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71.
Isometric muscle strength is an indicator of self-reported physical functional disability in patients with rheumatoid arthritis 总被引:4,自引:1,他引:3
The objective of our study was to examine (1) whether isometric muscle
strength contributes to the explanation of the physical functional
disability of a rheumatoid arthritis (RA) patient population after
accounting for other disease parameters and demographic variables and (2)
whether change in isometric muscle strength is an indicator of change in
physical functional disability. Sixty-five consecutive patients fulfilling
the American Rheumatism Association 1987 revised criteria for RA were
included in the study. Isometric muscle strength was measured with a
validated Muscle Strength Index (MSI) calculated as the mean score of
standardized isometric extension and flexion strength of the knee and elbow
joints. Physical functional disability was measured with the physical
dimension of the Health Assessment Questionnaire (HAQ). For 56 patients, we
could obtain 1 yr follow-up data. Cross-sectionally, there was a
significant correlation (r = - 0.51, P < 0.01) between the MSI and the
HAQ. Muscle strength remained a significant determinant of the HAQ in
multivariate analysis accounting for disease and demographic variables.
Longitudinally, change in MSI explained additional variance of change in
HAQ after accounting for change in pain, the most important correlate of
change in HAQ.
相似文献
72.
Postoperative radiotherapy for locally advanced colon cancer 总被引:1,自引:0,他引:1
Dr. E. Henry Amos MD William M. Mendenhall MD Patricia J. McCarty BA John O. Gage MD J. Logan Emlet MD Gerald C. Lowrey MD Craig A. Peterson MD Warren R. Amos MD 《Annals of surgical oncology》1996,3(5):431-436
Background: The role of adjuvant postoperative radiotherapy for locally advanced colon cancer is not well documented.
Methods: Seventy-eight patients who underwent a complete resection of B2-C colon cancer received postoperative radiotherapy. Twenty-eight
patients received ⩽45 Gy; 50 patients received 50–55 Gy. Twenty-seven patients received adjuvant fluorouracil-based chemotherapy.
All patients were followed for a minimum of 3 years; no patients were lost to follow-up.
Results: The overall local control rate was 88%. The 5-year actuarial rate of local control was 96% after 50–55 Gy postoperative radiotherapy
compared with 76% after <50 Gy (p=0.0095). Multivariate analysis of local control showed that only radiotherapy dose significantly
influenced this end point. Cause-specific survival rates at 5 years were B2, 67%; B3, 90%; C1, 100%; C2, 61%; C3, 36%; and
overall, 63%. Multivariate analysis of cause-specific survival showed that only stage significantly influenced this end point.
Bowel obstruction caused by adhesions developed in three patients and required a laparotomy; radiation-induced sarcoma developed
in one additional patient.
Conclusions: Postoperative radiotherapy appears to reduce the risk of local recurrence in patients with locally advanced colon cancer.
The optimal dose is probably 50–55 Gy at 1.8 Gy per fraction. Postoperative radiotherapy may improve cause-specific survival
for patients with stages B3 and C2 cancers. 相似文献
73.
G Hussein Rassool MSc BA RMN RCNT RNT FETC CertEd CertCouns CertSupervision & Consultation 《Journal of advanced nursing》1993,18(9):1401-1407
The widespread use and misuse of alcohol, drug and other psychoactive substances are major health and social concerns that affect the lives of many The social and health sequelae of psychoactive drugs and alcohol are preventable and manageable with minimal interventions Nurses and other health workers can effectively respond to substance misuse problems and their existing generic skills can be easily adapted in working with substance misusers This paper considers some of the issues such as the extent of the problem, attitudinal considerations, response to substance misusers and a brief outline of the role of the nurse The urgent need for education and training in substance misuse and addictive behaviour for nurse practitioners is also addressed 相似文献
74.
Tai-Chan Peng MD Robert P. Kusy PhD Philip F. Hirsch PhD John R. Hagaman BA 《Alcoholism, clinical and experimental research》1988,12(5):655-659
Chronic ingestion of ethanol resulted in ultrastructural and mechanical changes in rat femurs. Scanning electron microscopy of the distal end of the femur revealed that the trabeculae of bones from ethanol-fed rats were thinner, more columnar, and more extensive than those from control rats. Three-point bending tests of the rat femurs showed that the maximum force or so-called "strength" required to break the bone was less in ethanol- than in control-fed animals. A significant inverse correlation was observed between the strength required to break the femur and the dose of ethanol calculated on a body weight basis. For the first time our study presents quantitative proof that a relationship exists between bone strength and the consumption of ethanol in rats. The study revealed that ethanol consumption resulted in a weaker femur compared to controls. We suggest that a common mechanism may be responsible for the decreased bone strength of ethanol-fed rats and the increased incidence of fractures in human alcoholics. 相似文献
75.
Summary The effects of personality characteristics on social support and hence risk of depression are explored in a group of 150 largely working-class mothers, a subsample of 400 women who took part in a prospective study. This established that once those with depression at first interview were excluded, practically all of the onsets of depression in the follow-up year occurred among 150 women with a severe event or major difficulty — that is a provoking agent. It was also found that low self-esteem and lack of support from a core tie at the time of the crisis was associated with a considerably increased risk. In the subsample as a whole, measures of dependency and attitudinal constraints to support taken at first interview were not associated with risk of depression. But, it is argued, any enduring personality traits that play a role in the link between lack of support and depression would most likely be seen in a smaller group, namely those who had had early inadequate parenting. And the most promising lead concerning the role of personality characteristics did in fact emerge in relation to a small high risk group with such parenting. Most of them had low self-esteem, and they appeared to confide in inappropriate and unreliable sources of support at time of crisis. 相似文献
76.
The effects of co-culture with human fibroblasts on human embryo development in vitro and implantation 总被引:5,自引:0,他引:5
Wetzels AM; Bastiaans BA; Hendriks JC; Goverde HJ; Punt-van der Zalm AP; Verbeet JG; Braat DD 《Human reproduction (Oxford, England)》1998,13(5):1325-1330
In a human in-vitro fertilization (IVF) programme, the effect of co-
culture of embryos with human fibroblasts was evaluated with respect to
pregnancy rate and embryo development. Patients were included in the study
after giving informed written consent. The IVF treatments were randomly
assigned by stratification of both age (<36 versus > or =36 years)
and previous IVF attempts (yes versus no). After fertilization was
established, the zygotes were transferred to a 4-well dish with or without
fibroblasts and cultured for 2 days. On the third day after ovum pick-up
(OPU), cell number and quality [5 (good) to 1 (poor)] of the embryos were
scored and a maximum of three embryos was transferred. Supernumerary
embryos of good quality were cryopreserved. The design of this study was a
group sequential trial with the objective of detecting differences between
pregnancy rates following IVF with conventional incubation or incubation in
co-culture with fibroblasts. This design included one evaluation at
half-way data collection. In the study, 148 patients had an OPU, of whom 77
were allocated to the co-culture group. There was no statistically
significant difference in pregnancy rate, cell number and embryo quality
between the two groups. The ongoing pregnancy rate per embryo transfer was
27% in co-culture and 30% in the conventional culture group. The
implantation rates per transferred embryo were 17 and 18% respectively.
Using a multivariate logistic regression model for the probability of
ongoing pregnancies, the odds ratio of co-culture, adjusted for age and
previous IVF attempts, was not statistically significant. In conclusion,
co-culture with human fibroblasts does not contribute to an improvement of
embryo quality nor to a higher pregnancy rate after IVF in an unselected
group of patients.
相似文献
77.
78.
Horne G; Jamaludin A; Critchlow JD; Falconer DA; Newman MC; Oghoetuoma J; Pease EH; Lieberman BA 《Human reproduction (Oxford, England)》1998,13(11):3045-3048
Insemination with donor spermatozoa is an integral part of infertility
treatment. For the last 3 years in our unit, intrauterine insemination with
donor spermatozoa (IUID) has been used in preference to vaginal
insemination. In this retrospective study, patients were offered an initial
course of five single intrauterine inseminations with cryopreserved donor
spermatozoa and treatment was then reviewed. A total of 389 patients
received 1465 inseminations. In all, 1119 cycles were monitored using
luteinizing hormone serum analyses and 346 cycles using the urine home test
kits. The clinical pregnancy rate per insemination for the cycles monitored
by the serum assay was 18.0% (202/1119) compared with the urine cycles
(13.7%, 46/346) (P <05). The pregnancy loss rate was not significantly
different (14.4%, 29/202 and 21.7%, 10/46) (serum and urine cycles
respectively). The viable clinical pregnancy rate was significantly higher
(P <03) for the serum cycles than for the cycles using the urinary
monitoring (15.5%, 173/1119 and 10.4%, 36/346 respectively). The cycles
monitored by serum assay had a significantly higher cumulative viable
clinical pregnancy rate (P <0001) of 70.2% after nine inseminations
compared with the urine monitored cycles of 54.8%. The majority of patients
opted for the serum cycles, with a minority self-selecting the urine cycles
mainly for travelling convenience. The explanation for the significant
differences between the viable clinical pregnancy rates per insemination
and the cumulative viable clinical pregnancy rates may be due to the
sensitivity of the urine home test kit or the patients' interpretation of
the result.
相似文献
79.
80.
James B. Harris MD Richard C. Ahrens MD Gary Milavetz PharmD Linda Annis Rebecca Ries BA Connie Hendricker RRT 《The Journal of allergy and clinical immunology》1990,85(6):1043-1049
Inhaled beta-agonists can produce bronchodilatation and reduce airway hyperreactivity in patients with asthma. Using these two measures, we compared inhaled bitolterol (three puffs, 1110 micrograms), albuterol (two puffs, 180 micrograms), and placebo administered by metered-dose inhaler in a blinded, crossover study of 40 subjects with chronic asthma. On each study day, subjects underwent histamine challenges at 1 1/2 hours before, and 1/2, 2, 4, 6, and 8 hours after inhaling one of the three test-drug treatments. Both drugs produced significant bronchodilatation at 30 minutes through 4 hours and significant effects on airway reactivity at 30 minutes through 2 hours (p less than 0.05). Bitolterol also produced small but significant bronchodilator effects at 6 hours and effects on airway reactivity at 4 hours (p less than 0.05). Effects of bitolterol on airway reactivity diminished significantly more slowly than effects of albuterol in subjects with baseline provocative concentration causing a 20% fall in FEV1 greater than or equal to 1.0 mg/ml of histamine (half-life of biologic effect 1.37 versus 0.92 hours; p less than 0.05) but not in subjects with baseline provocative concentration causing a 20% fall in FEV1 less than or equal to 1.0 mg/ml (half-life of biologic effect of 1.01 versus 1.00 hours; p greater than 0.05). 相似文献