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11.
PURPOSE: To examine changes in health habits (sleep, alcohol, and exercise) and the effects of an educational intervention promoting self-care on the emotional and academic adjustment of first-year medical students. METHOD: Fifty-four medical students completed questionnaires that assessed various health habits, alcohol use, depression severity, and areas of life satisfaction at the beginning of the semester, at mid-term, and at finals. Approximately half of the students received written feedback or participated in an educational discussion group at mid-term. RESULTS: The students demonstrated significant changes in health habits, with increases in alcohol consumption and decreases in exercise and socialization. The changes in health habits were predictive of both emotional and academic adjustment, with students who decreased in positive health habits, particularly socialization, being more depressed at finals. The feedback and educational interventions influenced some sleep and exercise behaviors, but the groups did not differ in overall emotional or academic adjustment. CONCLUSIONS: First-year medical students show significant changes in health habits as they adjust to medical school. An educational intervention demonstrated promising effects in changing these patterns, but self-care needs to be further elaborated to address the specific challenges associated with acute adjustment as well as with long-term stressors. 相似文献
12.
Alan G. Fraser Peter T. Buser Jeroen J. Bax Willem R. Dassen Petros Nihoyannopoulos Jürg Schwitter Juhani M. Knuuti Martin Höher Frank Bengel András Szatmári 《European journal of nuclear medicine and molecular imaging》2006,33(8):955-959
Advances in medical imaging now make it possible to investigate any patient with cardiovascular disease using multiple methods which vary widely in their technical requirements, benefits, limitations and costs. The appropriate use of alternative tests requires their integration into joint clinical diagnostic services where experts in all methods collaborate. This statement summarises the principles that should guide developments in cardiovascular diagnostic services.This paper is published simultaneously in the European Heart Journal (2006;27:1750–1753) and in the European Journal of Echocardiography (2006;7:268–273). 相似文献
13.
F J Beek M S van Leeuwen N M Bax E H Dillon T D Witkamp A P van Gils 《AJNR. American journal of neuroradiology》1994,15(3):445
PURPOSETo determine whether the lumbosacral junction of the vertebral column can be identified with sonography in newborns and infants and thus serve as a method for counting the lumbar and sacral vertebral bodies.METHODSIn 32 newborns and infants, the number of ossified vertebral bodies distal to the lumbosacral junction was counted with sonography and radiography.RESULTSSonographic and radiographic findings agreed in 29 of 32 examinations (91%).CONCLUSIONSThe lordotic transition at the lumbosacral junction can be identified with sonography in the majority of newborns and infants, allowing intraspinal structures to be related to a specific vertebral level. 相似文献
14.
Assessment of global and regional left ventricular function and volumes with 64-slice MSCT: a comparison with 2D echocardiography. 总被引:5,自引:0,他引:5
Maureen M Henneman Joanne D Schuijf J Wouter Jukema Eduard R Holman Hildo J Lamb Albert de Roos Ernst E van der Wall Jeroen J Bax 《Journal of nuclear cardiology》2006,13(4):480-487
BACKGROUND: In patients with coronary artery disease (CAD), LV function and volumes are important parameters for long-term prognosis. Multislice computed tomography (MSCT) allows noninvasive assessment of the coronary arteries, but the accuracy of 64-slice MSCT for the assessment of left ventricular (LV) volumes and function is unknown. METHODS AND RESULTS: A head-to-head comparison between 64-slice MSCT and 2-dimensional (2D) echocardiography was performed in 40 patients with known or suspected CAD. The LV end-diastolic volume (LVEDV) and LV end-systolic volume (LVESV) were determined and the LV ejection fraction (LVEF) was derived. Regional wall motion was assessed visually using a 17-segment model. A 3-point scoring system was used to assign to each segment a wall motion score: 1 = normokinesia, 2 = hypokinesia, 3 = akinesia or dyskinesia. Two-dimensional echocardiography served as the gold standard. MSCT agreed well with 2D echocardiography for assessment of LVEDV (r = 0.97; p < .0001) and LVESV (r = 0.98; p < .0001). An excellent correlation between MSCT and 2D echocardiography was shown for the evaluation of LVEF (r = 0.91; p < .0001). Agreement for the assessment of regional wall motion was excellent (96%, kappa = 0.82). CONCLUSIONS: An accurate assessment of global and regional LV function and volumes is feasible with 64-slice MSCT. 相似文献
15.
16.
G M J M Welten O Schouten R T van Domburg H H H Feringa S E Hoeks M Dunkelgrün Y R B M van Gestel D Goei J J Bax D Poldermans 《European journal of vascular and endovascular surgery》2007,34(6):632-638
OBJECTIVE: The Lee-risk index [Lee-index] was developed to predict major adverse cardiac events [MACE]. However, age is not included as a risk factor. The aim was to assess the value of the Lee-index in vascular surgery patients among different age categories. METHODS: Of 2642 patients cardiovascular risk factors were noted to calculate the Lee-index. Patients were divided into four age categories; < or = 55 (n=396), 56-65 (n=650), 66-75 (n=1058) and > 75 years (n=538). Outcome measures were postoperative MACE (cardiac death, MI, coronary revascularization and heart failure). The performance of the Lee-index was determined using C-statistics within the four age groups. RESULTS: The incidence of MACE was 10.9%, for Lee-index 1, 2 and > or = 3; 6%, 13% and 20%, respectively. However, the prognostic value differed among age groups. The predictive value for MACE was highest among patients under 55 year (0.76 vs 0.62 of patients aged > 75). The prediction of MACE improved in elderly (aged > 75) after adjusting the Lee-index with age, revised risk of operation (low, low-intermediate, high-intermediate and high-risk procedures) and hypertension (0.62 to 0.69). CONCLUSION: The prognostic value of the Lee-index is reduced in elderly vascular surgery patients, adjustment with age, risk of surgical procedure, and hypertension improves the Lee-index significantly. 相似文献
17.
Prognostic significance of declining ankle-brachial index values in patients with suspected or known peripheral arterial disease. 总被引:2,自引:1,他引:1
H H H Feringa S E Karagiannis O Schouten R Vidakovic V H van Waning E Boersma G Welten J J Bax D Poldermans 《European journal of vascular and endovascular surgery》2007,34(2):206-213
BACKGROUND: Peripheral arterial disease (PAD) is a risk factor for cardiovascular events. This study assessed the prognostic significance of repeated ankle-brachial index (ABI) measurements at rest and after exercise in patients with PAD receiving conservative treatment. METHODS: In a cohort study of 606 patients (mean age 62+/-12 years, 68% male), ABI at rest and after exercise was measured at baseline and after 1 year. Patients with reductions in ABI were divided into three equally-sized groups (minor, intermediate and major reductions) and were compared to patients without reductions. During a mean follow-up of 5+/-3 years, all-cause mortality, cardiac events, stroke and progression to kidney failure were noted. RESULTS: Death was recorded in 83 patients (14%) of which 49% were due to cardiac causes. Non-fatal myocardial infarction occurred in 38 patients (6%), stroke in 46 (8%) and progression to kidney failure in 35 (6%). By multivariate analysis, patients with major declines in resting (>20%) and post-exercise (>30%) ABI were at increased risk of all-cause mortality (HR: 3.3, 95% CI: 1.5-7.2, HR: 3.0, 95% CI: 1.4-6.4, respectively), cardiac events (HR: 3.1, 95% CI: 1.3-7.2, HR: 2.4, 95% CI: 1.1-5.6, respectively), stroke (HR: 4.2, 95% CI: 1.6-10.4, HR: 3.9, 95% CI: 1.4-10.2, respectively) and kidney failure (HR: 2.7, 95% CI: 1.1-7.5, HR: 6.9, 95% CI: 1.5-31.5, respectively), compared to patients with no declines in ABI. CONCLUSIONS: This study shows that major 1-year declines in resting and post-exercise ABI are associated with all-cause mortality, cardiac events, stroke and kidney failure in patients with PAD. 相似文献
18.
T. W. Bax D. R. Marcus G. Q. Galloway L. L. Swanstrom B. C. Sheppard 《Surgical endoscopy》1996,10(12):1150-1153
Background: Laparoscopic adrenalectomy has recently been shown to be a safe and effective means of treating adrenal pathology with much
lower morbidity than the traditional approach. The majority of reports in the literature involve removal of adrenal tumors.
Although open bilateral adrenalectomy has been utilized for persistent Cushing's syndrome following attempted hypophysectomy,
there is little data available describing the application of laparoscopic adrenal surgery to this problem.
Methods: Four patients with persistent Cushing's syndrome after attempted treatment with hypophysectomy underwent laparoscopic bilateral
adrenalectomy at our institution. One procedure was done transabdominally in the supine position. Three procedures were done
transabdominally using sequential lateral decubitus positions.
Results: All procedures were completed laparoscopically. The mean operative time was 4.6 h (range 3.9–5.25). Repositioning and reprepping
the patients resulted in a slight increase in operative time, but visualization was improved using the lateral decubitus position.
Average blood loss: 156 cc (range 50–300). One patient required early reoperation for bleeding from the left adrenal bed,
which was controlled laparoscopically. Three patients were eating the following day and were discharged on postoperative days
1, 2, and 5. The fourth patient remained hospitalized for 18 days due to problems unrelated to surgery. After a mean follow-up
of 10 months, all patients have done well and have no clinical or biochemical evidence of recurrent disease.
Conclusion: Our clinical experience indicates that laparoscopic bilateral adrenalectomy is a viable treatment option for Cushing's syndrome
following failed hypophysectomy.
Received: 29 March 1996/Accepted: 12 June 1996 相似文献
19.
A. van Belkum R. Bax G. Prevost 《European journal of clinical microbiology & infectious diseases》1994,13(5):420-424
Twenty-six methicillin-resistantStaphylococcus aureus strains were genetically differentiated by interrepeat PCR and the results compared with those of ribotyping, pulsed-field gel electrophoresis (PFGE) and random amplified polymorphic DNA analysis obtained in a previous study for the same strains. The comparison showed that the PCR-mediated assays were as discriminatory as PFGE, whereas ribotyping was the least powerful genotyping method. Due to the ease of performance, PCR fingerprinting may become the method of choice for establishing clonal relationships amongStaphylococcus aureus isolates. 相似文献
20.
Molecular Approaches to Diagnosis of Pulmonary Diseases Due to Mycoplasma pneumoniae 总被引:8,自引:0,他引:8
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Marianne Abele-Horn Ulrich Busch Hans Nitschko Enno Jacobs Ralph Bax Friederike Pfaff Beatrix Schaffer Jürgen Heesemann 《Journal of clinical microbiology》1998,36(2):548-551
In this prospective study, the use of a culture-enhanced PCR assay for the detection of Mycoplasma pneumoniae, followed by hybridization with a specific probe (MP-HPCR) or without hybridization (MP-PCR), and the use of a nested PCR (MP-NPCR) were evaluated. Clinical samples (190 specimens) from 190 patients with respiratory complaints were incubated in culture broth overnight and then subjected to PCR. The results of the PCR were compared to those obtained by culture, the direct antigen test, and serologic testing by microparticle agglutination and by immunoblotting in unclear cases. The sensitivities were 19 CFU for MP-PCR, 1.9 CFU for MP-HPCR, and 0.019 CFU for MP-NPCR. PCR amplification of the β-globin gene was possible in 98% of cases: after dilution of the β-globin-negative samples, all samples were reactive. Correlation between negative MP-NPCR results and negative serology results was found in 89% of cases; a positive correlation was found with 10% of the patients. Samples from three immunocompromised patients were MP-NPCR positive but serologically negative. High respiratory colonization by M. pneumoniae (>105 CFU/ml) in patients with acute respiratory disease could be detected by culture, MP-PCR, and MP-NPCR. These results indicate that MP-PCR and MP-NPCR are reliable methods for the detection of M. pneumoniae in respiratory tract samples of patients with respiratory complaints. 相似文献