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Continuity of relationship between physician and patient is a fundamental aspect of the health care provided by family physicians. Measurement of continuity has proved difficult, however. Commonly applied measures, usual provider of care (UPC), continuity of care (COC), and the modified continuity index (MCI), either ignore key aspects of continuity or provide misleading results. Consequently, a new measure of continuity, the modified, modified continuity index (MMCI), with a possible range of 0 to 1, was developed to overcome these problems. It was applied to a residency model practice, in which mean MMCI was found to be 0.59 (range 0.3 to 1.0). Mean COC was .41 and a mean MCI was .44. Thus, unlike COC and MCI, MMCI suggests fairly good continuity of care in this practice while still implying possible improvement. The MMCI should be useful for enhancing training and practice of family medicine. 相似文献
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W J Thompson P S Anderson S F Britcher T A Lyle J E Thies C A Magill S L Varga J E Schwering P A Lyle M E Christy 《Journal of medicinal chemistry》1990,33(2):789-808
A series of 73 dibenzo[a,d]cycloalkenimines were synthesized and evaluated for their ability to displace (+)-10,11-dihydro-5-methyl-5H-dibenzo[a,d]cyclohepten-5,10-imine ([3H]-(+)-10) from its specific binding site on rat cortical membranes. A number of the more active compounds (Ki ranging from 0.006 to 0.21 microM) were evaluated for N-methyl-D-aspartate (NMDA) antagonist activity in the rat cortical slice (Kb ranging from 0.08 to 0.9 microM) and anticonvulsant activity in the mouse against NMDA induced convulsions. The ED50 values ranged from 0.22 to 7.76 mg/kg and correlated reasonably well with the Kb determination. In the dibenzo[a,d]cyclohepten-5,10-imine series, the (+)-5S,10R enantiomer displayed consistently higher levels of biological activity. While substitution at the 3-position of (+)-10 with electronegative atoms generally increased in vitro activity, a loss of potency relative to (+)-10 (MK-801) was observed in vivo for all of the compounds tested. 相似文献
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Leonidas JC; Berdon WE; Valderrama E; Neveling U; Schuval S; Weiss SJ; Hilfer C; Godine L 《Radiology》1996,198(2):377
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JC Sitek† M Loeb‡ JR Ronnevig¶ 《Journal of the European Academy of Dermatology and Venereology》2007,21(7):891-896
BACKGROUND: Since 1997, a number of trials have shown promising results in treating generalized vitiligo with narrowband ultraviolet B (UVB) both in adults and children. However, there is little knowledge concerning the duration and permanency of the treatment-induced repigmentation. OBJECTIVE: Our main objective was to perform a follow-up trial of successfully treated patients receiving narrowband UVB for generalized vitiligo. METHODS: We have investigated to what degree the treatment-induced repigmentation remains stable for up to 2 years post-treatment. We performed an initial open trial including 31 patients with generalized vitiligo. They received narrowband UVB thrice weekly for up to 12 months. Patients experiencing > 75% repigmentation were defined responders and were included in the follow-up trial. Responders were followed every 6 months for up to 2 years after cessation of treatment. We observed the pigmentation status and registered any changes indicating loss of pigmentation and relapse. RESULTS: Eleven of the 31 treated patients were included in the follow-up trial. Six patients had relapse and five patients had stable response 24 months after cessation of treatment. Four out of six relapses were within 6 months post-treatment. CONCLUSION: In our study population of 31 patients with generalized vitiligo, five patients (16%) experienced > 75% stable repigmentation 2 years after cessation of a treatment programme of up to 1 years narrowband UVB therapy. 相似文献
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Ongoing pregnancies after intracytoplasmic injection using cryopreserved testicular spermatozoa 总被引:4,自引:2,他引:2
Perraguin-Jayot S; Audebert A; Emperaire JC; Parneix I 《Human reproduction (Oxford, England)》1997,12(12):2706-2709
We report two clinical pregnancies occurring after intracytoplasmic sperm
injection (ICSI) using cryopreserved spermatozoa obtained from testicular
biopsy, made in two different infertility situations in our clinic. The
first patient showed a secretory azoospermia associated with elevated serum
follicular stimulating hormone (FSH) level and spermiogenesis maturation
arrest. The second patient was affected by azoospermia resulting from
bilateral epididymal obstruction. Spermatozoa present in the wet
preparation of testicular biopsy made on the day of scrotal exploration
were cryopreserved within the testicular tissue for both men.
Intracytoplasmic injections were performed at a later date, using
spermatozoa prepared from frozen-thawed tissues. In each case, three
embryos were obtained and transferred in utero. The transfers resulted in a
twin pregnancy for the first case, and in a singleton pregnancy for the
second. Living foetuses were seen in the ultrasound scan at the 7th week
and both pregnancies are proceeding to date beyond 30 weeks without
complications.
相似文献
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