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排序方式: 共有909条查询结果,搜索用时 15 毫秒
31.
Janneke AL van Kempen Henk J Schers Anne Jacobs Sytse U Zuidema Franca Ruikes Sarah HM Robben René JF Melis Marcel GM Olde Rikkert 《The British journal of general practice》2013,63(608):e225-e231
Background
Primary care is increasingly interested in the identification of frailty, as it selects the target population for integrated care. However, instruments for the identification of frailty specifically validated for use in primary care are scarce. This study developed the Easycare Two-step Older persons Screening (Easycare-TOS), which provides a valid, efficient, and pragmatic screening procedure to identify frail older people.Aim
This paper aims to describe the development of the Easycare-TOS and the data from the pilot studies.Design and setting
Observational pilot study in seven academic GP practices in and around Nijmegen, The Netherlands.Method
The Easycare-TOS was developed in a cyclic process with the input of stakeholders. In every cycle, the requirements were first defined, then translated into a prototype that was tested in a pilot study. The Easycare-TOS makes optimal use of prior knowledge of the GP, and the professionals’ appraisal is decisive in the frailty decision, instead of a cut-off score. Further, it considers aspects of frailty, as well as aspects of the care context of the patient.Results
The pilot data have shown that after step 1, two-thirds of the patients do not need further assessment, because they are judged as not frail, based on prior knowledge of the GP. The overall prevalence of frailty in this pilot study is 24%. Most professionals who participated in the pilot studies considered the time investment acceptable and the method to be of added value.Conclusion
The Easycare-TOS instrument meets the predefined efficiency, flexibility, and acceptability requirements for use as an identification instrument for frailty in primary care. 相似文献32.
Early transvaginal ultrasound following an accurately dated pregnancy: the importance of finding a yolk sac or fetal heart motion 总被引:1,自引:2,他引:1
Deaton JL; Honore GM; Huffman CS; Bauguess P 《Human reproduction (Oxford, England)》1997,12(12):2820-2823
Our goals were to determine the prognostic value of a yolk sac or fetal
heart motion seen during an early accurately dated transvaginal ultrasound
(TVU). We reviewed 225 consecutive pregnancies for fetal heart motion data.
Furthermore, 63 pregnancies following in-vitro fertilization were reviewed
for yolk sac information. The TVU was performed between 5 and 6 weeks
following presumed conception (heart motion data) and between 22 and 32
days following in-vitro fertilization (yolk sac data). Pregnancies were
followed until an ongoing pregnancy or spontaneous abortion was documented.
The presence of a yolk sac between 22 and 32 days from fertilization was
associated with the development of fetal heart motion in 94% of cases. The
absence of the yolk sac by 32 days after fertilization was always
associated with a poor outcome. In women < 36 years of age, the presence
of fetal heart motion was associated with a spontaneous abortion in only
4.5% of the cases. However, the incidence of spontaneous abortion following
fetal heart motion increased to 10% in women 36-39 years and 29% in women
> or = 40 years of age. The presence of heart motion should not be
considered a reassuring sign in the older woman. These data have
implications regarding early embryology and the counselling of infertility
patients.
相似文献
33.
Warnes GM; Payne D; Jeffrey R; Hourigan L; Kirby C; Kerin J; Matthews C 《Human reproduction (Oxford, England)》1997,12(7):1525-1530
Over a 26 month period 17% of couples having treatment in our clinical
programmes selected a commercially available protein (normal serum albumin,
NSA) prepared from pooled human sera instead of using their own serum as a
supplement for their embryo culture media. In a retrospective analysis of
>2000 gonadotrophin-stimulated cycles and 1000 cycles where
frozen/thawed embryos were transferred, fertilization, embryo quality and
pregnancy rates following in-vitro fertilization (IVF), gamete
intra-Fallopian transfer (GIFT) or intracytoplasmic sperm injection (ICSI)
were unaffected by the type of protein used to supplement the culture
medium. When embryos were thawed in medium containing NSA, both pregnancy
(PR) and implantation rates (IR) were significantly lower (P <0.05) than
if the medium was supplemented with serum (PR 8.3% and 17.5%; IR 4.6% and
10.5%). Inclusion of NSA before freezing reduced the IR of thawed embryos.
To further test this observation all cycles where embryos were cultured and
frozen in medium containing NSA (173 cycles) were matched to cycles where
serum was used and the outcome was compared. At the end of 1995 just over
half of the embryos in both groups had been thawed. No statistical
difference was noted in the pregnancy rates (NSA, 5.6% versus serum, 11.3%)
but the IR per embryo was significantly lower when embryos were cultured
and frozen in medium supplemented with NSA (2.2%) than when serum was used
as the supplement (6.6%).
相似文献
34.
35.
36.
Arnault Tauzide-Espariat Philipp Sievers Frdrique Larousserie Joseph Benzakoun Delphine Guillemot Gaëlle Pierron Mathilde Duchesne Emmanuelle Uro-Coste Alexandre Roux Alexandre Vasiljevic Tanguy Fenouil David Meyronet Karima Mokhtari Marc Polivka Audrey Rousseau Frdrique Bost-Bezeaud Samir Akoury Johan Pallud Chiara Benevello Lauren Hasty Albane Gareton Emmanule Lechapt Fabrice Chrtien Thomas Blauwblomme Kvin Beccaria Stphanie Puget Felix Sahm Pascale Varlet 《Brain pathology (Zurich, Switzerland)》2022,32(1):e13010
37.
Recent investigations have emphasized the role of activated granulocytes in mediating vascular endothelial injury in the pathogenesis of shock lung. In vitro studies have indicated that tight adherence of the neutrophil to the endothelium is crucial for the development of cellular injury. Fibronectin is critical to cell-to- substratum and cell-to-cell interactions. Since fibronectin resides in plasma, on endothelial cell surfaces and is secreted into cell matrices, the adhesive properties of fibronectin must be modulated, lest universal cell agglomeration occur, yet be enhanced when cell attachment is appropriate. In these studies, treatment of fibronectin- coated surfaces with neutrophil release products increased the adhesion of activated neutrophils. Similarly, endothelial cells treated with neutrophil release products become a more adherent substrate for neutrophils. This enhanced adherence generated by treatment of fibronectin with neutrophil supernatants is inhibitable by heat and the lysosomal proteinase inhibitor, pepstatin-A. Neutrophil release products cause proteolytic fragmentation of fibronectin and enhanced fibronectin immunofluorescence on endothelial cells. In addition, neutrophils are more injurious to endothelial cells that have been pretreated with neutrophil release products. Neutrophils may enhance their own adherence to endothelial cells by altering fibronectin, and this altered, or "inflamed," fibronectin may serve as an amplifier of inflammation. 相似文献
38.
Aimée E van Dijk Manon van Eijsden Karien Stronks Reinoud JBJ Gemke Tanja GM Vrijkotte 《BMC public health》2010,10(1):251
Background
Recent evidence, both animal and human, suggests that modifiable factors during fetal and infant development predispose for cardiovascular disease in adult life and that they may become possible future targets for prevention. One of these factors is maternal psychosocial stress, but so far, few prospective studies have been able to investigate the longer-term effects of stress in detail, i.e. effects in childhood. Therefore, our general aim is to study whether prenatal maternal psychosocial stress is associated with an adverse cardio-metabolic risk profile in the child at age five. 相似文献39.
We recently introduced a patch‐wise technique to estimate brain age from anatomical T1‐weighted magnetic resonance imaging (T1w MRI) data. Here, we sought to assess its longitudinal reliability by leveraging a unique dataset of 99 longitudinal MRI scans from a single, cognitively healthy volunteer acquired over a period of 17 years (aged 29–46 years) at multiple sites. We built a robust patch‐wise brain age estimation framework on the basis of 100 cognitively healthy individuals from the MindBoggle dataset (aged 19–61 years) using the Desikan‐Killiany‐Tourville atlas, then applied the model to the volunteer dataset. The results show a high prediction accuracy on the independent test set (R2 = .94, mean absolute error of 0.63 years) and no statistically significant difference between manufacturers, suggesting that the patch‐wise technique has high reliability and can be used for longitudinal multi‐centric studies. 相似文献
40.
Susanne J van Veluw Jaco JM Zwanenburg Annemieke JM Rozemuller Peter R Luijten Wim GM Spliet Geert Jan Biessels 《Journal of cerebral blood flow and metabolism》2015,35(4):676-683
Cerebral microinfarcts (CMIs) are common neuropathologic findings in aging and dementia. We explored the spectrum of cortical CMIs that can be visualized with 7T magnetic resonance imaging (MRI). Thirty-three coronal brain slices of 11 individuals with neuropathologically confirmed dementia were subjected to a high-resolution postmortem 7T MRI protocol. First, we identified all visible small (⩽5 mm) intracortical and juxtacortical lesions on postmortem MRI. Lesions were classified as CMI or nonCMI based on histology, and their MR features were recorded. Thirty lesions were identified on the initial MRI evaluation, of which twenty-three could be matched with histology. Histopathology classified 12 lesions as CMIs, all of which were located intracortically. On the basis of their MR features, they could be classified as chronic gliotic CMIs—with or without cavitation or hemorrhagic components—and acute CMIs. Eleven MRI identified lesions were not of ischemic nature and most commonly enlarged or atypically shaped perivascular spaces. Their MRI features were similar to gliotic CMIs with or without cavitation, but these ‘CMI mimics'' were always located juxtacortically. 7T postmortem MRI distinguishes different histopathologic types of cortical CMIs, with distinctive MR characteristics. On the basis of our findings, we propose in vivo rating criteria for the detection of intracortical CMIs. 相似文献