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排序方式: 共有662条查询结果,搜索用时 15 毫秒
111.
Janneke AL van Kempen Sarah HM Robben Sytse U Zuidema Marcel GM Olde Rikkert René JF Melis Henk J Schers 《The British journal of general practice》2012,62(601):e554-e560
Background
A number of studies have examined the effects of home visits and showed inconsistent results on physical functioning, institutionalisation, and mortality. Despite continuing interest from professionals in home visits for older people, reports on older people’s needs and preferences for such visits are scarce.Aim
This qualitative study aims to explore the views and needs of community-dwelling frail older people concerning home visits.Design and setting
A qualitative study including interviews with frail older persons and their informal caregivers living in the area of Nijmegen, the Netherlands.Method
Semi-structured interviews were conducted with frail older people and informal caregivers. A grounded theory approach was used for data-analysis.Results
Eleven frail older people and 11 informal caregivers were included. Most participants emphasised the importance of home visits for frail older people. They felt that it would give older people the personal attention they used to receive from GPs but miss nowadays. Most stated that this would give them more trust in GPs. Participants stated that trust is one of the most important factors in a good patient–professional relationship. Further, participants preferred home visits to focus on the psychosocial context of the patient. They stated that more knowledge of the psychosocial context and a good patient–professional relationship would enable the professional to provide better and more patient-centred care.Conclusion
Patients’ expectations of home visits are quite different from the actual purpose of home visiting programmes; that is, care and wellbeing versus cure and prevention. This difference may partly explain why the effectiveness of home visits remains controversial. Future studies on home visits should involve patients in the development of home visiting programmes. 相似文献112.
113.
Warnes GM; Payne D; Jeffrey R; Hourigan L; Kirby C; Kerin J; Matthews C 《Human reproduction (Oxford, England)》1997,12(7):1525-1530
Over a 26 month period 17% of couples having treatment in our clinical
programmes selected a commercially available protein (normal serum albumin,
NSA) prepared from pooled human sera instead of using their own serum as a
supplement for their embryo culture media. In a retrospective analysis of
>2000 gonadotrophin-stimulated cycles and 1000 cycles where
frozen/thawed embryos were transferred, fertilization, embryo quality and
pregnancy rates following in-vitro fertilization (IVF), gamete
intra-Fallopian transfer (GIFT) or intracytoplasmic sperm injection (ICSI)
were unaffected by the type of protein used to supplement the culture
medium. When embryos were thawed in medium containing NSA, both pregnancy
(PR) and implantation rates (IR) were significantly lower (P <0.05) than
if the medium was supplemented with serum (PR 8.3% and 17.5%; IR 4.6% and
10.5%). Inclusion of NSA before freezing reduced the IR of thawed embryos.
To further test this observation all cycles where embryos were cultured and
frozen in medium containing NSA (173 cycles) were matched to cycles where
serum was used and the outcome was compared. At the end of 1995 just over
half of the embryos in both groups had been thawed. No statistical
difference was noted in the pregnancy rates (NSA, 5.6% versus serum, 11.3%)
but the IR per embryo was significantly lower when embryos were cultured
and frozen in medium supplemented with NSA (2.2%) than when serum was used
as the supplement (6.6%).
相似文献
114.
Early transvaginal ultrasound following an accurately dated pregnancy: the importance of finding a yolk sac or fetal heart motion 总被引:1,自引:2,他引:1
Deaton JL; Honore GM; Huffman CS; Bauguess P 《Human reproduction (Oxford, England)》1997,12(12):2820-2823
Our goals were to determine the prognostic value of a yolk sac or fetal
heart motion seen during an early accurately dated transvaginal ultrasound
(TVU). We reviewed 225 consecutive pregnancies for fetal heart motion data.
Furthermore, 63 pregnancies following in-vitro fertilization were reviewed
for yolk sac information. The TVU was performed between 5 and 6 weeks
following presumed conception (heart motion data) and between 22 and 32
days following in-vitro fertilization (yolk sac data). Pregnancies were
followed until an ongoing pregnancy or spontaneous abortion was documented.
The presence of a yolk sac between 22 and 32 days from fertilization was
associated with the development of fetal heart motion in 94% of cases. The
absence of the yolk sac by 32 days after fertilization was always
associated with a poor outcome. In women < 36 years of age, the presence
of fetal heart motion was associated with a spontaneous abortion in only
4.5% of the cases. However, the incidence of spontaneous abortion following
fetal heart motion increased to 10% in women 36-39 years and 29% in women
> or = 40 years of age. The presence of heart motion should not be
considered a reassuring sign in the older woman. These data have
implications regarding early embryology and the counselling of infertility
patients.
相似文献
115.
J J Driessen J B Harbers J van Egmond L H Booij 《European journal of anaesthesiology》1999,16(9):622-627
The bispectral index, a value derived from the electroencephalogram, has been proposed as a measure of anaesthetic effect. The aim of the present study was to evaluate the bispectral index during midazolam-fentanyl anaesthesia for cardiac surgery for its possible role as a predictor of increases in systolic blood pressure during endotracheal intubation and sternotomy. After institutional approval 15 consenting patients, scheduled for elective cardiac surgery, were selected for the study. Anaesthesia was induced in all patients with a loading dose of fentanyl 7.5-10 micrograms kg-1, midazolam 0.15 mg kg-1 and pancuronium 0.1 mg kg-1. After a further bolus dose of fentanyl 10-12.5 micrograms kg-1 prior to the start of incision and sternotomy, maintenance infusion rates of fentanyl 4-6 micrograms kg-1 h-1 and midazolam 0.1 mg kg-1 h-1 were started and continued through surgery at the discretion of the anaesthetist and guided by the presenting clinical and haemodynamic responses. The control of anaesthesia was never based on the value of the bispectral index. The mean bispectral index value decreased from 95.7 (3.1) at base-line to 59.5 (12.0) after induction of anaesthesia and then remained below 70 throughout surgery. However, there was an important interindividual variability in bispectral index values despite standardized dosages of fentanyl and midazolam. There was no significant correlation between the bispectral index values in the pre-intubation and pre-incision period and the changes in systolic blood pressure during endotracheal intubation and sternotomy, respectively. In conclusion, the large intersubject variability in the bispectral index values should be investigated further in the light of the great variability in the clinical effects of midazolam and fentanyl. The lack of significant correlation between the bispectral index values and the haemodynamic responses suggest that the bispectral index, which is a helpful monitor of anaesthetic depth, is not a very reliable monitor of global anaesthetic adequacy during total intravenous anaesthesia with a combination of midazolam and fentanyl in cardiac surgical patients. 相似文献
116.
甘露聚糖、壳聚糖、α-酸性糖蛋白和姜黄素对脂蛋白(a)和去唾液酸脂蛋白(a)代谢影响的对比分析 总被引:2,自引:1,他引:1
分析多糖和姜黄素对脂蛋白 (a)和去唾液酸脂蛋白 (a)代谢的影响 ,从刺猬腋下静脉注入甘露聚糖、壳聚糖、α -酸性糖蛋白和姜黄素 ,2min后注射12 5I-脂蛋白 (a)或12 5I-去唾液酸脂蛋白 (a) ,1h后处死动物 ,测定血、肝、肾、脾、胆汁和肾上腺的同位素含量。结果发现 ,脂蛋白 (a)去唾液酸后能大量进入肝脏 ,加速在体内的分解代谢 ,使血中浓度迅速降低。α -酸性糖蛋白抑制组织对脂蛋白 (a)和去唾液酸脂蛋白 (a)的摄入 ,使血中脂蛋白 (a)和去唾液酸脂蛋白 (a)含量显著增高。壳聚糖和姜黄素增加肝脏和肾上腺对脂蛋白 (a)的摄取 ,使血中脂蛋白 (a)含量略降低 ,但对去唾液酸脂蛋白 (a)代谢无明显影响。甘露聚糖增加脾脏对脂蛋白 (a)的摄取 ,减少胆囊中脂蛋白 (a)含量 ,但增加肾脏和胆囊对去唾液酸脂蛋白 (a)的摄取 ,降低肾上腺对去唾液酸脂蛋白 (a)的摄取。结果提示 ,脂蛋白 (a)去唾液酸后能使脂蛋白 (a)分解代谢加快 ,脂蛋白 (a)分子中的唾液酸在结构稳定中起重要的作用。α -酸性糖蛋白抑制脂蛋白 (a)和去唾液酸脂蛋白 (a)代谢 ,而壳聚糖和姜黄素则促进脂蛋白 (a)代谢 相似文献
117.
Lukoye Atwoli Abdullah H. Baqui Thomas Benfield Raffaella Bosurgi Fiona Godlee Stephen Hancocks Richard Horton Laurie Laybourn-Langton Carlos Augusto Monteiro Ian Norman Kirsten Patrick Nigel Praities Marcel GM Olde Rikkert Eric J. Rubin Peush Sahni Richard Smith Nick Talley Sue Turale Damin Vzquez 《Croatian medical journal》2021,62(5):429
118.
119.
M Heuer GM Kaiser S Lendemans S Vernadakis JW Treckmann A Paul 《European journal of medical research》2010,15(4):169-173
Objective
Liver injury due to trauma is a rare indication for transplantation. The main indications in such cases were uncontrollable bleeding and insufficient hepatic function. Because of poor results, liver transplantation in these patients is occasionally described as "waste of organs", however based on insufficient data. This study aims to report our experience and to critically question the indication of transplantation in these patients.Methods
All liver transplantations at our institution were reviewed retrospectively. This covered 1,529 liver transplants between September 1987 and December 2008. Of them, 6 transplants were performed due to motor-vehicle accidents which caused uncontrollable acute liver trauma in 4 patients. The patients'' peri-operative course, short- and long-term outcomes were analyzed.Results
Five deceased-donor liver transplantations (4 full size, 1 split) and 1 living donor (right) transplantation were performed. The median GCS score was 9/15; the median MELD score was 15. Postoperative complications were observed in 3 patients, requiring re-operation in 2. After a median (range) follow-up of 32.95 (10.3-55.6) months, 2 patients are alive and remain well on immunosuppression.Conclusion
Liver transplantation in patients with otherwise surgically uncontrollable acute liver injury can be indicated as a life saving procedure and can be performed successfully in highly selected cases. 相似文献120.
M Heuer G Taeger GM Kaiser D Nast-Kolb CA Kühne S Ruchholtz R Lefering A Paul S Lendemans the Trauma Registry of The DGU 《European journal of medical research》2010,15(6):258-265