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121.
Altered Balance Between Matrix Metalloproteinases and Their Inhibitors in Experimental Biliary Fibrosis 总被引:20,自引:0,他引:20
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122.
Julian P Rodrigues Dylan J Edwards Susan E Walters Michelle L Byrnes Gary Thickbroom Rick Stell Frank L Mastaglia 《Movement disorders》2005,20(7):865-870
Primary orthostatic tremor (OT) is characterized by leg tremor and instability on standing. High frequency (13-18 Hz) tremor bursting is present in leg muscles during stance, and posturography has shown greater than normal sway. We report on an open-label add-on study of gabapentin in 6 patients with OT. Six patients were studied with surface electromyography, force platform posturography, and a modified Parkinson's disease questionnaire (PDQ-39) quality of life (QOL) scale before and during treatment with gabapentin 300 mg t.d.s. If on other medications for OT, these were continued unchanged. Of the 6 patients, 4 reported a subjective benefit of 50 to 75% with gabapentin, 3 of whom showed reduced tremor amplitude and postural sway of up to 70%. Dynamic balance improved in all 3 patients who completed the protocol. QOL data from 5 patients showed improvement in all cases. No adverse effects were noted. Gabapentin may improve tremor, stability, and QOL in patients with OT, and symptomatic response correlated with a reduction in tremor amplitude and postural sway. The findings confirm previous reports of symptomatic benefit with gabapentin and provide justification for larger controlled clinical trials. Further work is required to establish the optimal dosage and to validate the methods used to quantify the response to treatment. 相似文献
123.
Harris D 《Postgraduate medical journal》2007,83(982):525-528
Delirium in advanced disease, while common, is often not recognised or poorly treated. The aim of management of delirium is to assess and treat reversible causes in combination with environmental, psychological and pharmacological intervention to control symptoms. Delirium presents significant distress and impedes communication between patients and their families at the end of life. A structured approach to recognise, assess and manage delirium is essential for all clinicians caring for patients with terminal illness. 相似文献
124.
Jinhan Xie MPharm PhD Amit Kumar PhD M. Emmy M. Dolman PhD Chelsea Mayoh BSc Dong-Anh Khuong-Quang MD PhD Roxanne Cadiz BSc Marie Wong-Erasmus PhD Emily V. A. Mould PhD Dylan Grebert-Wade BSc Paulette Barahona PhD Alvin Kamili BMedSc PhD Maria Tsoli PhD Timothy W. Failes PhD Shu-Oi Chow BSc Greg M. Arndt BSc PhD Kanika Bhatia MD Glenn M. Marshall AM MB BS MD FRACP David S. Ziegler MBBS BSc FRACP MD Michelle Haber AM PhD Hon DSc FAHMS Richard B. Lock BSc PhD Vanessa Tyrrell BAppSc MHGSA FHGSA MBA CSA ARCPA Loretta Lau MBBS MMed PhD FRACP Penny Athanasatos BAppSc CT CF Andrew J. Gifford BSc Hons PhD MBBS FRCPA 《Cancer cytopathology》2021,129(10):805-818
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127.
Diane MacKenzie Gail Creaser Kim Sponagle Gordon Gubitz Peter MacDougall Dylan Blacquiere 《Journal of interprofessional care》2017,31(6):793-796
Interprofessional practice (IPP) is the accepted standard of care for clients following a stroke. A brief, embedded and evidence-based IPP team simulation was designed to address stroke care knowledge and IPP competencies for students within limited curriculum space. Each team was required to construct a collaborative care plan for their patient during the simulation and submit the care plan for evaluation of best practice stroke care knowledge and implementation with evidence of interprofessional collaboration (IPC). A total of 302 students (274 on-site, 28 by distance technology) representing four professions comprised of 55 teams took part in this experience. Post-simulation, voluntary and anonymous programme evaluations were completed using the standardised interprofessional collaborative competency assessment scale (ICCAS) and open-ended free-text responses to five questions. There was a significant improvement for all pre–post ratings on the ICCAS regardless of profession or previous interprofessional experience. Additionally, the open-ended responses indicated perceived changes to role clarification, communication, and teamwork. The combined interpretation of the programme evaluation results supports interprofessional team simulation as an effective and efficient learning experience for students regardless of previous interprofessional experience, and demonstrated positive changes in stroke best-practice knowledge and IPC competencies. 相似文献
128.
Chiou CF Weisman M Sherbourne CD Reyes C Dylan M Ofman J Wallace DJ Mizutani W Suarez-Almazor ME 《The Journal of rheumatology》2005,32(12):2326-2329
OBJECTIVE: To estimate weights for health states comprising American College of Rheumatology (ACR) response and different levels of adverse events associated with rheumatoid arthritis (RA) treatments. METHODS: A survey was mailed to 748 patients with RA from southern California. In addition to several questionnaires commonly used for patients with RA, patients were instructed to evaluate 10 hypothetical health states, in which they could have an ACR response and/or adverse events due to new treatments, with a visual analog scale (VAS). Patients also evaluated their current health with a VAS question and a time tradeoff (TTO) question. Linear extrapolation was used to derive 6 more health states. The Pearson correlation coefficient was used to validate VAS and TTO results. RESULTS: A total of 487 (65%) patients returned the survey. Among the 10 health states evaluated with VAS directly, the health state in which a patient has ACR70 with no adverse events had the highest VAS weight (0.84), followed by the one having an ACR50 response with no adverse events (0.80). Correlation coefficients ranged from 0.63 for the correlation between VAS and physical component summary to -0.18 between TTO and pain and tender joint count; the correlation coefficients were all statistically significant, indicating there was convergent validity of the VAS and that VAS functioned differently from TTO in how it measured weights. CONCLUSION: VAS weights for 16 ACR response health states of patients with RA were derived. These weights could be used for cost-utility analyses of interventions for patients with RA. 相似文献
129.
Yasmi O. Crystal Malvin N. Janal Dylan S. Hamilton Richard Niederman 《Journal of the American Dental Association (1939)》2017,148(7):510-518.e4
Background
The caries arrest that can be achieved by using silver diamine fluoride (SDF) offers a minimally invasive and inexpensive alternative to traditional restorative caries treatment. The authors evaluated how the dentinal staining that is associated with SDF influences the acceptance of this treatment among parents of young children in the New York City metropolitan area.Methods
The authors invited the parents of children who had experienced dental caries and who had appointments at the New York University Pediatric Dentistry Clinic and at several private clinics in New Jersey to participate in a Web-based survey designed to assess parents’ demographics, perceptions of photographs of SDF-treated carious teeth, and acceptability of treatment in different behavior management scenarios.Results
Ninety-eight mothers and 22 fathers from diverse backgrounds participated. Most parents (67.5%) judged SDF staining on the posterior teeth to be esthetically tolerable, but only 29.7% of parents made this same judgment about anterior teeth (P < .001). In the absence of their child having behavioral barriers to conventional restorations, 53.6% of parents reported that they were likely to choose SDF to treat their child’s posterior teeth, but only 26.9% of parents were likely to choose SDF to treat their child’s anterior teeth. As the number of children’s behavioral barriers increased, so did the parents’ level of acceptance. In extreme cases, in which parents had to decide whether their children should undergo general anesthesia during treatment, parents’ acceptance rate of SDF as a treatment method increased to 68.5% on posterior teeth and to 60.3% on anterior teeth. Parents’ acceptance of the treatment also varied according to their socioeconomic status.Conclusions
Staining on posterior teeth was more acceptable than staining on anterior teeth. Although staining on anterior teeth was undesirable, most parents preferred this option to advanced behavioral techniques such as sedation or general anesthesia.Practical Implications
Clinicians need to understand parental sensitivities regarding the staining effect of SDF to plan adequately for the use of SDF as a method of caries management in pediatric patients. 相似文献130.
Deirdre L Church Anshula Ambasta Amanda Wilmer Holly Williscroft Gordon Ritchie Dylan R Pillai Sylvie Champagne Daniel G Gregson 《The Canadian Journal of Infectious Diseases & Medical Microbiology》2015,26(5):263-267
BACKGROUND:Pneumocystis jirovecii (PJ), a pathogenic fungus, causes severe interstitial Pneumocystis pneumonia (PCP) among immunocompromised patients. A laboratory-developed real-time polyermase chain reaction (PCR) assay was validated for PJ detection to improve diagnosis of PCP.METHODS:Forty stored bronchoalveolar lavage (BAL) samples (20 known PJ positive [PJ+] and 20 known PJ negative [PJ−]) were initially tested using the molecular assay. Ninety-two sequentially collected BAL samples were then analyzed using an immunofluorescence assay (IFA) and secondarily tested using the PJ real-time PCR assay. Discrepant results were resolved by retesting BAL samples using another real-time PCR assay with a different target. PJ real-time PCR assay performance was compared with the existing gold standard (ie, IFA) and a modified gold standard, in which a true positive was defined as a sample that tested positive in two of three methods in a patient suspected to have PCP.RESULTS:Ninety of 132 (68%) BAL fluid samples were collected from immunocompromised patients. Thirteen of 92 (14%) BALs collected were PJ+ when tested using IFA. A total of 40 BAL samples were PJ+ in the present study including: all IFA positive samples (n=13); all referred PJ+ BAL samples (n=20); and seven additional BAL samples that were IFA negative, but positive using the modified gold standard. Compared with IFA, the PJ real-time PCR had sensitivity, specificity, and positive and negative predictive values of 100%, 91%, 65% and 100%, respectively. Compared with the modified gold standard, PJ real-time PCR had a sensitivity, specificity, and positive and negative predictive values of 100%.CONCLUSION:PJ real-time PCR improved detection of PJ in immunocompromised patients. 相似文献