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991.
目的:研究系列康复治疗对住院慢性稳定期精神分裂症患者的个人和社会功能的疗效。方法:将符合入组标准的120例住院慢性稳定期精神分裂症患者随机分为两组,干预组每周接受系列康复治疗2次,共治疗12周。在干预前、干预4周,干预8周及干预12周对2组患者分别采用个人和社会功能量表中文版(PSP)及阳性和阴性症状量表(PANSS)进行评估。结果:两组患者在康复治疗前量表及各项因子评分差异均无统计学意义(P0.05);在康复治疗第8周至12周结束时,两组在扰乱及攻击行为的评分差异有显著的统计学意义(P0.05),精神症状因子评分差异存在统计学意义(P0.05);系列康复治疗对干预组患者的治疗效果也存在随着时间变化的趋势,特别是个人关系和社会关系、自我照料、扰乱及攻击行为,以及精神症状的时间主效应存在统计学意义(P均0.01)。结论:系列康复治疗有助于改善住院慢性稳定期精神分裂症患者的个人和社会功能及残留的部分精神症状;其中,自我照料、扰乱及攻击行为和精神症状、阴性症状改善明显。  相似文献   
992.

Background

In this systematic review and meta-analysis, the authors evaluated the pain during scaling and root planing with use of topical anesthetic versus that with the use of injected anesthetic in adult patients.

Types of Studies Reviewed

The authors searched 6 databases for randomized clinical trials in which the investigators compared the clinical effectiveness of intrapocket and injectable anesthetics. The primary outcome was the risk of developing pain or intensity of pain. Quality assessment followed the guidelines from the Cochrane Collaboration’s risk-of-bias tool. The authors performed meta-analyses on studies considered at low and unclear risk of bias.

Results

From 976 articles identified, 6 remained in the qualitative synthesis (4 at low and 2 at unclear risk of bias). Injected anesthetic produced lower pain intensity than did anesthetic gel (P = .03) and required less rescue anesthetic than did topical anesthetic (P < .0001). There was no difference in patient preference (P = .09).

Conclusions and Practical Implications

Injected anesthetic decreased the intensity of pain and the need for rescue anesthetic during scaling and root planing, but the risk of developing pain yielded similar results for injected and topical anesthetics.  相似文献   
993.

Background

The authors conducted a systematic review and meta-analysis on the effect of dexamethasone (DX) on edema, trismus, and pain during early and late postoperative periods after third-molar (M3) extraction.

Types of Studies Reviewed

The authors identified eligible reports by searching PubMed, Embase, and the Cochrane Central Register of Controlled Trials up through April 2016. The full text of the studies that met the minimum inclusion requirements were those in which the investigators evaluated the effects of submucosal injection of DX compared with inactive treatments in patients undergoing surgical extraction of an M3.

Results

The authors included 11 eligible trials in this study. Participants receiving DX had significantly less edema during both early (standardized mean difference, 3.28; 95% confidence interval [CI], 2.21-4.36; P < .00001) and late (standardized mean difference, 0.56; 95% CI, 0.27-0.86; P < .00001) periods after surgery, as well as less trismus than did control participants during the early (standardized mean difference, 5.34; 95% CI, 2.44-8.24; P = .004) phase, but there was no strong evidence for the reduction of trismus in the late period. Because of heterogeneity in intervention and outcome assessments across the studies, the authors only qualitatively summarized pain outcomes.

Conclusions and Practical Implications

The findings of this study suggest that submucosal injection of DX reduced not only early and late edema but also early trismus in experimental compared with control participants after M3 extraction, which makes it a likely choice for dental clinical use. However, larger and higher-quality trials are needed to guard against bias to confirm the effect in late trismus and pain.  相似文献   
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997.
Expectations of results from genome sequencing by end users are influenced by perceptions of uncertainty. This study aimed to assess uncertainties about sequencing by developing, evaluating, and implementing a novel scale. The Perceptions of Uncertainties in Genome Sequencing (PUGS) scale comprised ten items to assess uncertainties within three domains: clinical, affective, and evaluative. Participants (n=535) from the ClinSeq® NIH sequencing study completed a baseline survey that included the PUGS; responses (mean = 3.4/5, SD=0.58) suggested modest perceptions of certainty. A confirmatory factor analysis identified factor loadings that led to elimination of two items. A revised eight‐item PUGS scale was used to test correlations with perceived ambiguity (r = ?0.303, p < 0.001), attitudinal ambivalence (r = ?0.111, p = 0.011), and ambiguity aversion (r = ?0.093, p = 0.033). Results support nomological validity. A correlation with the MICRA uncertainty subscale was found among 175 cohort participants who had received results (r = ?0.335, p < 0.001). Convergent and discriminant validity were also satisfied in a second sample of 208 parents from the HudsonAlpha CSER Project who completed the PUGS (mean = 3.4/5, SD = 0.72), and configural invariance was supported across the two datasets. As such, the PUGS is a promising scale for evaluating perceived uncertainties in genome sequencing, which can inform interventions to help patients form realistic expectations of these uncertainties.  相似文献   
998.

Background

The purpose of the study was to determine whether prefabricated foot orthoses immediately reduce pain during functional tasks in people with patellofemoral osteoarthritis, compared to flat insoles and shoes alone.

Methods

Eighteen people with predominant lateral patellofemoral osteoarthritis (nine women; mean [SD] age 59 [10] years; body mass index 27.9 [3.2] kg/m2) performed functional tasks wearing running sandals, and then wearing foot orthoses and flat insoles (random order). Participants rated knee pain during each task (11-point numerical rating scales), ease of performance and knee stability (five-point Likert scales), and comfort (100 mm visual analogue scales).

Results

Compared to shoes alone, foot orthoses (p = 0.002; median difference 1.5 [IQR 3]) and flat insoles (p < 0.001; 2 [3]) significantly reduced pain during step-downs; foot orthoses reduced pain during walking (p = 0.008; 1 [1.25]); and flat insoles reduced pain during stair ambulation (p = 0.001; 1 [1.75]). No significant differences between foot orthoses and flat insoles were observed for pain severity, ease of performance or knee stability. Foot orthoses were less comfortable than flat insoles and shoes alone (p < 0.05).

Conclusions

In people with patellofemoral osteoarthritis, immediate pain-relieving effects of prefabricated, contoured foot orthoses are equivalent to flat insoles. Further studies should investigate whether similar outcomes occur with longer-term wear or different orthosis designs.  相似文献   
999.

Background

Systemic sclerosis (SSc), or systemic scleroderma, is a chronic multisystem autoimmune disease characterised by widespread vascular injury and progressive fibrosis of the skin and internal organs. Patients with SSc have decreased survival, with pulmonary involvement as the main cause of death. Current treatments for SSc manage a range of symptoms but not the cause of the disease. Our review describes the humanistic and cost burden of SSc.

Methods

A structured review of the literature was conducted, using predefined search strategies to search PubMed, Embase, and the Cochrane Library. Grey literature searches also were conducted.

Results

In total, 2226 articles were identified in the databases and 52 were included; an additional 10 sources were included from the grey literature. The review identified six studies reporting relevant cost estimates conducted in five different countries and four studies that assessed the humanistic burden of SSc. Total direct annual medical costs per patient for Europe varied from €3544 to €8452. For Canada, these costs were reported to be from Can$5038 to Can$10,673. In the United States, the total direct health care costs were reported to be US$17,365 to US$18,396. Different key drivers of direct costs were reported, including hospitalisations, outpatients, and medication. The total annual costs per patient were reported at Can$18,453 in Canada and varied from €11,074 to €22,459 in Europe. Indirect costs represented the largest component of the total costs. EQ-5D utility scores were lower for patients with SSc than those observed in the general population, with reported mean values of 0.49 and 0.68, respectively. The average value of the Health Assessment Questionnaire for patients with SSc was significantly higher than the control population (0.94), and the average value of the SF-36 was significantly lower than the control population: 49.99 for the physical dimension and 58.42 for the mental dimension.

Conclusions

Overall, there is a paucity of information on the burden of SSc. Nonetheless, our review indicates that the quality of life of patients with SSc is considerably lower than that of the general population. In addition, SSc places a considerable economic burden on health care systems and society as a whole.  相似文献   
1000.
目的比较静脉移植与局部移植骨髓间充质干细胞(Bone Marrow Stromal Cells,BMSCs)对脊髓损伤大鼠运动功能恢复的效果。方法计算机检索Medline、EMbase、The Cochrane Library(2014年第10期)、中国生物医学文献数据库、万方数据库、中国知网1990~2014年第10期间的静脉移植与局部移植BMSCs治疗脊髓损伤大鼠的随机对照实验。使用Rev Man 5.2.0软件进行Meta分析,纳入研究分为脊髓损伤后3天内细胞移植(3天组)和脊髓损伤后7天细胞移植(7天组)2个亚组,对细胞移植后2、4、6周三个时间点的BBB评分进行分析。结果共6篇文献符合纳入标准。Meta分析结果示:细胞移植后2周,3天组静脉与局部移植BBB评分差异无统计学意义(WMD:-1.15[-2.72,0.42],=0.15),7天组静脉移植BBB评分低于局部移植,差异有统计学意义(WMD:-1.02[-1.99,-0.05],0.05);细胞移植后4周,3天组静脉与局部移植BBB评分差异无统计学意义(WMD:-0.26[-2.26,1.74],=0.80),7天组静脉移植BBB评分低于局部移植,差异有统计学意义(WMD:-0.96[-1.85,-0.07],0.05);细胞移植后6周,3天组静脉与局部移植BBB评分差异无统计学意义(WMD:2.56[-4.39,9.51],=0.47),7天组静脉移植BBB评分低于局部移植,差异有统计学意义(WMD:-1.72[-2.71,-0.73],0.05)。结论脊髓损伤后3天内进行BMSCs移植,局部移植和静脉移植对改善大鼠后肢运动功能没有明显区别;脊髓损伤后7天进行移植,局部移植对大鼠后肢运动功能的恢复效果优于静脉移植。  相似文献   
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