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41.
R. Parker Ward MD Mouaz H. Al-Mallah MD Gabriel B. Grossman MD PhD Christopher L. Hansen MD Robert C. Hendel MD Todd C. Kerwin MD Benjamin D. McCallister Jr MD Rupa Mehta MD Donna M. Polk MD MPH Peter L. Tilkemeier MD Aseem Vashist MD Kim Allan Williams MD David G. Wolinsky MD Edward P. Ficaro PhD 《Journal of nuclear cardiology》2007,14(6):911-e38
42.
R. Parker Ward Mouaz H. Al-Mallah Gabriel B. Grossman Christopher L. Hansen Robert C. Hendel Todd C. Kerwin Benjamin D. McCallister Rupa Mehta Donna M. Polk Peter L. Tilkemeier Aseem Vashist Kim Allan Williams David G. Wolinsky Edward P. Ficaro 《Journal of nuclear cardiology》2007,14(6):e26-e38
Conclusion The ACCF/ASNC AC for SPECT MPI provides recommendations for the appropriate use of SPECT MPI. After the publication of the
AC document in 2005, the AC has been used by nuclear cardiology practices with many clinical studies evaluating the list of
indications in routine clinical practice. From these data. ASNC recommends minor but important changes to the indication list,
suggesting the addition of 6 new indications and the modification of the definitions for “chest pain syndrome” and “CHD high
risk.”. An objective review of existing indications focused on only those indications that had significant variability among
the reviewers (n=20). These indications were reviewed in the presence of existing and new evidence-based data, and ASNC recommends
that the grades for 6 indications be re-evaluated.
The AC for SPECT MPI will require periodic review as new evidence becomes available or as clinical practice evolves. ASNC
recognizes the importance of these criteria to improve the quality of patient care, and it will continue to play a key role
in assembling the information for this ongoing review. From the current summary of evidence, ASNC consensus opinions, and
ASNC recommendations in this document, ASNC strongly recommends that the AC guidelines be reviewed
Prepared by the American Society of Nuclear Cardiology Quality Assurance Subcommittee for Quality in Imaging Standards.
Reviewed by members of the American Society of Nuclear Cardiology Quality Assurance Committee.
Approved by the American Society of Nuclear Cardiology Board of Directors, September 6, 20. 相似文献
43.
Ingi Lee Todd D. Barton Simin Goral Alden M. Doyle Roy D. Bloom Donna Chojnowski Kathleen Korenda Emily A. Blumberg 《American journal of transplantation》2005,5(11):2791-2795
Dapsone, used for prevention of Pneumocystis jirovecii infections, has been reported to cause hemolytic anemia and methemoglobinemia; its tolerability in solid organ transplant recipients is not well described. We investigated dapsone-related adverse events in patients undergoing solid organ transplantation from 1999 to 2004. Transplant providers identified patients for the investigators who then reviewed the patients' hospital and outpatient records. Sixteen solid organ transplant recipients fit case definitions for dapsone-related hemolytic anemia (n = 11) or methemoglobinemia (n = 5). Median time from event to dapsone discontinuation was 15 days; all patients improved after drug discontinuation. G6PD enzyme activity was normal in all patients whose test results were available. Dapsone may be associated with hemolytic anemia or methemoglobinemia, even with normal G6PD levels. These events are often not promptly recognized, and drug discontinuation is delayed. Dapsone-related hemolytic anemia or methemoglobinemia should be considered in solid organ transplant recipients with unexplained anemia or hypoxia. 相似文献
44.
Cerebral Cortical Aquaporin-4 Expression in Brain Edema following Cardiac Arrest in Rats 总被引:14,自引:0,他引:14
Feng Xiao MD MS Thomas C. Arnold MD Shu Zhang MD Carlos Brown J. Steven Alexander PhD Donna L. Carden MD Steven A. Conrad MD PhD 《Academic emergency medicine》2004,11(10):1001-1007
OBJECTIVES: Brain edema occurs following clinical as well as experimental cardiac arrest (CA) and predicts a poor neurologic outcome. The objective of this study was to determine the expression of cerebral cortex aquaporin (AQP)-4, a member of a family of membrane water-channel proteins, in brain edema formation following normothermic or hypothermic CA. METHODS: Twenty-four rats were subjected to time-matched normothermic (N-Sham, 37.5 degrees C +/- 0.5 degrees C, n = 6) or hypothermic (H-Sham, 34 degrees C +/- 0.5 degrees C, n = 6) sham experiments and normothermic (N-CA, n = 6) or hypothermic (H-CA, n = 6) CA induced by asphyxiation for 8 minutes. Hypothermia was induced before CA. The animals were resuscitated with cardiopulmonary resuscitation, ventilation, and epinephrine administration. Brain edema was determined by brain wet-to-dry weight ratio at one hour of resuscitation. AQP4 immunoactivity in the cerebral cortex was determined using immunohistochemical staining and was semiquantified as an intensity of staining with an automated cell imaging system. RESULTS: Mild hypothermia in the sham experiments did not alter cerebral cortex AQP4 immunoactivity (mean +/- SD) (55.0 +/- 3.7 in H-Sham vs. 53.3 +/- 1.7 in N-Sham, p > 0.05). N-CA resulted in a significant increase in AQP4 immunoactivity (61.8 +/- 4.5) compared with N-Sham (p = 0.01) and H-Sham (p = 0.03). H-CA attenuated AQP4 compared with N-CA (53.4 +/- 1.3, p = 0.01). Brain wet-to-dry weight ratios were 4.41 +/- 0.07 in N-Sham, 4.40 +/- 0.08 in H-Sham (p > 0.05 vs. N-Sham), 4.55 +/- 0.04 in N-CA (p = 0.004 vs. N-Sham; p = 0.005 vs. H-Sham), and 4.43 +/- 0.09 in H-CA (p = 0.02 vs. N-CA; p > 0.05 vs. N-Sham and H-Sham). CONCLUSIONS: Cerebral cortical AQP4 expression is up-regulated after normothermic CA, which is attenuated by hypothermia induced before CA. 相似文献
45.
46.
47.
Bonnie L. Westra R.N. Ph.D. Laura Cullen R.N. M.A. Donna Brody R.N. M.S.N. Patricia Jump R.N. M.S. Letitia Geanon R.N. M.S. Ellen Milad R.N. M.S. 《Public health nursing (Boston, Mass.)》1995,12(6):393-399
Abstract Client (patient) satisfaction has been studied extensively in the health care sector, yet those receiving home health care services have been the focus of few studies. The purpose of this study was to test the reliability and validity of the Home Care Client Satisfaction Instrument (HCCSI). A total of 400 clients, randomly selected from 20 randomly chosen home care agencies in one state, completed the HCCSI and demographic form. Most respondents were older adults with multiple health problems and their families or informal support systems. Since data were skewed, item analysis was used. The revised instrument (HCCSI-R) is unidimensional and includes 12 items rated on a 5-point Likert scale measuring specific aspects of care. In addition, there are three global measures of satisfaction rated on a 10-point scale. All items except one had significant item-total correlations greater than .59. The total score correlates with likeliness to recommend the agency to others (.37, p = .0001), showing some evidence for criterion-related validity. 相似文献
48.
French Donna L. Häglund Bert O. Himmelstein Kenneth J. Mauger John W. 《Pharmaceutical research》1995,12(10):1513-1520
Purpose. The objective of this study is to correlate drug release mechanism with measured drug concentration profiles in gel layers of Carbopol® matrices containing mesalamine or benzoic acid.
Methods. Release rate experiments with Carbopol® matrices were performed using a rotating disk apparatus. Matrices were frozen and the gel layer in the matrices was sliced using a microtome in a cryostat. Drug concentration profiles were determined by direct measurement of the concentration of the drug in the gel slices. The pH of the slices was measured using microelectrodes, and water content was measured by Karl Fisher titration.
Results. The concentration gradient in mesalamine matrices decreased over time and correlated with square root of time release rate kinetics. The concentration profiles of benzoic acid were unchanged over time and correlated with zero order release rate kinetics. Carbopol gel layers were highly hydrated (93–95% water). Gel layers in matrices with mesalamine had a more alkaline microenvironmental pH. This higher pH resulted in increased growth of the thickness of the gel layer and a reduction drug diffusivity in comparison to benzoic acid matrices.
Conclusions. The release rate kinetics of mesalamine and benzoic acid correlated to the measured concentration profiles. The shape of the concentration profiles is determined by the rate of growth of the Carbopol® gel layer and drug diffusivity. 相似文献
49.
Marilyn Rodney Carla Clasen Gloria Goldman Ronald Markert Donna Deane 《Journal of community health》1998,23(5):371-381
The title Community Health Advocate (CHA) is one of thirty or more titles used throughout the world for an indigenous outreach worker who is trusted and respected in his or her community and who serves as a bridge between peers and health professionals. In 1992, the Center for Healthy Communities in Dayton, Ohio developed a program to train as Advocates people indigenous to the communities in which they would be working. Since the first CHAs began work in January 1993, the effectiveness of the program has been evaluated from three perspectives: the Community Health Advocates, the managers directors of the community sites at which the CHAs work, and the clients with whom the CHAs work. Advocates indicated that the training program adequately prepared them for their roles and functions. They also identified systematic frustrations and barriers that made it more difficult for them to perform their job. Community site directors and community leaders indicated that the CHAs were considered a positive force in meeting client needs and facilitating independence, and were very effective in outreach and coordination of resources. A survey of CHA clients revealed an overwhelmingly positive response to the Advocate's work, validating the belief that CHAs can fill an important niche in the health care community. The three evaluation processes described in this paper helped to document the need for and the effectiveness of this program and can serve as a model for similar programs. 相似文献
50.