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81.
82.
Kee F; McDonald P; Kirwan JR; Patterson CC; Love AH 《QJM : monthly journal of the Association of Physicians》1997,90(11):669-676
To determine the factors that influenced doctors' prioritization and
decisions on safe waiting time for coronary artery bypass surgery, 50
'paper patients', based on a random sample of cases who actually had
surgery, were assessed by 33 clinicians. We used linear regression models
to reflect the impact of clinical and non-clinical 'cues' on safe waiting
time and priority decisions. The benefits of surgery tended to be
over-estimated. For example, the average perceived gain in life expectancy
for patients with left main-stem disease was 6.74 years. However, models
incorporating only the perceptions of benefit as independent variables
(i.e. the anticipated symptom reduction, MI risk reduction and life
expectancy extension), had only modest explanatory power (mean R2 was 0.55
for safe waiting time, and 0.56 for priority decisions). Models which
incorporated perceptions of benefit and the cases' clinical and
non-clinical characteristics had generally much higher explanatory power
(mean R2, 0.83 and 0.86, respectively). Lifestyle and demographic variables
had much less impact on the doctors' judgements than the major clinical
cues of angina severity and left main-stem stenosis. Demographic and
lifestyle cues had different impacts on safe waiting time and priority for
about 25% of doctors.
相似文献
83.
Although fractures of the clavicle are common, complications are rare. A 41 year old painter developed two uncommon complications of clavicular fracture, mechanical intermittent subclavian artery occlusion and subclavian vein thrombosis. Both conditions were clearly identified on the clinical symptoms and signs and confirmed with dynamic angiography and computerised tomography. Operative intervention led to complete resolution of symptoms. 相似文献
84.
目的:对坐式排球运动员进行腰背肌筋膜炎损伤检查与积极治疗,并制定有效措施预防腰背肌筋膜炎损伤的发生,以提高其成绩水平。方法:实验于2006-03/07于鲁东大学体育学院完成。①选取2006年参加山东省残疾人运动会的烟台队坐式排球运动员22名,男12名,女10名,平均年龄(27±2)岁。②对22名坐式排球运动员进行腰背肌筋膜炎损伤状况检查,病历需要详细注明受伤原因、腰背部肌肉筋膜的痛点及运动障碍、确定损伤性质是急性还是慢性、确定损伤位置、抗阻力实验是否为阳性。③检查完毕后,对存在腰背肌筋膜炎损伤的运动员采用日本温热式低周波治疗器 外敷中药治疗。温热式低周波治疗器主要选择拍打、推压、按摩、左右变换按揉,每次治疗时间为15min,温度控制在38~43℃,将(-)导子放在痛点部位,( )导子放在阿是穴、肾俞、命门、腰眼等相应的治疗穴位上。中药以散寒活血祛瘀止痛为主,将川乌头、天南星、生半夏、乳香、没药、独活、马钱子、红花等混合研成粉状,加入体积分数为0.75的乙醇搅拌成糊状,用沙布制成直径约15cm饼状态物,敷于患处,6~12d为1个疗程。④治疗结束后,对所有队员1年的训练过程制定预防腰背肌筋膜炎的有效措施,即训练中加强腰背部肌肉力量和伸展性;通过温热式低周波治疗器 推拿按摩促进腰背部肌肉筋膜的放松及疲劳恢复;训练中采用肌肉牵伸性练习,注意避免牵拉过度;建立急性运动损伤档案,尽量减少急性损伤转变为慢性损伤的可能性。结果:①腰背肌筋膜炎的患病率:烟台队22名坐式排球运动员中,10名存在腰背肌筋膜炎损伤,患病率45.5%,损伤部位集中在腰背部和颈部。②腰背肌筋膜炎损伤治疗结果:采用日本温热式低周波治疗器 外敷中药治疗一两个疗程后效果良好,10名腰背肌筋膜炎损伤运动员中9名痊愈,治愈率90%。③采取预防措施后运动员腰背肌筋膜炎的发生情况:训练中采取预防措施,1年后22名坐式排球运动员腰背肌筋膜炎损伤得到明显控制,腰背肌筋膜炎患病率为29.3%,与治疗预防前比较下降16.2%,效果显著。结论:坐式排球运动损伤部位集中在腰背部和颈部,腰背肌筋膜炎是常发病。针对发病原因及时治疗并给予有效预防措施,可明显降低腰背肌筋膜炎损伤发生率,对其运动训练能力和比赛成绩的提高均具有积极意义。 相似文献
85.
The inactivation of HIV by gamma-radiation was studied in frozen and liquid plasma; a reduction of the virus titer of 5 to 6 logs was achieved at doses of 5 to 10 Mrad at -80 degrees C and 2.5 Mrad at 15 degrees C. The effect of irradiation on the biologic activity of a number of coagulation factors in plasma and in lyophilized concentrates of factor VIII (FVIII) and prothrombin complex was examined. A recovery of 85 percent of the biologic activity of therapeutic components present in frozen plasma and in lyophilized coagulation factor concentrates was reached at radiation doses as low as 1.5 and 0.5 Mrad, respectively. As derived from the first-order radiation inactivation curves, the radiosensitive target size of HIV was estimated to be 1 to 3 MDa; the target size of FVIII was estimated to be 130 to 160 kDa. Gamma radiation must be disregarded as a method for the sterilization of plasma and plasma-derived products, because of the low reduction of virus infectivity at radiation doses that still give acceptable recovery of biologic activity of plasma components. 相似文献
86.
Charles Kouanfack Gabrièle Laborde‐Balen Avelin F. Aghokeng Anke Bourgeois Marlise Dontsop Jean‐Marc Mben Serge Kazé Eitel Mpoudi‐Ngolé Sinata Koulla‐Shiro Eric Delaporte Christian Laurent for the Stratall ANRS /ESTHER Study Group 《Tropical medicine & international health : TM & IH》2010,15(5):580-583
Objective To assess the proportion of patients infected with HIV with a CD4 count above 350 cells/mm3 among those classified at WHO clinical stage 3 or 4 who initiated antiretroviral therapy in rural district hospitals in Cameroon to assess the 2009 revised WHO recommendations. Methods Cross‐sectional study in nine rural district hospitals where the treatment initiation is based on the WHO clinical criteria. The proportion of patients who were classified at stage 3 or 4 and who had a CD4 count >350 cells/mm3 was assessed. Results Of 458 patients included in 2006–2008 (women 70.5%; median age 37.0 years), 337 (73.6%) were classified at WHO clinical stage 3 and 121 (26.4%) at stage 4. Overall, 108 patients (23.6%) had a CD4 count >350 cells/mm3. Of them, 94 patients (20.5%) were classified at WHO clinical stage 3, and 14 (3.1%) were classified at WHO clinical stage 4. Conclusion The WHO clinical stages 3 and 4 were poorly correlated with the ‘gold standard’ of CD4 cell count. This study highlights the need to promote CD4 testing for assessing the patient eligibility. 相似文献
87.
One hundred planned lesbian-parent families (i.e., two-mother families in which the child was born to the lesbian relationship) were compared with 100 heterosexual-parent families on child adjustment, parental characteristics, and child rearing. Questionnaires, observations, and a diary of activities were used to collect the data. The results show that especially lesbian social mothers (i.e., nonbiological mothers) differ from heterosexual fathers on parental characteristics (e.g., more parental justification and more satisfaction with the partner as coparent) and child rearing (e.g., more parental concern and less power assertion). Child adjustment is not associated with family type (lesbian-parent families vs. heterosexual-parent families), but is predicted by power assertion, parental concern, and satisfaction with the partner as coparent. 相似文献
88.
Darlington AS Dippel DW Ribbers GM van Balen R Passchier J Busschbach JJ 《Cerebrovascular diseases (Basel, Switzerland)》2007,23(5-6):401-407
BACKGROUND: Quality of life (QoL) is reduced for stroke patients and coping strategies have been suggested as determinants of QoL. Thus far the relationship between coping and QoL has only been examined in small-scale cross-sectional designs. Therefore, the current study set out to examine this relationship in a longitudinal setting. METHODS: Stroke patients who were discharged home were interviewed at 4 different time points; just before discharge (T1), and 2 months (T2), 5 months (T3) and 9-12 months after discharge (T4). QoL was measured by the EQ-5D index score and the SF-36 utility score and coping expressed in terms of tenacious goal pursuit and flexible goal adjustment. Modified Rankin scale was assessed as a measure of general functioning. RESULTS: Eighty stroke patients were included. Coping was not predictive of QoL at T1 and T2 but rather at T3 and T4. At T4 both coping strategies determined the levels of QoL as measured with the EQ-5D index score; higher levels of tenacious goal pursuit as well as flexible goal adjustment were associated with higher levels of QoL. This regression model explained 44% of the variance. CONCLUSIONS: Coping is a powerful determinant of QoL, but only more than 5 months after discharge; before this time QoL is mainly determined by general functioning. Both coping strategies were important determinants of QoL. 相似文献
89.
Maja Cigrovski Berkovic Monika Ulamec Sonja Marinovic Ivan Balen Anna Mrzljak 《World Journal of Clinical Cases》2022,10(16):5124-5132
Insulinomas are the most frequent type of functional pancreatic neuroendocrine tumors with a variety of neuroglycopenic and autonomic symptoms and well-defined diagnostic criteria; however, prediction of their clinical behavior and early differentiation between benign and malignant lesions remain a challenge. The comparative studies between benign and malignant cases are limited, suggesting that short clinical history, early hypoglycemia during fasting, high proinsulin, insulin, and C-peptide concentrations raise suspicion of malignancy. Indeed, malignant tumors are larger with higher mitotic count and Ki-67 proliferative activity, but there are no accurate histological criteria to distinguish benign from malignant forms. Several signaling pathways have been suggested to affect the pathophysiology and behavior of insulinomas; however, our knowledge is limited, urging a further understanding of molecular genetics. Therefore, there is a need for the identification of reliable markers of metastatic disease that could also serve as therapeutic targets in patients with malignant insulinoma. This opinion review reflects on current gaps in diagnostic and clinical aspects related to the malignant behavior of insulinoma. 相似文献
90.
Hartdorff Caroline M Frank Kneepkens CM van Dijk Alice EM Stok Anita Engels Michelle AH Gemke Reinoud JBJ Kindermann Angelika 《Tijdschrift voor kindergeneeskunde》2013,81(1):11-11
Tijdschrift voor Kindergeneeskunde - 相似文献