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91.
92.
Ji Su Jang Yeon‐Hee Lee Hemant K. Kandahar Suman K. Shrestha Jae Sung Lee Jin‐Koo Lee Seung Jae Park Na Rea Lee Jae Jun Lee Sang‐Soo Lee 《Brazilian Journal of Anesthesiology》2018,68(6):558-563
Background and objectives
An ultrasound guided femoral nerve block is an established analgesic method in patients with a hip fracture. Elevated cytokine levels correlate with poor patient outcomes after surgery. Hence, the aim of the study was to describe the levels of tumor necrosis factor‐α after an ultrasound‐guided femoral nerve block in elderly patients having a femoral neck fracture.Methods
A total of 32 patients were allocated into two treatment groups: 16 patients (femoral nerve block group; ultrasound‐guided femoral nerve block with up to 20 mL of 0.3 mL.kg?1 of 0.5% bupivacaine and intravenous tramadol) and 16 patients (standard management group; up to 3 mL of 0.9% saline in the femoral sheath and intravenous tramadol). Tumor necrosis factor‐α and visual analogue scale scores were evaluated immediately before the femoral nerve block and again at 4, 24, and 48 h after the femoral nerve block. All surgery was performed electively after 48 h of femoral nerve block.Results
The femoral nerve block group had a significantly lower mean tumor necrosis factor‐α level at 24 (4.60 vs. 8.14, p < 0.001) and 48 h (5.05 vs. 8.56, p < 0.001) after the femoral nerve block, compared to the standard management group. The femoral nerve block group showed a significantly lower mean visual analogue scale score at 4 (3.63 vs. 7.06, p < 0.001) and 24 h (4.50 vs. 5.75, p < 0.001) after the femoral nerve block, compared to the standard management group.Conclusions
Ultrasound‐guided femoral nerve block using 0.3 mL.kg?1 of 0.5% bupivacaine up to a maximum of 20 mL resulted in a significant lower tumor necrosis factor‐α level. 相似文献93.
94.
Deborah Schofield Rupendra N. Shrestha Melanie J. B. Zeppel Michelle M. Cunich Robert Tanton Jacob Lennert Veerman Simon J. Kelly Megan E. Passey 《Health & social care in the community》2019,27(2):493-501
We estimated the economic costs of informal care in the community from 2015 to 2030, using an Australian microsimulation model, Care&WorkMOD. The model was based on data from three Surveys of Disability, Ageing, and Carers (SDACs) for the Australian population aged 15–64 years old. Estimated national income lost was AU$3.58 billion in 2015, increasing to $5.33 billion in 2030 (49% increase). Lost tax payments were estimated at AU$0.99 billion in 2015, increasing to AU$1.44 billion in 2030 (45% increase), and additional welfare payments were expected to rise from $1.45 billion in 2015 to AU$1.94 in 2030 (34% increase). There are substantial economic costs both to informal carers and the government due to carers being out of the labour‐force to provide informal care for people with chronic diseases. Health and social policies supporting carers to remain in the labour force may allow governments to make substantial savings, while improving the economic situation of carers. 相似文献
95.
Sadeep Shrestha Staci L Sudenga Jennifer S Smith Laura H Bachmann Craig M Wilson Mirjam C Kempf 《BMC infectious diseases》2010,10(1):295
Background
The implementation of highly active antiretroviral therapy (HAART) among HIV-positive patients results in immune reconstitution, slower progression of HIV disease, and a decrease in the occurrence of opportunistic infections. However, the impact of HAART on cervical human papillomavirus (HPV) infection, clearance, and persistence in high-risk adolescents remains controversial. 相似文献96.
97.
Aim: Hepatic vena cava disease is a primary obliterative disease of the hepatic portion of the inferior vena cava (IVC) that often causes liver cirrhosis and hepatocellular carcinoma. Its geographic prevalence is inversely related to the standard of community hygiene. The disease is endemic in Nepal and is commonly associated with bacterial infection. The cause of the disease is not known. It was previously thought to be congenital. Thrombosis due to hypercoagulable condition is suggested as a possible cause of the disease. This study looks at the relation of the disease to bacterial infection. Methods: Ultrasonography is sensitive and specific for the diagnosis of acute and chronic lesions of hepatic vena cava disease. Patients attending the Liver Clinic with pyrexia with and without bacteremia were examined by ultrasonography for acute "thrombophlebitic" lesion of the IVC, and five patients with bacterial infection with acute lesion in the hepatic portion of the IVC were followed. Results: Sixty eight percent of the patients with bacteremia had ultrasonographic evidence of acute lesion in the hepatic portion of the IVC, compared to 18% patients without bacteremia. A follow-up study of five patients showed transformation of the acute lesion into chronic obliterative lesion - stenosis or complete obstruction. Conclusion: Bacterial infection is probably the cause of hepatic vena cava disease seen in developing countries. 相似文献
98.
Guo B Documet J Lee J Liu B King N Shrestha R Wang K Huang HK Grant EG 《Academic radiology》2007,14(3):270-278
RATIONALE AND OBJECTIVES: Most health care facilities currently struggle with protecting medical data privacy, misidentification of patients, and long patient waiting times. This article demonstrates a novel system for a clinical environment using wireless tracking and facial biometric technologies to automatically monitor and identify staff and patients to address these problems. MATERIALS AND METHODS: The design of the location tracking and verification system (LTVS) was based on a workflow study which was performed to observe the physical location and movement of patient and staff at the Healthcare Consultation Center II (HCC II) running hospital information systems, radiology information systems, picture archive and communication systems, and a voice recognition system. Based on the results from this workflow study, the LTVS was designed using a wireless real-time location system and a facial biometric system integrated with the radiology information system. The LTVS was tested for its functionality in a laboratory environment, then evaluated at HCC II. RESULTS: Experimental results in the laboratory and clinical environments demonstrated that patient and staff real-time location information and identity verification can be obtained from LTVS. Warning messages can immediately be sent to alert staff when patient's waiting time is over a predefined limit, and unauthorized access to a security area can be audited. Additionally, patient misidentification can be prevented during the course of examinations. CONCLUSIONS: The system enabled health care providers to streamline the patient workflow, protect against erroneous examinations and create a security zone to prevent, and audit unauthorized access to patient health care data required by the Health Insurance Portability and Accountability Act mandate. 相似文献
99.
A. Chakravorty N. SanmugalingamA. Shrestha E. ThomeeJ. Rusby N. RocheF. MacNeill 《European journal of surgical oncology》2011,37(2):122-126
Aims
Axillary nodal status is the most important prognostic indicator which in turn influences adjuvant therapy and long term outcomes. The aim of this study was to compare total nodal yields from primary axillary lymph node dissection (pALND) with completion ALND after a cancer positive SLNB: either concurrently (cALND) following intra-operative assessment (IOA) of the SLN’s or as a delayed procedure (dALND) when the SLN was found to be cancer positive on post-operative histological examination.Methods
All axillary procedures performed between May 2006 and September 2009 were identified from a prospective database and categorised into four groups: SLNB with no further axillary surgery, pALND, cALND and dALND. Total nodal yield was the sum of SLN/s and ALND yields.Results
Of 1025 axillary procedures, ALND accounted for 332 (32.4%) of which 207 (62.3%) underwent pALND, 43 (12.9%) cALND, and 82 (24.6%) dALND. Median nodal yields were 15.0, 16.0 and 14.5 respectively (p = 0.3).Conclusion
Total nodal yields for primary, concurrent and delayed ALND were comparable suggesting completion dALND performed as a second operation does not compromise axillary staging. 相似文献100.
Getts DR Terry RL Getts MT Müller M Rana S Shrestha B Radford J Van Rooijen N Campbell IL King NJ 《The Journal of experimental medicine》2008,205(10):2319-2337
In a lethal West Nile virus (WNV) model, central nervous system infection triggered a threefold increase in CD45(int)/CD11b(+)/CD11c(-) microglia at days 6-7 postinfection (p.i.). Few microglia were proliferating, suggesting that the increased numbers were derived from a migratory precursor cell. Depletion of "circulating" (Gr1(-)(Ly6C(lo))CX3CR1(+)) and "inflammatory" (Gr1(hi)/Ly6C(hi)/CCR2(+)) classical monocytes during infection abrogated the increase in microglia. C57BL/6 chimeras reconstituted with cFMS-enhanced green fluorescent protein (EGFP) bone marrow (BM) showed large numbers of peripherally derived (GFP(+)) microglia expressing GR1(+)(Ly6C(+)) at day 7 p.i., suggesting that the inflammatory monocyte is a microglial precursor. This was confirmed by adoptive transfer of labeled BM (Ly6C(hi)/CD115(+)) or circulating inflammatory monocytes that trafficked to the WNV-infected brain and expressed a microglial phenotype. CCL2 is a chemokine that is highly expressed during WNV infection and important in inflammatory monocyte trafficking. Neutralization of CCL2 not only reduced the number of GFP(+) microglia in the brain during WNV infection but prolonged the life of infected animals. Therefore, CCL2-dependent inflammatory monocyte migration is critical for increases in microglia during WNV infection and may also play a pathogenic role during WNV encephalitis. 相似文献