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排序方式: 共有130条查询结果,搜索用时 15 毫秒
1.
OBJECTIVE: We aimed to determine whether general practitioner GP hospitals,
compared with alternative modes of health care, are cost- saving. METHODS:
Based on a study of admissions (n = 415) to fifteen GP hospitals in the
Finnmark county of Norway during 8 weeks in 1992, a full 1-year patient
throughput in GP hospitals was estimated. The alternative modes of care
(general hospital, nursing home or home care) were based on assessments by
the GPs handling the individual patients. The funds transferred to finance
GP hospitals were taken as the cost of GP hospitals, while the cost of
alternative care was based on municipality and hospital accounts, and
standard charges for patient transport. RESULTS: The estimated total annual
operating cost of GP hospitals was 32.2 million NOK (10 NOK = 1 Pound)
while the cost of alternative care was in total 35.9 million NOK.
Sensitivity analyses, under a range of assumptions, indicate that GP care
in hospitals incurs the lowest costs to society. CONCLUSION: GP hospitals
are likely to provide health care at lower costs than alternative modes of
care.
相似文献
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Mohamed Elsafi Mirvat Fawzi Dib Hoda Ezzelddin Mustafa M. I. Sayyed Mayeen Uddin Khandaker Abdullah Alsubaie Abdulraheem S. A. Almalki Mahmoud I. Abbas Ahmed M. El-Khatib 《Materials》2021,14(24)
We prepared red clays by introducing different percentages of PbO, Bi2O3, and CdO. In order to understand how the introduction of these oxides into red clay influences its attenuation ability, the mass attenuation coefficient of the clays was experimentally measured in a lab using an HPGe detector. The theoretical shielding capability of the material present was obtained using XCOM to verify the accuracy of the experimental results. We found that the experimental and theoretical values agree to a very high degree of precision. The effective atomic number (Zeff) of pure red clay, and red clay with the three metal oxides was determined. The pure red clay had the lowest Zeff of the tested samples, which means that introducing any of these three oxides into the clay will greatly enhance its Zeff, and consequently its attenuation capability. Additionally, the Zeff for red clay with 10 wt% CdO is lower than the Zeff of red clay with 10 wt% Bi2O3 and PbO. We also prepared red clay using 10 wt% CdO nanoparticles and compared its attenuation ability with the red clay prepared with 10 wt% PbO, Bi2O3, and CdO microparticles. We found that the MAC of the red clay with 10 wt% nano-CdO was higher than the MAC of the clay with microparticle samples. Accordingly, nanoparticles could be a useful way to enhance the shielding ability of current radiation shielding materials. 相似文献
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Olutobi Babatope Ojuawo Olufemi Olumuyiwa Desalu Ademola Emmanuel Fawibe Ayotade Boluwatife Ojuawo Adeniyi Olatunji Aladesanmi Christopher Muyiwa Opeyemi Mosunmoluwa Obafemi Adio Abdulraheem Olayemi Jimoh Dele Ohinoyi Amadu Abayomi Fadeyi Kazeem Alakija Salami 《African health sciences》2020,20(4):1655
BackgroundThe optimal management of community acquired pneumonia (CAP) depends on the clinical and microbiological profile in the locality.ObjectivesTo determine the clinical and microbiological profile of patients admitted with CAP in Ilorin, Nigeria.MethodsOne hundred and two consenting consecutively selected patients with clinical and radiologic confirmation of CAP were recruited in 12 months. The socio-demographic, physical examination and laboratory/radiologic parameters were documented in a questionnaire. Microbiological evaluation of their sputum was done and blood samples were taken for complete blood count, culture, serum urea and serological evaluation for atypical bacteria and some viral pathogens.ResultsCAP constituted 5.9% of the total medical admissions during the one-year study period. The mean age of the patients was 49 ± 22 years with the largest frequency in those aged 65 years and above. The commonest symptoms were shortness of breath (96.1%) and cough (94.1%), with a median duration of 3 days from symptom onset to admission. Systemic hypertension was the commonest comorbid illness (25/102; 24.5%). Klebsiella pneumoniae was the predominant pathogen isolated (20/102; 28.1%). The susceptible antibiotics were Imipenem, Ceftazidime and Ceftriaxone. Intra-hospital mortality was 17.6%. CURB – 65 score of ≥ 2 and the presence of complications of CAP were the independent predictors of mortality.ConclusionCAP constitutes a significant disease burden in Ilorin, Nigeria. Typical bacteria accounted for over half of the pathogens isolated from the patients with gram negative agents predominating. This highlights a possible shift in the microbiological profile which could guide empirical treatment. 相似文献
6.
Bile duct obstruction: radiologic evaluation of level, cause, and tumor resectability 总被引:6,自引:0,他引:6
Gibson RN; Yeung E; Thompson JN; Carr DH; Hemingway AP; Bradpiece HA; Benjamin IS; Blumgart LH; Allison DJ 《Radiology》1986,160(1):43-47
In a prospective study of 65 patients with bile duct obstruction, various radiologic modalities were compared for their capability to demonstrate the level and cause of obstruction and to indicate accurately tumor resectability. Ultrasound (US) was performed in 65 patients, computed tomography (CT) in 51, direct cholangiography (DC) in 57, and angiography in 35. The level of obstruction was correctly indicated by US in 95% of patients and by CT in 90%, and the cause was correctly indicated by US in 88%, by CT in 63%, and by DC in 89%. In predicting tumor resectability, US was correct in 71% of patients, compared with 42% for CT, 58% for DC, and 25% for angiography. US therefore appears to be the single most useful modality in the evaluation bile duct obstruction. 相似文献
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IS Park H Kiyomoto F Alvarez YC Xu HE Abboud SL Abboud 《American journal of kidney diseases》1998,32(6):1000-1010
The renal insulin-like growth factor-I (IGF-I) system has been implicated in the pathogenesis of renal hypertrophy, altered hemodynamics, and extracellular matrix expansion associated with early diabetes. The relative abundance of IGF binding proteins (IGFBPs) in the renal microenvironment may modulate IGF-I actions. However, the precise IGFBPs expressed in the glomerular and tubulointerstitial compartments during diabetic renal growth have not been characterized. In the present study, in situ hybridization studies were performed to examine the expression of IGFBP-1 to -6 messenger RNAs (mRNAs) 3, 7, and 14 days after streptozotocin (STZ) injection in rats. In control, nondiabetic kidneys, all six IGFBP mRNAs were differentially expressed with a predominance of IGFBP-5. The onset of renal hypertrophy in STZ-induced diabetes was associated with a rapid and site-specific induction of IGFBP-1, -3, and -5 mRNAs. In contrast, basal expression of IGFBP-2, -4, and -6 mRNAs was not altered in diabetic rats. IGFBP-5 mRNA expression increased in diabetic glomeruli, cortical, and inner medullary peritubular interstitial cells at days 3, 7, and 14. Although normal glomeruli failed to express IGFBP-3, it was induced concomitantly with IGFBP-5 in diabetic glomeruli and cortical peritubular interstitial cells. IGFBP-1 mRNA levels also increased in cortical tubular cells at each time point tested. Peak induction of IGFBP-3 and -5 was observed at day 3, whereas IGFBP-1 was delayed until day 7. IGFBP-1, -3, and -5 mRNA levels declined by day 14, but remained persistently elevated above control. By immunoperoxidase staining, similar alterations in the pattern of IGFBP-3 and -5 protein expression were observed at each time point. The preferential and site-specific increase in IGFBP-1, -3, and -5 suggest that these IGFBPs may regulate the local autocrine and/or paracrine actions of IGF-I and contribute to the pathogenesis of the early manifestations of diabetic nephropathy. 相似文献
9.
SM Dyer IS de la Lande DB Frewin & RJ Head 《Clinical and experimental pharmacology & physiology》1998,25(3-4):246-251
1. 5-Hydroxytryptamine (5-HT) exerts both contractile and relaxant effects in the marmoset isolated aorta, actions that are unaffected by the 5-HT2 antagonist ketanserin. The aim of the present study was to define the receptors mediating the contractile activity of 5-HT in the marmoset aorta.
2. Contractile responses were elicited in aortic rings that were either: (i) precontracted submaximally with the thromboxane A2 agonist U44069 in order to amplify the responses; or (ii) exposed to N ω -nitro- L -arginine (100 μmol/L) plus LY 53857 (0.1 μmol/L; a 5-HT2 receptor antagonist shown previously to inhibit relaxation). The effect of 5-HT on adenosine 3',5'-cyclic monophosphate (cAMP) formation was also investigated.
3. The effects of agonists and antagonists comprised: (i) agonist potencies in the order 5-carboxamidotryptamine > 5-HT > sumatriptan > 8-hydroxy-2-(di- n -propylamino)tetralin; (ii) inhibition of contractile action of 5-HT by the 5-HT1D antagonist GR 127935; (iii) a contractile response to methysergide; (iv) a lack of effect of tropisetron, an antagonist of 5-HT3 and 5-HT4 receptors; and (v) inhibition of forskolin-stimulated cAMP formation by 5-HT (in the presence of LY 53857), indicative of negative coupling to adenylate cyclase.
4. The above effects fulfil the criteria for a 5-HT1 -like receptor. In view of the previous finding that this contractile response is insensitive to ketanserin, it is concluded that the contractile effects of 5-HT in the marmoset aorta are mediated exclusively by a 5-HT1 -like receptor. 相似文献
2. Contractile responses were elicited in aortic rings that were either: (i) precontracted submaximally with the thromboxane A
3. The effects of agonists and antagonists comprised: (i) agonist potencies in the order 5-carboxamidotryptamine > 5-HT > sumatriptan > 8-hydroxy-2-(di- n -propylamino)tetralin; (ii) inhibition of contractile action of 5-HT by the 5-HT
4. The above effects fulfil the criteria for a 5-HT
10.
Siddhartha Ganguly Trisha Home Abdulraheem Yacoub Suman Kambhampati Huidong Shi Prasad Dandawate Subhash Padhye Ashok K. Saluja Joseph McGuirk Rekha Rao 《Oncotarget》2015,6(31):31767-31779
CLL is a disease characterized by chromosomal deletions, acquired copy number changes and aneuploidy. Recent studies have shown that overexpression of Heat Shock Factor (HSF) 1 in aneuploid tumor cells can overcome deficiencies in heat shock protein (HSP) 90-mediated protein folding and restore protein homeostasis. Interestingly, several independent studies have demonstrated that HSF1 expression and activity also affects the chaperoning of HSP90 kinase clients, although the mechanism underlying this observation is unclear. Here, we determined how HSF1 regulates HSP90 function using CLL as a model system. We report that HSF1 is overexpressed in CLL and treatment with triptolide (a small molecule inhibitor of HSF1) induces apoptosis in cultured and primary CLL B-cells. We demonstrate that knockdown of HSF1 or its inhibition with triptolide results in the reduced association of HSP90 with its kinase co-chaperone cell division cycle 37 (CDC37), leading to the partial depletion of HSP90 client kinases, Bruton''s Tyrosine Kinase (BTK), c-RAF and cyclin-dependent kinase 4 (CDK4). Treatment with triptolide or HSF1 knockdown disrupts the cytosolic complex between HSF1, p97, HSP90 and the HSP90 deacetylase- Histone deacetylase 6 (HDAC6). Consequently, HSF1 inhibition results in HSP90 acetylation and abrogation of its chaperone function. Finally, tail vein injection of Mec-1 cells into Rag2−/−IL2Rγc−/− mice followed by treatment with minnelide (a pro-drug of triptolide), reduced leukemia, increased survival and attenuated HSP90-dependent survival signaling in vivo. In conclusion, our study provides a strong rationale to target HSF1 and test the activity of minnelide against human CLL. 相似文献