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排序方式: 共有458条查询结果,搜索用时 31 毫秒
1.
Thomas Rimmelé Sophie Malhière Alexandre Ben Cheikh Emmanuel Boselli Monique Bret Charles-Eric Ber Paul Petit Bernard Allaouchiche 《Journal canadien d'anesthésie》2007,54(8):652-656
PURPOSE: In France, legislation mandates that the clinical diagnosis of brain death be confirmed by one paraclinical test before organ donation is allowed. That test may be either the electroencephalogram (EEG) or cerebral angiography. We report a case in which the clinical diagnosis of brain death was first confirmed by two EEGs performed according to the French guidelines, but ruled out by cerebral angiography. Considering that the EEG is no longer recommended to establish the diagnosis of brain death, we discuss the relevance of maintaining the EEG for brain death diagnosis in France. CLINICAL FINDINGS: A 58 yr-old man was admitted to the intensive care unit because of coma secondary to a massive subarachnoid hemorrhage with herniation below the falx shown by computed tomography. Clinical criteria of brain death were rapidly present. Two EEGs first confirmed the diagnosis but a four-vessel cerebral angiography was finally performed because the patient moved spontaneously. This cerebral angiography showed flow in the right internal carotid artery. A computed tomography performed the next day definitely confirmed the absence of brain death and organ donation did not occur. CONCLUSIONS: This case demonstrates the limitations of the EEG for this indication and suggests that angiography should be preferred. French legislation is probably maladjusted and would benefit by incorporating guidelines of other countries like Canada. International harmonization of criteria for brain death diagnosis would also be welcome. 相似文献
2.
Overcoming barriers to teaching the behavioral and social sciences to medical students. 总被引:2,自引:0,他引:2
Most U.S. medical schools offer courses in the behavioral and social sciences (BSS), but their implementation is frequently impeded by problems. First, medical students often fail to perceive the relevance of the BSS for clinical practice. Second, the BSS are vaguely defined and the multiplicity of the topics that they include creates confusion about teaching priorities. Third, there is a lack of qualified teachers, because physicians may have received little or no instruction in the BSS, while behavioral and social scientists lack experience in clinical medicine. The authors propose an approach that may be useful in overcoming these problems and in shaping a BSS curriculum according to the institutional values of various medical schools. This approach originates from insights gathered during their attempts to teach various BSS topics at four Israeli medical schools. They suggest that medical faculties (1) adopt an integrative approach to learning the biomedical, behavioral, and social sciences using Engel's "biopsychosocial model" as a link between the BSS and clinical practice, (2) define a hierarchy of learning objectives and assign the highest priority to acquisition of clinically relevant skills, and (3) develop clinical role models through teacher training programs. This approach emphasizes the clinical relevance of the BSS, defines learning priorities, and promotes cooperation between clinical faculty and behavioral scientists. 相似文献
3.
Ladislav Novotný Hassan Farghali Miloš Ryba Ivo Janků Jiří Beránek 《Cancer chemotherapy and pharmacology》1984,13(3):195-199
Summary Both transport and biotransformation processes for a series of pyrimidine nucleobases, ribonucleosides, 2-deoxyribonucleosides, and acetyl and 5-substituted derivatives of the cancerostatic agent araC were studied in the isolated everted rat jejunum with a continuous perfusion technique. Metabolic alterations during penetration were assessed by HPLC. 5-Halogeno and 5-deoxy derivatives of cytosine nucleosides exhibited higher transport rates and higher stability towards the deamination reaction than did unsubstituted derivatives. Octanol-buffer partition coefficients were estimated for the study compounds, and fragmental constants for the sugar moieties of nucleosides were assessed. With the present study compounds there was no correlation between lipophilicity and transport rate, as previously reported, but there was a correlation between lipophilicity and metabolic alteration of araC derivatives (r=0.99, n=5). 相似文献
4.
It has been proposed that -blocker therapy reverses metabolic and cardiovascular disorders in acute theophylline poisoning. We present a case of acute theophylline overdose treated with esmolol under haemodynamic control. Haemodynamic monitoring was useful in determining the appropriate duration of administration of esmolol and in deciding on treatment with fluids. 相似文献
5.
Kirsten van Gink Katharina Visser Arne Popma Robert R.J.M. Vermeiren Lieke van Domburgh Ber van der Stegen Lucres M.C. Jansen 《Archives of Psychiatric Nursing》2018,32(3):353-359
Staff members in residential care for youth are frequently confronted with aggressive behaviour, which has adverse effects on their stress levels and work satisfaction. This paper describes a qualitative evaluation to find out how staff members benefit from Non-violent Resistance (NVR), a method to create an aggression mitigating residential climate. Staff members were positive about NVR and reported feeling more relaxed. Most valued aspects of this method were the focus on being a team, delayed response and giving up the illusion of control. However, training and the intention to use NVR isn't enough, high quality implementation and maintenance are crucial. 相似文献
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Dyspnoea is the most frequent complaint in respiratory diseases. During clinical care, the physiotherapist is often in front of a dyspneic patient.So the physiotherapist has an important place in care of the dyspneic patients, first time for the evaluation, and then for the treatment. He is also a major interlocutor in a multidisciplinary staff.This article aims to show evaluation tools of the dyspnoea which allow to cover the various domains of the dyspnoea, and then the different physiotherapy’s methods which allow to decrease it. 相似文献
9.
Target gland insufficiency and pituitary tumours 总被引:1,自引:0,他引:1