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21.
《Gaceta sanitaria / S.E.S.P.A.S》2021,35(3):230-235
ObjectiveTo analyse the profile of the persons and associations that participated in the course, quantify peer education activities and analyse their evolution.MethodA quantitative study using an analysis of the course records from 2009 to 2018 was designed for this purpose inside mihsalud program designed to promote health amongst persons in vulnerable situations in the city of Valencia (Spain). It offers a yearly training-action course of community health workers (CHW) that is attended by persons who have been proposed by associations. The associations were defined according to their population (immigrant, local or intercultural) and the CHWs according to gender, country of birth, year of course, association and continuity after training. Means and confidence intervals were calculated at 95% and a bivariate analysis was conducted in order to compare the activities that took place in 2009 to 2013 with those of 2014 to 2018. The time trends were analysed by applying linear regression models that included the different years studied as the dependent variable.Results201 CHW of 31 nationalities were trained, 81.6% (95% confidence interval [95% CI]: 75.5-86.7] were women. Eighty-two associations participated, 51.2% (95% CI: 39.9-62.4] worked with culturally diverse populations. Participation by associations (p = .017) and CHWs (p = .377) increased in a statistically significant manner over the years. After the course, 35.3% (95% CI: 28.7-42.4] of the CHWs continued to collaborate voluntarily in the associations.ConclusionsThe results of the CHW training-action course improve over time given that a significant increase in participation by associations and women can be seen, along with a greater number of activities completed during the training. One effect of this is that CHWs are contracted or carry out voluntary activities in the associations. 相似文献
22.
三维CT在颅底缺损重建中的作用 总被引:1,自引:0,他引:1
目的 用三维CT技术进行颅底重建手术的分析、设计、提高一期重建的成功率。方法 手术前联合采用三维CT、MRI或CT了解病变与颅底的关系,颅底缺损的大小、范围及所涉及的重要结构。根据不同情况设计相应手术方案,以自体骨、颞肌瓣和硅橡胶为修复材料。结果 10例中1例颅骨纤维结构不良者发生脑膜炎。3周后痊愈。余9例无类似或组织下垂、脑脊液鼻漏等并发症。结论 三维CT为分析颅底重建手术方案提供了立体分析资料,同时也为手术后评价颅底重建效果提供了直接的实体影像。 相似文献
23.
Objectives To evaluate the efficacy of early arytenoid adduction in the management of vagal paralysis after skull base surgery. Study Design Retrospective evaluation at a tertiary care skull base center. Methods Aggressive surgical management of skull base lesions has become increasingly popular owing to advances in surgical technique and intraoperative monitoring. Temporary and permanent lower cranial neuropathies occur frequently, especially after the surgical management of lesions involving the vertebrobasilar system and the jugular foramen. An injury to the proximal vagus nerve is usually associated with dysphonia and swallowing dysfunction. An early arytenoid adduction has been employed in 26 patients with a vagal paralysis after skull base surgery. Most commonly, the neurosurgical patient underwent an arytenoid adduction under general anesthesia on postoperative day 2. Results Videostroboscopy after arytenoid adduction demonstrated 76% of patients had complete glottic closure. Of those with inadequate glottic closure, all demonstrated a well‐medialized posterior glottis with a persistent anterior glottal gap. These patients were easily treated with a secondary type I thyroplasty under local anesthesia with sedation resulting in complete glottic closure. Despite excellent voice outcomes, 66% of these patients had dysphagia requiring enteral feedings for nutritional support. Conclusions An early arytenoid adduction is an excellent medialization technique that can be performed safely in the early postoperative period under general anesthesia after skull base surgery. 相似文献
24.
目的:探讨应用针形内窥镜对小儿鼻颅底疾病进行探查与手术的方法及疗效。方法:在外径1.9mm的进口针形内窥镜及电视同图像系统监视下,对8例小儿(7d ̄12岁)鼻颅底有关疾病进行探杳与手术。结果:先天性后鼻孔闭锁3例中,1例好转,3例痊愈。外伤性脑脊液鼻漏1例,经修补痊愈先天性脑膜脑膨出2例,确诊后1例暂缓治疗。另1例行内窥镜手术痊愈。颅底神经母细胞瘤2例取材作病理检查确诊。结论:在电视图像监视下应用 相似文献
25.
起始密码下游序列与16srRNA3′端序列的匹配性对基因表达效率的影响 总被引:1,自引:0,他引:1
目的 :研究起始密码下游序列与 16srRNA 3′端 +146 9——— +1482局部序列间的匹配关系对基因表达效率的影响。方法 :我们一方面对人IL_2、人IL_8、人IL_6 ,人GM_CSF、人G_CSF、人IL_1ra、人IL_9等全长cDNA序列及 5′末端局部序列与 16srRNA 3′端 +146 9——— +1482序列进行匹配性进行分析 ,寻找序列匹配性与表达效率间的关系 ;另一方面 ,对人IL_6、人GM_CSFcDNA 5′端序列进行沉默突变 ,增强其与 16srRNA 3′端 +146 9——— +1482序列间的匹配性 ,并克隆入pKpL4表达型质粒载体 ,通过大肠杆菌进行表达 ,实验验证序列匹配性与基因表达效率的关系。结果 :分析发现起始密码下游局部序列与 16srRNA 3′端 +146 9——— +1482核酸匹配性越好 ,则目的蛋白表达效率越高 ;目的基因编码区内与 16srRNA 3′ +146 9——— +1482间的最大匹配区域越靠近 5′末端 ,目的蛋白表达效率越高。通过对人IL_6、人GM_CSFcDNA 5′末端序列进行沉默突变 ,改善其与 16srRNA 3′端 +146 9——— +1482序列的匹配性后 ,目的蛋白的表达量均呈不同程度地提高。结论 :提高起始密码下游序列与 16srRNA 3′端 +146 9——— +1482局部序列间的匹配性 ,可增强目的基因的表达效率。 相似文献
26.
目的:探讨临床常用药物对人体酸碱平衡的影响,指导临床工作。方法:用酸度计测定九种药品pH值,计算氢离子浓度。结果:偏碱性的药物有50g/L碳酸氢钠,谷氨酸钠、谷氨酸钾注射液;偏酸性的药物有盐酸精氨酸、维生素C、各种浓度葡萄糖注射液、氯化钠注射液。结论:临床上一些常用药品会影响人体的酸碱平衡,尤其在机体酸碱平衡调节发生障碍的情况下,更应谨慎。 相似文献
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29.
Micheline Glauser MS Peter Bauerfeind MD Wolfgang Feil MD Martin Riegler MD Robert Fraser MD André L. Blum MD 《Digestive diseases and sciences》1996,41(5):964-971
Acid inhibition increases gastric mucosal susceptibility to damage by luminal acid. This might be due to reduced metabolic CO2 and bicarbonate whereas, during normal acid, secretion cytoprotective CO2/HCO3- production parallels acid production. Metabolic activity and mucosal damage caused by luminal acid perfusion was determined in anin vitro mouse stomach, with and without acid inhibition, and at 0%, 1%, or 5% serosal CO2 supply. Without acid inhibition there was no mucosal damage at any level of serosal CO2/HCO3- supply. Acid inhibition reduced metabolic CO2 production by 29% (P<0.004) and resulted in microscopic damage to 55% of the mucosal area and perforation in four of five stomachs (P<0.05). Although, 1% CO2 supply completely replaced the reduction in metabolic CO2, it did not protect against mucosal damage. Overreplacement by 5% serosal CO2/HCO3- was required to prevent damage. There was no correlation between luminal CO2/HCO3- output and mucosal damage. The protection by endogenous or exogenous CO2/HCO3- appears to act intracellularly rather than by intragastric or intercellular neutralization.This study was supported by Swiss National Foundation grants 32-26369.89 and 32-33626.92. The morphometry equipment was supported by a grant from the Osterreichische Nationalbank. 相似文献
30.
Osteoplastic frontal sinusotomy and extradural microsurgical repair of frontobasal cerebrospinal fluid fistulas 总被引:3,自引:0,他引:3
L. Mayfrank J. M. Gilsbach S. Hegemann I. Kreitschmann-Andermahr H. J. Schmitz H. Bertalanffy 《Acta neurochirurgica》1996,138(3):245-254
Summary The choice of the surgical approach and operative technique for the management of cerebrospinal fluid (CSF) fistulas of the anterior cranial fossa are still a controversially discussed topic. Although extracranial approaches through the paranasal sinuses are becoming increasingly more popular among otolaryngologists and maxillo-facial surgeons, most neurosurgeons traditionally prefer the intracranial repair of CSF fistulas by a craniotomy.We present an approach through the frontal sinus for the repair of dural defects behind the posterior wall of the frontal sinus and at the floor of the anterior cranial fossa. The operative procedure comprises the following main steps: 1) exposure of the anterior wall of the frontal sinus by a bicoronal incision; 2) excision of the anterior wall without frontal burr holes; 3) bilateral removal of the posterior wall of the fronal sinus; 4) extradural inspection of the dura behind the frontal sinus and above the cribriform plate, ethmoidal roof, and orbital roof bilaterally; 5) closure of dural tears by direct suture and a periosteal graft; 6) reinsertion of the anterior wall of the frontal sinus and fixation with titanium micro plates.Twenty-five patients operated upon using this technique are described. The aetiology of the frontobasal lesion was traumatic in 23, and an ethmoid carcinoma in two. In all patients, the dural fistulas were successfully repaired during the initial procedure. One patient died from sudden circulatory arrest after an uneventful postoperative course of nine days. Otherwise, there were no postoperative complications.This technique affords atraumatic extradural inspection and repair of dural fistulas bilaterally behind the frontal sinus, and above the cribriform plate and the ethmoidal and orbital roofs with none or minimal brain retraction. It therefore allows early repair of CSF fistulas also in patients with severe brain injury. Although we consider the extradural closure of fistulas the method of choice, this approach also allows for a combined extradural-intradural procedure, thus enabling the surgeon to treat associated intradural pathologies, such as traumatic lesions or tumours of the frontal cranial base. 相似文献