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61.
Naveed T. Siddiqui MD Cristian Arzola MD Iram Ahmed MD Sharon Davies MD Jose C. A. Carvalho MD PhD 《Journal canadien d'anesthésie》2014,61(8):710-716
Purpose
The objective of this study was to determine the impact of a low-fidelity simulation model on mastering the sterile technique during placement of epidural catheters.Methods
Trainees, including residents and fellows, were given conventional teaching consisting of a lecture and a video demonstration on the appropriate sterile technique to apply during the placement of epidural catheters. The trainees were then provided with a one-on-one demonstration session using a low-fidelity Styrofoam? epidural model, followed by a series of simulation sessions. After conventional teaching and following each simulation session, the trainees were assessed on their performance until competence was achieved based on a 15-point checklist. The retention of competence was subsequently evaluated bi-weekly in clinical practice for four assessments.Results
Twenty-one trainees participated in the study. The average score for the residents following conventional teaching was 6.0 out of 15 points on the checklist. Following the initial one-on-one hands-on demonstration, the average score increased to 10.8 (difference = 4.8, 95% confidence interval (CI): 3.3 to 6.2; P < 0.001). The average score for the fellows following conventional teaching was 7.9 out of 15 points on the checklist. Following the initial one-on-one hands-on demonstration the average score increased to 11.2 (difference = 3.3, 95% CI: 0.05 to 6.6; P = 0.047). During the retention of competence phase, scores ranged from 13-15 for both residents and fellows.Conclusion
This study describes a comprehensive teaching model for mastering the sterile technique during epidural catheter placement. It suggests that low-fidelity simulation improves the learning process when used in addition to conventional teaching. 相似文献62.
Naomi Holman PhD Peter Knighton MPhys Jackie OʼKeefe MSc Sarah H. Wild PhD Sarah Brewster MRCP Hermione Price FRCP Kiran Patel PhD Wasim Hanif MD Vinod Patel MD Edward W. Gregg PhD Richard I. G. Holt PhD Roger Gadsby MB Kamlesh Khunti MD Jonathan Valabhji MD Bob Young MD Naveed Sattar MD 《Diabetes, obesity & metabolism》2021,23(12):2728-2740
63.
Jai Kumar Roha Saeed Memon Izza Shahid Tehlil Rizwan Maryam Zaman Ritesh G. Menezes Sarwan Kumar Tariq Jamal Siddiqi Muhammad Shariq Usman 《Digestive and liver disease》2021,53(1):44-51
BackgroundThe efficacy of antidiabetic agents for the treatment of non-alcoholic fatty liver disease (NAFLD) remains unclear.AimTo conduct a meta-analysis to study the efficacy of pioglitazone and three novel anti-diabetic agents: glucagon-like peptide-1 (GLP-1) agonists, sodium-glucose co-transporter-2 (SGLT2) inhibitors, and dipeptidyl-peptidase-4 (DPP4) inhibitors in treating NAFLD.MethodsOnline databases were searched in May 2020 for randomized clinical trials. Results from random-effects meta-analysis are presented as weighted mean differences (WMDs) or standard mean differences (SMDs) and corresponding 95% confidence intervals (CIs).ResultsTwenty-six studies (n=946 NAFLD patients) were included. Reductions in ALT were seen with all four drugs: pioglitazone (MD -38.41, p<0.001), SGLT2 inhibitors (MD -16.17, p<0.001), GLP-1 agonists (MD -27.98, p=0.04) and DPP-4 inhibitors (MD -7.41, p<0.001). Pioglitazone (SMD -1.01; p<0.001) and GLP-1 agonists (SMD -2.53, p=0.03) also demonstrated significant improvements in liver steatosis. SGLT2 inhibitors (SMD -4.64, p=0.06) and DPP-4 (SMD -2.49, p=0.06) inhibitors trended towards reduced steatosis; however, these results were non-significant.ConclusionPioglitazone demonstrates significant improvements in transaminases and liver histology in both diabetic and non-diabetic NAFLD patients. Early evidence from diabetic NAFLD patients suggests that novel antidiabetics may lead to improvements in liver enzymes and hepatic steatosis, and this should encourage further research into possible utility of these drugs in treating NAFLD. 相似文献
64.
In this study, a Zn3(VO4)2/BiVO4 heterojunction nanocomposite photocatalyst was prepared using a hydrothermal route with different molar concentration ratios. The as-synthesized nanophotocatalyst was characterized using XRD, SEM, EDS, XPS, FT-IR, Raman, BET, UV-vis DRS, EPR and PL. The effect of molar ratio on composition and morphology was studied. The as-prepared nanocomposite exhibited excellent photocatalytic response by completely degrading the model pollutant methylene blue (MB) dye in 60 min at molar concentration ratio of 2 : 1. In basic medium at pH 12, the Zn3(VO4)2/BiVO4 nanocomposite degrades MB completely within 45 min. The nanocomposite was also successfully used for the electrochemical detection of an important analyte hydrogen peroxide (H2O2). This study opens up a new horizon for the potential applications of Zn3(VO4)2/BiVO4 nanocomposite in environmental wastewater remediation as well as biosensing sciences.In this study, a Zn3(VO4)2/BiVO4 heterojunction nanocomposite photocatalyst was prepared using a hydrothermal route with different molar concentration ratios. 相似文献
65.
Anderson RA Wallace AM Sattar N Kumar N Sundaram K 《The Journal of clinical endocrinology and metabolism》2003,88(6):2784-2793
The potent synthetic androgen 7 alpha-methyl-19-nortestosterone (MENT) is resistant to 5 alpha-reductase but is a substrate for aromatase. It may therefore offer selective sparing of the prostate gland while supporting other androgen-dependent tissues. MENT acetate implants were administered for 24 wk to 16 hypogonadal men, randomly allocated to 1 or 2 implants (groups I and II, respectively; releasing approximately 400 microg/d x implant). Hemoglobin concentration and hematocrit were maintained during MENT treatment. Prostate volume fell in group I and to a small, but statistically nonsignificant, degree in group II; the level of prostate-specific antigen fell significantly in both. Lumbar spine bone mineral density decreased in both groups. Sexual behavior and erectile function declined in group I, but were maintained in group II. Thus, overall, one MENT implant appeared to provide subphysiological androgen replacement. The 2-implant dose of MENT was able to maintain most androgen-dependent functions, except bone mass, and there was evidence to support selective sparing of the prostate gland. These results demonstrate for the first time in humans the selectivity of MENT in tissues dependent on 5 alpha-reductase. In addition, our data are consistent with the importance of adequate estrogenicity as part of the necessary spectrum of activity of an androgen for replacement therapy in men. 相似文献
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69.
Ameer A. Memon Nawfal R. Hussein Véronique Y. Miendje Deyi Alain Burette John C. Atherton 《Journal of clinical microbiology》2014,52(8):2984-2989
The Helicobacter pylori virulence gene, cagA, and active forms of the vacuolating cytotoxin gene, vacA, are major determinants of pathogenesis. However, previous studies linking these factors to disease risk have often included patients using aspirin/nonsteroidal anti-inflammatory agents (NSAIDs) or acid-suppressing drugs, both of which may confound results. Also, particularly for gastric cancer (GC), controls have often been of quite different ages. Here, we performed a careful study in a “clean” Belgian population with gastric cancer cases age and sex matched to 4 controls and with a parallel duodenal ulcer (DU) group. As in other populations, there was a close association between the presence of cagA and the vacA s1 genotype. For GC, associations were found for vacA s1-positive (P = 0.01, odds ratio [OR], 9.37; 95% confidence interval [CI], 1.16 to 201.89), i1-positive (P = 0.003; OR, 12.08; 95% CI, 1.50 to 259.64), and cagA-positive status (P < 0.05; OR, infinity; 95% CI, 0.76 to infinity). For DU, associations were found with vacA s1 (P = 0.002; OR, 6.04; 95% CI, 1.52 to 27.87) and i1 (P = 0.004; OR, 4.35; 95% CI, 1.36 to 14.78) status but not with cagA status. Neither condition showed independent associations with the vacA m1 allele or with more biologically active forms of cagA with longer 3′ variable regions. In this Belgian population, the best markers of gastric cancer- and duodenal ulcer-associated strains are the vacA s1 and i1 genotypes. This fits with experimental data showing that the s and i regions are the key determinants of vacuolating cytotoxin activity. 相似文献
70.
Federica Cerri Luca Salvatore Danish Memon Filippo Martinelli Boneschi Marta Madaghiele Paola Brambilla Ubaldo Del Carro Carla Taveggia Nilo Riva Amelia Trimarco Ignazio D. Lopez Giancarlo Comi Stefano Pluchino Gianvito Martino Alessandro Sannino Angelo Quattrini 《Biomaterials》2014
Several bioengineering approaches have been proposed for peripheral nervous system repair, with limited results and still open questions about the underlying molecular mechanisms. We assessed the biological processes that occur after the implantation of collagen scaffold with a peculiar porous micro-structure of the wall in a rat sciatic nerve transection model compared to commercial collagen conduits and nerve crush injury using functional, histological and genome wide analyses. We demonstrated that within 60 days, our conduit had been completely substituted by a normal nerve. Gene expression analysis documented a precise sequential regulation of known genes involved in angiogenesis, Schwann cells/axons interactions and myelination, together with a selective modulation of key biological pathways for nerve morphogenesis induced by porous matrices. These data suggest that the scaffold's micro-structure profoundly influences cell behaviors and creates an instructive micro-environment to enhance nerve morphogenesis that can be exploited to improve recovery and understand the molecular differences between repair and regeneration. 相似文献