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排序方式: 共有3946条查询结果,搜索用时 71 毫秒
71.
Noor H. A. Suaini Evelyn Xiu-Ling Loo Rachel L. Peters Gaik Chin Yap Katrina J. Allen Hugo Van Bever David J. Martino Anne Eng Neo Goh Shyamali C. Dharmage Marjorelee T. Colega Mary Foong Fong Chong Anne-Louise Ponsonby Kok Hian Tan Mimi L. K. Tang Keith M. Godfrey Bee Wah Lee Lynette Pei-Chi Shek Jennifer J. Koplin Elizabeth Huiwen Tham 《Allergy》2021,76(10):3171-3182
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Nelly Mauras Paul Mazaika Bruce Buckingham Stuart Weinzimer Neil H. White Eva Tsalikian Tamara Hershey Allison Cato Peiyao Cheng Craig Kollman Roy W. Beck Katrina Ruedy Tandy Aye Larry Fox Ana Maria Arbelaez Darrell Wilson Michael Tansey William Tamborlane Daniel Peng Matthew Marzelli Karen K. Winer Allan L. Reiss 《Diabetes》2015,64(5):1770-1779
Significant regional differences in gray and white matter volume and subtle cognitive differences between young diabetic and nondiabetic children have been observed. Here, we assessed whether these differences change over time and the relation with dysglycemia. Children ages 4 to <10 years with (n = 144) and without (n = 72) type 1 diabetes (T1D) had high-resolution structural MRI and comprehensive neurocognitive tests at baseline and 18 months and continuous glucose monitoring and HbA1c performed quarterly for 18 months. There were no differences in cognitive and executive function scores between groups at 18 months. However, children with diabetes had slower total gray and white matter growth than control subjects. Gray matter regions (left precuneus, right temporal, frontal, and parietal lobes and right medial-frontal cortex) showed lesser growth in diabetes, as did white matter areas (splenium of the corpus callosum, bilateral superior-parietal lobe, bilateral anterior forceps, and inferior-frontal fasciculus). These changes were associated with higher cumulative hyperglycemia and glucose variability but not with hypoglycemia. Young children with T1D have significant differences in total and regional gray and white matter growth in brain regions involved in complex sensorimotor processing and cognition compared with age-matched control subjects over 18 months, suggesting that chronic hyperglycemia may be detrimental to the developing brain. 相似文献
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Jon Banks Fiona M Walter Nicola Hall Katie Mills William Hamilton Katrina M Turner 《The British journal of general practice》2014,64(629):e775-e782
Background
The challenge for GPs when assessing whether to refer a patient for cancer investigation is that many cancer symptoms are also caused by benign self-limiting illness. UK National Institute for Health and Care Excellence (NICE) referral guidelines emphasise that the patient should be involved in the decision-making process and be informed of the reasons for referral. Research to date, however, has not examined the extent to which these guidelines are borne out in practice.Aim
To assess the degree to which patients are involved in the decision to be referred for investigation for symptoms associated with cancer and their understanding of the referral.Design and setting
Qualitative interview study of patients referred to secondary care for symptoms suspicious of lung and colorectal cancer. Patients were recruited from two regions of England using maximum variation sampling.Method
Transcribed interviews were analysed thematically.Results
The analysis was based on 34 patient interviews. Patients in both symptom pathways reported little involvement in the decision to be referred for investigation. This tended to be accompanied by a patient expectation for referral, however, to explain ongoing and un-resolving symptoms. It was also found that reasons for referral tended to be couched in non-specific terms rather than cancer investigation, even when the patient was on a cancer-specific pathway.Conclusion
GPs should consider a more overt discussion with patients when referring them for further investigation of symptoms suspicious of cancer. This would align clinical practice with NICE guidelines and encourage more open discussion between GPs and primary care patients around cancer. 相似文献77.
Kimberly Englert Katrina Ruedy Julie Coffey Kimberly Caswell Amy Steffen Lucy Levandoski for the Diabetes Research in Children Study Group 《Journal of diabetes science and technology》2014,8(4):745-751
Background:The purpose of this article is to describe challenges associated with successful use of continuous glucose monitoring (CGM) by young children with type 1 diabetes (T1D) and to detail the techniques and products used to improve the duration of sensor wear.Methods:The DirecNet Study Group conducted 2 studies in 169 children with T1D between the ages of 1 and 9 years who were instructed to wear a CGM device daily. Problems related to skin irritation and sensor adhesiveness in these young children presented challenges to daily use of the CGM. Study coordinators instituted a variety of techniques using commercially available products to attempt to overcome these problems.Results:Three primary factors that contributed to reduced CGM use were identified: the limited body surface area in smaller children, ambient temperature and humidity, as well as the type and duration of physical activity. Using supplemental products to minimize the impact of these factors resulted in improved adherence and reduced skin irritation.Conclusion:Achieving satisfactory adhesion of the CGM sensor and transmitter may involve finding the right supplemental product or combination of products through trial and error. Optimizing adhesion and minimizing skin irritation can significantly improve duration of use and tolerability of CGM devices by young children. 相似文献
78.
Ryan J. Marker Jennifer L. Stephenson Benzi M. Kluger Douglas Curran-Everett Katrina S. Maluf 《Journal of psychosomatic research》2014
Objective
Psychosocial stress has been associated with a variety of chronic pain disorders although the mechanisms responsible for this relationship are unknown. The purpose of this study was to compare the excitability of intracortical and corticospinal pathways to the trapezius muscle in individuals with and without chronic neck pain during exposure to low and high levels of psychosocial stress.Methods
Single and paired-pulse transcranial magnetic stimulation was used to assess motor evoked potentials (MEPs) and short-interval intracortical inhibition (SICI) during mental math performed in the presence and absence of social evaluative threat.Results
All participants demonstrated higher amplitude MEPs in the high stress compared to the low stress condition (p < 0.01). Participants with chronic neck pain had significantly greater SICI than healthy participants in the low stress condition (p = 0.03). During exposure to the stressor, healthy participants showed an increase in SICI, whereas participants with neck pain showed no change (group difference for change in SICI, p < 0.01).Conclusions
These findings suggest that individuals with chronic neck pain inhibit motor output to the trapezius in the presence of minor stressors, and are unable to compensate for additional stress-evoked increases in corticospinal excitability through further modulation of SICI. This observation has potential implications for the management of patients who have difficulty relaxing painful muscles during times of stress. 相似文献79.
80.
Diaz K Kelly SG Smith B Malani PN Younger JG 《American journal of infection control》2012,40(1):65-67
Despite successful efforts to improve overall central line-associated bloodstream infections (CLABSI) rates, little is known about CLABSI rates or even central venous catheter insertion practices in the Emergency Department. We sought to determine the baseline CLABSI rate for Emergency Department-inserted central venous catheters and to describe indications for placement, duration of use, and the natural history of these devices. 相似文献