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排序方式: 共有1172条查询结果,搜索用时 15 毫秒
101.
The provision of renal replacement therapy for adults in England and Wales: recent trends and future directions 总被引:1,自引:7,他引:1
Roderick PJ; Ferris G; Feest TG 《QJM : monthly journal of the Association of Physicians》1998,91(8):581-587
We assessed the level of provision of renal replacement therapy for adults
in England and Wales. All autonomous main renal units in England (n = 52)
and Wales (n = 5) were surveyed in 1996. Data for England were compared to
the 1993 National Renal Review. The acceptance rate in England 1995 was 82
(80-85) per million population (p.m.p.) compared with 67 (65-70) p.m.p. in
1991-2. The rate in 1995 in Wales was 109 (98- 122) p.m.p. The prevalence
rate in England was 476 p.m.p. at end-1995 compared to 393 p.m.p. in 1993,
in Wales it was 487 p.m.p. The number of main renal units in England did
not rise between 1993 and 1995; capacity was increased by use of more
treatment shifts and temporary haemodialysis stations, and by opening more
satellite units. The main growth was in hospital haemodialysis. There was
an uneven geographical distribution of services. Patients accepted were
older with more comorbidity. The use of better-quality processes of
dialysis increased. The steady-state position for RRT will not be reached
for over a decade. Health authorities will face continued pressure to fund
increases in quantity and quality improvements. A stronger evidence base of
the effectiveness of therapies, and a national registry to monitor the
equity and cost-effectiveness of services are needed.
相似文献
102.
Cuello C; Palladinetti P; Tedla N; Di Girolamo N; Lloyd AR; McCluskey PJ; Wakefield D 《Rheumatology (Oxford, England)》1998,37(7):779-783
OBJECTIVE: To investigate the expression and source of chemokines in minor
salivary gland biopsies (MSGs) in patients with Sjogren's syndrome (SS).
METHODS: Immunohistochemical analysis was used to determine the pattern of
chemokine expression in MSGs from patients with (n=6) and without (n=5) SS,
as well as to examine the phenotype of both resident and infiltrating cells
expressing chemokines. RESULTS: Significant differences in the number of
infiltrating mononuclear (MN) cells in patients with and without SS were
noted. Ductal epithelial cells of SS biopsies expressed significantly
increased levels of macrophage inflammatory protein (MIP)-1alpha,
MIP-1beta, interleukin-8 (IL-8) and RANTES (Regulated upon Activation,
Normal T cell Expressed and Secreted). Biopsies from patients with SS
showed that MIP-1beta was expressed by 51% of infiltrating cells, while 41%
expressed MIP-1alpha, whereas 22 and 7% expressed RANTES and IL-8,
respectively. CONCLUSION: Chemokines expressed by ductal epithelial cells
may attract circulating leucocytes, in particular CD4+ T cells, towards the
site of inflammation, thereby orchestrating the influx of MN cells
characteristically seen in MSGs in SS. Chemokines may be induced directly
by a putative triggering agent for SS, or secondary to the release of
pro-inflammatory cytokines produced by epithelial cells. These findings
further implicate epithelial cells as playing a major role in the
pathogenesis of SS and implicate chemokines in the leucocyte recruitment in
this setting.
相似文献
103.
We report the successful long-term engraftment of normal male donor bone marrow (BM) transfused into noncytoablated female mice, challenging the assumption that "niches" need to be created for marrow to engraft. We have used chromosomal banding and Southern blot analysis to identify transplanted male marrow cells, and shown the long-term stability of the chimeric marrows. Balb/C, BDF1, or CBA-J female hosts (no irradiation) received for 5 consecutive days 40 x 10(6) male cells (per day) of the same strain, and repopulation patterns were observed. Parallel studies were performed using tibia/femur equivalents of normal marrow or marrow from Balb/C mice pretreated 6 days previously with 150 mg/kg 5-fluorouracil (5-FU). Chromosome banding techniques showed that 5% to 46% of marrow cells were male 3 to 9 months posttransplant with normal donor marrow. Southern blot analysis, using the pY2 probe, showed continued engraftment at 21 to 25 months posttransplant, ranging from 15% to 42% male engrafted cells in marrow. Normal donor male marrow engrafted significantly better than 5-FU-pretreated male marrow as shown 1 to 12 months posttransplant in non-cytoablated female recipients. Percentages of male engrafted cells in BM ranged from 23% to 78% for recipients of normal donor marrow and from 0.1% to 39% for recipients of 5-FU marrow. Mean engraftment for 6 mice receiving normal marrow was 38%, whereas that for 6 mice receiving post-5-FU marrow was 8%, as assayed 1 to 3 months posttransplant. At 10 to 12 months, mean engraftment for the normal donor group was 46%, compared with 16% for the 5-FU group. The patterns of engraftment with normal and 5-FU marrow were similar for spleen and thymus. These results show that long-term chimerism can be established after transplantation of normal donor marrow to normal nonirradiated host mice and indicate that marrow spaces do not have to be created for successful engraftment. They suggest that transplanted marrow competes equally with host marrow for marrow space. Finally, these data show that post-5-FU Balb/C male marrow is markedly inferior in the repopulation of Balb/C female host marrow, spleen, and thymus, and suggest that this population of cells may not be the ideal population for gene transfer studies. 相似文献
104.
Little is known of the influence race has on the development of leg ulceration, with most studies being performed in almost exclusively white populations. As part of a wider audit of leg ulcer services, health care professionals were contacted to give details of age, sex and ethnic background of all patients who attended for treatment of leg ulceration over a one year period in an area of west London. West London Health Care Trust provides services to a population of 275000 of whom 53000 have an ethnic background from the Indian subcontinent (South Asian).In all, 280 patients were identified, of whom 264 (94%) had details of age and sex. This gave a crude ascertainment rate of 1.02 per 1000 population. Of the 264 patients, five were classified as South Asians, with one patient classified as Afro-caribbean. The Mantel Haenzsel test demonstrated a significantly higher proportion of whites suffering from leg ulceration than South Asians, giving an odds ratio of 4.43, with 95% confidence intervals between 1.94 and 10.13 (P=0.0004). The expected frequency of South Asian patients should be 23, based on rates from the white population, of which 13 would be women and 10 men. Only five South Asian men were identified, and no Asian women with leg ulceration.Reasons for this low ascertainment are two-fold. Either there is a real difference between the white and South Asian populations, or South Asian patients are not presenting for treatment. Further work must be performed to determine whether this is an effect of low prevalence, or unmet need in the community. 相似文献
105.
106.
107.
Gerald Cohen Griet Glorieux Paul Thornalley Eva Schepers Natalie Meert Joachim Jankowski Vera Jankowski Angel Argiles Bj?rn Anderstam Philippe Brunet Claire Cerini Laetitia Dou Reinhold Deppisch Bart Marescau Ziad Massy Alessandra Perna Jana Raupachova Mariano Rodriguez Bernd Stegmayr Raymond Vanholder Walter H H?rl 《Nephrology, dialysis, transplantation》2007,22(12):3381-3390
108.
Blakeborough A; Ward J; Wilson D; Griffiths M; Kajiya Y; Guthrie JA; Robinson PJ 《Radiology》1997,203(3):759
109.
JC Sutton PhD PJ Standen PhD WA Wallace FRCS 《International journal of clinical practice》1994,48(2):63-66
SUMMARY Many previous studies of reported patient accidents in hospital used the accident report forms as the only data source, without questioning their reliability and despite 80% of the accidents being unwitnessed. This paper reports on three studies using data from patient interviews, staff questionnaires, medical and nursing notes and the accident report forms. The studies confirm that falls amongst elderly patients are the most common type of patient accident. However, patients' and staff's versions of the event often differed widely. Accident reports are stated to be required for legal purposes, but they were often incomplete and unreliable. Patient accidents and safety are too important to remain marginalised to mere compliance with out-of-date regulations. A new, ‘slim-line‘, more accurate but less time-consuming patient accident reporting system should be developed, for which improvement in patient safety is the main aim and legal considerations the secondary aim. 相似文献
110.
Trabecular bone architecture in female renal allograft recipients-- assessed by computed tomography 总被引:1,自引:0,他引:1
Grotz WH; Mundinger FA; Muller CB; Rasenack J; Schulte-Monting J; Langer MF; Schollmeyer PJ 《Nephrology, dialysis, transplantation》1997,12(3):564-569
BACKGROUND: Osteopenia with decreased bone mineral density (BMD) is a
frequent finding in renal allograft recipients. Data concerning the bone
architecture in these patients do not exist, however. METHODS: We compared
the bone architecture of 33 randomly assigned women (age 49 +/- 12 years),
who had received renal allografts 5.6 +/- 5.3 years before the
investigation, with 74 women (age 50 +/- 14 years) who were admitted for
osteodensitometry. All patients underwent single-energy computed tomography
(SEQCT) and a midvertebral high-resolution tomography with
computer-assisted analysis of the trabecular vertebral body architecture.
RESULTS: Progressive alteration of bone architecture was associated with
increasing vertebral height loss of the vertebral body. Height reduction of
a vertebral body of more than 15% was associated with a significantly lower
BMD (-2.3 +/- 0.8 versus -1.1 +/- 1.1 standard deviations below normal
BMD), a lower trabecular bone area (13 +/- 8% versus 42 +/- 22%) and a
lower trabecular diameter (1.4 +/- 0.5 mm versus 2.2 +/- 0.8 mm) compared
to recipients without height reduction. In comparison to a matched group of
patients with similarly reduced BMD (1.1 +/- 1.2 versus 1.2 +/- 1.1 SD
below normal BMD), renal allograft recipients showed a lower number of
trabecular plates (5.6 +/- 3.1 versus 7.0 +/- 3.7) and a smaller
intertrabecular surface (54 +/- 116 mm versus 75 +/- 138 mm). CONCLUSIONS:
Alterations of bone architecture in renal allograft recipients were
associated with progressive vertebral height loss. Despite similar bone
mineral density, differences of bone architecture could be observed between
renal allograft recipients and patients with osteoporosis.
相似文献