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排序方式: 共有5980条查询结果,搜索用时 15 毫秒
61.
OBJECTIVE: The purpose of this retrospective study was to present 7 years of data from operations of currently active, chronic venous leg ulcers (CEAP: C6), focusing on the short- and long-term effects of healing and recurrence and considering concomitant risk factors. METHODS: Between January 1997 and March 2004, 173 patients (239 legs) with a currently active, chronic venous leg ulcer were surgically treated. The surgical procedures included two main steps: (1) the surgical interruption of reflux in the superficial and perforating veins to reduce venous hypertension in the entire leg and/or the affected area and (2) the surgical procedure involving the ulcer. A total of 123 patients (173 legs) who came to the follow-up were examined. The follow-up period ranged from 3 months to 7 years. The data collection integrated a preoperative examination that included medical history and clinical diagnoses and incorporated measurements such as body mass index, ankle-brachial pressure index, and the neutral position method at the follow-up. The function of the veins was measured with duplex ultrasonography. Finally, the data were analyzed by using various statistical methods, including Kaplan-Meier analysis, Cox regression analysis, and paired t tests. RESULTS: Initially, ulcer healing occurred in 87% of the cases (151 legs). A total of 13% (22 legs) of the venous ulcers never healed, and recurrent venous ulcers occurred in 5% (9 legs). The Kaplan-Meier analyses of ulcer healing showed a healing rate of 85% in 6 months for all legs. The mean time of healing was 1.5 months. Furthermore, the Kaplan-Meier analyses of ulcer recurrence showed a 1.7% rate of recurrence in 6 months for all legs. The 5-year ulcer recurrence rate was 4.6%. The mean time of recurrence was 70.4 months. CONCLUSIONS: On the basis of the results from the 7 years of data from functional surgery of venous leg ulcers and as a result of the outcomes of our study, we recommend surgical treatment of venous leg ulcers at any stage. We therefore conclude that surgery is indicated before an ulcer is intractable to treatment. In general, our findings are based on the understanding and identification of the causes and symptoms of venous ulceration and illustrate that standard surgical methods can be applied for the therapy of venous leg ulcers at any stage. 相似文献
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Health promotion (HP) amongst older people is an increasingly prominent policy concern for governments. The development of an evidence-base and the advocacy of effective interventions in the light of this act as legitimation tools for the overall HP phenomenon – assisting the growth of state and non-state funding for public health initiatives for older people. In structuring decision-making as to which individual projects/initiatives receive funding, frameworks for acknowledging efficacy impact on formats of HP work both positively and negatively. Drawing on recent research across the EU and focusing on the specific national contexts of Austria and England, this comparative policy analysis triangulates best-practice modelling, evaluation data and interviews with project coordinators to explore how policy contexts impact on the nature and format of HP interventions. Amidst a developing awareness of what effective practice looks like, successful HP initiatives must advocate their legitimacy within narrow rules of quality, where measurable outcomes have become the keys which unlock financial resources. Findings across both countries suggest that this instrumentalisation of legitimation, driven by economic pressures and bureaucratic generalisability, threatens the rationality of HP. From a Habermasian perspective, tensions emerge between projects’ remaining reflexive towards processes and their need to articulate the ‘success’ of the interventions in a language of outcomes. Over time, in an era where resources are increasingly scarce and competition over these intensifies, a danger exists whereby the instrumentality of HP begins to separate from, and impinge upon, the capacity for projects to think and act holistically. 相似文献
63.
Katharine Bray-French Katharina Hartman Guido Steiner Céline Marban-Doran Juliana Bessa Neil Campbell Meret Martin-Facklam Kay-Gunnar Stubenrauch Corinne Solier Thomas Singer Axel Ducret 《Journal of pharmaceutical sciences》2021,110(7):2575-2584
Biotherapeutics have revolutionized our ability to treat life-threatening diseases. Despite clinical success, the use of biotherapeutics has sometimes been limited by the immune response mounted against them in the form of anti-drug antibodies (ADAs). The multifactorial nature of immunogenicity has prevented a standardized approach for assessing this and each of the assessment methods developed so far does not exhibit high enough reliability to be used alone, due to limited predictiveness. This prompted the Roche Pharma Research and Early Development (pRED) Immunogenicity Working Group to establish an internal preclinical immunogenicity toolbox of in vitro/in vivo approaches and accompanying guidelines for a harmonized assessment and management of immunogenicity in early development. In this article, the complex factors influencing immunogenicity and their associated clinical ramifications are discussed to highlight the importance of an end-to-end approach conducted from lead optimization to clinical candidate selection. We then examine the impact of the resulting lead candidate categorization on the design and implementation of a multi-tiered ADA/immunogenicity assay strategy prior to phase I (entry into human) through early clinical development. Ultimately, the Immunogenicity Toolbox ensures that Roche pRED teams are equipped to address immunogenicity in a standardized manner, paving the way for lifesaving products with improved safety and efficacy. 相似文献
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65.
Michael Dörks Katharina Allers Falk Hoffmann 《Journal of the American Medical Directors Association》2019,20(3):287-293.e7
Objectives
In addition to routinely administered long-term medication, complex drug regimens of nursing home residents often include as needed or pro re nata (PRN) medication. However, there has been no systematic evaluation of the frequency and concomitants of PRN medication in nursing homes. The main objective of this systematic review was to provide a current assessment of PRN drug use in nursing homes.Design
A systematic literature search was performed. Data were identified from 4 electronic bibliographic databases: MEDLINE, Embase, CINAHL, and Scopus. Studies were included if they reported quantitative data on PRN drug use in nursing home residents.Results
Our search strategy resulted in 484 hits, of which 27 articles satisfied the inclusion criteria. The mean number of PRN drugs ranged between 0.4 and 4.9 per resident with a median of 2.5. The proportion of residents prescribed at least 1 PRN drug was between 48.4% and 97.4% (median = 74.9). Administration of prescribed PRN medication was rather low as the proportion of residents with administered PRN drugs ranged from 28% to 55%. Frequently prescribed PRN drugs were analgesics, laxatives, and sedatives. Advanced age, dementia, a higher number of regularly scheduled medications, and length of stay in the nursing home were associated with higher use of PRN drugs.Conclusions/Implications
Although not regularly administered, PRN drug use in nursing home residents should be taken into account as part of complex drug regimens. In that sense, there seems to be an inadequate number of studies reporting on it. When screening tools like the Beers Criteria are adapted, PRN drugs should be included. 相似文献66.
Philipp Stiefel Stefan Mauerhofer Jana Schneider Katharina Maniura-Weber Urs Rosenberg Qun Ren 《Antimicrobial agents and chemotherapy》2016,60(6):3647-3652
Efficient removal of biofilms from medical devices is a big challenge in health care to avoid hospital-acquired infections, especially from delicate devices like flexible endoscopes, which cannot be reprocessed using harsh chemicals or high temperatures. Therefore, milder solutions such as enzymatic cleaners have to be used, which need to be carefully developed to ensure efficacious performance. In vitro biofilm in a 96-well-plate system was used to select and optimize the formulation of novel enzymatic cleaners. Removal of the biofilm was quantified by crystal violet staining, while the disinfecting properties were evaluated by a BacTiter-Glo assay. The biofilm removal efficacy of the selected cleaner was further tested by using European standard (EN) for endoscope cleaning EN ISO 15883, and removal of artificial blood soil was investigated by treating TOSI (Test Object Surgical Instrument) cleaning indicators. Using the process described here, a novel enzymatic endoscope cleaner was developed, which removed 95% of Staphylococcus aureus and 90% of Pseudomonas aeruginosa biofilms in the 96-well plate system. With a >99% reduction of CFU and a >90% reduction of extracellular polymeric substances, this cleaner enabled subsequent complete disinfection and fulfilled acceptance criteria of EN ISO 15883. Furthermore, it efficiently removed blood soil and significantly outperformed comparable commercial products. The cleaning performance was stable even after storage of the cleaner for 6 months. It was demonstrated that incorporation of appropriate enzymes into the cleaner enhanced performance significantly. 相似文献
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68.
Kirsten van Gink Katharina Visser Arne Popma Robert R.J.M. Vermeiren Lieke van Domburgh Ber van der Stegen Lucres M.C. Jansen 《Archives of Psychiatric Nursing》2018,32(3):353-359
Staff members in residential care for youth are frequently confronted with aggressive behaviour, which has adverse effects on their stress levels and work satisfaction. This paper describes a qualitative evaluation to find out how staff members benefit from Non-violent Resistance (NVR), a method to create an aggression mitigating residential climate. Staff members were positive about NVR and reported feeling more relaxed. Most valued aspects of this method were the focus on being a team, delayed response and giving up the illusion of control. However, training and the intention to use NVR isn't enough, high quality implementation and maintenance are crucial. 相似文献
69.
How the human brain exchanges information across sensory modalities to recognize other people 下载免费PDF全文
Recognizing the identity of other individuals across different sensory modalities is critical for successful social interaction. In the human brain, face‐ and voice‐sensitive areas are separate, but structurally connected. What kind of information is exchanged between these specialized areas during cross‐modal recognition of other individuals is currently unclear. For faces, specific areas are sensitive to identity and to physical properties. It is an open question whether voices activate representations of face identity or physical facial properties in these areas. To address this question, we used functional magnetic resonance imaging in humans and a voice‐face priming design. In this design, familiar voices were followed by morphed faces that matched or mismatched with respect to identity or physical properties. The results showed that responses in face‐sensitive regions were modulated when face identity or physical properties did not match to the preceding voice. The strength of this mismatch signal depended on the level of certainty the participant had about the voice identity. This suggests that both identity and physical property information was provided by the voice to face areas. The activity and connectivity profiles differed between face‐sensitive areas: (i) the occipital face area seemed to receive information about both physical properties and identity, (ii) the fusiform face area seemed to receive identity, and (iii) the anterior temporal lobe seemed to receive predominantly identity information from the voice. We interpret these results within a prediction coding scheme in which both identity and physical property information is used across sensory modalities to recognize individuals. Hum Brain Mapp, 36:324–339, 2015. © 2014 Wiley Periodicals, Inc . 相似文献
70.