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11.
Iapichino G Morabito A Mistraletti G Ferla L Radrizzani D Reis Miranda D 《Intensive care medicine》2003,29(10):1751-1756
Objective To assess the predictive ability of preillness and illness variables, impact of care, and discharge variables on the post-intensive care mortality.Setting and patients 5,805 patients treated with high intensity of care in 89 ICUs in 12 European countries (EURICUS-I study) surviving ICU stay.Methods Case-mix was split in training sample (logistic regression model for post-ICU mortality: discrimination assessed by area under ROC curve) and in testing sample. Time to death was studied by Cox regression model validated with bootstrap sampling on the unsplit case-mix.Results There were 5,805 high-intensity patients discharged to ward and 423 who died in hospital. Significant odds ratios were observed for source of admission, medical/surgical unscheduled admission, each year age, each SAPSII point, each consecutive day in high-intensity treatment, and each NEMS point on the last ICU day. Time to death in ward was significantly shortened by different source of admission; age over 78 years, medical/unscheduled surgical admission; SAPSII score without age, comorbidity and type of admission over 16 points; more than 2 days in high-intensity treatment; all days spent in high treatment; respiratory, cardiovascular, and renal support at discharge; and last ICU day NEMS higher than 27 pointsConclusions Worse outcome is associated with the physiological reserve before admission in the ICU, type of illness, intensity of care required, and the clinical stability and/or the grade of nursing dependence at discharge.This study was supported in part, by the Foundation for Research on Intensive Care in Europe (FRICE) and by a grant from the Commission of the European communities (BMH1-CT93-1340) 相似文献
12.
Daniel Hu Deborah Taira Juarez Michelle Yeboah Theresa P Castillo 《Hawai'i Journal of Medicine & Public Health》2014,73(1):11-18
The objective of this systematic review was to investigate the effectiveness of interventions to improve medication adherence in ethnic minority populations. A literature search from January 2000 to August 2012 was conducted through PubMed/Medline, Web of Science, The Cochrane Library, and Google Scholar. Search terms used included: medication (MeSH), adherence, medication adherence (MeSH), compliance (MeSH), persistence, race, ethnicity, ethnic groups (MeSH), minority, African-American, Hispanic, Latino, Asian, Pacific Islander, and intervention. Studies which did not have ≥75% of the sample population comprised of individuals of any one ethnic background were excluded, unless the authors performed sub-group analyses by race/ethnicity. Of the 36 studies identified, 20 studies showed significant post-intervention differences. Sample population sizes ranged from 10 to 520, with a median of 126.5. The studies in this review were conducted with patients of mainly African-American and Latino descent. No studies were identified which focused on Asians, Pacific Islanders, or Native Americans. Interventions demonstrating mixed results included motivational interviewing, reminder devices, community health worker (CHW) delivered interventions, and pharmacist-delivered interventions. Directly observed therapy (DOT) was a successful intervention in two studies. Interventions which did not involve human contact with patients were ineffective. In this literature review, studies varied significantly in their methods and design as well as the populations studied. There was a lack of congruence among studies in the way adherence was measured and reported. No single intervention has been seen to be universally successful, particularly for patients from ethnic minority backgrounds.Keyword: Medication adherence, compliance, intervention, ethnic minority 相似文献
13.
Strozzi Alfonso Gastelum Peláez-Ballestas Ingris Granados Ysabel Burgos-Vargas Rubén Quintana Rosana Londoño John Guevara Sergio Vega-Hinojosa Oscar Alvarez-Nemegyei José Juarez Vicente Pacheco-Tena César Cedeño Ligia Garza-Elizondo Mario Santos Ana María Goycochea-Robles María Victoria Feicán Astrid García Hazel Julian-Santiago Flor Crespo María Elena Rodriguez-Amado Jacqueline Rueda Juan Camilo Silvestre Adriana Esquivel-Valerio Jorge Rosillo Celenia Gonzalez-Chavez Susana Alvarez-Hernández Everardo Loyola-Sanchez Adalberto Navarro-Zarza Eduardo Maradiaga Marco Casasola-Vargas Julio Sanatana Natalia Garcia-Olivera Imelda Goñi Mario Sanin Luz Helena Gamboa Rocío Cardiel Mario Humberto Pons-Estel Bernardo A. 《Clinical rheumatology》2020,39(9):2715-2726
Clinical Rheumatology - Although low back pain (LBP) is a high-impact health condition, its burden has not been examined from the syndemic perspective. To compare and assess clinical,... 相似文献
14.
15.
Luca Aldrighetti Carlo Pulitanò Marco Catena Marcella Arru Eleonora Guzzetti Massimiliano Casati Laura Comotti Gianfranco Ferla 《Journal of gastrointestinal surgery》2008,12(3):457-462
Background Left lateral sectionectomy is one of the most commonly performed laparoscopic liver resections, but limited clinical data
are actually available to support the advantage of laparoscopic versus open-liver surgery. The present study compared the
short-term outcomes of laparoscopic versus open surgery in a case-matched analysis.
Materials and Methods Surgical outcome of 20 patients who underwent left lateral sectionectomy by laparoscopic approach (LHR group) from September
2005 to January 2007 were compared in a case-control analysis with those of 20 patients who underwent open left lateral sectionectomy
(OHR group). Both groups were similar for: tumor size, preoperative laboratory data, presence of cirrhosis, and histology
of the lesion. Surgical procedures were performed in both groups combining the ultrasonic dissector and the ultrasonic coagulating
cutter without portal clamping.
Results Compared with OHR, the LHR group had a decreased blood loss (165 mL versus 214 mL, P = 0.001), and earlier postoperative recovery (4.5 versus 5.8 days, P = 0.003). There were no significant differences in terms of surgical margin and operative time. Morbidity was comparable
between the two groups, but two cases of postoperative ascites were recorded in two cirrhotic patients in the OHR. Major complications
were not observed in either groups.
Conclusions Laparoscopic resection results in reduced operative blood loss and earlier recovery with oncologic clearance and operative
time comparable with open surgery. Laparoscopic liver surgery may be considered the approach of choice for tumors located
in the left hepatic lobe. 相似文献
16.
Luca Aldrighetti MD Carlo Pulitanò MD Marco Catena MD Marcella Arru MD Eleonora Guzzetti MD Jane Halliday MD Gianfranco Ferla MD 《Annals of surgical oncology》2009,16(5):1254-1254
Introduction Hepatocellular carcinoma (HCC) tends to invade the intrahepatic vasculature, especially the portal vein.1 The presence of portal vein tumor thrombus (PVTT) in patients with HCC is one of the most significant factors for a poor
prognosis.2
–
5 The presence of macroscopic PVTT in patients with HCC is also a significant factor for poor prognosis, with a median survival
of <3 months without treatment.1 In surgically resected series, in patients with gross PVTT (PVTT in the portal trunk, its first-order branch, or its second-order
branch), the 3-year and 5-year survival rates are reportedly 15% to 28% and 0% to 17%, respectively.2
–
5
Methods The patient was a 77-year-old woman with well-compensated hepatitis C virus–related cirrhosis (stage A6 according to Child-Pugh
classification) who sought care at our department for vague abdominal discomfort. Triphasic spiral computed tomographic scan
confirmed HCC 6 cm in diameter in the left lobe of the liver. In addition, portal vein tumor thrombosis of the left branch
that extended to the right portal vein was present.
Results The procedure included left hepatectomy and en-bloc portal vein thrombectomy with clamping of both the common portal vein
trunk and the right portal vein. The portal vein was incised at the bifurcation of the right and left portal veins, and the
thrombus was extracted from the incision in the portal vein. With this procedure, we were able to examine under direct vision
the exact extent of the portal vein thrombus, and we identified whether the tumor thrombus was adherent to the venous wall
or was freely floating in the venous lumen.
Portal clamping and length of operation were 16 and 330 minutes, respectively. Intraoperative blood loss was 550 mL. The
patient was discharged on postoperative day 6, and she was free of disease at 15 months after surgery.
Discussion Liver resection should be considered a valid therapeutic option for HCC with PVTT.
Electronic supplementary material The online version of this article (doi:) contains supplementary video material, which is available to authorized users.
Presented to Annual Meeting of the American Hepato-Pancreato-Biliary Association (AHPBA), Miami, Florida, USA, March 9-12,
2006. 相似文献
17.
Cardiovascular Risk Factors in Women With Primary Sjögren's Syndrome: United Kingdom Primary Sjögren's Syndrome Registry Results 下载免费PDF全文
18.
In recent years, websites that stress the message of thinness as the ideal and only choice have surfaced on the internet. The possibility that pro-anorexia websites may reinforce restrictive eating and exercise behaviors is an area of concern. In addition, friends may be influencing one another to view these websites, further contributing to drive for thinness in women and drive for muscularity in men. Three hundred male and female undergraduate psychology students responded to questionnaires assessing: internalization of pro-anorexia website content, internalization of general media content, influence of friends to view pro-anorexia websites, peer influence, drive for muscularity, and drive for thinness. Results showed internalization of pro-anorexia website content was positively correlated with drive for thinness in women, and negatively correlated with drive for muscularity in men. Internalization of pro-anorexia website content was found to be related to both drive for thinness in women and drive for muscularity in men. 相似文献
19.
J. Ventura‐Juarez MR. Campos‐Esparza J. Pacheco‐Yepez J. A López‐Blanco A. Adabache‐Ortíz M. Silva‐Briano R. Campos‐Rodríguez 《Parasite immunology》2016,38(8):503-509
Entamoeba histolytica invades the intestine and other organs during the pathogenesis of amoebiasis. In the early stages, the host organism responds with an inflammatory infiltrate composed mostly of neutrophils. It has been reported that these immune cells, activated by E. histolytica, exert a protective role by releasing proteolytic enzymes and generating reactive oxygen/nitrogen species (ROS/RNS) and antimicrobial peptides. It is now known that neutrophils also produce neutrophil extracellular traps (NETs), which are able to damage and kill pathogens. Studies have shown that intracellular protozoan pathogens, including Toxoplasma gondi, Plasmodium falciparum and Leishmania spp, induce neutrophils to release NETs and are damaged by them. However, the action of this mechanism has not been explored in relation to E. histolytica trophozoites. Through scanning electron, epifluorescence microscopy and viability assays, we show for first time that during in vitro interaction with E. histolytica trophozoites, human neutrophils released NETs that covered amoebas and reduced amoebic viability. These NETs presented histones, myeloperoxidase and decondensed chromatin. The results suggest that NETs participate in the elimination of the parasite. 相似文献
20.
O serogroups, biotypes, and eae genes in Escherichia coli strains isolated from diarrheic and healthy rabbits. 总被引:2,自引:0,他引:2 下载免费PDF全文
J E Blanco M Blanco J Blanco A Mora L Balaguer M Mourio A Juarez W H Jansen 《Journal of clinical microbiology》1996,34(12):3101-3107
A total of 305 Escherichia coli strains isolated from diarrheic and healthy rabbits in 10 industrial fattening farms from different areas of Spain were serotyped, biotyped, and tested for the presence of the eae gene and toxin production. The characteristics found in strains isolated from healthy rabbits were generally different from those observed in E. coli strains associated with disease. Thus, strains with the eae gene (74% versus 22%); strains belonging to serogroups O26, O49, O92, O103, and O128 (64% versus 12%); rhamnose-negative strains (51% versus 5%); and rhamnose-negative O103 strains with eae genes present (41% versus 1%) were significantly (P < 0.001 in all cases) more frequently detected in isolates from diarrheic animals than in those from healthy rabbits. Whereas a total of 35 serogroups and 17 biotypes were distinguished, the majority of the strains obtained from diarrheic rabbits belonged to only four serobiotypes, which in order of frequency were O103:B14 (72 strains), O103:B6 (16 strains), O26:B13 (12 strains), and O128:B30 (12 strains). These four serobiotypes accounted for 48% (112 of 231) and 5% (4 of 74) of the E. coli strains isolated from diarrheic and healthy rabbits, respectively. Only six strains were toxigenic (three CNF1+, two CNF2+, and one VT1+). We conclude that enteropathogenic E. coli strains that possess the eae gene are a common cause of diarrhea in Spanish rabbit farms and that the rhamnose-negative highly pathogenic strains of serotype O103:K-:H2 and biotype B14 are especially predominant. Detection of the eae gene is a useful method for the identification of enteropathogenic E. coli strains from rabbits. However, a combination of serogrouping and biotyping may be sufficient to accurately identify the highly pathogenic strains for rabbits. 相似文献