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71.
Evaluation of Resistance Assays Trial Investigators MRC Clinical Trials Unit London United Kingdom 《HIV clinical trials》2013,14(4):183-186
AbstractPurpose: To assess the clinical utility of genotypic resistance testing among HIV-1-infected patients with limited prior exposure to antiretroviral drugs. Method: Patients experiencing virological failure were randomly allocated to either centralized genotypic resistance testing or to no testing and were followed for a minimum of 1 year. Results: 55 patients were recruited from 14 centers in the United Kingdom. There were no demonstrable differences between the groups in terms of virological or immunological response. For patients allocated to resistance testing, there was an increased tendency to recycle previously used drugs. Conclusion: The study did not demonstrate a benefit of genotypic resistance testing in this population, although statistical power was low. However, testing did alter prescribing behavior, and clinical effects may become manifest in the longer term. 相似文献
72.
本文采用改良单克隆抗体特异性抗原捕获酶免疫法(MACE)使用5种抗原血小板单克隆抗体对59例ITP患者进行了相关自身抗原研究,结果28例ITP患者血浆呈现抗血小板自身抗体阳性(47.46%),其中单独抗GPI_b/2例、抗GPⅡ_b/Ⅲ_α5例、抗α颗粒膜蛋白-1401例,抗凝血酶敏感蛋白6例,另14例出现2种以上自身抗体,以抗GPⅡ_b/Ⅲ_α为多见。找们建议将以上抗体针对的抗原称为血小板活化依赖性自身抗体。虽然我们未发现这类自身抗原与其它类型自身抗原间的临床表现及治疗结果存在明显差异,但这类自身抗原应引起重视,有必要对此作进一步观察和深入研究。 相似文献
73.
Abidov A Kaluski E Hod H Leor J Vered Z Gottlieb S Behar S Cotter G;Israel Working Group on Intensive Cardiac Care 《The American journal of cardiology》2004,93(1):76-80
Right bundle branch block and complete atrioventricular (AV) block are conduction disorders (CDs) that have been observed in 14% of patients admitted with ST-elevation acute myocardial infarction. CDs carry a poor prognosis, with a threefold increase in the mortality rate, mainly due to cardiogenic shock and recurrent fatal myocardial infarction at 1-year follow-up. According to multivariable analysis, CD was the second strongest predictor of death, after high Killip class. Compared with patients without CD, the 1-year outcome of patients with CD was identically worse, irrespective of whether CD appeared during admission, disappeared, or remained constant. Similar adverse outcomes were seen in patients with complete AV block and right bundle branch block. 相似文献
74.
Chambers LW Hendriks A Hall HL Raina P McDowell I;Care for the Caregiver Working Group 《Chronic diseases in Canada》2004,25(3-4):108-118
In December 2002, a national workshop was held in Ottawa to guide research directions for the caregiving of people with Alzheimer's disease in Canada. Prior to the workshop, a search was conducted to identify Canadian-based investigators who have conducted research related to caregiving of individuals with cognitive impairment, Alzheimer's disease and other dementia, identify relevant Canadian research studies, and provide an overview of results and themes emerging from this research. This paper summarizes findings from our search for Canadian studies, research themes identified at the national workshop in Ottawa, and recommendations from the workshop. The report first outlines patterns of caregiving and subsequently focusses on the impact of different ways of assisting Alzheimer's caregivers. It concludes by outlining the methodological challenges of observational and intervention studies related to Alzheimer's caregiving and recommendations on how to increase Canada's capacity to conduct research on Alzheimer's caregiving. 相似文献
75.
76.
Ran-hui Cha Joon-Sung Joh Ina Jeong Ji Yeon Lee Hyoung-Shik Shin Gayeon Kim Yeonjae Kim Critical Care Team of National Medical Center 《Journal of Korean medical science》2015,30(12):1807-1814
Some cases of Middle East Respiratory Syndrome-Coronavirus (MERS-CoV) infection presented renal function impairment after the first MERS-CoV patient died of progressive respiratory and renal failure. Thus, MERS-CoV may include kidney tropism. However, reports about the natural courses of MERS-CoV infection in terms of renal complications are scarce. We examined 30 MERS-CoV patients admitted to National Medical Center, Korea. We conducted a retrospective analysis of the serum creatinine (SCr), estimated glomerular filtration rate (eGFR), urine dipstick tests, urinary protein quantitation (ACR or PCR), and other clinical parameters in all patients. Two consecutive results of more than trace (or 1+) of albumin and blood on dipstick test occurred in 18 (60%) (12 [40%]) and 22 (73.3%) (19 [63.3%]) patients, respectively. Fifteen (50.0%) patients showed a random urine ACR or PCR more than 100 mg/g Cr. Eight (26.7%) patients showed acute kidney injury (AKI), and the mean and median durations to the occurrence of AKI from symptom onset were 18 and 16 days, respectively. Old age was associated with a higher occurrence of AKI in the univariate analysis (HR [95% CI]: 1.069 [1.013-1.128], P = 0.016) and remained a significant predictor of the occurrence of AKI after adjustment for comorbidities and the application of a mechanical ventilator. Diabetes, AKI, and the application of a continuous renal replacement therapy (CRRT) were risk factors for mortality in the univariate analysis (HR [95% CI]: diabetes; 10.133 [1.692-60.697], AKI; 12.744 [1.418-114.565], CRRT; 10.254 [1.626-64.666], respectively). Here, we report renal complications and their prognosis in 30 Korean patients with MERS-CoV. 相似文献
77.
78.
Fridkin SK Edwards JR Courval JM Hill H Tenover FC Lawton R Gaynes RP McGowan JE;Intensive Care Antimicrobial Resistance Epidemiology 《Annals of internal medicine》2001,135(3):175-183
BACKGROUND: Patient-specific risk factors for acquisition of vancomycin-resistant enterococci (VRE) among hospitalized patients are becoming well defined. However, few studies have reported data on the institutional risk factors, including rates of antimicrobial use, that predict rates of VRE. Identifying modifiable institutional factors can advance quality-improvement efforts to minimize hospital-acquired infections with VRE. OBJECTIVE: To determine the independent importance of any association between antimicrobial use and risk factors for nosocomial infection on rates of VRE in intensive care units (ICUs). DESIGN: Prospective ecologic study. SETTING: 126 adult ICUs from 60 U.S. hospitals from January 1996 through July 1999. PATIENTS: All patients admitted to participating ICUs. MEASUREMENTS: Monthly use of antimicrobial agents (defined daily doses per 1000 patient-days), nosocomial infection rates, and susceptibilities of all tested enterococci isolated from clinical cultures. RESULTS: Prevalence of VRE (median, 10%; range, 0% to 59%) varied by type of ICU and by teaching status and size of the hospital. Prevalence of VRE was strongly associated with VRE prevalence among inpatient non-ICU areas and outpatient areas in the hospital, ventilator-days per 1000 patient-days, and rate of parenteral vancomycin use. In a weighted linear regression model controlling for type of ICU and rates of VRE among non-ICU inpatient areas, rates of vancomycin use (P < 0.001) and third-generation cephalosporin use (P = 0.02) were independently associated with VRE prevalence. CONCLUSIONS: Higher rates of vancomycin or third-generation cephalosporin use were associated with increased prevalence of VRE, independent of other ICU characteristics and the endemic VRE prevalence elsewhere in the hospital. Decreasing the use rates of these antimicrobial agents could reduce rates of VRE in ICUs. 相似文献
79.
Patient‐level Factors and the Quality of Care Delivered in Pediatric Emergency Departments 下载免费PDF全文
James P. Marcin MD MPH Patrick S. Romano MD MPH Parul Dayal MS Madan Dharmar MBBS PhD James M. Chamberlain MD Nanette Dudley MD Charles G. Macias MD MPH Lise E. Nigrovic MD MPH Elizabeth C. Powell MD MPH Alexander J. Rogers MD Meridith Sonnett MD Leah Tzimenatos MD Elizabeth R. Alpern MD MSCE Rebecca Andrews‐Dickert MD Dominic A. Borgialli DO MPH Erika Sidney MD T. Charles Casper PhD J. Michael Dean MD Nathan Kuppermann MD MPH for the Pediatric Emergency Care Applied Research Network 《Academic emergency medicine》2018,25(3):301-309
Objective
Quality of care delivered to adult patients in the emergency department (ED) is often associated with demographic and clinical factors such as a patient's race/ethnicity and insurance status. We sought to determine whether the quality of care delivered to children in the ED was associated with a variety of patient‐level factors.Methods
This was a retrospective, observational cohort study. Pediatric patients (<18 years) who received care between January 2011 and December 2011 at one of 12 EDs participating in the Pediatric Emergency Care Applied Research Network (PECARN) were included. We analyzed demographic factors (including age, sex, and payment source) and clinical factors (including triage, chief complaint, and severity of illness). We measured quality of care using a previously validated implicit review instrument using chart review with a summary score that ranged from 5 to 35. We examined associations between demographic and clinical factors and quality of care using a hierarchical multivariable linear regression model with hospital site as a random effect.Results
In the multivariable model, among the 620 ED encounters reviewed, we did not find any association between patient age, sex, race/ethnicity, and payment source and the quality of care delivered. However, we did find that some chief complaint categories were significantly associated with lower than average quality of care, including fever (–0.65 points in quality, 95% confidence interval [CI] = –1.24 to –0.06) and upper respiratory symptoms (–0.68 points in quality, 95% CI = –1.30 to –0.07).Conclusion
We found that quality of ED care delivered to children among a cohort of 12 EDs participating in the PECARN was high and did not differ by patient age, sex, race/ethnicity, and payment source, but did vary by the presenting chief complaint.80.
The effects of hypermagnesaemia on calcitonin secretion in vivo 总被引:1,自引:0,他引:1