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91.
Oluwatobi O Onafowokan Nicola F. Fine Francis Brooks Oliver M. Stokes Timothy WR Briggs Mike Hutton 《European spine journal》2020,29(3):564-578
To examine the strength of evidence available for multiple facet joint injections (FJIs) and medial branch blocks (MBBs), and to report on the variations in the NHS England framework using the getting it right first time (GIRFT) data. Systematic review using patient, intervention, comparison, outcome and study strategy. The literature search using Cochrane, MEDLINE and EMBASE databases using MeSH terms: lumbar spine, spinal injection and facet joint (“Appendix A”). Three studies were identified that investigated the efficacy of multiple FJIs or MBBs. None of these studies reported sustained positive outcomes at long-term follow-up. There is a paucity of levels I and II evidence available for the efficacy of multiple FJIs and MBBs in treating low back pain. GIRFT data show a high degree of variation in the use of multiple FJIs, which would not be supported by the literature. These slides can be retrieved under Electronic Supplementary Material. 相似文献
92.
Verena R. Cimarolli Joann P. Reinhardt Jillian Minahan Orah Burack Channing Thomas Regina Melly 《Journal of the American Medical Directors Association》2017,18(11):991.e1-991.e4
Objectives
Use of exercise technologies has benefits for community-dwelling older adults in terms of improved gait and balance. But research on the feasibility of use of exercise technologies in various geriatric health care settings is lacking. Hence, the current study examined the feasibility of implementing an exercise technology intended to augment rehabilitation in patients receiving post-acute care (PAC) in a skilled nursing facility (SNF). We focused on 3 indicators of feasibility: extent of usage (including predictors of more intense use), patients' acceptability of the technology, and limited efficacy.Design
Cross-sectional study with data from patients' electronic medical records (EMR), exercise technology portal, and patient interviews.Setting
SNF.Participants
A sample of post-acute patients (n = 237).Measurements
Sociodemographic and health-related variables, time spent using the technology, and 8 items of the Physical Activity Enjoyment Scale (PACES).Results
Average time spent using the technology varied greatly (range, 1–460 minutes). A regression analysis showed that patients who had a longer length of stay (β = .01, P < .05) and were younger (β = ?0.01, P < .05) spent significantly more time using the technology. Acceptability of technology was high among patients. Finally, patients who used the technology had lower 30-day rehospitalization rates.Conclusion
Exercise technology is feasible to use in supporting rehabilitation in patients receiving PAC in a SNF and seems to have beneficial effects. 相似文献93.
94.
Isabelle van Riesenbeck Kathrin Boerner Adrita Barooah Orah R. Burack 《Home health care services quarterly》2013,32(3-4):204-219
This study explored the experiences of 80 home health aides (HHAs) whose client died within the last 2 months. Data collection involved comprehensive semi-structured in-person interviews to try to better understand characteristics of HHAs and their clients associated with preparedness for death. Among those, personal end-of-life (EOL) care preferences of HHAs and having knowledge of preferences and decisions regarding client’s EOL care showed significant links to preparedness. Findings suggest that HHAs’ preparedness for client death could be enhanced both by addressing their personal views on EOL care and by providing more information about the client’s EOL care plans. 相似文献
95.
96.
97.
Benign prostatic hypertrophy: retrograde transurethral dilation of the prostatic urethra in humans. Work in progress 总被引:1,自引:0,他引:1
Castaneda F; Reddy P; Wasserman N; Hulbert J; Lund G; Letourneau JG; Hunter DW; Castaneda-Zuniga WR; Amplatz K 《Radiology》1987,163(3):649-653
Retrograde transurethral balloon dilation of the prostatic urethra was performed in five human volunteers with benign prostatic hypertrophy. Each patient underwent cystoscopy, uroflow studies, voiding cystourethrography, retrograde urethrography, and magnetic resonance imaging before dilation and at defined intervals afterward. The longest follow-up to date is 8 months. Patients were given topical anesthetics and mild sedatives, and dilation was performed with a 25-mm urethroplasty balloon catheter inflated at 3-6 atm for 10 minutes. All catheter manipulations were done with a guide wire and under fluoroscopic control. Significant resolution of symptoms of prostatism was seen in four patients. The unsatisfactory results in the last patient were believed to be caused by ineffectual dilation of predominantly middle lobe hypertrophy--a condition that is now regarded as a contraindication to dilation. This technique has promise to replace transurethral resection of the prostate as the treatment of choice for this common male ailment. 相似文献
98.
A new guide wire that provides markedly improved torque control is described. It was compared with a conventional guide wire in two models, one simulating a drainage tube with numerous side holes and one, the biliary tree. The new wire was much more easily controlled than the conventional guide wire and passed through both models significantly faster (P less than .01 and P less than .005). Although some deterioration in control was noted when it was inserted through a catheter in vivo, the new torque-control wire still exhibited a definite improvement over conventional wires in directional control. 相似文献
99.
Mechanical clot dissolution: new concept 总被引:3,自引:0,他引:3
The authors present preliminary data on in vitro mechanical clot dissolution by means of a catheter with a tiny high-speed propeller enclosed in a special housing. Preweighed human blood clots were subjected to the catheter in a test tube with saline at various propeller speeds and durations of application. After filtration of the resultant slurry, the clot residue was weighed and examined histologically. Clot dissolution was found to be related to both the duration and speed of propeller rotation. No fibrin residue was seen after dissolution, although potential embolic material, composed of clumps of cellular debris as large as 208 microns in longest dimension, was found. Mechanical clot dissolution could possibly be used in any natural or synthetic blood vessel in which there is acute or subacute thrombosis, with fewer complications and lower cost than obtained with traditional methods. 相似文献
100.
The pulse-sequence equations for spin-echo magnetic resonance imaging were used to determine interpulse delay times that give the highest signal-to-noise ratio from a single tissue. This theoretical result was then verified experimentally using 1-, 2-, and 5-mM/l copper sulfate solutions imaged on a 0.15-T resistive system. Theoretical analysis determined the spin-echo interpulse delay times that maximize the signal-to-noise ratio from a single tissue as TEopt = TEmin, the minimum echo delay time permitted by the system, and, to a good approximation, TRopt = 1.27 T1 + 1.90 TEmin, with T1 the longitudinal magnetic relaxation time of the tissue. Phantom measurements of the signal-to-noise ratio in a typical imaging system confirmed the theoretically determined TRopt values to within 7%. 相似文献