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121.
Zhao-Jin Chen Mamun Al-Mahtab Salimar Rahman Ngiap-Chuan Tan Nan Luo Bee-Choo Tai 《Quality of life research》2010,19(9):1343-1348
Purpose
Hepatitis B virus (HBV) is endemic in Bangladesh, and the quality of life (QoL) of these patients remains unknown as there is no instrument available in the native language. In this study, we translated the 56-item Hepatitis Quality of Life Questionnaire (HQLQ) into Bengali and evaluated its validity and reliability. 相似文献122.
Healthcare information systems (HISs) are often implemented to enhance the quality of care and the degree to which it is patient-centered,
as well as to improve the efficiency and safety of services. However, the outcomes of HIS implementations have not met expectations.
We set out to organize the knowledge gained in qualitative studies performed in association with HIS implementations and to
use this knowledge to outline an updated structure for implementation planning. A multi-disciplinary team performed the analyses
in order to cover as many aspects of the primary studies as possible. We found that merely implementing an HIS will not automatically
increase organizational efficiency. Strategic, tactical, and operational actions have to be taken into consideration, including
management involvement, integration in healthcare workflow, establishing compatibility between software and hardware and,
most importantly, user involvement, education and training. The results should be interpreted as a high-order scheme, and
not a predictive theory. 相似文献
123.
Ian F. Dunn Pankaj K. Agarwalla Alexander M. Papanastassiou William E. Butler Edward R. Smith 《Child's nervous system》2007,23(10):1191-1194
Objective Approximately 10% of patients with neurofibromatosis I (NFI) patients will have central nervous system (CNS) tumors. The most
common of these are hypothalamic–optic gliomas, followed by brainstem and cerebellar pilocytic astrocytomas. While isolated
pilocytic astrocytomas in NFI are well described, the appearance of multiple pilocytic astrocytomas in an individual patient
is less common. The most frequent combination in NFI patients with more than one pilocytic astrocytoma is optic tract/hypothalamic
and brainstem. Other combinations are exceedingly rare; multiple pilocytic astrocytomas have only been reported once in the
cerebral hemispheres in a patient with NFI. This report presents the first documented case, to our knowledge, of multiple
pilocytic astrocytomas in the cerebellum of a patient with NF1.
Methods Case report.
Conclusion The finding of multiple cerebellar pilocytic astrocytomas in a patient with NF1 is important because it expands the spectrum
of presentations for patients with NF1 and also highlights specific diagnostic and therapeutic challenges faced by the treating
physicians. The genetic and molecular basis of NF1 is reviewed. Strategies of diagnosis and treatment outlined here are relevant
to both patients with NF1 and all patients with multiple posterior fossa tumors. 相似文献
124.
Juli Busquets Jose Castellote Jaume Torras Juan Fabregat Emilio Ramos Laura Llado Antonio Rafecas Esmeralda de la Banda Juan Figueras 《Journal of gastrointestinal surgery》2007,11(4):458-463
Background Cold ischemia time and the presence of postoperative hepatic arterial thrombosis have been associated with biliary complications
(BC) after liver transplantation. An ABO-incompatible blood group has also been suggested as a factor for predisposal towards
BC. However, the influence of Rh nonidentity has not been studied previously.
Materials Three hundred fifty six liver transplants were performed from 1995 to 2000 at our hospital. BC incidence and risk factors
were studied in 345 patients.
Results Seventy patients (20%) presented BC after liver transplantation. Bile leakage (24/45%) and stenotic anastomosis (21/30%) were
the most frequent complications. Presence of BC in Rh-nonidentical graft–host cases (23/76, 30%) was higher than in Rh-identical
grafts (47/269, 17%) (P = 0.01). BC was also more frequent in grafts with arterial thrombosis (9/25, 36% vs 60/319, 19%; P = 0.03) and grafts with cold ischemia time longer than 430 min (26/174, 15% vs 44/171, 26%; P = 0.01). Multivariate logistic regression confirmed that Rh graft–host nonidentical blood groups [RR = 2(1.1–3.6); P = 0.02], arterial thrombosis [RR = 2.6(1.1–6.4); P = 0.02] and cold ischemia time longer than 430 min [RR = 1.8(1–3.2); P = 0.02] were risk factors for presenting BC.
Conclusion Liver transplantation using Rh graft–host nonidentical blood groups leads to a greater incidence of BC. 相似文献
125.
Association of Hypoalbuminemia on the First Postoperative Day and Complications Following Esophagectomy 总被引:1,自引:0,他引:1
Aoife M. Ryan Aine Hearty Ruth S. Prichard Aileen Cunningham Suzanne P. Rowley John V. Reynolds 《Journal of gastrointestinal surgery》2007,11(10):1355-1360
Objective Changes in serum albumin may reflect systemic immunoinflammation and hypermetabolism in response to insults such as trauma
and sepsis. Esophagectomy is associated with a major metabolic stress, and the aim of this study was to determine if the absolute
albumin level on the first postoperative day was of value in predicting in-hospital complications.
Methods A retrospective study of 200 patients undergoing esophagectomy for malignant disease at St. James Hospital between 1999 and
2005 was performed. Patients who had pre and postoperative (days 1, 3, and 7) serum albumin levels measured were included
in the study. Patients were subdivided into three postoperative albumin categories <20 g/l, 20–25 g/l, >25 g/l. Logistic regression
analysis was performed to calculate the odds of morbidity and mortality according to the day 1 albumin level.
Results Patients with an albumin of less than 20 g/l on the first postoperative day were twice as likely to develop postoperative
complications than those with an albumin of greater than 20 g/l (54 vs 28% respectively, p < 0.011). Correspondingly, these patients also had a significantly higher rate of Adult Respiratory Distress Syndrome (22
vs 5%, p < 0.001), respiratory failure (27 vs 8%, p < 0.01) and in-hospital mortality (27 vs 6% (p < 0.001). On multivariate logistic regression analysis, day 1 albumin level was independently related to postoperative complications
(odds ratios, 0.89: 95%; confidence intervals, 0.83–0.96; p < 0.005). In addition, albumin <20 g/l on the first postoperative day was associated with the need for further surgery and
a return to ICU.
Conclusion Serum albumin concentration on the first postoperative day is a better predictor of surgical outcome than many other preoperative
risk factors. It is a low cost test that may be used as a prognostic tool to detect the risk of adverse surgical outcomes. 相似文献
126.
127.
Factors affecting aseptic loosening of 4750 total hip arthroplasties: multivariate survival analysis
Barbara Bordini Susanna Stea Manuela De Clerico Sergio Strazzari Antonio Sasdelli Aldo Toni 《BMC musculoskeletal disorders》2007,8(1):69
Background
Total hip arthroplasty is a successful surgery, that fails at a rate of approximately 10% at ten years from surgery. Causes for failure are mainly aseptic loosening of one or both components partially due to wear of articular surfaces and partially to design. The present analysis aimed to identify risk factors and quantify their effects on aseptic failure. 相似文献128.
目的观察低、中、高浓度臭氧注入猪正常椎间盘后不同时间段髓核组织的变化,探索既高效又安全的臭氧浓度,为临床注射臭氧治疗腰椎间盘突出症提供实验依据。方法小型猪10只,于透视下用21G Chiba针刺入猪腰椎间盘中心部,经穿刺针注入臭氧3 ml,重复3次,在椎间孔处注入5 ml于椎旁组织内。其中L5~6,L4~5,L3~4和L2~3分别注入臭氧浓度为90μg/ml,60μg/ml,30μg/ml及无菌空气,L6~S1不进行任何干预,为空白对照。分别在注射后1天、1周、1个月、2个月和3个月后处死动物各2只,在相同时间点进行CT及MR检查。处死后取出椎间盘及椎旁肌肉标本,作大体和光镜下观察,对髓核氧化及退变程度进行量化评分。结果术后3个月内髓核氧化及退变程度评分随时间推移逐渐增高,臭氧浓度越高,增高趋势越明显。术后MRI随访1个月时高浓度组髓核信号T2加权开始减低,其他组不明显。术后2个月注射组所有椎间盘信号均减低,臭氧浓度越高,信号减低越明显。光镜下1天出现髄核细胞的肿胀变性,1周髄核细胞出现与注射浓度正相关的体积缩小和基质含量减少,此后胶原纤维增生,逐渐取代髄核组织,在3个月时,高浓度组髄核干涸的程度,继发纤维化均较中、低浓度组高,并且出现相邻椎体骨性融合。中、高浓度椎旁肌肉注射1周时出现肌纤维肿胀变性及间质黏液变性。结论臭氧浓度越高,髄核的干涸效果越明显,椎间盘退行性变也越明显。高浓度臭氧盘内注射,3个月后椎间盘退变严重,不宜进行临床应用,椎旁肌肉内不宜注射中、高浓度臭氧。 相似文献
129.
F. Specchiulli R. Gabrieli D. Borsetti V. Di Carlo 《Journal of orthopaedics and traumatology》2007,8(3):123-127
We examined the clinical and radiographic results of 93 patients affected by knee arthritis or osteonecrosis subjected to
unilateral cementless mobile-bearing total knee arthroplasty with the LCS prothesis (Depuy/Johnson & Johnson). The mean follow-up
was 9.5 years (range, 7–12 years). Clinical evaluation was performed using the Knee Society rating system, while radiographic
evaluation was done according to the Knee Society roentgenographic system. At the latest follow-up, the mean knee score was
87 points: the functional score improved from 40 to 90. Radiolucent lines were small and not progressive. The implant survival
at 12 years was 88%. Six knees (7%) required revision for implant-related problems. We conclude that the mobile-bearing prosthesis
is a successful device even at long-term follow-up. 相似文献
130.
Michael T Fitch David E Manthey Henderson D McGinnis Bret A Nicks Manoj Pariyadath 《BMC medical education》2008,8(1):38