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1.
Kamal Narayan Arya Shanta Pandian Abhishek Sharma Vikas Kumar Varun Kumar Kashyap 《Topics in stroke rehabilitation》2020,27(4):272-289
ABSTRACT
Background
The interlimb coupling, coordination between the limbs, gets hampered in post-stroke hemiparesis. Most of the poststroke motor regimes primarily focus on the more affected limb. 相似文献2.
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Mohd. Aamir Kundan Mittal Jaya Shankar Kaushik Haripal Kashyap Gurpreet Kaur 《Indian journal of pediatrics》2014,81(11):1167-1170
Objective
To determine the sociodemographic and clinical factors leading to stress among parents whose children are admitted in pediatric intensive care unit (PICU).Methods
A prospective observational study was conducted in PICU of a tertiary care hospital of north India. Parents of children admitted to PICU for at least 48 h duration were eligible for participation. At the end of 48 h, parental stress was assessed using parental stress scale (PSS:PICU) questionnaire which was administered to the parents. Baseline demographic and clinical parameters of children admitted to PICU were recorded. The parental stress was compared with demographic and clinical characteristics of children using appropriate statistical methods.Results
A total of 49 parents were finally eligible for participation. Mean (SD) parental stress scores was highest in domains of procedures [1.52 (0.66)] and behavior and emotional [1.32 (0.42)] subscales. Mean (SD) total parental stress score among intubated children [1.31 (0.25)] was significantly more than among non intubated children [0.97 (0.26)] (p?0.001). However, parental stress score were comparable in terms of gender (p?=?0.15) and socioeconomic status (p?=?0.32). On subscale analysis, it was found that professional communication is a significant stressor in age groups 0–12 mo [0.61(0.41)] (p?=?0.02). It was observed that parents of intubated children were significantly stressed by the physical appearance of their children (p?0.001), procedures performed on them (p?=?0.008) and impairment in parental role (p?=?0.002). Total parental stress score had a positive correlation with PRISM score (r?=?0.308).Conclusions
Indian parents are stressed maximally with environment of PICU. Factor leading to parental stress was intubation status of the child and was not affected by gender or socio demographic profile of the parents. 相似文献6.
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M. H. Nathanson J. Andrzejowski J. Dinsmore C.A. Eynon K. Ferguson T. Hooper A. Kashyap J. Kendall V. McCormack S. Shinde A. Smith E. Thomas 《Anaesthesia》2020,75(2):234-246
The location of care for many brain-injured patients has changed since 2012 following the development of major trauma centres. Advances in management of ischaemic stroke have led to the urgent transfer of many more patients. The basis of care has remained largely unchanged, however, with emphasis on maintaining adequate cerebral perfusion as the key to preventing secondary injury. Organisational aspects and training for transfers are highlighted, and we have included an expanded section on paediatric transfers. We have also provided a table with suggested blood pressure parameters for the common types of brain injury but acknowledge that there is little evidence for many of our recommendations. These guidelines remain a mix of evidence-based and consensus-based statements. We have received assistance from many organisations representing clinicians who care for these patients, and we believe our views represent the best of current thinking and opinion. We encourage departments to review their own practice using our suggestions for audit and quality improvement. 相似文献
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Walker AS; Peto TE; Babiker AG; Darbyshire JH 《QJM : monthly journal of the Association of Physicians》1998,91(6):423-438
The Concorde trial compared immediate (Imm) with deferred (Def) AZT
monotherapy in asymptomatic HIV-positive participants. Haematological and
immunological markers and weight were measured throughout, and correlated
with clinical endpoints. Markers associated with disease progression (CD4
lymphocyte count and percentage, platelets, p24 antigen and beta 2
microglobulin favoured Imm: those associated with toxicity (haemoglobin,
neutrophils and white cell count) favoured Def. CD8 and total lymphocyte
count did not differ significantly between groups. In multivariate
analysis, the combination of baseline CD4, p24 antigen and beta 2m was the
best baseline predictor of disease. Including change in CD4 and beta 2m at
12 weeks, or changes over follow- up in these markers significantly
improved the fit. Markers were also incorporated into the definition of
'clinical' endpoints. Hazard ratio estimates from end-points that included
CD4 < 50 and CD4 < 25 were closest to those for AIDS or death alone,
but added very few extra events. Use of other landmark CD4 counts (100 or
greater) or relative decreases in counts (25% or more) increased the number
of events, but overestimated the effect of immediate AZT. Although AZT had
a beneficial effect on the surrogate markers of efficacy evaluated, these
changes did not predict clinical outcome, nor could the markers be usefully
incorporated into an endpoint definition.
相似文献