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41.
Fetal diagnosis has vastly improved over the last decade. Ultrasound has become the imaging modality of choice. As real-time
equipment has improved technologically, the ability to deduce subtle abnormalities has greatly increased.
The fetal genitourinary tract may be evaluated for renal dysplasias, anomalies, or obstruction. Points of obstruction and,
at times, the exact cause of obstruction may be deduced. Abnormalities of the ureter, bladder, urethra, scrotum, or reproductive
system can be detected. 相似文献
42.
The crystal structure of a tripeptide, tryptophanyl-glycyl-glycine dihydrate (C15H18N4O4·2H2O, molecular weight = 354) has been determined. The crystals are orthorhombic, space group P212121 with a= 7.875 (1) A,b= 9.009(1), c= 24.307(1) and Z = 4. The final R-index is 0.058 for 1488 reflections ((sin θ/λ≤ 0.6 A?1) with I < 2σ(I). The molecule exists as a zwitterion, with terminal NH+3 and COO? groups. The peptide units are trans and nearly perpendicular to the plane of the carboxyl group. The backbone torsion angles are: ψ1= 132.7°, ω1= 174.2°, φ2 88.2°, ψ= 8.6°, ω2 - 179.8°, φ= - 85.2°, ψ31, = - 178.1°, ψ32 5.0°. For the sidechain of tryptophan, χ1= - 171.6°, χ2 101.0°. 相似文献
43.
An 8-year longitudinal study of elderly people has provided data concerning age-associated impairment (AAMI). In 1985 a random sample of 146 persons aged 65 years or more, living in their own homes, were assessed using the Guild Memory Test the Mini–Mental State Examination (MMSE) and other ratings. After excluding 21% of the sample because they scored less than 24 on the MMSE, and another 34% who fulfilled other exclusion criteria, some 48% of the remainder (22% of the total sample) clearly fulfilled NIMH criteria for AAMI and a further 36% (16% of the total sample) were recorded as forgetful. The NIMH criteria are appropriate for certain research purposes but not in assessing prevalence of memory disorders. Follow–up interviews were conducted after 2, 4, 6 and 8 years. The mortality rate and development of dementia among those fulfilling criteria for AAMI appeared similar to the other non-demented groups of subjects; the mortality rate of those with MMSE scores below 24 was significantly higher. Guild test results at 2-yearly intervals showed considerable changes; half of those scoring least well who were retested showed improvement. 相似文献
44.
John L. Adams Matthias Schonlau José J. Escarce Meredith Kilgore Michael Schoenbaum Dana P. Goldman 《Health services & outcomes research methodology》2003,4(3):151-167
In order to better inform study design decisions when sampling patients within and across health care providers we develop a simulation-based approach for designing complex multi-stage samples. The approach explores the tradeoff between competing design goals such as precision of estimates, coverage of the target population and cost.We elicit a number of sensible candidate designs, evaluate these designs with respect to multiple sampling goals, investigate their tradeoffs, and identify the design that is the best compromise among all goals. This approach recognizes that, in the practice of sampling, precision of the estimates is not the only important goal, and that there are tradeoffs with coverage and cost that should be explicitly considered. One can easily add other goals. We construct a sample frame with all phase III clinical cancer treatment trials that are conducted by cooperative oncology groups of the National Cancer Institute from October 1, 1998 through December 31, 1999. Simulation results for our study suggest sampling a different number of trials and institutions than initially considered.Simulations of different study designs can uncover efficiency gains both in terms of improved precision of the estimates and in terms of improved coverage of the target population. Simulations enable us to explore the tradeoffs between competing sampling goals and to quantify these efficiency gains. This is true even for complex designs where the stages are not strictly nested in one another. 相似文献
45.
Eva Dragomirecka William R. Lenderking Lucie Motlova Eva Goppoldova Pavla Šelepova 《Quality of life research》2006,15(2):307-312
The Schwartz Outcomes Scale-10 (SOS-10) is a 10-item scale developed to measure the effectiveness of psychiatric treatments.
Using standard methodology, we translated the scale into Czech and examined the psychometric properties of the Czech version.
207 in-patients admitted to Prague Psychiatric Center were included in the study. All patients completed the SOS at admission
and discharge. The SOS-10 scale was also administered to 170 persons from the general population. Reliability, validity and
sensitivity to treatment change of the Czech SOS-10 were analyzed. The Cronbach’s α coefficient was 0.92. The item-total correlation coefficients varied from 0.56 to 0.82. The SOS-10 correlated well with condition-specific
measures including depression (BDI) and anxiety (BAI) and a global self-rated symptom severity scale (CGI). The SOS-10 also
had significant correlations with the Health, Basic needs, Relationship, and Leisure time domains of the Czech version of
the Subjective Quality of Life Analysis (SQUALA-CZ). The scale discriminated well between patients and controls, with patients
scoring significantly lower on all SOS items. The patient sample’s admission and discharge scores were significantly different,
indicating that the scale is sensitive to treatment changes. We concluded that the Czech SOS-10 is valid with reliability
and factor structure similar to the American language version. 相似文献
46.
M. Amgwerd M. Röthlin D. Candinas R. Schimmer H. P. Klotz F. Largiadèr 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》1994,379(6):335-340
A number of studies have shown that ultrasound has an advantage over physical examination in the diagnosis of acute appendicitis. Most of these studies were conducted by experts in the field of ultrasonography. In this study the influence of experience on the results of the sonography of actue appendicitis were evaluated. All 203 patients admitted to our unit between December 1990 and December 1992 were examined physically and sonographically by a team of surgeons consisting of one experienced sonographer and six inexperienced surgical trainees. Laparotomy was performed in 136 patients (46%). Appendicitis was demonstrated histologically in 119 cases (39.4%). Initial clinical findings were positive in 87 (28.8%). Sonography was positive in 119 patients (39.4%). The 163 patients not operated on demonstrated other pathology on ultrasound in 60 cases (19.9%). The rate of negative laparotomies amounted to 7.2% in our study. Sensitivity and specificity for the sonographic diagnosis were 92% and 95%, respectively. They were only 81% and 80% for physical examination. Overall accuracy was 92% for sonography. Sensitivity and specificity for the inexperienced surgeons were 87% and 93%, respectively, while the experienced surgeon reached values of 97% and 98%, respectively. The results of both groups are comparable with values in the literature, suggesting that ultrasound evaluation of appendicitis is not a diagnostic tool limited to a few experienced sonographers. 相似文献
47.
精神发育迟滞儿童特殊教育三年随访 总被引:4,自引:0,他引:4
采用H-NTLA量表及婴儿~初中学生社会生活能力量表对太原市一个培智学校44例精神发育迟滞患儿从1989~1992年连续4次测查智力,2次测查适应行为。结果显示3年间IQ值变化无显著统计学意义,但视觉联想、概念关系、注意力及视觉识知能力有明显提高。患儿适应行为明显提高。经多元逐步回归分析显示,精神发育迟滞儿童智商的提高和母亲文化程度较高、患儿智力低下程度较轻、母亲职业为科技或行政管理人员、患儿初始教育年龄早呈正相关。 相似文献
48.
This paper examines two approaches for the analysis of quantitative traits: (1) association studies and (2) linkage studies. The trait studied was Q1 from simulated Problem 2 data set in Genetic Analysis Workshop 9. Our purpose was to evaluate associations present in the data, to identify nongenetic and genetic predictors of the trait, and to explore the simulated genome for linkage. Through the association study, we found evidence for the primary major gene associated with this trait. The linkage study found evidence of residual genetic effect acting through other traits. Adjustments of Q1 for Q2 and Q3 led to a failure to find significant effects of MG2 and MG3. This supports the suggestion that adjustment for genetically influenced traits for effects of other genetic traits can reduce the power to detect major gene effects. In summary, we detected the major gene directly associated with the trait of interest through association studies. Linkage analysis detected evidence for two other genes associated to a lesser degree with the trait. © 1995 Wiley-Liss, Inc. 相似文献
49.
S D Walter 《Annals of oncology》2003,14(8):1190-1192
BACKGROUND: The case-control design can be used to evaluate the benefit of cancer screening programmes. MATERIALS AND METHODS: This paper outlines the main methodological features of the case-control design in this context, and indicates some potential biases. It also reviews the existing case-control literature on mammographic screening. RESULTS: Case-control studies consistently indicate a reduction of approximately 50% in breast cancer mortality associated with mammography. This result indicates greater benefit than shown in randomised trials; however, one should recognise that trials indicate effectiveness whereas case-control studies indicate efficacy. The two types of evidence are broadly compatible when one allows for screening non-compliance and contamination in the randomised trials. CONCLUSIONS: The case-control evidence supports and is consistent with the findings of randomised trials of mammography. Effectiveness estimates from trials indicate the benefit of screening to the population as a whole, and are pertinent to the public policy debate as to the value of offering screening. In contrast, case-control studies indicate benefit to actual screening participants. As such, case-control estimates of efficacy are appropriate for individual decision-making by women about their use of mammography when it is potentially available to them. 相似文献
50.