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81.
Ulla A. Botha Marise Coetzee Liezl Koen Dana J.H. Niehaus 《Archives of Psychiatric Nursing》2018,32(3):384-389
Introduction
Pressure on inpatient beds often results in premature discharges, which may precipitate early readmission. This has prompted an increased interest in transitional care interventions to bridge the gap between in- and outpatient care to reduce such readmissions. Our study aimed to assess the effect of a Transitional Care Service (TCS) on readmission rates in a high pressure inpatient service which utilizes a premature discharge policy to address bed pressures.Methods
Sixty male patients identified for crisis discharge were offered a TCS for the first ninety days after discharge. Patients received a structured intervention consisting of four phone calls and one home visit, focusing on maintaining adherence, appointment reminders and psychoeducation. The TCS patients were retrospectively compared to a matched control group in terms of readmission after 90 days. Data was collected on adherence to medication, attendance of appointments and incidence of substance use.Results
There was no significant difference in readmission rates. Prevalence of substance use was very high (90%), especially methamphetamine use (48%). Adherence dropped from 45% (n = 27) at one week post-discharge to 25% (n = 15) at 90 days.Conclusion
Structured telephone-based transitional interventions have no effect on readmission rates in this setting. Prematurely discharged patients require more comprehensive support with focus on comorbid substance use. 相似文献82.
83.
Reduction of portal vein pressure with the enlargement of portal-systemic shunts: observation made in one patient 总被引:1,自引:0,他引:1
K Ohnishi T Nakayama F Nomura H Koen K Okuda 《Journal of clinical gastroenterology》1984,6(5):447-451
Whether portal vein pressure is reduced as spontaneous portal-systemic shunts are enlarged has long been disputed. We measured portal vein pressure directly by percutaneous transhepatic catheterization in one patient with cirrhosis at a 4-year interval, and demonstrated a significant reduction in portal vein pressure that had occurred along with enlargement of a collateral paraumbilical vein and splenorenal shunt during this period. 相似文献
84.
85.
Maxim Grymonprez Andreas Capiau Tine L. De Backer Stephane Steurbaut Koen Boussery Lies Lahousse 《Clinical cardiology》2021,44(5):599
Although obesity is associated with the development and progression of atrial fibrillation (AF), an obesity paradox may be present, illustrated by seemingly protective effects of obesity on AF‐related outcomes. Body mass index (BMI) has an impact on outcomes in AF patients using oral anticoagulants. After searching Medline and Embase, meta‐analysis of results of four randomized and five observational studies demonstrated significantly lower risks of stroke or systemic embolism (RR 0.80, 95%CI [0.73–0.87]; RR 0.63, 95%CI [0.57–0.70]; and RR 0.42, 95%CI [0.31–0.57], respectively) and all‐cause mortality (RR 0.73, 95%CI [0.64–0.83]; RR 0.61, 95%CI [0.52–0.71]; and RR 0.56, 95%CI [0.47–0.66], respectively) in overweight, obese and morbidly obese anticoagulated AF patients (BMI 25 to <30, ≥30 and ≥40 kg/m2, respectively) compared to normal BMI anticoagulated AF patients (BMI 18.5 to <25 kg/m2). In contrast, thromboembolic (RR 1.92, 95%CI [1.28–2.90]) and mortality (RR 3.57, 95%CI [2.50–5.11]) risks were significantly increased in underweight anticoagulated AF patients (BMI <18.5 kg/m2). In overweight and obese anticoagulated AF patients, the risks of major bleeding (RR 0.86, 95%CI [0.76–0.99]; and RR 0.88, 95%CI [0.79–0.98], respectively) and intracranial bleeding (RR 0.75, 95%CI [0.58–0.97]; and RR 0.57, 95%CI [0.40–0.80], respectively) were also significantly lower compared to normal BMI patients, while similar risks were observed in underweight and morbidly obese patients. This meta‐analysis demonstrated lower thromboembolic and mortality risks with increasing BMI. However, as this paradox was driven by results from randomized studies, while observational studies rendered more conflicting results, these seemingly protective effects should still be interpreted with caution. 相似文献
86.
Koen Venema Pieter van den Abbeele 《Best Practice & Research: Clinical Gastroenterology》2013,27(1):115-126
The human gut contains a diverse microbiota with large potential to influence health. Given the difficulty to access the main sites of the gut, in vitro models have been developed to dynamically monitor microbial processes at the site of metabolic activity. These models range from simple batch fermentations to complex multi-compartmental continuous systems. The latter include different models, focussing on similar but each also on distinct digestive parameters. The most intensively used include the three-stage continuous culture system, SHIME®, EnteroMix, Lacroix model and TIM-2. Especially after inclusion of surface-attached mucosal microbes (M-SHIME), such models have been shown representative of the in vivo situation in terms of microbial composition and activity. They have even been shown to maintain the interpersonal variation among different human fecal inocula. Novel developments, such as the incorporation of host cells, will further broaden the potential of in vitro models to unravel the importance of gut microbes for human health and disease. 相似文献
87.
Van Roy N Van Gele M Vandesompele J Messiaen L Van Belle S Sciot R Mortéle K Gyselinck J Michiels E Forsyth R Van Marck E De Paepe A Speleman F 《Cancer Genetics and Cytogenetics》2003,143(2):120-124
Malignant peripheral nerve sheath tumors (MPNST) are rare soft-tissue malignancies. The genetic basis of these tumors is still poorly understood. Cytogenetic analyses predominantly revealed complex karyotypes, precluding the identification of recurrent chromosomal changes. We report loss of 1p material in a near-diploid karyotype with few or no additional structural chromosome changes in two sporadic cases of MPNST, indicating an important role of 1p loss in MPNST development. In one of these two tumors, a distal 1p deletion (1p31.2 approximately pter) was detected suggesting involvement of a tumor suppressor gene located within this distal region of 1p. Further evidence for recurrent 1p loss in MPNST was obtained by interphase fluorescence in situ hybridization, which showed loss of 1p material in 3 out of 13 tumors. These findings together with data from the literature suggest that loss of a tumor suppressor gene located within distal 1p is implicated in the pathogenesis of MPNST. 相似文献
88.
Bernard Thienpont Eftychia Dimitriadou Katerina Theodoropoulos Jeroen Breckpot Helen Fryssira Sophia Kitsiou-Tzeli Meropi Tzoufi Joris R. Vermeesch Maria Syrrou Koen Devriendt 《European journal of medical genetics》2009,52(6):393-397
In 1991, a large family was described with an autosomal dominant inheritance of otological and branchial manifestations which was termed branchio-otic syndrome type 2 (BOS2). This trait was mapped by linkage analysis in this family to a region of 23–31 Mb on chromosome 1q25.1q32.1. In the present report we describe the clinical features of two patients with a deletion in this region: one patient has a deletion but no otological or branchial manifestations, the other patient manifests mild conductive hearing loss resulting from bilaterally malformed middle ear ossicles, as well as a preauricular pit. Mapping of the deletion breakpoints allowed to delineate the region involved in BOS2 to a 5.25 Mb region containing 27 protein-coding genes. A detailed medical history of both patients is provided and they are compared with the literature on other detected interstitial deletions of 1q25q32. These findings will aid in the identification of the genetic cause underlying BOS2. 相似文献
89.
Nicky H.G.M. Peters MD PhD Koen L. Vincken PhD Maurice A.A.J. van den Bosch MD PhD Peter R. Luijten PhD Willem P.Th.M. Mali MD PhD Lambertus W. Bartels PhD 《Journal of magnetic resonance imaging : JMRI》2010,31(5):1100-1105
Purpose:
To evaluate the influence of the choice of different combinations of b‐values on the ADC and on the diagnostic performance of quantitative diffusion weighted imaging (DWI) in breast lesions.Materials and Methods:
Seventy‐three patients (90 lesions) underwent 3 Tesla (T) breast MRI including a DWI‐scan using b‐values 0, 150, 499, and 1500 s/mm2 and histological analysis. Five combinations of b‐values were used to calculate the ADC, each with different sensitivities to perfusion and diffusion effects. The median ADC of benign lesions, noninvasive carcinomas and invasive carcinomas and the diagnostic performance of the five methods were compared.Results:
Eighty‐eight lesions were analyzed (37 benign, 13 noninvasive carcinomas, 38 invasive carcinomas). The median ADC was highest in benign lesions, intermediate in noninvasive carcinomas and lowest in invasive carcinomas for all methods. Calculating the ADC with the lowest 2 b‐values yielded the highest ADC for all lesions types; the highest 2 b‐values yielded the lowest ADC. The area under the receiver operating characteristic curve was approximately equal for all methods.Conclusion:
The ADC of breast lesions varied substantially with the choice of different b‐values, indicating that absolute ADC threshold values to differentiate benign and malignant lesions should be interpreted with caution. However, the diagnostic performance of quantitative DWI was not affected by the choice of different b‐values. J. Magn. Reson. Imaging 2010;31:1100–1105. © 2010 Wiley‐Liss, Inc. 相似文献90.
Functional bladder capacity (FBC) and urine output are important variables in the management of incontinence and nocturnal
enuresis. The lack of reference ranges for FBC vs. age, and the arbitrarily defined time-windows for measuring urine output,
impede the clinical use of these variables in children. To solve these impediments, we had 26 girls and 28 boys, between 6
and 12 years of age, collect, measure, time, and sample every voiding, using 72-h frequency-volume charts; all samples were
analysed for osmolality and creatinine concentration. Voided volumes show a very wide range (10–550 ml) and a subset that
is significantly larger than all other voidings: early morning voidings (EMV). The individual maximum voided volume (MVV)
belongs to the category of EMV in 74% of the children. MVV, the measure for FBC, fits the 5–95% centiles that have been published
for cystographic bladder capacity for age in normal children; all other voiding are mostly below the 5% centile. Voided volume
plotted vs. corresponding urine output rate shows that, with output rates below 50 ml/h, rest-phase bladder filling always
results in significantly larger voidings (EMV) than activity-phase bladder filling. Two circadian rhythms seem to be involved,
one for urine output, and another for inhibition of bladder contractility. With hourly population averages of individual urine
and osmole output rates plotted on a time scale, circadian patterns appear; these patterns are masked when urine output is
collected in blocks of 6, 8, or 12 h. Both plots are promising tools for studying the pathophysiology of voided volume vs.
urine output, e.g. in children with nocturnal enuresis. 相似文献