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991.
992.
993.
A comparison of a Patient Enablement Instrument (PEI) against two established satisfaction scales as an outcome measure of primary care consultations 总被引:17,自引:8,他引:9
OBJECTIVES: We aimed to compare a new primary care outcome measure-the
Patient Enablement Instrument (PEI)-against two established satisfaction
measures [the Medical Interview Satisfaction Scale (MISS) and the
Consultation Satisfaction Questionnaire (CSQ)]. Specifically, we sought (i)
to test whether enablement and satisfaction are related or separate
concepts; and (ii) to assess whether the internal consistency of the PEI
might be enhanced by the inclusion of items from the satisfaction
instruments. METHODS: Questionnaire forms containing the three instruments
in a variety of combinations were distributed to a total of 818 patients
attending for routine surgery consultations in three urban general
practices of varying socio-economic mix. The main outcome measures were:
scores on the PEI; scores on the CSQ, the MISS and their individual
components; rank correlations between scores on the PEI and scores on the
CSQ, the MISS and their component subscales; and Cronbach's alpha
coefficient for the PEI. RESULTS: Overall mean scores, expressed as
percentages of maximum scores attainable, were 44.1% for the PEI, 76.9% for
the CSQ and 77.6% for the MISS. Rank correlations between PEI scores and
scores for the complete CSQ and MISS instruments were 0.48 (P < 0.01)
and 0.47 (P < 0.01), respectively. Correlations of PEI scores with
individual component scores on the CSQ were generally lower and ranged from
0.14 to 0.53; correlations of PEI scored with MISS component scores were
also generally lower and ranged from 0.21 to 0.53. Internal consistency of
the PEI items (assessed by Cronbach's alpha coefficient) was lowered when
items from the CSQ or MISS were added. CONCLUSIONS: The study shows that
'enablement' is a primary care outcome measure which is related to but is
different from general satisfaction.
相似文献
994.
995.
The prognostic significance of the immunotype in diffuse large-cell lymphoma: a comparative study of the T-cell and B-cell phenotype 总被引:6,自引:0,他引:6
The clinical significance of immunophenotyping of the non-Hodgkin's lymphomas is controversial. Therefore, we conducted the present study of 103 consecutively accrued diffuse large-cell lymphoma (DLCL) patients to define, independently of histologic subtypes, the prognostic importance of phenotyping. We used an extensive panel of monoclonal antibodies to T- and B-cell antigens to assign all patients immunologically into the T-cell (20 patients) or B-cell group (83 patients). The only significant differences in pretreatment clinical variables between the two patient groups were the higher frequency of bulky disease (greater than 10 cm) in B-cell patients (P = .008) and more frequent skin involvement in the T-cell group (P less than or equal to .001). Multiagent doxorubicin-containing chemotherapy regimens were employed as initial therapy in over 83% of the patients in each group. Our study revealed that disease-free survival (DFS) was significantly shorter in the T-cell patients than in the B-cell DLCL patients (median DFS, 10.8 months for T-cell and 42.7 months for B- cell; P = .01, log rank). No patient with T-cell DLCL remained disease free for longer than 2 years, whereas 55% of the B-cell group were disease free at 2 years. Univariate and multivariate analyses of all major prognostic factors of DFS suggest that the T-cell phenotype indicates an incurable subset of DLCL patients. Although the B-cell group had a twofold advantage in median survival (35 months v 18 months), actuarial overall survival was not significantly different between the two patient groups (P = .23). Our results indicate the need for new approaches in the search for a curative treatment for T-cell DLCL. 相似文献
996.
Caveolin-3 in muscular dystrophy 总被引:2,自引:0,他引:2
McNally EM; de Sa Moreira E; Duggan DJ; Bonnemann CG; Lisanti MP; Lidov HGW; Vainzof M; Passos-Bueno MR; Hoffman EP; Zatz M; Kunkel LM 《Human molecular genetics》1998,7(5):871-877
The dystrophin-glycoprotein complex (DGC) serves as a link between
cytoplasmic actin, the membrane and the extracellular matrix of striated
muscle. Genetic defects in genes encoding a subset of DGC proteins result
in muscular dystrophy and a secondary decrease in other DGC proteins.
Caveolae are dynamic structures that have been implicated in a number of
functions including endocytosis, potocytosis and signal transduction.
Caveolin (VIP-21) is thought to play a structural role in the formation of
non-clathrin-coated vesicles in a number of different cell types.
Caveolin-3, or M-caveolin, was identified as a muscle- specific form of the
caveolin family. We show that caveolin-3 co- purifies with dystrophin, and
that a fraction of caveolin-3 is a dystrophin-associated protein. We
isolated the gene for human caveolin- 3 and mapped it to chromosome 3p25.
We determined the genomic organization of human caveolin-3 and devised a
screening strategy to look for mutations in caveolin-3 in patients with
muscular dystrophy. Of 82 patients screened, two nucleotide changes were
found that resulted in amino acid substitutions (G55S and C71W); these
changes were not seen in a control population. The amino acid changes map
to a functionally important domain in caveolin-3, suggesting that these are
not benign polymorphisms and instead are disease-causing mutations.
相似文献
997.
998.
999.
The therapeutic reactivation of fetal haemoglobin 总被引:3,自引:1,他引:2
Unusually high levels of fetal haemoglobin production can ameliorate sickle
cell disease and beta thalassaemia. Although efforts directed at the
pharmacological stimulation of fetal haemoglobin as an approach to managing
these conditions have met with limited success, there is wide variation in
individual responses. Whether this reflects the particular mutations that
underlie these conditions or other genetic factors remains to be
determined, as does the ideal combination of agents to achieve this end.
These results are encouraging, however, in particular in view of the recent
demonstration that other monogenic diseases, Duchenne muscular dystrophy,
for example, might be amenable to the same therapeutic strategy.
相似文献
1000.
Intracardiac extension of intravenous leiomyomatosis 总被引:2,自引:0,他引:2
Kaszar-Seibert DJ; Gauvin GP; Rogoff PA; Vittimberga FJ; Margolis S; Hilgenberg AD; Saal DK; Goldsmith GO 《Radiology》1988,168(2):409-410
A 42-year-old woman was found to have intravenous leiomyomatosis of the uterus with extension into the inferior vena cava and right atrium. Intravenous leiomyomatosis is a rare neoplastic disease characterized by invasion of venous channels by a benign smooth muscle tumor arising either from the wall of a vessel or from a uterine myoma. Intracardiac extension is often initially misdiagnosed as a right atrial myxoma and may cause death by mechanical obstruction. The diagnosis of intravenous leiomyomatosis should be considered in young women with cardiac symptoms associated with a right atrial mass who also have a pelvic mass or who have previously undergone hysterectomy because of leiomyoma uteri. 相似文献