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排序方式: 共有653条查询结果,搜索用时 15 毫秒
1.
TOBIAS HUND MD BENJAMIN ASCHER MD BERTHOLD RZANY MD SCM FOR THE SMILE STUDY GROUP 《Dermatologic surgery》2006,32(10):1256-1260
BACKGROUND: Several clinical scoring systems have been used to evaluate the efficacy of botulinum toxin A in the treatment of hyperkinetic wrinkles. So far very few have been investigated for their reproducibility. OBJECTIVE: The aim of this study was to investigate the reproducibility of two clinical four-point scales for lateral canthal lines (crow's feet), at rest and at maximum smile. MATERIAL AND METHODS: Based on standardized photographs, a consensus atlas depicting the different severity grades [from 0 (none) to 3 (severe)] was developed. After training based on the atlas, 49 photographs at rest and 48 at maximum smile were graded by the same group of investigators on 2 consecutive days (n=9 on Day 1; n=8 on Day 2). The scores were compared for reproducibility using kappa statistics. RESULTS: Overall, reproducibility was good for both scales. Interobserver reproducibility showed an agreement of 0.6 at rest and 0.58 at maximum smile (unweighted kappa). Intraobserver reproducibility showed an agreement between 0.47 and 0.86 at rest and between 0.62 and 0.81 at maximum smile (unweighted kappa). Using weighted kappa analysis, the agreement ranged between 0.63 and 0.91 at rest and between 0.71 and 0.85 at maximum smile. CONCLUSION: The clinical scales using scores of 0 to 3 for crow's feet, both at rest and at maximum smile, show a good inter- and intraobserver reproducibility. The use of these scores in clinical trials can be recommended. 相似文献
2.
Effect of metoprolol on death and cardiac events during a 2-year period after coronary artery bypass grafting 总被引:1,自引:0,他引:1
PURPOSE: To evaluate the effect of long-term treatment with metoprololafter coronary bypass grafting on death and cardiac events. METHODS: Patients in western Sweden on whom coronary artery bypass graftingwas performed between June 1988 and June 1991 were evaluatedfor inclusion during the first 3 weeks after surgery. Majorexclusion criteria were age >75 years, concomitant valvesurgery, traditional contraindications to beta-blockers andunwillingness to participate. Patients were randomized in adouble-blind fashion to 100 mg of metoprolollplacebo daily for2 weeks and thereafter 200 mg daily for 2 years. RESULTS: Of 2365 patients who were operated on, 967 were randomized toeither metoprolol (n=480) or placebo (n=487). Primary end points(death, non-fatal myocardial infarction, unstable angina pectoris,need for coronary artery bypass grafting or percutaneous transluminalangioplasty), were reached by 42 patients in the metoprololgroup (8·8%) as compared with 39 in the placebo group(8·0%) (P=0·73). Of all the patients randomizedto metoprolol, 34% withdrew from blind treatment prematurelycompared with 44% for placebo (P<0·01) CONCLUSION: Prophylactic treatment with metoprolol over a 2-year periodafter coronary artery bypass grafting did not reduce death orthe development of cardiac events. However, the 95% confidencelimits ranged from the possibility of a 30% reduction in eventsto a 68% increase in events if patients were treated with metoprololas compared with placebo. 相似文献
3.
YUKIO HOMMA HIDEYUKI AKAZA KIYOKI OKADA MASAO YOKOYAMA MICHIYUKI USAMI YOSHIHIKO HIRAO TOMOYASU TSUSHIMA ATSUHIKO SAKAMOTO YASUO OHASHI YOSHIO ASO THE PROSTATE CANCER STUDY GROUP 《International journal of urology》2004,11(4):218-224
BACKGROUND: We retrospectively compared the 5-year survival rates of T1b-T3N0M0 prostate cancer patients treated either by endocrine therapy plus radical prostatectomy or endocrine therapy alone. METHODS: Clinical T1b-T3N0M0 prostate cancer patients were enrolled at 104 institutions in Japan. They were assigned to study 1 (n = 176), if they were indicated to prostatectomy, if not indicated, they were assigned to study 2 (n = 151). The indication of prostatectomy was based on the clinical judgement of physicians and/or patients. Those assigned to study 1 underwent prostatectomy and adjuvant endocrine therapy with or without preoperative androgen deprivation. Those assigned to study 2 were treated with leuprorelin acetate with or without chlormadinone acetate. They were followed-up every 3 months until death or for 5 years and over. RESULTS: Those assigned to study 1 were younger (mean age 67.2 vs 75.7 years), less advanced in clinical stage, and had lower prostate specific antigen levels (mean 43.8 vs 103.6 ng/mL). Death for any reason was observed less frequently in study 1 (n = 29, 16%) than study 2 (n = 50, 33%), and the 5-year overall survival rate was higher in study 1 (87 vs. 68%). However, prostate cancer deaths were comparatively seldom (9% in study 1 and 7% in study 2), resulting in the identical 5-year cause specific survival rate in both study groups (91%). In both study groups the overall survival was almost equal to the natural survival of age-matched men. CONCLUSIONS: Endocrine therapy offers a reasonable survival rate in T1b-T3 prostate cancer patients within a 5-year follow-up. Observation will be extended to determine 10-year outcomes. 相似文献
4.
In November 1991 69% of a random sample of 998 Danish generalpractitioners (GPs) participated in a survey by anonymouslyfilling in a mailed questionnaire concerning the way in whichthey use health education in their practices. Among the participatingGPs, 97% used health education material. The study showed differencesin attitudes towards and use of health education material. Thematerial most often used by GPs at the consultation concerneddiet/overweight, allergy and pregnancy. Pamphlets and postersin the waiting room mainly dealt with vaccination, alcohol andsmoking. The female practitioners were generally most sympatheticto the use of health education material, but they are also thosemost critical, of material advertising for medicine. The malepractitioners thought that there was too much material and thatthey did not have enough time to use it. 相似文献
5.
267株烧伤感染细菌的调查分析 总被引:1,自引:0,他引:1
目的:回顾性分析1995年1月至2003年12月间本院烧伤科细菌分布和菌种耐药情况,以指导临床合理用药。方法:收集烧伤病人创面分泌物、血液、痰液及静脉导管末端行普通细菌培养,统计细菌分布情况及常用药物的敏感性。结果:9年来共检出19种267株细菌.其中铜绿假单胞菌和金黄葡萄球菌占83.14%,并有逐渐增加的趋势。铜绿假单胞菌以亚胺培南、头孢哌酮/舒巴坦和多粘菌素B最敏感;氨曲南亦较敏感,且敏感性呈逐渐上升趋势。金黄色葡萄球菌以万古霉素最敏感.呋喃妥因、利福平次之,青霉素类和大部分头孢菌素则高度耐药。结论:目前烧伤感染仍以铜绿假单胞菌和金黄色葡萄球菌为主.防治该两种细菌感染是抗烧伤感染的主要任务。 相似文献
6.
7.
H. REIJONEN S. NEJENTSEV J. TUOKKO S. KOSKINEN E. TUOMILEHTO-WOLF H. K. KERBLOM J. ILONEN THE CHILDHOOD DIABETES IN FINLAND STUDY GROUP 《International journal of immunogenetics》1997,24(5):357-363
We determined the distribution of DR4 subtypes in 309 DQB1*0302-positive haplotypes found in insulin-dependent diabetes mellitus (IDDM) patients and 70 control haplotypes present only in healthy family members. An increased frequency of DRB1*0401 allele (74.4% vs. 55.7%, P = 0.003) and a decrease of DRB1*0404 allele (23.6% vs. 40.0%, P = 0.0064) was revealed. A further analysis of extended haplotypes demonstrated strong linkages between various B alleles and DRB1*04 subtypes. HLA-B39 was more frequent in DRB1*0404–DQB1*0302-positive IDDM haplotypes compared with control ones (37.0% vs. 14.3%, P = 0.049), suggesting an involvement of the region telomeric to HLA-DRB1 in the susceptibility to IDDM. 相似文献
8.
JOST S.; DECKERS J. W.; NIKUTTA P.; WIESE B.; RAFFLENBEUL W.; HECKER H.; LIPPOLT P.; LICHTLEN P. R.; THE INTACT INVESTIGATORS 《European heart journal》1994,15(5):648-653
A correlation of the angiographic evolution of coronary stenoses(stenosis diameter 20%) with morphological stenosis parametersat baseline could help to identify the risk of progressive stenoses.Therefore, the data of the prospective INTACT study (InternationalNifedipine Trial on Antiatherosclerotic Therapy) were reviewed.In 348 patients with moderate coronary artery disease, standardizedcoronary angiograms were taken 3 years apart and were quantitativelyanalysed. Changes in the minimal diameter of the 1063 preexistingcoronary stenoses compared between both angiograms were setin relation to a number of conventional stenosis parametersat baseline. Regression analysis demonstrated a significantcorrelation of the changes in minimal diameter with baseline% diameter stenosis (r=0.30; P<0.001), minimal diameter (r=0.28;P<0.001) and reference diameter of stenoses (r=0.14;P<0.001). The changes were not correlated with stenosis lengthand plaque area. The baseline parameters of 22 preexisting stenosesprogressing to occlusions differed from those remaining patentonly with regard to the % diameter stenosis (43 ± 9%vs 39 ± 11%; P<0.05). Additional progression of coronarydisease became manifest through development of 228 stenosesand 19 occlusions at arterial sites free from definitive stenosesin the baseline angiograms. Thus, progression of atherosclerosis predominantly occurredin mild preexisting coronary stenoses and developed at previouslyangiographically normal sites. Since the conventional angiographicparameters analysed in this study failed to identify individualarterial sites with an increased risk for progression, definitionof new angiographic parameters or application of new techniquesseem mandatory to this end. 相似文献
9.
WEINBERG JULIUS; GRIMAUD OLIVIER; NEWTON LISA; ON BEHALF OF THE CHARTER GROUP 《European journal of public health》1999,9(3):236-240
Background: Several collaborations in communicable disease surveillancehave developed between European Union member states. Involvementin these activities takes time and money. It is vital that collaborationsare established in areas most likely to be beneficial. An exercisewas undertaken to inform national surveillance centres and theEuropean Commission as to priority areas for the developmentof collaborations. Methods: A modified Delphi exercise was undertakenamongst the heads of centres with responsibilities for surveillanceat national level in the member states of the EU. Participantsdeveloped, agreed and ranked criteria for developing collaborations.A list of communicable diseases and syndromes was then rankedusing a Likert-type scale. Three rounds were undertaken. Betweenrounds, scores and a ranking were fed back showing where participantshad ranked items, compared to the overall mean and rank distribution.For the third round participants were asked to use a categoricalscale, nominating six or ten high priority disease areas. Results:Response rates were 87.5% for round 1, 44% round 2 and 87% round3. The low round 2 response rate appeared to be because respondentsdid not wish to alter their rankings. The six high priorityareas were outbreaks of gastroenteritis/food poisoning, CID/otherslow virus infections, serious imported diseases, legionellosis,antimicrobial resistance and tuberculosis. When participantsgave ten high priority areas meningococcal disease, travel advice,vaccination/immunization and influenza were also included. Thefinal lists were accepted at the meeting of participants. Conclusions:The process was successful in developing both a priority listand consensus. 相似文献
10.
Marina Cuttini Veronica Casotto Marcello Orzalesi & THE EURONIC STUDY GROUP 《Acta paediatrica (Oslo, Norway : 1992)》2006,95(S452):42-46
An international project (EURONIC) was carried out to explore the end-of-life decision-making process in a large, representative sample of neonatal intensive care units (NICUs) in eight western European countries: France, Germany, Great Britain, Italy, Luxembourg, the Netherlands, Spain and Sweden. Structured questionnaires were used to record data on NICU organization and policies, and to survey staff views and practices regarding ethical decision-making. One hundred and twenty-two NICUs were recruited by census or random sampling (response rate 86%); 1235 physicians and 3115 nurses completed the staff questionnaire (response rates 89 and 85%, respectively). This paper focuses on the physicians' answers. In all countries but Italy, most physicians reported having been involved at least once in setting limits to intensive care because of a baby's incurable condition and/or poor neurological prognosis. Adopted strategies varied between countries. Practices such as the continuation of current treatment without intensifying it and the withholding of emergency manoeuvres appeared widespread. In contrast, the frequency of doctors reporting withdrawal of mechanical ventilation was highest in the Netherlands (93%), Sweden (91%) and the Great Britain (88%), intermediate in France and Germany, and lowest in Spain and Italy (34 and 21%, respectively).
Conclusion: Ethically problematic clinical cases are approached differently in the various countries. The findings of this study may provide an opportunity for physicians to review their practices critically, in light of how other colleagues proceed, and foster an open discussion about these difficult issues. 相似文献
Conclusion: Ethically problematic clinical cases are approached differently in the various countries. The findings of this study may provide an opportunity for physicians to review their practices critically, in light of how other colleagues proceed, and foster an open discussion about these difficult issues. 相似文献