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61.
62.
Quality of life at three months following admission to intensive and coronary care units. 总被引:1,自引:0,他引:1
OBJECTIVE: Measurement of quality of life three months following critical illness, to assess impact on health expectations. DESIGN: Continuous quantitative study of patients admitted to a combined intensive and coronary care unit during a nine-month period. Questionnaires giving baseline information were completed soon after admission, and postal questionnaires incorporating the Nottingham Health Profile were sent to surviving patients three months following discharge from the unit. SETTING: District General Hospital. SUBJECTS: ICU sample included 60 patients, male n = 31, female n = 29. Twenty-nine patients received surgical treatment, 31 patients received medical treatment. Coronary Care Unit (CCU) sample included 112 patients, male n = 74, female n = 38. Fifty-four patients admitted following acute myocardial infarction (MI), 58 patients non-MI admission. MEASUREMENTS AND MAIN RESULTS: Hospital mortality for ICU patients was 31%, increasing to 34% at three months. Hospital mortality for CCU patients was 14%, increasing to 19% at three months. Significant differences in mean NHP scores between ICU and CCU patients were noted with higher CCU scores in the areas of sleep (p = 0.04), and social isolation (p = 0.01). Within the ICU group surgical patients had a higher mean NHP score in the area of pain (p = 0.02). There were no significant differences in the scores of male and female ICU patients. Within the CCU group non-MI patients had significantly higher mean scores than MI patients in the areas of energy (p = 0.007), pain (p = 0.04), emotion (p = 0.05), social isolation (p = 0.01) and physical ability (p = 0.003). Female CCU patients had higher mean NHP scores than male patients with significant differences in the areas of pain (p = 0.04), sleep (p = 0.009) and physical ability (p = 0.006). CONCLUSION: ICU patient quality of life three months after admission compares favourably with a corresponding group of CCU patients, particularly in areas of sleep and social isolation. CCU patients' general functional status deteriorated significantly compared to their pre-admission status. Critical illness is a costly area of medicine, but the results suggest that outcomes are beneficial in terms of quality of life for those surviving acute illness. 相似文献
63.
BCSH Blood Transfusion Task Force D. Voak R. Cann R. D. Finney K. Foreman S. M. Knowles R. Mitchell J. A. F. Napier P. K. Phillips A. J. Rejman A. H. Waters J. K. Wood R. M. Hutchinson A. J. Bell J. K. M. Duguid J. M. Hows K. Jestice D. E. Pegg N. G. Testa 《Transfusion medicine (Oxford, England)》1994,4(2):165-172
SUMMARY. There are no current U.K. or international guidelines or regulations covering the production, processing and storage of haemopoietic cells such as to allow their engraftment following myeloablative therapy. This paper seeks to provide such guidelines. It enumerates how quality control and assurance can be applied to this area of transfusion medicine; procedural steps relating to bone marrow harvest on peripheral blood stem cell collection are outlined and recommended doses of nucleated cells suggested for both procedures. General specifications for identification, storage and transportation of bone marrow and peripheral blood stem cells are included and specific laboratory procedures related to the provision of haemopoietic cells for engraftment are outlined. Umbilical cord blood transplants and long-term bone marrow culture are alluded to but these are still in a research phase. 相似文献
64.
M C Hirst S J Knight M V Bell M Super K E Davies 《Clinical science (London, England : 1979)》1992,83(3):255-264
An amplification of a highly unstable DNA element has been identified at the fragile X locus in Xq27.3. This sequence appears to be both the source of the primary mutation causing the fragile X syndrome, apparently having its causative effect through the methylation of the FMR-1 HTF island and the region of cytogenetic fragility. The direct analysis of the genotype of carrier and affected individuals can be used as a direct diagnosis tool which will improve both the accuracy and speed of diagnosis. The identification of hereditary unstable DNA in a disease with such a wide level of non-penetrance and variable phenotype may give clues as to the basis of non-penetrance in other human genetic disorders. 相似文献
65.
In the present studies, arterial lipid metabolism was evaluated in the spontaneously hyperlipidemic obese Zucker rat (fa/fa), the lean Zucker rat (Fa/-), and the Sprague-Dawley (SD) rat. Mean serum cholesterol levels in the obese Zucker, lean Zucker and SD rats were 216 +/- 18 mg/dl, 145 +/- 14 mg/dl and 84 +/- 5 mg/dl, respectively. Arterial cholesterol content was in the same rank order as plasma cholesterol and ranged from a mean of 2.23 +/- 0.10 mg/gm wet wt. in the obese rats to 1.36 +/- 0.04 mg/gm wet wt. in the SD rats. The increased arterial sterol in the obese rats was associated with increased lipid metabolism activity. The in vitro incorporation of [14C]oleate into arterial cholesteryl esters was increased 3-4-fold (P less than 0.01) and incorporation into phospholipids and triglycerides was also elevated (P less than 0.001 and P less than 0.01, respectively). The arterial sterol content and arterial lipid metabolism pattern observed in obese Zucker rat aortas are similar to those found in vessels of other species undergoing atherogenic change. 相似文献
66.
Two recently published multicentre trials have confirmed the overall benefit of carotid endarterectomy in symptomatic patients with severe carotid artery disease. The key to improving further the long-term advantages of carotid endarterectomy, however, remains the continued reduction of the initial operative risk. While the principal responsibility for this continues to be borne by the surgeon, specifically in reducing technical error, the time is perhaps approaching when he or she might also be able to apply some of the recent advances in cerebrovascular research to reduce operative morbidity still further in the future. This article summarizes the aetiology and pathophysiology of operation-related neurological deficits and reviews current approaches towards intraoperative monitoring, cerebral protection and assessment of quality control. 相似文献
67.
N. London J. Swales K. Hollinrake P. Bell A. Heagerty 《Postgraduate medical journal》1992,68(806):976-977
We describe the occurrence of primary hyperaldosteronism in two sisters. Although this is only the second published report of familial Conn''s syndrome, it does have implications for the relatives of patients with Conn''s syndrome and these are discussed. 相似文献
68.
D. S. H. Bell 《Diabetologia》2007,50(3):695
69.
70.
Susan Bell 《The Journal of neuroscience nursing》2004,36(4):195-199
Germinomas are the most common type of germ cell tumor occurring commonly before the second decade of life. Because of the radiosensitivity of germinomas, traditional treatment following diagnosis has been conventional radiotherapy. The desire to defer radiotherapy to avoid the delayed neurocognitive effects has led researchers to investigate the use of up front chemotherapy. A major limitation in using chemotherapy for brain tumors has been the inability to deliver drugs across the blood brain barrier. The blood brain barrier consortium has developed chemotherapy protocols for patients with malignant brain tumors through the use of reversible osmotic opening of the blood brain barrier. While the patient is under general anesthesia, osmotic opening or disruption is achieved by a 30-second intracarotid infusion of mannitol. The mannitol infusion is followed by both intraarterial and intravenous chemotherapy. By administering chemotherapy in conjunction with blood brain barrier disruption, drug delivery to the tumor and the brain around tumor is increased. 相似文献