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排序方式: 共有336条查询结果,搜索用时 140 毫秒
1.
Christina L. Luong Kevin Ong Kendeep Kaila Patricia A. Pellikka Kenneth Gin Teresa S. M. Tsang 《Journal of ultrasound in medicine》2019,38(4):865-876
Focused cardiac ultrasonography is performed by clinicians at the bedside and is used in time‐sensitive scenarios to evaluate a patient's cardiovascular status when comprehensive echocardiography is not immediately available. This simplified cardiac ultrasonography is often performed by noncardiologists using small, portable devices to augment the physical examination, triage patients, and direct management in both critical care and outpatient settings. However, as the use of focused cardiac ultrasonography continues to expand, careful consideration is required regarding training, scope of practice, impact on patient outcomes, and medicolegal implications. In this review, we examine some of the challenges with rapid uptake of this technique and explore the benefits and potential risk of focused cardiac ultrasonography. We propose possible mechanisms for cross‐specialty collaboration, quality improvement, and oversight. 相似文献
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Poverty is a frequently cited risk factor for child maltreatment. This review critically assesses how Canadian research on child maltreatment has operationalized economic hardship to improve understanding of the relationship between the two concepts. The review includes 16 studies between 1986 and 2011 using data reported by individuals, child protection workers, and third party sources such as Statistics Canada. Variables used to measure economic hardship included income, income source, perceived ability of income to meet needs, employment status, education achievements, and variables related to shelter such as number of moves and home ownership. Operationalizing economic hardship with these variables shows differing results—both in direction and magnitude—depending on the outcome variable. The knowledge base would be improved with more precise measurement of economic hardship variables. 相似文献
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Timo Kaila MD Esko Iisalo Aapo Lehtonen Heikki Saarimaa 《Cardiovascular drugs and therapy / sponsored by the International Society of Cardiovascular Pharmacotherapy》1993,7(6):839-849
Summary We estimated antagonist activity of metoprolol, pindolol, and propranolol in elderly cardiovascular patients by determining the extent to which the drugs occupied rabbit lung beta1- and rat reticulocyte beta2-adrenoceptors in plasma samples during drug treatment. The randomized, double-blind, crossover study was carried out by administering twice daily 100 mg metoprolol, 5 mg pindolol, and 80 mg propranolol for 7 days to 20 hypertensive subjects with a mean age of about 70 years. A 2-week interval was kept between administration of the different regimens. Receptor occupancy was measured at 1 hour before and 2 hours after administration of the last dose of each regimen by adding rabbit lung beta1- and rat reticulocyte beta2-receptors to plasma samples and by labeling the receptors with a radiolabeled beta-antagonist, (–)-[3H]CGP-12177. The results and conclusions were the following: (a) The extent to which metoprolol, pindolol, and propranolol occupied rabbit lung beta1-and rat reticulocyte beta2-adrenoceptors in plasma samples estimated accurately the intensity of beta-receptor antagonism in the patients who did not tolerate physiological and pharmacological tests measuring the degree of beta1- and beta2-adrenoceptor blockade. (b) The mean beta1- and beta2-receptor occupancy of pindolol and propranolol varied between 76% and 99% during the treatments. The mean beta1-receptor occupancy of the metoprolol regimen varied between 54% and 92%, and its beta2-receptor occupancy varied between 6% and 38%. Thus the antagonist activity of the metoprolol regimen differed significantly from that of the other regimens (ANOVA for repeated measures, p<0.05 and 0.001, for the beta1- and beta2-occupancy, respectively). (c) The extent of beta1- and beta2-receptor occupancy in plasma samples was in conformity with the literature on the intensity, selectivity, and duration of beta-blockade after similar drug doses. (d) The data on the receptor occupancy of beta-blocking drugs in plasma samples appear to be valuable in analyzing their effects, and it may be a method for optimizing drug therapy for aged cardiovascular patients. 相似文献
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Leena Tuomisto Vesa Jarvinen Jukka Laitinen Marina Erhola Minna Kaila Pirkko Brander 《Primary care respiratory journal》2008,17(4):226-231
AIMS: To assess the quality of primary care spirometry by visual inspection of the flow-volume expiratory curve and to study the quantity of clinical information provided on the spirometry report sheets. METHODS: Retrospective audit of 868 expiratory flow-volume curves referred to three pulmonary clinics assessed against five predefined quality criteria. Clinical information included on the spirometry report sheets was also collected. RESULTS: Quality was good in 78% of pre-bronchodilation curves and in 80% of post-bronchodilation curves. Obtaining a sharp PEF value and full vital capacity exhalation seemed to be the critical points of measurement. Inter-rater reliability of the curve assessment was mainly good. Data on where the spirometry took place, and comments on the use of respiratory medication and patient co-operation were often lacking. CONCLUSIONS: The quality of primary care spirometry was good. Adequate clinical information on the report sheets would further improve the quality of this diagnostic process. 相似文献
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Malmström K Kaila M Kajosaari M Syvänen P Juntunen-Backman K 《Pediatric pulmonology》2007,42(3):210-215
Several studies show that asthma mortality in children and adolescents increased until the mid-1990s, after which it has slightly decreased worldwide. The objective of this study was to describe the mortality rates of childhood asthma in Finland, and to analyze patient characteristics to identify predisposing factors for fatal asthma exacerbation among children and adolescents during 1976-1998 (2004). All death certificates where asthma or related respiratory tract disease was coded as the underlying cause of death were reviewed for those under 20 years of age. Health care records and autopsy reports were evaluated to validate the cause of death and to identify any predisposing factors. In all, there had been 28 asthma deaths. The validity of the death certificates proved to be good as only 7% were misclassified. Death occurred either in the very young children or adolescents: the median age in the group of <12 years (n = 15) was 3.3 years while the median age in the group of >12 years (n = 13) was 18.1 years. The fatal exacerbations occurred mostly during summer and early autumn. Clinical triggers, recorded for 14/22 patients with available patient records, included respiratory infection, (12) use of ibuprofen despite known allergy (1), and exercise after visiting a horse stable (1). The severity of the disease was discernible in 21 patients: severe in 15, moderate in 5, and mild in 1 patient. Inhaled corticosteroids were not used as maintenance or periodic therapy in 12/22 patients, of whom 4 had died during the 1990s. In conclusion, asthma mortality in Finnish children and adolescents was rare and its incidence remained stable. The validity of the death certificate diagnoses proved to be good. Poor asthma management and non or undertreatment with inhaled corticosteroids were risk factors for fatal asthma. 相似文献
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Elizabeth C. Raff Kaila L. Schollaert David E. Nelson Philip C. J. Donoghue Ceri-Wyn Thomas F. Rudolf Turner Barry D. Stein Xiping Dong Stefan Bengtson Therese Huldtgren Marco Stampanoni Yin Chongyu Rudolf A. Raff 《Proceedings of the National Academy of Sciences of the United States of America》2008,105(49):19360-19365
Fossilized embryos with extraordinary cellular preservation appear in the Late Neoproterozoic and Cambrian, coincident with the appearance of animal body fossils. It has been hypothesized that microbial processes are responsible for preservation and mineralization of organic tissues. However, the actions of microbes in preservation of embryos have not been demonstrated experimentally. Here, we show that bacterial biofilms assemble rapidly in dead marine embryos and form remarkable pseudomorphs in which the bacterial biofilm replaces and exquisitely models details of cellular organization and structure. The experimental model was the decay of cleavage stage embryos similar in size and morphology to fossil embryos. The data show that embryo preservation takes place in 3 distinct steps: (i) blockage of autolysis by reducing or anaerobic conditions, (ii) rapid formation of microbial biofilms that consume the embryo but form a replica that retains cell organization and morphology, and (iii) bacterially catalyzed mineralization. Major bacterial taxa in embryo decay biofilms were identified by using 16S rDNA sequencing. Decay processes were similar in different taphonomic conditions, but the composition of bacterial populations depended on specific conditions. Experimental taphonomy generates preservation states similar to those in fossil embryos. The data show how fossilization of soft tissues in sediments can be mediated by bacterial replacement and mineralization, providing a foundation for experimentally creating biofilms from defined microbial species to model fossilization as a biological process. 相似文献
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