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181.
Barbara A. Laraia Author Vitae Judith B. BorjaAuthor Vitae Margaret E. BentleyAuthor Vitae 《Journal of the American Dietetic Association》2009,109(6):1042-1047
African Americans experience household food insecurity, ie, the limited availability of nutritionally adequate and safe food, or ability to acquire acceptable foods in socially acceptable ways, at three times the rate of non-Hispanic whites. Thirty percent of all African-American children live in food-insecure households. The purpose of this study was to identify characteristics associated with household food insecurity among a high-risk postpartum population. Two-hundred six low-income, African-American mother−infant dyads were recruited through the Special Supplemental Nutrition Program for Women, Infants, and Children clinics. The six-item US Department of Agriculture food security scale was used to classify households as food secure, marginally food secure, or food insecure. Multinomial logistic regression was used to estimate the association between selected maternal/household characteristics and household food-security status. Fifty-three percent of households were food secure, 34% were marginally food secure, and 13% were food insecure. Maternal education less than college (relative risk ratio [RRR]=0.46; 95% confidence interval [CI]: 0.22 to 0.98) was inversely associated with marginal food security. Depressive symptoms (RRR=1.09; 95% CI: 1.02 to 1.16) and having the baby's father in the household (RRR=3.46; 95% CI: 1.22 to 9.82) were associated with household food insecurity, while having a grandmother in the household (RRR=0.15; 95% CI: 0.03 to 0.80) was inversely associated with experiencing household food insecurity. Findings from this study suggest that young, low-income, African-American families with only one child are particularly susceptible to experiencing household food insecurity. Intergenerational support and transfer of knowledge can be a key protective attribute among low-income African-American households. 相似文献
182.
183.
Gastrojejunostomy stricture after Roux-en-Y gastric bypass occurs in 3 to 27% of morbidly obese patients in the USA. We questioned
whether preoperative patient characteristics, including demographic attributes and comorbid disease, might be significant
factors in the etiology of stricture. In this study from November 2001 to February 2006 (51 months), at a high-volume bariatric
center, of the 1,351 patients who underwent laparoscopic gastric bypass, 92 developed stricture (6.8%). All but two were treated
successfully by endoscopic dilation. All patients stopped nonsteroidal anti-inflammatory medications 2 weeks prior to surgery
and did not restart them. The operative procedure included the use of a 21-mm transoral circular stapler to create the gastrojejunostomy;
the Roux limb was brought retrogastric, retrocolic. In an effort to reduce our center’s stricture rate, late in the study,
U-clips used at the gastrojejunostomy were replaced by absorbable sutures, and postoperative H2 antagonists were added to the treatment protocol. The change to absorbable polyglactin suture proved to be significant, resulting
in a lower stricture rate. The addition of H2 antagonists showed no significant effect. Following the retrospective review of the prospective database, univariate and
multivariate logistic regression analyses identified factors associated with the development of stricture. Gastroesophageal
reflux disease and age were each shown to be statistically significant independent predictors of stricture following laparoscopic
gastric bypass.
Presented at the 2006 Annual Meeting of the Society for Surgery of the Alimentary Tract, May 20–24, Los Angeles, CA (poster
presentation). 相似文献
184.
Michael Dietrich Christoph Meier Daniela Zeller Patrick Grueninger Roger Berbig Andreas Platz 《European journal of trauma and emergency surgery》2007,33(5):512-519
Abstract
Background: Primary shoulder hemiarthroplasty is an established treatment modality for complex fractures of the proximal humerus. Long-term
functional outcome is often disappointing. However, little is known about social implications particularly in the elderly.
Methods: A single-institution case series of consecutive geriatric patients (age > 70 years) treated with shoulder hemiarthroplasty
for complex fractures of the proximal humerus between 1994 and 1997 was analysed. Postoperative morbidity, long-term function,
radiological outcome and social implications were evaluated.
Results: Seventy-seven patients fulfilled the study criteria. Median age at the time of operation was 80 years (range 70–93 years).
Systemic and local postoperative complications were observed in 8% including 2 patients (3%) with revision surgery. Postoperative
mortality was 1%. Forty-eight patients (62%) were available for follow-up (median 49 months, range 25–80 months), 22 (29%)
died from causes unrelated to hemiarthroplasty before follow-up and 7 patients (9%) did not attend follow-up examination.
Median Constant-Murley score was 41 points (range 17–77 points). Long-term results concerning pain were satisfying. The Oxford
shoulder score ranged from 14 to 40 (median 30). Forty-one patients (85%) still lived in their original environment and managed
their daily life independently despite poor shoulder function. Four patients (8%) lived in a retirement home and 3 (6%) in
a nursery home. Eighty percent of our patients were still able to use public transportation, do the daily shopping and wash
their whole body by themselves.
Conclusion: Most patients managed their daily life independently despite poor shoulder function. 相似文献
185.
Dittmar Böckler Hardy Schumacher Klaus Klemm Marcel Riemensperger Philipp Geisbüsch Drosos Kotelis Harry Rotert Jens-Rainer Allenberg 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》2007,392(6):715-723
OBJECTIVES: to report our experience with hybrid vascular procedures in patients with pararenal and thoracoabdominal aortic pathologies. METHODS: 68 patients were treated for thoracoabdominal aortic pathologies between October 1999 and February 2004; 19 patients (16 men; mean age 68, range 40-79) with high risk for open thoracoabdominal repair were considered to be candidates for combined endovascular and open repair. Aortic pathologies included five thoracoabdominal Crawford I aneurysms, one postdissection expanding aneurysm, three symptomatic plaque ruptures (Crawford IV), five combined thoracic descending and infrarenal aneurysms with a healthy visceral segment, three juxtarenal or para-anastomotic aneurysms, and two patients with simultaneous open aortic arch replacement and a rendezvous maneuver for thoracic endografting. Commercially available endografts were implanted with standardized endovascular techniques after revascularization of visceral and renal arteries. RESULTS: Technical success was 95%. One patient developed a proximal type I endoleak after chronic expanding type B dissection and currently is waiting conversion. Nine patients underwent elective, five emergency and five urgent (within 24 h) repair. 17 operations were performed simultaneously, and 2 as a staged procedure. Postoperative complications include two retroperitoneal hemorrhages, and one patient required long-term ventilation with preexisting subglottic tracheal stenosis. Thirty-day mortality was 17% (one multiple organ failure, one secondary rupture after open aortic arch repair, one myocardial infarction). Paraplegia or acute renal failure were not observed. Total survival rate was to 83% with a mean follow-up of 30 months. CONCLUSIONS: Midterm results of combined endovascular and open procedures in the thoracoabdominal aorta are encouraging in selected high risk patients. Staged interventions may reduce morbidity. 相似文献
186.
Background
Hip dislocation in children with cerebral palsy (CP) is a common and severe problem. The dislocation can be avoided, by screening and preventive treatment of children with hips at risk. The aim of this study was to analyse the characteristics of children with CP who develop hip displacement, in order to optimise a hip surveillance programme. 相似文献187.
Steven Z George John D Childs Deydre S Teyhen Samuel S Wu Alison C Wright Jessica L Dugan Michael E Robinson 《BMC musculoskeletal disorders》2007,8(1):92
Background
There are few effective strategies reported for the primary prevention of low back pain (LBP). Core stabilization exercises targeting the deep abdominal and trunk musculature and psychosocial education programs addressing patient beliefs and coping styles represent the current best evidence for secondary prevention of low back pain. However, these programs have not been widely tested to determine if they are effective at preventing the primary onset and/or severity of LBP. The purpose of this cluster randomized clinical trial is to determine if a combined core stabilization exercise and education program is effective in preventing the onset and/or severity of LBP. The effect of the combined program will be compared to three other standard programs. 相似文献188.
Philippe Béchard Pierre Dolbec Julie Germain Gino Perron 《Journal canadien d'anesthésie》2004,51(4):398-399
189.
190.