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排序方式: 共有292条查询结果,搜索用时 46 毫秒
1.
BACKGROUND: Many patients with asthma or chronic obstructive pulmonary diseaseuse their medication inhalers incorrectly. General practitioners,pharmacists and other health care providers do not always havethe opportunity to instruct patients in correct inhaler technique. OBJECTIVE: To find out whether the inhaler technique and respiratory symptomsof patients can be improved after instruction by practice assistants. METHODS: Single blind, randomized intervention study in which 48 patientswho had been using a dry powder inhaler for at least one monthtook part. Their inhaler technique was videotaped on two visitswith a two-week interval between visits. The inhaler techniqueon the videos was subsequently scored by two experts on ninecriteria. At both visits the patients completed a questionnaireabout their respiratory symptoms. After the first video, 25patients were randomly chosen to receive instruction from oneof six practice assistants who had followed a one evening courseabout inhaler instruction, and who had been issued an instruction-set. RESULTS: The patients who received instruction had a significantly greaterreduction in number of mistakes at the second visit than thepatients who did not (P = 0.01). The instructed patients alsoreported less dyspnoea at the second visit (P = 0.03). No effectof instruction was found on wheezing, cough and sputum production. CONCLUSION: The inhaler technique of patients can be improved significantlyby the instruction of patients by trained practice assistants,possibly resulting in less dyspnoea. Keywords. Administration-inhalation, obstructive lung diseases, airways symptoms, patient-education, general practice. 相似文献
2.
Molecular genetic characterization of XRCC4 function 总被引:2,自引:0,他引:2
XRCC4 is a generally expressed protein of 334 amino acids that is involved
in the repair of DNA double-strand breaks and in V(D)J recombination, but
its function is unknown. In this study, we have used a mutational approach
and the yeast two-hybrid method to perform an initial characterization of
this protein. We show that the XRCC4 protein is located in the nucleus. We
also demonstrate that several potential phosphorylation sites are not
required for XRCC4 function in a transient V(D)J recombination assay. In
addition, we show that XRCC4 forms a homodimer in vivo with the
homodimerization domain being located within amino acids 115-204. Finally,
we define a core domain of XRCC4 that functions in V(D)J recombination and
comprises amino acids 18-204. Potential functions of XRCC4 are discussed.
相似文献
3.
Is fecundability associated with month of birth? An analysis of 19th and early 20th century family reconstitution data from The Netherlands 总被引:1,自引:4,他引:1
Smits LJ; Van Poppel FW; Verduin JA; Jongbloet PH; Straatman H; Zielhuis GA 《Human reproduction (Oxford, England)》1997,12(11):2572-2578
The relationship between fecundability and month of birth was investigated
in a cohort of 1526 women who married between 1802 and 1929, using only
women whose first marriage occurred before the age of 35 years. On the
basis of their time to pregnancy (TTP, calculated as time between wedding
and first birth minus gestational length), women were categorized into two
groups: fecunds (TTP up to 12 months or prenuptial conceptions, n = 1348)
and subfecunds (TTP >18 months, n = 118). By use of logistic regression,
cosinor functions with a period of 1 year or 6 months and variable shift
and amplitude were fitted through the monthly odds of subfecunds versus
fecunds. The best fitting curve was unimodal, with a zenith in September (P
= 0.13 for H0: no differences). Exclusion of childless women (n = 36,
minimum follow-up 5 years) from the subfecunds led to a similar curve (P
< 0.01), while childless women, as compared with fecunds, showed a birth
distribution that was best represented with a bimodal curve with zeniths in
January and July (P = 0.06). This study provides evidence for the existence
of differences in fecundability by month of birth. The cause of this
relationship is unclear, but may lie in a melatonin-dependent circannual
variability of the quality of the oocyte.
相似文献
4.
Emsley CL Gao S Li Y Liang C Ji R Hall KS Cao J Ma F Wu Y Ying P Zhang Y Sun S Unverzagt FW Slemenda CW Hendrie HC 《American journal of epidemiology》2000,151(9):913-920
The relation between trace element levels in drinking water and cognitive function was investigated in a population-based study of elderly residents (n = 1,016) in rural China in 1996-1997. Cognitive function was measured using a Chinese translation of the Community Screening Interview for Dementia. A mixed effects model was used to evaluate the effect of each of the elements on cognitive function while adjusting for age, sex, and educational level. Several of the elements examined had a significant effect on cognitive function when they were assessed in a univariate context. However, after adjustment for other elements, many of these results were not significant. There was a significant quadratic effect for calcium and a significant zinc-cadmium interaction. Cognitive function increased with calcium level up to a certain point and then decreased as calcium continued to increase. Zinc showed a positive relation with cognitive function at low cadmium levels but a negative relation at high levels. 相似文献
5.
Yuli R Tak Rinka MP Van Zundert Rowella CWM Kuijpers Boukje S Van Vlokhoven Hettie FW Rensink Rutger CME Engels 《BMC public health》2012,12(1):21
Background
The incidence of depressive symptoms increases during adolescence, from 10.0% to 24.5% at age 11 to 15, respectively. Experiencing elevated levels of depressive symptoms increases the risk of a depressive disorder in adulthood. A universal school-based depression prevention program Op Volle Kracht (OVK) was developed, based on the Penn Resiliency Program, aimed at preventing the increase of depressive symptoms during adolescence and enhancing positive development. In this study the effectiveness of OVK will be tested and possible mediators of program effects will be focus of study as well. 相似文献6.
Factors that affect human hemopoiesis are produced by T-cell growth factor dependent and independent cultured T-cell leukemia-lymphoma cells 总被引:3,自引:0,他引:3
Some laboratory results and clinical situations suggest that human T cells may be important in the regulation of growth of hematopoietic cells. Since the discovery of T-cell growth factor (TCGF), systems are now available for the long-term specific in vitro propagation of mature normal or neoplastic human T cells, providing an opportunity to study the influence of T cells on hematopoiesis. Recently, 24 cell lines from patients with cutaneous T-cell lymphoma (CTCL) and T-cell acute lymphoblastic leukemia (T-ALL) were grown with TCGF and then assessed for release of humoral factors that affect hematopoiesis. Conditioned media (CM) from these cell lines were tested for erythroid burst- promoting activity (BPA) and granulocyte colony-stimulating activity (CSA). BPA was detected in CM from 3/6 cultures of T-ALL patients and 4/6 CTCL cultures. CSA was found in the CM from 6/8 cultures of T-ALL patients, 7/12 CTCL cultures, and 3/4 CTCL cell lines that become independent of exogenous TCGF for growth. The CSA from several of the neoplastic T-cell cultures stimulated high levels of eosinophil colonies, a possible source of the eosinophilia seen in these patients. The ability of continuously proliferating human T lymphocytes, which retain functional specificity and responsiveness to normal humoral regulation, to produce factors that directly or indirectly stimulate myeloid and erythroid colony formation lends further credence to the role of T lymphocytes in regulating hematopoiesis. 相似文献
7.
In long-term hamster bone marrow cultures, proliferation and differentiation of hemopoietic stem cells occurs for several months without need for hydrocortisone or adherent stromal elements, which are requirements for bone marrow growth in all other species studied. Only the most primitive erythroid progenitors (BFU-E) are produced in the cultures. Following treatment of the cells with erythropoietin, these progenitor cells undergo differentiation into mature hemoglobinized red blood cells. Concomitant addition of erythropoietin (Epo) and prostaglandin-E1 (PGE1) results in the production of large numbers of maturing red blood cells. In cultures stimulated with Epo and PGE1, as many as 70% of the cells are benzidine-positive, while Epo alone stimulated as many as 45% of the cells to become erythroid. Epo and PGE1 do not have any apparent deleterious effect on the continuous hemopoiesis occurring in these cultures. Under identical conditions, syngeneic adherent cell cultures do not produce any erythroid elements. The development of mature red blood cells from primitive erythroid precursors occurs in the presence of Epo alone and without any apparent need for adherent stromal elements. These cultures provide a useful in vitro model for dissecting the positive and negative signals that regulate erythropoiesis. 相似文献
8.
George W. Rebok PhD Karlene Ball PhD Lin T. Guey PhD Richard N. Jones ScD Hae‐Young Kim DrPH Jonathan W. King PhD Michael Marsiske PhD John N. Morris PhD Sharon L. Tennstedt PhD Frederick W. Unverzagt PhD Sherry L. Willis PhD for the ACTIVE Study Group 《Journal of the American Geriatrics Society》2014,62(1):16-24
9.
Sarah R. Gillett Evan L. Thacker Abraham J. Letter Leslie A. McClure Virginia G. Wadley Frederick W. Unverzagt 《The Clinical neuropsychologist》2013,27(4):466-486
Objective: To identify approximately 500 cases of incident cognitive impairment (ICI) in a large, national sample adapting an existing cognitive test-based case definition and to examine relationships of vascular risk factors with ICI. Method: Participants were from the REGARDS study, a national sample of 30,239 African-American and White Americans. Participants included in this analysis had normal cognitive screening and no history of stroke at baseline, and at least one follow-up cognitive assessment with a three-test battery (TTB). Regression-based norms were applied to TTB scores to identify cases of ICI. Logistic regression was used to model associations with baseline vascular risk factors. Results: We identified 495 participants with ICI of 17,630 eligible participants. In multivariable modeling, income (OR 1.83 CI 1.27,2.62), stroke belt residence (OR 1.45 CI 1.18,1.78), history of transient ischemic attack (OR 1.90 CI 1.29,2.81), coronary artery disease(OR 1.32 CI 1.02,1.70), diabetes (OR 1.48 CI 1.17,1.87), obesity (OR 1.40 CI 1.05,1.86), and incident stroke (OR 2.73 CI 1.52,4.90) were associated with ICI. Conclusions: We adapted a previously validated cognitive test-based case definition to identify cases of ICI. Many previously identified risk factors were associated with ICI, supporting the criterion-related validity of our definition. 相似文献
10.
Implementing a screening and diagnosis program for dementia in primary care 总被引:1,自引:0,他引:1
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Boustani M Callahan CM Unverzagt FW Austrom MG Perkins AJ Fultz BA Hui SL Hendrie HC 《Journal of general internal medicine》2005,20(7):572-577
BACKGROUND: Primary care physicians are positioned to provide early recognition and treatment of dementia. We evaluated the feasibility
and utility of a comprehensive screening and diagnosis program for dementia in primary care.
METHODS: We screened individuals aged 65 and older attending 7 urban and racially diverse primary care practices in Indianapolis.
Dementia was diagnosed according to International Classification of Diseases (ICD)-10 criteria by an expert panel using the
results of neuropsychologic testing and information collected from patients, caregivers, and medical records.
RESULTS: Among 3,340 patients screened, 434 scored positive but only 227 would agree to a formal diagnostic assessment. Among those
who completed the diagnostic assessment, 47% were diagnosed with dementia, 33% had cognitive impairment—no dementia (CIND),
and 20% were considered to have no cognitive deficit. The overall estimated prevalence of dementia was 6.0% (95% confidence
interval (CI) 5.5% to 6.6%) and the overall estimate of the program cost was $128 per patient screened for dementia and $3,983
per patient diagnosed with dementia. Only 19% of patients with confirmed dementia diagnosis had documentation of dementia
in their medical record.
CONCLUSIONS: Dementia is common and undiagnosed in primary care. Screening instruments alone have insufficient specificity to establish
a valid diagnosis of dementia when used in a comprehensive screening program; these results may not be generalized to older
adults presenting with cognitive complaints. Multiple health system and patient-level factors present barriers to this formal
assessment and thus render the current standard of care for dementia diagnosis impractical in primary care settings.
Supported by grant R01 HS10884-01 from the Agency for Healthcare Research and Quality. 相似文献