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排序方式: 共有314条查询结果,搜索用时 109 毫秒
1.
Atul K Madan Constantine T Frantzides Christopher L Tebbit William C Park Nakka V Aruna Kumari Nina Shervin 《JSLS, Journal of the Society of Laparoendoscopic Surgeons》2004,8(2):191-193
BACKGROUND: Laparoscopic suturing and tying constitute advanced minimally invasive surgery skills. Developing proficiency in the standard methods with needle drivers is often an arduous process. Recent advances in laparoscopic instrumentations has allowed for easier methods of suturing and tying. This study investigated the hypothesis that the use of a specialized suturing device and a specialized tying device allows inexperienced medical students to suture and tie laparoscopically. METHODS: Preclinical medical students who had not received any training in open or laparoscopic surgery were included in this investigation. Each student was given a 5-minute demonstration of a specialized suturing device and a specialized tying device. The medical students were not allowed to deploy either device before actual use. After the demonstration, each student was given the device to use in a porcine model. Times were recorded and a subjective grade was given for each student. RESULTS: Twenty medical students were involved in this study. All medical students were able to complete the task of suturing and tying. The average time to suture was 104.6 seconds and the average time to tying was 31.2 seconds. The average subjective performance grade was 90 (out of 100). CONCLUSION: Specialized devices are easy to learn and use for laparoscopic suturing and tying with minimal instruction even for inexperienced medical students. Even surgeons who are not well versed in laparoscopic surgery should be able to suture and tie with certain laparoscopic instruments. 相似文献
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Frech Tracy M. VanBuren John M. Startup Emily Assassi Shervin Bernstein Elana J. Castelino Flavia V. Chung Lorinda Correia Chase Gordon Jessica K. Hant Faye N. Hummers Laura Khanna Dinesh Sandorfi Nora Shah Ami A. Shanmugam Victoria K. Steen Virginia Evnin Luke 《Clinical rheumatology》2021,40(3):965-971
Clinical Rheumatology - The objective of this analysis is to examine whether the severity of systemic sclerosis (SSc)-hand involvement influences patient-reported outcome measure (PROM) completion... 相似文献
4.
Carmona FD Gutala R Simeón CP Carreira P Ortego-Centeno N Vicente-Rabaneda E García-Hernández FJ García de la Peña P Fernández-Castro M Martínez-Estupiñán L Egurbide MV Tsao BP Gourh P Agarwal SK Assassi S Mayes MD Arnett FC Tan FK Martín J;Spanish Scleroderma Group 《Annals of the rheumatic diseases》2012,71(1):114-119
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Hessam Nowzari DDS PhD Shervin Molayem DDS Ching Hsiu Ketty Chiu DDS Sandra K. Rich RDH PhD 《Clinical implant dentistry and related research》2012,14(4):595-602
Background: The initial thickness of maxillary bone has significant impact on the responding level of facial bone and soft tissue after extraction and immediate implant placement. A prevailing notion is that following implant placement in fresh extraction sites, at least 2 mm of facial bone is needed to prevent soft tissue recession, fenestration, and dehiscence. Purpose: The purpose of this study was to use cone beam computed tomography (CBCT) to measure horizontal width of facial alveolar bone overlying healthy maxillary central incisors and to determine prevalence of bone thickness ≥2 mm. Materials and Methods: Tomographic data from 101 randomly selected patients were evaluated by two independent observers. Assessments were made of facial bone width at levels 1.0 to 10.0 mm apical to the bone crest. Results: Healthy maxillary central incisors (n = 202) were measured from 101 patient scans. The percent of teeth with facial bone ≥2 mm at levels 1, 2, 3, 4, and 5 mm from the bone crest was 0, 1.5, 2.0, 3.0, and 2.5%, respectively. Overall mean thickness of the bone was 1.05 mm for right and left central incisors combined. The range of individual measurements for all levels was 0 to 5.1 mm. The occurrence of ≥2 mm thickness bone measurements increased with increasing depth. However, mean widths observed at levels 6 to 10 mm from the crest ranged only 1.0 to 1.3 mm because of apparent fenestration occurrence (0 mm bone) in approximately 12% of teeth. Overall, no significant differences in bone thickness were found between ethnic, gender, age, or scan groups. Conclusions: Using CBCT, occurrences of ≥2 mm maxillary facial alveolar bone were found on no more than 3% of root surfaces 1.0 to 5.0 mm apical to the bone crest in this sample of maxillary central incisors. The study evidenced prevalence of a thin facial alveolar bone (<2 mm) that may contribute to risk of facial bone fenestration, dehiscence, and soft tissue recession after immediate implant therapy. 相似文献
7.
Soroush Assari Alan Kaufmann Kurosh Darvish Jung Park Jonathan Haw Fayez Safadi Saqib Rehman 《Injury》2013
Objective
Biomechanical comparison between locked plating and retrograde nailing of supracondylar femur fractures with simulated postoperative weight-bearing.Methods
The Locking Condylar Plate (LCP) and Retrograde/Antegrade EX Femoral Nail (RAFN) were tested using 10 paired elderly cadaveric femurs, divided into Normal and Low Bone Mineral Density (BMD) groups, with a simulated AO/OTA type 33-A3 supracondylar femur fracture. Each specimen was subjected to 200,000 loading cycles in an attempt to simulate six weeks of postoperative recovery with full weight-bearing for an average individual. The construct's subsidence due to cyclic loading, and axial stiffness before and after the cyclic loading were measured and their correlation with BMD was studied. The two implants were compared in a paired study within each BMD group.Results
LCP constructs showed higher axial stiffness compared to RAFN for both Normal and Low BMD groups (80% and 57%, respectively). After cyclic loading, axial stiffness of both constructs decreased by 20% and RAFN constructs resulted in twice as much subsidence (1.9 ± 0.6 mm). Two RAFN constructs with Low BMD failed after a few cycles whereas the matched pairs fixed with LCP failed after 70,000 cycles.Conclusions
The RAFN constructs experienced greater subsidence and reduced axial stiffness compared to the LCP constructs. In Low BMD specimens, the RAFN constructs had a higher risk of failure. 相似文献8.
9.
Shervin S. Churchill Michael C. Leo Eileen M. Brennan Claudia Sellmaier Judy Kendall Gail M. Houck 《Maternal and child health journal》2018,22(8):1172-1182
Objective Evaluate the efficacy of a 12 month nursing case-management intervention over a period of 18 months, 6 months after the end of intervention, for families of children attention deficit hyperactivity disorder (ADHD). Methods Mother and child dyads were enrolled to participate in a randomized controlled clinical trial. Children were 4–18 years old. Data were collected at baseline, 6, 12, and 18 months or 6 months after the termination of direct intervention. Longitudinal analyses, using generalized estimating equations, were conducted to assess change in study outcomes relating to family function, maternal stress, and child behavior over the 18 month period. Results Compared to control families, some family function outcomes were moderately improved in the intervention group. In particular, intervention families demonstrated substantial improvement in implementing family behavior controls (p value?=?0.038) and improvement in family satisfaction (not statistically significant p?=?0.062). Although there was improvement in the overall family function measure there was not a statistically significant difference between groups. Maternal stress and child behavior outcomes were not significantly different between control and intervention groups by the end of the intervention. Conclusions for Practice Addressing ADHD is complex and requires the assessment of comorbidities that might exacerbate negative behavior. Our findings support the latest American Academy of Pediatrics guidelines to use behavioral therapy as the first line of treatment in young children. Nursing case-management interventions that provide direct family education and improve family function, especially with respect to providing structure and behavior control, may complement and facilitate behavioral therapy for treatment of ADHD and improving child behavior. 相似文献
10.
Gail M. Kieckhefer Cristine M. Trahms Shervin S. Churchill Lyn Kratz Nancy Uding Nanci Villareale 《Maternal and child health journal》2014,18(3):563-574
To test the 6-month efficacy of an inclusive non-diagnosis-specific, 7-session parent education curriculum on five pre-specified outcomes. A randomized clinical trial with 100 parents having children 2–11 years with a variety of chronic conditions was conducted. The 7-session curriculum, Building on Family Strengths (BFS), was created by an interdisciplinary pediatric team as a derivative of a successful adult chronic disease self-Management program distributed by Stanford University Patient and Education Research Center. Despite no differences at baseline, intervention participants had higher scores on self-efficacy to manage the child’s condition (p = 0.049), coping with childhood chronic illness (p < 0.001), parent–child shared management of the condition (p = 0.097), family quality of life (p = 0.010), and, lower scores on a measure of depressive symptoms (p = 0.046) at the 6-month end-point. Average effect-sizes were modest across outcomes (7–11 % improvement) with intervention participants having baseline scores in the least favorable quartile improving the most (12–41 %). This research provides evidence that the BFS curriculum can yield significant improvements across five important outcomes for parents of children with various chronic conditions. Parent education programs should be offered especially to parents of children with chronic health conditions, regardless of the type of condition, who lack adequate support. These programs can help parents cope with and manage their children’s chronic conditions more effectively. 相似文献