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51.
Treatment and primary prevention in people who inject drugs for chronic hepatitis C infection: is elimination possible in a high‐prevalence setting?
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52.
Antonio Moreno Galdó Juan Solé Montserrat Antonio Roman Broto 《Archivos de bronconeumologia》2013,49(12):523-528
Lung transplantation has become in recent years a therapeutic option for infants with terminal lung disease with similar results to transplantation in adults. In Spain, since 1996 114 children lung transplants have been performed; this corresponds to 3.9% of the total transplant number. The most common indication in children is cystic fibrosis, which represents between 70-80% of the transplants performed in adolescents. In infants common indications are interstitial lung disease and pulmonary hypertension. In most children a sequential double lung transplant is performed, generally with the help of extracorpo-real circulation. Lung transplantation in children presents special challenges in monitoring and follow-up, especially in infants, given the difficulty in assessing lung function and performing transbronchial biopsies.There are some more specific complications in children like postransplant lymphoproliferative syndrome or a greater severity of respiratory virus infections. After lung transplantation children usually experiment a very important improvement in their quality of life. Eighty eight per cent of children have no limitations in their activity after 3 years of transplantation. According to the registry of the International Society for Heart & Lung Transplantation (ISHLT) survival at 5 years of transplantation is 54% and at 10 years is around 35%. 相似文献
53.
《Clinical neurophysiology》2021,132(10):2639-2653
ObjectiveThis study brought together over 60 transcranial magnetic stimulation (TMS) researchers to create the largest known sample of individual participant single and paired-pulse TMS data to date, enabling a more comprehensive evaluation of factors driving response variability.MethodsAuthors of previously published studies were contacted and asked to share deidentified individual TMS data. Mixed-effects regression investigated a range of individual and study level variables for their contribution to variability in response to single and paired-pulse TMS data.Results687 healthy participant’s data were pooled across 35 studies. Target muscle, pulse waveform, neuronavigation use, and TMS machine significantly predicted an individual’s single-pulse TMS amplitude. Baseline motor evoked potential amplitude, motor cortex hemisphere, and motor threshold (MT) significantly predicted short-interval intracortical inhibition response. Baseline motor evoked potential amplitude, test stimulus intensity, interstimulus interval, and MT significantly predicted intracortical facilitation response. Age, hemisphere, and TMS machine significantly predicted MT.ConclusionsThis large-scale analysis has identified a number of factors influencing participants’ responses to single and paired-pulse TMS. We provide specific recommendations to minimise interindividual variability in single and paired-pulse TMS data.SignificanceThis study has used large-scale analyses to give clarity to factors driving variance in TMS data. We hope that this ongoing collaborative approach will increase standardisation of methods and thus the utility of single and paired-pulse TMS. 相似文献
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Julio E. González-Aguirre Claudia Paola Rivera-Uribe Erick Joel Rendón-Ramírez Rogelio Cañamar-Lomas Juan Antonio Serna-Rodríguez Roberto Mercado-Longoría 《Archivos de bronconeumologia》2019,55(4):195-200
Introduction
Invasive respiratory support is a cornerstone of Critical Care Medicine, however, protocols for withdrawal of mechanical ventilation are still far from perfect. Failure to extubation occurs in up to 20% of patients, despite a successful spontaneous breathing trial (SBT).Methods
We prospectively included ventilated patients admitted to medical and surgical intensive care unit in a university hospital in northern Mexico. At the end of a successful SBT, we measured diaphragmatic shortening fraction (DSF) by the formula: diaphragmatic thickness at the end of inspiration – diaphragmatic thickness at the end of expiration/diaphragmatic thickness at the end of expiration × 100, and the presence of B-lines in five regions of the right and left lung. The primary objective was to determine whether analysis of DSF combined with pulmonary ultrasound improves prediction of extubation failure.Results
Eighty-two patients were included, 24 (29.2%) failed to extubation. At univariate analysis, DSF (Youden's J: >30% [sensibility and specificity 62 and 50%, respectively]) and number of B-lines regions (Youden's J: >1 zone [sensibility and specificity 66 and 92%, respectively]) were significant related to extubation failure (area under the curve 0.66 [0.52–0.80] and 0.81 [0.70–0.93], respectively). At the binomial logistic regression, only the number of B-lines regions remains significantly related to extubation failure (OR 5.91 [2.33–14.98], P < .001).Conclusion
In patients with a successfully SBT, the absence of B-lines significantly decreases the probability of extubation failure. Diaphragmatic shortening fraction analysis does not add predictive power over the use of pulmonary ultrasound. 相似文献55.
李珍 《中国卫生政策研究》2019,12(12):1-6
新中国成立70年以来,政府在医疗保险领域做了大量的努力,尤其是进入21世纪以来,基本医疗保险制度实现了人群基本全覆盖,各项制度筹资水平和保障水平不断提高,城镇居民医疗服务利用水平和健康水平明显提高。中国基本医疗保险发展的基本经验可以表述为选择了社会保险的模式,遵循了全覆盖、保基本、多层次、可持续的原则。本文认为当前基本医疗保险应发挥核心作用,商业健康保险提供差异化、多样性的医保服务;面临的医保二元结构等问题,可通过职工家庭联保和属地参保来增加职工参保人减少居民参保人,实现全民统一覆盖、平等且充分的目标。 相似文献
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Johan Larsson 《Physiotherapy theory and practice》2018,34(9):723-729
Evidence suggests that research benefits from diversity, yet science is concentrated to a small group of countries. Diversity in physical therapy research has so far not been studied thoroughly, and this is the first study to map physical therapy research geographically. The objective was to study the frequency and methodological quality of physical therapy-related randomized controlled trials (RCTs) across the world. PEDro was searched for RCTs in physical therapy published between January 1 2015 and December 5 2016. For each trial, the first and last authors’ affiliations and the PEDro scale were extracted. Using the first and last authors’ affiliations, each article was geocoded using the Data Science Toolkit API. The search located 2,959 RCTs, which were affiliated primarily with a small cluster of countries. The median PEDro score for all trials was 5 (IQR 4:7). The geographical spread of the RCTs was focused around Europe, the Middle East, Southeast Asia, Oceania, the United States, and parts of South America. The lack of diversity might be problematic for the research field, even though the average clinical trial in physical therapy is of fair quality. 相似文献