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101.
Greene E Cunningham CJ Eustace A Kidd N Clare AW Lawlor BA 《International journal of geriatric psychiatry》2001,16(10):965-968
OBJECTIVES: To identify factors which may contribute to prolonged length of stay in an elderly psychiatric inpatient setting. DESIGN: Retrospective case note study. METHODS: A list of all patients over the age of 65 discharged from a private psychiatric hospital over a three-year period excluding those with a length of stay of over 365 days was obtained (n = 1147). A random sample of 150 patients was selected from the study population. A case note study was then performed looking at a number of variables which have been postulated to affect length of stay. The resulting data was analysed using multivariate statistics. RESULTS: There was no statistically significant association found between baseline factors (including age, gender, cognitive impairment, marital status, order of admission and preadmission living arrangement) and length of stay. Having recurrent falls whilst an inpatient was associated with prolonged hospital stay (p = 0.0006). CONCLUSION: Experiencing recurrent falls whilst an inpatient is associated with prolonged length of stay. Recurrent falls in the elderly may be associated with both physical illness and the use of psychotropic medications. A prospective study examining factors contributing to falls would be important in decreasing fall risk and reducing length of stay. 相似文献
102.
103.
Allelic imbalance on chromosome 2q and alterations of the caspase 8 gene in neuroblastoma 总被引:12,自引:0,他引:12
Takita J Yang HW Chen YY Hanada R Yamamoto K Teitz T Kidd V Hayashi Y 《Oncogene》2001,20(32):4424-4432
104.
Rarity of colon cancer in Africans is associated with low animal product consumption, not fiber 总被引:3,自引:0,他引:3
O'Keefe SJ Kidd M Espitalier-Noel G Owira P 《The American journal of gastroenterology》1999,94(5):1373-1380
OBJECTIVE: To investigate whether the rarity of colon cancer in black Africans (prevalence, < 1:100,000) can be accounted for by dietary factors considered to reduce risk, and by differences in colonic bacterial fermentation. METHODS: Samples of the adult black South African population were drawn from several rural and urban regions. Food consumption was assessed by home visits, food frequency questionnaires, computerized analysis of 72-h dietary recall, and blood sampling. Colonic fermentation was measured by breath H2 and CH4 response to a traditional meal, and to 10-g of lactulose. Cancer risk was estimated by measurement of epithelial proliferation indices (Ki-67 and BrdU) in rectal mucosal biopsies. Results were evaluated by comparison to measurements in high-risk white South Africans (prevalence, 17:100,000). RESULTS: Epithelial proliferation was significantly lower in rural and urban blacks than whites. The diets of all the black subgroups were characterized by a low animal product and high boiled maize-meal content, whereas whites consumed more fresh animal products, cheese, and wheat products. Blacks consumed below RDA quantities of fiber (43% of RDA), vitamin A (78%), C (62%), folic acid (80%) and calcium (67%), whereas whites consumed more animal protein (177% of RDA) and fat (153%). Fasting and food-induced breath methane production was two to three times higher in blacks. CONCLUSIONS: The low prevalence of colon cancer in black Africans cannot be explained by dietary "protective" factors, such as, fiber, calcium, vitamins A, C and folic acid, but may be influenced by the absence of "aggressive" factors, such as excess animal protein and fat, and by differences in colonic bacterial fermentation. 相似文献
105.
Spontaneous ambulatory activity as a quantifiable outcome measure for rheumatoid arthritis 总被引:1,自引:1,他引:0
OBJECTIVE: To validate the objective monitoring of ambulatory activity as an outcome measure for rheumatoid arthritis (RA). METHODS: We have compared ambulatory activity to a range of currently favoured outcome measures, ranging from subjective opinions to X-ray damage, in a population of 93 RA sufferers. RESULTS: Correlations were stronger with measures of joint damage and disability, and less strong with measures of disease activity. Sensitivity to change was good. Three different interventions were compared for the quantity of the response, and the results agree with clinical experience, with steroid injection of the knee and use of non-steroidal anti-inflammatory drugs (NSAIDs) having a similar response and the provision of surgical shoes producing a more modest increase in ambulation. CONCLUSION: The measurement of ambulatory activity has validity for RA assessment. It provides different but related data to the currently used measures. It is objective, relevant, quantifiable and of unlimited scale. It could be used to quantify interventions aimed at increasing ambulation, in carefully constructed studies. 相似文献
106.
107.
Objective: To develop a reliable assay for quantifying the analgesic efficacy of non-steroidal anti-inflammatory drugs (NSAIDs) using
a model that is accepted as a paradigm of clinical pain.
Subjects: Fifteen normal subjects, all of whom were volunteers from medical school staff, took part in the study.
Methods: Capsaicin (20 μl) in solution (0.03 mg/ml) was applied to the volar surface of the forearm, and the skin was maintained
at a constant temperature using a thermal stimulator. The magnitude of the surrounding area of mechanical allodynia to a brush
stimulus (i.e. a clinical correlate of tenderness to touch) was assessed. Under double-blind, placebo-controlled conditions,
the test was repeated using skin previously treated with ibuprofen gel or placebo.
Results: A close linear relationship was observed between skin temperature over a range of 30 °C to 40 °C and the area of capsaicin-induced
allodynia. Ibuprofen gel significantly reduced (P < 0.004) the area of touch-evoked allodynia at a constant skin temperature of 40 °C.
Conclusions: The thermal-facilitated adaptation of the capsaicin model described in this study represents an inexpensive and reliable
assay for the effects of topical formulations of NSAID upon mechanical sensitivity. As such, it is a potential alternative
to many clinical studies in which inherent confounding and bias can preclude a meaningful conclusion.
Received: 13 September 1999 / Accepted in revised form: 14 March 2000 相似文献
108.
Discontinuation of Anticytomegalovirus Therapy in Patients With HIV Infection and Cytomegalovirus Retinitis 总被引:7,自引:0,他引:7
Whitcup Scott M.; Fortin Eric; Lindblad Anne S.; Griffiths Paul; Metcalf Julia A.; Robinson Michael R.; Manischewitz Jody; Baird Barbara; Perry Cheryl; Kidd I. Michael; Vrabec Tamara; Davey Richard T. Jr; Falloon Judith; Walker Robert E.; Kovacs Joseph A.; Lane H. Clifford; Nussenblatt Robert B.; Smith Janine; Masur Henry; Polis Michael A. 《JAMA》1999,282(17):1633-1637
Context Persons with cytomegalovirus (CMV) retinitis and acquired immunodeficiency syndrome (AIDS) have required lifelong anti-CMV therapy to prevent the progression of retinal disease and subsequent loss of vision. Objective To determine whether patients who were taking highly active antiretroviral therapy (HAART) and who had stable CMV retinitis could safely discontinue anti-CMV therapy without reactivation of their retinitis or increase in human immunodeficiency virus (HIV) viral load. Design Prospective nonrandomized interventional trial performed from July 1997 to August 1999. Setting Clinical Center of the National Institutes of Health, Bethesda, Md. Patients Fourteen patients with stable CMV retinitis and HIV infection and CD4+ cell counts higher than 0.15 x 109/L and being treated with systemic anti-CMV medications and HAART. Interventions Discontinuation of specific anti-CMV therapy. Main Outcome Measures Reactivation of CMV retinitis, development of extraocular CMV infection, detection of CMV in blood and urine, HIV burden, immunologic function, quality of life, morbidity, and mortality. Results Twelve (89.7%) of 14 patients had evidence of immune recovery uveitis before anti-CMV drugs were discontinued. No patient had reactivation of CMV retinitis or development of extraocular CMV disease during mean follow-up of 16.4 months (range, 8.3-22.0 months) without anti-CMV therapy. Human immunodeficiency viral load remained stable following cessation of anti-CMV medications. Blood and urine assays for CMV were briefly positive in 9 patients but did not predict reactivation of CMV disease. Worsening immune recovery uveitis was associated with a substantial (>3 lines) vision loss in 3 patients. Conclusions Maintenance anti-CMV medications were safely stopped in those patients who had stable CMV retinitis and elevated CD4+ cell counts and who were taking HAART. The study demonstrates that immune recovery following potent antiretroviral therapy is effective in controlling a major opportunistic infection, even in patients with a history of severe immunosuppression. 相似文献
109.
110.
In modern dentistry the primary aim when excavating carious dentine is to eradicate only the highly infected, irreversibly demineralised and denatured biomass in order to allow effective restoration of the cavity, restoration of the surface anatomy of the tooth and to prevent disease progression. However, the boundary between this superficial zone of dentine requiring excavation and the deeper, affected but repairable tissue is not always obvious either in the clinic or in the research laboratory. The inherent subjectivity in detecting this excavation boundary can result in clinically significant differences in the quality and quantity of dentine removed by different operators and makes the in vitro comparison of newer excavation techniques more difficult. This article discusses the rationale behind carious dentine excavation and the criteria available to the dentist, both clinical and laboratory, to help identify the dentine requiring removal. 相似文献