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1.
The Postoperative Short Course Content Study group 《Anaesthesia》2022,77(5):570-579
Most surgical and anaesthetic mortality and morbidity occurs postoperatively, disproportionately affecting low- and middle-income countries. Various short courses have been developed to improve patient outcomes in low- and middle-income countries, but none specifically to address postoperative care and complications. We aimed to identify key features of a proposed short-course addressing this topic using a Delphi process with low- and middle-income country anaesthesia providers trained as short-course facilitators. An initial questionnaire was co-developed from literature review and exploratory workshops to include 108 potential course features. Features included content; teaching method; appropriate participants; and appropriate faculty. Over three Delphi rounds (panellists numbered 86, 64 and 35 in successive cycles), panellists indicated which features they considered most important. Responses were analysed by geographical regions: Africa, the Americas, south-east Asia and Western Pacific. Ultimately, panellists identified 60, 40 and 54 core features for the proposed course in each region, respectively. There were high levels of consensus within regions on what constituted core course content, but not between regions. All panellists preferred the small group workshop teaching method irrespective of region. All regions considered anaesthetists to be key facilitators, while all agreed that both anaesthetists and operating theatre nurses were key participants. The African and Americas regional panels recommended more multidisciplinary healthcare professionals for participant roles. Faculty from high-income countries were not considered high priority. Our study highlights variability between geographical regions as to which course features were perceived as most locally relevant, supporting regional adaptation of short-course design rather than a one-size-fits-all model. 相似文献
2.
María Cabrerizo Gloria Trallero María José Pena Amaia Cilla Gregoria Megias Carmen Mu?oz-Almagro Eva Del Amo Diana Roda Ana Isabel Mensalvas Antonio Moreno-Docón Juan García-Costa Nuria Rabella Manuel Ome?aca María Pilar Romero Sara Sanbonmatsu-Gámez Mercedes Pérez-Ruiz María José Santos-Mu?oz Cristina Calvo And the study group of “Enterovirus parechovirus infections in children under ?years-old Spain” PI- 《European journal of pediatrics》2015,174(11):1511-1516
3.
Claudia Trenkwalder MD Heike Benes MD Ludger Grote MD Svenja Happe MD Birgit Högl MD Johannes Mathis MD Gerda M. Saletu‐Zyhlarz MD Ralf Kohnen PhD CALDIR study group 《Movement disorders》2007,22(5):696-703
We report the first large-scale double-blind, randomly assigned study to compare two active dopaminergic therapies for Restless Legs Syndrome (RLS), the dopamine agonist cabergoline (CAB) and levodopa/benserazide (levodopa). Patients with idiopathic RLS were treated with fixed daily doses of 2 or 3 mg CAB or 200 or 300 mg levodopa for 30 weeks. Efficacy was assessed by changes in the IRLS (International RLS Severity Scale) and by time to discontinuation of treatment due to loss of efficacy or augmentation. 361 of 418 screened patients (age 58 +/- 12 years, 71% females) were randomly assigned and treated (CAB: n = 178; levodopa: n = 183) in 51 centers of four European countries. Baseline IRLS total score was 25.7 +/- 6.8. The baseline-adjusted mean change from baseline to week 6 in IRLS sum score was d = -16.1 in the CAB group and d = -9.5 in the levodopa group (d = -6.6, P < 0.0001). More patients in the levodopa group (24.0%) than in the CAB group (11.9%, P = 0.0029, log-rank test) discontinued because of loss of efficacy (14.2% vs. 7.9%, P = 0.0290) or augmentation (9.8% vs. 4.0%, P = 0.0412). Adverse events (AEs) occurred in 83.1% of the CAB group and in 77.6% of the levodopa group. In both groups, most frequent AEs were gastrointestinal symptoms (CAB: 55.6%, levodopa: 30.6%, P < 0.0001). This first large-scale active controlled study in RLS showed superior efficacy of cabergoline versus levodopa after a 30-week long-term therapy. Tolerability was found more favorable with levodopa than with cabergoline. 相似文献
4.
F. Horak Jr S. Matthews† G. Ihorst‡ S. H. Arshad† T. Frischer J. Kuehr‡ A. Schwieger‡ J. Forster‡ the SPACE study group 《Clinical and experimental allergy》2004,34(8):1220-1225
BACKGROUND: Sensitization to house dust mite (HDM) is an important risk factor for the development of asthma and allergic disease in childhood. Higher levels of HDM allergen are linked to increased sensitization to HDM. OBJECTIVE: To study the effect of mite-impermeable mattress encasings and an educational package on the development of allergies in a newborn cohort. METHODS: Six hundred and ninety-six newborns at high risk of developing allergies were enrolled in three European countries (Germany, Austria, UK) in a prospective, randomized, controlled birth-cohort study. Children were randomly assigned to an intervention and control group. Intervention measures included the use of mite-impermeable mattress encasings for the child's bed and a simple educational package on allergen avoidance. The control group received basic information about allergies. Children were followed up at age 6, 12, 18 and 24 months. RESULTS: 80.9% of the children were followed up to the age of 24 months. No difference in the prevalence of sensitization to HDM (control vs. intervention group: 8.4% vs. 6.1%, P=0.33) or the development of symptoms (recurrent wheezing 10.3% vs. 10.7%, nocturnal cough 12.5% vs. 12.5%) or allergic diseases (asthma 3.5% vs. 5.1%, eczema 20.0% vs. 19.6%, rhinitis 28.9% vs. 25.8%) could be found between the control and intervention group. CONCLUSION: In this study, HDM avoidance did not show a protective effect on the development of sensitization to HDM or symptomatic allergy in children at age 24 months. 相似文献
5.
6.
Evolution of age at menarche and at onset of regular cycling in a large cohort of French women 总被引:1,自引:0,他引:1
Clavel-Chapelon F;EN-EPIC group. European Prospective Investigation into Cancer 《Human reproduction (Oxford, England)》2002,17(1):228-232
BACKGROUND: Early exposure to ovarian hormones is considered to increase breast cancer incidence. The age at which the ovaries become functional is thus important. METHODS: We explored the evolution of age at first menstruation and at onset of regular cycling in 86 031 women participating in the E3N-EPIC cohort study, part of the European Prospective Investigation into Cancer. RESULTS: We observed an increase in mean age at menarche among women born between 1925 and 1930, followed by a steady decrease in the youngest birth cohorts. In contrast, age at onset of regular cycling increased gradually from 1925 onwards. There was thus a steady increase in the interval between age at menarche and at onset of regular cycling, mainly due to an increase in the percentage of women in whom regular cycling started at least 5 years after menarche (from 9.0% among women born in 1925-1929 to 20.8% in those born in 1945-1950). The increase in the interval between menarche and onset of regular cycling was even greater among women with a late menarche. CONCLUSIONS: This increase might be due to a change in dietary intake and/or physical exercise aimed at achieving the slim silhouette desired by the younger generations. 相似文献
7.
8.
Identification of testis development and spermatogenesis-related genes in human and mouse testes using cDNA arrays 总被引:12,自引:0,他引:12
Sha J Zhou Z Li J Yin L Yang H Hu G Luo M Chan HC Zhou K;Spermatogenesis study group 《Molecular human reproduction》2002,8(6):511-517
We have constructed cDNA microarrays from the human testis large insert cDNA library, containing 9216 genes, together with several housekeeping genes. The cDNA microarrays were used to identify gene expression differences between human fetal and adult testes. Of >8700 hybridized clones, 731 exhibited significant differential expression characteristics. About 7500 genes were identified when the same cDNA microarrays were used for hybridization with cDNA probes from mouse testis, with 256 genes having significant differential expression between the age of 1-4 weeks. Among these genes, 101 were identified as critically related to testis development and possibly to spermatogenesis since they were found in both human and mouse testes, and expressed differentially at different stages of testis development. Of the 101 development-related genes, 59 full-length cDNAs have been sequenced previously, while the full-length cDNAs of the other 42 genes have not been published. We have obtained 11 full-length sequences of the 42 genes and deposited them in the GenBank. The conserved testis development-related genes found in both human and mouse testes may include genes that are likely to be involved in testicular functions, especially spermatogenesis, thus providing a basis for further functional characterization of the genes in mouse models. 相似文献
9.
Efficacy and safety of recombinant human activated protein C for severe sepsis 总被引:168,自引:0,他引:168
Bernard GR Vincent JL Laterre PF LaRosa SP Dhainaut JF Lopez-Rodriguez A Steingrub JS Garber GE Helterbrand JD Ely EW Fisher CJ;Recombinant human protein C Worldwide Evaluation in Severe Sepsis 《The New England journal of medicine》2001,344(10):699-709
BACKGROUND: Drotrecogin alfa (activated), or recombinant human activated protein C, has antithrombotic, antiinflammatory, and profibrinolytic properties. In a previous study, drotrecogin alfa activated produced dose-dependent reductions in the levels of markers of coagulation and inflammation in patients with severe sepsis. In this phase 3 trial, we assessed whether treatment with drotrecogin alfa activated reduced the rate of death from any cause among patients with severe sepsis. METHODS: We conducted a randomized, double-blind, placebo-controlled, multicenter trial. Patients with systemic inflammation and organ failure due to acute infection were enrolled and assigned to receive an intravenous infusion of either placebo or drotrecogin alfa activated (24 microg per kilogram of body weight per hour) for a total duration of 96 hours. The prospectively defined primary end point was death from any cause and was assessed 28 days after the start of the infusion. Patients were monitored for adverse events; changes in vital signs, laboratory variables, and the results of microbiologic cultures; and the development of neutralizing antibodies against activated protein C. RESULTS: A total of 1690 randomized patients were treated (840 in the placebo group and 850 in the drotrecogin alfa activated group). The mortality rate was 30.8 percent in the placebo group and 24.7 percent in the drotrecogin alfa activated group. On the basis of the prospectively defined primary analysis, treatment with drotrecogin alfa activated was associated with a reduction in the relative risk of death of 19.4 percent (95 percent confidence interval, 6.6 to 30.5) and an absolute reduction in the risk of death of 6.1 percent (P=0.005). The incidence of serious bleeding was higher in the drotrecogin alfa activated group than in the placebo group (3.5 percent vs. 2.0 percent, P=0.06). CONCLUSIONS: Treatment with drotrecogin alfa activated significantly reduces mortality in patients with severe sepsis and may be associated with an increased risk of bleeding. 相似文献
10.
“课堂理论教学与临床实践教学相结合”的两步教学法理论与实践 总被引:10,自引:4,他引:6
山东大学医学院医学伦理学教学模式改革课题组 《中国医学伦理学》2001,(5):38-41
阐述了山东大学医学院医学伦理学课程“课程理论教学与临床实践教学相结合”教学模式改革的设想提出过程,具体实施办法和实施效果。实践证明,这一教学法,对于培养医学生的医德信念和医学伦理决策能力是切实有效的,值得在实践中进一步完善和推广。 相似文献