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91.
Inter-study differences: How should they influence the interpretation and analysis of results? 总被引:2,自引:0,他引:2
K R Bailey 《Statistics in medicine》1987,6(3):351-360
In determining the role inter-study variation should play in an overview analysis, it is important to consider three factors: which question one is trying to answer; the degree of similarity or dissimilarity of design, and the degree to which heterogeneity of outcomes can be explained. Three questions one might be interested in are: whether treatment can be effective in some circumstances; whether treatment is effective on average, and whether treatment was effective on average in the trials at hand. Under the assumption of no qualitative interaction, the answers to these questions coincide. The O-E analysis most directly answers the third question. Other analyses are suggested when the first question is of interest, using the aspirin post-MI studies as an example. 相似文献
92.
93.
I. Y. Shvera A. M. Cherniavsky W. Yu. Ussov M. P. Plotnikov A. A. Sokolov V. M. Shipulin V. I. Chernov 《European journal of nuclear medicine and molecular imaging》1995,22(2):132-138
In this study we aimed to work out a quantitative prognostic index for preoperative assessment of brain technetium-99m hexamethylpropylene amine oxime (HMPAO) single-photon emission tomography (SPET) in patients referred for urgent carotid endarterectomy due to acute obstructive disease of the internal carotid artery (ICA) and neurological deficit. To this end we compared data from preoperative SPET studies with the postinterventional changes in neurological status in 20 patients (17 males, three females; mean age 53 years, SD 4 years) with acute ischaemic cerebral disorders induced by obstruction of the ICA. Carotid obstruction was diagnosed by ultrasound B-mode study. All patients underwent urgent carotid endarterectomy from the ICA. Patients were divided into two groups in accordance with the results of postoperative follow-up: group A comprised patients with significant (more than 3 points) postoperative improvement in neurological condition as quantified by the Canadian Neurological Scale (11 patients); group B consisted of patients with minimal improvement or deterioration (nine, three of whom died). All patients were studied preoperatively by99mTc-HMPAO SPET. The volume of nonperfused tissue (VS, cm3) was quantified using the Mountz technique. Hypoperfused volume (V
hypoperf, cm3) in the affected hemisphere was calculated as the total volume of voxels with99mTc-HMPAO uptake <90% of the contralateral symmetric voxels. Discriminant prognostic function was calculated by discriminant analysis as:PF = 0.072×VS + 29.46×(VS/V
hypoperf). Patients with preoperativePF values <8.20 demonstrated postoperative improvement in neurological status, while the group withPF>8.90 comprised patients who demonstrated minimal improvement or deterioration. PF values in the range 8.20–8.90 carried an indefinite prognosis. We conclude that the preoperative99mTc-HMPAO SPET can be used for the selection of patients in whom improvement in neurological status may be expected after urgent surgical correction of acute extracranial obstruction of the ICA. 相似文献
94.
目的:观察偏瘫患者早期床上训练的效果。方法:对58例脑血管意外致偏瘫患者随机分成2组:观察组30例,护理中指导早期床上体操训练;对照组28例,按常规护理。以上、下肢肌力和日常生活活动能力(ADL)为评价指标,于训练开始时、训练4周、训练8周各评价1次。结果:观察组训练4周、8周时患侧上肢肌力以及ADL水平明显增加,与对照组比较有显著差异(P<001)。患侧下肢肌力训练4周及8周时均增加,与对照组比较,4周时无明显差异(P>005),8周时有显著性差异(P<001)。结论:对早期偏瘫患者实施床上功能训练,不仅可以提高患者的生命质量,而且可以减少、甚至解除患者及家属的经济和精神负担。 相似文献
95.
Cerebralvasospasm(CVS)remainsoneofthemajorcausesofseriousoutcomeinpatientswithsubarachnoidhemorrhage(SAH);however,themechanismofwhichisstillnotwellunderstood.Sofaralargenumberofputativespasmogenshavebeenproposedandoneofwhichisendothelins(ETs).ETs,akindofverypotentendogenousvasoconstrictorsubstancesknown[1],hasthreeiso-forms:ET-1,2and3,andET-1isthemostpo-tentvasoconstrictorofthem.lnrecentstudies,ET-lhasbeenproposedasamediatorofCVSfol-lowingSAH[2-4j.TheavailabilityofETantagonistprovided… 相似文献
96.
急性脑梗塞患者血清肿瘤坏死因子水平变化的观察 总被引:7,自引:0,他引:7
采用双抗体夹心ELISA法对30例正常对照和36例急性脑梗塞患者血清肿瘤坏死因子(TNF)水平进行了检测。结果显示:急性脑梗塞组血清TNF水平显著高于正常对照组,血清TNF水平变化与脑梗塞容积大小密切相关,恢复期血清TNF水平显著降低。结果提示,TNF参与了脑梗塞发生后病理变化过程,检测血清TNF对判定脑梗塞容积大小有一定的临床意义。 相似文献
97.
Kazumichi Yamada Satoshi Goto Taro Oyama Makoto Yoshikawa Shinji Nagahiro Yukitaka Ushio 《Acta neuropathologica》1995,89(2):172-177
The present study concerns the vulnerability of striatal interneurons immunopositive for the Ca2+-binding protein calretinin to ischemic neuronal injury. An immunohistochemical study was carried out on the striata of rats which had undergone transient middle cerebral artery occlusion. Two weeks after the ischemia, there was a marked reduction in the number of calretinin-positive neurons in the ipsilateral ischemic lesion, although the striatal interneurons positive for parvalbumin, which are a neuronal population distinct from the calretinin-immunoreactive cells in the striatum, were spared in the insulted areas. The present data indicate that the striatal calretinin-positive neurons are less resistant to transient ischemia, suggesting that there may exist vulnerability differences among the striatal interneurons in ischemia-induced neuronal injury. 相似文献
98.
Summary A simple technique of stereotactic craniotomy and intraoperative lesion localisation that uses the Brown-Robert-Wells (BRW) stereotactic frame is presented. The method optimises craniotomy placement and facilitates localisation of small intracerebral lesions. Using the system, 16 patients have had resection of intracranial neoplasms from deep and/or eloquent areas of the brain with no neurological morbidity. 相似文献
99.
Clinical Efficacy of New Antiepileptic Drugs in Refractory Partial Epilepsy: Experience in the United States With Three Novel Drugs 总被引:1,自引:1,他引:0
Jacqueline A. French 《Epilepsia》1996,37(S2):S23-S26
Summary: A number of new antiepileptic drugs (AEDs), including topiramate (TPM), felbamate (FBM), and gabapentin (GBP), are approved or believed to be close to approval for marketing in the United States. Key efficacy findings for these AEDs in refractory partial epilepsy were reviewed. Large and significant drug-placebo differences were observed with TPM in two large dose-finding trials conducted in the United States. The minimal effective dose of TPM in the population studied was determined to be approximately 200 mg/day, and doses above 600 mg/day produced good efficacy but little incremental benefit versus the lower dosages for the overall study population. FBM is active in partial epilepsy, although seizure reduction is less marked and drug interactions complicate the findings. GBP is also active in this population, but only the 1,800 mg/day dosage was significantly better than placebo with respect to percent re-sponders. It may be useful to explore higher dosage ranges for both FBM and GBP if they can be well tolerated. 相似文献
100.
研究深低温停循环(DHCA)与逆行脑灌注(RCP)时脑组织自由基的变化。健康杂种犬14只,随机等分为DHCA组和RCP组,在停循环前(A点)、DHCA/RCP30分(B点)、DHCA/RCP60分(C点)DHCA/RCP90分(D眯)和复温再灌注30分(E点)取脑皮层lg,检测丙二醛(MDA)和超氧化物歧化酶(SOD)水平。结果见两组在A点MDA和SOD无差别。在B、C、D、E点,DHCA组MDA 相似文献