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排序方式: 共有2109条查询结果,搜索用时 31 毫秒
71.
Niharika Saw Joshua C. Vacanti Xiaoxia Liu Monica SaRego Hugh Flanagan Bhavani Shankar Kodali 《Journal of investigative surgery》2015,28(2):95-102
Purpose: On time start of the first surgical case improves operating room (OR) utilization, physician, and patient satisfaction and decreases delays in subsequent cases. The goal of our study was to evaluate the effect of a multidisciplinary initiative to improve first patient in the room (FPIR) and first case on time start (FCOTS) metrics in a tertiary care setting. Materials and Methods: A multidisciplinary committee focused on first case start data collection. Reasons for both anesthesia and surgical delays were analyzed. Improvement efforts focused on the timely completion of surgical consent, a requirement of a surgical, anesthesia, and nurse team member presence at the patient's bedside by specific time, and parallel processing in the OR. Results: Over 65,100 OR cases were analyzed between 2007 and 2014. There was a statistically significant improvement in FPIR (82.80% versus 69.60%, p < .0001) and FCOTS (66.60% versus 55.90%, p < .0001). Surgical consent completion rate increased from 35% baseline to 68%–100%, depending on the surgical subspecialty. Improvements appeared sustainable several years following process implementation for both FPIR (84.60% versus 69.60%, p < .0001) and FCOTS (67.60% versus 55.90%, p < .0001). Conclusions: Our study demonstrates a successful targeted, multidisciplinary initiative to improve first case surgical starts in an academic setting. Our approach was organizational rather than punitive or rewarding on an individual basis. Strategies included establishing concrete, time-specific goals and posting them visibly, empowering individuals to fulfill them, and ensuring no compromise in patient safety. In the complex environment of academic medicine including research protocols and teaching in the ORs, our organizational approach proved sustainable over several years. 相似文献
72.
Paris R Sirisopana N Benenson M Amphaiphis R Tuntichaivanich C Myint KS Brown AE 《AIDS (London, England)》2003,17(9):1363-1367
OBJECTIVES: To study the association between hepatitis C virus (HCV) and HIV-1, and HCV seropositivity as an indicator of HIV-1 risk behavior for HIV vaccine preparatory cohorts in Thailand. DESIGN: Cross-sectional study of HIV-1-infected persons identified at screening for potential HIV vaccine trial cohort studies. METHODS: Sera from HIV-1-infected and uninfected volunteers was matched by age, sex, and community, and tested for HCV reactivity. Logistic regression methods were used to measure associations between HIV-1, HCV and other risk factors for HIV infection. RESULTS: The prevalence of HCV among HIV-negative controls was 8.3% (6/72) for men and 4.2% (5/118) for women. Co-infection with HIV and occurred in 50.7% (37/73) of men and 3.4% (4/118) of women. Among men who reported injection drug use (IDU), 96.4% (27/28) were HCV seropositive. No women reported IDU. HCV was associated with HIV infection [odds ratio (OR), 11.3; 95% confidence interval (CI), 4.4-29.3] and IDU (OR, 12.0; 95% CI, 3.4-41.9) among men, but not women (OR, 0.8; 95% CI, 0.2-3.0). After adjustment for potential confounding, HCV, but not IDU, remained strongly associated with HIV-1 infection among men (OR, 9.4; 95% CI, 2.7-32.6). CONCLUSIONS: The strong associations between HCV seropositivity, HIV-1 infection, and IDU history suggest that IDU was reported accurately in this study. The surprisingly high prevalence of HCV among HIV-1-infected young men may assist health policy makers in the choice of behavioral interventions for this important subgroup of the population. 相似文献
73.
Eva Y.F. Pang Shirley S.M. Fong Mimi M.Y. Tse Eric W.C. Tam Shamay SM Ng Billy C.L. So 《Journal of Physical Therapy Science》2015,27(6):1839-1845
[Purpose] This study investigated the intra-rater, inter-rater and test-retest
reliability of the sideways step test (SST), its correlation with other indicators of
stroke-specific impairment, and the cut-off count best discriminating subjects with stroke
from their healthy counterparts. [Subjects and Methods] Forty-three subjects with chronic
stroke and 41 healthy subjects older than 50 years participated in this study. The SST was
administered along with the Fugl-Meyer motor assessment for the lower extremities
(FMA-LE), the five-times sit to stand (5TSTS) test, the Berg Balance Scale (BBS), the
movement velocity (MVL) by the limits of stability (LOS) test, the ten-metre walk (10mW)
test, the timed “Up and Go” (TUG) test and the Activities-specific Balance Confidence
(ABC) scale. [Results] The SST showed good to excellent intra-rater, inter-rater and
test-retest reliability. The SST counts correlated with 5TSTS times, 10mW times, TUG
times, and the FMA-LE and BBS scores. SST counts of 11 for the paretic leg and 14 for the
non-paretic leg were found to distinguish the healthy adults from subjects with stroke.
[Conclusion] The sideways step test is a reliable clinical test, which correlates with the
functional strength, gait speed, and functional balance of people with chronic stroke.Key words: Balance, Stroke, Rehabilitation 相似文献
74.
Assessment of aldehyde dehydrogenase in viable cells 总被引:3,自引:4,他引:3
Jones RJ; Barber JP; Vala MS; Collector MI; Kaufmann SH; Ludeman SM; Colvin OM; Hilton J 《Blood》1995,85(10):2742-2746
Cytosolic aldehyde dehydrogenase (ALDH), an enzyme responsible for oxidizing intracellular aldehydes, has an important role in ethanol, vitamin A, and cyclophosphamide metabolism. High expression of this enzyme in primitive stem cells from multiple tissues, including bone marrow and intestine, appears to be an important mechanism by which these cells are resistant to cyclophosphamide. However, although hematopoietic stem cells (HSC) express high levels of cytosolic ALDH, isolating viable HSC by their ALDH expression has not been possible because ALDH is an intracellular protein. We found that a fluorescent aldehyde, dansyl aminoacetaldehyde (DAAA), could be used in flow cytometry experiments to isolate viable mouse and human cells based on their ALDH content. The level of dansyl fluorescence exhibited by cells after incubation with DAAA paralleled cytosolic ALDH levels determined by Western blotting and the sensitivity of the cells to cyclophosphamide. Moreover, DAAA appeared to be a more sensitive means of assessing cytosolic ALDH levels than Western blotting. Bone marrow progenitors treated with DAAA proliferated normally. Furthermore, marrow cells expressing high levels of dansyl fluorescence after incubation with DAAA were enriched for hematopoietic progenitors. The ability to isolate viable cells that express high levels of cytosolic ALDH could be an important component of methodology for identifying and purifying HSC and for studying cyclophosphamide-resistant tumor cell populations. 相似文献
75.
Corticosteroids have the ability to suppress the production of growth factors and cytokines and are thus implicated in the negative regulation of hematopoiesis. We have shown that the corticosteroids, prednisolone and dexamethasone, were able to effectively protect progenitor cells in four strains of mice against cell-cycle-specific antimetabolic chemotherapy agents. The highest levels of protection against 5-fluorouracil (FU; 200 mg/kg) were achieved when two or three intraperitoneal injections of dexamethasone were administered between - 7 and +3 hours at a dose of 7.5 mg/kg/injection (optimal dose) or by continuous infusion between -4 and +20 hours. This protective effect is manifested as an increase in the number of high proliferative potential colony-forming cells that survive in the bone marrow 3 days after treatment with FU from between 0.5% and 11% to between 10% and 34% of normal. The bone marrow progenitors and blood cell numbers return to normal from 3 to 5 days and 1 to 2 days earlier, respectively. Less dexamethasone than prednisolone is required to give an equivalent protective effect, which is consistent with their anti-inflammatory potency. These findings are further evidence of the negative regulatory role played by corticosteroids, and indicate that the treatment schedules of corticosteroids during cancer therapy need to be reexamined to obtain the maximum benefit from their use. 相似文献
76.
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78.
Jacqueline Saw MD 《Catheterization and cardiovascular interventions》2014,84(7):1115-1122
Spontaneous coronary artery dissection (SCAD) is under‐diagnosed and the true prevalence is underestimated. Unfortunately, SCAD is frequently missed on coronary angiogram since the arterial wall is not imaged with this test. Optical coherence tomography or intravascular ultrasound should be the true gold‐standard to diagnose SCAD. Given the elusive angiographic diagnosis of SCAD and the lack of familiarity with angiographic variants of SCAD, a diagnostic algorithm and angiographic classification for SCAD is proposed in this article. © 2013 Wiley Periodicals, Inc. 相似文献
79.
Practice patterns and clinical outcomes among non‐ST‐segment elevation acute coronary syndrome (NSTE‐ACS) patients presenting to primary and tertiary hospitals: Insights from the EARLY glycoprotein IIb/IIIa inhibition in NSTE‐ACS (EARLY‐ACS) trial
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Olga Toleva MD Cynthia M. Westerhout PhD Manohara P.J. Senaratne MBBS PhD Christoph Bode MD Magnus Lindroos MD PhD Vitaly A. Sulimov MD PhD Gilles Montalescot MD L. Kristin Newby MD MHS Robert P. Giugliano MD SM Frans Van de Werf MD PhD Paul W. Armstrong MD 《Catheterization and cardiovascular interventions》2014,84(6):934-942
80.
Procedural variation in the performance of primary percutaneous coronary intervention for ST‐elevation myocardial infarction: A SCAI‐based survey study of US interventional cardiologists
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Austin Chiang MD Hemal Gada MD MBA Susheel K. Kodali MD Michael S. Lee MD Allen Jeremias MD Duane S. Pinto MD MPH Sripal Bangalore MD MHA Robert W. Yeh MD MSc Timothy D. Henry MD Georgina Lopez‐Cruz BS MSHA Roxana Mehran MD Ajay J. Kirtane MD SM 《Catheterization and cardiovascular interventions》2014,83(5):721-726