共查询到20条相似文献,搜索用时 31 毫秒
1.
2.
Jacquelinet C Audry B Pessione F Antoine C Loty B Calmus Y 《Presse medicale (Paris, France : 1983)》2008,37(12):1782-1786
Previous rules of allocation of livers for transplantation were based mainly on local priorities, with final management left to the local team. This created substantial regional disparities. A prospective survey of waiting list deaths and dropouts due to aggravation of liver disease (2003-2005) validated the MELD (Model for End-stage Liver Disease) score on French data. A new allocation score (Liver Score) for liver transplants, based on specific variables for each liver disease, was introduced in March 2007. An initial evaluation, based on the first 5 months of practice, clearly shows that the Liver Score reduces the rates of deaths, dropouts, and futile transplantations; it also accelerates access to transplantation for the sickest patients. Several points remain unresolved: both the MELD and Liver scores may be improved. The variability of the MELD score related to different laboratory assay methods requires harmonization between laboratories. 相似文献
3.
4.
Yuichi Kasai M.D. Akihiro Sudo Yasuo Shiokawa Yoshio Ogihara Hiroyasu Kobayashi 《Journal of bone and mineral metabolism》1994,12(1):65-68
We evaluated 207 individuals (49 men and 158 women) living in a small town in central Japan to identify the risk factors for,
and the etiology of, osteoporosis. Female sex, advanced age, short stature, low body weight, and deficiencies in calcium and
protein intake were associated with an increased risk of osteoporosis. Nutrition appeared to be strongly related to a decrease
in bone mass, because subjects who lived solitary lives were more likely to have decreased bone mass and bone mass was similar
between husbands and wives. 相似文献
5.
The management of patients with subarachnoid haemorrhage following rupture of an intracranial aneurysm is changing. The recent introduction of endovascular occlusion of the aneurysm using detachable coils offers an alternative to craniotomy and clipping of the aneurysm for the prevention of recurrent aneurysmal haemorrhage. The aim of this survey was to evaluate the current provision of peri-operative care for patients with an aneurysmal subarachnoid haemorrhage in the United Kingdom and Republic of Ireland. A survey was conducted of the 34 neuroscience centres which provide an adult neurosurgery service in the United Kingdom and Republic of Ireland. Most centres reported an increasing role for coiling, and a decreasing role for clipping in the management of aneurysmal subarachnoid haemorrhage. The provision of peri-operative care for patients undergoing interventional neuroradiology procedures varied greatly between centres. Neurovascular services in the UK are being reorganised and adequate staff and facilities should be available for the peri-operative care of patients undergoing interventional neuroradiology procedures. 相似文献
6.
目的探讨昏迷患者气管切开术后应用不同类型气管套管预防肺部感染的效果。方法将102例昏迷气管切开患者按入院时间分为对照组(50例)和观察组(52例),对照组采用不带气囊的金属气管套管;观察组采用一次性低压气囊气管套管,均予气管切开术后常规护理。两组分别在气管切开后第3天、第15天,从气管套管内留取痰标本进行细菌培养。结果两组气管切开术后第15天细菌阳性率比较,差异有显著性意义(P〈0.01);观察组气管切开术后15d总菌株少于对照组(P〈0.01);第3天与第15天总菌株比较,对照组差异有显著性意义(P〈0.01),观察组差异无显著性意义(P〉0.05)。观察组肺部感染率显著低于对照组(P〈0.05)。结论采用一次性低压气囊气管套管能有效降低昏迷气管切开术患者的肺部感染率。 相似文献
7.
8.
9.
10.
Because of the high prevalence of co-morbid conditions and poor life expectancy a Body Mass Index (BMI) of 40 kg/m(2) or more is an indication for surgery in a fully informed, consenting adult in optimal medical condition to tolerate general anaesthesia. Patients with BMI of 35-40 kg/m(2) and the existence of one or more serious obesity-related conditions ameliorated by weight loss, such as hypertension, pulmonary insufficiency, non-insulin-dependent diabetes mellitus etc., are also candidates for surgical treatment. The bariatric surgeon should use these international criteria as guidelines only, not strict rules. Attempts on the part of internists and more frequently insurance carriers to require documented failure of previous non-operative treatment is not meaningful. 相似文献
11.
护士分层级能力培养模型的构建 总被引:2,自引:1,他引:1
目的构建护士分层级能力培养模型,为合理培养各层级护士提供依据。方法在总结相关实践的基础上,进行文献分析和讨论,构建护士分层级能力培养模型。结果护士分层级能力培养模型包括新护士、通科护士、专科护士和护理顾问4个能力进阶层级和学校教育、临床实践、专科培训3种培养方式。结论该模型为我国护士的分层级培养提供了路径,具有实践参考价值。 相似文献
12.
13.
Factors of importance for selecting cases for sphincter preserving surgery for rectal cancer 总被引:1,自引:0,他引:1
B C Morson 《Annales chirurgiae et gynaecologiae》1986,75(2):114-120
14.
15.
The Center for Medicaid and Medicare Services (CMS) has recently revised their end-stage renal disease (ESRD) Medical Evidence Report, Medicare Entitlement, and Patient Registration CMS 2728 Form. The modified algorithm calls for the use of formulae to estimate glomerular filtration rate (GFR). The new criterion is defined as estimated GFR of less than 20 ml/min per 1.73 m2. GFR is either estimated by Schwartz formula (CSCH) in children or Modification of Diet in Renal Disease formula (CMDRD) in adults. The purpose of this communication is to test the validity of the new CMS GFR algorithm in detecting children who need renal replacement therapy. We evaluated two cohorts of children. Group I included single-center data from 626 125I-iothalamate clearance studies (CIO) that were compared with the simultaneous estimation of GFR by CSCH. Group II included data on 659 children from the patient incidence registry obtained from the ESRD Network of Texas between February 1996 and October 2003. In group I there were 76 children (76 CIO) with CSCH less than 20 ml/min per 1.73 m2 of whom 50 (67%) had CIO less than 15 ml/min per 1.73 m2. Of children with CIO less than 15 ml/min per 1.73 m2, 62% had a CSCH less than 20 ml/min per 1.73 m2. The ability of CSCH greater than 20 ml/min per 1.73m2 to predict CIO greater than 15 ml/min per 1.73 m2 (negative predictive value) is 0.95. The number of children who were started on dialysis in Texas within the study period was 659 (group II). The mean CSCH±SD was 10.8±7.7 ml/min per 1.73 m2. Of the patients who were initiated on dialysis, 94% had CSCH less than 20 ml/min per 1.73 m2. The results were sustained when race, gender, age range, and type of diagnosis were considered. The new CMS algorithm provides a good negative predictive estimate of GFR less than 15 ml/min per 1.73 m2.
Disclaimer The analyses upon which this publication is based were performed under contract number 500–03-NW14 entitled End-Stage Renal Disease Networks Organization for the State Texas, sponsored by the Centers for Medicare and Medicaid Services, Department of Health and Human Services. The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government. The authors assume full responsibility for the accuracy and completeness of the ideas presented. This article is a direct result of the Health Care Quality Improvement Program initiated by the Centers for Medicare and Medicaid Services, which has encouraged identification of quality improvement projects derived from analysis of patterns of care, and therefore required no special funding on the part of this contractor. Ideas and contributions to the author concerning experience in engaging with issues presented are welcomed. 相似文献
16.
17.
18.
19.