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941.
A. Bersano L. Candelise R. Sterzi G. Micieli M. Gattinoni A. Morabito 《Neurological sciences》2006,27(5):332-339
Abstract The future challenge for improving stroke patients’ outcome will be to implement new Stroke Units (SUs) worldwide. However
the best SU model remains uncertain. The aim of this study was to evaluate the number of SUs and the quality characteristics
of acute stroke care in Italy. We conducted a SU survey in Italy, interviewing the directors of the hospital wards that discharged
at least 50 acute stroke patients a year. A SU was defined as an acute ward area with stroke-dedicated beds and staff. To
compare the quality of care provided in SUs with that in general wards (GWs) we investigated the characteristics of five domains:
hospital setting, unit setting, staffing, process of care and diagnostic investigations. We identified 68 SUs and 677 GWs.
Multivariate logistic regression analyses demonstrated that SUs compared to GWs had higher quality scores in unit setting
(ROC area=0.9721), staffing (ROC area=0.8760) and care organisation (ROC area=0.7984). The hospital setting (ROC area=0.7033)
and the availability of rapid diagnostic investigations (ROC area=0.7164) had lower power in discriminating SU from GW. In
Italy in 2003/04 only 9% of the hospital services had organised SU care. The study demonstrated that SUs admitted more than
100 patients per year, had more monitoring equipment and staffing time, and practised multidisciplinary meetings and early
mobilisation. The utility of these structural and performance characteristics needs validation from outcome studies. 相似文献
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Claire M Rickard Brigit L Roberts Jonathon Foote Matthew R McGrail 《Dimensions of critical care nursing》2006,25(5):234-242
Research coordinators in intensive care are a growing specialty about which little is known. This cross-sectional study surveyed the Australia and New Zealand Intensive Care Research Coordinators' Group (n = 49) regarding demographics, education, employment history, job structure, and role content. Most research coordinators were highly qualified and experienced nurses who undertake pharmaceutical trials, multicenter projects, departmental medical and nursing research, audits and data registries, and their own projects. 相似文献
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950.
C. M. Gordon E. Binello M. S. LeBoff M. E. Wohl C. J. Rosen A. A. Colin 《Osteoporosis international》2006,17(5):783-790
Introduction Patients with cystic fibrosis (CF) are known to be at risk for early osteoporosis, and the mechanisms that mediate bone loss
are still being delineated. The aim of the present investigation was to investigate if a correlation exists in these patients
between skeletal measurements by dual-energy x-ray absorptiometry (DXA) and two anabolic factors, dehydroepiandrosterone (DHEA)
and insulin-like growth factor I (IGF-I), and proresorptive factors such as the cytokines interleukin-1β, tumor necrosis factor α,
and interleukin-6.
Methods We studied 32 outpatients (18 females; mean age: 26.2 ± 7.9 years) at a tertiary care medical center. The subjects had venous
samples obtained, underwent anthropometric and bone mineral density (BMD) measurements, and completed a health survey. Serum
IGF-I concentrations were below the age-adjusted mean in 78% of the participants, and DHEA sulfate (DHEAS) concentrations
were low in 72%. Serum concentrations of all cytokines were on the low side of normal; nonetheless, there was a modest inverse
correlation between IL-1β and BMD at all sites.
Results In univariate analyses, IGF-I and DHEAS were significant correlates of BMD or bone mineral content. In final multivariate
models controlling for anthropometric and other variables of relevance to bone density, only IGF-I was identified as a significant
independent skeletal predictor. While alterations in DHEAS, IGF-I, and specific cytokines may contribute to skeletal deficits
in patients with CF, of these factors a low IGF-I concentration appears to be most strongly correlated with BMD.
Conclusions These findings may have therapeutic implications for enhancing bone density in these patients. 相似文献