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81.
RN BN IC Cert. MN Grad. Cert. Ed. Studies Andrea Marshall Senior Research Fellow 《Australian critical care》2004,17(4):142-150
The development of research priorities for critical care nurses has been previously examined from the perspective of both Australian and international critical care nursing experts. A variety of techniques have been used to determine research priorities for critical care nursing, however, a clear articulation of research priorities for Australian critical care nurses, which are both timely and encompass all aspects of critical care nursing practice, is lacking. Research priorities previously determined in Australia and elsewhere identify similar clinical research priorities such as nutritional support, infection control, supporting respiratory and cardiac function, and follow-up of critically ill patients. However, differences between the few available studies exist, possibly because of the changing nature of critical care nursing practice. Despite the identification of research priorities for critical care nursing in the past, there is little evidence to demonstrate a direct effect on research output in these areas. Future development of research priorities for Australian critical care nurses needs to be carefully considered. It is essential that identification of such research priorities be done within the context of their intended use. 相似文献
82.
Nikolaos Kopsachilis Manpreet Brar Anca IC Marinescu Richard Andrews 《Clinical & experimental optometry》2013,96(1):121-123
Branch retinal vein occlusion (BRVO) associated with ocular tuberculosis (TB) is a rare presentation of retinal vasculitis but it can also present in the absence of active uveitis. We present a 39‐year‐old patient with BRVO who slowly developed bilateral papilloedema due to TB in the central nervous system. To our knowledge, this is the first case of systemic central nervous system TB confirmed by biopsy presenting as a branch retinal vein occlusion and shows the importance of extensive causative investigation of BRVO, especially for young patients. 相似文献
83.
F Groenendaal JUM Termote M Van Der Heide‐Jalving IC Van Haastert LS De Vries 《Acta paediatrica (Oslo, Norway : 1992)》2010,99(3):354-358
Aim: In this study, we determined whether outcome of preterm neonates has improved over a period of 16 years. Study design: Inborn neonates with a gestational age of 25.0–29.9 weeks were included. Patients with severe congenital malformations were excluded. Mortality and morbidity (chronic lung disease; CLD, intraventricular haemorrhage: IVH grade III or IV, cystic periventricular leukomalacia: cPVL, perforated necrotizing enterocolitis: NEC, severe retinopathy of prematurity needing surgery: ROP and cerebral palsy: CP) were compared in three periods (period 1: 1991–1996 n = 434; period 2: 1997–2001 n = 356; period 3: 2002–2006 n = 422). Results: Infant mortality decreased from 15.2% to 10.9%. CLD did not differ significantly between periods (14.1–14.8%). Perforated NEC decreased from 2.8% to 1.6%. IVH grade III and IV both remained at 5.7% in period 3, whereas cPVL decreased significantly from 4.5% to 1.6%. Cerebral palsy decreased from 5.8% to 3.5% in period 3. Two neonates in each period were in need of surgery for ROP. Conclusion: Inborn preterm patients showed an improved survival and a significant reduction in cPVL and CP. Perforated NEC showed a trend to decrease. CLD and IVH grade III and IV remain a matter of concern. 相似文献
84.
Leon IC Tang Anna PK Ling Rhun Y Koh Soi M Chye Kenny GL Voon 《BMC complementary and alternative medicine》2012,12(1):3
Background
Dengue fever regardless of its serotypes has been the most prevalent arthropod-borne viral diseases among the world population. The development of a dengue vaccine is complicated by the antibody-dependent enhancement effect. Thus, the development of a plant-based antiviral preparation promises a more potential alternative in combating dengue disease. 相似文献85.
CD Briggs GB Irving CD Mann A Cresswell L Englert M Peterson IC Cameron 《Annals of the Royal College of Surgeons of England》2009,91(7):583-590
INTRODUCTION
The objective of this study was to determine the safety and acceptability of the implementation of a day-case laparoscopic cholecystectomy (LC) service in a large UK teaching hospital, and analyse factors influencing contact with primary care providers. Wide-spread introduction of day-case LC in the UK is a major target of healthcare providers. However, few centres have reported their experience. In the US, out-patient surgery for LC has been reported, though many groups have utilised 24-h observation units to facilitate discharge. Concerns remain amongst surgeons regarding the feasibility and acceptability of the introduction of day-case LC in the UK.PATIENTS AND METHODS
Comprehensive care and operative data were prospectively collected on the first 106 consecutive day-case procedures in our hospital. Postoperative recovery was monitored by telephone questionnaire on days 2, 5 and 14, including complications, satisfaction and general practitioner consultation.RESULTS
A total of 106 patients were admitted for day-case LC, of whom 84% were discharged on the day of surgery. Patient satisfaction rate was 94% in both the successful day-case and the admitted patients. Mean operation time was 62 min, with an average total stay on the day-care unit of 426 min. Training-grade surgeons performed 31% of operations. Both the re-admission rate after surgery and rate of conversion to open surgery were 2%. Advice from primary healthcare providers was sought by 33% of patients within the first 14 postoperative days.CONCLUSIONS
Introduction of day-case LC in the UK is feasible and acceptable to patients. The potential burden to primary care providers needs further study. 相似文献86.
Background
A potential problem of clinical examinations is known as the hawk-dove problem, some examiners being more stringent and requiring a higher performance than other examiners who are more lenient. Although the problem has been known qualitatively for at least a century, we know of no previous statistical estimation of the size of the effect in a large-scale, high-stakes examination. Here we use FACETS to carry out a multi-facet Rasch modelling of the paired judgements made by examiners in the clinical examination (PACES) of MRCP(UK), where identical candidates were assessed in identical situations, allowing calculation of examiner stringency.Methods
Data were analysed from the first nine diets of PACES, which were taken between June 2001 and March 2004 by 10,145 candidates. Each candidate was assessed by two examiners on each of seven separate tasks. with the candidates assessed by a total of 1,259 examiners, resulting in a total of 142,030 marks. Examiner demographics were described in terms of age, sex, ethnicity, and total number of candidates examined.Results
FACETS suggested that about 87% of main effect variance was due to candidate differences, 1% due to station differences, and 12% due to differences between examiners in leniency-stringency. Multiple regression suggested that greater examiner stringency was associated with greater examiner experience and being from an ethnic minority. Male and female examiners showed no overall difference in stringency. Examination scores were adjusted for examiner stringency and it was shown that for the present pass mark, the outcome for 95.9% of candidates would be unchanged using adjusted marks, whereas 2.6% of candidates would have passed, even though they had failed on the basis of raw marks, and 1.5% of candidates would have failed, despite passing on the basis of raw marks.Conclusion
Examiners do differ in their leniency or stringency, and the effect can be estimated using Rasch modelling. The reasons for differences are not clear, but there are some demographic correlates, and the effects appear to be reliable across time. Account can be taken of differences, either by adjusting marks or, perhaps more effectively and more justifiably, by pairing high and low stringency examiners, so that raw marks can be used in the determination of pass and fail. 相似文献87.
88.
IC Chikanza MB ChB MRCP B Clarke R Hopkins DG Macfarlane MD MRCP H Bird MD FRCP R Grahame FRCP FACP 《International journal of clinical practice》1994,48(2):67-69
SUMMARY In a two-period, double-blind, crossover study, patients with osteoarthritis of the knee and/or hip received etodolac 300 mg twice daily for 4 weeks and naproxen 500 mg twice daily for 4 weeks in random order. The assessment of efficacy showed that naproxen and etodolac were equally effective in the management of pain and stiffness in osteoarthritis. However, a significantly higher proportion of patients preferred naproxen to etodolac for the relief of pain intensity. The incidence of adverse events caused by either drug was the same. 相似文献
89.
Background
Liver fibrosis represents a significant and severe health care problem and there are no efficient drugs for therapy so far. Preventing the progression of fibrogenesis and revival endogenous repair activities is an important strategy for both current and future therapies. Many studies of liver fibrosis consist of animal testing with various hepatotoxins. Although this method is often used, the model at which cirrhosis or extensive fibrosis becomes irreversible has not been well defined and is not representative of early-stage fibrogenesis. We here report the establishment of a transient and reversible liver fibrosis animal model which may better represent an early and natural fibrotic event. We used a high-speed intravenous injection of naked plasmid DNA of transforming growth factor-β1 (TGF-β1) gene which is under the control of a metallothionein-regulated gene in a pPK9A expression vector into the tail vein (the hydrodynamics-based transfer) and fed the mouse with zinc sulfate (ZnSO4)-containing water simultaneously. 相似文献90.
Hypothalamic-pituitary-mediated immunomodulation: arginine vasopressin is a neuroendocrine immune mediator 总被引:1,自引:0,他引:1
Organisms respond to a variety of environmental agents, such as those that
cause inflammation, by mounting a coordinated complex series of adaptive
responses involving the immune, nervous and endocrine systems. These
adaptations are aimed at restoring the homeostatic balance and the return
to the status quo ante. This interaction is facilitated by cytokines,
hormones and neurotransmitters, as well as receptors that are endogenous to
the neural, immune and endocrine systems. These shared ligands and
receptors provide the molecular basis of this cross- talk. Studies of
animal models of autoimmune diseases have shown that defects in the
neuroendocrine immune communications contribute to the development of
chronic inflammatory autoimmune disease. By analogy, similar observations
have now been made in patients with inflammatory rheumatic disorders. For
instance, patients with rheumatoid arthritis have abnormally low cortisol
responses to inflammation, whilst the production of prolactin is excessive
and dysregulated. Prolactin is a pro-inflammatory neuropeptide. This paper
reviews the evidence to support the viewpoint that the neuropeptide
arginine vasopressin, which is also produced by the hypothalamus, should be
considered to be another neuroendocrine modulator of immune and
inflammatory responses. It is also being hypothesized that the production
of arginine vasopressin might be dysregulated and excessive in rheumatoid
arthritis, and that this could be another additional neuroendocrine factor
contributing to the pathophysiology of the disease.
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