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31.
The aim of the present study was to compare the efficacy of intratracheal continuous insufflation of oxygen (CIO) with intermittent positive pressure ventilation (IPPV) regarding gas exchange and haemodynamics during mechanical chest compression-active decompression cardiopulmonary resuscitation (mCPR) provided by the LUCAS device. Ventricular fibrillation (VF) was induced electrically and ventilation was discontinued in 16 pigs, mean body weight 23 kg (range 22-27 kg). They were randomized into two groups (CIO versus IPPV). After 8 min of VF, mCPR was started and run for 30 min in normothermia, after which defibrillation was attempted during on-going mCPR. Return of spontaneous circulation was obtained in eight of eight CIO pigs and in four of eight IPPV pigs. Arterial oxygen tension (P < 0.05) and coronary perfusion pressure (P < 0.01) were significantly higher in the CIO pigs. Arterial CO(2)-tension was subnormal in both groups and significantly (P < 0.05) lower in the IPPV-pigs (around 4.5 versus 3.0 kPa). The intratracheal pressure differed significantly (P < 0.001) between the two groups. It was negative in each decompression phase in the IPPV pigs in spite of 6 mmHg of PEEP. The CIO pigs had a positive intratracheal pressure during the whole cycle of mCPR, with a minimum pressure of 8 mmHg during each decompression phase. To conclude, mCPR combined with CIO gave adequate ventilation and significantly better oxygenation and coronary perfusion pressure than mCPR combined with IPPV. 相似文献
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Coghill D Soutullo C d'Aubuisson C Preuss U Lindback T Silverberg M Buitelaar J 《Child and adolescent psychiatry and mental health》2008,2(1):31-15
Background
Children with attention-deficit/hyperactivity disorder (ADHD) often experience problems with education, interaction with others and emotional disturbances. Families of ADHD children also suffer a significant burden, in terms of strain on relationships and reduced work productivity. This parent survey assessed daily life for children with ADHD and their families.Method
This pan-European survey involved the completion of an on-line questionnaire by parents of children (6–18 years) with ADHD (ADHD sample) and without ADHD (normative population sample). Parents were questioned about the impact of their child's ADHD on everyday activities, general behaviour and family relationships.Results
The ADHD sample comprised 910 parents and the normative population sample 995 parents. 62% of ADHD children were not currently receiving medication; 15% were receiving 6–8 hour stimulant medication and 23% 12-hour stimulant medication. Compared with the normative population sample, parents reported that ADHD children consistently displayed more demanding, noisy, disruptive, disorganised and impulsive behaviour. Significantly more parents reported that ADHD children experienced challenges throughout the day, from morning until bedtime, compared with the normative population sample. Parents reported that children with ADHD receiving 12-hour stimulant medication experienced fewer challenges during early afternoon and late afternoon/early evening than children receiving 6–8 hour stimulant medication; by late evening and bedtime however, this difference was not apparent. ADHD was reported to impact most significantly on activities such as homework, family routines and playing with other children. All relationships between ADHD children and others were also negatively affected, especially those between parent and child (72% of respondents). Parents reported that more children with ADHD experienced a personal injury in the preceding 12 months, including those requiring the attention of healthcare professionals. Although 68% of parents were satisfied with their child's current treatment, 35–40% stated that their child's ADHD symptoms needed to be more effectively treated during the afternoon and evening.Conclusion
This parent survey highlights the breadth of problems experienced by ADHD children and the impact throughout the day on both activities and relationships. Therefore, there is a need for treatment approaches that take into account the 24-hour impact of the disorder and include all-day coverage with effective medication. 相似文献34.
Bodil Ivarsson Sylvia Larsson Per Johnsson Carsten Lührs Trygve Sjberg 《Intensive & critical care nursing》2008,24(4):242-250
OBJECTIVE: Relatives of patients undergoing cardiac surgery expect successful outcome but sometimes complications cause death. The aim was to interview relatives of patients who have died in connection with cardiac surgery and describe their experiences of information, reception and care. METHODS: Data were obtained from semi-structured interviews with 18 relatives of deceased patients and then analysed using qualitative content analysis. RESULTS: Two main groups emerged: "Analysing the situation" with the sub-groups: knowledge of cardiac disease, the road to operation, hope and despair, information and choice and "The thin thread of life" with the sub-groups, reception, life is over, care, death as a relief, cause of death and support. CONCLUSION: Most relatives were satisfied with the information and care in connection with the operation and at the end of life. However, some aspects such as inadequate pain control and transportation of critically ill patients to other wards and hospitals could be improved. One way is to introduce a co-ordinator in order to better support patients, next of kin and colleagues without experience of cardio-thoracic surgery who need help during the patients' way from diagnosis and acceptance of cardiac surgery and through the treatment and postoperative care. 相似文献
35.
BACKGROUND: Analysis of the electrocardiogram (ECG) can predict if a cardiac arrest patient in ventricular fibrillation is likely to have a return of spontaneous circulation if defibrillated. The accuracy of such methods determines how useful it is clinically and for retrospective analysis. METHODS AND RESULTS: We wanted to identify if there is a potential of improving prediction accuracy by adding peri-arrest factors to an ECG-based prediction system, or constructing a prediction system that adapts to each patient. Therefore, we analysed shock outcome prediction data with a mixed effects logistic regression model to identify if there are random effects (unexplained variation between patients) influencing the prediction accuracy. We also added information about the patients' age, sex and presenting rhythm, ambulance response time and presence of bystander CPR to the model to try to improve it by reducing the random effects. For all the six predictive features analysed random effects where present, with p-values below 10(-3). The random effect size was 73-189% of the feature effect size. Adding the peri-arrest factors to the best ECG-based model gave no significant improvement. CONCLUSIONS: The presence of random effects shows that the shock outcome prediction accuracy can be improved by explaining more of the variation between patients, for example using the approaches outlined above, and that there is within-patient correlation between samples that should be accounted for when evaluating prediction accuracy. The specific peri-arrest factors tested here did not significantly improve prediction accuracy, but other factors should be explored. 相似文献
36.
The significance of meaningful and enjoyable activities for nursing home resident's experiences of dignity
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?shild Sletteb? PhD Berit S?teren PhD Synn?ve Caspari PhD Vibeke Lohne PhD Arne Wilhelm Rehnsfeldt PhD Anne Kari Tolo Heggestad PhD Britt Lillest? PhD Bente H?y PhD Maj‐Britt R?holm PhD Lillemor Lindwall PhD Trygve Aasgaard PhD Dagfinn N?den PhD 《Scandinavian journal of caring sciences》2017,31(4):718-726
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38.
Odd Helge Gilja Trygve Hausken Christen J. Bang Arnold Berstad 《Digestive diseases and sciences》1997,42(10):2124-2131
The purpose of this study was to investigatewhether sublingual glyceryl trinitrate influences thesize of the proximal stomach and postprandial symptomsin patients with functional dyspepsia. Twenty patients with functional dyspepsia were included in adouble-blind, placebo-controlled crossover study withsublingual glyceryl trinitrate. All patients werescanned twice on consecutive days, receiving eitherplacebo or 0.5 mg glyceryl trinitrate randomly 5 minprior to ingestion of 500 ml meat soup. Total symptoms,pain, nausea, and bloating were scored on a visualanalog scale before and after the meal. Standardized ultrasonograms were obtained 1, 10, and 20 minpostprandially of the proximal and distal stomach. Theproximal stomach was larger in the sagittal section at1 min postcibally (26.5 ± 3.9 vs 24.8 ±4.9 cm2, P = 0.036) and 10 min postprandially (22.0± 5.1 vs 19.8 ± 5.3 cm2, P =0.009) after administration of glyceryl trinitratecompared with placebo, whereas a tendency was observedafter 20 min (18.7 ± 5.5 vs 17.3 ± 5.7 cm2, P = 0.076). The correspondingchanges in the frontal diameters were 8.3 ± 1.1vs 7.8 ± 1.2 cm (P = 0.067) after 1 min, 7.2± 0.9 vs 6.4 ± 0.8 cm (P = 0.001) after 10min, and 6.3 ± 1.1 vs 5.6 ± 1.2 cm (P =0.016) after 20 min. The area of the distal stomach was notdifferent (P = 0.31) in the two groups. Afteradministration of glyceryl trinitrate, the patientsreported less pain (P = 0.048) and nausea (P = 0.023) 5min postprandially, but this effect was reduced 15min later. Total symptom score was improved by glyceryltrinitrate treatment (P = 0.042). Sublingual glyceryltrinitrate improves accommodation of the proximal stomach to a meal and reduces postprandialsymptoms in a group of patients with functionaldyspepsia. 相似文献
39.
Anjali Gupta Taofik Oyekunle Omolola Salako Adetola Daramola Olusegun Alatise Gabriel Ogun Adewale Adeniyi April Deveaux Veeral Saraiya Allison Hall Omobolaji Ayandipo Thomas Olajide Olalekan Olasehinde Olukayode Arowolo Adewale Adisa Oludolapo Afuwape Aralola Olusanya Aderemi Adegoke Trygve O. Tollefsbol Donna Arnett Michael J. Muehlbauer Christopher B. Newgard H Africa Kidney Research Network Tomi Akinyemiju 《Oncotarget》2021,12(13):1230
Breast cancer (BC) in Nigeria is characterized by disproportionately aggressive molecular subtypes. C-reactive protein (CRP) is associated with risk and aggressiveness for several types of cancer. We examined the association of high-sensitivity CRP (hsCRP) with odds of BC by molecular subtype among Nigerian women. Among 296 newly diagnosed BC cases and 259 healthy controls, multivariable logistic regression models were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for the association between hsCRP and odds of BC overall and by molecular subtype (luminal A, luminal B, HER2-enriched and triple-negative or TNBC). High hsCRP (> 3 mg/L) was observed in 57% of cases and 31% of controls and was associated with 4 times the odds of BC (aOR: 4.43; 95% CI: 2.56, 7.66) after adjusting for socio-demographic, reproductive, and clinical variables. This association persisted regardless of menopausal status and body mass index (BMI) category. High hsCRP was associated with increased odds of TNBC (aOR: 3.32; 95% CI: 1.07, 10.35), luminal A BC (aOR: 4.03; 95% CI: 1.29, 12.64), and HER2-enriched BC (aOR: 6.27; 95% CI: 1.69, 23.25). Future studies are necessary in this population to further evaluate a potential role for CRP as a predictive biomarker for BC. 相似文献
40.
Anja Wiedswang Horjen Ingebjørg Seljeflot Trygve Berge Pål Smith Harald Arnesen Arnljot Tveit 《Thrombosis journal》2017,15(1):30