready to initiate therapy immediately upon learning their diagnosis, and 25% were ready within 1 year. Sixty-four percent of respondents experienced barriers that interfered with therapy initiation. Although 98% of respondents experienced at least one emotional response to HIV diagnosis, less than 25% of respondents thought that their responses interfered with readiness. However, five emotional responses demonstrated an association with readiness through chi-square analysis. CONCLUSION: Further research is needed to explain the relationships among emotional responses to HIV diagnosis, readiness to initiate ART, and adherence. 相似文献
78.
Taking the guesswork out of supplying multicompartment compliance aids: do pharmacists require further guidance on medication stability? 下载免费PDF全文
79.
Previous studies have demonstrated that the compliance of peripheral artery changes with arm movement. This study aimed to quantify the bilateral difference in radial artery pulse morphology with one-side arm movement. Twenty-four healthy subjects were recruited. Radial artery pulses were synchronously recorded from both arms, with one arm (left or right) at five different positions (90°, 45°, 0°, −45° and −90°) and the other arm at horizontal level (0°) as reference. Two types of indices of arterial pulse morphology were derived from the normalized arterial pulse signals: the waveform width corresponding to the 50%, 60% and 70% pulse amplitude (W50, W60, W70) and the total area of normalized pulse waveform (Apulse). No matter whether the moving arm was left or right arm, when compared with the other side reference arm, all the waveform widths decreased with arm moving from 90°, 45°, 0°, −45°, and −90°. The bilateral difference of W50, W60 and W70 with the moving arm (either left or right) at 90°, 45° were significantly positive (both p < 0.01) and significantly negative at −90° (both p < 0.05). Meanwhile, no matter whether the moving arm is left or right, Apulse decreased with arm moving from 90°, 45°, 0°, −45°, and −90°. The bilateral difference of Apulse with the left moving arm were significantly positive at 45°, 90° (both p < 0.05). Meanwhile, the bilateral difference of Apulse from the moving right arm was significantly positive at 90° and significantly negative at −45° and −90° (all p < 0.05). In summary, this study quantified the bilateral arterial pulse morphology between arteries with different compliances induced by a simple arm positioning procedure. 相似文献
80.
目的探究基于风险识别的群组管理对冠状动脉CT血管成像(CTA)检查依从性及图像质量的影响。方法选取2019年1—12月收治的冠心病、均至少接受1次64层CT冠状动脉血管检查患者114例为研究对象,按照两组患者一般资料均衡可比的原则分为观察组和对照组,每组57例。采用问卷调查与量表评估形式,比较两组患者检查依从性及图像质量。结果观察组检查依从性明显优于对照组;观察组检查图像质量优良率高于对照组;观察组平均检查耗时低于对照组,碘对比剂外渗率低于对照组;差异均有统计学意义(P<0.05)。结论基于风险识别的群组管理运用于冠状动脉CTA患者检查过程中,可提高患者检查依从性,提升图像质量,值得临床参考借鉴。 相似文献