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101.
Cynthia J. Berg Jelka Zupan Philip J. d'Almada† Muin J. Khoury Lisa J. Fuller† ‡ 《Paediatric and perinatal epidemiology》1994,8(1):53-61
Summary. Very low birthweight (VLBW) is a commonly used endpoint in perinatal epidemiology, but the population of VLBW infants comprises a wide range of gestational ages and rates of fetal growth. We used data from a population-based study of all 1072 black and white VLBW liveborn infants born in 29 counties in Georgia between April 1986 and March 1988. Less than 1% of the VLBW infants were ≥ 37 weeks gestation; most were 29–32 weeks (26%) or 25 to 28 weeks (40%); 12% were 22 weeks or less. All infants 33 weeks gestation or greater were growth retarded. The population of VLBW infants seems to comprise three groups: approximately 11% very immature infants of 22 weeks or less; the majority of infants, born between 23 and 30 weeks, 90% of which are of normal weight for their gestational age; and a group of less premature, growth-retarded infants from 31 to 36 weeks. We found little or no difference in the distribution of gestational age or the percentage of intrauterine growth rates (IUGR) between black and white infants. In the USA the VLBW rate among black infants is over three times greater than that among white infants and consequently the rates of the three types of VLBW among black infants are likely to be triple those among white infants. 相似文献
102.
Verna W. Y. Yiu Robert P. Dluhy Richard P. Lifton Lisa M. Guay-Woodford 《Pediatric nephrology (Berlin, Germany)》1997,11(3):343-346
In evaluating hypertensive children and adolescents, the etiological considerations should include a set of inherited disorders
that share very low plasma renin activity (PRA) as a common feature. In particular among these disorders, glucocorticoid remediable
aldosteronism (GRA) appears to be emerging as an important etiology of hypertension in the pediatric population. We report
the evaluation of a 9-year-old Caucasian girl who presented with severe hypertension and a strong family history of early-onset
hypertension. Her suppressed PRA, her family history, and her failure to respond to conventional antihypertensive therapy
raised GRA as a potential etiology. The diagnosis was confirmed by an elevated ratio of urinary 18-oxotetrahydrocortisol to
urinary tetrahydroaldosterone and genetic testing, which demonstrated the chimeric gene duplication. The molecular pathogenesis
of GRA and the clinical implications are reviewed.
Received May 15, 1996; received in revised form and accepted September 16, 1996 相似文献
103.
S. Störkel 《Der Urologe. Ausg. A》2004,43(3):118-119
104.
105.
Pia Hovbrandt Agneta Ståhl Susanne Iwarsson Vibeke Horstmann Gunilla Carlsson 《European journal of ageing》2007,4(4):201-211
Due to decreased functional capacity as well as high environmental demands there is a risk of diminishing activity outside
home in very old age (age 80+). In order to explore differences according to functional limitations (FL) among very old people
with respect to frequency of activity, perceived health, overall perception of neighbourhood environment, and perceived problems
in the pedestrian environment, data derived from a postal questionnaire survey to very old people living in an urban area
in Sweden were used. This explorative study is based on the sub-sample of people aged 80+ who reported outdoor activities
(n = 97). Four groups of respondents with different types of FL were identified: with no FL (n = 23), with only movement-related FL (n = 26), with only perception/cognition-related FL (n = 16), and with both movement- and perception/ cognition-related FL (n = 32). The majority of the respondents reported rather high frequency of activity outside home. When examining differences
between the four groups, the analysis indicated how the complexity of FL and perceived problems in the pedestrian environment
impacted on their activity performance. Persons with both movement- and perception/cognition-related FL were less satisfied
with their frequency of activity, experienced their health more negatively and experienced more problems in the pedestrian
environment than in the other groups. The findings from this study indicate the importance of considering combinations of
FL in creating supportive environments for activity and health. 相似文献
106.
Dr. K. Hekmat Dr. A. Kröner Dr. H. Stützer Prof. Dr. R. H. G. Schwinger PD Dr. S. Kampe Prof. Dr. G. B. W. E. Bennink Prof. Dr. U. Mehlhorn 《Zeitschrift für Herz-, Thorax- und Gef??chirurgie》2004,18(6):257-267
Zusammenfassung
Einleitung:
Das Ziel dieser Studie war die Entwicklung eines spezifischen Schweregradklassifizierungssystems für die Beurteilung und Vorhersage von Organfunktionsstörungen und Überleben bei herzchirurgischen Intensivpatienten.
Methoden:
Hierzu wurden konsekutiv alle erwachsenen Patienten nach einem herzchirurgischen Eingriff unter Einsatz der Herzlungenmaschine über einen Zeitraum von 3 Jahren in die Studie aufgenommen. Im Konstruktionsset erfolgte die Auswahl der Variablen mit Hilfe der Patienten, die mindestens 24 Stunden auf der Intensivstation verbrachten. Die Ergebnisse wurden dann in zwei Validierungssets mit allen Intensivpatienten überprüft. Die Qualität des Scores wurde mit dem Hosmer-Lemeshow-Test (HL) sowie der ROC-Analyse beurteilt, und mit dem APACHE-II- und dem MODS-Score verglichen.
Ergebnisse:
Insgesamt wurden 3230 Patienten über einen Zeitraum von 3 Jahren auf unserer Intensivstation aufgenommen. Die HL-Werte für den neuen Score waren 5,8 (APACHE-II: 11,3; MODS: 9,7) für das Konstruktionsset, 7,2 (APACHE-II: 8,0; MODS: 4,5) für das Validierungsset I und 5,9 für das Validierungsset II. Die Fläche unter der ROC-Kurve war 0,91 (APACHE-II: 0,86; MODS: 0,84) für den neuen Score im Konstruktionsset, 0,88 (APACHE-II: 0,84; MODS: 0,84) in dem Validierungsset I, und 0,92 in dem Validierungsset II.
Schlussfolgerung:
Der neue CASUS (Cardiac Surgery Score) zeigt für herzchirurgische Intensivpatienten eine exzellente Kalibrierung und Diskriminierung bezüglich der 30-Tage-Letalität. Die Variablen des CASUS sind einfach, reproduzierbar und werden routinemäßig in herzchirurgischen Intensivstationen erfasst. Der CASUS könnte als Expertensystem für das Diagnostizieren von Organfunktionsstörungen, der Entscheidungsfindung, der Ressourcenauswertung und Vorhersage der Letalität für herzchirurgische Intensivpatienten dienen. 相似文献
107.
Anjali Shah Eric Eggenberger Robert Zivadinov Olaf Stüve Elliot M. Frohman 《Neurotherapeutics》2007,4(4):627-632
Physicians who treat multiple sclerosis (MS) face the challenge of patients exhibiting ongoing disease activity, including
exacerbations, loss of functional capabilities, intellectual decline, and radiologic progression, despite being on a disease-modifying
agent (DMA). After searching for factors that might at least in part explain these changes—such as nonadherent drug-taking
behavior, or the presence of interfer-on-neutralizing antibodies—some providers may ultimately decide to switch the patient
to another DMA. In most circumstances, patients likely derive only partial effects from these agents, even in the absence
of compromising factors. Thus, a number of factors must be considered in order to intensify the treatment regimen in response
to disease progression. In the context of an inadequate treatment response to a DMA, some clinicians will convert the patient
to an alternative therapy, and others will instead use a second agent in combination with the first (the so-called platform
agent). In the first of this two-part series, we explored the use of anti-inflammatory CS and ACTH to treat MS exacerbations.
Although we underscored the limited availability of evidence-based studies to support specific regimens for this purpose,
there is an even greater paucity of data to support the routine use of these agents in order to achieve chronic disease-modifying
effects in those who continue to deteriorate clinically, radiographically, or both. Without doubt, a number of factors influence
the formulation of combination treatment plan for MS. Nevertheless, we will focus on the rationale and practical schemes that
can be considered for using corticosteroids (CS) (and perhaps even ACTH) in an attempt to modify various domains of ongoing
disease activity. 相似文献
108.
109.
PD Dr. S. Ständer 《Der Hautarzt; Zeitschrift für Dermatologie, Venerologie, und verwandte Gebiete》2007,58(7):627-638
Chronic pruritus (starting from 6 weeks duration) is symptom of dermatological, internal, neurological or psychiatric disease. Identification and treatment of the underlying diseases is of great importance especially in the initial phase of chronic pruritus in order to prevent peripheral and central sensitization processes and thus chronification. Application of the redefined clinical classification, newly defined clinical algorithms and inquiry of clinical characteristics of pruritus is helpful in finding the underlying disease. In chronic pruritus existing for several years, clarifying the underlying origin is difficult and therapies are often ineffective. Next to conventional therapies such as antihistamines and corticosteroids, central effective substances can be applied preventing pruritus sensation on spinal or cerebral level. 相似文献
110.
Social problem solving as a moderating variable between negative life stress and depressive symptoms
Arthur M. Nezu Christine M. Nezu Lisa Saraydarian Kathleen Kalmar George F. Ronan 《Cognitive therapy and research》1986,10(5):489-498
The present study sought to investigate the moderating function that social problem-solving effectiveness serves in relation to negative stressful life events and depressive symptomatology. It was also hypothesized that knowledge of problem solving would improve upon the prediction of level of depressive symptoms beyond the assessment of stressful events. Results involving 462 undergraduate students provide support for both predictions. Specifically, findings from a multiple regression analysis indicated that (1) differences in reported depressive mood between subjects under high and low stress levels were minimal for individuals characterized as effective problem-solvers, relative to those persons with problem-solving scores reflective of ineffective problem solving; and (2) assessment of problem-solving scores and their interaction with stress level provided for an additional three times the amount of explained variance in predicting depression scores beyond life stress scores. Additionally, a cross-validation of the regression analysis was conducted and found to result in a minimal amount of shrinkage that could be due to samplespecific characteristics.We would like to extend our appreciation to two anonymous reviewers for their helpful comments on an earlier draft of this article. The study was supported in part by a grant funded by Fairleigh Dickinson University to the first author. 相似文献