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21.
W T Yuh E T Tali H D Nguyen T M Simonson N A Mayr D J Fisher 《AJNR. American journal of neuroradiology》1995,16(2):373
PURPOSETo evaluate the effect of MR contrast dose versus delayed imaging time on the detection of metastatic brain lesions based on lesion size.METHODSContrast MR examinations with gadoteridol were obtained in 45 patients with brain metastases. The patients were divided into two groups: 16 received cumulative standard dose (0.1 mmol/kg) and 29 received cumulative triple dose (0.3 mmol/kg). Both groups were evaluated at two dose levels (lower dose and higher dose) with two separate injections. Each patient received an initial bolus injection of either 0.05 (cumulative standard dose) or 0.1 (cumulative triple dose) mmol/kg of gadoteridol to reach the lower-dose level and underwent imaging immediately and 10 and 20 minutes later. Thirty minutes after injection, an additional bolus injection of 0.05 (cumulative standard dose) or 0.2 (cumulative triple dose) mmol/kg was administered to reach the cumulative higher-dose level (cumulative standard dose, 0.1 mmol/kg; cumulative triple dose, 0.3 mmol). Images were acquired immediately.RESULTSThere was no difference in the detection rate for lesions larger than 10 mm among T2-weighted, lower-dose immediate and delayed, or immediate higher-dose images in both study groups. Lesions smaller than 10 mm had improved detection with delayed imaging in both study groups; however, the immediate higher-dose studies still had the highest detection rate.CONCLUSIONIn the evaluation of small central nervous system metastases, either delayed imaging after the injection of standard contrast dose or higher contrast dose may improve their detection, and therefore affect clinical management. Higher contrast dose (cumulative triple dose) studies appear to be more effective than delayed imaging with standard dose. 相似文献
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23.
Janice F. Munro Debra Haire-Joshu Edwin B. Fisher H. James Wedner 《The Journal of asthma》1996,33(5):313-325
Low-income minority patients from East St. Louis, Illinois, a depressed midwestern urban city, who had visited acute care settings with asthma symptoms, participated in a focus group. Questions were constructed around the Health Belief Model to characterize participants' experiences in receiving asthma care, their confidence in long-term asthma self-management, barriers they perceived to managing their asthma, and recommendations they would make for improving asthma care in their community. Analysis of comments suggests an appreciable understanding of asthma triggers, limited coping behaviors for asthma symptoms, very limited practice of active asthma management, perception of the health care system as frequently insensitive to their needs or their knowledge of their own care, exchange of well-articulated information regarding how to deal with the system, and an apparent lack of awareness of any potential contribution of patient education or support system. 相似文献
24.
S.J. Gallacher G. Thomson W.D. Fraser B.M. Fisher C.G. Gemmell A.C. MacCuish 《Diabetic medicine》1995,12(10):916-920
Neutrophil bactericidal activity was assessed in patients with type 1 (n=45) and Type 2 diabetes mellitus (n=68) and non-diabetic control subjects (n=40) by measurement of whole blood chemiluminescence. Though chemiluminescence values tended to be highest in the non-diabetic subjects these differences were not statistically significant (mean ± SD) (2.73 ± 1.65 mV (controls), 2.33 ± 1.41 mV (Type 1 diabetes) and 2.38 ± 1.12 mV (Type 2 diabetes), F=1.12, p=0.33). Significant negative correlations were evident, however, in patients with both Type 1 and Type 2 diabetes between chemiluminescence and glycated haemoglobin (rs=-0.35, p=0.005 (Type 1), rs=-0.45, p=0.002 (Type 2), fructosamine (rs=-0.36, p=0.003 (Type 1), rs=-0.42, p=0.004 (Type 2)), and random blood glucose (rs=-0.25, p=0.04 (Type 1), rs=-0.48, p=0.001 (Type 2)). Changes in whole blood chemiluminescence in a further group of 10 patients with Type 2 diabetes mellitus commenced on insulin therapy were followed for 21 days. Serum fructosamine concentrations fell significantly over this time (524 ± 58 μmol l?1 to 405 ± 47 μmol l?1, p<0.001), however, although chemiluminescence values tended to rise these changes were not statistically significant (1.01 ± 0.38 mV to 1.60 ± 0.91 mV, S=4.24, df=5, p=0.52). These results suggest that impaired neutrophil bactericidal function is associated with poor blood glucose control. While it is likely that neutrophil bactericidal function will improve as blood glucose control improves, further studies are required both to confirm this and to demonstrate a reduction in the incidence of clinical bacterial infection. 相似文献
25.
26.
W H Fisher R A Dorwart M Schlesinger S Epstein H Davidson 《Hospital & community psychiatry》1992,43(11):1114-1119
For almost three decades, many have regarded general hospital psychiatric units as the most appropriate setting for acute treatment of persons with serious mental illness who were once treated mostly in state hospitals. The extent to which this transfer has taken place and the differences between public and private general hospitals have been unclear. Using data from the 1988 National Mental Health Facilities Study and published data from the 1970s, the authors found that nearly half of all general hospitals providing psychiatric services treat persons with serious mental illness. Significant differences in case and payer mix were observed between public and private general hospitals, although these differences were smaller than in the 1970s. The findings suggest increased involvement by private general hospitals in treating patients reimbursed by public payers, but the findings also indicate that persons with serious mental illness and those using Medicaid are still more prevalent in public general hospitals than in private ones. 相似文献
27.
Anita MacDonald Dr Sandra Warrington Chairman Professional Development Committee 《Journal of human nutrition and dietetics》1990,3(2):71-77
At the present time, there are many fundamental issues coming from the Department of Health or from other national organizations, which will have an effect on the future development of the dietetic profession. The British Diatetic Association (BDA) Professional Development Committee will consider these issues, as and when appropriate, and will publish the information in the form of Briefing Papers.
The first Briefing Paper on 'Quality Assurance' was published by the BDA in November 1989. The second on 'Measuring clinical outcome' is published below. In each case the opinion of BDA members and specialist groups has been sought and the Professional Development Committee wishes to thank individuals and the specialist groups for their comments.
The Briefing Papers are intended to provide information and promote discussion among the membership. I would welcome further comments from readers, which may be directed to the British Dietetic Association Office. 相似文献
The first Briefing Paper on 'Quality Assurance' was published by the BDA in November 1989. The second on 'Measuring clinical outcome' is published below. In each case the opinion of BDA members and specialist groups has been sought and the Professional Development Committee wishes to thank individuals and the specialist groups for their comments.
The Briefing Papers are intended to provide information and promote discussion among the membership. I would welcome further comments from readers, which may be directed to the British Dietetic Association Office. 相似文献
28.
Joseph G Rajendran Darrell R Fisher Ajay K Gopal Lawrence D Durack Oliver W Press Janet F Eary 《Journal of nuclear medicine》2004,45(6):1059-1064
Radioimmunotherapy (RIT) using (131)I-tositumomab has been used successfully to treat relapsed or refractory B-cell non-Hodgkin's lymphoma (NHL). Our approach to treatment planning has been to determine limits on radiation absorbed dose to critical nonhematopoietic organs. This study demonstrates the feasibility of using CT to adjust for actual organ volumes in calculating organ-specific absorbed dose estimates. METHODS: Records of 84 patients who underwent biodistribution studies after a trace-labeled infusion of (131)I-tositumomab for RIT (January 1990 and April 2003) were reviewed. Serial planar gamma-camera images and whole-body NaI probe counts were obtained to estimate (131)I-antibody source-organ residence times as recommended by the MIRD Committee. The source-organ residence times for standard man or woman were adjusted by the ratio of the MIRD phantom organ mass to the CT-derived organ mass. RESULTS: The mean radiation absorbed doses (in mGy/MBq) for our data using the MIRD model were lungs = 1.67; liver = 1.03; kidneys = 1.08; spleen = 2.67; and whole body = 0.3; and for CT volume-adjusted organ volumes (in mGy/MBq) were lungs = 1.30; liver = 0.92; kidneys = 0.76; spleen = 1.40; and whole body = 0.22. We determined the following correlation coefficients between the 2 methods for the various organs: lungs, 0.49 (P = 0.0001); liver, 0.64 (P = 0.004); kidneys, 0.45 (P = 0.0004); spleen, 0.22 (P = 0.0001); and whole body, 0.78 (P = 0.0001), for the residence times. For therapy, patients received mean (131)I administered activities of 19.2 GBq (520 mCi) after adjustment for CT-derived organ mass compared with 16.0 GBq (433 mCi) that would otherwise have been given had therapy been based only using standard MIRD organ volumes-a statistically significant difference (P = 0.0001). CONCLUSION: We observed large variations in organ masses among our patients. Our treatments were planned to deliver the maximally tolerated radiation dose to the dose-limiting normal organ. This work provides a simplified method for calculating patient-specific radiation doses by adjusting for the actual organ mass and shows the value of this approach in treatment planning for RIT. 相似文献
29.
Jennifer Orlet Fisher Diane C Mitchell Helen Smiciklas-Wright Leann Lipps Birch 《Journal of the American Dietetic Association》2002,102(1):58-64
OBJECTIVE: To evaluate parents' fruit and vegetable intake and their use of pressure to eat in child feeding as predictors of their 5-year-old daughters' fruit and vegetable, micronutrient, and fat intakes. SUBJECTS: Data were obtained from 191 non-Hispanic white families with 5-year-old girls. DESIGN: Parent data included reports of pressure in child feeding and their own fruit and vegetable intake. Girls' intakes of fruits and vegetables, selected micronutrients, and fat were the main outcomes of interest. STATISTICAL ANALYSIS: Structural equation modeling was used to test a model describing relationships among parents' fruit and vegetable intake, parents' use of pressure in child feeding, and daughters' fruit and vegetable, micronutrient, and fat intakes. RESULTS: The model provided a good fit to the data, revealing that girls' fruit and vegetable intake was positively related to their parents' reported fruit and vegetable intake. Parents who consumed fewer fruits and vegetables tended to report greater pressure in child feeding and had daughters who consumed fewer fruits and vegetables. Girls' reported fruit and vegetable intakes were positively related to their micronutrient intakes and negatively associated with fat intake. APPLICATIONS/CONCLUSIONS: This research demonstrates that parents' own fruit and vegetable intake may encourage fruit and vegetable intake in their daughters, leading to higher micronutrient intakes and lower dietary fat intakes. Conversely, pressure to eat may discourage fruit and vegetable intake among young girls. 相似文献
30.
Ross W. James Peter A Howat K. John Fisher 《Australian and New Zealand journal of public health》1987,11(1):54-61
Health education campaigns which utilise the mass media generally employ advertising techniques. Television and print media are considered more influential, with radio being primarily used for awareness raising and campaign support messages. There is relatively little research into the effectiveness of radio talkback programs in promoting health or reducing illness. This paper argues a case for health and welfare professionals to utilise talkback radio as part of their health promotion activities. 相似文献