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141.
The objective of this study was to determine the impact of the learning
curve of one surgeon on the term delivery rate following laparoscopic
salpingostomy for tubal infertility. This was a retrospective audit of
ongoing clinical practice, undertaken in two tertiary level infertility
programmes. Subjects in this study were women undergoing surgery for total
occlusion of the distal Fallopian tube. The main outcome measure was
cumulative term delivery rates. On stepwise life-table analysis the length
of infertility, primary and secondary infertility, tubal diameter and
whether surgery was performed in the first or second half of the series
were significantly associated with outcome. These data suggest that there
is a learning curve in obtaining skills to perform laparoscopic
salpingostomy, that patient selection may improve with experience, and that
selection criteria should be emphasized during didactic teaching and the
preceptorship process.
相似文献
142.
Donna Scott Tilley PhD RN CHPN Margaret Brackley PhD APRN BC 《Perspectives in psychiatric care》2004,40(4):157-170
PROBLEM. To identify critical developmental periods, experiences, and events in women's lives associated with violence to guide a larger study.
METHODS. Two focus groups of 10 women each (N = 20) were conducted to determine the critical times when girls and women might be exposed to violence.
FINDINGS. Broad themes in the data were developmental periods, abusers, staying in the relationship, leaving the relationship, parenting, and living with violence. The women in these focus groups clearly identified times of increased risk for violence in their lives: establishing intimate relationships, pregnancy, childrearing years, and times when substance abuse is occurring.
CONCLUSIONS. While clinicians should be vigilant for the presence of domestic violence with all clients, it is important to know when a woman experiences increased risk for violence. The findings indicate a need for education for communities, those who provide care for women and children, and people in whom victims may confide. 相似文献
METHODS. Two focus groups of 10 women each (N = 20) were conducted to determine the critical times when girls and women might be exposed to violence.
FINDINGS. Broad themes in the data were developmental periods, abusers, staying in the relationship, leaving the relationship, parenting, and living with violence. The women in these focus groups clearly identified times of increased risk for violence in their lives: establishing intimate relationships, pregnancy, childrearing years, and times when substance abuse is occurring.
CONCLUSIONS. While clinicians should be vigilant for the presence of domestic violence with all clients, it is important to know when a woman experiences increased risk for violence. The findings indicate a need for education for communities, those who provide care for women and children, and people in whom victims may confide. 相似文献
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145.
Double-blind, comparative study of rufloxacin once daily versus amoxicillin three times a day in treatment of outpatients with exacerbations of chronic bronchitis. 总被引:1,自引:1,他引:1 下载免费PDF全文
W Klietmann M Cesana R K Rondel J Focht 《Antimicrobial agents and chemotherapy》1993,37(11):2298-2306
In a double-blind, randomized, multicenter study, the efficacy and safety of two dosage schedules of rufloxacin once daily were compared with those of amoxicillin three times a day in the treatment of 192 outpatients with exacerbations of chronic bronchitis. Rufloxacin was given as a single oral dose of 400 mg on day 1 and single daily doses of 200 mg on the subsequent 9 days (n = 64) or as 300 mg on day 1 and then 150 mg daily for 9 days (n = 63); amoxicillin was given as 500 mg orally three times a day for 10 days (n = 65). Clinical and bacteriological assessments were carried out before treatment, between study days 3 and 5, and at days 1 and 8 after treatment. Pretreatment cultures were positive for 139 patients, the most frequently isolated pathogens being Streptococcus pneumoniae, Moraxella catarrhalis, and Haemophilus influenzae. Clinical success rates were comparable in the three groups (94, 95, and 98%, respectively), as were bacteriological success rates at the end of treatment (93, 95, and 91%, respectively) and at follow-up (88, 95, and 98%, respectively). The power to detect a significant 15% difference in cure rates was 74.9%. Follow-up bacteriological failures from pneumococcal infection were 18% in both rufloxacin groups combined and 5% in the amoxicillin group. The 200-mg dose regimen achieved average steady-state concentrations in plasma higher than did the 150-mg dose regimen (3.75 versus 2.72 micrograms/ml). Adverse events occurred in 11 and 13 patients, respectively, on rufloxacin and 8 on amoxicillin. This study shows that rufloxacin once daily ay be a possible option for the treatment of acute exacerbations of chronic bronchitis. The 200-mg daily oral dose preceeded by a loading dose of 400 mg displays a better pharmacokinetic profile than the lower dose. 相似文献
146.
血管黏附分子中选择素结构、功能及其表达的特点 总被引:3,自引:0,他引:3
目的:归纳总结选择素的组成、分布、结构、表达及其选择素与配体相互作用的主要功能。资料来源:应用计算机检索Medline数据库1990-01/2007-01有关选择素功能的相关文章,检索词“Selectin,function”,限定文章语言种类为英文。同时计算机检索中国期刊全文数据库、万方数据库1994-01/2007-01期间的选择素的相关文章,检索词“选择素、功能”,限定文章语言种类为中文。资料选择:对资料进行初审,选取与选择素研究进展相关文献,然后筛除明显无关文献或相关性不强的文献,对剩余文献开始查找全文,进一步明确其相关性。纳入标准:随机对照研究;实验或临床研究包含平行对照组。排除标准:重复或类似的同一研究、综述文献(或个案报道等)。资料提炼:共收集到79篇有关选择素研究方面的文章,33个实验或临床研究符合纳入标准。排除的46篇文献中,32篇为未随机研究或重复性研究,14篇为综述类文章。资料综合:33个实验包括403例患者和342只实验动物,分别阐述了以下3点:①选择素家族的组成、分布:目前发现的选择素家族包括3个成员:L-选择素、P-选择素、E-选择素,P-选择素和E-选择素表达于内皮细胞,L-选择素只表达于白细胞。②选择素的结构及其表达:选择素分子是一类Ⅰ型跨膜糖蛋白,它分为胞外区、跨膜区和胞内区,3种选择素的胞外区的不同部位在同一物种或不同物种间有一定的同源性。而跨膜区和胞内区则没有同源性,胞内区是细胞内部分。③选择素的配体:选择素执行其功能离不开和其配体的相互作用,配体包括糖类配体和蛋白类配体两部分。糖类配体主要是一些寡糖基团。蛋白类配体多是一些分子量在数万到数十万单位的蛋白分子。④选择素的主要功能为:介导炎症过程中白细胞的起始黏附,参与肿瘤转移过程,参与缺血-再灌注损伤,参与血栓形成及促进创伤的修复和愈合,参与细胞内外的信号传递,参与器官移植免疫排斥反应等。结论:①目前发现的选择素家族的3个成员,P-选择素和E-选择素表达于内皮细胞,L-选择素只表达于白细胞。②选择素的主要作用是在炎症发生时介导白细胞与血管内皮细胞的起始黏附,以及介导白细胞之间、白细胞与血小板之间的黏附。此外,在淋巴细胞归巢、炎症反应、血栓形成、自身免疫性疾病及肿瘤转移等过程中,选择素还发挥着重要作用。 相似文献
147.
The Patient Care Paradox: An Interprofessional Qualitative Study of Agitated Patient Care in the Emergency Department 下载免费PDF全文
148.
This brief indicates how methods used by the National Academy of Clinical Biochemistry (NACB) in the development of its guidelines and recommendation for the laboratory analysis in the diagnosis and management of diabetes mellitus may be applied to advance nomenclature, clinical practice, and research development within nursing. Specifically, human response diagnoses require the identification of accurate tests to confirm or reject the diagnoses. Each test needs to be described in terms of its use, rationale, analytical, and emerging considerations. Accurate test development will move nursing nomenclature, clinical practice, and research forward. 相似文献
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