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Coronary artery bypass grafts: visualization with MR imaging   总被引:1,自引:0,他引:1  
Gomes  AS; Lois  JF; Drinkwater  DC  Jr; Corday  SR 《Radiology》1987,162(1):175
  相似文献   
3.
腕管综合征主要症状体征敏感性与特异性的比较   总被引:5,自引:1,他引:4  
目的 比较腕管综合征 (carpaltunnelsyndrome ,CTS)主要症状、体征的敏感性与特异性。方法 对 10 1例 ( 162只手 )进行症状严重程度与功能状况的询问 ,感觉、运动功能的检查 ;其中 62只手在术后 6周再次测定。结果  162只患手中 15 8只具有典型症状 ( 98% )。Phalen征、前臂正中神经加压征、Semmes Weinstein单丝纤维测试阳性率分别为 98%、96%、82 %。 87%的患手出现肌力下降 ,拇短展肌肌力测定 (定量法 )结果显示 ,与徒手法相比 ,不同性别间、术前与术后的差异均具非常显著意义 (P <0 .0 1)。结论 典型症状、Phalen征、前臂正中神经加压征、拇短展肌肌力变化的敏感性与特异性最高 ,拇短展肌肌力定量法测定是判断腕管综合征严重程度、评定疗效的一个良好的客观指标。  相似文献   
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Urban and Rural Differences in Health Insurance and Access to Care   总被引:3,自引:0,他引:3  
This study considers differences in access to health care and insurance characteristics between residents of urban and rural areas. Data were collected from a telephone survey of 10,310 randomly selected households in Minnesota. Sub-samples of 400 group-insured, individually insured, intermittently insured, and uninsured people, were asked about access to health care. Those with group or individual insurance were also asked about the costs and characteristics of their insurance policies.
Rural areas had a higher proportion of uninsured and individually insured respondents than urban areas. Among those who purchased insurance through an employer, rural residents had fewer covered benefits than urban residents (5.1 vs 5.7, P < 0.01) and were more likely to have a deductible (80% versus 40%, P < 0.01). In spite of this, rural uninsured residents were more likely to have a regular source of care than urban residents (69% versus 51%, P < 0.01), and were less likely to have delayed care when they thought it was necessary (21% versus 32%, P<0.01). These differences were confirmed by multivariate analysis.
Rural residents with group insurance have higher out-of-pocket costs and fewer benefits. Uninsured rural residents may have better access to health care than their urban counterparts. Attempts to expand access to health care need to consider how the current structure of employment-based insurance creates inequities for individuals in rural areas as well as the burdens this structure may place on rural providers.  相似文献   
6.
The event of preterm birth represents a significant risk to the equilibrium of the family, often placing the family under significant stress. This paper is intended to assist neonatal nurses in understanding factors related to a family's appraisal of stress and strategies used for coping. Such factors are an important consideration in planning the most effective interventions to support optimal family adaptation to their preterm infant's birth. In identifying the best clinical approaches to supporting a family coping with the event of a preterm birth, nurses need to consider levels of the evidence that supports adoption of clinical intervention strategies. Working to reduce family stress and improve family coping ensures the most optimal home environment for the preterm infant to grow and thrive in after discharge.  相似文献   
7.
Preincubation of donor platelets with ticarcillin will prevent the reactivity of a platelet antibody against these platelets, whereas no influence was observed on antisera against HLA, 5A, 5b and ZWa. The implications for the mechanism of drug-induced antibodies with restricted specificity will be discussed.  相似文献   
8.
Controlled studies of treatments effective with victims of natural disasters are almost nonexistent. This is a small study conducted under difficult conditions to test the effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) in treating trauma related reactions following Hurricane Andrew. The results were positive in that EMDR produced significant improvement over wail list controls in perceived posttraumatic avoidance behaviors and thoughts as measured by changes in the Impact of Event Scale and significant improvement in subjective aversive reactions to representative experiences of the hurricane. These results suggest and support other studies that EMDR can be an effective therapeutic intervention for trauma reactions.  相似文献   
9.
The management of patients through the use of evidence-based medicine has become the 'mantra' of medicine within many Western countries. Evidence-based medicine is aimed at providing the best objective, scientific care to all patients, and reducing as far as possible patients' risks of disease and complications from disease. Based on family physicians' discussions of the use of evidence-based recommendations for two cardiac diseases, this paper explores how subjectively-based trust enters into family physicians' decision to use evidence-based medicine. In addition, we show how trust influences physicians' work of recommending evidence-based medicine to patients, and physicians' perceptions of why patients follow recommendations aimed at risk reduction. We conclude that although much of the current discussion about evidence-based medicine assumes a 'rational' model of physician behaviour based on the application of the 'best objective scientific' results, subjectively-based perceptions of trust influence physician practices, and point to the need to understand the power of relational issues in influencing physician practices even when utilizing evidence-based knowledge.  相似文献   
10.
Prednisone-Free Maintenance Immunosuppression—A 5-Year Experience   总被引:1,自引:0,他引:1  
Concern persists that prednisone-free maintenance immunosuppression in kidney transplant recipients will be associated with an increase in late allograft dysfunction and graft loss. We herein report 5-year follow-up of a trial of prednisone-free maintenance immunosuppression. From October 1, 1999, through January 31, 2005, at our center, 589 kidney transplant recipients were treated with a protocol incorporating discontinuation of their prednisone on postoperative day 6. At 5 years, actuarial patient survival was 91%; graft survival, 84%; death-censored graft survival, 92%; acute rejection-free graft survival, 84% and chronic rejection-free graft survival, 87%. The mean serum creatinine level (+/-SD) at 1 year was 1.6 +/- 0.6; at 5 years, 1.7 +/- 0.8. In all, 86% of kidney recipients with functioning grafts remain prednisone-free as of April 30, 2005. As compared with historical controls, recipients on prednisone-free maintenance immunosuppression had a significantly lower rate of a number of complications, including cataracts (p < 0.001), posttransplant diabetes mellitus (p < 0.001), avascular necrosis (p = 0.001), and fractures (p = 0.004). We conclude that prednisone-related side effects can be minimized in a protocol incorporating prednisone-free maintenance immunosuppression. Five-year graft outcome remains good.  相似文献   
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