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61.
Despite many advances in catheter design and use, the most common cause of hospital-acquired infections is catheterization of the urinary tract. In the present investigation the adherence of bacteria to catheters coated with heparin was studied. Since heparin itself does not coat the plastic catheter surface, a complex of heparin with tridodecylmethylammonium chloride (TDMAC) was used which results in hydrophobic association of hydrocarbon chains of the TDMAC with the catheter leaving the quaternary ammonium moiety of TDMAC exposed to the surface forming ionic bonds with the highly anionic sulfate groups of heparin. Coating latex catheter material with TDMAC without heparin resulted in 3.6-fold higher adherence whereas coating with the TDMAC-heparin complex reduced adherence to less than 10% of control untreated latex. TDMAC-heparin also significantly reduced bacterial adherence to teflon coated latex (Bardex) and vinyl catheter material. Less than 30% of the original heparin was removed after wash periods of up to one week. These results indicate that TDMAC-heparin coating of urethral catheters reduces bacterial adherence and thereby may delay the acquisition of catheter associated urinary tract infection. 相似文献
62.
HYPOTHESIS: Irrigation of the mastoid with a quinolone antibiotic-steroid solution may mitigate hearing loss caused by iatrogenic semicircular canal injury in the presence of Pseudomonas aeruginosa (PA) otitis media (OM). BACKGROUND: Studies have shown the cochlea to be more vulnerable to semicircular canal transection (SCT)-related hearing loss in the presence of PA OM. Prophylactic systemic antibiotics and steroids may decrease this hearing loss, but SCT is usually not planned. The aim of this study was to determine if irrigation with ciprofloxacin-dexamethasone (cipro-dex) could improve hearing outcomes following SCT in PA OM. METHODS: PA OM was induced in 28 animals. After three to five days, unilateral SCT was performed in each animal, with sham SCT on the contralateral ear. At surgery, half of the animals (n = 14) underwent irrigation of the both mastoid bullae with cipro-dex; the second group of animals (n = 14) underwent irrigation of the bullae with sterile saline. Auditory thresholds were obtained immediately prior to SCT and 7-10 days after SCT. RESULTS: SCT ears treated with cipro-dex showed a mean click threshold improvement of 4.6 dB from pre-transection to 7-10 days post-transection, whereas thresholds in the SCT ears treated with saline worsened by 7.5 dB (p = 0.15). CONCLUSION: Irrigation of the guinea pig bulla with cipro-dex following SCT in the setting of PA OM appears safe and may yield beneficial effects on hearing. 相似文献
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Bibhuti B Das Linda B Pauliks Ole A Knudson Scott Kirby Kak-Chen Chan Lilliam Valdes-Cruz Raul O Cayre 《Journal of the American Society of Echocardiography》2005,18(3):231-236
We identified 18 patients with double-orifice mitral valve (DOMV) and intact atrioventricular (AV) septum out of 40,179 echocardiographic studies performed between 1997 and 2002 at Children's Hospital, Denver, CO. In this study we describe (1) the anatomic characteristics of the DOMV in the absence of AV septal defect, (2) the function of the mitral valve by spectral and color Doppler flow mapping, and (3) associated lesions. The topographic location of the orifices in the leaflets suggests possible embryologic mechanisms of DOMV. In this series, DOMV was most commonly associated with left-sided obstructive lesions (in 39% of patients). Spectral and color Doppler interrogation demonstrated a normal flow profile in most cases; only 2 patients had significant mitral regurgitation or stenosis. Therefore, due to the uncertain natural history of this lesion and the potential need for endocarditis prophylaxis, careful imaging of the mitral valve is recommended, particularly in the presence of left-sided obstructive lesions. 相似文献
66.
Miriam Stewart Linda Reutter Edward Makwarimba Irving Rootman Deanna Williamson Kim Raine Doug Wilson Janet Fast Rhonda Love Sharon McFall Deana Shorten Nicole Letourneau Karen Hayward Jeff Masuda William Rutakumwa 《Revue canadienne de recherche en sciences infirmières》2005,37(3):104-131
Poverty influences health status, life expectancy, health behaviours, and use of health services. This study examined factors influencing the use of health-related services by people living in poverty. In the first phase, 199 impoverished users of health-related services in 2 large Canadian cities were interviewed by their peers. In the second phase, group interviews with people living in poverty (n = 52) were conducted. Data were analyzed using thematic content analysis. Diverse health-related services were used to meet basic and health needs, to maintain human contact, and to cope with life's challenges. Use of services depended on proximity, affordability, convenience, information, and providers' attitudes and behaviours. Use was impeded by inequities based on income status. To promote the health of people living in poverty, nurses and other health professionals can enhance the accessibility and quality of services, improve their interactions with people living in poverty, provide information about available programs, offer coordinated community-based services, collaborate with other sectors, and advocate for more equitable services and policies. 相似文献
67.
Linda S Baas 《Dimensions of critical care nursing》2004,23(3):131-138
An ex post facto correlational study was conducted to examine predictors of quality of life in persons 3 to 6 months after a myocardial infarction. Self-care resources, self-care knowledge (needs), activity level, and selected demographic variables were examined as predictor variables. A convenience sample of 86 subjects with a mean age of 61 years, was recruited for participation in this study. The study that explained 35% of the variance in quality of life included self-care resources available, activity level, and self-care needs. Modeling and Role Modeling Paradigm provided a useful explanation of how self-care resources and self-care knowledge can be applied to persons recovering from myocardial infarction. 相似文献
68.
Perry D. Cohen Linda Herman Sheryl Jedlinski Peggy Willocks Paula Wittekind 《Neurotherapeutics》2007,4(3):537-544
A patient-centered paradigm for clinical research and medical care is presented as a solution to the problem of declining
innovation and increasing costs and development time in the pipeline for new therapies. Fundamental differences in values
and motivations among scientists, clinicians, industry sponsor, and patients in neurotherapeutics provide a framework for
analysis of ethical conflicts and the loss of public confidence in medical research. Parkinson advocates’ views on clinical
trial participation, perceived risks and benefits, placebo controls, and sham surgery are presented. These views reflect the
sense of urgency and the unique perspective that comes from living with this progressive, debilitating condition full time.
A patient-centered paradigm that includes authentic voices of patients as collaborators at every stage of development will
help to resolve conflicts, build trust, recruit trial participants, and accelerate new therapies. Key elements are adaptive
clinical trial methods and the development of information technology for the assessment of outcomes and surveillance of safety
over the life cycle of a medical product. Supported by the Parkinson’s Disease Foundation, the Parkinson Pipeline Project
is a grassroots group of Parkinson’s patients whose goal is to represent an authentic voice for patients in the treatment
development process. This group promotes education and communication between members of the Parkinson’s community and active
stakeholders in medical research, industry, and regulatory agencies. Its members are an example of a new breed of knowledgeable
consumers, armed with first-hand access to research findings and reinforced by on-line connections to like-minded peers throughout
the world. 相似文献
69.
Society is currently on the threshold of a new revolution in understanding the interaction of genes and the environment. This research has profound implications for understanding occupational disease and will present ethical challenges to occupational health practice. The public must be educated about the potential promise, as well as the threats, posed by emerging genetic technologies. 相似文献
70.
Toward a VA women’s health research agenda: Setting evidence-based priorities to improve the health and health care of women veterans 下载免费PDF全文
Elizabeth M. Yano Lori A. Bastian Susan M. Frayne Alexandra L. Howell Linda R. Lipson Geraldine McGlynn Paula P. Schnurr Margaret R. Seaver Ann M. Spungen Stephan D. Fihn 《Journal of general internal medicine》2006,21(3):S93-S101
The expansion of women in the military is reshaping the veteran population, with women now constituting the fastest growing segment of eligible VA health care users. In recognition of the changing demographics and special health care needs of women, the VA Office of Research & Development recently sponsored the first national VA Women’s Health Research Agenda-setting conference to map research priorities to the needs of women veterans and position VA as a national leader in Women’s Health Research. This paper summarizes the process and outcomes of this effort, outlining VA’s research priorities for biomedical, clinical, rehabilitation, and health services research. 相似文献