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1.
Klaus Krüger Gerd Rüdiger Burmester Siegfried Wassenberg 《Current medical research and opinion》2020,36(9):1559-1567
Abstract
Background
Golimumab (GLM) has shown its efficacy and safety in various clinical trials. We aimed to assess the effect of GLM on socio economic and health economic parameters in daily clinical practice. 相似文献2.
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OBJECTIVES: To assess the knowledge and clinical practice of dental students in infection control procedures at a UK dental hospital.
DESIGN: A questionnaire concerning various aspects of infection control was completed by all clinical dental students under examination conditions. Their actual clinical practice was later observed and certain aspects recorded.
SETTING: A UK dental hospital.
SUBJECTS: One hundred and eleven dental students from three clinical years completed the questionnaire. Clinical practice for all 3 years was observed in a total of 280 treatment events.
METHODS: The questionnaire was marked by two of the authors and observations recorded by another author. MAIN OUTCOME MEASURES: Degree of compliance with recognised policy for infection control.
RESULTS: Knowledge of infection control procedures was variable particularly concerning duties usually undertaken by the dental nurse. The suggested high compliance with masks and eye protection was not always apparent in clinical practice, although virtually all students washed their hands prior to donning gloves, which were worn by all students.
CONCLUSION: There can be marked differences between what students say they would do and what they actually do in clinical practice. The topic of infection control requires a pro-active approach throughout the course, since results for the final year were not significantly different from the other clinical yearS. Ways of improving compliance are discussed. 相似文献
DESIGN: A questionnaire concerning various aspects of infection control was completed by all clinical dental students under examination conditions. Their actual clinical practice was later observed and certain aspects recorded.
SETTING: A UK dental hospital.
SUBJECTS: One hundred and eleven dental students from three clinical years completed the questionnaire. Clinical practice for all 3 years was observed in a total of 280 treatment events.
METHODS: The questionnaire was marked by two of the authors and observations recorded by another author. MAIN OUTCOME MEASURES: Degree of compliance with recognised policy for infection control.
RESULTS: Knowledge of infection control procedures was variable particularly concerning duties usually undertaken by the dental nurse. The suggested high compliance with masks and eye protection was not always apparent in clinical practice, although virtually all students washed their hands prior to donning gloves, which were worn by all students.
CONCLUSION: There can be marked differences between what students say they would do and what they actually do in clinical practice. The topic of infection control requires a pro-active approach throughout the course, since results for the final year were not significantly different from the other clinical yearS. Ways of improving compliance are discussed. 相似文献
5.
Anaphylaxis is an acutely presenting life‐threatening medical emergency. Surveys indicate that dentists feel inadequately able to recognize and treat anaphylaxis. This paper reviews the terminology and pathophysiology of anaphylaxis, and describes the recognition and initial management of anaphylaxis for dentists. Dentists should be able to administer intramuscular adrenaline during anaphylaxis at the appropriate dose. The role of further medical care is also explained. Six cases of anaphylaxis arising from dental oral maxillofacial surgery practice are discussed. 相似文献
6.
Letícia Bojikian CALIXTRE Bruno Leonardo da Silva GRüNINGER Thais Cristina CHAVES Ana Beatriz de OLIVEIRA 《Journal of applied oral science : revista FOB》2014,22(1):15-21
Objective
Considering the high incidence of Temporomandibular Disorders (TMD) in the population aged 15-30 years and the fact that students are exposed to stressful psychosocial factors, the purposes of this study were: to verify clinical symptoms and jaw functionality in college students with TMD according to the anxiety/depression (A/D) level and to evaluate the correlation between A/D and functionality, maximum mouth opening (MMO) and pain and muscle activity.Material and Methods
Nineteen students with TMD diagnosed according to the Research Diagnostic Criteria for Temporomandibular Disorders underwent two assessments during an academic semester. The evaluations were based on questionnaires (MFIQ - Mandibular Function Impairment Questionnaire; HADS - Hospital Anxiety and Depression Scale), clinical measurements (MMO without pain, MMO and assisted MMO; palpation of joint and masticatory muscles), and electromyography. The HADS scores obtained in the two assessments were used to classify all data as either "high" or "low" A/D. Data normality, differences and correlations were tested with the Shapiro-Wilk test, Student''s t-test (or the Wilcoxon test), and Spearman test, respectively. The alpha level was set at 0.05.Results
None of the clinical variables were significantly different when comparing low and high A/D data. In low A/D there was a significant correlation between HADS score and: MFIQ (P=0.005, r=0.61), and MMO without pain (P=0.01, r=-0.55).Conclusions
Variation in A/D level did not change clinical symptoms or jaw functionality in college students with TMD. Apparently, there is a correlation between TMJ functionality and A/D level, which should be further investigated, taking into account the source of the TMD and including subjects with greater functional limitation. 相似文献7.
认知矫正治疗对慢性精神分裂症患者临床症状和社会功能的影响 总被引:2,自引:0,他引:2
目的:观察认知矫正治疗对慢性精神分裂症患者临床症状和社会功能的改善作用。方法:选择2003-01/08在北京回龙观医院住院的慢性精神分裂症患者104例。均符合CCMD-Ⅲ及DSM-Ⅳ关于精神分裂症诊断标准;年龄25~55岁;病程≥2年;病情稳定,处于迁延、残留或部分缓解状态;药物治疗状况稳定,近期无换药打算;纳入对象或家属同意入组并签署知情同意书。应用随机数字表法将患者分认知矫正治疗组和对照组,每组52例。在相近药物治疗的基础上,认知矫正治疗组以Ann Delahunty和Rodney Morice等制定的神经认知矫正手册(汉化)为治疗工具,在治疗师的指导下进行认知作业练习,内容包括认知灵活性、工作记忆、计划执行功能3大功能模块。对照组予以相同时间的工娱治疗,主要包括有治疗师指导的操作性音乐治疗和舞蹈治疗。治疗前后两组患者分别进行PANSS、住院精神患者社会功能缺陷量表和护士观察量表的评定。结果:实验共纳入慢性精神分裂症患者104例,认知矫正治疗组44例,对照组46例进入结果分析,14例脱落。①治疗前后两组患者PANSS量表总分以及阴性症状量表、复合量表、一般精神病理量表、反应缺乏量表4个分量表的评分均有下降,组内比较差异有显著性意义(t=2.12~4.59,P<0.05);减分情况在两组间差异不明显(P>0.05)。②两组患者的社会功能缺陷量表总分在治疗后均有下降,与治疗前比较,差异有显著性意义(t=3.89,2.04,P<0.05);两组间比较,差异无显著性意义(P>0.05)。认知矫正治疗组治疗后护士观察量表的总病情以及总消极、迟滞2个分量表评分下降,与治疗前比较差异有显著性意义(t=1.49,1.19,2.81,P<0.05);其中迟滞项的减分在两组间比较,差异具有显著性意义(F=4.97,P<0.05)。③社会功能量表的改善与词语流畅性的改善呈正相关(R2=0.36,P<0.05),护士观察量表中总病情与积极两项评分的改善也与言语流畅性测验的改善正相关(R2=0.37,0.34,P<0.05)。结论:认知矫正治疗能在一定程度上改善精神分裂症患者的社会功能,并与部分认知功能的改善相关,但对临床症状无明显改善作用。 相似文献
8.
Treatment of compulsive behaviour in eating disorders with intermittent ketamine infusions 总被引:2,自引:0,他引:2
Mills IH; Park GR; Manara AR; Merriman RJ 《QJM : monthly journal of the Association of Physicians》1998,91(7):493-503
We have previously shown that eating disorders are a compulsive behaviour
disease, characterized by frequent recall of anorexic thoughts. Evidence
suggests that memory is a neocortical neuronal network, excitation of which
involves the hippocampus, with recall occurring by re-excitement of the
same specific network. Excitement of the hippocampus by glutamate-NMDA
receptors, leading to long-term potentiation (LTP), can be blocked by
ketamine. Continuous block of LTP prevents new memory formation but does
not affect previous memories. Opioid antagonists prevent loss of
consciousness with ketamine but do not prevent the block of LTP. We used
infusions of 20 mg per hour ketamine for 10 h with 20 mg twice daily
nalmefene as opioid antagonist to treat 15 patients with a long history of
eating disorder, all of whom were chronic and resistant to several other
forms of treatment. Nine (responders) showed prolonged remission when
treated with two to nine ketamine infusions at intervals of 5 days to 3
weeks. Clinical response was associated with a significant decrease in
Compulsion score: before ketamine, mean +/- SE was 44.0 +/- 2.5; after
ketamine, 27.0 +/- 3.5 (t test, p = 0.0016). In six patients
(non-responders) the score was: before ketamine, 42.8 +/- 3.7; after
ketamine, 44.8 +/- 3.1. There was no significant response to at least five
ketamine treatments, perhaps because the compulsive drive was
re-established too soon after the infusion, or because the dose of opioid
antagonist, nalmefene, was too low.
相似文献
9.
Can we identify termination of resuscitation criteria in cardiac arrest due to drowning: results from the French national out‐of‐hospital cardiac arrest registry 下载免费PDF全文
Hervé Hubert PhD Joséphine Escutnaire MSc Pierre Michelet MD PhD Evgéniya Babykina PhD Carlos El Khoury MD PhD Karim Tazarourte MD PhD Christian Vilhelm PhD Lahcen El Hiki PhD Benjamin Guinhouya PhD Pierre‐Yves Gueugniaud MD PhD on behalf GR‐RéAC 《Journal of evaluation in clinical practice》2016,22(6):928-935
10.
Impact of age, CYP2C9 genotype and concomitant medication on the rate of rise for prothrombin time during the first 30 days of warfarin therapy 下载免费PDF全文
Wilke RA Berg RL Vidaillet HJ Caldwell MD Burmester JK Hillman MA 《Clinical Medicine & Research》2005,3(4):207-213
OBJECTIVES: To characterize the impact of several important clinical variables on the rate of anticoagulation during warfarin initiation (i.e., the first 30 days). DESIGN: Retrospective study. SETTING: An anticoagulation service of a large horizontally integrated, multispecialty group practice in central and northern Wisconsin. PARTICIPANTS: Patients with sufficient laboratory data obtained during the initiation phase of warfarin treatment.Methods: Patients were consented and genotyped for cytochrome P450 (CYP) 2C9 polymorphisms. Anticoagulation laboratory data were then electronically abstracted and fitted to a logistic growth model. Rate of anticoagulation was compared between groups. RESULTS: During warfarin initiation, the mean slope for rise in International Normalized Ratio (INR) of prothrombin time was significantly associated with age (p = 0.03, n = 166). Because a relationship between diabetes and warfarin dosing has been suggested previously, we assessed the impact of this comorbidity in our model as well. Diabetes showed relatively little impact, but concomitant treatment with an anti-diabetic sulfonylurea medication was associated with an increase in slope (3-fold, p < 0.05). Since this drug interaction may occur at the level of CYP2C9, we also assessed the impact of CYP2C9 genotype in our model. The impact of CYP2C9 genotype was marginally significant (p = 0.119, non-pooled dataset; p = 0.053, data pooled for CYP2C9 *2/*2, *2/*3 and *3/*3). CONCLUSIONS: Age and concomitant sulfonylurea therapy alter the rate of anticoagulation during the first 30 days of warfarin therapy. 相似文献