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101.
Ronald B. Stewart Ronald G. Marks Phillip D. Padgett William E. Hale 《Pharmacoepidemiology and drug safety》1994,3(1):23-29
The objective of the work was to identify changes in antidepressant drug use and determine if the prevalence of antidepressant use has changed over 14 years. A longitudinal analysis comparing antidepressant drug use at 14 yearly intervals from 1978–79 to 1991–92 was undertaken using the longitudinal health screening program of ambulatory elderly participants (Florida Geriatric Research Program). Participants included all subjects screened in the Florida Geriatric Research Program from 1 August 1978 to 31 July 1992. The outcome measures were self-reported antidepressant drug use. Approximately 3.0 per cent (range of 2.3 to 3.2 per cent over 14 yearly intervals) of participants in this program reported the use of an antidepressant drug. There was no statistically significant change in antidepressant use between 1978–79 and 1991–92 (p > 0.6630). Across all study intervals women reported more frequent use of antidepressant drugs than men. In 1991–92, amitriptyline and imipramine represented over 50 per cent of all antidepressant drug use in this elderly population. Less than 6 per cent of all antidepressant drug use was for fluoxetine, the newest selective serotonin uptake inhibitor. The majority of elderly patients are receiving older tertiary amine tricyclic antidepressants such as amitriptyline, imipramine and doxepin that are not the preferred drugs for the elderly. Educational programs are needed to improve antidepressant prescribing for geriatric patients. 相似文献
102.
Cardiac conduction abnormalities and rhythm changes after neonatal anatomical correction of transposition of the great arteries.
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S Menahem M S Ranjit C Stewart W J Brawn R B Mee J L Wilkinson 《Heart (British Cardiac Society)》1992,67(3):246-249
Seventy three infants who underwent neonatal anatomical correction for transposition of the great arteries with or without a ventricular septal defect were reviewed for evidence of conduction and rhythm abnormalities on preoperative and postoperative 12 lead electrocardiograms and during 24 hour Holter monitoring. There was a partial right bundle branch block pattern in 47% (29/62) of all patients and in 60% (24/40) of those with simple transposition. Complete right bundle branch block was noted in 21% including 5% with simple transposition. Holter monitoring showed sinus rhythm in all patients except three: one had episodes of supraventricular tachycardia, another an intermittent second degree heart block, and a third a complete heart block. Atrial extrasystoles were noted in 47% (29/62) of patients but were frequent in only three patients. Occasional unifocal ventricular extrasystoles were encountered in 37% (23/62) of patients and were frequent in a further 3% (2/62). Only one patient (2%) developed multifocal ventricular extrasystoles. The frequency of important cardiac arrhythmias after neonatal anatomical correction of transposition of the great arteries was 5%, significantly less than that reported after atrial inflow diversion for the same malformation. 相似文献
103.
104.
Lygia Stewart J. McLeod Griffiss Gary A. Jarvis Lawrence W. Way 《Journal of gastrointestinal surgery》2007,11(8):977-984
Objective Gallstone bacteria provide a reservoir for biliary infections. Slime production facilitates adherence, whereas β-glucuronidase
and phospholipase generate colonization surface. These factors facilitate gallstone formation, but their influence on infection
severity is unknown.
Methods Two hundred ninety-two patients were studied. Gallstones, bile, and blood (as applicable) were cultured. Bacteria were tested
for β-glucuronidase/phospholipase production and quantitative slime production. Infection severity was correlated with bacterial
factors.
Results Bacteria were present in 43% of cases, 13% with bacteremia. Severe infections correlated directly with β-glucuronidase/phospholipase
(55% with vs 13% without, P < 0.0001), but inversely with slime production (55 vs 8%, slime <75 or >75, P = 0.008). Low slime production and β-glucuronidase/phospholipase production were additive: Severe infections were present
in 76% with both, but 10% with either or none (P < 0.0001). β-Glucuronidase/phospholipase production facilitated bactibilia (86% with vs 62% without, P = 0.03). Slime production was 19 (±8) vs 50 (±10) for bacteria that did or did not cause bacteremia (P = 0.004). No bacteria with slime >75 demonstrated bacteremia.
Conclusions Bacteria-laden gallstones are biofilms whose characteristics influence illness severity. Factors creating colonization surface
(β-glucuronidase/phospholipase) facilitated bacteremia and severe infections; but abundant slime production, while facilitating
colonization, inhibited detachment and cholangiovenous reflux. This shows how properties of the gallstone biofilm determine
the severity of the associated illness.
Presented at the annual meeting of the Society for Surgery of the Alimentary Tract, held May 20–24, 2006 in Los Angeles, California. 相似文献
105.
106.
107.
Screening for osteoporotic vertebral fractures traditionally involves X-ray of the thoracic and lumbar spine. We evaluated use of dual energy X-ray technology in patients with osteoporosis. We found this technology useful in the clinic setting and it has advantages in that less radiation is delivered to the patient. 相似文献
108.
109.
Asai T.; McBeth C.; Stewart JIM.; Williams J.; Vaughan R. S.; Power I. 《British journal of anaesthesia》1997,78(1):28-33
We have investigated the effects of clonidine on gastric emptying of
liquids in 30 patients. In a double-blind, randomized design, clonidine 150
micrograms, morphine 10 mg or saline in 1 ml was given i.m. One hour later,
the patient drank a paracetamol solution (1.5 g in 50 ml water). Venous
blood samples were obtained every 15 min for 90 min thereafter. Plasma
paracetamol concentrations were measured using high- pressure liquid
chromatography and the area under the concentration- time curve was
calculated. The degree of sedation and complications were recorded. The
area under the curve for 0-60 min was significantly smaller in the morphine
group than in the saline group (P = 0.002; 95% confidence interval (CI) for
difference -1237 to -502 micrograms min ml- 1), whereas it was greater in
the clonidine group compared with the saline group, although this was not
significant (95% CI for difference - 423 to 1264 micrograms min ml-1).
Arterial pressure was significantly lower in the clonidine group compared
with the saline group. Both clonidine and morphine appeared to cause mild
sedation. We conclude that clonidine 150 micrograms i.m. does not delay
gastric emptying of liquids in a similar manner to morphine.
相似文献
110.
L E Davis K E Rarey J A Stewart L C McLaren 《The Annals of otology, rhinology, and laryngology》1987,96(4):380-383
Cytomegalovirus (CMV) was recovered from a 5-month-old infant with probable congenital infection. In life, no hearing impairment had been observed. Auditory brain stem evoked responses were bilaterally intact. At necropsy, both temporal bones were morphologically normal, as demonstrated by light and electron microscopy. Sensory hair cells of the organ of Corti appeared intact. Cytomegalovirus was recovered from a mixture of perilymph and endolymph, but not the brain, CSF, or vitreous humor. This appears to be the first report of an individual with an inner ear CMV infection in which neither structural nor functional alterations of the inner ear were apparent. This case also suggests that CMV can persist within the inner ear for prolonged periods following congenital infection. 相似文献