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41.
42.
目的:通过对HIV抗体快速检测试剂的临床评估,为HIV检测试剂的临床应用提供参考.方法:对快速试剂的使用性能进行比较,并采用美国输血协会(AABB)血清盘、临床样品血清盘、特性血清盘(阳性样品盘)、稀释系列血清盘评估快速试剂的敏感性和特异性.结果:三种快速试剂在检测AABB血清盘时,敏感性分别是86.4%、86.4%、100%,特异性皆为100%;三种快速试剂在检测临床样品血清盘时,敏感性分别是88.6%、91.4%、97.1%,特异性皆为100%.快速试剂具有很高的阳性预期值,对于低危人群(感染率很低人群)也具有很高的阴性预期值.快速试剂检测弱阳性的样品(酶联试剂s/co比值小于6~8的样品)存在漏检.快速试剂与ELISA参考试剂在分析灵敏度方面相差3个以上倍比稀释度.结论:快速试剂具有较好的使用特性,非常适用于样本量较少的实验室及对低危人群的HIV筛查,在对高危人群筛查时,可能有弱阳性样品漏检,同时快速试剂在分析灵敏度方面有待提高. 相似文献
43.
Marisa Klein-Gitelman 《Clinical and Applied Immunology Reviews》2004,4(5):333-350
Systemic lupus erythematosus (SLE) is the archetypical immunologic disease. Approximately 20% of patients present in the first two decades of life. This article highlights some of the differences between pediatric and adult onset lupus.Children are defined as different from adults on the basis of age. Lupus presents with different gender ratios based on hormonal or pubertal status with more significant skewing toward female patients in the childbearing years. Female patients in the childbearing years appear to have a higher relative risk for mortality. Despite this, children have greater disease severity at onset based on the number of patients who present with significant organ inflammation, the amount of corticosteroids required and the abnormalities in lupus serologies including autoantibodies and low complements. Children present frequently with congenital and acquired complement defects. Children have an increased risk of infections that can be confused with lupus. They have a higher risk of serious pneumococcal infection and may have less protection from vaccinations received at the time of disease onset.The clinical immunology laboratory is critical in the diagnosis and treatment of pediatric SLE. The rapid analysis and transfer of laboratory results can be life saving for the child with suspected new onset lupus. The laboratory is also helpful in determining disease activity through analysis of immunologic trends over time in pediatric lupus patients. This is especially important in the noncompliant adolescent patient who has a correlation between disease activity and lupus serologic tests. Finally, the clinical immunology laboratory is an important tool for better understanding of the immunologic phenomena associated with lupus and of disease pathophysiology. 相似文献
44.
The Student Training, Education and Practice for Dietetics (STEP‐DIET) CD‐ROM was developed at the University of Surrey to prepare dietetic students for the practical dietetic training component of their Nutrition/Dietetics degree. This study aimed to evaluate student response to the programme and its effectiveness as a teaching tool, based on the evaluation framework of D.L. Kirkpatrick (Evaluating a Course, 2nd edn. London, Kogan Page). Quantitative and qualitative methodologies were employed, with 41 dietetic students, separated by year group, completing questionnaires and taking part in six focus groups, at the University of Surrey. Student attitudes towards the instruction method and the STEP‐DIET programme itself were investigated, in conjunction with their perceived learning achievements. Students rated the programme highly in terms of design and content, however, there was a reluctance to accept computer‐assisted instruction (CAI) as a sole teaching method. A number of learning achievements relevant to dietetic practice were reported including a perceived increase in ability to conduct a dietetic interview and an increased understanding of the management of Type 2 diabetes. In general students reacted positively to the STEP‐DIET programme and it was perceived by students to be effective in preparing them for the practical component of their dietetic training. 相似文献
45.
临床科室工作量评价方法及其应用 总被引:5,自引:1,他引:4
目的:探讨测量、评价临床科室工作量的指标和方法,加强医院科室管理,促进效益评价与核算。方法:应用医院病案和报表资料,每月计算科室工作强度指数并进行排位,用相对比方法初步分析科室临床工作量和排位变动的状况。结果:选取了实际占用床位数、危重病人抢救次数、门急诊人次数、出会诊人次数、出院病人数5项指标,计算出各科室工作强度指数和排位,并对各科室工作量排位变动进行了比较。结论:临床工作量评价指标和方法的代表性、灵敏性和可靠性较好,实际评价效果也较客观地反映了各临床科室的实际工作量大小。 相似文献
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47.
Michael C. Kontos Kristin L. Schmidt Michael McCue Louis F. Rossiter Michael Jurgensen Christopher S. Nicholson Robert L. Jesse Joseph P. Ornato James L. Tatum 《Journal of nuclear cardiology》2003,10(3):284-290
BACKGROUND: Our objective was to determine the cost-effectiveness of a comprehensive, risk-based triage system, composed of multiple critical pathways, with the use of early myocardial perfusion imaging (MPI) in low-risk patients. We found previously that a chest pain evaluation system that uses MPI in low-risk patients was safe and effective, but the cost-effectiveness of this approach was not studied. METHODS AND RESULTS: We compared two groups. The Acute Cardiac Team (ACT) group (n = 874) was assigned prospectively to 1 of 4 risk levels by emergency department (ED) physicians. Level 1, 2, and 3 patients were admitted; level 4 patients were evaluated in the ED. Level 3 and 4 patients underwent ED MPI. The control group (n = 713) represented consecutive patients evaluated in the prior year according to standard care and assigned retrospectively to an ACT level based on the presenting electrocardiographic and clinical data. Record and hospital administrative data were assessed for clinical variables, outcomes, lengths of stay, and all expenses incurred within 30 days of the index visit. The baseline characteristics of the two groups were similar, including age, sex, myocardial infarction prevalence, and 30-day revascularization rates within each level or between the two groups. Mean costs per encounter were reduced for the ACT patients for each level, which was significant when all patients were compared ($5,030 +/- $7,081 vs $6,044 +/- $10,432, P =.02). Use of MPI in the low-risk patients was associated with reduced costs (level 3, $4,958 +/- $4,948 vs $5,051 +/- $7,036; level 4, $1,529 +/- $2,664 vs $1,794 +/- $6,854) and was associated with a significantly lower angiography rate and shorter length of stay. CONCLUSIONS: Implementation of a comprehensive strategy for chest pain evaluation and triage reduced overall costs for patients with chest pain on presentation. Acute MPI in the ED setting did not increase net cost. 相似文献
48.
对173例支气管哮喘特异性脱敏治疗的疗效及影响疗效的因素进行了分析。结果表明:显效为30.6%(53/173).有效为56.1%(97/173),无效为13.3%(23/173)。影响疗效的因素与病情的程度有关,而与年龄、病程、皮试阳性反应强弱及脱敏治疗前4个疗程内是否应用曲安缩松等无关。并对特异性脱敏治疗支气管哮喘的优缺点进行讨论。 相似文献
49.
50.
Clinical evaluation of a potassium nitrate dentifrice for the treatment of dentinal hypersensitivity
Toshihiko Nagata Hiroshi Ishida Hiroyuki Shinohara Seiji Nishikawa Shinji Kasahara Yoichi Wakano Shusaku Daigen Emanuel S. Troullos 《Journal of clinical periodontology》1994,21(3):217-221
Abstract The effectiveness of a 5% potassium nitrate dentifrice as a daily home treatment for dentinal hypersensitivity was evaluated in a double-blind study in 36 Japanese subjects who complained of cold and/or tactile hypersensitivity. The subjects were divided into 2 groups, with 18 being given a 5% potassium nitrate dentifrice (treated group) and the other 18 a vehicle paste (control group). Both groups were instructed to brush their teeth 2 × a day. The hypersensitivity levels of the affected teeth were assessed by 2 stimuli, one tactile and the other cold air, and by the perception of pain. The results of all 3 assessment methods indicated that the potassium nitrate dentifrice significantly decreased the level of hypersensitivity at weeks 4, 8, and 12. In the treated group, a rapid decrease of positive scores for both the cold air stimulus and the subjective symptoms appeared from week 2. Although a significant decrease of the assessment score was also observed in the control group, the reduction rate of the score was much greater in the treated group by ail 3 assessment methods at weeks 4, 8, and 12. Complete relief of subjective symptoms throughout the 12 weeks’examination was noted in 67% of the subjects in the treated group, but in only 6% in the control group. These results suggest the usefulness of a 5% potassium nitrate dentifrice in Japanese patients with dentinal hypersensitivity. 相似文献