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1.
Claire Letournel François Babinet Bénédicte Allard Vincent Montecot 《Néphrologie & thérapeutique》2019,15(1):51-58
Objective
The “Centre Hospitalier Francois Dunan” is located on an isolated island and ensures patients care in hemodialysis thanks to telemedicine support. Many research studies have demonstrated the importance of hemodialysis fluids composition to reduce morbidity in patients on chronic hemodialysis. The aim of this study was to identify the risks inherent in the production of dialysis fluids in a particular context, in order to set up an improvement action plan to improve risk control on the production of dialysis fluids.Methods
The risk analysis was conducted with the FMECA methodology (Failure Mode, Effects and Criticality Analysis) by a multi professional work group. Three types of risk have been reviewed: technical risks that may impact the production of hemodialysis fluids, health risks linked with chemical composition and health risks due to microbiological contamination of hemodialysis fluids.Results
The work group, in close cooperation with the expert staff of the dialysis center providing telemedicine assistance, has developed an action plan in order to improve the control of the main risks brought to light by the risk analysis.Conclusion
The exhaustive analysis of the risks and their prioritisation have permitted to establish a relevant action plan in this improving quality of dialysis fluids approach. The risk control of dialysis fluids is necessary for the security of dialysis sessions for patients, even more when these sessions are realized by telemedicine in Saint-Pierre-et-Miquelon. 相似文献2.
顺铂聚乳酸微球的药物释放特性及肝动脉栓塞研究 总被引:5,自引:0,他引:5
对顺铂聚乳酸微球进行了体外药物释放和家犬肝动脉栓塞研究。该微球粒径范围为50~200μm,平均粒径为115.76±35.94μm,顺铂含量为37.16%(W/W);体外药物释放机制符合Higuchi方程;肝动脉栓塞后8h,肝组织顺铂浓度高达21.55±12.18μg/g,明显高于肝动脉灌注顺铂组:3.16±0.09μg/g(P<0.05);肝动脉栓塞组的顺铂血浓峰值、各取血点浓度及曲线下面积AUC皆低于肝动脉灌注顺铂组。可望达到提高栓塞部位的药物疗效,降低全身毒副反应的作用。 相似文献
3.
PC Chamyal A Mehta SL Ojha JR Bhardwaj 《Indian journal of otolaryngology and head and neck surgery》1991,43(1):26-27
Primary tuberculous pathology in nasolpolypi is a rare condition. A case of bilateral ethmoidal polypi with tubercular lesion diagnosed on histopathologlcal examination is being reported and the available relevant literature has been reviewed. 相似文献
4.
The function but not the expression of rat liver inhibitory guanine nucleotide binding protein is altered in streptozotocin-induced diabetes 总被引:1,自引:0,他引:1
Adenylate cyclase activity was examined as a measure of inhibitory guanine nucleotide binding protein (Gi) function in liver plasma membranes from rats made chemically diabetic by streptozotocin (STZ) treatment. Clonidine activation of the alpha 2 adrenergic receptor, which activates Gi, inhibited forskolin--stimulated adenylate cyclase activity in control membranes. However, there was no effect on adenylate cyclase activity in membranes from STZ diabetic animals. Also, a polyclonal antipeptide antibody was raised to a highly conserved segment of the Gi alpha 2 subunit. This antibody specifically recognizes a 41 kilodalton protein, is blocked by an excess of peptide, does not recognize the alpha-subunit of transducin, and immunoprecipitates a 41 kilodalton protein which was ADP-ribosylated by pertussis toxin. Immunoblots using this antibody detect no difference between normal and STZ diabetic animals in the level of liver plasma membrane Gi expression. Therefore, STZ-induced diabetes altered the function of Gi but had no effect on Gi expression. 相似文献
5.
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
6.
Kinnison ML; Perler BA; Kaufman SL; Mitchell SE; Kadir S; Williams GM; White RI Jr 《Radiology》1986,160(3):727-730
In situ saphenous vein grafts are being used with increasing frequency for bypass procedures involving the femoral and popliteal arteries. Complications of these procedures include anastomotic stenoses and persistent arteriovenous fistulae that may result in failure of the graft. Balloon angioplasty and embolotherapy with detachable balloons were employed successfully in three or four recent cases of patients with complications from in situ grafts. Tailored angiography is essential for evaluating in situ grafts, and interventional techniques are extremely useful for managing complications. 相似文献
7.
Digital radiography of subtle pulmonary abnormalities: an ROC study of the effect of pixel size on observer performance 总被引:3,自引:0,他引:3
Forty conventional radiographs with examples of mild interstitial infiltrates and subtle pneumothoraces and 40 normal studies of the chest were selected and digitized, with pixel sizes of 1.0, 0.5, 0.2, and 0.1 mm. Observer performance tests were carried out using receiver operating characteristic analysis. Conventional radiographs and digitized images were compared. The results indicate that, in such cases, diagnostic accuracy increases significantly as the pixel size is reduced, at least to the 0.1-mm level. We conclude that, for digital systems using screen-film or similar image receptors, use of a pixel size substantially larger than 0.1 mm may result in some loss of diagnostic accuracy. 相似文献
8.
Most studies have been unable to identify reliable acoustic cues for the recognition of the English nonsibilant fricatives [see text]. The present study was designed to test the extent to which the perception of these fricatives by normal-hearing adults is based on other sources of information, namely, linguistic context and visual information. In Experiment 1, target words beginning with /f/, /theta/, /s/, or [see text] were preceded by either a semantically congruous or incongruous precursor sentence. Results showed an effect of linguistic context on the perception of the distinction between /f/ and /theta/ and on the acoustically more robust distinction between /s/ and [see text]. In Experiment 2, participants identified syllables consisting of the fricatives [see text] paired with the vowels /i, a, u/. Three conditions were contrasted: Stimuli were presented with (a) both auditory and visual information, (b) auditory information alone, or (c) visual information alone. When errors in terms of voicing were ignored in all 3 conditions, results indicated that perception of these fricatives is as good with visual information alone as with both auditory and visual information combined, and better than for auditory information alone. These findings suggest that accurate perception of nonsibilant fricatives derives from a combination of acoustic, linguistic, and visual information. 相似文献
9.
10.
BACKGROUND: Growing interest is nowadays focused on the quality of life of
elderly people who survive with chronic diseases. Coronary heart disease
(CHD) is one of the most common diseases among the elderly and may have an
unfavourable impact on the patient's emotional well-being. OBJECTIVES: We
aimed to describe the prevalence of depression and the occurrence of
depressive symptoms among elderly CHD patients, with a special emphasis on
the relations between depression and the severity of CHD, and to find out
the possible association between CHD and depression. METHODS: The study was
carried out at the health centre of the municipality of Lieto, in
south-west Finland. The study population consisted of 488
community-dwelling men and 708 women, over 64 years old, from among whom
the participants with CHD (89 men and 73 women) were selected, and for whom
178 male and 146 female sex- and age- matched controls (free of CHD) were
drawn from the population. CHD patients were selected on the basis of the
presence of angina pectoris or a past myocardial infarction. Depressive
symptoms were measured with the Zung Self-rating Depression Scale.
Depression was described in relation to the severity of dyspnoea and chest
pain among patients. The associations between depression and age, health,
health behaviour, drugs, functional ability and social, psychosocial and
environmental factors were analysed by logistic regression analyses.
RESULTS: The prevalence of depression was 29% among male patients and 20%
among female patients. Depression was significantly more common among male
CHD patients than among male controls (P = 0.011). Among women, depression
was not associated with CHD. Earlier, depression had gone undiagnosed among
many CHD patients and controls, especially male patients. Among male CHD
patients, depression was associated with more severe dyspnoea, but no
similar association was found among female CHD patients. Among men the
occurrence of CHD, physical disability, widowhood or divorce, and among
women previous clinical depression, physical disability and the use of
angiotensin-converting enzyme (ACE) inhibitors, were associated with
depression. CONCLUSION: Depression is common among patients with CHD. It
seems that CHD is not an independent factor in the aetiology of depression
among the elderly. The association of CHD with depression among men is
explained by the acute or chronic psychic stress caused by CHD. It may be
that the more complicated the patient's CHD, the more probable is the
presence of depression.
相似文献