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排序方式: 共有346条查询结果,搜索用时 31 毫秒
1.
Immunological and echocardiographic evaluation of decellularized versus cryopreserved allografts during the Ross operation. 总被引:3,自引:0,他引:3
Francisco Diniz Affonso da Costa Pascal Maria Dohmen Daniele Duarte Cristina von Glenn Sérgio Veiga Lopes Hermínio Haggi Filho Marise Brenner Affonso da Costa Wolfgang Konertz 《European journal of cardio-thoracic surgery》2005,27(4):572-578
OBJECTIVE: Compare the immunological and echocardiographic data of decellularized versus cryopreserved allografts used for RVOT reconstruction during Ross operation. METHODS: From 16/01/03 thru 07/10/03, 20 Ross operations were performed using decellularized (n=11) or cryopreserved (n=9) allografts. Echocardiography was done at discharge, 1, 3, 6 and 12 months and annually thereafter. Samples for determination of antibodies against HLA class I and II were obtained preoperatively and at days 5, 10, 30, 90 and 180 postoperatively. These samples were tested by the ELISA method in LAT-M dishes (unspecific) for identification of circulating antibodies and the results expressed as mean sample values (Is=DO/cutoff). If positive, LAT-E (specific) was performed and PRA levels determined. RESULTS: There was no mortality. Cryopreserved allografts showed marked Is values elevations for class I and II antibodies which started at the first month and remained elevated up to 6 months. In contrast, of the patients receiving decellularized allografts, seven remained negative, two patients had only marginal elevation of class I antibodies and two patients showed abnormal elevations of PRA levels. This response happened earlier than in the cryopreserved group, starting on the 5th postoperative day and has returned to baseline levels in one case. Echocardiography showed mild, but significant, elevation of gradients in cryopreserved valves but none in the decellularized. CONCLUSIONS: Decellularized allografts had normal function up to 18 months and showed important reduction of the immunogenic response when compared to cryopreserved valves. 相似文献
2.
Renate H. Rosenthal Frank W. Ling Ted L. Rosenthal S. Gene McNeeley 《Psychosomatics》1984,25(11):833-841
One hundred three consecutive patients referred for treatment of chronic pelvic pain underwent MMPI testing, and 60 had diagnostic laparoscopy. A physical cause for the pain was found in 45 (75%) of the 60. However, three fourths (34) of patients with an organic cause for the pain also had evidence of psychopathology on the MMPI. Reassurance and education as to the role of stress in causing or exacerbating pain complaints appeared helpful. Most patients improve without major surgery. 相似文献
3.
S.L. Hendrix DO S.D. Piereson MD S.G. McNeeley MD 《American journal of obstetrics and gynecology》1995,172(6):1719-1725
Objective: Our purpose was to determine whether primary and preventive care is practiced by a university obstetrician-gynecologist group practice.Study design: A retrospective chart review spanning 2 years of four academic physicians' private practices was performed. A total of 335 patients were reviewed with 739 patient encounters and 1032 patient problems identified. The definition of a primary care physician according to The American College of Obstetricians and Gynecologists was used to standardize data collection and evaluation.Results: Obstetric complaints accounted for 27.7% of all visits, whereas 65.4% were for gynecologic problems. Almost 7% of all complaints were neither obstetric nor gynecologic, and of those 74.6% were primary care problems completely managed by the obstetrician-gynecologist. Only 19.7% of these were referred for management. More than 89% of all encounters () involved some element of primary care.Conclusion: This study provides evidence that the majority of health care provided by the obstetrician-gynecologists is primary care. 相似文献
4.
Pelvic inflammatory disease. 总被引:3,自引:0,他引:3
S G McNeeley 《Current opinion in obstetrics & gynecology》1992,4(5):682-686
Pelvic inflammatory disease is a common serious complication of the sexually transmitted pathogens Neisseria gonorrhoeae and Chlamydia trachomatis. There are more than 800,000 cases of pelvic inflammatory disease annually accounting for approximately 200,000 hospital admissions for acute and chronic infections. Early accurate diagnosis and treatment are essential to prevent the serious sequelae including ectopic pregnancy, tubal disease infertility, chronic pain, and disability requiring multiple hospitalizations and surgery. Although clinical models to aid in the diagnosis and management of pelvic inflammatory disease have been developed by numerous investigators, all have lacked the sensitivity and specificity to be helpful to the clinician. Laparoscopy, considered by many to be the "gold standard" for diagnosis, is underutilized, and the definition of pelvic infection differs between investigators. Improved patient compliance and safety may be seen if single-agent therapy for acute pelvic inflammatory disease becomes a reality. In a small prospective randomized study, oral ofloxacin was as effective as cefoxitin plus doxycycline for outpatient treatment of chlamydial and gonococcal pelvic inflammatory disease. Treatment of tuboovarian abscess appears to be successful with single agent and combination therapy. Risk factors for developing postabortion endometritis continue to be identified, and the most efficacious prophylactic antibiotic regimen has not been determined to date. 相似文献
5.
6.
Impact of oral clinical problems on oral health‐related quality of life in brazilian children: a hierarchical approach 下载免费PDF全文
João Gabriel Silva Souza Andréa Maria Eleutério De Barros Lima Martins Marise Fagundes Silveira Kimberly Marie Jones Maria Paula Maciel Rando Meirelles 《International journal of paediatric dentistry / the British Paedodontic Society [and] the International Association of Dentistry for Children》2017,27(1):66-78
7.
Integrity situational judgement test for medical school selection: judging ‘what to do’ versus ‘what not to do’ 下载免费PDF全文
Wendy E de Leng Karen M Stegers‐Jager Marise Ph Born Axel P N Themmen 《Medical education》2018,52(4):427-437
Context
Despite their widespread use in medical school selection, there remains a lack of clarity on exactly what situational judgement tests (SJTs) measure.Objectives
We aimed to develop an SJT that measures integrity by combining critical incident interviews (inductive approach) with an innovative deductive approach. The deductive approach guided the development of the SJT according to two established theoretical models, of which one was positively related to integrity (honesty–humility [HH]) and one was negatively related to integrity (cognitive distortions [CD]). The Integrity SJT covered desirable (HH‐based) and undesirable (CD‐based) response options. We examined the convergent and discriminant validity of the Integrity SJT and compared the validity of the HH‐based and CD‐based subscores.Methods
The Integrity SJT was administered to 402 prospective applicants at a Dutch medical school. The Integrity SJT consisted of 57 scenarios, each followed by four response options, of which two represented HH facets and two represented CD categories. Three SJT scores were computed, including a total, an HH‐based and a CD‐based score. The validity of these scores was examined according to their relationships with external integrity‐related measures (convergent validity) and self‐efficacy (discriminant validity).Results
The three SJT scores correlated significantly with all integrity‐related measures and not with self‐efficacy, indicating convergent and discriminant validity. In addition, the CD‐based SJT score correlated significantly more strongly than the HH‐based SJT score with two of the four integrity‐related measures.Conclusions
An SJT that assesses the ability to correctly recognise CD‐based response options as inappropriate (i.e. what one should not do) seems to have stronger convergent validity than an SJT that assesses the ability to correctly recognise HH‐based response options as appropriate (i.e. what one should do). This finding might be explained by the larger consensus on what is considered inappropriate than on what is considered appropriate in a challenging situation. It may be promising to focus an SJT on the ability to recognise what one should not do. 相似文献8.
9.
Ulla A. Botha Marise Coetzee Liezl Koen Dana J.H. Niehaus 《Archives of Psychiatric Nursing》2018,32(3):384-389
Introduction
Pressure on inpatient beds often results in premature discharges, which may precipitate early readmission. This has prompted an increased interest in transitional care interventions to bridge the gap between in- and outpatient care to reduce such readmissions. Our study aimed to assess the effect of a Transitional Care Service (TCS) on readmission rates in a high pressure inpatient service which utilizes a premature discharge policy to address bed pressures.Methods
Sixty male patients identified for crisis discharge were offered a TCS for the first ninety days after discharge. Patients received a structured intervention consisting of four phone calls and one home visit, focusing on maintaining adherence, appointment reminders and psychoeducation. The TCS patients were retrospectively compared to a matched control group in terms of readmission after 90 days. Data was collected on adherence to medication, attendance of appointments and incidence of substance use.Results
There was no significant difference in readmission rates. Prevalence of substance use was very high (90%), especially methamphetamine use (48%). Adherence dropped from 45% (n = 27) at one week post-discharge to 25% (n = 15) at 90 days.Conclusion
Structured telephone-based transitional interventions have no effect on readmission rates in this setting. Prematurely discharged patients require more comprehensive support with focus on comorbid substance use. 相似文献10.
Graham SM Ahmed T Amanullah F Browning R Cardenas V Casenghi M Cuevas LE Gale M Gie RP Grzemska M Handelsman E Hatherill M Hesseling AC Jean-Philippe P Kampmann B Kabra SK Lienhardt C Lighter-Fisher J Madhi S Makhene M Marais BJ McNeeley DF Menzies H Mitchell C Modi S Mofenson L Musoke P Nachman S Powell C Rigaud M Rouzier V Starke JR Swaminathan S Wingfield C 《The Journal of infectious diseases》2012,205(Z2):S199-S208
There is a critical need for improved diagnosis of tuberculosis in children, particularly in young children with intrathoracic disease as this represents the most common type of tuberculosis in children and the greatest diagnostic challenge. There is also a need for standardized clinical case definitions for the evaluation of diagnostics in prospective clinical research studies that include children in whom tuberculosis is suspected but not confirmed by culture of Mycobacterium tuberculosis. A panel representing a wide range of expertise and child tuberculosis research experience aimed to develop standardized clinical research case definitions for intrathoracic tuberculosis in children to enable harmonized evaluation of new tuberculosis diagnostic technologies in pediatric populations. Draft definitions and statements were proposed and circulated widely for feedback. An expert panel then considered each of the proposed definitions and statements relating to clinical definitions. Formal group consensus rules were established and consensus was reached for each statement. The definitions presented in this article are intended for use in clinical research to evaluate diagnostic assays and not for individual patient diagnosis or treatment decisions. A complementary article addresses methodological issues to consider for research of diagnostics in children with suspected tuberculosis. 相似文献