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81.
Andrea Billè Lawrence Okiror Wolfram Karenovics Debajeet Choudhuri Tom Routledge 《General thoracic and cardiovascular surgery》2013,61(7):409-413
Objective
To evaluate the feasibility of training program in video assisted thoracic surgery (VATS) lobectomy comparing intraoperative and postoperative data of patients operated on by an established consultant and trainees.Methods
Retrospective analysis of 100 consecutive patients who underwent VATS lobectomies between May 2008 and May 2012. 66 patients were operated on by an established consultant (Group A) and 34 by trainees (Group B).Results
The groups were comparable for clinical characteristics and pathological staging. The mean operating time in Group A was 125 ± 30 min and in Group B was 133 ± 26 min (p = 0.18). The rate of conversion was similar in both groups: 9.1 % in Group A and 8.8 % in Group B (p = 0.6). The complication rate was comparable (p = 0.4): 36.3 % in Group A and 32.3 % in Group B. Median time to drain removal and median length of hospital stay was 3 and 5.5 days in Group A and 3 and 5 days in Group B, showing no statistical differences between the two groups (p = 0.3 and 0.5). There were no differences in term of long-term complications between the two groups.Conclusion
Our study showed that a training program in VATS lobectomy is feasible, without increasing the operative time, conversion rate, postoperative complication, time to drain removal, and length of hospital stay. 相似文献82.
William M. Sherk Minhaj S. Khaja Bill S. Majdalany Wael E. Saad Aaron M. Udager Kyle J. Cooper David M. Williams 《Journal of vascular and interventional radiology : JVIR》2019,30(1):54-60
Between September 2008 and August 2017, 36 patients (mean age 56 y; range, 30–89 y) underwent transvenous biopsy of suspected tumor thrombus or perivascular tumor. Intravascular biopsy was pursued because of inaccessible percutaneous access in 9 patients (25%) and as part of a planned revascularization procedure in 27 patients (75%). Histopathologic results showed malignancy in 26 patients (72%) and benign etiologies in 10 patients (28%). No patients required repeat biopsy. There were no complications related to the biopsy procedure. The present series suggests that transvenous biopsy is a safe and accurate method of intravascular and perivascular mass tissue sampling. 相似文献
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Willie Muehlhausen Bill Byrom Barbara Skerritt Marie McCarthy Bryan McDowell Jeremy Sohn 《Value in health》2018,21(1):41-48
Objectives
To synthesize the findings of cognitive interview and usability studies performed to assess the measurement equivalence of patient-reported outcome (PRO) instruments migrated from paper to electronic formats (ePRO), and make recommendations regarding future migration validation requirements and ePRO design best practice.Methods
We synthesized findings from all cognitive interview and usability studies performed by a contract research organization between 2012 and 2015: 53 studies comprising 68 unique instruments and 101 instrument evaluations. We summarized study findings to make recommendations for best practice and future validation requirements.Results
Five studies (9%) identified minor findings during cognitive interview that may possibly affect instrument measurement properties. All findings could be addressed by application of ePRO best practice, such as eliminating scrolling, ensuring appropriate font size, ensuring suitable thickness of visual analogue scale lines, and providing suitable instructions. Similarly, regarding solution usability, 49 of the 53 studies (92%) recommended no changes in display clarity, navigation, operation, and completion without help. Reported usability findings could be eliminated by following good product design such as the size, location, and responsiveness of navigation buttons.Conclusions
With the benefit of accumulating evidence, it is possible to relax the need to routinely conduct cognitive interview and usability studies when implementing minor changes during instrument migration. Application of design best practice and selecting vendor solutions with good user interface and user experience properties that have been assessed in a representative group may enable many instrument migrations to be accepted without formal validation studies by instead conducting a structured expert screen review. 相似文献85.
Oppenheimer M Embil JM Black B Wiebe L Limerick B MacDonald K Trepman E 《Southern medical journal》2007,100(6):570-578
A retrospective study of 45 patients hospitalized with blastomycosis of bones or joints revealed 41 cases of osteomyelitis and 12 cases of septic arthritis. The majority were men (35 [78%] patients) and non-Aboriginal (32 [71%] patients). Median time from the onset of symptoms to hospitalization was shorter in women than men (male, 48 d; female, 14 d; P < 0.02), and shorter for Aboriginals than non-Aboriginals (non-Aboriginal, 50 d; Aboriginal, 19 d; P < 0.04). Cutaneous disease was present in 33 (73%) patients, and lung involvement was present in 29 (64%) patients. The most common osseous sites of involvement were the lower limb and axial skeleton. Common orthopaedic symptoms of bone lesions included bone pain in 42 (78%) patients, swelling in 32 (59%) patients, and soft tissue abscesses in 21 (39%) patients. Joint infection (12 patients) manifested as a monoarticular arthropathy presenting with effusion in 9 (75%) patients, pain in 8 (67%) patients, and decreased range of motion in 5 (42%) patients. Osseous blastomycosis can mimic bacterial infection and should be included in the differential diagnosis of bone and joint infection in patients who have visited or who live in geographic regions where B dermatitidis is endemic. 相似文献
86.
Background and aims Continuous veno–venous haemofiltration (CVVH) is an established treatment for acute renal failure (ARF). Recently, extended
intermittent dialytic techniques have been proposed for the treatment of ARF. The aim of this study was to compare these two
approaches.
Setting Intensive care unit of tertiary hospital.
Subjects Sixteen critically ill patients with ARF.
Design Randomised controlled trial.
Intervention We randomised sixteen patients to three consecutive days of treatment with either CVVH (8) or extended daily dialysis with
filtration (EDDf) (8) and compared small-solute, electrolyte and acid–base control.
Results There was no significant difference between the two therapies for urea or creatinine levels over 3 days. Of 80 electrolyte
measurements taken before treatment, 19 were abnormal. All values were corrected as a result of treatment, except for one
patient in the CVVH group who developed hypophosphataemia (0.54 mmol/l) at 72 h. After 3 days of treatment, there was a mild
but persistent metabolic acidosis in the EDDf group compared to the CVVH group (median bicarbonate: 20 mmol/l vs. 29 mmol/l:
p = 0.039; median base deficit: –4 mEq/l vs. –2.1 mEq/l, p = 0.033).
Conclusions CVVH and EDDf as prescribed achieved similar control of urea, creatinine and electrolytes. Acidosis was better controlled
with CVVH.
Electronic supplementary material The online version of this article (doi:) contains supplementary material, which is available to authorized users. 相似文献
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89.
Pierre‐Antoine Gourraud PhD Roland G. Henry PhD Bruce A. C. Cree MD PhD MAS Jason C. Crane PhD Antoine Lizee MS Marram P. Olson BS Adam V. Santaniello BSc Esha Datta MS Alyssa H. Zhu MSc Carolyn J. Bevan MD MS Jeffrey M. Gelfand MD MAS Jennifer S. Graves MD PhD Douglas S. Goodin MD Ari J. Green MD MCR H.‐Christian von Büdingen MD Emmanuelle Waubant MD PhD Scott S. Zamvil MD PhD Elizabeth Crabtree‐Hartman MD Sarah Nelson PhD Sergio E. Baranzini PhD Stephen L. Hauser MD 《Annals of neurology》2014,76(5):633-642
We present a precision medicine application developed for multiple sclerosis (MS): the MS BioScreen. This new tool addresses the challenges of dynamic management of a complex chronic disease; the interaction of clinicians and patients with such a tool illustrates the extent to which translational digital medicine—that is, the application of information technology to medicine—has the potential to radically transform medical practice. We introduce 3 key evolutionary phases in displaying data to health care providers, patients, and researchers: visualization (accessing data), contextualization (understanding the data), and actionable interpretation (real‐time use of the data to assist decision making). Together, these form the stepping stones that are expected to accelerate standardization of data across platforms, promote evidence‐based medicine, support shared decision making, and ultimately lead to improved outcomes. Ann Neurol 2014;76:633–642 相似文献
90.
Matthew S. Herbert M.A. Burel R. Goodin Ph.D. Samuel T. Pero IV B.S. Jessica K. Schmidt B.A. Adriana Sotolongo M.P.H. Hailey W. Bulls B.S. Toni L. Glover Ph.D. GNP-BC Christopher D. King Ph.D. Kimberly T. Sibille Ph.D. Yenisel Cruz-Almeida M.S.P.H. Ph.D. Roland Staud M.D. Barri J. Fessler M.D. M.S.P.H. Laurence A. Bradley Ph.D. Roger B. Fillingim Ph.D. 《Annals of behavioral medicine》2014,48(1):50-60