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81.
Peter M Miller Ruth Stockdell Lynne Nemeth Chris Feifer Ruth G Jenkins Paul J Nietert Andrea Wessell Heather Liszka Steven Ornstein 《Substance Abuse》2006,27(1-2):61-70
Many medical conditions are caused or exacerbated by heavy drinking, necessitating alcohol screening and discussion in primary care practices. This is particularly true of hypertension, the most common primary diagnosis in the United States, which has been linked to the regular consumption of 3 or more standard alcoholic beverages a day. The Accelerating Alcohol Screening-Translating Research into Practice (AA-TRIP) project was designed to improve detection and management of alcohol problems in primary care patients with hypertension. Medical providers are being trained using the Practice Partner Research Network's- Translating Research into Practice (PPRNet-TRIP) quality improvement model. This includes a multi-method intervention (electronic medical records, on-site academic detailing, practice feedback reports and annual network meetings) to help practices increase adherence to clinical guidelines. Qualitative analyses of initial steps taken by nine primary care practices toward the routine implementation of alcohol screening guidelines are presented. Organizational factors and provider and patient characteristics all influenced the method and consistency of alcohol screening and intervention. Perceived time constraints, patient sensitivity to questions about alcohol, and possible stigma associated with a diagnosis of alcoholism were also relevant barriers requiring problem solving. 相似文献
82.
Ping L. Zhang Sayeed K. Malek Jeffery W. Prichard Fan Lin Taher M. Yahya Michael S. Schwartzman Ruth P. Latsha Evan R. Norfolk Thomas M. Blasick Mingyue Lun Robert E. Brown James E. Hartle Santosh Potdar 《American journal of transplantation》2005,5(3):604-607
Campath-1H has been used successfully for induction and has resulted in a low rate of acute cellular rejection (ACR) in renal transplantation in combination with various postoperative immunosuppression regimens. This study was undertaken to investigate the extent of monocyte involvement in ACR, with or without Campath-1H induction. We found that monocytes represented the majority of inflammatory cells in grades Ib or higher ACR, but not with Ia type of ACR, regardless of the status of Campath-1H induction. Cases of ACR, following Campath-1H induction, appear to demonstrate a 'pure form' of monocytic ACR, whereas monocytes were mixed with many other types of inflammatory cells in the cases of ACR in the absence of Campath-1H induction. In addition with Campath-1H induction, the cases of monocyte-predominant ACR were found to uniformly exhibit a good response to corticosteroid treatment. We conclude that monocyte-predominate ACR may represent a severe form of rejection, with or without Campath-1H treatment. 相似文献
83.
Jean-Pierre Lindenmayer M.D. Ruth Bernstein-Hyman Ph.D. Sandra Grochowski B.A. 《The Psychiatric quarterly》1994,65(4):299-322
Schizophrenic psychopathology is heterogeneous and multidimensional. Various strategies have been developed over the past
several years to assess and measure more accurately discrete domains of psychopathology. One of the more fruitful strategies
to investigate more homogenous domains of psychopathology has been the positive-negative syndrome approach. However, this
approach is unable to address a number of important issues. Most schizophrenics present a mixed syndrome; the criteria for
what constitutes a positive and negative syndrome are variable; distinguishing primary from secondary negative symptoms can
be difficult. In order to address some of these problems, we propose the introduction of a five syndrome model based on a
reanalysis of factor analytic procedures used on 240 schizophrenics assessed with the Positive and Negative Syndrome Scale
(PANSS). We present data on a 5-factor solution which appears to best fit the psychopathological data and which is supported
by three independent and comparable factor analyses; negative, positive, excitement, cognitive and depression/anxiety domains
of psychopathology give patients their individual mark. Data on internal consistency of the five factors and on initial validation
using demographic and clinical variables are presented. 相似文献
84.
Ast Gil; Goldblatt Drora; Waisman Ari; Sperling Ruth; Mozes Edna; Sperling Joseph 《International immunology》1994,6(8):1097-1105
85.
Jun Gu Yang O Huh Feng Jiang Nancy P Caraway Jorge E Romaguera Tanweer M Zaidi Ricardo L Fernandez Huazhong Zhang Issa F Khouri Ruth L Katz 《Modern pathology》2004,17(5):553-560
Mantle cell lymphoma is non-Hodgkin's B-cell lymphoma characterized by the t(11;14)(q13;q32) translocation. Peripheral blood involvement of mantle cell lymphoma is usually associated with a poor prognosis and therefore, its identification is clinically important. In this study, we performed cyclin D1/IgH-probe fusion fluorescence in situ hybridization analysis on 223 peripheral blood samples: 185 from 125 mantle cell lymphoma patients, and 38 normal controls. The cutoff values for the test were established using normal controls. Flow cytometry on peripheral blood and corresponding bone marrow samples was used to evaluate this test. In all, 26% of the 185 peripheral blood samples and 27% of the 161 corresponding bone marrow samples were flow cytometry positive for mantle cell lymphoma. The mean numbers of single and- double-fusion signals and the mean number of CD5/CD19-positive cells, absolute blood lymphocyte count, and white blood cell count were significantly higher in peripheral blood and corresponding bone marrow samples with mantle cell lymphoma-positive flow cytometry. Double-fusion signals were more specific than single-fusion ones. Fluorescence in situ hybridization was far more likely to be positive for mantle cell lymphoma when the peripheral blood and the corresponding bone marrow samples had positive flow cytometry results or morphology (P<0.01). Our study indicates that cyclin D1/IgH-fusion fluorescence in situ hybridization analysis could be used to determine the presence and character of circulating mantle cell lymphoma cells in peripheral blood, thus enhancing our ability to evaluate leukemic mantle cell lymphoma and minimum residual disease. 相似文献
86.
J. Mittler A. Pascher S. Jonas J. Pratschke U. P. Neumann J. M. Langrehr P. Neuhaus 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》2007,392(6):657-662
Background Adult living donor liver transplantation (LDLT) has become a routine treatment option for patients waiting for liver transplantation.
In European and North American countries, LDLT for adult recipients is mainly performed with right lobe grafts. Indications,
when compared to deceased donor liver transplantation, are controversial.
Materials and methods In our institution, patients suffering from hepatocellular carcinoma in cirrhosis, non-resectable hilar cholangiocarcinoma,
viral hepatitis associated cirrhosis, as well as cholestatic liver and biliary disease are considered good candidates for
LDLT.
Results In this overview, donor evaluation, graft selection, and the donor operation with special regard to operative techniques and
strategies are discussed. For visualization, a 5-min video sequence of the standard donor operation as performed in our institution
is attached.
Conclusion Given the ongoing shortage of donor organs, adult LDLT has become a routine treatment option for patients waiting for liver
transplantation. The associated inevitable risk for the healthy donor, however, remains ethically controversial.
Electronic supplementary material The online version of this article (doi:) contains supplementary material, which is available to authorized users. 相似文献
87.
Lorraine N Clark Eneli Haamer Helen Mejia-Santana Juliette Harris Suzanne Lesage Alexandra Durr Sabine Janin Bs Katja Hedrich Elan D Louis Lucien J Cote Howard Andrews Stanley Fahn Cheryl Waters Blair Ford Steven Frucht William Scott Christine Klein Alexis Brice Hanno Roomere Ruth Ottman Karen Marder 《Movement disorders》2007,22(7):932-937
Parkin mutations account for the majority of familial and sporadic early onset Parkinson's disease (EOPD) cases with a known genetic association. More than 100 mutations have been described in the Parkin gene that includes homozygous, compound heterozygous, and single heterozygous mutations. We have designed a Parkin mutation genotyping array (gene chip) that includes published Parkin sequence variants and allows their simultaneous detection. The chip was validated by screening 85 PD cases and 47 controls previously tested for Parkin mutations. Similar genotyping microarrays have been developed for other genetically heterogeneous diseases including age-related macular degeneration. Here, we show the utility of a genotyping array for Parkinson's disease by analysis of 60 subjects from the Genetic Epidemiology of Parkinson Disease (GEPD) study that includes 15 early-onset PD case probands and 45 relatives. 相似文献
88.
89.
90.
Felix Matthews Valentin Neuhaus Daniel Schmucki Ronald Schwyn Thomas Gross Pietro Regazzoni Otmar Trentz Peter Messmer 《European Journal of Trauma》2005,31(6):568-574
Abstract During treatment of femoral shaft fractures, not only the actual fracture reduction but also the retention of the achieved
reduction is essential. Substantial forces may apply to the bone fragments, due to multidirectional muscular contraction.
Furthermore, forces from manipulation of one bone fragment may be transferred over the soft tissues onto the other fragments,
thus hindering accurate fracture reduction. Once a sufficient reduction has been achieved, this position must be retained
whilst definitive internal fixation is performed. Conventional methods comprise mounting patients on a traction table and
applying manual distraction or employing special distraction devices, such as the AO distractor device. These approaches,
however, only insufficiently stabilize both main fragments. For example, on the traction table the proximal femoral fragment
can pivot around the hip joint thus complicating precise reduction. A novel pneumatic stabilization device to assist surgeons
during operative procedures is described. This passive holding device “Passhold” connects to one main fragment through a minimally
invasive bone interface and statically locks the fragment’s position. Thereafter, only the other main fragment is manipulated
to achieve reduction. Mutual interference of the reciprocal fragment positions, due to soft-tissue force transfer during manipulation,
is avoided. The authors examined the stability of the novel retention device on a test rig and proved its functionality under
sterile settings using cadaver tests. It is concluded that this device largely facilitates the operative procedure in femoral
shaft fractures, is sufficiently stable and ergonomically suitable for intraoperative deployment. 相似文献