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1.
2.
Maxillary sinusitis in adults: an evaluation of placebo-controlled double-blind trials 总被引:1,自引:0,他引:1
BACKGROUND: In general practice, acute sinusitis is frequently diagnosed
and treated with antibiotics. OBJECTIVE: This study aimed to determine the
evidence for the effectiveness of antibiotic treatment in acute maxillary
sinusitis in adults by assessing the methodological quality of
placebo-controlled double-blind randomized trials. METHOD: An evaluation by
four raters through a 35-item scoring-scale for internal and external
validity of all placebo-controlled double-blind randomized trials on acute
sinusitis found between January 1966 and July 1996. RESULTS: Eighty-five
trials were excluded because they were not placebo-controlled,
double-blind, randomized, or were carried out in patients with chronic
sinusitis or in children. The three remaining trials were performed in
different populations (one in general practice) between 1973 and 1978. Only
one study claimed superiority of antibiotic treatment. Different inclusion
criteria and major outcome measures were used by the authors. The
reliability of major outcome events was reported poorly or not at all and
in two studies outcome measures were clinically inappropriate. The studies
scored 30-62% of the maximum attainable score for internal validity and
10-20% for external validity. CONCLUSION: The effectiveness of antibiotic
treatment in acute maxillary sinusitis in a general practice population is
not based sufficiently on evidence.
相似文献
3.
HUGH F. MOLLOY F.A.C.D. ERIC LAMONT-GREGORY M.SC. CHRIS IDZIKOWSKI PH.D. F.B.PS.S. TERENCE J. RYAN D.M. F.R.C.P. 《International journal of dermatology》1993,32(9):668-672
Background. Extensive questioning of patients with a wide variety of skin disorders led to the impression that nocturnal overheating was probably an important factor in the initiation and the perpetuation of many skin disorders. Methods. In order to test the hypothesis, 12 “clean-skinned” subjects (6M/6F) aged 18 to 45 years were monitored electronically every 30 seconds during an 8 hour sleep period (2300 to 0700 hours), sleeping under a standard 10 tog duvet. Results. All the subjects were too hot by 3 to 4°C. All showed changes in their EEG patterns with reduced REM sleep, increased awakenings, and all showed changes in their sleep stage patterns. In addition, they all showed evidence of increased sweating in the “heat-sink” area. Conclusions. The mechanisms where by such changes could be implicated in the precipitation and perpetuation of skin disease are discussed. “Lifestyle” modification as a very effective, noninvasive, therapeutic regime is recommended. Further research along these lines would probably be very valuable and instructive. 相似文献
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Ten thrombocytopenic patients (platelets < 10–24 × 10(9)/L) who were refractory to platelet transfusion were investigated for their responsiveness to staphylococcal protein A column therapy. Nine patients had previously been treated with steroids, intravenous immune globulin, and/or other forms of immunosuppressive therapy without improvement in their transfusion response. All patients were receiving multiple platelet transfusions without achieving 1-hour corrected count increments (CCIs) > or = 7500. Eight patients had antibodies that reacted with platelets and were directed against HLA class I antigens, ABO antigens, and/or platelet-specific alloantigens. Plasma (500-2000 mL) from each patient was passed over a protein A silica gel column and then returned to the patient. Patients received from 1 to 14 treatments. A positive response to protein A therapy was defined as at least a doubling of the pretreatment platelet count and/or two successive 10- to 120-minute posttransfusion CCIs > or = 7500. Following plasma treatments, 6 of 10 patients responded with daily platelet counts that averaged 48 +/− 11 × 10(9) per L as compared with counts of 16 +/− 7 × 10(9) per L (p < 0.0005) before treatment. Posttransfusion CCI values determined in four of these patients averaged 2480 +/− 810 and 10,010 +/− 3540 (p < 0.005) before and after treatment, respectively. In contrast, among the four unresponsive patients, platelet counts averaged 10 +/− 9 and 13 +/− 10 × 10(9) per L (p = NS), respectively, while posttransfusion CCIs were 700 +/− 1410 and 1520 +/− 2460 (p = NS), respectively.(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献
6.
Medial border of the perirenal space: CT and anatomic correlation 总被引:11,自引:0,他引:11
7.
Eva Broberger Carol Tishelman Louise von Essen Eva Doukkali Mirjam A. G. Sprangers 《Quality of life research》2007,16(10):1635-1645
Patients with lung cancer experience considerable distress. Therefore, accurate methods for assessing distress and quality
of life over time may play a key role for managing and evaluating palliative care. Alternatives to commonly used standardized
questionnaires are individual measures. This study prospectively and retrospectively explored the concerns that 46 patients
with inoperable lung cancer spontaneously reported as causing most distress close to diagnosis and 6 months later. Changes
in content individually generated through a structured inductive freelisting were compared with EORTC-QLQ-C30+LC13 ratings.
The results showed that patients perceived a wide variety of concerns as most distressing and that their concerns changed
over time. Between 56 and 62% of these concerns were assessed by items included in the EORTC-QLQ-C30+LC13 questionnaires.
Furthermore, patients’ reports of most distress from fatigue, pain and dyspnea were not always reflected in intensity ratings
of comparable EORTC-QLQ-C30+LC13 items. These results indicate that items included in standardized measures are not always
adequate to assess patients’ concerns, priorities and changes over time. In addition to standardized questionnaires, individualized
measures may be useful in the clinical palliative setting for providing detailed information about the individual’s problems
and prioritizations. 相似文献
8.
Berend H. F. Sombekke Willemina M. Molenaar Anthonie J. van Essen Coen J. F. Schoots 《Fetal and pediatric pathology》1994,14(2):277-285
Congenital muscular dystrophy (CMD) comprises a heterogeneous group of muscle disorders. We report on two stillborn sibs with early lethal CMD and a prematurely born boy who died within minutes after birth. The pregnancies were complicated by polyhydramnios. All presented with arthrogryposis multiplex congenita, severe muscle wasting, lung hypoplasia, and hydrops. The muscle biopsies showed fibrosis, variation in fiber size, and extensive fat replacement compatible with muscular dystrophy. Fatal CMD seems to be distinct from CMD with survival after birth and is probably autosomal recessively inherited. 相似文献
9.
10.
Rechtsanwalt und Notar Dr. iur.
Franz-Josef Dahm Fachanwalt für Verwaltungsrecht Essen 《MedR Medizinrecht》2004,22(3):175-176
Ohne Zusammenfassung 相似文献