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排序方式: 共有572条查询结果,搜索用时 31 毫秒
31.
Dr. Michael E. Klepser Pharm.D. Ms. Zhu Zhu M.S. Dr. David P. Nicolau Pharm.D. Ms. Mary Anné Banevicius B.S. Dr. Paul P Belliveau Pharm.D. Dr. Jack W. Ross M.D. Dr. Larry Broisman M.D. Dr. Richard Quintiliani M.D. Dr. Charles H. Nightingale Ph.D. 《Pharmacotherapy》1996,16(4):656-662
Study Objective . To determine the bioavailability of trimethoprim-sulfamethoxazole (TMP-SMX) in patients infected with the human immunodeficiency virus (HIV). Design . Open-label, randomized, two-way crossover trial. Setting . Outpatient clinical research center affiliated with a community-based teaching hospital. Patients . Ten individuals diagnosed with the acquired immunodeficiency syndrome (AIDS) with CD4+ counts less than 200 cells/mm3, receiving TMP-SMX one double-strength tablet 3 times/week as prophylaxis for Pneumocystis carinii pneumonia (PCP), and without documented gastroenteropathy or diarrhea agreed to participate in the trial. One patient withdrew from the study secondary to development of symptomatic PCP. Data were available for analysis from the remaining nine subjects. Interventions . Participants received TMP 160 mg and SMX 800 mg orally or intravenously during two study periods. Following dose administration, blood samples were collected at predetermined time points over 36 hours. Measurements and Main Results . Analysis of TMP-SMX pharmacokinetic parameters (half-life, total body clearance, area under the serum concentration versus time curve, and peak concentration) failed to reveal any significant differences between intravenous and oral preparations. The calculated bioavailabilities of oral TMP and SMX (mean ± SD) were 102.7% ± 19.8% and 109.4% ± 19.4%, respectively. Conclusion . The absorption of TMP-SMX is not adversely affected by HIV infection in the absence of HIV-induced gastroenteropathy or diarrhea. 相似文献
32.
The A-B scale was developed to distinguish therapists with a high rate of therapeutic improvement with schizophrenic patients from those with a low rate. The present study tests the hypothesis, developed by Whitehorn and Betz, expanded by McNair and Lorr, of an interaction between a therapist factor, i.e. the A-B score (identified in this study by the Campbell et al. revision of the Whitehorn and Betz A-B scale), patient diagnosis, and treatment outcome.An automated data system identified all of the adult patients treated by 42 therapists during their training at a psychiatric center containing inpatient and outpatient facilities. The patient group was broken down according to diagnosis and whether or not psychotropic drugs were a major treatment modality. Using a linear logistic regression model, the slope of the line specifying log odds of improvement in relation to therapist A-B was found to be significantly different for schizophrenics and neurotics treated without drugs. (No relationship to A-B was found for drug-treated patients.) For those therapists who had treated both neurotic and schizophrenic patients (N=19) without drugs, A-B was found to be significantly associated (p=.075) with a measure of dependence between patient type and outcome. These two findings were consistent with the hypothesized relationship between the A-B dimension, patient diagnosis, and case outcome.This research was supported by General Research Support Grant FR 72-24. We thank Francis Krikorian, Computer Programmer, for his assistance. 相似文献
33.
Dr. Robert N. Glenn Ph.D. Mrs. Betsy Davis R.N. Ms JoAnn Bluhm B.S. Ms. Pamela Motley B.S. 《The Psychiatric quarterly》1977,49(4):316-321
The present study investigated the manner in which psychiatric aides used their time when not involved in staff meetings or off-ward activities. Aides' behaviors on two shifts were observed during times they had the greatest likelihood of interacting with patients. It was found that aides were most likely to be observed in the Nursing Station on both shifts. Aides typically had a specific purpose for interacting with patients when they were on the wards. It was concluded that increased structuring of patient-aide interactions was necessary along with more stringent guidelines regarding the use of the Nursing Station.He is now a staff psychologist at Commonwealth Psychiatric Center.This research was supported in part by Hospital Improvement Program Grant No. 03-R-000, 812-03, from the Department of Health, Education, and Welfare, Washington. 相似文献
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35.
Laser Doppler flowmetry (LDF) is a non-invasive method to measure tissue blood flow. During reactive hyperaemia, the LDF signal
increases to a peak and then returns to a resting value. A simplified model is developed to explain these variations. The
emphasis is on simulating the effects occurring rather than on trying to mimic the anatomical structure of the microcirculation.
A single blood vessel is therefore analysed. The increasing value of blood velocity is studied, and vasodilatation as well
as vasoconstriction are taken into account. The model parameters are calculated using wavelets. For a 2-min occlusion on a
healthy subject, the radius of the vessel is initially 15 μm, increasing to 24.6 μm at the peak, reached 14 s after the release
of the occlusion. The model shows that the high value of the LDF signal during the initial phase of reactive hyperaemia is
produced by an increasing number of erythrocytes in a cross-section, due to vasodilatation rather than an increase in moving
blood cell velocities. Moreover, the rapidity of the vasodilatation and vasoconstriction effects determine the rapidity of
the signal variations. The paper aims to give a basic solution to develop a numerical model. 相似文献
36.
Drs. Andrea Carlson Gielen ScD Drs. Linda Fogarty PhD Dr. Patricia O'Campo PhD Dr. Jean Anderson MD Ms. Jean Keller PAC Dr. Ruth Faden PhD 《Journal of urban health》2000,77(3):480-491
This paper describes the frequency of women's disclosure of their HIV status, examines the extent to which they experience adverse social and physical consequences when others learn they are infected, and analyzes correlates of these negative outcomes. There were 257 HIV-positive women between the ages of 18 and 44, recruited from HIV/AIDS primary care clinics and from community sites, who completed a face-to-face interview. Women in the sample were 33 years old on average; 92% were African-American; 54% had less than 12 years of education; 56% had used intravenous drugs; and 30% knew they were HIV positive for 5 or more years. There were 97% who disclosed their HIV status; 64% told more than 5 people. Negative consequences associated with others knowing they were HIV-positive were reported by 44%, most commonly the loss of friends (24%), being insulted or sworn at (23%), and being rejected by family (21%). There were 10 women (4%) who reported being physically or sexually assaulted as a result of their being HIV positive, and 16% reported having no one they could count on for money or a place to stay. Violence was widespread in this sample, with 62% having experienced physical or sexual violence, including sexual abuse or rape (27%), being beaten up (34%), and weapon-related violence (26%). Logistic regression analysis indicated that women with a history of physical and sexual violence were significantly more likely to experience negative social and physical consequences when their infection became known to others, adjusting for age and the number of people women had disclosed to, both of which were only marginally significant. Partner notification policies and support programs must be responsive to the potential negative consequences associated with others learning that a woman is HIV positive. The high rates of historical violence in the lives of women living with HIV underscore the need for routine screening and intervention for domestic violence in all settings that provide health care to HIV-positive women. 相似文献
37.
Ms. Deborah M. Prout 《Journal of general internal medicine》1986,1(1):44-48
Since 1976, federal support for training in general internal medicine has been provided through the primary care residency programs under Title VII of the Public Health Service Act. Continuation of these programs is now in jeopardy because of severe fiscal pressures and the response of Congress to the resulting budgetary stringency. General internal medicine faces immediate problems in the budgetary, authorization, and appropriations arenas. However, Congressional proposals for changing the method by which Medicare pays for all graduate medical education may provide an important opportunity. Under a revised method of financing graduate medical education, general internal medicine could eliminate its historical dependence on increasingly unstable federal grant funds and could contribute to the development of new federal incentives for training in the primary care specialties. 相似文献
38.
We report on the comparative acceptability of a prototype latex female condom and the polyurethane Reality female condom.
We also identified factors associated with acceptability, measured via a composite index with domains related to ease of insertion,
noise, and comfort during insertion and use. There were 135 couples in this randomized crossover trial. The average age was
30 years; more than 60% had education beyond high school; 40% were married; and participants were at low risk for sexually
transmitted disease and pregnancy (due to the investigational status of the prototype). Participants were asked to use three
of each of the study condoms during a 6-week period. Acceptability ratings on 12 items were summed into a composite index
for each participant by condom type. The index midpoint (range) for females was 48 (12–84), and it was 32 (8–56) for males,
with lower scores indicating higher acceptability (men completed only a subset of the acceptability questions). Both condoms
were equally acceptable: Mean scores were 37 and 40 for the women's ranking of the prototype and Reality, respectively (P=.07) and 29 and 30 for men's rankings, respectively (P=.35). Multiple regression models to predict acceptability scores by gender were somewhat uninformative (most R
2 values were less than 0.10). Nevertheless, minority ethnicity (African American or Hispanic vs. white) was associated with
higher acceptability by both genders for both condom types. Among women, for both condom types, less education (less than
high school compared with high school or beyond) was associated with higher acceptability. Female condom acceptability may
not be equally distributed across demographic groups, which is important for health educators to keep in mind when promoting
the female condom. 相似文献
39.
Ms. Nancy Hughart Rn MPH Dr. Elizabeth Holt DrPH Dr. Jorge Rosenthal PhD Dr. Alan Ross PhD Dr. Alison Jones PhD Dr. Virginia Keane MD Dr. Patrick Vivier MD PhD Dr. Bernard Guyer MD MPH 《Journal of urban health》1998,75(1):123-134
Objective To evaluate the effectiveness of pediatric practice consultation in reducing missed-opportunity rates at eight pediatric sites
in Baltimore, Maryland. The overarching goal was to decrease the occurrence of missed opportunities from 33% to 15% for the
first, second, and third diphtheria and tetanus toxoids and pertussis vaccines during visits at which children were eligible
for the vaccines.
Design The effect of an in-office educational program alone at four sites is compared with the educational program and a consultation
on office vaccination practices at four matched sites. All eight sites received a small grant ($2,000) to fund practice changes.
The medical records of children making visits before and after the interventions were audited to determine missed-opportunity
rates. The policies and operations and the knowledge, attitudes, and practices of physicians and nurse practitioners at each
site were also assessed.
Results The four education-consultation sites experienced a statistically significant 14% net reduction in the missed-opportunity
rate relative to the education-only sites. This positive effect, however, was largely due to an increase in missed opportunities
at one education-only site. There was a 10% increase in the missed-opportunity rate among the education-only sites and a 4%
decrease among the education-consultation sites; neither change was statistically significant. Two of the three sites that
reduced missed opportunities were matched health maintenance organizations (HMOs). Shortly after the interventions, both HMOs
implemented tracking and follow-up information systems, which were planned before the interventions.
Conclusions There is no evidence that either the educational program alone or the educational program and consultation combination reduced
missed opportunities. The findings suggest that improved tracking and follow-up data systems and vaccination of children at
sick visits may reduce missed opportunities.
This study was funded by the Centers for Disease Control and Prevention, contract number 200-90-0850. 相似文献
40.