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Jim Siderov 《Journal of clinical oncology》2003,21(10):2044-5; author reply 2045
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Background
In meningitis, the cerebrospinal fluid contains high levels of innate immune molecules (e.g. complement) which are essential to ward off the infectious challenge and to promote the infiltration of phagocytes (neutrophils, monocytes). However, epithelial cells of either the ependymal layer, one of the established niche for adult neural stem cells, or of the choroid plexus may be extremely vulnerable to bystander attack by cytotoxic and cytolytic complement components. 相似文献14.
A clinical trial on the prevention of catheter-related sepsis using a new hub model. 总被引:8,自引:0,他引:8
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M Segura F Alvarez-Lerma J M Tellado J Jiménez-Ferreres L Oms J Rello T Baró R Sánchez A Morera D Mariscal J Marrugat A Sitges-Serra 《Annals of surgery》1996,223(4):363-369
BACKGROUND: Catheter hub contamination is being increasingly recognized as a source of catheter-related sepsis. The authors have investigated the efficacy of a new hub design in preventing endoluminal catheter contamination and catheter-related sepsis arising at the hub. METHODS: Adult surgical and intensive care patients requiring a subclavian catheter for at least 1 week were randomly assigned to receive catheters with standard connectors (control group, n=73) or equipped with a new hub model (new hub group, n=78). Skin, catheter tip, and hub cultures were performed at the time the catheter was withdrawn because therapy was terminated or because of suspicion of sepsis, in which case peripheral blood cultures were taken. RESULTS: Of the 151 patients included, 15 (10%) developed catheter-related sepsis. Catheters were more often withdrawn because suspicion of infection in the control group (42 vs. 19%, p<0.005). Catheter sepsis rate was higher in the control group (16 vs. 4%, p<0.01) because of the low rate of catheter sepsis arising at the hub observed in the new hub group (1 vs. 11%, p<0.01). The prevalence of culture-positive catheter hubs without associated bacteremia (colonization) was higher in the control group (18 vs. 5%, P<0.03). CONCLUSIONS: A new catheter hub has proved to be useful in preventing endoluminal bacterial colonization and catheter-related sepsis in subclavian lines inserted for a mean of 2 weeks. 相似文献
15.
Disposition and hypoglycaemic action of glipizide in diabetic patients given a single dose of nifedipine 总被引:4,自引:0,他引:4
A. A. Connacher A. H. El Debani T. E. Isles I. H. Stevenson 《European journal of clinical pharmacology》1987,32(1):81-83
Summary Adrenaline, when administered in dental local anaesthetic solutions, significantly reduces the plasma potassium concentration in young healthy adults. This effect occurs within 10 min of extravascular injections into the maxillary buccal sulcus and may influence the choice of local anaesthetic solution for patients receiving kaliuretic diuretics. 相似文献
16.
Jim Orford Lorna Templeton Asmita Patel Richard Velleman Alex Copello 《Drugs (Abingdon, England)》2007,14(2):117-135
Background: This is the second of two papers using qualitative methods from a study of an intervention for family members affected by close relatives' substance misuse problems.
Participants: 168 primary healthcare professionals (PHCPs: GPs, practice nurses and health visitors) working in general practices in two areas of England, and who took part in the study.
Data sources: Recruitment and post-session forms completed by PHCPs; telephone interviews with each PHCP 12 weeks after recruitment of a family member; interviews with PHCPs at the end of the study.
Results: At the end of the project PHCPs were overwhelmingly positive about the family member intervention and about primary care as the appropriate site. Difficulties were encountered, however, in identifying and engaging affected family members, who were often excluded on grounds of the complexity of their problems or the level of their distress. Shortage of PHCP time and other practice-related factors added to the difficulty. Active work by a PHCP was often necessary in order to make the link between presenting symptoms of physical or mental ill-health and the existence of a family substance misuse problem. When family members were identified and recruited, PHCPs were usually positive about what was achieved. Nearly all were in favour of an approach that combined giving a self-help manual with some follow-up contact with a family member as needed.
Conclusions: Taken in conjunction with statistical outcome findings of significant reductions in symptoms and changes in ways of coping, plus qualitative analysis of the views of family members, the present results encourage the view that a flexible form of this intervention should be developed for use in primary healthcare, and that further work should build on existing strengths and attempt to overcome weaknesses identified. 相似文献
Participants: 168 primary healthcare professionals (PHCPs: GPs, practice nurses and health visitors) working in general practices in two areas of England, and who took part in the study.
Data sources: Recruitment and post-session forms completed by PHCPs; telephone interviews with each PHCP 12 weeks after recruitment of a family member; interviews with PHCPs at the end of the study.
Results: At the end of the project PHCPs were overwhelmingly positive about the family member intervention and about primary care as the appropriate site. Difficulties were encountered, however, in identifying and engaging affected family members, who were often excluded on grounds of the complexity of their problems or the level of their distress. Shortage of PHCP time and other practice-related factors added to the difficulty. Active work by a PHCP was often necessary in order to make the link between presenting symptoms of physical or mental ill-health and the existence of a family substance misuse problem. When family members were identified and recruited, PHCPs were usually positive about what was achieved. Nearly all were in favour of an approach that combined giving a self-help manual with some follow-up contact with a family member as needed.
Conclusions: Taken in conjunction with statistical outcome findings of significant reductions in symptoms and changes in ways of coping, plus qualitative analysis of the views of family members, the present results encourage the view that a flexible form of this intervention should be developed for use in primary healthcare, and that further work should build on existing strengths and attempt to overcome weaknesses identified. 相似文献
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A lawsuit directed by parents at a day care program following an outbreak of infectious disease would most likely be based on the legal theory of negligence--the failure to exercise due care as required by circumstances. In the determination of liability for infectious diseases in child day care, the element of causation is most critical. Did the day care facility's actions or failure to act cause the harm? Another important question is whether an infectious disease can be occupational and under what circumstances. Although worker's compensation laws initially had no provisions for occupational disease, now all states recognize responsibility for them. Awareness of potential problems with legal liability and establishment of procedures to minimize risk are important for day care providers, public health officials, clinicians, and parents. 相似文献