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排序方式: 共有373条查询结果,搜索用时 15 毫秒
91.
Hyosun Kim Sion Jo Jae Baek Lee Youngho Jin Taeoh Jeong Jaechol Yoon Jeong Moon Lee Boyoung Park 《The American journal of emergency medicine》2018,36(1):5-11
Purpose
The predictive value of serum albumin in adult aspiration pneumonia patients remains unknown.Methods
Using data collected during a 3-year retrospective cohort of hospitalized adult patients with aspiration pneumonia, we evaluated the predictive value of serum albumin level at ED presentation for in-hospital mortality.Results
248 Patients were enrolled; of these, 51 cases died (20.6%). The mean serum albumin level was 3.4 ± 0.7 g/dL and serum albumin levels were significantly lower in the non-survivor group than in the survivor group (3.0 ± 0.6 g/dL vs. 3.5 ± 0.6 g/dL). In the multivariable logistic regression model, albumin was associated with in-hospital mortality significantly (adjusted odds ratio 0.30, 95% confidential interval (CI) 0.16–0.57). The area under the receiver operating characteristics (AUROC) for in-hospital survival was 0.72 (95% CI 0.64–0.80). The Youden index was 3.2 g/dL and corresponding sensitivity, specificity, positive predictive value, negative predictive value, positive and negative likelihood ratio were 68.6%, 66.5%, 34.7%, 89.1%, 2.05 and 0.47, respectively. High sensitivity (98.0%) was shown at albumin level of 4.0 g/dL and high specificity (94.9%) was shown at level of 2.5 g/dL.Conclusion
Initial serum albumin levels were independently associated with in-hospital mortality among adult patients hospitalized with aspiration pneumonia and demonstrated fair discriminative performance in the prediction of in-hospital mortality. 相似文献92.
Glyn-Jones S Isaac S Hauptfleisch J McLardy-Smith P Murray DW Gill HS 《The Journal of arthroplasty》2008,23(3):337-343
A prospective double-blind, randomized, and controlled trial was conducted using roentgen stereophotogrammetric analysis; 54 total hip arthroplasty patients were randomized to receive either highly cross-linked polyethylene (HXLPE) or standard ultra-high-molecular-weight polyethylene (UHMWPE) liners. The 3-dimensional penetration of the liner was determined over 2 years. For the first 3 months, both polyethylene types had a rapid penetration rate (HXLPE: 0.22 mm, SD = 0.17 mm; UHMWPE: 0.21 mm, SD = 0.15 mm; P = .78). After 3 months, the HXLPE penetration rate (0.06 mm/y, SD = 0.06 mm/y) was significantly lower than the UHMWPE penetration rate (0.10 mm/y, SD = 0.07 mm/y; P = .04). The penetration in the first 3 months was probably caused by creep or bedding in; from 3 months onward, much of the penetration was probably caused by wear. We conclude that HXLPE has a 40% lower wear rate as compared with UHMWPE, suggesting that it will perform better in the long term. 相似文献
93.
Susan Hrisos Martin P Eccles Jill J Francis Marije Bosch Rob Dijkstra Marie Johnston Richard Grol Eileen FS Kaner Ian N Steen 《BMC health services research》2009,9(1):140
Background
Long term management of patients with Type 2 diabetes is well established within Primary Care. However, despite extensive efforts to implement high quality care both service provision and patient health outcomes remain sub-optimal. Several recent studies suggest that psychological theories about individuals' behaviour can provide a valuable framework for understanding generalisable factors underlying health professionals' clinical behaviour. In the context of the team management of chronic disease such as diabetes, however, the application of such models is less well established. The aim of this study was to identify motivational factors underlying health professional teams' clinical management of diabetes using a psychological model of human behaviour. 相似文献94.
AM Alazami SA Schneider D Bonneau L Pasquier M Carecchio M Kojovic K Steindl M De Kerdanet MM Nezarati KP Bhatia B Degos E Goh FS Alkuraya 《Clinical genetics》2010,78(6):585-590
Alazami AM, Schneider SA, Bonneau D, Pasquier L, Carecchio M, Kojovic M, Steindl K, de Kerdanet M, Nezarati MM, Bhatia KP, Degos B, Goh E, Alkuraya FS. C2orf37 mutational spectrum in Woodhouse–Sakati syndrome patients. Woodhouse–Sakati syndrome (WSS) is a rare autosomal recessive disorder that encompasses hypogonadism, deafness, alopecia, mental retardation, diabetes mellitus and progressive extrapyramidal defects. The syndrome is caused by mutation of the C2orf37 gene. Here we studied a cohort of seven new cases from three ethnic backgrounds, presenting with the hallmarks of WSS, in an effort to extend the mutational spectrum of this disorder. Genetic analysis revealed a novel mutation in each of the four families investigated, of which three were nonsense mutations and the fourth was a splice site ablation. We also examined a separate collection of 11 cases presenting with deafness and dystonia, two constituents of WSS, but found no pathogenic changes. This study doubles the number of known mutations for this disorder, confirms that truncating mutations in C2orf37 are the only known cause of WSS, and suggests that mutations in this gene do not contribute significantly to cases presenting with isolated elements of WSS such as deafness and dystonia. The lack of correlation between clinically expressivity of WSS and the site of the eight truncating mutations strongly supports that they are equally null, while the intrafamilial variability argues for an important role of modifiers in this disease. 相似文献
95.
FS Chung S Eyal M Muzi JM Link DA Mankoff A Kaddoumi F O'Sullivan P Hsiao JD Unadkat 《British journal of pharmacology》2010,159(2):394-404
Background and purpose:
Changes in tissue P-glycoprotein (P-gp) activity during pregnancy could affect the pharmacokinetics and thus the efficacy and toxicity of many drugs. Therefore, using positron emission tomography (PET) imaging, we tested whether gestational age affects tissue P-gp activity in the pregnant non-human primate, Macaca nemestrina.Experimental approach:
Mid-gestational (day 75 ± 13, n= 7) and late-gestational (day 150 ± 10, n= 5) age macaques were imaged after administration of a prototypic P-gp substrate, 11C-verapamil (13.7–75.4 MBq·kg−1), before and during intravenous infusion of a P-gp inhibitor, cyclosporin A (CsA) (12 or 24 mg·kg−1·h−1). Accumulation of radioactivity in the fetal liver served as a reporter of placental P-gp activity. P-gp activity was expressed as CsA-induced percent change in the ratio of the area (0–9 min) under the 11C-radioactivity concentration–time curve in the tissue (AUCtissue) to that in the maternal plasma (AUCplasma).Key results:
The CsA-induced change in AUCfetal liver/AUCmaternalplasma of 11C-radioactivity significantly increased from mid- (35 ± 25%) to late gestation (125 ± 66%). Likewise, the CsA-induced change in AUCmaternal brain/AUCplasma increased from mid- (172 ± 80%) to late gestation (337 ± 148%). The AUC ratio for the other maternal tissues was not significantly affected. Neither the CsA blood concentrations nor the level of circulating 11C-verapamil metabolites were significantly affected by gestational age.Conclusions and implications:
P-gp activity at the blood–brain barrier and the placental barrier in the macaque increased with gestational age. If replicated in humans, the exposure of the fetus and maternal brain to P-gp substrate drugs, and therefore their efficacy and toxicity, will change during pregnancy. 相似文献96.
肛管直肠超声可用来诊断多种肛管直肠良、恶性疾病。近几年来.该技术取得了长足进步.其应用360度旋转高频(6.16MHZ)探头(焦距2.8~6.2cm),无需转动探头便可获得高清晰的肛管直肠三维结构图。位于探头远端的换能晶片向近端边旋转边移动,持续55S.可获得长约6cm的图像。这个图像是将连续的0.2mm层厚轴向切面通过容积再现技术合成的高清晰的三维数字立体图像。其拥有多个视角(同时4~6个视野).可同时观察多个解剖平面.进行低亮度、高对比度调整,可形成半透明暗腔。 相似文献
97.
98.
99.
Jean Anne Connor Nancy E. Kline Sandra Mott Sion Kim Harris Kathy J. Jenkins 《Journal of pediatric health care》2010,24(5):318-325
IntroductionThe purpose of this study was to describe the cost burden of congenital heart disease (CHD) and the associated social impact as experienced by families.MethodQualitative methods were used to collect and interpret data. Semi-structured interviews were conducted with parents of children with various degrees of CHD complexity and socioeconomic status currently admitted for congenital heart surgery at a large tertiary care regional center.ResultsThe meaning of cost burden as defined by participants resulted in the emergence of two major categories, lifestyle change and uncertainty. Cost was described beyond monetary terms and as a result, data in each category were further clustered into three underlying subcategories labeled financial, emotional, and family burden. The child's disease complexity and parent's socioeconomic status seem to be linked to higher levels of stress experienced in terms of finances, emotional drain, and family member burden. Prenatal diagnosis was noted to trigger early discussion of financial uncertainty, often resulting in altered personal spending prior to birth.DiscussionThe cost experienced by parents of children with complex CHD was described as both life-changing and uncertain. Informing families of these types of additional stressors may allow issues of finances to be considered early in the overall preparation of caring for a child with complex CHD. 相似文献
100.
Woods ER Samples CL Melchiono MW Harris SK 《Seminars in pediatric infectious diseases》2003,14(1):43-53
The Boston HAPPENS Program is a collaborative network of care consisting of multiservice outreach agencies; community health centers; and hospitals for HIV-positive, homeless, and hard-to-reach youth. In four years of data collection, the program served more than 2,000 youth, including 54 HIV-positive youth. The youth were 19.9 +/- 2.9 years old; 64 percent female; 45 percent youth of color; 11 percent gay/lesbian, bisexual, or undecided; and 13 percent homeless or runaway. Homeless youth were much more likely to have been involved with a mental health system (47% vs. 12%, P < 0.001), the criminal justice system (20% vs. 2%, P < 0.001), high-risk sexual behaviors (21% vs. 3%, P < 0.001), and substance abuse (25% vs. 6%, P < 0.001) than were other youth served by the program. Comprehensive networks of care offering a continuum of services and a variety of entry routes and types of care sites are needed to connect under-served youth to health care. Outreach and human immunodeficiency virus (HIV) counseling and testing services can offer important portals of entry into health services for at-risk youth. Support services such as outreach, case management, and mental health services are needed to complement medical services by all youth at-risk for contracting HIV. Support services are necessary for the initiation and retention of youth in care so that early case identification and complex treatment regimens can be initiated and tailored to the individual. 相似文献