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111.
Jose M. Quintana PhD Antonio Escobar PhD Amaia Bilbao MSc Gemma Navarro PhD Jose M. Begiristain PhD Nerea Fernandez De Larrea MD Emilio Perea PhD Txomin Alberdi MD the IRYSS Cataract Group 《Journal of evaluation in clinical practice》2010,16(4):665-672
Objective To evaluate the contribution of hospital‐to‐hospital variability in changes in clinical and health‐related quality of life outcomes among patients undergoing cataract extraction by phacoemulsification. Methods Prospective observational study of 14 public hospitals. We recruited consecutive patients on waiting lists for cataract extraction. Clinical data were collected prior to the intervention and 6 weeks afterward. Subjects completed the visual function index (VF‐14) prior to the procedure and 3 months afterward. Univariate and multivariate analysis were performed for visual acuity and VF‐14 scores. Results Substantial differences were observed across the 14 hospitals. At baseline, mean visual acuity ranged from 0.16 to 0.34, and mean VF‐14 scores ranged from 48.06 to 75.89. Following cataract extraction, the mean improvement in visual acuity ranged from 0.35 to 0.57 and in VF‐14 scores from 10.94 to 41.70. The ranges were even more pronounced among patients with low visual acuity or low VF‐14 scores prior to the intervention. Significant differences remained in multivariate analysis. Within the multivariate analysis, the variable ‘hospitals’ had an R2 of 0.069 for the visual acuity model and of 0.073 for the VF‐14 model, 20% and 13%, respectively, of the total variability explained. Variation was also observed within geographic regions. Conclusions Outcomes of patients undergoing cataract extractions vary widely from hospital to hospital, even within the same geographic region, explaining an important part of the results. Quality improvement efforts should concentrate on patients with low pre‐intervention visual acuity or vision‐related disability to reduce this variability in outcomes. 相似文献
112.
Tuset M Martín-Conde MT Miró JM Del Cacho E Alberdi A Codina C Ribas J 《Enfermedades infecciosas y microbiología clínica》2003,21(8):433-57; quiz 458, 467
This article summarizes the principal characteristics of the drugs used to treat viral infections, with the exception of human immunodeficiency virus infection. It includes antiviral agents active against herpes virus, cytomegalovirus, hepatitis B and C virus, and respiratory viruses, such as influenza and respiratory syncytial virus. Dosage according to the indication, dose adjustment in the case of renal or hepatic insufficiency, significant pharmacokinetic characteristics, and the main adverse effects and interactions are described. 相似文献
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114.
J R Banegas J C Alberdi F Rodríguez-Artalejo V Domínguez J del Rey Calero 《Gaceta sanitaria / S.E.S.P.A.S》1992,6(30):97-104
With the objective of studying the temporal evolution of ischaemic cardiopathy (IC), or coronary heart disease mortality, in Spain, we carried out a cohort analysis with conventional graphic techniques and modern statistical methods. This permits better understanding and quantification of the age-period-cohort effects and identification of the potential factors operating upon them. To this end, loglineal (Poisson regression) models were constructed of the IC mortality rates for both sexes, using the GLIM package, in which the regression coefficients are the natural Relative Risk (RR) logarithms of the various age groups (35-74 years), period of death (1970-1985) and birth cohort (1985-1960) with respect to the reference group mortality, controlled by the effect of other groups. In respect of the results, the maximum RR value corresponds to decrease year 1975, and falls progressively to 1985, though at all times remaining above the 1970 value. The effect of 1985, though less than 1980, does not present significant differences from the latter. Nevertheless, no clear cohort effect was found. As a probable explanation for the pattern observed, this would suggest recent changes in life style and in medical attention. There is a discussion of the consistency of the models selected with the graphical results and with present knowledge of the natural history of IC and with the evolution of its determining factors, together with validation of the models. In summary, the IC mortality patterns observed show an increase up to the mid-seventies, and stabilization from that date onwards, in all age and sex groups, which is consistent with an age-period effect. 相似文献
115.
The goal is to achieve that the maximum possible number of nurses arrive at the deep conviction that practice without theory is only routine and that theory without practice which justifies it is empty erudition. Therefore, the objective of this article is to reflect about the excessively frequent incoherence between that which is taught in schools and the practice which is carried out by the great number of nurses in our country. 相似文献
116.
Alberdi Castell R Artigas Lelong B Cuxart Ainaud N Agüera Ponce A 《Revista de enfermería (Barcelona, Spain)》2003,26(9):73-74
The authors introduce three guidelines as part of the process to implant the nursing methodology based on the Virginia Henderson Conceptual Model; they propose to help nurses adopt the aforementioned method in their daily practice. These three guidelines shall be published in successive articles: Guidelines to identify attitudes and aptitudes related to the nursing profession; Guidelines to implant the nursing methodology based on the Virginia Henderson Conceptual Model; and Guidelines to plan areas for improvement. 相似文献
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118.
Di Marzio WD Sáenz M Alberdi J Tortorelli M Silvana G 《Ecotoxicology and environmental safety》2005,61(3):380-391
An ecotoxicologic study was performed to assess the environmental status of the Lujan River. It is an important freshwater system in the northeast of Buenos Aires Province, Argentina. Surface waters (SWs) and liquids effluents (LEs), before they reached the river, and sediments were assessed via acute toxicity screening using a battery of tests with native species. Additionally, the presence, in each LE and SW sample, of bioaccumulatable compounds was checked by SPME extraction and gas chromatograph-MS determination. An environmental risk assessment of each LE was carried out via toxic units and assessment factors approach and through extrapolation methods. Hazardous concentrations for each LE were compared with their river effluent concentrations. Ninety-one percent (91%) of the total toxic load of the river was due to 4 of 11 LEs (37%) evaluated. Although SW samples were not toxic, a real environmental risk was found for this freshwater environment. Sediment toxicity was found to be related to the proximity to pipe discharges. Bioaccumulatable compounds were found in SWs and in LEs. Esters of phthalic acids, morpholine, hydroquinone, and nonylphenol were found throughout the river at different sample sites and in different months during the 1-year sampling program. 相似文献
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120.
I Gallo A Sáenz C Alonso A Germán F Cesari I Alberdi J Doxandabaratz M Larmán J L Martínez de Ubago 《Revista espa?ola de cardiología》1992,45(7):486-488
We report our initial experience in 2 patients with degenerative calcific aortic stenosis who underwent ultrasonic debridement of the aortic valve. Compared with preoperative studies, doppler echocardiographic and hemodynamic evaluation before hospital discharge revealed a reduction in the mean aortic valve pressure gradient (80 and 65 mmHg to less than 10 mmHg). There was no change in aortic regurgitation grade. Follow-up doppler echocardiographic evaluation at four and six months showed no changes in gradient or regurgitation in the comparison to the postoperative data. Long-term results will show the convenience to attempt or not ultrasonic salvage of the native aortic valve in severe calcific stenosis. 相似文献