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Sample records for abca4 influence clinical

  1. Genetic and epigenetic factors at COL2A1 and ABCA4 influence clinical outcome in congenital toxoplasmosis.

    Directory of Open Access Journals (Sweden)

    Sarra E Jamieson

    Full Text Available BACKGROUND: Primary Toxoplasma gondii infection during pregnancy can be transmitted to the fetus. At birth, infected infants may have intracranial calcification, hydrocephalus, and retinochoroiditis, and new ocular lesions can occur at any age after birth. Not all children who acquire infection in utero develop these clinical signs of disease. Whilst severity of disease is influenced by trimester in which infection is acquired by the mother, other factors including genetic predisposition may contribute. METHODS AND FINDINGS: In 457 mother-child pairs from Europe, and 149 child/parent trios from North America, we show that ocular and brain disease in congenital toxoplasmosis associate with polymorphisms in ABCA4 encoding ATP-binding cassette transporter, subfamily A, member 4. Polymorphisms at COL2A1 encoding type II collagen associate only with ocular disease. Both loci showed unusual inheritance patterns for the disease allele when comparing outcomes in heterozygous affected children with outcomes in affected children of heterozygous mothers. Modeling suggested either an effect of mother's genotype, or parent-of-origin effects. Experimental studies showed that both ABCA4 and COL2A1 show isoform-specific epigenetic modifications consistent with imprinting. CONCLUSIONS: These associations between clinical outcomes of congenital toxoplasmosis and polymorphisms at ABCA4 and COL2A1 provide novel insight into the molecular pathways that can be affected by congenital infection with this parasite.

  2. Genetic and Epigenetic Factors at COL2A1 and ABCA4 Influence Clinical Outcome in Congenital Toxoplasmosis

    OpenAIRE

    JAMIESON, S.E.; de Roubaix, L. A.; Cortina-Borja, M.; Tan, H K; Mui, E. J.; Cordell, H J; Kirisits, M. J.; Miller, E. N.; Peacock, C. S.; Hargrave, A. C.; Coyne, J J; Boyer, K.; Bessieres, M H; Buffolano, W.; Ferret, N

    2008-01-01

    Background: Primary Toxoplasma gondii infection during pregnancy can be transmitted to the fetus. At birth, infected infants may have intracranial calcification, hydrocephalus, and retinochoroiditis, and new ocular lesions can occur at any age after birth. Not all children who acquire infection in utero develop these clinical signs of disease. Whilst severity of disease is influenced by trimester in which infection is acquired by the mother, other factors including genetic predisposition may ...

  3. Complex inheritance of ABCA4 disease: four mutations in a family with multiple macular phenotypes.

    Science.gov (United States)

    Lee, Winston; Xie, Yajing; Zernant, Jana; Yuan, Bo; Bearelly, Srilaxmi; Tsang, Stephen H; Lupski, James R; Allikmets, Rando

    2016-01-01

    Over 800 mutations in the ABCA4 gene cause autosomal recessive Stargardt disease. Due to extensive genetic heterogeneity, observed variant-associated phenotypes can manifest tremendous variability of expression. Furthermore, the high carrier frequency of pathogenic ABCA4 alleles in the general population (~1:20) often results in pseudo-dominant inheritance patterns further complicating the diagnosis and characterization of affected individuals. This study describes a genotype/phenotype analysis of an unusual family with multiple macular disease phenotypes spanning across two generations and segregating four distinct ABCA4 mutant alleles. Complete sequencing of ABCA4 discovered two known missense mutations, p.C54Y and p.G1961E. Array comparative genomic hybridization revealed a large novel deletion combined with a small insertion, c.6148-698_c.6670del/insTGTGCACCTCCCTAG, and complete sequencing of the entire ABCA4 genomic locus uncovered a new deep intronic variant, c.302+68C>T. Patients with the p.G1961E mutation had the mildest, confined maculopathy phenotype with peripheral flecks while those with all other mutant allele combinations exhibited a more advanced stage of generalized retinal and choriocapillaris atrophy. This family epitomizes the clinical and genetic complexity of ABCA4-associated diseases. It contained variants from all classes of mutations, in the coding region, deep intronic, both single nucleotide variants and copy number variants that accounted for varying phenotypes segregating in an apparent dominant fashion. Unequivocally defining disease-associated alleles in the ABCA4 locus requires a multifaceted approach that includes advanced mutation detection methods and a thorough analysis of clinical phenotypes.

  4. Analysis of the ABCA4 genomic locus in Stargardt disease

    DEFF Research Database (Denmark)

    Zernant, Jana; Xie, Yajing Angela; Ayuso, Carmen;

    2014-01-01

    was designed to find the missing disease-causing ABCA4 variation by a combination of next-generation sequencing (NGS), array-Comparative Genome Hybridization (aCGH) screening, familial segregation and in silico analyses. The entire 140 kb ABCA4 genomic locus was sequenced in 114 STGD patients with one...... once. Multimodal analysis suggested 12 new likely pathogenic intronic ABCA4 variants, some of which were specific to (isolated) ethnic groups. No copy number variation (large deletions and insertions) was detected in any patient suggesting that it is a very rare event in the ABCA4 locus. Many variants...... were excluded since they were not conserved in non-human primates, were frequent in African populations and, therefore, represented ancestral, and not disease-associated, variants. The sequence variability in the ABCA4 locus is extensive and the non-coding sequences do not harbor frequent mutations in...

  5. Phenotypic and genetic spectrum of Danish patients with ABCA4-related retinopathy

    DEFF Research Database (Denmark)

    Duno, Morten; Schwartz, Marianne; Larsen, Pernille L.;

    2012-01-01

    Pathogenic variations in the ABCA4 gene were originally recognized as genetic background for the autosomal recessive disorders Stargardt disease and fundus flavimaculatus, but have expanded to embrace a diversity of retinal diseases, giving rise to the new diagnostic term, ABCA4-related retinopat...

  6. Characteristics of ABCA4 genotype in Chinese patients with Stargardt disease%国人Stargardt病患者ABCA4基因突变分析与表型特征

    Institute of Scientific and Technical Information of China (English)

    田露; 蒋凤; 许可; 张晓慧; 孙腾洋; 卢宁; 彭晓燕; 李杨

    2016-01-01

    目的通过对眼底黄色斑点症患者ABCA4基因突变分析,分析国人Stargardt病(STGDI)患者中ABCA4基因突变特点及其表型特征.设计回顾性病例系列.研究对象北京同仁医院可疑Stargardt病患者119例,其中17例家族史明确,102例为散发.方法利用PCR扩增DNA直接测序方法检测患者ABCA4基因50个编码外显子及外显子与内含子交界区,并记录患者的表型特征.主要指标ABCA4基因测序结果、家族史、眼底像、相干光断层扫描(OCT)、眼底自发荧光(AF)、视网膜电图(ERG)、视力.结果119例STGDI患者中110例(92.4%)检测到2个及以上ABCA4基因致病突变,9例(7.6%)检测到1个致病突变.本研究共检出136种突变,其中新发现突变16种.基因突变中55.1%(75/136)为错义突变,15.4%(21/136)为缺失或插入,17.6%(24/136)为剪接位点突变,11.8%(16/136)为无义突变.最常见突变为无义突变p.YS08X,其等位基因频率最高为17次(7.1%).STGDI 患者平均发病年龄(12.85±9.01)岁,平均最佳矫正视力(0.11±0.12).结论本研究结果拓展了ABCA4基因突变谱.中国人STGDI患者发病年龄早、视力损伤重,且ABCA4基因特点与其他种族明显不同.%Objective To report the results of mutation analysis of the ABCA4 gene in a cohort of patients with Stargardt disease (STGDI) and describe their associated phenotype.Design Retrospective case series.Participants 119 suspected STGDI probands including 17 patients with family history and 102 sporadic cases were recruited.Methods All the exons including intron-exon boundary of the ABCA4 gene,were amplified by PCR and the products were analyzed by direct sequencing in all the patients.The clinical features of STGDI patients were recorded.Main Outcome Measures Mutations of ABCA4 gene,family history,fundus photography,optical coherence tomography (OCT),fundus autofluorescence (AF),electroretinogram (ERG) and visual acuity.Results 119 A BCA4 pathogenic mutations were

  7. Association between genotype and phenotype in families with mutations in the ABCA4 gene

    OpenAIRE

    Kjellström, Ulrika

    2014-01-01

    Purpose To investigate the genotype and phenotype in families with adenosine triphosphate–binding cassette, sub-family A, member 4 (ABCA4)–associated retinal degeneration. Methods Three families with at least one family member with known homozygous or compound heterozygote mutations in the ABCA4 gene were studied. The investigations included full field electroretinography (ff-ERG), multifocal ERG (mERG), Goldmann visual fields, optical coherence tomography (OCT), and standard ophthalmological...

  8. ABCA4 is an N-retinylidene-phosphatidylethanolamine and phosphatidylethanolamine importer.

    Science.gov (United States)

    Quazi, Faraz; Lenevich, Stepan; Molday, Robert S

    2012-06-26

    ATP-binding cassette (ABC) transporters comprise a superfamily of proteins, which actively transport a variety of compounds across cell membranes. Mammalian and most eukaryotic ABC transporters function as exporters, flipping or extruding substrates from the cytoplasmic to the extracellular or lumen side of cell membranes. Prokaryotic ABC transporters function either as exporters or importers. Here we show that ABCA4, an ABC transporter found in retinal photoreceptor cells and associated with Stargardt macular degeneration, is a novel importer that actively flips N-retinylidene-phosphatidylethanolamine from the lumen to the cytoplasmic leaflet of disc membranes, thereby facilitating the removal of potentially toxic retinoid compounds from photoreceptors. ABCA4 also actively transports phosphatidylethanolamine in the same direction. Mutations known to cause Stargardt disease decrease N-retinylidene-phosphatidylethanolamine and phosphatidylethanolamine transport activity of ABCA4. These studies provide the first direct evidence for a mammalian ABC transporter that functions as an importer and provide insight into mechanisms underlying substrate transport and the molecular basis of Stargardt disease.

  9. SNPs analysis of ABCA4 gene in Han Chinese in Beijing%中国北京汉族人群 ABCA4基因的 SNPs 研究

    Institute of Scientific and Technical Information of China (English)

    张小龙; 王红

    2015-01-01

    Objective:To provide the basis of single nucleotide polymorphism(SNPs)for identification and analysis of ABCA4 gene related etiologic studies in Han Chinese in Beijing(CHB).Methods:SNPs of ABCA4 gene were analyzed for minor allele frequencies (MAFs),haplotype frequencies,linkage disequilibrium patterns,and tag SNPs by Haploview program using the HapMap data.Re-sults:129(37.6%)of 343 SNPs were monotonic.95 tagging SNPs were identified in 214 eligible SNPs with 3 haplotype blocks identi-fied.The frequencies of the top 2 haplotypes among each of the 3 haplotype blocks were between 91.1% and 94.0%.Conclusion:SNPs in ABCA4 gene were analyzed by Haploview program.The analysis provides clues for future studies involving this gene.%目的:研究北京汉族人群中 ABCA4基因单核苷酸多态性,为病因学研究提供依据。方法:选取国际人类基因组单体型图计划(HapMap)公布的北京汉族人群(Han Chinese in Beijing,China,CHB)ABCA4基因 SNPs 基因型数据,利用 Haploview 4.2软件对其进行分析。结果:Hapmap 提供的343个 ABCA4基因的 SNPs 中,有129个(37.6%)纯合基因型 SNPs 和214个(62.39%)合格 SNPs。本研究共确定95个标签 SNPs,构建了 3个单体域,各单体域均以前2种单体型为主,累计频率在91.1%~94.0%之间。结论:通过分析北京汉族人群 ABCA4基因 SNPs 数据,得到了标签 SNPs、单体域和主要单体型,为进一步的病因学研究打下了基础。

  10. Generalized Choriocapillaris Dystrophy, a Distinct Phenotype in the Spectrum of ABCA4-Associated Retinopathies

    DEFF Research Database (Denmark)

    Bertelsen, Mette; Zernant, Jana; Larsen, Michael;

    2014-01-01

    earliest recorded manifestation of ABCA4-associated disease was a central bull's eye type of macular dystrophy that progressed to chorioretinal atrophy of the macula with coarse rounded hyperpigmentations and expanding involvement of the periphery. The mean age at first presentation was 10.3 years, the...

  11. 目标区域捕获测序检测到一视网膜色素变性家系ABCA4基因新突变%Targeted next-generation sequencing identifies a novel ABCA4 gene mutation in a Chinese family with retinitis pigmentosa

    Institute of Scientific and Technical Information of China (English)

    丁思加; 陈雪; 赵堪兴; 盛迅伦; 赵晨

    2016-01-01

    Objective To identify the pathogenic mutation in a Chinese family with autosomal recessive retinitis pigmentosa (RP) and to analyze its genotype-phenotype correlations.Methods Seven participants from one family were recruited for this experimental study,including 2 patients and 5 asymptomatic siblings.All participants underwent comprehensive ophthalmic examinations including best-corrected visual acuity,visual field testing,fundus photography,optical coherence tomography,and full-field flash electroretinography.Targeted next-generation sequencing (NGS) was selectively performed on the proband to reveal the RP causative mutation in this family using a microarray targeting 180 reported inherited retinal dystrophies (IRDs) causative genes and 9 potential IRDs relevant genes.All variants initially detected by NGS were then screened and filtered with optimized bioinformatics analyses and validated by intra-familial cosegregation analyses using Sanger sequencing.Genotype-phenotype correlation was also analyzed.Results Ophthalmic examination suggested the clinical diagnosis of typical RP for both patients from this family.Genetic analysis indicated ABCA4 c.419G>A as the RP causative mutation for this family.This mutation induced the amino acid change from arginine to glutamine at residue 140 of the protein encoded by the ABCA4 gene (p.Argl40Gln).Conservational analysis revealed the high conservation of the mutational spot among all tested species,and the online predictive software,PolyPhen-2,suggested the pathogenicity of this mutation.Conclusion By means of a targeted NGS approach,this study identifies a novel mutation,ABCA4 p.Arg140Gln,as the disease causative mutation for a Chinese autosomal recessive RP family,which extends both the genotypic and phenotypic spectrums for the ABCA4 gene.%目的 研究我国一个常染色体隐性遗传的视网膜色素变性(RP)家系患者的临床表型及致病基因突变,并分析表型与基因型间的关系.方法 实验

  12. A genome-wide association study of cleft lip with and without cleft palate identifies risk variants near MAFB and ABCA4

    DEFF Research Database (Denmark)

    Beaty, Terri H; Murray, Jeffrey C; Marazita, Mary L;

    2010-01-01

    Case-parent trios were used in a genome-wide association study of cleft lip with and without cleft palate. SNPs near two genes not previously associated with cleft lip with and without cleft palate (MAFB, most significant SNP rs13041247, with odds ratio (OR) per minor allele = 0.704, 95% CI 0...... and ABCA4. Expression studies support a role for MAFB in palatal development....

  13. Rescuing Trafficking Mutants of the ATP-binding Cassette Protein, ABCA4, with Small Molecule Correctors as a Treatment for Stargardt Eye Disease.

    Science.gov (United States)

    Sabirzhanova, Inna; Lopes Pacheco, Miquéias; Rapino, Daniele; Grover, Rahul; Handa, James T; Guggino, William B; Cebotaru, Liudmila

    2015-08-01

    Stargardt disease is the most common form of early onset macular degeneration. Mutations in ABCA4, a member of the ATP-binding cassette (ABC) family, are associated with Stargardt disease. Here, we have examined two disease-causing mutations in the NBD1 region of ABCA4, R1108C, and R1129C, which occur within regions of high similarity with CFTR, another ABC transporter gene, which is associated with cystic fibrosis. We show that R1108C and R1129C are both temperature-sensitive processing mutants that engage the cellular quality control mechanism and show a strong interaction with the chaperone Hsp 27. Both mutant proteins also interact with HDCAC6 and are degraded in the aggresome. We also demonstrate that novel corrector compounds that are being tested as treatment for cystic fibrosis, such as VX-809, can rescue the processing of the ABCA4 mutants, particularly their expression at the cell surface, and can reduce their binding to HDAC6. Thus, our data suggest that VX-809 can potentially be developed as a new therapy for Stargardt disease, for which there is currently no treatment. PMID:26092729

  14. Associations of chromosomes 17q22, 10q25.3 and ABCA4 gene polymorphisms with non-syndromic cleft lip/palate in Ningxia Hui and Han population%宁夏回汉族人群中染色体17q22、10q25.3和ABCA4基因多态性与非综合征型唇腭裂的关联

    Institute of Scientific and Technical Information of China (English)

    周忠伟; 杨雄; 万应彪; 信燕华; 翟堃; 马坚; 黄永清; 姜敏; 王怡瑞

    2013-01-01

    目的 研究中国宁夏地区回汉族人群染色体17q22(rs227731)、ABCA4(rs560426)和10q25.3(7078160)位点单核苷酸多态性与非综合征型唇腭裂的相关性.方法 研究对象包括非综合征型唇腭裂患儿415例,其中汉族191例,回族224例;患儿父亲205例,母亲240例;其中完整3人核心家系158个.将他们分为单纯唇裂组、单纯腭裂组、唇腭裂组,单纯唇裂组与唇腭裂组合并为唇裂伴或不伴腭裂组;对照组为健康大学生385例,其中汉族281例,回族104例.采用TaqMan基因型鉴定技术检测3个单核苷酸多态位点的基因型,进行病例对照分析、传递不平衡检验、以家系为基础的相关性分析.结果 ①染色体17q22区段的rs227731位点在汉族单纯唇裂组等位基因频率与对照组比较存在统计学差异(P<0.05),在唇裂伴或不伴腭裂组中等位基因频率与对照组比较存在统计学差异(P<0.05).回汉族唇腭裂组等位基因频率和唇裂伴或不伴腭裂组基因型、等位基因频率比较均存在统计学差异(P=0.04,P=0.04,P=0.01);②ABCA4基因的rs560426位点在汉族单纯唇裂组基因型与等位基因频率与对照组比较存在统计学差异(P<0.05),在唇裂伴或不伴腭裂组中基因型与等位基因频率与对照组比较存在统计学差异(P<0.05),回汉族单纯唇裂组基因型、等位基因比较存在统计学差异(P=0.04,P=0.01);③染色体10q25.3区段的rs7078160位点基因型与等位基因频率与对照组比较及回汉族相互比较均无统计学差异(P<0.05).结论 在宁夏汉族人群中染色体17q22区段的rs227731位点和ABCA4基因的rs560426位点单核苷酸多态性与非综合征型唇腭裂有统计学关联,染色体10q25.3区段的rs7078160位点与非综合征型唇腭裂无统计学关联.%Objective To explore if genetic variation in chromosome 17q22 (rs22731), ABCA4 (rs560426) and 10q25. 3(rs7078160)genes contributes to non-syndromic cleft lip

  15. Single residue AAV capsid mutation improves transduction of photoreceptors in the Abca4-/- mouse and bipolar cells in the rd1 mouse and human retina ex-vivo

    OpenAIRE

    Silva, SR; Charbel Issa, P; Singh, MS; Lipinski, DM; Barnea-Cramer, AO; Walker, NJ; Barnard, AR; Hankins, MW; MacLaren, RE

    2016-01-01

    Gene therapy using adeno-associated viral vectors (AAV) for the treatment of retinal degenerations has shown safety and efficacy in clinical trials. However, very high levels of vector expression may be necessary for the treatment of conditions such as Stargardt disease where a dual vector approach is potentially needed, or in optogenetic strategies for end-stage degeneration in order to achieve maximal light sensitivity. In this study, we assessed two vectors with single ca...

  16. Acetaminophen (paracetamol) oral absorption and clinical influences.

    Science.gov (United States)

    Raffa, Robert B; Pergolizzi, Joseph V; Taylor, Robert; Decker, John F; Patrick, Jeffrey T

    2014-09-01

    Acetaminophen (paracetamol) is a widely used nonopioid, non-NSAID analgesic that is effective against a variety of pain types, but the consequences of overdose can be severe. Because acetaminophen is so widely available as a single agent and is increasingly being formulated in fixed-ratio combination analgesic products for the potential additive or synergistic analgesic effect and/or reduced adverse effects, accidental cumulative overdose is an emergent concern. This has rekindled interest in the sites, processes, and pharmacokinetics of acetaminophen oral absorption and the clinical factors that can influence these. The absorption of oral acetaminophen occurs primarily along the small intestine by passive diffusion. Therefore, the rate-limiting step is the rate of gastric emptying into the intestines. Several clinical factors can affect absorption per se or the rate of gastric emptying, such as diet, concomitant medication, surgery, pregnancy, and others. Although acetaminophen does not have the abuse potential of opioids or the gastrointestinal bleeding or organ adverse effects of NSAIDs, excess amounts can produce serious hepatic injury. Thus, an understanding of the sites and features of acetaminophen absorption--and how they might be influenced by factors encountered in clinical practice--is important for pain management using this agent. It can also provide insight for design of formulations that would be less susceptible to clinical variables.

  17. What variables can influence clinical reasoning?

    Directory of Open Access Journals (Sweden)

    Vahid Ashoorion

    2012-01-01

    Full Text Available Background: Clinical reasoning is one of the most important competencies that a physician should achieve. Many medical schools and licensing bodies try to predict it based on some general measures such as critical thinking, personality, and emotional intelligence. This study aimed at providing a model to design the relationship between the constructs. Materials and Methods: Sixty-nine medical students participated in this study. A battery test devised that consist four parts: Clinical reasoning measures, personality NEO inventory, Bar-On EQ inventory, and California critical thinking questionnaire. All participants completed the tests. Correlation and multiple regression analysis consumed for data analysis. Results: There is low to moderate correlations between clinical reasoning and other variables. Emotional intelligence is the only variable that contributes clinical reasoning construct (r=0.17-0.34 (R 2 chnage = 0.46, P Value = 0.000. Conclusion: Although, clinical reasoning can be considered as a kind of thinking, no significant correlation detected between it and other constructs. Emotional intelligence (and its subscales is the only variable that can be used for clinical reasoning prediction.

  18. Nursing students’ perceived stress and influences in clinical performance

    OpenAIRE

    Laila Akhu-Zaheya; Insaf Shaban; Wejdan Khater

    2015-01-01

    Background: It is known that stress related to clinical training among nursing students could contribute to many physical and mental problems. However, little empirical evidence about the influence of stress in nurse students’ clinical performance Objective: The objective of this study was to assess the association between perceived stresses, stress related factors, and students’ clinical performance. Method: Using the perceived stress scale, 539 Jordanian nursing students from 2 publ...

  19. [Influence of clinical guidelines on medical practitioners].

    Science.gov (United States)

    Arii, Shigeki

    2007-09-01

    Evidenced-based clinical guidelines for diagnosing and treating hepatocellular carcinoma patients were published in 2005, which were edited by the executive members of the Liver Cancer Study Group of Japan (Chief Editor, Professor Masatosi Makuuchi, MD). This article presents the results of two surveys investigating the validity and usefulness of those guidelines. The author's opinions regarding the evaluation of the guidelines and guideline-based clinical practice are also presented. The surveys revealed that the guidelines are well known and thought to be useful by medical practitioners. The guidelines had changed the therapeutic strategy of 20% of experts in the field. However, 43% of experts and 30% of nonexperts believed that the guidelines restricted their medical discretion. Additionally, the percentage of physicians who felt that medical malpractice suits would increase exceeded those who did not. However, the guidelines do not provide clear recommendations in about 45% of diagnostic and therapeutic points because of a lack of evidence. The recommendations on these points in the guidelines require the commonsense discretion of physicians. The guidelines should be followed based on an understanding of biology and medicine, and not based on dogmatism. PMID:17907456

  20. Factors influencing radiation therapy student clinical placement satisfaction

    International Nuclear Information System (INIS)

    Introduction: Radiation therapy students at Queensland University of Technology (QUT) attend clinical placements at five different clinical departments with varying resources and support strategies. This study aimed to determine the relative availability and perceived importance of different factors affecting student support while on clinical placement. The purpose of the research was to inform development of future support mechanisms to enhance radiation therapy students’ experience on clinical placement. Methods: This study used anonymous Likert-style surveys to gather data from years 1 and 2 radiation therapy students from QUT and clinical educators from Queensland relating to availability and importance of support mechanisms during clinical placements in a semester. Results: The study findings demonstrated student satisfaction with clinical support and suggested that level of support on placement influenced student employment choices. Staff support was perceived as more important than physical resources; particularly access to a named mentor, a clinical educator and weekly formative feedback. Both students and educators highlighted the impact of time pressures. Conclusions: The support offered to radiation therapy students by clinical staff is more highly valued than physical resources or models of placement support. Protected time and acknowledgement of the importance of clinical education roles are both invaluable. Joint investment in mentor support by both universities and clinical departments is crucial for facilitation of effective clinical learning

  1. Influence of light source and clinical experience on shade matching

    OpenAIRE

    GÁSPÁRIK, CRISTINA; TOFAN, ALINA; CULIC, BOGDAN; BADEA, MÎNDRA; DUDEA, DIANA

    2014-01-01

    Introduction Shade is one of the most important attributes when evaluating the success of a restoration. Several factors can influence the visual shade matching process, and therefore the outcome of the final restoration. Objectives 1. to assess the importance of clinical experience on shade matching accuracy; 2. to assess the influence of two standard light sources on the ability to match shade tabs; 3. to identify the area in a VITA Classical shade guide where matching errors are most likel...

  2. Infrapopliteal Percutaneous Transluminal Balloon Angioplasty: Clinical Results and Influence Factors

    Energy Technology Data Exchange (ETDEWEB)

    Song, Jang Hyeon; Lee, Seung Jin; Jung, Hye Doo; Lim, Jae Hoon; Chang, Nam Kyu; Yim, Nam Yeol; Kim, Jae Kyu [Dept. of Radiology, Chonnam National University Hospital, Gwangju (Korea, Republic of); Lee, Keun Bae [Dept. of Radiology, Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2011-09-15

    To assess the efficacy of percutaneous transluminal angioplasty (PTA) in patients with infrapopliteal arterial disease, and to determine the influencing factor for prognosis. A total of 55 patients (60 limbs) with infrapopliteal arterial stenosis or occlusion underwent PTA. Atherosclerotic risk factors, clinical symptoms, TransAtlantic Inter-Society Consensus (TASC) classification, and vascular wall calcification were evaluated before PTA. The number of patent infrapopliteal arteries was estimated, and the outcome was evaluated by symptom relief and limb salvage. Technical success was achieved in 53/60 limbs (88.3%) and 81/93 arteries (87.1%), TASC classification (p = 0.038) and vascular calcification (p = 0.002) influenced on technical failure. During follow-up, 26 of 55 limbs (47%) achieved symptom relief and 42/55 limbs (76%) underwent limb salvage. Non-diabetic patients (9/12, 75%) were superior to diabetic patients (17/43, 40%) in terms of symptom relief (p = 0.024). TASC classification and vascular wall calcification influenced on symptom relief and limb salvage. The number of patent infrapopliteal arteries after PTA influenced symptom relief (p < 0.001) and limb amputation (p = 0.003). PTA in patients with chronic critical limb ischemia is worthwhile as a primary treatment. The influence factors should be considered before PTA, and PTA should be performed in as many involved arteries as possible.

  3. Prognostic factors influencing clinical outcomes of glioblastoma multiforme

    Institute of Scientific and Technical Information of China (English)

    LI Shou-wei; QIU Xiao-guang; CHEN Bao-shi; ZHANG Wei; REN Huan; WANG Zhong-cheng; JIANG Tao

    2009-01-01

    Background Glioblastoma multiforme (GBM) is the most malignant kind of astrocytic tumors and is associated with a poor prognosis. In this retrospective study, we assessed the clinical, radiological, genetic molecular and treatment factors that influence clinical outcomes of patients with GBM.Methods A total of 116 patients with GBM who received surgery and radiation between January 2006 and December 2007 were included in this study. Kaplan-Meier survival analysis and Cox regression analysis were used to find the factors independently influencing patients' progression free survival (PFS) time and overall survival (OS) time.Results Age, preoperative Kamofsky Performance Scale (KPS) score, KPS score change at 2 weeks after operation, neurological deficit symptoms, tumor resection extent, maximal tumor diameter, involvement of eloquent cortex or deep structure, involvement of brain lobe, Ki-67 expression level and adjuvant chemotherapy were statistically significant factors (P <0.05) for both PFS and OS in the univariate analysis. Cox proportional hazards modeling revealed that age ≤50 years, preoperative KPS score ≥80, KPS score change after operation ≥0, involvement of single frontal lobe,non-eloquent area or deep structure involvement, low Ki-67 expression and adjuvant chemotherapy were independent favorable factors (P <0.05) for patients' clinical outcomes.Conclusions Age at diagnosis, preoperative KPS score, KPS score change at 2 weeks postoperation, involvement of brain lobe, involvement of eloquent cortex or deep structure, Ki-67 expression level and adjuvant chemotherapy correlate significantly with the prognosis of patients with GBM.

  4. Site Characteristics Influencing the Translation of Clinical Research Into Clinical Practice

    DEFF Research Database (Denmark)

    Smed, Marie; Getz, Kenneth A.

    2014-01-01

    , although both academic and independent sites generate the same level of knowledge, academic sites share more of this knowledge with sponsor companies. This study suggests new strategies that sponsors can leverage to drive greater transfer of clinical research knowledge into clinical practice and ultimately...... on to sponsor companies and may ultimately assist in positioning new products and driving commercialization success. This study evaluates site characteristics that influence the acquisition and sharing of knowledge gained through clinical trial experience. The impact of 2 central site characteristics...... on the process of translating drug experience is assessed: site location (North America/rest of the world) and site type or setting (academic/independent). The results show that investigative sites located outside North America generate and share more knowledge than those within North America. Furthermore...

  5. Factors influencing radiation therapy student clinical placement satisfaction

    OpenAIRE

    Bridge, Pete; Carmichael, Mary-Ann

    2014-01-01

    Introduction: Radiation therapy students at Queensland University of Technology (QUT) attend clinical placements at five different clinical departments with varying resources and support strategies. This study aimed to determine the relative availability and perceived importance of different factors affecting student support while on clinical placement. The purpose of the research was to inform development of future support mechanisms to enhance radiation therapy students’ experience on clini...

  6. Clinical Nursing Instructor Perception of the Influence of Engagement in Bedside Nursing Practice on Clinical Teaching

    Science.gov (United States)

    Berndt, Jodi L.

    2013-01-01

    Clinical experiences are an integral component of nursing education. Because the amount of time that a student spends in clinical experiences can be as many as twelve to sixteen hours per week, the clinical instructor plays a significant role in the nursing student's development of nursing knowledge. Many nurse educators attempt to balance dual…

  7. Korean Cultural Influences on the Millon Clinical Multiaxial Inventory III.

    Science.gov (United States)

    Gunsalus, Ae-Jung Chang; Kelly, Kevin R.

    2001-01-01

    Investigates the effect of Korean culture on the results of the Millon Clinical Multiaxial Inventory-III (MCMI-III) by comparing profiles of 147 Korean and 132 American college students. Results indicate that MCMI-III personality profile differences exist between Korean and American college students. Discusses implications for mental health…

  8. Haemodynamic influences on kidney oxygenation : Clinical implications of integrative physiology

    NARCIS (Netherlands)

    Evans, Roger G.; Ince, Can; Joles, Jaap A.; Smith, David W.; May, Clive N.; O'Connor, Paul M.; Gardiner, Bruce S.

    2013-01-01

    Renal blood flow, local tissue perfusion and blood oxygen content are the major determinants of oxygen delivery to kidney tissue. Arterial pressure and segmental vascular resistance influence kidney oxygen consumption through effects on glomerular filtration rate and sodium reabsorption. Diffusive s

  9. Growth conditions influence melanization of Brazilian clinical Sporothrix schenckii isolates

    OpenAIRE

    Almeida-Paes, Rodrigo; FRASES, SUSANA; Monteiro, Paulo Cezar Fialho; Gutierrez-Galhardo, Maria Clara; Zancopé-Oliveira, Rosely Maria; Nosanchuk, Joshua D.

    2009-01-01

    Sporothrix schenckii is known to produce DHN melanin on both conidial and yeast cells, however little information is available regarding the factors inducing fungal melanization. We evaluated whether culture conditions influenced melanization of 25 Brazilian S. schenckii strains and one control strain (ATCC 10212). Tested conditions included different media, pH, temperature, incubation time, glucose concentrations, and presence or absence of tricyclazole or L-DOPA. Melanization was reduced on...

  10. [Influence of chitosan on clinical-biochemical rates and protein metabolism of patients with cardiovascular diseases].

    Science.gov (United States)

    Baĭgarin, E K; Pogozheva, A V

    2008-01-01

    The article tells about influence of combined chitosan (5 g/day) and triweekly dietotherapy on clinical-biochemical rates and nitrogen balance of patients with cardiovascular diseases. We obtained data indicating negative influence of chitosan on nitrogen balance. PMID:19227863

  11. Transition to clinical training : influence of pre-clinical knowledge and skills, and consequences for clinical performance

    NARCIS (Netherlands)

    van Hell, Elisabeth A.; Kuks, Jan B. M.; Schonrock-Adema, Johanna; van Lohuizen, Mirjam T.; Cohen-Schotanus, Janke

    2008-01-01

    CONTEXT Many students experience a tough transition from pre-clinical to clinical training and previous studies suggest that this may constrict students' progress. However, clear empirical evidence of this is lacking. The aim of this study was to determine: whether the perceived difficulty of transi

  12. East meets West: The influence of language and culture in clinical education.

    Science.gov (United States)

    Ladyshewsky, Richard

    1996-01-01

    The marketing of education in South East Asia has become big business for Australian Universities. Physiotherapy programs are not exempt from this marketing push, with increases in foreign student enrollment becoming commonplace. This raises numerous opportunities and dilemmas for those involved in physiotherapy clinical education. This action research project investigated the influence of language and culture on clinical education practices. Nine South East Asian undergraduate physiotherapy students and 11 clinical instructors were involved in this qualitative research project. A variety of issues were identified which have important ramifications for academics and clinical instructors. Cultural membership, issues of authority and respect, and language proficiency were identified as having a direct influence on the clinical education process. Strategies for dealing with these cross cultural teaching and learning challenges are discussed.

  13. Physician judgment in clinical settings: methodological influences and cognitive performance.

    Science.gov (United States)

    Dawson, N V

    1993-07-01

    Understanding the quality of physicians' intuitive judgments is essential in determining the appropriate use of their judgments in medical decision-making (vis-a-vis analytical or actuarial approaches). As part of this process, the quality of physicians' predictions must be assessed because prediction is fundamental to common clinical tasks: determining diagnosis, prognosis, and therapy; establishing monitoring intervals; performing screening and preventive maneuvers. Critical evaluation of predictive capabilities requires an assessment of the components of the prediction process: the data available for prediction, the method used for prediction, and the accuracy of prediction. Although variation in and uncertainty about the underlying data elements are often acknowledged as a source of inaccurate predictions, prediction also can be confounded by both methodological and cognitive limitations. During the past two decades, numerous factors have been recognized that may bias test characteristics (sensitivity and specificity). These same factors may also produce bias in intuitive judgments. The use of cognitive processes to simplify judgment tasks (e.g., the availability and representativeness heuristics) and the presence of certain biases in the judgment process (e.g., ego, regret) may present obstacles to accurate estimation of probabilities by physicians. Limitations on the intuitive use of information (cognitive biases) have been demonstrated in both medical and nonmedical decision-making settings. Recent studies have led to a deepening understanding of the advantages and disadvantages of intuitive and analytical approaches to decision making. Here, many aspects of the basis for this understanding are reviewed.

  14. Growth conditions influence melanization of Brazilian clinical Sporothrix schenckii isolates.

    Science.gov (United States)

    Almeida-Paes, Rodrigo; Frases, Susana; Fialho Monteiro, Paulo Cezar; Gutierrez-Galhardo, Maria Clara; Zancopé-Oliveira, Rosely Maria; Nosanchuk, Joshua D

    2009-04-01

    Sporothrix schenckii is known to produce DHN melanin on both conidial and yeast cells, however little information is available regarding the factors inducing fungal melanization. We evaluated whether culture conditions influenced melanization of 25 Brazilian S. schenckii strains and one control strain (ATCC 10212). Tested conditions included different media, pH, temperature, incubation time, glucose concentrations, and presence or absence of tricyclazole or L-DOPA. Melanization was reduced on Sabouraud compared to defined chemical medium. The majority of strains produced small amounts of melanin at 37 degrees C and none melanized at basic pH. Increased glucose concentrations did not inhibit melanization, rather increasing glucose enhanced pigment production in 27% of strains. Melanin synthesis was also enhanced by the addition of L-DOPA and its addition to medium with tricyclazole, an inhibitor of melanin synthesis, resulted in fungal melanization, including hyphal melanin production. Our results suggest that different S. schenckii strains have distinct control of melanization and that this fungus can use phenolic compounds to enhance melanization in vitro.

  15. Human REM sleep: influence on feeding behaviour, with clinical implications.

    Science.gov (United States)

    Horne, James A

    2015-08-01

    Rapid eye movement (REM) sleep shares many underlying mechanisms with wakefulness, to a much greater extent than does non-REM, especially those relating to feeding behaviours, appetite, curiosity, exploratory (locomotor) activities, as well as aspects of emotions, particularly 'fear extinction'. REM is most evident in infancy, thereafter declining in what seems to be a dispensable manner that largely reciprocates increasing wakefulness. However, human adults retain more REM than do other mammals, where for us it is most abundant during our usual final REM period (fREMP) of the night, nearing wakefulness. The case is made that our REM is unusual, and that (i) fREMP retains this 'dispensability', acting as a proxy for wakefulness, able to be forfeited (without REM rebound) and substituted by physical activity (locomotion) when pressures of wakefulness increase; (ii) REM's atonia (inhibited motor output) may be a proxy for this locomotion; (iii) our nocturnal sleep typically develops into a physiological fast, especially during fREMP, which is also an appetite suppressant; (iv) REM may have 'anti-obesity' properties, and that the loss of fREMP may well enhance appetite and contribute to weight gain ('overeating') in habitually short sleepers; (v) as we also select foods for their hedonic (emotional) values, REM may be integral to developing food preferences and dislikes; and (vii) REM seems to have wider influences in regulating energy balance in terms of exercise 'substitution' and energy (body heat) retention. Avenues for further research are proposed, linking REM with feeding behaviours, including eating disorders, and effects of REM-suppressant medications.

  16. How customer satisfaction can influence clinical outcome in a back specialty clinic.

    Science.gov (United States)

    Reznik, B

    1994-01-01

    Determining what defines quality is the aim of the study produced at the Texas Back Institute. Bob Reznik, M.B.A., vice president of the institute, presents a methodology for measuring the outcomes of clinical care and relating it to physician performance on a variety of levels. PMID:10131360

  17. How customer satisfaction can influence clinical outcome in a back specialty clinic.

    Science.gov (United States)

    Reznik, B

    1994-01-01

    Determining what defines quality is the aim of the study produced at the Texas Back Institute. Bob Reznik, M.B.A., vice president of the institute, presents a methodology for measuring the outcomes of clinical care and relating it to physician performance on a variety of levels.

  18. The Influence of Postoperative Tibiofemoral Alignment on the Clinical Results of Unicompartmental Knee Arthroplasty

    OpenAIRE

    Kim, Kyung Tae; Lee, Song; Kim, Tae Woo; Lee, Jung Soo; Boo, Kyung Hwan

    2012-01-01

    Purpose To evaluate the influence of postoperative tibiofemoral alignment on the clinical results and failure in patients who underwent unicompartmental knee athroplasty (UKA). Materials and Methods We reviewed 246 cases of medial UKA which were followed up for at least 5 years after the operation. The clinical results were compared between 5 groups classified according to the tibiofemoral angle that was measured at 3 months after surgery. We analyzed the relationship between the tibiofemoral...

  19. Influence of clinical and pathologic features on the pathologist's diagnosis of mycosis fungoides: a pilot study.

    Science.gov (United States)

    Rovner, Rebecca; Smith, Hayden L; Katz, Peter J; Liu, Vincent

    2015-07-01

    Although clinicopathologic correlation is critical in the diagnosis of early mycosis fungoides (MF), how clinical information directly affects the pathologist's interpretation is unknown. This pilot study aimed to assess the influence of provided clinical information and specific histopathologic features on the histopathologic diagnosis of MF vs. its inflammatory simulants. A computerized survey recorded diagnostic impressions by 24 dermatopathologists of 30 hematoxylin-eosin stained images, including 15 MF images and 15 dermatitis images. Images were accompanied by concordant clinical descriptions (33%), no clinical information (33%) or discordant clinical descriptions (33%). Percentage of correctly classified MF histopathologic images for the three scenarios of concordant clinical information, no clinical information or discordant clinical information were 32% (kappa 0.19), 56% (kappa 0.12) and 16% (kappa 0.33), respectively. The percentage of correctly classified slides presented with no clinical information was different from the other two groups (p < 0.0001). Pautrier collections were most associated with correct classification. Clinical information may play a significant role in the histopathologic diagnosis of MF, although there may be some value in initial blinded histopathologic interpretation. Specific histopathologic features differ in relative importance in the diagnosis of MF.

  20. Factors influencing outcomes of clinical information systems implementation: a systematic review.

    Science.gov (United States)

    Gruber, Dianne; Cummings, Greta G; LeBlanc, Lisa; Smith, Donna L

    2009-01-01

    Healthcare agencies spend significant resources to acquire or develop clinical information systems. However, implementation of clinical information systems often report significant failures. A systematic review of the research literature identified processes and outcomes of clinical information system implementation and factors that influenced success or failure. Of 124 original papers, 18 met the primary inclusion criteria-clinical systems implementation, healthcare facility, and outcome measures. Data extraction elements included study characteristics, outcomes, and implementation risk factors classified according to the Expanded Systems Life Cycle. The quality of each study was also assessed. Forty-nine outcomes of clinical information system implementation were identified. No single implementation strategy proved completely effective. The findings of this synthesis direct the attention of managers and decision makers to the importance of clinical context to successful implementation of clinical information systems. The highest number of factors influencing success or failure was reported during implementation and system "go-live." End-user support or lack thereof was the important factor in both successful and failed implementations, respectively. Following the Expanded Systems Life Cycle management model instead of a traditional project management approach may contribute to greater success over time, by paying particular attention to the underrecognized maintenance phase of implementation. PMID:19411944

  1. Factors Influencing Electronic Clinical Information Exchange in Small Medical Group Practices

    Science.gov (United States)

    Kralewski, John E.; Zink, Therese; Boyle, Raymond

    2012-01-01

    Purpose: The purpose of this study was to identify the organizational factors that influence electronic health information exchange (HIE) by medical group practices in rural areas. Methods: A purposive sample of 8 small medical group practices in 3 experimental HIE regions were interviewed to determine the extent of clinical information exchange…

  2. Knowledge of the D-dimer test result influences clinical probability assessment of pulmonary embolism

    NARCIS (Netherlands)

    R.A. Douma; J.B.F. Kessels; H.R. Büller; V.E.A. Gerdes

    2010-01-01

    Background: In patients with suspected pulmonary embolism (PE), an unlikely or non-high probability assessment combined with a normal D-dimer test can safely exclude the diagnosis. We studied the influence of early D-dimer knowledge on clinical probability assessment. Methods: A questionnaire was se

  3. Influence of mutation type on clinical expression of Leber hereditary optic neuropathy.

    NARCIS (Netherlands)

    Spruijt, L.; Kolbach, D.; Coo, R.F. de; Plomp, A.S.; Bauer, N.J.; Smeets, H.J.M.; Die-Smulders, C.E.M. de

    2006-01-01

    PURPOSE: The aim of this research was to determine the molecular factors of influence on the clinical expression of Leber hereditary optic neuropathy (LHON), which might aid in counseling LHON patients and families. The prevalence of LHON in the Dutch population was determined. DESIGN: Observational

  4. Factors influencing success of clinical genome sequencing across a broad spectrum of disorders

    DEFF Research Database (Denmark)

    Taylor, Jenny C; Martin, Hilary C; Lise, Stefano;

    2015-01-01

    To assess factors influencing the success of whole-genome sequencing for mainstream clinical diagnosis, we sequenced 217 individuals from 156 independent cases or families across a broad spectrum of disorders in whom previous screening had identified no pathogenic variants. We quantified the numb...

  5. Influence of early post-burn enteral nutrition on clinical outcomes of patients with extensive burns

    OpenAIRE

    Lu, Guozhong; Huang, Jiren; Yu, Junjie; Zhu, Yugang; Cai, Liangliang; Gu, Zaiqiu; Su, Qinghe

    2011-01-01

    Sepsis commonly occurs in severe post-burn patients, often resulting in death. We aimed to evaluate the influence of early enteral feeding on outcomes in patients with extensive burns, including infection incidence, healing and mortality. We retrospectively reviewed 60 patients with extensive burns, 35 who had received early enteral nutrition and 25 who had received parenteral nutrition. Average healing time, infection incidence and mortality were clinically observed. Hemoglobin and serum alb...

  6. Influence of societal and practice contexts on health professionals’ clinical reasoning: a scoping study protocol

    Science.gov (United States)

    Carrier, Annie; Levasseur, Mélanie; Freeman, Andrew; Mullins, Gary; Quénec'hdu, Suzanne; Lalonde, Louise; Gagnon, Michaël; Lacasse, Francis

    2013-01-01

    Introduction In a context of constrained resources, the efficacy of interventions is a pivotal aim of healthcare systems worldwide. Efficacy of healthcare interventions is highly compromised if clinical reasoning (CR), the process that practitioners use to plan, direct, perform and reflect on client care, is not optimal. The CR process of health professionals is influenced by the institutional dimension (ie, legal, regulatory, administrative and organisational aspects) of their societal and practice contexts. Although several studies have been conducted with respect to the institutional dimension influencing health professionals’ CR, no clear integration of their results is yet available. The aim of this study is to synthesise and disseminate current knowledge on the influence of the institutional dimension of contexts on health professionals’ CR. Methods and analysis A scoping study of the scientific literature from January 1980 to March 2013 will be undertaken to summarise and disseminate research findings about the influence of the institutional dimension on CR. Numerous databases (n=18) from three relevant fields (healthcare, health law and politics and management) will be searched. Extended search strategies will include the manual search of bibliographies, health-related websites, public registries and journals of interest. Data will be collected and analysed using a thematic chart and content analysis. A systematic multidisciplinary team approach will allow optimal identification of relevant studies, as well as effective and valid content analysis and dissemination of the results. Discussion This scoping study will provide a rigorous, accurate and up-to-date synthesis of existing knowledge regarding: (1) those aspects of the institutional dimension of health professionals’ societal and practice contexts that impact their CR and (2) how these aspects influence health professionals’ CR. Through the synergy of a multidisciplinary research team from a

  7. An Investigation of Factors Influencing Nurses' Clinical Decision-Making Skills.

    Science.gov (United States)

    Wu, Min; Yang, Jinqiu; Liu, Lingying; Ye, Benlan

    2016-08-01

    This study aims to investigate the influencing factors on nurses' clinical decision-making (CDM) skills. A cross-sectional nonexperimental research design was conducted in the medical, surgical, and emergency departments of two university hospitals, between May and June 2014. We used a quantile regression method to identify the influencing factors across different quantiles of the CDM skills distribution and compared the results with the corresponding ordinary least squares (OLS) estimates. Our findings revealed that nurses were best at the skills of managing oneself. Educational level, experience, and the total structural empowerment had significant positive impacts on nurses' CDM skills, while the nurse-patient relationship, patient care and interaction, formal empowerment, and information empowerment were negatively correlated with nurses' CDM skills. These variables explained no more than 30% of the variance in nurses' CDM skills and mainly explained the lower quantiles of nurses' CDM skills distribution. PMID:26906246

  8. Variables influencing presenting symptoms of patients with eating disorders at psychiatric outpatient clinics.

    Science.gov (United States)

    Tseng, Mei-Chih Meg; Chen, Kuan-Yu; Chang, Chin-Hao; Liao, Shih-Cheng; Chen, Hsi-Chung

    2016-04-30

    Eating disorders (EDs) have been underdiagnosed in many clinical settings. This study investigates the influence of clinical characteristics on presenting symptoms of patients with EDs. Psychiatric outpatients, aged 18-45, were enrolled sequentially and received a two-phase survey for EDs in August 2010-January 2013. Their primary reasons for seeking psychiatric help were obtained at their first encounter with outpatient psychiatrists. Patients' clinical and demographic characteristics were compared according to presenting symptoms with or without eating/weight problems. Of 2140 patients, 348 (16.3%) were diagnosed with an ED (22.6% of women and 6.3% of men). The three most common reasons for seeking psychiatric help were eating/weight problems (46.0%), emotional problems (41.3%), and sleep disturbances (19.3%). The multivariate analyses suggest that when patients with EDs presented symptoms that were less related to eating/weight problems, they were significantly more likely to be those having diagnoses other than anorexia nervosa or bulimia nervosa and less severe degree of binge-eating. Further, patients with EDs who demonstrated more impulsive behaviors and poorer functioning were less likely to report their eating problems when visiting psychiatric clinics. Thus, ED should be assessed routinely in patients with complex psychopathology to facilitate comprehensive treatment. PMID:27086254

  9. A Research on Factors Influencing the Clinical Prognosis of Acute Stroke Patie.patients

    Institute of Scientific and Technical Information of China (English)

    Luo Zuming; Li Manli

    2000-01-01

    Object: To search for the factors significantly influencing the clinical prognosis of acute stroke patients. Background: There are lack of prospective multivariate analysis research m acute stroke in the world. Method: We chose 17 factors possibly influencing the prognosis of acute patients, took Barthel′s Index at the end of 2 months after stroke onset and decreased percentage of neurological deficit scores (MESSS) between 72h after hospitalization and 2 months after onset as gold standard, to have a prospective, multivariate analysis research combined with univariate analysis. Results: Multivariate analysis of 106 acute stroke patients combined with univariate analysis showed the factors significantly influencing the clinical prognosis of acute stroke patients were: initial MESSS score、 age、 complication、 mass effect、 stroke location、 time of delay before emergency arrival (BDT). Time of delay after emergency arrival was not found to be a significant prognostic factor. Discussion: Barthel Index at the end of 1 month after stroke onset was strongly related to that at the end of 2 month after onset, as was the same with MESSS score. It showed there was no significant difference between 1 month and 2 months after stroke onset when we choose time interval in evaluating prognosis of acute stroke patients.Conclusion: BDT、 initial MESSS score、 age、 stroke location、 mass effect、 complication were important factors of acute stroke patients. Avoid the delay before emergency arrival after onset, prevent and treat complications after stroke, more carefully treat acute stroke patients with advanced age, advanced age, high initial MESSS scores and those with mass effect reported by CT, we can improve the outcome of stroke patients.

  10. IL8 gene as modifier of cystic fibrosis: unraveling the factors which influence clinical variability.

    Science.gov (United States)

    Furlan, Larissa Lazzarini; Marson, Fernando Augusto Lima; Ribeiro, José Dirceu; Bertuzzo, Carmen Sílvia; Salomão Junior, João Batista; Souza, Dorotéia Rossi Silva

    2016-08-01

    The severity of cystic fibrosis (CF) is associated with classes of mutations in the CFTR gene (cystic fibrosis transmembrane regulator), physical environment and modifier genes interaction. The IL8 gene (interleukin 8), according to its respective polymorphisms, influences inflammatory responses. This study analyzed IL8 gene polymorphisms (rs4073, rs2227306 and rs2227307), by means of PCR/RFLP, and their association with pulmonary function markers and clinical severity scores in 186 patients with CF, considering the CFTR genotype. There was an association between rs2227307 and precocity of the disease. The severity of lung disease was associated with the following markers: transcutaneous arterial hemoglobin oxygen saturation (SaO2) (regardless of CFTR genotype, for the polymorphisms rs4073, rs2227306 and rs2227307); mucoid Pseudomonas aeruginosa (regardless of CFTR genotype, for the polymorphisms rs2227306 and rs2227307). Pulmonary function markers (SaO2 and spirometric variables) and clinical severity scores were also associated with IL8 gene polymorphisms. This study identified the IL8 gene, represented by rs4073 and rs2227306 polymorphisms, and particularly the rs2227307 polymorphism, as potentiating factors for the degree of variability in the severity of CF, especially in pulmonary clinical manifestation correlated with increased morbidity and mortality. PMID:27209008

  11. Graeco-Roman case histories and their influence on Medieval Islamic clinical accounts.

    Science.gov (United States)

    Alvarez Millan, C

    1999-04-01

    The medieval Islamic medical tradition was the direct heir of Classical and Hellenistic medicine thanks to an unprecedented movement of translation into Arabic, commentaries and systematizations of Greek scientific texts. In the process of assimilation, not only theoretical principles, but also literary models of presenting medical knowledge were adopted, amongst them the case history. Since the clinical account can be used as a tool for medical instruction as well as an instrument for professional self-promotion, this study seeks to investigate which purpose most motivated Islamic physicians, and to demonstrate the extent to which they were influenced by the stylistic patterns which served them as a model. This article comprises an analysis of the context, literary devices and purpose of case histories of the Epidemics, Rufus of Ephesos and Galen, and compares them with those by the tenth-century Islamic physician Abu Bakr Muhammad b. Zakariya al-Razi. Author of the largest number of case histories preserved within the medieval Islamic medical literature, al-Razi's clinical records constitute an instrument with which to study and expand medical knowledge as well as providing useful material for students' medical training. Although al-Razi fused elements from the sources which served him as a model, he did not emulate Galen's use of the clinical history to assert himself in order to gain authority and prestige, but remained faithful to the Hippocratic essence. PMID:11623808

  12. Factors influencing clinical students' perceptions of an embedded research project and associated publication output.

    Science.gov (United States)

    Weller, Renate; May, Stephen A

    2013-01-01

    In this article, we describe student perceptions of the value of a short, compulsory research project embedded in a clinical degree program, the research output in terms of publications, and the factors influencing this. It was hypothesized that student attitudes toward the project, student perceptions of how much the project contributed to their generic skills, and the number of publications submitted or prepared for submission would be associated with perceived quality of supervision, perceived difficulty of the project, career plans, and attitude before commencement of the project. We explored this using a questionnaire comprising 30 questions that included demographics, Likert scales, and categorical responses. Student attitudes toward research were found to be associated with student attitude before the start of the project, perceived difficulty of the project, perceived quality of supervision, and perceived relevance to the profession. Students thought that the research project contributed most to the skills of "information gathering" and "critical evaluation" and the least to "teamwork," "problem solving," and "oral communication." Research output was significantly linked to perceived quality of supervision and the help students received with data analysis and data collection, though not with the project report itself. In conclusion, although the success of the research project was influenced by many factors, the perceived quality of supervision influenced all three outcome measures. Therefore it is clear that optimization of this aspect offers the most scope for enhancing the student learning experience. PMID:23709108

  13. The Influence of Clinical Experience and Photographic Presentation on Age Assessment of Women

    DEFF Research Database (Denmark)

    Nielsen, Barbara Rubek; Linneberg, Allan; Christensen, Kaare;

    2016-01-01

    as the presentation of participants. OBJECTIVE: It is not known whether the clinical experience of the assessor or photographic presentation have an influence on the assessment of perceived age, which the present study aimed to investigate. METHODS: In a cross-sectional study of 460 women aged 25-93 years, 10...... consultants and 10 residents were asked to estimate the age of each participant using three different photographic presentations: facial photograph, whole-body photograph, and combined facial and whole-body photographs. Data were analyzed by means of summary statistics and linear mixed models. RESULTS......: The inter-class correlation coefficient within each assessor group and photographic presentation varied from 0.66 to 0.75. Limits of agreement were in a broad range but were similar in the two assessor groups. The best inter-assessor agreement was obtained from photographs of both the face and the whole...

  14. Influence of Clinical and Pathologic Parameters on Prognosis of Cervical Carcinoma in China

    Institute of Scientific and Technical Information of China (English)

    LUPing; LIANGQiudong; ZHENGQuanqing

    2003-01-01

    Objective: To explore the influence of clinical and pathologic parameters on the prognosis of squamous cell carcinoma and adenocarcinoma. Methods: 702 cases of cervical carcinoma were retrospec-tively studied. Cox regression model was informed in multi-variable analysis. Results: The retrospective analysis showed that 630 out of 702 cases of cervical carcinoma were squamous cell carcinoma, cumulative rate 89.4% and 72 case were adenocarcinoma, cumulative rate 10.6% respectively. The 5-year survival rate was lower for patients with adenocarcinoma than for patients with squamous cell carcinoma (58.3% vs 57.3%), but there was no significant difference. Cox regression model showed that the variable into equation for squamous cell carcinoma included tumor grade of differentiation, lymph node metastasis and FIGO stage, but only lymph node metastasis and FIGO stage for adenocarcinoma. Conclusion: FIGO stage and lymph node metastasis was independent parameter evaluating prognosis of cervical carcinoma.

  15. Factors influencing success of cement versus screw-retained implant restorations: a clinical review

    Directory of Open Access Journals (Sweden)

    Ahmad Manawar

    2012-10-01

    Full Text Available Aim: As more and more dental practitioners are focusing on implant-supported fixed restorations, some clinicians favor the use of cement retained restorations while others consider screw retained prosthesis to be the best choice. Discussion: In screw-retained restorations, the fastening screw provides a solid joint between the restoration and the implant abutment, while in cement-retained prostheses the restorative screw is eliminated to enhance esthetics, occlusal stability, and passive fit of the restorations. The factors that influence the type of fixation of the prostheses to the implants like passivity of the framework, ease of fabrication, occlusion, esthetics, accessibility, retention and retrievability are discussed in this article with scientific studies demonstrating superior outcomes of one technique over another. Screwretained implant restorations have an advantage of predictable retention, retrievability and lack of potentially retained subgingival cement. However, a few disadvantages exist such as precise placement of the implant for optimal and esthetic location of the screw access hole and obtaining passive fit. On the other hand, cement retained restorations eliminate unesthetic screw access holes, have passive fit of castings, reduced complexity of clinical and lab procedures, enhanced esthetics, reduced cost factors and non disrupted morphology of the occlusal table. Conclusion: This article compares the advantages, potential disadvantages and limitations of screw and cement retained restorations and their specific implications in the most common clinical situation.

  16. Time Interval between Trauma and Arthroscopic Meniscal Repair Has No Influence on Clinical Survival.

    Science.gov (United States)

    van der Wal, Robert J P; Thomassen, Bregje J W; Swen, Jan-Willem A; van Arkel, Ewoud R A

    2016-07-01

    Arthroscopic meniscal repair is the gold standard for longitudinal peripheral meniscal tears. The time interval between trauma and meniscal repair remains controversial. The aim of this study was to evaluate failure rates and clinical outcome of arthroscopic meniscal repair in relation to chronicity of injury. A total of 238 meniscal repairs were performed in 234 patients. Anterior cruciate ligament (ACL) was reconstructed in almost all ACL-deficient knees (130 out of 133). Time interval between injury and repair was divided into acute ( 2 to  12 weeks). Patients completed postal questionnaires to evaluate clinical outcome and failure rates. Study instruments included Lysholm, Knee injury and Osteoarthritis Outcome Score (KOOS), and Tegner scoring systems. At a median follow-up of 41 months (interquartile range [IQR], 34-53 months) 55 medial and 10 lateral meniscal repairs failed (overall failure rate, 27%). There was a significant higher failure rate for medial meniscal repair (p meniscal repair has no influence on the failure rate. Differences in survival rate of meniscal repair are more dependent on location of the lesion and ACL status, rather than chronicity of injury.

  17. Impression materials in fixed prosthodontics: influence of choice on clinical procedure.

    Science.gov (United States)

    Hamalian, Techkouhie A; Nasr, Elie; Chidiac, José J

    2011-02-01

    The purpose of this article is to review impression materials used for fabricating fixed restorations in dentistry. Their compositions, properties, advantages, and disadvantages are presented and compared. How these properties influence clinical decisions is also described. This review helps the clinician choose which material is more suitable for a specific case. A broad search of the published literature was performed using Medline to identify pertinent current articles. Textbooks, the Internet, and manufacturers' literature were also used to supplement this information. It is limited to impression materials used in fixed prosthodontics. The review gives basic knowledge of ideal impression material properties and discusses traditional and, primarily, more recently developed products, such as polyethers, poly(vinyl siloxane), polysulfides, and condensation silicone materials. Clear advantages and disadvantages for these impression materials are provided along with the role that compositional variations have on the outcome of the impression. This should enable clinicians and technicians to easily identify the important physical properties of each type of impression material and their primary clinical indications. PMID:21284760

  18. Examining rater and occasion influences in observational assessments obtained from within the clinical environment

    Directory of Open Access Journals (Sweden)

    Clarence D. Kreiter

    2016-02-01

    Full Text Available Background: When ratings of student performance within the clerkship consist of a variable number of ratings per clinical teacher (rater, an important measurement question arises regarding how to combine such ratings to accurately summarize performance. As previous G studies have not estimated the independent influence of occasion and rater facets in observational ratings within the clinic, this study was designed to provide estimates of these two sources of error. Method: During 2 years of an emergency medicine clerkship at a large midwestern university, 592 students were evaluated an average of 15.9 times. Ratings were performed at the end of clinical shifts, and students often received multiple ratings from the same rater. A completely nested G study model (occasion: rater: person was used to analyze sampled rating data. Results: The variance component (VC related to occasion was small relative to the VC associated with rater. The D study clearly demonstrates that having a preceptor rate a student on multiple occasions does not substantially enhance the reliability of a clerkship performance summary score. Conclusions: Although further research is needed, it is clear that case-specific factors do not explain the low correlation between ratings and that having one or two raters repeatedly rate a student on different occasions/cases is unlikely to yield a reliable mean score. This research suggests that it may be more efficient to have a preceptor rate a student just once. However, when multiple ratings from a single preceptor are available for a student, it is recommended that a mean of the preceptor's ratings be used to calculate the student's overall mean performance score.

  19. Clinical factors influencing normalization of prothrombin time after stopping warfarin: a retrospective cohort study

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    Zondag Michelle

    2008-10-01

    Full Text Available Abstract Background Anticoagulation with warfarin should be stopped 4–6 days before invasive procedures to avoid bleeding complications. Despite this routine, some patients still have high International Normalized Ratio (INR values on the day of surgery and the procedure may be cancelled. We sought to identify easily available clinical characteristics that may influence the rate of normalization of prothrombin time when warfarin is stopped before surgery or invasive procedures. Methods Clinical data were collected retrospectively from consecutive cases from two cohorts, who stopped warfarin 6 days before surgery. An INR value of 1.6 or higher on the day of surgery or requirement for reversal with vitamin K the day before surgery were criteria for slow return (S to normal INR. Results Of 202 patients, 14 (7% were classified as S. Eight of the S-patients required reversal with vitamin K one day before surgery and in another case surgery was cancelled due to high INR. Baseline INR was the only variable significantly associated with classification as S in stepwise logistic regression analysis (p = 0.003. The odds ratio for being in the normal group was 0.27 (95% confidence interval 0.12–0.62 for each unit baseline INR increased. The positive predictive value of baseline INR with a cut off at > 3.0 was only 15% and for INR > 3.5 it was 33%. Conclusion Baseline INR, but not the size of the maintenance dose, is associated with the rate of normalization of prothrombin time after stopping warfarin, but it has limited utility as predictor in clinical practice. Whenever normal hemostasis is considered crucial for the safety, the INR should be checked again before the invasive procedure.

  20. Peer influence in clinical workplace learning : A study of medical students’ use of social comparison in clinical practice

    NARCIS (Netherlands)

    Raat, Adriana

    2015-01-01

    Undergraduate students in clinical workplace frequently compare their own experiences with those of peers. The research reported in this thesis shows that these so called social comparisons are vital to the process of learning in clinical practice. The first study confirms students’ tendency to comp

  1. Peer influence in clinical workplace learning: A study of medical students’ use of social comparison in clinical practice

    OpenAIRE

    Raat, Adriana

    2015-01-01

    Undergraduate students in clinical workplace frequently compare their own experiences with those of peers. The research reported in this thesis shows that these so called social comparisons are vital to the process of learning in clinical practice. The first study confirms students’ tendency to compare themselves with peers and shows that their responses to the comparisons are more often stimulating for learning than discouraging. After that, an experimental study demonstrates how students’ e...

  2. Influence of supplemental vitamin D on intensity of benign paroxysmal positional vertigo: A longitudinal clinical study

    Science.gov (United States)

    Sheikhzadeh, Mahboobeh; Lotfi, Yones; Mousavi, Abdollah; Heidari, Behzad; Monadi, Mohsen; Bakhshi, Enayatollah

    2016-01-01

    Background: Benign paroxysmal positional vertigo (BPPV) is linked to vitamin D deficiency. This clinical trial aimed to determine the influence of vitamin D supplementation on intensity of BPPV. Methods: The study population was selected consecutively and the diagnosis of BPPV was made by history and clinical examination and exclusion of other conditions. Intensity of BPVV was assessed based on VAS score (0-10). Serum 25-hydroxyvitamin D (25-OHD) was measured using ELISA method and levels < 20 ng/ml was considered a deficiency. All patients received rehabilitation treatment using Epley's maneuver one time per week for one month. Serum 25-OHD deficient patients were classified as treated and non-treated groups (rehabilitation with or without 50.000 IU cholecalciferol weekly for two months).The results of treatment were compared with vitamin D sufficient group as control. All patients were followed-up for 6 months. Results: After two months of treatment, in both vitamin D treated and non-treated groups the intensity of BPPV decreased significantly as compared with control (P=0.001 for both groups) but at endpoint, the intensity of BPPV aggravated and regressed to the baseline value in vitamin D deficient non-treated group (P=0.001) whereas, in vitamin D treated group, improvement of BPPV remained stable and unchanged over the study period. Conclusion: This study indicates that correction of vitamin D deficiency in BPPV provides additional benefit to rehabilitation therapy (Epley maneuver) regarding duration of improvement. These findings suggest serum 25-OHD measurement in recurrent BPPV. PMID:27386060

  3. Factors influencing the implementation of clinical guidelines for health care professionals: A systematic meta-review

    Directory of Open Access Journals (Sweden)

    de Veer Anke JE

    2008-09-01

    Full Text Available Abstract Background Nowadays more and more clinical guidelines for health care professionals are being developed. However, this does not automatically mean that these guidelines are actually implemented. The aim of this meta-review is twofold: firstly, to gain a better understanding of which factors affect the implementation of guidelines, and secondly, to provide insight into the "state-of-the-art" regarding research within this field. Methods A search of five literature databases and one website was performed to find relevant existing systematic reviews or meta-reviews. Subsequently, a two-step inclusion process was conducted: (1 screening on the basis of references and abstracts and (2 screening based on full-text papers. After that, relevant data from the included reviews were extracted and the methodological quality of the reviews was assessed by using the Quality Assessment Checklist for Reviews. Results Twelve systematic reviews met our inclusion criteria. No previous systematic meta-reviews meeting all our inclusion criteria were found. Two of the twelve reviews scored high on the checklist used, indicating only "minimal" or "minor flaws". The other ten reviews scored in the lowest of middle ranges, indicating "extensive" or "major" flaws. A substantial proportion (although not all of the reviews indicates that effective strategies often have multiple components and that the use of one single strategy, such as reminders only or an educational intervention, is less effective. Besides, characteristics of the guidelines themselves affect actual use. For instance, guidelines that are easy to understand, can easily be tried out, and do not require specific resources, have a greater chance of implementation. In addition, characteristics of professionals – e.g., awareness of the existence of the guideline and familiarity with its content – likewise affect implementation. Furthermore, patient characteristics appear to exert influence: for

  4. What factors influence the prevalence and accuracy of nursing diagnoses documentation in clinical practice? A systematic literature review

    NARCIS (Netherlands)

    Paans, W.; Nieweg, R.M.B.; van der Schans, C.P.; Sermeus, W.

    2011-01-01

    Aim. To identify what determinants influence the prevalence and accuracy of nursing diagnosis documentation in clinical practice. Background. Nursing diagnoses guide and direct nursing care. They are the foundation for goal setting and provide the basis for interventions. The literature mentions sev

  5. Migrant encounters in the clinic: Bureaucratic, biomedical, and community influences on patient interactions with front-line workers.

    Science.gov (United States)

    Smith, Sarah A

    2016-02-01

    Ethnographic research on the clinical encounter has focused almost exclusively on what happens in exam rooms-particularly patient-provider interactions-leaving much to be understood about other actors within the clinic. As part of a larger ethnographic study examining the impact of colonialism, transnational migration, discrimination, and gender relations on Chuukese migrant women's reproductive and sexual health outcomes in Guam, I conducted eight months of participant observation in three publicly funded health clinics, 24 interviews with health care workers, and 15 life-history interviews with Chuukese women between September 2012 and February 2014. Findings demonstrated differential treatment of Chuukese patients by front-line workers (FLWs), who engaged in "boundary work" with these patients. Further, care varied by clinic space and the actors in that space. This differential treatment and variation in care impacted Chuukese women's access to and experiences with health care in Guam. Utilizing the concept of "deservingness," this analysis unpacks how FLWs, like Lipsky's "street-level bureaucrats," are influenced by bureaucratic, biomedical, and community hierarchies, all contributing to differential patient treatment. This study concludes by calling for more integrated analyses of clinical environments which utilize Lipsky's concept to include community narratives of "deservingness" and incorporate the influence of clinic and community stratification. PMID:26730881

  6. Does undertaking an intercalated BSc influence first clinical year exam results at a London medical school?

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    Jones Melvyn

    2011-02-01

    Full Text Available Abstract Background Intercalated BScs (iBScs are an optional part of the medical school curriculum in many Universities. Does undertaking an iBSc influence subsequent student performance? Previous studies addressing this question have been flawed by iBSc students being highly selected. This study looks at data from medical students where there is a compulsory iBSc for non-graduates. Our aim was to see whether there was any difference in performance between students who took an iBSc before or after their third year (first clinical year exams. Methods A multivariable analysis was performed to compare the third year results of students at one London medical school who had or had not completed their iBSc by the start of this year (n = 276. A general linear model was applied to adjust for differences between the two groups in terms of potential confounders (age, sex, nationality and baseline performance. Results The results of third year summative exams for 276 students were analysed (184 students with an iBSc and 92 without. Unadjusted analysis showed students who took an iBSc before their third year achieved significantly higher end of year marks than those who did not with a mean score difference of 4.4 (0.9 to 7.9 95% CI, p = 0.01. (overall mean score 238.4 "completed iBSc" students versus 234.0 "not completed", range 145.2 - 272.3 out of 300. There was however a significant difference between the two groups in their prior second year exam marks with those choosing to intercalate before their third year having higher marks. Adjusting for this, the difference in overall exam scores was no longer significant with a mean score difference of 1.4 (-4.9 to +7.7 95% CI, p = 0.66. (overall mean score 238.0 " completed iBSc" students versus 236.5 "not completed". Conclusions Once possible confounders are controlled for (age, sex, previous academic performance undertaking an iBSc does not influence third year exam results. One explanation for this

  7. Factors that influence the clinical decision-making of rehabilitation professionals in long-term care settings.

    Science.gov (United States)

    Wainwright, Susan Flannery; McGinnis, Patricia Quinn

    2009-01-01

    The purpose of this qualitative research was to evaluate the reasoning of clinicians practicing in long-term care facilities and to explore factors influencing their professional development. Eighteen participants were recruited from eight clinical sites and included seven occupational therapists, eight physical therapists, and three speech therapists distributed across three groups relative to experience. Nonparticipant observation and videotape of therapist-patient interactions were used in semi-structured interviews with each participant. Qualitative data analysis software was used during a process of open and axial coding, followed by thematic analysis. The facilitory and inhibitory factors that affect clinical reasoning and professional development were identified. Rehabilitation professionals in long-term care demonstrated clinical reasoning within the context of patient-centered goals. Well-developed and explicit programs for mentorship, professional development, and continuing education fostered their clinical reasoning abilities. Participants perceived that these factors were vital to achieving optimal patient outcomes. PMID:19753425

  8. Factors influencing clinical outcomes of acute ischemic stroke treated with intravenous recombinant tissue plasminogen activator

    Institute of Scientific and Technical Information of China (English)

    HUANG Yin-hui; ZHUO Shi-tu; CHEN Ya-fang; LI Ming-mei; LIN You-yu; YANG Mei-li; CHEN Zhen-jie

    2013-01-01

    Background Thrombolysis with recombinant tissue plasminogen activator (rt-PA) has gained international recognition,clinical outcomes following this thrombolytic therapy varied from patient to patient.Factors affecting clinical outcomes have not been well understood yet,so this retrospective case-control study aimed to investigate factors that may influence clinical outcomes of acute ischemic stroke treated with intravenous rt-PA.Methods One hundred and one patients with acute ischemic stroke who received intravenous rt-PA thrombolysis within 4.5 hours from disease onset were included.Patients were divided into good or poor outcome group according to modified Rankin Scale (mRS) score,good outcome group:mRS score of 0-1; poor outcome group:mRS of 2-6.Stroke characteristics were compared between the two groups.Factors for stroke outcomes were analyzed via univariate analysis and Logistic regression.Results Of the 101 patients studied,patients in good outcome group (n=55) were significantly younger than patients in poor outcome group (n=46,(62.82±14.25) vs.(68.81±9.85) years,P=0.029).Good outcome group had fewer patients with diabetic history (9.09% vs.28.26%,P=0.012),fewer patients with leukoaraiosis (7.27% vs.28.26%,P=0.005) and presented with lower blood glucose level ((5.72±1.76) vs.(6.72±1.32) mmol/L,P=0.012),lower systolic blood pressure level ((135.45±19.36) vs.(148.78±19.39) mmHg,P=0.003),lower baseline NIHSS score (12.02±5.26 vs.15.78±4.98,P=0.002) and shorter onset-to-treatment time (OTT) ((2.38±1.21) vs.(2.57±1.03) hours,P=0.044) than poor outcome group.Logistic regression analysis showed that absence of diabetic history (odds ratio (OR) 0.968 (95% CI 0.941-0.996)),absence of leukoaraiosis (OR 0.835 (95% CI 0.712-0.980)),lower baseline NIHSS score (OR 0.885 (95% CI 0.793-0.989)),lower pre-thrombolysis systolic blood pressure (OR 0.962 (95% CI 0.929-0.997)),and lower blood glucose level (OR 0.699 (95% CI 0.491-0.994)) before

  9. Microenvironmental influence on pre-clinical activity of polo-like kinase inhibition in multiple myeloma: implications for clinical translation.

    Directory of Open Access Journals (Sweden)

    Douglas W McMillin

    Full Text Available Polo-like kinases (PLKs play an important role in cell cycle progression, checkpoint control and mitosis. The high mitotic index and chromosomal instability of advanced cancers suggest that PLK inhibitors may be an attractive therapeutic option for presently incurable advanced neoplasias with systemic involvement, such as multiple myeloma (MM. We studied the PLK 1, 2, 3 inhibitor BI 2536 and observed potent (IC50<40 nM and rapid (commitment to cell death <24 hrs in vitro activity against MM cells in isolation, as well as in vivo activity against a traditional subcutaneous xenograft mouse model. Tumor cells in MM patients, however, don't exist in isolation, but reside in and interact with the bone microenvironment. Therefore conventional in vitro and in vivo preclinical assays don't take into account how interactions between MM cells and the bone microenvironment can potentially confer drug resistance. To probe this question, we performed tumor cell compartment-specific bioluminescence imaging assays to compare the preclinical anti-MM activity of BI 2536 in vitro in the presence vs. absence of stromal cells or osteoclasts. We observed that the presence of these bone marrow non-malignant cells led to decreased anti-MM activity of BI 2536. We further validated these results in an orthotopic in vivo mouse model of diffuse MM bone lesions where tumor cells interact with non-malignant cells of the bone microenvironment. We again observed that BI 2536 had decreased activity in this in vivo model of tumor-bone microenvironment interactions highlighting that, despite BI 2536's promising activity in conventional assays, its lack of activity in microenvironmental models raises concerns for its clinical development for MM. More broadly, preclinical drug testing in the absence of relevant tumor microenvironment interactions may overestimate potential clinical activity, thus explaining at least in part the gap between preclinical vs. clinical efficacy in MM

  10. Dysfunctional Attitudes and Affective Responses to Daily Stressors: Separating Cognitive, Genetic, and Clinical Influences on Stress Reactivity

    OpenAIRE

    Conway, Christopher C.; Slavich, George M.; Hammen, Constance

    2014-01-01

    Despite decades of research examining diathesis-stress models of emotional disorders, it remains unclear whether dysfunctional attitudes interact with stressful experiences to shape affect on a daily basis and, if so, how clinical and genetic factors influence these associations. To address these issues, we conducted a multi-level daily diary study that examined how dysfunctional attitudes and stressful events relate to daily fluctuations in negative and positive affect in 1...

  11. Does informed consent influence therapeutic outcome? A clinical trial of the hypnotic activity of placebo in patients admitted to hospital.

    OpenAIRE

    Dahan, R.; Caulin, C; Figea, L; Kanis, J. A.; Caulin, F; Segrestaa, J M

    1986-01-01

    To examine whether written informed consent might influence the results of clinical trials the effect of placebo when given with or without informed consent to patients suffering from insomnia was studied. The study was a single blind observer blinded trial, and patients were paired according to sex, age, and hospital environment. Randomisation assigned the first patient of each pair to the control group (without informed consent) or the group to give informed consent. Of the 56 patients, 26 ...

  12. Peer influence on students' estimates of performance : social comparison in clinical rotations

    NARCIS (Netherlands)

    Raat, A. N. (Janet); Kuks, Jan B. M.; van Hell, E. Ally; Cohen-Schotanus, Janke

    2013-01-01

    Context During clinical rotations, students move from one clinical situation to another. Questions exist about students strategies for coping with these transitions. These strategies may include a process of social comparison because in this context it offers the student an opportunity to estimate h

  13. INFLUENCE OF PHYSIOTHERAPY ON CLINICAL AND IMMUNOLOGICAL PARAMETERS IN CHILDREN WITH JUVENILE RHEUMATOID ARTHRITIS

    OpenAIRE

    T.L. Nastausheva; L.T. Dmitrieva

    2008-01-01

    Clinical and immunological status has been evaluated in 85 children with juvenile rheumatoid arthritis (RA) before and after physiotherapeutic procedures: electrophoresis with dimexid and magnetotherapy. The control group of 31 children did not follow physiotherapeutic procedures. The following results were fixed: clinical indices and immunological status of children with juvenile rheumatoid arthritis have been changed in a larger degree in case of magnetotherapy.

  14. Mathematical evaluation of the influence of multiple factors on implant stability quotient values in clinical practice: a retrospective study

    Science.gov (United States)

    Huang, Hairong; Wismeijer, Daniel; Shao, Xianhong; Wu, Gang

    2016-01-01

    Objectives The objective of this study is to mathematically evaluate the influence of multiple factors on implant stability quotient values in clinical practice. Patients and methods Resonance frequency analysis was performed at T1 (measured immediately at the time of implant placement) and at T2 (measured before dental restoration) in 177 patients (329 implants). Using a multivariate linear regression model, we analyzed the influence of the following eleven candidate factors: sex, age, maxillary/mandibular location, bone type, immediate/delayed implantation, bone grafting (presence or absence), insertion torque, I-/II-stage healing pattern, implant diameter, implant length, and T1–T2 time interval. Results The following factors were identified to significantly influence the implant stability quotient (ISQ) values at T1: insertion torque, bone grafting, I-/II-stage healing pattern, immediate/delayed implantation, maxillary/mandibular location, implant diameter, and sex. In contrast, the ISQ values at T2 were significantly influenced only by three factors: implant diameter, T1–T2 time interval, and insertion torque. Conclusion Among the eleven candidate factors, seven key factors were found to influence the T1-ISQ values, while only three key factors influenced the T2-ISQ values. Both T1 and T2-ISQ values were found to be influenced by implant diameter and insertion torque. T1 was influenced specifically by the sex of the patient, the location (maxillary or mandibular), the implantation mode (immediate/delayed implantation), the healing stage, and the absence or presence of bone graft materials. PMID:27785040

  15. The influence of clinical information in the histopathologic diagnosis of melanocytic skin neoplasms.

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    Gerardo Ferrara

    Full Text Available BACKGROUND: We tested the relevance of clinical information in the histopathologic evaluation of melanocytic skin neoplasm (MSN. METHODS: Histopathologic specimens from 99 clinically atypical MSN were circulated among ten histopathologists; each case had clinical information available in a database with a five-step procedure (no information; age/sex/location; clinical diagnosis; clinical image; dermoscopic image; each step had a histopathologic diagnosis (D1 through D5; each diagnostic step had a level of diagnostic confidence (LDC ranging from 1 (no diagnostic certainty to 5 (absolute diagnostic certainty. The comparison of the LDC was employed with an analysis of variance (ANOVA for repeated measures. FINDINGS: In D1 (no information, 36/99 cases (36.3% had unanimous diagnosis; in D5 (full information available, 51/99 cases (51.5% had unanimous diagnosis (p for difference between proportions <0.001. The observer agreement expressed as kappa increased significantly from D1 to D5. The mean LDC linearly increased for each observer from D1 through D5 (p for linear trend <0.001. On average, each histopathologist changed his initial diagnosis in 7 cases (range: 2-23. Most diagnostic changes were in D2 (age/sex/location. INTERPRETATION: The histopathologic criteria for the diagnosis of MSN can work as such, but the final histopathologic diagnosis is a clinically-aided interpretation. Clinical data sometimes reverse the initial histopathologic evaluation.

  16. Influence of clerks’ personality on their burnout in the clinical workplace: a longitudinal observation

    OpenAIRE

    Lin, Cheng-Chieh; Lin, Blossom Yen-Ju; Lin, Chia-Der

    2016-01-01

    Background The clinical training of medical students in clerkship is crucial to their future practice in healthcare services. This study investigates burnout during a 2-year clerkship training period as well as the role of personality traits on burnout during training. Methods Ninety-four clerks at a tertiary medical centre who provided at least 10 responses to a routine survey on clinical rotation were included in this study, which spanned September 2013 to April 2015. Web-based, validated, ...

  17. INFLUENCE OF PHYSIOTHERAPY ON CLINICAL AND IMMUNOLOGICAL PARAMETERS IN CHILDREN WITH JUVENILE RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    T.L. Nastausheva

    2008-12-01

    Full Text Available Clinical and immunological status has been evaluated in 85 children with juvenile rheumatoid arthritis (RA before and after physiotherapeutic procedures: electrophoresis with dimexid and magnetotherapy. The control group of 31 children did not follow physiotherapeutic procedures. The following results were fixed: clinical indices and immunological status of children with juvenile rheumatoid arthritis have been changed in a larger degree in case of magnetotherapy.

  18. Influence of saliva and mucin on the adhesion of Candida oral clinical isolates

    OpenAIRE

    Seabra, C.; Botelho, C.M.; Oliveira, Ana C. N.; Henriques, Mariana

    2015-01-01

    Objectives: This research work intends to clarify the role of artificial saliva, in particularly the role of mucin, a salivary protein, on the surface properties and adhesion ability of Candida spp. oral clinical isolates to abiotic surfaces. Methods: Four oral clinical isolates of Candida spp. were used: two Candida albicans strains (AC; AM) and two Candida parapsilosis strains (AD; AM2). The strains were isolated from patients using oral prosthesis. The microorganisms were cultured in the a...

  19. Problems for clinical judgement: 5. Principles of influence in medical practice

    OpenAIRE

    Donald A Redelmeier; Cialdini, Robert B.

    2002-01-01

    THE BASIC SCIENCE OF PSYCHOLOGY HAS IDENTIFIED specific ingrained responses that are fundamental elements of human nature, underpin common influence strategies and may apply in medical settings. People feel a sense of obligation to repay a perceived debt. A request becomes more attractive when preceded by a marginally worse request. The drive to act consistently will persist even if demands escalate. Peer pressure is intense when people face uncertainty. The image of the requester influences ...

  20. Mathematical evaluation of the influence of multiple factors on implant stability quotient values in clinical practice: a retrospective study

    Directory of Open Access Journals (Sweden)

    Huang H

    2016-10-01

    Full Text Available Hairong Huang,1 Daniel Wismeijer,1 Xianhong Shao,2 Gang Wu1 1Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA, MOVE Research Institute, VU University Amsterdam and University of Amsterdam, Amsterdam, Nord-Holland, the Netherlands; 2Best & Easy Dental Clinic, Hangzhou, Zhejiang Province, People’s Republic of China Objectives: The objective of this study is to mathematically evaluate the influence of multiple factors on implant stability quotient values in clinical practice.Patients and methods: Resonance frequency analysis was performed at T1 (measured immediately at the time of implant placement and at T2 (measured before dental restoration in 177 patients (329 implants. Using a multivariate linear regression model, we analyzed the influence of the following eleven candidate factors: sex, age, maxillary/mandibular location, bone type, immediate/delayed implantation, bone grafting (presence or absence, insertion torque, I-/II-stage healing pattern, implant diameter, implant length, and T1–T2 time interval.Results: The following factors were identified to significantly influence the implant stability quotient (ISQ values at T1: insertion torque, bone grafting, I-/II-stage healing pattern, immediate/delayed implantation, maxillary/mandibular location, implant diameter, and sex. In contrast, the ISQ values at T2 were significantly influenced only by three factors: implant diameter, T1–T2 time interval, and insertion torque.Conclusion: Among the eleven candidate factors, seven key factors were found to influence the T1-ISQ values, while only three key factors influenced the T2-ISQ values. Both T1 and T2-ISQ values were found to be influenced by implant diameter and insertion torque. T1 was influenced specifically by the sex of the patient, the location (maxillary or mandibular, the implantation mode (immediate/delayed implantation, the healing stage, and the absence or presence of bone

  1. Less travelled roads in clinical immunology and allergy: drug reactions and the environmental influence.

    Science.gov (United States)

    Selmi, Carlo; Crotti, Chiara; Meroni, Pier Luigi

    2013-08-01

    Allergy and clinical immunology are examples of areas of knowledge in which working hypotheses are dominant over mechanistic understanding. As such, sometimes scientific efforts follow major streams and overlook some epidemiologically prevalent conditions that thus become underestimated by the research community. For this reason, we welcome the present issue of Clinical Reviews in Allergy and Immunology that is dedicated to uncommon themes in clinical immunology and allergy. First, comprehensive discussions are provided for allergy phenomena of large potential impact in clinical practice such as reactions to cephalosporins or aspirin-induced asthma and in everyday life such as allergies to food additives or legumes. Further, the issue addresses other uncommon themes such as urticaria and angioedema, cercarial dermatitis, or late-onset inflammation to soft tissue fillers. Last, there will be discussion on transversal issues such as olfactory defects in autoimmunity, interleukin 1 beta pathway, and the search for new serological markers in chronic inflammation. As a result, we are convinced that this issue will be of help to clinicians involved in internal medicine as well as to allergists and clinical immunologists. More importantly, we are convinced that these discussions will be of interest also to basic scientists for the numerous translational implications.

  2. The influence of family history on prostate cancer risk : implications for clinical management

    NARCIS (Netherlands)

    Madersbacher, Stephan; Alcaraz, Antonio; Emberton, Mark; Hammerer, Peter; Ponholzer, Anton; Schroeder, Fritz H.; Tubaro, Andrea

    2011-01-01

    A family history of prostate cancer has long been identified as an important risk factor for developing the disease. This risk factor can be easily assessed in clinical practice and current guidelines recommend to initiate prostate cancer early detection 5 years earlier (i.e. around the age of 40 ye

  3. Acoustic neuroma ingrowth in the cochlear nerve: does it influence the clinical presentation?

    NARCIS (Netherlands)

    Forton, G.E.J.; Cremers, C.W.R.J.; Offeciers, E.E.

    2004-01-01

    We examined the clinical presentation in patients with a histologically proven ingrowth of the cochlear nerve by acoustic neuroma to see whether this differs from what is known from large acoustic neuroma series. In total, 85 acoustic neuromas had an en bloc dissection to study histologically the re

  4. Influencing CYP Enzymes to Boost Psychiatric Treatment : A Review on Clinical Evidence

    NARCIS (Netherlands)

    van Hasselt, F. M.; Coehorst, Y.; Wilffert, B.; Loonen, A. J. M.

    2013-01-01

    Introduction: Therapeutic drug monitoring to optimize blood plasma concentrations is advised for certain psychiatric drugs. The current standard is to change the dose based on the blood plasma concentration. We present an overview that blood plasma concentrations can also be influenced by adding co-

  5. Prognostic influence of clinical and pathological factors in medullary thyroid carcinoma: a study of 53 cases

    Directory of Open Access Journals (Sweden)

    Lenine G. Brandão

    2009-01-01

    Full Text Available OBJECTIVES AND INTRODUCTION: Medullary thyroid carcinoma, a neoplasia of intermediate prognosis and differentiation, does not always respond predictably to known treatments. This study aimed to correlate the clinical progression of surgically treated patients with clinical and pathological data. METHODS: A total of 53 patients were followed for 75 months (mean average in tertiary-care hospital. The clinical status of patients at the end of the study period was characterized to determine correlations with a range of disease aspects. A value of p < 0.05 was considered statistically significant. RESULTS: Twenty-two patients (41.5% were alive and disease-free at the end of the follow-up period; twenty-three patients (43.4% had persistent disease; and eight patients (15.1% had recurrent disease. Four patients (7.6% died from medullary thyroid carcinoma with clinical and/or imaging evidence of neoplasia. The following aspects demonstrated statistically significant correlations with the final medical condition: positive initial cervical examination (p = 0.002; neoplastic extensions to the thyroid capsule (p = 0.004 and adjacent tissues (p = 0.034; cervical lymph node metastases (p < 0.001; diameter of neoplasia (p = 0.018; TNM (tumor, node and metastasis Stage (p = 0.001 and evidence of distant and/or cervical diseases in the absence of a cure (p = 0.011. Through logistic regression, the presence of cervical lymph node metastases was considered an independent variable (p < 0.001. CONCLUSIONS: Clinical and pathological aspects of patients with surgically treated medullary thyroid carcinomas are predictors of disease progression. Specifically, even treated cervical lymph node metastases are significantly correlated with disease progression.

  6. Influence of Body Mass Index and Albumin on Perioperative Morbidity and Clinical Outcomes in Resected Pancreatic Adenocarcinoma.

    Science.gov (United States)

    Hendifar, Andrew; Osipov, Arsen; Khanuja, Jasleen; Nissen, Nicholas; Naziri, Jason; Yang, Wensha; Li, Quanlin; Tuli, Richard

    2016-01-01

    Obesity is a known risk factor for PDA and recent reports suggest obesity has a negative impact on clinical outcomes in patients with PDA. Pretreatment body mass index (BMI) and serum albumin (SA) have been shown to be associated with worse overall survival in patients with advanced and metastatic PDA. However, minimal data exists on the impact of BMI and SA on perioperative and long-term clinical outcomes in patients with early-stage resected PDA. Herein, we report on the impact of these variables on perioperative clinical outcomes, overall survival (OS) and disease free survival (DFS) in patients with resected PDA. With IRB approval, we evaluated 1,545 patients with PDA treated at a single institution from 2007-2013 and identified 106 patients who underwent upfront resection with curative intent. BMI and SA were calculated preoperatively and at the time of last clinical evaluation. Influence of preoperative BMI, SA, change in either variable, and influence of other clinical and pathologic variables on perioperative morbidity and mortality was assessed. The impact of these variables on DFS and OS was assessed with cox regression modeling and ANOVA. Actuarial estimates for DFS and OS were calculated using Kaplan-Meier methods. Median follow up time was 16 months (3-89). Mean age was 68 years. Median survival was 14 months (3-65) and median time to recurrence was 11 months (1-79). Length of hospital stay was associated with BMI (p = .023), change in BMI (p = .003) and SA (p = .004). Post-operative transfusion rate was associated with SA (p = .021). There was a strong correlation between BMI change and positive margin (p = .04) and lymph node status (p = .01). On multivariate analysis, change in SA (p = .03) and node positivity (p = .008) were associated with decreased DFS. Additionally, preoperative SA (p = .023), node positivity (p = .026) and poor differentiation (p = .045) were associated with worse OS on multivariate analysis. Low preoperative SA was associated

  7. Influence of Body Mass Index and Albumin on Perioperative Morbidity and Clinical Outcomes in Resected Pancreatic Adenocarcinoma.

    Directory of Open Access Journals (Sweden)

    Andrew Hendifar

    Full Text Available Obesity is a known risk factor for PDA and recent reports suggest obesity has a negative impact on clinical outcomes in patients with PDA. Pretreatment body mass index (BMI and serum albumin (SA have been shown to be associated with worse overall survival in patients with advanced and metastatic PDA. However, minimal data exists on the impact of BMI and SA on perioperative and long-term clinical outcomes in patients with early-stage resected PDA. Herein, we report on the impact of these variables on perioperative clinical outcomes, overall survival (OS and disease free survival (DFS in patients with resected PDA. With IRB approval, we evaluated 1,545 patients with PDA treated at a single institution from 2007-2013 and identified 106 patients who underwent upfront resection with curative intent. BMI and SA were calculated preoperatively and at the time of last clinical evaluation. Influence of preoperative BMI, SA, change in either variable, and influence of other clinical and pathologic variables on perioperative morbidity and mortality was assessed. The impact of these variables on DFS and OS was assessed with cox regression modeling and ANOVA. Actuarial estimates for DFS and OS were calculated using Kaplan-Meier methods. Median follow up time was 16 months (3-89. Mean age was 68 years. Median survival was 14 months (3-65 and median time to recurrence was 11 months (1-79. Length of hospital stay was associated with BMI (p = .023, change in BMI (p = .003 and SA (p = .004. Post-operative transfusion rate was associated with SA (p = .021. There was a strong correlation between BMI change and positive margin (p = .04 and lymph node status (p = .01. On multivariate analysis, change in SA (p = .03 and node positivity (p = .008 were associated with decreased DFS. Additionally, preoperative SA (p = .023, node positivity (p = .026 and poor differentiation (p = .045 were associated with worse OS on multivariate analysis. Low preoperative SA was

  8. Does exercise and the stress of clinical examination influence endothelial function in dogs with mitral regurgitation?

    DEFF Research Database (Denmark)

    Moesgaard, Sophia Gry; Pedersen, Henrik Duelund; Holte, Andreas;

    2005-01-01

    to indicate endothelial function. As in man with heart failure, mitral regurgitation (MR) associated with mitral valve prolapse in dogs, has been found to be associated with a decreased plasma concentation of NOx early in the course of heart failure. Correction of such endothelial dysfunction in human...... subjects is regarded as being an important therapeutic target.An aim of this PhD project is to investigate the involvement of NO in mitral valve disease and explain possible reasons for the decrease in NOx seen in connection with MR.When dogs are examined under clinic conditions there is an inevitable...... amount of stress and agitation, which may affect the cardiovascular system and endothelial function. Plasma NOx measured in dogs with MR in their home environment was similar to that of dogs without MR which were measured in the clinic. However, the same dogs with MR showed a significant decrease...

  9. [Influence of prostatilen on smooth muscle organs functional activity in surgical patients (clinical and experimental study)].

    Science.gov (United States)

    Al'-Shukri, S Kh; Aĭvazian, A I; Barabanov, S V; Barabanova, V V; Bobkov, Iu A; Gorbachev, A G; Parastaeva, M M

    1999-01-01

    The action of prostatilen on contractile activity of smooth muscles of isolated line slices of urine bladder of Wistar rats (myography) and arterial vessels of cat kidneys (resistography) was studied. On the basis of clinical cases effectiveness of prostatilen was analysed as a treatment restorting urine bladder function in acute reflex urinary retention after operations in the area of rectal sphincter, as well as in treatment of patients with chronic prostatitis. It is shown, that prostatilen produces contractile action on smooth muscles of renal blood vessels in cats and urine bladder walls in rats and it raises contractile activity of smooth muscles of human urine bladder. The results of experimental and clinical investigations make it possible to recommend the application of this bioregulating preparation for treatment and prophylaxis of disturbances in urination.

  10. The influence of job characteristics on job outcomes of pharmacists in hospital, clinic, and community pharmacies.

    Science.gov (United States)

    Lin, Blossom Yen-Ju; Yeh, Ying-Chen; Lin, Wen-Hung

    2007-06-01

    This study examines the relationship between job characteristics and job outcomes of pharmacists in hospital, clinic, and community pharmacies in Taiwan. The structured questionnaires covered the items of job characteristics, job outcomes, and demographics of pharmacists, and were distributed between Feb 2004 and April 2004. Two hundred and ninety-eight pharmacists responded. Data were analyzed descriptively, and univariate analyses, factor analysis, and multiple regression analyses were used. It found the more enriched the job, the greater the job satisfaction and less intention to leave. And community pharmacists reported greater job enrichment and job satisfaction and less intention to leave than did hospital and clinic pharmacists. It suggests pharmacy managers could recognize the needs of pharmacists to redesign and enrich their work arrangements. PMID:17622026

  11. Problems for clinical judgement: 5. Principles of influence in medical practice.

    Science.gov (United States)

    Redelmeier, Donald A; Cialdini, Robert B

    2002-06-25

    The basic science of psychology has identified specific ingrained responses that are fundamental elements of human nature, underpin common influence strategies and may apply in medical settings. People feel a sense of obligation to repay a perceived debt. A request becomes more attractive when preceded by a marginally worse request. The drive to act consistently will persist even if demands escalate. Peer pressure is intense when people face uncertainty. The image of the requester influences the attractiveness of a request. Authorities have power beyond their expertise. Opportunities appear more valuable when they appear less available. These 7 responses were discovered decades ago in psychology research and seem intuitively understood in the business world, but they are rarely discussed in medical texts. An awareness of these principles can provide a framework for physicians to help patients change their behaviour and to understand how others in society sometime alter patients' choices. PMID:12126325

  12. Influence of picture element size on the quality of clinical radionuclide images

    Energy Technology Data Exchange (ETDEWEB)

    Sharp, P.F.; Chesser, R.B.; Mallard, J.R. (Aberdeen Univ. (UK). Dept. of Medical Physics)

    1982-07-01

    The effect of picture element (pixel) size on radionuclide image quality is investigated. Asked simply to state their preference for clinical images displayed with different pixel sizes, observers preferred those with the smallest pixel. Specific perceptual tasks, however, such as abnormality detection, are found to be insensitive to changes in pixel size up to a limit. Interpolation is found to have no effect on perceptual tasks, but 'random interpolation' produced a more pleasing image than simple linear interpolation.

  13. Clinical Factors and Viral Load Influencing Severity of Acute Hepatitis A.

    Directory of Open Access Journals (Sweden)

    Hyun Woong Lee

    Full Text Available Clinical manifestations of hepatitis A virus (HAV infection vary from mild to fulminant hepatic failure (FHF in adults. We investigated the relationship between laboratory findings, including viral load, and clinical outcomes in patients with acute hepatitis A (AHA and evaluated predictive factors for severe acute hepatitis (s-AH.We analyzed the clinical manifestations of AHA in 770 patients. Patients with a prothrombin time (PT of less than 40% of normal were classified as s-AH and included 4 patients with FHF, 11 patients with acute renal failure, and 3 patients with prolonged jaundice (n = 128. Other patients were defined as mild acute hepatitis (m-AH (n = 642. Serum samples were obtained from 48 patients with acute hepatitis A. Among them, 20 with s-AH, and 28 with m-AH, were tested for HAV RNA titer.In a multivariate analysis, age (HR = 1.042, P = 0.041, peak creatinine (HR = 4.014, P = 0.001, bilirubin (HR = 1.153, P = 0.003, alanine aminotransferase (ALT (HR = 1.001, P < 0.001, initial lactate dehydrogenase (LDH (HR = 1.000, P = 0.045 and total cholesterol (HR = 0.978, P < 0.001 were independent factors for s-AH. Serum HAV RNA was detected in 20/20 (100% patients with s-AH and 22/28 (78.6% patients with m-AH. In a multivariate analysis of the 48 patients who were tested for HAV RNA, peak ALT (HR = 1.001, P = 0.004 and HAV RNA titer (HR = 2.076, P = 0.012 were independent factors for s-AH.Clinical factors including age, peak creatinine, bilirubin, ALT, initial LDH and total cholesterol were independent factors for s-AH in a multivariate analysis. In particular, HAV load strongly correlated with the severity of hepatitis A.

  14. Incentives and barriers that influence clinical computerization in Hong Kong: A population-based physician survey

    OpenAIRE

    Leung, Gabriel M.; Yu, Philip L.H.; Wong, Irene O L; Johnston, Janice M.; Tin, Keith Y. K.

    2003-01-01

    Objective: Given the slow adoption of medical informatics in Hong Kong and Asia, we sought to understand the contributory barriers and potential incentives associated with information technology implementation. Design and Measurements: A representative sample of 949 doctors (response rate = 77.0%) was asked through a postal survey to rank a list of nine barriers associated with clinical computerization according to self-perceived importance. They ranked seven incentives or catalysts that may ...

  15. Delusional Disorder over the Reproductive Life Span: The Potential Influence of Menopause on the Clinical Course

    OpenAIRE

    Alexandre González-Rodríguez; Oriol Molina-Andreu; Rafael Penadés; Marina Garriga; Alexandre Pons; Rosa Catalán; Miguel Bernardo

    2015-01-01

    Background and Objectives. Recent evidence supports an association between estrogen levels and severity of psychopathology in schizophrenia women. Our main goal was to investigate whether delusional disorder (DD) women with premenopausal onset and those with postmenopausal onset differ in demographic and clinical features. Methods. Psychopathological symptoms were assessed in 80 DD women (DSM-IV-TR), at baseline and after six and 24 months. Scores in the PANSS, PSP for functionality, HRSD 17 ...

  16. Trauma reactivation under the influence of propranolol: an examination of clinical predictors

    OpenAIRE

    Poundja, Joaquin; Sanche, Steven; Tremblay, Jacques; Brunet, Alain

    2012-01-01

    Background: In two recent studies conducted by our group, a treatment combining propranolol with a brief reactivation session subsequently reduced posttraumatic stress disorder (PTSD) symptom severity and diagnosis, as well as reducing psychophysiological responses during trauma-related script-driven imagery. One likely explanation for those results is that memory reconsolidation was blocked by propranolol. Objective: We explored the influence of various predictors on treatment outcome (i.e.,...

  17. Factors influencing the outcome of intrauterine insemination (IUI): age, clinical variables and significant thresholds

    OpenAIRE

    Speyer, B.; Abramov, B.; Saab, W.; Doshi, A.; Sarna, U.; Harper, J. C.; Serhal, P

    2013-01-01

    The aim was to investigate the influence of various biological factors upon the outcome of intrauterine insemination (IUI). The total IUI history (856 cycles) of 352 couples was studied. Live-birth showed a strong negative correlation with female age but no correlation with male age. Antimullerian hormone (AMH) and antral follicle count (AFC) correlated negatively with female age, and follicle stimulating hormone (FSH) correlated positively. Significant thresholds were found for all three var...

  18. The Influence of BMX Gene Polymorphisms on Clinical Symptoms after Mild Traumatic Brain Injury

    Directory of Open Access Journals (Sweden)

    Yu-Jia Wang

    2014-01-01

    Full Text Available Mild traumatic brain injury (mTBI is one of the most common neurological disorders. Most patients diagnosed with mTBI could fully recover, but 15% of patients suffer from persistent symptoms. In recent studies, genetic factors were found to be associated with recovery and clinical outcomes after TBI. In addition, results from our previous research have demonstrated that the bone marrow tyrosine kinase gene in chromosome X (BMX, a member of the Tec family of kinases, is highly expressed in rats with TBI. Therefore, our aim in this study was to identify the association between genetic polymorphisms of BMX and clinical symptoms following mTBI. Four tagging single nucleotide polymorphisms (tSNPs of BMX with minimum allele frequency (MAF >1% were selected from the HapMap Han Chinese database. Among these polymorphisms, rs16979956 was found to be associated with the Beck anxiety inventory (BAI and dizziness handicap inventory (DHI scores within the first week after head injury. Additionally, another SNP, rs35697037, showed a significant correlation with dizziness symptoms. These findings suggested that polymorphisms of the BMX gene could be a potential predictor of clinical symptoms following mTBI.

  19. Trauma reactivation under the influence of propranolol: an examination of clinical predictors

    Directory of Open Access Journals (Sweden)

    Joaquin Poundja

    2012-02-01

    Full Text Available In two recent studies conducted by our group, a treatment combining propranolol with a brief reactivation session subsequently reduced posttraumatic stress disorder (PTSD symptom severity and diagnosis, as well as reducing psychophysiological responses during trauma-related script-driven imagery. One likely explanation for those results is that memory reconsolidation was blocked by propranolol.We explored the influence of various predictors on treatment outcome (i.e., PTSD severity, and whether the treated individuals improved in other important domains of functioning associated with PTSD.Thirty-three patients with longstanding PTSD participated in a 6-week open-label trial consisting of actively recalling one's trauma under the influence of propranolol, once a week.Treated patients reported a better quality of life, less comorbid depressive symptoms, less negative emotions in their daily life and during trauma recollections. Women were also found to improve more than men. Type of trauma (childhood vs. adulthood, time elapsed since trauma, borderline personality traits, depressive symptoms severity, Axis I comorbidity, and age did not influence treatment outcome.These results must await publication of a randomized-controlled trial to further delineate effectiveness with this novel treatment approach.For the abstract or full text in other languages, please see Supplementary files under Reading Toolsonline

  20. Can the clinical course of cancer be influenced by non-antineoplastic drugs?

    OpenAIRE

    Brandes, L. J.; Friesen, L A

    1995-01-01

    Laboratory and anecdotal clinical evidence suggests that some common non-antineoplastic drugs may affect the course of cancer. The authors present two cases that appear to be consistent with such a possibility: that of a 63-year-old woman in whom a high-grade angiosarcoma of the forehead improved after discontinuation of lithium therapy and then progressed rapidly when treatment with carbamazepine was started, and that of a 74-year-old woman with metastatic adenocarcinoma of the colon that re...

  1. The influence of clinical and pharmacological factors on enuresis treatment with imipramine.

    OpenAIRE

    Fernández de Gatta, M M; P. Galindo; Rey, F.; Gutierrez, J; Tamayo, M; García, M. J.; Domínguez-Gil, A

    1990-01-01

    1. The aim of this study has been to evaluate the response to imipramine treatment in enuretic children through the use of a series of clinical and pharmacological variables and by applying a multivariate (principal components) analysis technique. 2. The study was carried out on 146 children whose ages ranged from 5 to 14 years, and who received variable doses of imipramine (12.5 to 100 mg day-1). 3. The quantitative variables analyzed were: drug dosage, serum levels of imipramine and its met...

  2. Genetic modifiers of sickle cell anemia in the BABY HUG cohort: influence on laboratory and clinical phenotypes.

    Science.gov (United States)

    Sheehan, Vivien A; Luo, Zhaoyu; Flanagan, Jonathan M; Howard, Thad A; Thompson, Bruce W; Wang, Winfred C; Kutlar, Abdullah; Ware, Russell E

    2013-07-01

    The recently completed BABY HUG trial investigated the safety and efficacy of hydroxyurea in infants with sickle cell anemia (SCA). To investigate the effects of known genetic modifiers, genomic DNA on 190 randomized subjects were analyzed for alpha thalassemia, beta-globin haplotype, polymorphisms affecting endogenous fetal hemoglobin (HbF) levels (XmnI, BCL11A, and HBS1L-MYB), UGT1A1 promoter polymorphisms, and the common G6PD A(-) mutation. At study entry, infants with alpha thalassemia trait had significantly lower mean corpuscular volume, total bilirubin, and absolute reticulocyte count. Beta-globin haplotypes associated with milder disease had significantly higher hemoglobin and %HbF. BCL11A and XmnI polymorphisms had significant effects on baseline HbF, while UGT1A1 promoter polymorphisms significantly influenced baseline serum bilirubin. At study exit, subjects randomized to placebo still exhibited laboratory effects of alpha thalassemia and other modifiers, while those assigned hydroxyurea had treatment effects that exceeded most genetic influences. The pain phenotype was influenced by HbF modifiers in both treatment groups. These data document that genetic polymorphisms do modify laboratory and clinical phenotypes even in very young patients with SCA. The hydroxyurea effects are more potent, however, indicating that treatment criteria should not be limited to certain genetic subsets, and supporting the use of hydroxyurea for all young patients with SCA. PMID:23606168

  3. Episiotomy and its relationship to various clinical variables that influence its performance

    Science.gov (United States)

    Ballesteros-Meseguer, Carmen; Carrillo-García, César; Meseguer-de-Pedro, Mariano; Canteras-Jordana, Manuel; Martínez-Roche, Mª Emilia

    2016-01-01

    Objective: to understand the episiotomy rate and its relationship with various clinical variables. Method: a descriptive, cross-sectional, analytic study of 12,093 births in a tertiary hospital. Variables: Parity, gestational age, start of labor, use of epidural analgesia, oxytocin usage, position during fetal explusion, weight of neonate, and completion of birth. The analysis was performed with SPSS 19.0. Results: the global percentage of episiotomies was 50%. The clinical variables that presented a significant association were primiparity (RR=2.98), gestational age >41 weeks (RR=1.2), augmented or induced labor (RR=1.33), epidural analgesia use (RR=1,95), oxytocin use (RR=1.58), lithotomy position during fetal expulsion (RR=6.4), and instrumentation (RR=1.84). Furthermore, maternal age ≥35 years (RR=0.85) and neonatal weight <2500 g (RR=0.8) were associated with a lower incidence of episiotomy. Conclusions: episiotomy is dependent on obstetric interventions performed during labor. If we wish to reduce the episiotomy rate, it will be necessary to bear in mind these risk factors when establishing policies for reducing this procedure. PMID:27224064

  4. A clinical study on the influence of suturing material on oral wound healing

    Directory of Open Access Journals (Sweden)

    Gazivoda Dragan

    2015-01-01

    Full Text Available Background/Aim. Suture materials play an important role in healing, enabling reconstruction and reassembly of tissue separated by the surgical procedure or trauma, and at the same time facilitating and promoting healing and hemostasis. Suture materials are used daily in oral surgery, and are considered to be substances most commonly implanted in human body. The aim of this clinical study was to examine the speed of wound healing and complications incidence, after the use of three different absorbable synthetic suture materials in oral surgery (catgut, Dexon and Vicryl rapide, and to ascertain which one is the most suitable for oral surgery. Methods. The study was conducted on 96 patients undergoing root resection or surgical extraction of third molars. Each of the suture materials (catgut, Dexon and Vicryl rapide was used for 8 root resections and 8 surgical third molar extractions in the maxilla, as well as in the mandible (a total of 32 surgical interventions for each suture material. Results. The faster wound healing was obtained with Vicryl rapide compared to other two suturing material tested. There was no significant difference regarding the presence of local reaction in all the three groups of patients on the 21st postoperative day. Conclusion. The results of our clinical study point out that Vycrilrapid contributes more than catgut or Dexon to faster healing of human wounds, with fewer incidences of wound dehiscence and milder local reactions.

  5. The influence of family history on prostate cancer risk: implications for clinical management.

    Science.gov (United States)

    Madersbacher, Stephan; Alcaraz, Antonio; Emberton, Mark; Hammerer, Peter; Ponholzer, Anton; Schröder, Fritz H; Tubaro, Andrea

    2011-03-01

    • The most recent evidence for the link between a family history of prostate cancer and individual risk for future disease was examined, with the aim of understanding what the existence and nature of a family history of prostate cancer does to a man's risk of developing the disease. • Our findings highlighted the clear association between a family history of prostate cancer and increased risk of developing the disease; with a greater proximity of relatedness, greater number of family members affected and/or earlier age at diagnosis of the family member elevating risk further. • These findings have important clinical implications for the identification and subsequent management of men deemed to be at increased risk of developing prostate cancer. The evidence for prostate cancer risk reduction with the mono 5α-reductase inhibitor (5ARI) finasteride in a low-risk population and, more recently, with the dual 5ARI dutasteride in a population at increased risk of developing the disease, has potential to expand management options for men at risk of developing prostate cancer beyond more frequent and/or earlier surveillance. • Given that family history can be easily assessed in routine clinical practice, it should be regarded as an important parameter to consider alongside PSA level for prostate cancer risk assessment. PMID:21166744

  6. Influence of clinical and socioeconomic indicators on dental trauma in preschool children

    Directory of Open Access Journals (Sweden)

    Patrícia CORRÊA-FARIA

    2015-01-01

    Full Text Available The aim of the present study was to determine the prevalence of traumatic dental injury (TDI in the primary dentition and investigate associations with clinical and socioeconomic indicators. A population-based, cross-sectional study was carried out with a randomly selected sample of 301 children aged one to five years. Data were collected through clinical oral examinations and interviews with parents/guardians during immunization campaigns. Statistical analysis involved Pearson’s Chi-squared test and Poisson regression with robust variance. The prevalence of TDI was 33.9%. TDI was more prevalent in children with overjet > 3 mm (p < 0.001 and those with inadequate lip coverage (p < 0.001. A statistically significant association was also found between TDI and household income (p = 0.024. According to the adjusted Poisson regression model, greater prevalence rates of TDI were found for children from families with a monthly income ≥ twice the Brazilian minimum monthly wage (PR: 1.52; 95%CI: 1.10-2.12, those with accentuated overjet (PR: 1.53; 95%CI: 1.05-2.22 and those with inadequate lip coverage (PR: 2.00; 95%CI: 1.41-2.84. The prevalence of TDI was high in the present study and was associated with a higher family income, accentuated overjet and inadequate lip coverage.

  7. Episiotomy and its relationship to various clinical variables that influence its performance

    Directory of Open Access Journals (Sweden)

    Carmen Ballesteros-Meseguer

    2016-01-01

    Full Text Available Objective: to understand the episiotomy rate and its relationship with various clinical variables. Method: a descriptive, cross-sectional, analytic study of 12,093 births in a tertiary hospital. Variables: Parity, gestational age, start of labor, use of epidural analgesia, oxytocin usage, position during fetal explusion, weight of neonate, and completion of birth. The analysis was performed with SPSS 19.0. Results: the global percentage of episiotomies was 50%. The clinical variables that presented a significant association were primiparity (RR=2.98, gestational age >41 weeks (RR=1.2, augmented or induced labor (RR=1.33, epidural analgesia use (RR=1,95, oxytocin use (RR=1.58, lithotomy position during fetal expulsion (RR=6.4, and instrumentation (RR=1.84. Furthermore, maternal age ≥35 years (RR=0.85 and neonatal weight <2500 g (RR=0.8 were associated with a lower incidence of episiotomy. Conclusions: episiotomy is dependent on obstetric interventions performed during labor. If we wish to reduce the episiotomy rate, it will be necessary to bear in mind these risk factors when establishing policies for reducing this procedure.

  8. Quantum noise influencing human behaviour could fake effectiveness of drugs in clinical trials

    CERN Document Server

    Janzing, D; Janzing, Dominik; Beth, Thomas

    2002-01-01

    To test the effectiveness of a drug one can advice two randomly selected groups of patients to take or not to take it, respectively. It is well-known that the causal effect cannot be identified if not all patients comply. This holds even when the non-compliers can be identified afterwards since latent factors like patient's personality can influence both his decision and his physical response. However, one can still give bounds on the effectiveness of the drug depending on the rate of compliance. Remarkably, the proofs of these bounds given in the literature rely on models that represent all relevant latent factors (including noise) by hidden classical variables. In strong analogy to the violation of Bell's inequality, some of these bounds fail if patient's behavior is influenced by latent quantum processes (e.g. in his nervous system). Quantum effects could fake an increase of the recovery rate by about 13% although the drug would hurt as many patients as it would help if everyone took it. The other bounds a...

  9. Should the host reaction to anisakiasis influence the treatment?: Different clinical presentations in two cases

    Directory of Open Access Journals (Sweden)

    Stefano Pontone

    2012-12-01

    Full Text Available Gastrointestinal anisakiasis is a parasitic infection occurring in people that consume raw or inadequately cooked fish or squid. It is frequently characterized by severe epigastric pain, nausea and vomiting caused by the penetration of the larvae into the gastric wall. Acute gastric anisakiasis with severe chest discomfort is rarely reported in Italy. On the other hand, gastro-allergic anisakiasis with rash, urticaria and isolated angioedema or anaphylaxis is a clinical entity that has been described only recently. Also, if patients usually develop symptoms within 12 hours after raw seafood ingestion, not always endoscopic exploration can promptly identify the Anisakis larvae. Moreover, some authors consider the prevailing allergic reaction as a natural and effective defense against the parasitic attack. We report two cases of peculiar manifestations of anisakiasis in both acute and chronic forms (severe chest discomfort and anaphylactoid reaction.

  10. Variations in the influence of parental socialization of anxiety among clinic referred children.

    Science.gov (United States)

    Holly, Lindsay E; Pina, Armando A

    2015-06-01

    This study examined the relations between parental socialization of child anxious behaviors (i.e., reinforcement, punishment, modeling, transmission of information) and child anxiety and related problems at varying child sensitivity levels. Data corresponding to 70 clinic-referred children (M age = 9.86 years; 50% girls; 49% Hispanic/Latino, 51% Caucasian) showed that for children with low (but not high) anxiety sensitivity, anxiety-related parental socialization behaviors were associated with more child anxiety and depression symptoms. Findings also indicated that parental socialization of anxious behaviors and anxiety sensitivity functioned similarly in the prediction of anxiety and depression across Caucasian and Hispanic/Latino children. There were no significant mean level variations across child sociodemographic characteristics in general, but anxiety-promoting parenting behaviors were twice as high in Hispanic/Latino compared to Caucasian families.

  11. Non-genetic risk factors and their influence on the management of patients in the clinic.

    Science.gov (United States)

    Álvarez, Teresa; Soto, Immaculada; Astermark, Jan

    2015-02-01

    The development of inhibitors is the most serious iatrogenic complication affecting patients with haemophilia. This complication is associated with impaired vital or functional prognosis, reduced quality of life and increased cost of treatment. The reasons why some patients develop antibodies to factor replacement and others do not remain unclear. It is however clear that inhibitor development results from a complex multifactorial interaction between genetic and non-genetic risk factors. Environmental influences implicated in increasing the risk of inhibitor formation can be viewed as modifiable risk factors. Therefore, identification of the non-genetic risk factors may offer the possibility of personalising haemophilia therapy by modifying treatment strategies in high-risk patients in the critical early phase of factor VIII exposure. In this article, we review the non-genetic factors reported as well as the potential impact of danger signals and the different scores for inhibitor development risk stratification.

  12. Factors influencing the outcome of intrauterine insemination (IUI): age, clinical variables and significant thresholds.

    Science.gov (United States)

    Speyer, B E; Abramov, B; Saab, W; Doshi, A; Sarna, U; Harper, J C; Serhal, P

    2013-10-01

    The aim was to investigate the influence of various biological factors upon the outcome of intrauterine insemination (IUI). The total IUI history (856 cycles) of 352 couples was studied. Live-birth showed a strong negative correlation with female age but no correlation with male age. Antimüllerian hormone (AMH) and antral follicle count (AFC) correlated negatively with female age, and follicle stimulating hormone (FSH) correlated positively. Significant thresholds were found for all three variables, and also for total motile count (TMC) in the prepared sperm. Calculating pregnancy losses per positive pregnancy showed a strong correlation with increasing female age. This was highly significant for biochemical losses but not for fetal heart miscarriages. Male age had no effect on rate of pregnancy loss. In conclusion, female age, FSH, AMH and TMC are good predictive factors for live-birth and therefore relate to essential in vivo steps in the reproductive process. PMID:24127958

  13. Influences of intermittent preventive treatment and persistent multiclonal Plasmodium falciparum infections on clinical malaria risk.

    Directory of Open Access Journals (Sweden)

    Anne Liljander

    Full Text Available BACKGROUND: Intermittent preventive treatment (IPT of malaria involves administration of curative doses of antimalarials at specified time points to vulnerable populations in endemic areas, regardless whether a subject is known to be infected. The effect of this new intervention on the development and maintenance of protective immunity needs further understanding. We have investigated how seasonal IPT affects the genetic diversity of Plasmodium falciparum infections and the risk of subsequent clinical malaria. MATERIAL AND METHODS: The study included 2227 Ghanaian children (3-59 months who were given sulphadoxine-pyrimethamine (SP bimonthly, artesunate plus amodiaquine (AS+AQ monthly or bimonthly, or placebo monthly for six months spanning the malaria transmission season. Blood samples collected at three post-interventional surveys were analysed by genotyping of the polymorphic merozoite surface protein 2 gene. Malaria morbidity and anaemia was monitored during 12 months follow-up. RESULTS: Monthly IPT with AS+AQ resulted in a marked reduction in number of concurrent clones and only children parasite negative just after the intervention period developed clinical malaria during follow-up. In the placebo group, children without parasites as well as those infected with ≥2 clones had a reduced risk of subsequent malaria. The bimonthly SP or AS+AQ groups had similar number of clones as placebo after intervention; however, diversity and parasite negativity did not predict the risk of malaria. An interaction effect showed that multiclonal infections were only associated with protection in children without intermittent treatment. CONCLUSION: Molecular typing revealed effects of the intervention not detected by ordinary microscopy. Effective seasonal IPT temporarily reduced the prevalence and genetic diversity of P. falciparum infections. The reduced risk of malaria in children with multiclonal infections only seen in untreated children suggests that

  14. An innovative OSCE clinical log station: a quantitative study of its influence on Log use by medical students

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    Hudson Judith N

    2012-11-01

    Full Text Available Abstract Background A Clinical Log was introduced as part of a medical student learning portfolio, aiming to develop a habit of critical reflection while learning was taking place, and provide feedback to students and the institution on learning progress. It was designed as a longitudinal self-directed structured record of student learning events, with reflection on these for personal and professional development, and actions planned or taken for learning. As incentive was needed to encourage student engagement, an innovative Clinical Log station was introduced in the OSCE, an assessment format with established acceptance at the School. This study questions: How does an OSCE Clinical Log station influence Log use by students? Methods The Log station was introduced into the formative, and subsequent summative, OSCEs with careful attention to student and assessor training, marking rubrics and the standard setting procedure. The scoring process sought evidence of educational use of the log, and an ability to present and reflect on key learning issues in a concise and coherent manner. Results Analysis of the first cohort’s Log use over the four-year course (quantified as number of patient visits entered by all students revealed limited initial use. Usage was stimulated after introduction of the Log station early in third year, with some improvement during the subsequent year-long integrated community-based clerkship. Student reflection, quantified by the mean number of characters in the ‘reflection’ fields per entry, peaked just prior to the final OSCE (mid-Year 4. Following this, very few students continued to enter and reflect on clinical experience using the Log. Conclusion While the current study suggested that we can’t assume students will self-reflect unless such an activity is included in an assessment, ongoing work has focused on building learner and faculty confidence in the value of self-reflection as part of being a competent

  15. Clinical indicators of child development in the capitals of nine Brazilian states: the influence of regional cultural factors

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    André Laranjeira de Carvalho

    2008-01-01

    Full Text Available OBJECTIVE: Evaluating the interaction between mother or caregiver and infant through the Clinical Indicators of Risks in Infant Development and investigating whether local and cultural influences during infant development affect these clinical indicators. INTRODUCTION: The Clinical Indicators of Risks in Infant Development was created in order to fully assess infants' development and the subjective relationship between the babies and their caregivers. The absence of two or more Clinical Indicators of Risks in Infant Developments suggests a possibly inadequate mental development. Given the continental size of Brazil and its accentuated cultural differences, one might question how trustworthy these indicators can be when applied to each of the geographical regions of the country. METHODS: This was a cross-sectional study with 737 infants from the capitals of 9 Brazilian states. The size of the initial sample population was based on a pilot study carried out in the cities of São Paulo and Brasília. The ages of children were grouped: 0-3 months, 4-7 months, 8-11 months and 12-18 months. The chi-square test was used together with analyses by the statistical software SPSS 13.0. RESULTS: Statistical analysis of results from the different municipalities against the total sample did not reveal any statistically significant differences. Municipalities represented were Belém (p=0.486, Brasília (p=0.371, Porto Alegre (p=0.987, Fortaleza (p=0.259, Recife (p=0.630, Salvador (0.370, São Paulo (p=0.238, Curitiba (p=0.870, and Rio de Janeiro (p= 0.06. DISCUSSION: Care for mental development should be considered a public health issue. Its evaluation and follow-up should be part of the already available mother-child assistance programs, which would then be considered to provide "full" care to children. CONCLUSIONS: Local habits and culture did not affect the results of the Clinical Indicators of Risks in Infant Development indicators. Clinical Indicators of

  16. Astrocytic IL-6 Influences the Clinical Symptoms of EAE in Mice.

    Science.gov (United States)

    Erta, Maria; Giralt, Mercedes; Jiménez, Silvia; Molinero, Amalia; Comes, Gemma; Hidalgo, Juan

    2016-01-01

    Interleukin-6 (IL-6) is a multifunctional cytokine that not only plays major roles in the immune system, but also serves as a coordinator between the nervous and endocrine systems. IL-6 is produced in multiple cell types in the CNS, and in turn, many cells respond to it. It is therefore important to ascertain which cell type is the key responder to IL-6 during both physiological and pathological conditions. In order to test the role of astrocytic IL-6 in neuroinflammation, we studied an extensively-used animal model of multiple sclerosis, experimental autoimmune encephalomyelitis (EAE), in mice with an IL-6 deficiency in astrocytes (Ast-IL-6 KO). Results indicate that lack of astrocytic IL-6 did not cause major changes in EAE symptomatology. However, a delay in the onset of clinical signs was observed in Ast-IL-6 KO females, with fewer inflammatory infiltrates and decreased demyelination and some alterations in gliosis and vasogenesis, compared to floxed mice. These results suggest that astrocyte-secreted IL-6 has some roles in EAE pathogenesis, at least in females. PMID:27196935

  17. Delusional Disorder over the Reproductive Life Span: The Potential Influence of Menopause on the Clinical Course

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    Alexandre González-Rodríguez

    2015-01-01

    Full Text Available Background and Objectives. Recent evidence supports an association between estrogen levels and severity of psychopathology in schizophrenia women. Our main goal was to investigate whether delusional disorder (DD women with premenopausal onset and those with postmenopausal onset differ in demographic and clinical features. Methods. Psychopathological symptoms were assessed in 80 DD women (DSM-IV-TR, at baseline and after six and 24 months. Scores in the PANSS, PSP for functionality, HRSD 17 items, C-SSRS for suicide, and the SUMD were considered outcome variables. For comparison purposes, t- and χ2-tests were performed and nonparametric tests when necessary. Analysis of Covariance (ANCOVA was conducted for multivariate comparisons. Results. 57 out of 80 DD women completed the study. When unadjusted, DD with premenopausal onset had a longer DUP, higher educational level, and a tendency toward higher rates of gynaecological disorders. Erotomanic type was most frequent in DD women premenopausal onset, and somatic and jealous types were most frequent in those with postmenopausal onset. After 24 months, DD women with premenopausal onset showed higher depressive symptoms and a tendency toward higher rates of psychotic relapses. Conclusions. Our results support that some aspects of psychopathology and insight may differ according to the onset of DD and the reproductive status.

  18. Influence of weight loss on the clinical manifestations of osteoarthritis of the knee-joints.

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    Inna Vladimirovna Solov'eva

    2014-10-01

    Full Text Available Obesity consistently associated with the development of a number of chronic diseases, leading to a decrease in quality of life, disability and death. The article examines the connection between obesity and disease of the musculoskeletal system, describes the mechanisms by means of which obesity leads to the development of osteoarthritis. It is evident that reduction of body mass can slow the progression of osteoporosis. The own experience of non-pharmacological and pharmacological treatment of obesity with the use of orlistat in 50 obese patients with osteoarthritis of the knee II–III stage is presented. Treatment has resulted in a decrease in body weight, waist circumference, accompanied by a decrease in symptoms osteoarthritis among all the patients. Our results showed that the addition of orlistat to standard osteoarthritis scheme leads to significant reduction in weight and reduction of clinical manifestations of osteoarthritis. According to the above, the drugs that have impact on weight loss, should be included in the treatment regimen of patients with osteoarthritis and obesity.

  19. Extubation failure influences clinical and functional outcomes in patients with traumatic brain injury

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    Helena Franca Correia dos Reis

    2013-06-01

    Full Text Available OBJECTIVE: To evaluate the association between extubation failure and outcomes (clinical and functional in patients with traumatic brain injury (TBI. METHODS: A prospective cohort study involving 311 consecutive patients with TBI. The patients were divided into two groups according to extubation outcome: extubation success; and extubation failure (defined as reintubation within 48 h after extubation. A multivariate model was developed in order to determine whether extubation failure was an independent predictor of in-hospital mortality. RESULTS: The mean age was 35.7 ± 13.8 years. Males accounted for 92.3%. The incidence of extubation failure was 13.8%. In-hospital mortality was 4.5% and 20.9% in successfully extubated patients and in those with extubation failure, respectively (p = 0.001. Tracheostomy was more common in the extubation failure group (55.8% vs. 1.9%; p < 0.001. The median length of hospital stay was significantly greater in the extubation failure group than in the extubation success group (44 days vs. 27 days; p = 0.002. Functional status at discharge was worse among the patients in the extubation failure group. The multivariate analysis showed that extubation failure was an independent predictor of in-hospital mortality (OR = 4.96; 95% CI, 1.86-13.22. CONCLUSIONS: In patients with TBI, extubation failure appears to lengthen hospital stays; to increase the frequency of tracheostomy and of pulmonary complications; to worsen functional outcomes; and to increase mortality.

  20. The influence of clinical and pharmacological factors on enuresis treatment with imipramine.

    Science.gov (United States)

    Fernández de Gatta, M M; Galindo, P; Rey, F; Gutierrez, J; Tamayo, M; García, M J; Domínguez-Gil, A

    1990-11-01

    1. The aim of this study has been to evaluate the response to imipramine treatment in enuretic children through the use of a series of clinical and pharmacological variables and by applying a multivariate (principal components) analysis technique. 2. The study was carried out on 146 children whose ages ranged from 5 to 14 years, and who received variable doses of imipramine (12.5 to 100 mg day-1). 3. The quantitative variables analyzed were: drug dosage, serum levels of imipramine and its metabolite desipramine, the relationship between them both, the duration of treatment, age and weight. 4. The qualitative variables were: compliance, presence of side-effects, enuretic and/or psychiatric antecedents, intelligence quotient (I.Q.), the existence (or absence) of related pathologies, sex, and the type of enuresis. 5. The response to treatment was quantified by means of the percentage of decrease in frequency of enuresis as compared with the initial frequency. 6. The results obtained show that the variables which are most associated with the reduction of enuresis are, in decreasing order: the dosage of imipramine administered, the duration of treatment, compliance and the level/dose ratio for the sum of the drug and metabolite levels. PMID:2271368

  1. Delusional Disorder over the Reproductive Life Span: The Potential Influence of Menopause on the Clinical Course.

    Science.gov (United States)

    González-Rodríguez, Alexandre; Molina-Andreu, Oriol; Penadés, Rafael; Garriga, Marina; Pons, Alexandre; Catalán, Rosa; Bernardo, Miguel

    2015-01-01

    Background and Objectives. Recent evidence supports an association between estrogen levels and severity of psychopathology in schizophrenia women. Our main goal was to investigate whether delusional disorder (DD) women with premenopausal onset and those with postmenopausal onset differ in demographic and clinical features. Methods. Psychopathological symptoms were assessed in 80 DD women (DSM-IV-TR), at baseline and after six and 24 months. Scores in the PANSS, PSP for functionality, HRSD 17 items, C-SSRS for suicide, and the SUMD were considered outcome variables. For comparison purposes, t- and χ (2)-tests were performed and nonparametric tests when necessary. Analysis of Covariance (ANCOVA) was conducted for multivariate comparisons. Results. 57 out of 80 DD women completed the study. When unadjusted, DD with premenopausal onset had a longer DUP, higher educational level, and a tendency toward higher rates of gynaecological disorders. Erotomanic type was most frequent in DD women premenopausal onset, and somatic and jealous types were most frequent in those with postmenopausal onset. After 24 months, DD women with premenopausal onset showed higher depressive symptoms and a tendency toward higher rates of psychotic relapses. Conclusions. Our results support that some aspects of psychopathology and insight may differ according to the onset of DD and the reproductive status. PMID:26600949

  2. Influence of Peritoneal Transport Characteristics on Nutritional Status and Clinical Outcome in Chinese Diabetic Nephropathy Patients on Peritoneal Dialysis

    Institute of Scientific and Technical Information of China (English)

    Ji-Chao Guan; Wei Bian; Xiao-Hui Zhang; Zhang-Fei Shou; Jiang-Hua Chen

    2015-01-01

    Background:High peritoneal transport status was previously thought to be a poor prognostic factor in peritoneal dialysis (PD) patients.However,its effect on diabetic nephropathy PD patients is unclear in consideration of the adverse impact of diabetes itself.The purpose of this study was to investigate the influence of peritoneal transport characteristics on nutritional status and clinical outcome in diabetic nephropathy patients on PD.Methods:One hundred and two diabetic nephropathy patients on PD were enrolled in this observational cohort study.According to the initial peritoneal equilibration test result,patients were divided into two groups:Higher transport group (HT,including high and high average transport) and lower transport group (LT,including low and low-average transport).Demographic characteristics,biochemical data,dialysis adequacy,and nutritional status were evaluated.Clinical outcomes were compared.Risk factors for death-censored technique failure and mortality were analyzed.Results:Compared with LT group (n =37),serum albumin was significantly lower and the incidence of malnutrition by subjective global assessment was significantly higher in HT group (n =65) (P < 0.05).Kaplan-Meier analyses showed that death-censored technique failure and mortality were significantly increased in HT group compared with that in LT group.On multivariate Cox analyses,higher peritoneal transport status and lower residual renal function (RRF) were independent predictors of death-censored technique failure when adjusted for serum albumin and total weekly urea clearance (Kt/V).Independent predictors of mortality were advanced age,anemia,hypoalbuminemia,and lower RRF,but not higher peritoneal transport status.Conclusions:Higher peritoneal transport status has an adverse influence on nutrition for diabetic nephropathy patients on PD.Higher peritoneal transport status is a significant independent risk factor for death-censored technique failure,but not for mortality in

  3. Influence of hydrotherapy on clinical and cardiac autonomic function in migraine patients

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    M U Sujan

    2016-01-01

    Full Text Available Background: Migraine is associated with autonomic symptoms. The growing body of literature suggests that the dysfunctional autonomic nervous system might play a pivotal role in the pathogenesis of migraine. Thermal therapies have been hypothesized to modulate these changes and alleviate pain. However, data regarding the efficacy of hydrotherapy in migraine remain scant. We evaluated the effect of add on hydrotherapy procedure (a hot arm and foot bath with ice massage to head in migraine patients. Methods: Forty chronic migraine patients fulfilling the International Classification of Headache Disorders II criteria were recruited from the neurology outpatient clinic. Patients were randomized to receive either hydrotherapy plus conventional pharmacological care (n = 20 or conventional medication only (n = 20. Hydrotherapy group received treatment with hot arm and foot bath (103°F to 110°F and ice massage to head daily for 20 min for 45 days. Patients were assessed using headache impact test (HIT, visual analog scale for pain and cardiac autonomic function by heart rate variability (HRV before and after intervention period. Results: There was a significant decrease in HIT score, frequency, and intensity of headaches following treatment in both the groups. However, it was more evident in add on hydrotherapy group compared to pharmacological treatment alone group. There was also significant improvement in the HRV parameters. In particular, there was a significant decrease in heart rate (P = 0.017, increase in high frequency (HF (P = 0.014 and decrease in low frequency/HF ratio (P = 0.004 in add on hydrotherapy group. Conclusion: Our study shows that add on hydrotherapy enhanced the vagal tone in addition to reducing the frequency and intensity of headaches in migraine patients.

  4. A thermal monitoring sheet with low influence from adjacent waterbolus for tissue surface thermometry during clinical hyperthermia.

    Science.gov (United States)

    Arunachalam, Kavitha; Maccarini, Paolo F; Stauffer, Paul R

    2008-10-01

    This paper presents a complete thermal analysis of a novel conformal surface thermometer design with directional sensitivity for real-time temperature monitoring during hyperthermia treatments of large superficial cancer. The thermal monitoring sheet (TMS) discussed in this paper consists of a 2-D array of fiberoptic sensors embedded between two layers of flexible, low-loss, and thermally conductive printed circuit board (PCB) film. Heat transfer across all interfaces from the tissue surface through multiple layers of insulating dielectrics surrounding the small buried temperature sensor and into an adjacent temperature-regulated water coupling bolus was studied using 3-D thermal simulation software. Theoretical analyses were carried out to identify the most effective differential TMS probe configuration possible with commercially available flexible PCB materials and to compare their thermal responses with omnidirectional probes commonly used in clinical hyperthermia. A TMS sensor design that employs 0.0508-mm Kapton MTB and 0.2032-mm Kapton HN flexible polyimide films is proposed for tissue surface thermometry with low influence from the adjacent waterbolus. Comparison of the thermal simulations with clinical probes indicates the new differential TMS probe design to outperform in terms of both transient response and steady-state accuracy in selectively reading the tissue surface temperature, while decreasing the overall thermal barrier of the probe between the coupling waterbolus and tissue surface.

  5. Influence of the training: " Clinical practice based on the evidence " in the daily practice of the nurse

    Directory of Open Access Journals (Sweden)

    Ligia Rojas Valenciano

    2013-10-01

    Full Text Available The aim of this article is to present the results of the project Not. 421-B1-261: Influence of the training of theClinical Practice Based on the Evidence on the daily practice of the professional of nursing, approved by the Vicerrectoríaof Investigation of the University of Costa Rica. The commitment to renew the practice of Nursing in Costa Rica relates in adirect way to the improvement of the health of the society both in the collective thing and in the individual thing, in order toreduce the mistakes in the practice. A search was realized in EBSCO's databases, PubMed, Academic Research Completes,MedLine Plus and Scielo. A preliminary search was carried out, then limits of search interfered per date and describers;finally, for the critical analysis they were included only to complete text by title and they summarize 30 documents thatincluded reviews of literature, primary studies and conceptual frames that were relevant to give response to the clinicalquestion. Of 30 documents only it was considered six of them by your content, methodological structure and quality.Though there was not situated a forceful and direct response to the clinical question raised in this study, for the effectedreview it is possible to conclude that the professionals of Nursing consider to be essential the enrichment of a clinicalpractice based on the evidence, which generates a major quality and safety in the executed care.

  6. Influences of season, parity, lactation, udder area, milk yield, and clinical symptoms on intramammary infection in dairy cows.

    Science.gov (United States)

    Zhang, Z; Li, X P; Yang, F; Luo, J Y; Wang, X R; Liu, L H; Li, H S

    2016-08-01

    The aim of this study was to evaluate the influences of season, parity, lactation, udder area, milk yield, and clinical symptoms on bacterial intramammary infection (IMI) in dairy cows. A total of 2,106 mastitis pathogens in 12 species were isolated from 125 dairy farms distributed in 30 different cities in China, and the information about these factors was recorded at the same time. Mastitis pathogens were isolated from 63.43% of the milk samples, whereas Streptococcus agalactiae accounted for 38.61% of all pathogens, followed by Str. dysgalactiae (28.16%), Staphylococcus aureus (19.10%), Escherichia coli (6.90%), and other pathogens (7.23%). According to our investigation, IMI was more common in spring with the isolation rate of pathogens at 81.04%, and lowest in winter (52.34%). Cows were more likely to be infected by environmental pathogens (E. coli or Str. uberis) in summer, in rear quarters and in cows with higher daily milk yield or lower somatic cell count. In addition, Str. dysgalactiae exhibited a higher prevalence with increased parity. Different clinical symptoms of quarters with bacterial IMI were seen in this study, and mastitis pathogens were isolated from healthy quarters. PMID:27265170

  7. Access to reliable information about long-term prognosis influences clinical opinion on use of lifesaving intervention.

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    Stephen Honeybul

    Full Text Available BACKGROUND: Decompressive craniectomy has been traditionally used as a lifesaving rescue treatment in severe traumatic brain injury (TBI. This study assessed whether objective information on long-term prognosis would influence healthcare workers' opinion about using decompressive craniectomy as a lifesaving procedure for patients with severe TBI. METHOD: A two-part structured interview was used to assess the participants' opinion to perform decompressive craniectomy for three patients who had very severe TBI. Their opinion was assessed before and after knowing the predicted and observed risks of an unfavourable long-term neurological outcome in various scenarios. RESULTS: Five hundred healthcare workers with a wide variety of clinical backgrounds participated. The participants were significantly more likely to recommend decompressive craniectomy for their patients than for themselves (mean difference in visual analogue scale [VAS] -1.5, 95% confidence interval -1.3 to -1.6, especially when the next of kin of the patients requested intervention. Patients' preferences were more similar to patients who had advance directives. The participants' preferences to perform the procedure for themselves and their patients both significantly reduced after knowing the predicted risks of unfavourable outcomes, and the changes in attitude were consistent across different specialties, amount of experience in caring for similar patients, religious backgrounds, and positions in the specialty of the participants. CONCLUSIONS: Access to objective information on risk of an unfavourable long-term outcome influenced healthcare workers' decision to recommend decompressive craniectomy, considered as a lifesaving procedure, for patients with very severe TBI.

  8. A Clinical Investigation into the Factors Influencing the Prognosis of Patients with Primary Liver Cancer after Hepatectomy

    Institute of Scientific and Technical Information of China (English)

    Ji Xi-qing; Li Chao-long; Sheng Xing-hua

    2005-01-01

    Objective To explore the factors influencing the prognosis of patients with primary liver cancer(PLC) after hepatectomy on purpose to provide the preventive measures for improving the long-term effect.Methods All of the 189 patients who underwent hepatectomy with PLC from May,1994 to January,1998 were included by reviewing their clinical pathological characteristics and treatments. Totally, 22 factors contributed to the long-term survival rate(SR)and the disease-free SR were analysed . All patients were followed up at least 5 years. Results The 3- and 5-year cumulative SRs in the total group were 63% and 45% respectively. The 3- and 5-year SRs and disease-free SRs in the curative resection (CR) group (n=162) were 67%,47%,and 45% and 26% respectively. It was showed that the way by which a tumor was found, tumor size, portal thrombi, satellite nodule, cirrhosis type, TNM stage, tumor envelope, recurrence and treatment, vascular exclusion and transfusion, differentiation grade and CR were prognostic factors by individual variable analysis. A multivariable analysis showed that CR , tumor size and reoperation were significant factors associated with the prognosis. Conclusion The type of CR and tumor size are determinants influencing the prognosis. Early diagnosis of small carcinoma and CR as soon as possible is essential to improving the prognosis of PLC. Avoiding transfusion and controlling the progress of cirrhosis are expected to improve the disease-free SR.

  9. The clinical potential of influencing Nrf2 signaling in degenerative and immunological disorders

    Directory of Open Access Journals (Sweden)

    Gao B

    2014-02-01

    Full Text Available Bifeng Gao, An Doan, Brooks M HybertsonDepartment of Medicine, Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USAAbstract: Nuclear factor (erythroid-derived 2-like 2 (Nrf2; encoded in humans by the NFE2L2 gene is a transcription factor that regulates the gene expression of a wide variety of cytoprotective phase II detoxification and antioxidant enzymes through a promoter sequence known as the antioxidant-responsive element (ARE. The ARE is a promoter element found in many cytoprotective genes; therefore, Nrf2 plays a pivotal role in the ARE-driven cellular defense system against environmental stresses. Agents that target the ARE/Nrf2 pathway have been tested in a wide variety of disorders, with at least one new Nrf2-activating drug now approved by the US Food and Drug Administration. Examination of in vitro and in vivo experimental results, and taking into account recent human clinical trial results, has led to an opinion that Nrf2-activating strategies – which can include drugs, foods, dietary supplements, and exercise – are likely best targeted at disease prevention, disease recurrence prevention, or slowing of disease progression in early stage illnesses; they may also be useful as an interventional strategy. However, this rubric may be viewed even more conservatively in the pathophysiology of cancer. The activation of the Nrf2 pathway has been widely accepted as offering chemoprevention benefit, but it may be unhelpful or even harmful in the setting of established cancers. For example, Nrf2 activation might interfere with chemotherapies or radiotherapies or otherwise give tumor cells additional growth and survival advantages, unless they already possess mutations that fully activate their Nrf2 pathway constitutively. With all this in mind, the ARE/Nrf2 pathway remains of great interest as a possible target for the pharmacological control of degenerative and

  10. Clinical relevance of the biochemical, metabolic, and genetic factors that influence low-density lipoprotein heterogeneity.

    Science.gov (United States)

    Kwiterovich, Peter O

    2002-10-17

    increased levels of free fatty acids in plasma, increased flux of free fatty acids back to the liver, enhanced production of TGs, decreased proteolysis of apo B-100, and increased VLDL production. Decreased removal of postprandial TGs often accompanies these metabolic abnormalities. Genes regulating the expression of the major players in this metabolic cascade, such as LPL, cholesterol ester transfer protein, and hepatic lipase, can modulate the expression of small, dense LDL but these are not the major defects. New candidates for major gene effects have been identified on chromosome 1. Regardless of their fundamental causes, small, dense LDL (compared with normal LDL) particles have a prolonged residence time in plasma, are more susceptible to oxidation because of decreased interaction with the LDL receptor, and enter the arterial wall more easily, where they are retained more readily. Small, dense LDL promotes endothelial dysfunction and enhanced production of procoagulants by endothelial cells. Both in animal models of atherosclerosis and in most human epidemiologic studies and clinical trials, small, dense LDL (particularly when present in increased numbers) appears more atherogenic than normal LDL. Treatment of patients with small, dense LDL particles (particularly when accompanied by low HDL and hypertriglyceridemia) often requires the use of combined lipid-altering drugs to decrease the number of particles and to convert them to larger, more buoyant LDL. The next critical step in further reduction of CAD will be the correct diagnosis and treatment of patients with small, dense LDL and the dyslipidemia that accompanies it. PMID:12419479

  11. Birch pollen influence the severity of atopic eczema – prospective clinical cohort pilot study and ex vivo penetration study

    Directory of Open Access Journals (Sweden)

    Fölster-Holst R

    2015-10-01

    Full Text Available Regina Fölster-Holst,1 Jagoda Galecka,1 Sigo Weißmantel,1 Ute Dickschat,2 Frank Rippke,3 Kerstin Bohnsack,3 Thomas Werfel,4 Katja Wichmann,4 Matthias Buchner,1 Thomas Schwarz,1 Annika Vogt,5 Jürgen Lademann,5 Martina C Meinke5 1Department of Dermatology, Venerology and Allergy, University of Kiel, 2Wörth, 3Beiersdorf AG, Hamburg, 4Department of Dermatology, Venerology and Allergy, Division of Immunodermatology and Allergy Research, Hannover Medical School, Hannover, 5Department of Dermatology, Venerology and Allergology, Charité – Universitätsmedizin Berlin, Berlin, Germany Abstract: There is little clinical evidence for a correlation between the severity of atopic eczema (AE and pollen exposition. To obtain more data, we performed a clinical cohort pilot study about the influence of pollen on AE between sensitized and nonsensitized subjects and an experimental study addressing the cutaneous penetration of pollen into the skin. Fifty-five patients were monitored during birch pollen season. To study the cutaneous penetration, grass pollen allergens were applied on excised skin and the uptake in CD1c-expressing dendritic cells was investigated. The correlation between environmental pollen load and severity of the Scoring Atopic Dermatitis (SCORAD score and pruritus was observed, regardless of the status of sensitization. The sensitized group recovered significantly worse after the birch pollen season. Remarkably higher amounts of pollen allergens taken up by CD1c cells were detected in epidermal cells derived from skin explants with a disturbed epidermal barrier. These findings suggest an exacerbating role of pollen in AE utilizing the epidermal route. Keywords: aeroallergens, atopic eczema, seasonality, skin antigen-presenting cells, skin barrier penetration

  12. Clinical And Morphological Androgenic Status Characteristics At Children Suffering From Hypospadias And Its Influence On Results Of Surgical Correction

    Directory of Open Access Journals (Sweden)

    F.K. Napolnikov

    2009-09-01

    Full Text Available The goal of this article is to estimate the androgenic status and analyze its influence on the surgical treatment of hypospadias. From 2000 till 2008 there were 209 children under treatment, whose age varied from 8 months till 15 years old (average age — 4,5+ 1,5. 49 patients were subjected to clinical, humoral and morphological study. Preoperational preparation was carried out by testosterone medications. The comparison group consisted of 10 boys with cicatricial phimosis. The patients with the medium and back forms of hypospadias suffered from the androgenic deficit characterized by proximal level of meatus ectopia, diminution of penis length and prostate volume, decrease of blood vessels in deep layers of penis skin. The testosterone pre-operational medication of patients makes possible to improve the results of surgical correction due to blood supply of plastic material. On the basis of recieved data logistically regressive model has been worked out and the prognosis of results has been estimated

  13. Clinical holistic medicine: factors influencing the therapeutic decision-making. From academic knowledge to emotional intelligence and spiritual "crazy" wisdom.

    Science.gov (United States)

    Ventegodt, Søren; Kandel, Isack; Merrick, Joav

    2007-01-01

    Scientific holistic medicine is built on holistic medical theory, on therapeutic and ethical principles. The rationale is that the therapist can take the patient into a state of salutogenesis, or existential healing, using his skills and knowledge. But how ever much we want to make therapy a science it remains partly an art, and the more developed the therapist becomes, the more of his/her decisions will be based on intuition, feeling and even inspiration that is more based on love and human concern and other spiritual motivations than on mental reason and rationality in a simple sense of the word. The provocative and paradoxal medieval western concept of the "truth telling clown", or the eastern concepts of "crazy wisdom" and "holy madness" seems highly relevant here. The problem is how we can ethically justify this kind of highly "irrational" therapeutic behavior in the rational setting of a medical institution. We argue here that holistic therapy has a very high success rate and is doing no harm to the patient, and encourage therapists, psychiatrists, psychologist and other academically trained "helpers" to constantly measure their own success-rate. This paper discusses many of the important factors that influence clinical holistic decision-making. Sexuality could, as many psychoanalysts from Freud to Reich and Searles have believed, be the most healing power that exists and also the most difficult for the mind to comprehend, and thus the most "crazy-wise" tool of therapy. PMID:18167609

  14. Influence of implant position on clinical crown length and peri-implant soft tissue dimensions at implant-supported single crowns replacing maxillary central incisors

    DEFF Research Database (Denmark)

    Peng, Min; Fei, Wei; Hosseini, Mandana;

    2013-01-01

    The aims of the present study were to evaluate the influence of implant position on clinical crown length and marginal soft tissue dimensions at implant-supported single crowns of maxillary central incisors, and to validate the papilla index score (PIS). Twenty-five patients, who had lost one...

  15. Clinical effects of liraglutide are possibly influenced by hypertriglyceridemia and remaining pancreatic β-cell function in subjects with type 2 diabetes mellitus.

    Science.gov (United States)

    Tanabe, Akihito; Kaneto, Hideaki; Kamei, Shinji; Hirukawa, Hidenori; Shimoda, Masashi; Kimura, Tomohiko; Obata, Atsushi; Okauchi, Seizo; Tatsumi, Fuminori; Kohara, Kenji; Mune, Tomoatsu; Kaku, Kohei

    2016-08-01

    We searched for factors influencing the clinical effects of GLP-1 analogue liraglutide in subjects with type 2 diabetes. Multivariate analyses showed that hypertriglyceridemia and baseline HbA1c levels were independent predictors for the efficacy of liraglutide and that CPR index was an independent predictor for the durability of liraglutide. PMID:27220544

  16. The course of nonspecific work-related upper limb disorders and the influence of demographic factors, psychologic factors, and physical fitness on clinical status and disability.

    NARCIS (Netherlands)

    Eijsden-Besseling, M.D. van; Bergh, K.A. van den; Staal, J.B.; Bie, R.A. de; Heuvel, W.J.A. van den

    2010-01-01

    OBJECTIVE: To assess the course of nonspecific work-related upper limb disorders (WRULD) and the influence of sociodemographic factors, psychologic factors, and physical fitness on clinical status and functional disability. DESIGN: Retrospective cohort study with cross-sectional analysis among compu

  17. CLINICAL, HISTOLOGICAL AND RADIOLOGICAL ASPECTS REGARDING THE INFLUENCE OF SOME EXTERNAL FACTORS ON THE PULP-DENTIN COMPLEX

    Directory of Open Access Journals (Sweden)

    C. Giuroiu

    2012-12-01

    Full Text Available The present study aimed at assesssing – by clinical, histological and radiological investigations – the influence of some external factors on the pulp-dentin complex, and at providing a causal interpretation of the structural changes observed. Materials and methods. Clinical and radiological exams were performed on 65 old patients with ages between 60-75, and also on 40 young patients with ages between 20-35, presenting different dental-periodontal pathologies. The pulp-dentin complex was submitted to a morphopathological examination, to highlight the structural changes observed at microscopic level. Fragments of dental pulp were imersed in a 4% formaldehyde solution with phosphate buffer 0.1 M., pH 7.2, for 12 -14 hours, at a temperature of 4ºC, and 3-5 µm thick slices were prepared. The slices were coloured with hematoxylin-eosine (HE, by the trichromic technique – Masson. Photographies were taken with a Zeiss microscope, with Kodak 200 ASA. Results. Significant differences were observed, between the two groups of patients, as to the external factors that produce structural changes on pulp-dentin organ. In the group of young patients dental caries and coronal fillings prevailed, while the group of old patients was mostly associated with atrition and chronic marginal periodontitis. Out of the 40 young patients, 30 presented chronic dental caries (75%, while, among the 65 old patients, only 24 presented dental caries (36.9%. The percentages of coronary fillings between the two study groups were close, which could be considered as one of the causes producing changes in the pulp-dentin organ, following aggresive preparation of cavities, the action of materials used for the protection of pulp-dentin complex or of the materials used for coronry fillings. Conclusions. Dental pulp has a remarkable ability to counteract the action of harmful factors, producing a mineral barrier and stimulating the reparatory processes. Changes in the endodontic

  18. Factors influencing the choice of antidepressants: A study of antidepressant prescribing practice at University psychiatric clinic in Belgrade

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    Marić Nađa P.

    2012-01-01

    Full Text Available Background/Aim. Antidepressants are a widely used class of drugs. The aim of this study was to investigate different aspects of antidepressant prescribing practice at University Psychiatric Clinic in Belgrade. Methods. This cross-sectional study was carried out by retrospective analysis of the patient's medical charts. The study included all patients with antidepressant prescribed at discharge during 2009 (n = 296. The evaluation was focused on patient- related factors (socio-demographic and illness related, psychiatrist-related factors (sex and duration of working experience and drug related factors (type of antidepressant, dose, polypharmacy and reimbursement by national health insurance. Results. Antidepressants were prescribed for unipolar depression (F32-34, ICD X either without comorbidity (46.2% or with comorbidity (24.7%, mostly as a monotherapy (91% had one antidepressant, to the patients who were 65% female, aged 50.1 ± 8.9, most of them with 12 years of education (52.6%, married (69.3% and employed (55.9%. The majority of patients had a history of two hospitalizations (Med 2; 25th-75th perc. 1-4 during nine years (Med 9; 25th-75th perc. 2-15 after the first episode of depression. Among them, 19% were found to be suicidal in a lifetime. The single most prescribed antidepressant was sertraline (20.4%, followed by fluoxetine (13.3% and maprotiline (11.7%. Utilization of antidepressants was positively correlated with the rate of reimbursement (p < 0.01. The most prescribed antidepressant group was selective serotonin reuptake inhibitors (SSRI (47.8%, followed by tricyclic antidepresants (TCA (25.3% and new antidepressants - venlafaxine, tianeptine, mirtazapine, bupropion, trazodone (15.1%. Most of the drugs were prescribed in doses which are at the lower end of the recommended dose-range. Regarding severity of the actual depressive episode, TCA were prescribed for severe depression with psychotic features, while SSRI were choice for

  19. Influence of postoperative low-level laser therapy on the osseointegration of self-tapping implants in the posterior maxilla: A 6-week split-mouth clinical study

    OpenAIRE

    Mandić Borka; Lazić Zoran; Marković Aleksa; Mandić Bojan; Mandić Miška; Đinić Ana; Miličić Biljana

    2015-01-01

    Background/Aim. Low-level laser therapy (LLLT) has been proven to stimulate bone repair, affecting cellular proliferation, differentiation and adhesion, and has shown a potential to reduce the healing time following implant placement. The aim of this clinical study was to investigate the influence of postoperative LLLT osseointegration and early success of self-tapping implants placed into low-density bone. Methods. Following the split-mouth design, self-ta...

  20. Daytime of Sampling, Tooth-Brushing and Ascorbic Acid Influence Salivary Thiobarbituric Acid Reacting Substances – A Potential Clinical Marker of Gingival Status

    Directory of Open Access Journals (Sweden)

    Július Hodosy

    2005-01-01

    Sialic acid content of saliva is not influenced significantly by any of the investigated factors. Conclusion. TBARS levels in saliva are affected by daytime of sampling, tooth-brushing and ascorbic acid pre-treatment. These results must be considered in clinical research using salivary TBARS levels. Sialic acid seems not to be a major component of TBARS in saliva. Further studies should clarify the molecular compounds of salivary TBARS and uncover the role of oral microbial factors.

  1. Clinical perspectives on the influence of drug formulation on patient tolerability and use of commonly prescribed antidepressants in major depressive disorder

    Directory of Open Access Journals (Sweden)

    Matthew A Fuller

    2013-01-01

    Full Text Available The purpose of this review is to summarize the formulation options for currently available antidepressants, and discuss examples of the influence that formulation may have on the pharmacologic and clinical profiles of the medications. A review of current literature suggests that differences in drug-delivery technologies can lead to variations in the pharmacokinetic and pharmacodynamic profiles of generic and branded drugs, despite generic drugs being required to meet bioequivalence standards compared with their branded counterparts. These differences may influence the effectiveness and tolerability of treatment. Recent reports have highlighted the need for individualized treatment regimens and careful assessment of tolerability and efficacy when switching patients from brand to generic formulations. There is a growing body of evidence indicating that differences in formulation can substantially impact drug pharmacokinetics and pharmacodynamics, which in turn, can affect drug effects. The clinical impact of these differences remains unclear. Further research is needed to clarify the influence of antidepressant formulations on treatment adherence, patient preference, and quality of life, and how this impacts clinical practice with regard to brand versus generic treatment selection.

  2. Influence of a history of smoking on short term (six month) clinical and angiographic outcome after successful coronary angioplasty

    NARCIS (Netherlands)

    A.G. Violaris (Andonis); A. Thury (Attila); R. Melkert (Rein); P.W.J.C. Serruys (Patrick); E.S. Regar (Eveline)

    2000-01-01

    textabstractOBJECTIVES: To assess the influence of smoking on restenosis after coronary angioplasty. DESIGN AND PATIENTS: The incidence of smoking on restenosis was investigated in 2948 patients. They were prospectively enrolled in four major restenosis trials in which quantitative

  3. Positive Outcomes Influence the Rate and Time to Publication, but Not the Impact Factor of Publications of Clinical Trial Results

    OpenAIRE

    Suñé, Pilar; Suñé, Josep Maria; Montoro, J. Bruno

    2013-01-01

    Objectives: Publication bias may affect the validity of evidence based medical decisions. The aim of this study is to assess whether research outcomes affect the dissemination of clinical trial findings, in terms of rate, time to publication, and impact factor of journal publications. Methods and Findings: All drug-evaluating clinical trials submitted to and approved by a general hospital ethics committee between 1997 and 2004 were prospectively followed to analyze their fate and publication....

  4. Decision Making in the PICU: An Examination of Factors Influencing Participation Decisions in Phase III Randomized Clinical Trials

    OpenAIRE

    Slosky, Laura E; Marilyn Stern; Burke, Natasha L.; Siminoff, Laura A.

    2014-01-01

    Background. In stressful situations, decision making processes related to informed consent may be compromised. Given the profound levels of distress that surrogates of children in pediatric intensive care units (PICU) experience, it is important to understand what factors may be influencing the decision making process beyond the informed consent. The purpose of this study was to evaluate the role of clinician influence and other factors on decision making regarding participation in a randomiz...

  5. Computational challenges and human factors influencing the design and use of clinical research participant eligibility pre-screening tools

    Directory of Open Access Journals (Sweden)

    Pressler Taylor R

    2012-05-01

    Full Text Available Abstract Background Clinical trials are the primary mechanism for advancing clinical care and evidenced-based practice, yet challenges with the recruitment of participants for such trials are widely recognized as a major barrier to these types of studies. Data warehouses (DW store large amounts of heterogenous clinical data that can be used to enhance recruitment practices, but multiple challenges exist when using a data warehouse for such activities, due to the manner of collection, management, integration, analysis, and dissemination of the data. A critical step in leveraging the DW for recruitment purposes is being able to match trial eligibility criteria to discrete and semi-structured data types in the data warehouse, though trial eligibility criteria tend to be written without concern for their computability. We present the multi-modal evaluation of a web-based tool that can be used for pre-screening patients for clinical trial eligibility and assess the ability of this tool to be practically used for clinical research pre-screening and recruitment. Methods The study used a validation study, usability testing, and a heuristic evaluation to evaluate and characterize the operational characteristics of the software as well as human factors affecting its use. Results Clinical trials from the Division of Cardiology and the Department of Family Medicine were used for this multi-modal evaluation, which included a validation study, usability study, and a heuristic evaluation. From the results of the validation study, the software demonstrated a positive predictive value (PPV of 54.12% and 0.7%, respectively, and a negative predictive value (NPV of 73.3% and 87.5%, respectively, for two types of clinical trials. Heuristic principles concerning error prevention and documentation were characterized as the major usability issues during the heuristic evaluation. Conclusions This software is intended to provide an initial list of eligible patients to a

  6. Factors influencing patients seeking oral health care in the oncology dental support clinic at an urban university dental school setting.

    Science.gov (United States)

    Corrigan, Dale M; Walker, Mary P; Liu, Ying; Mitchell, Tanya Villalpando

    2014-01-01

    The purpose of this study was to identify predictors and/or factors associated with medically compromised patients seeking dental care in the oncology dental support clinic (ODSC) at the University of Missouri-Kansas City (UMKC) School of Dentistry. An 18-item survey was mailed to 2,541 patients who were new patients to the clinic from 2006 to 2011. The response rate was approximately 18% (n = 450). Analyses included descriptive statistics of percentages/frequencies as well as predictors based on correlations. Fifty percent of participants, 100 females and 119 males, identified their primary medical diagnosis as cancer. Total household income (p dental care (p dental health. Perceived overall health (p < .001) also had a significant association with cancer status and the need for organ transplants. This study provided the ODSC at UMKC and other specialty clinics with vital information that can contribute to future planning efforts.

  7. Influence of Body Mass Index and Albumin on Perioperative Morbidity and Clinical Outcomes in Resected Pancreatic Adenocarcinoma

    OpenAIRE

    Andrew Hendifar; Arsen Osipov; Jasleen Khanuja; Nicholas Nissen; Jason Naziri; Wensha Yang; Quanlin Li; Richard Tuli

    2016-01-01

    Obesity is a known risk factor for PDA and recent reports suggest obesity has a negative impact on clinical outcomes in patients with PDA. Pretreatment body mass index (BMI) and serum albumin (SA) have been shown to be associated with worse overall survival in patients with advanced and metastatic PDA. However, minimal data exists on the impact of BMI and SA on perioperative and long-term clinical outcomes in patients with early-stage resected PDA. Herein, we report on the impact of these var...

  8. Aneurysm diameter and proximal aortic neck diameter influence clinical outcome of endovascular abdominal aortic repair : A 4-year EUROSTAR experience

    NARCIS (Netherlands)

    Waasdorp, EJ; de Vries, JPPM; Hobo, R; Leurs, LJ; Buth, J; Moll, FL

    2005-01-01

    Our objective was to evaluate the effect of preoperative aneurysm and aortic neck diameter on clinical outcome after infrarenal abdominal endovascular aneurysm repair (EVAR). Data of patients in the European Collaborators Registry on Stent-Graft Techniques for Abdominal Aortic Aneurysm Repair (EUROS

  9. Growth of self-perceived clinical competence in postgraduate training for general practice and its relation to potentially influencing factors.

    NARCIS (Netherlands)

    Kramer, A.W.M.; Zuithoff, P.; Jansen, J.J.M.; Tan, L.H.; Grol, R.P.T.M.; Vleuten, C.P.M. van der

    2007-01-01

    OBJECTIVE: To examine the increase in self-perceived clinical competence during a three-year postgraduate training in general practice and to explore the relation between the growth of self-perceived competence and several background variables. DESIGN: Cohort, 1995-1998. SETTING: Three-year Postgrad

  10. Influence of the sFlt-1/PlGF Ratio on Clinical Decision-Making in Women with Suspected Preeclampsia

    Science.gov (United States)

    Klein, Evelyn; Schlembach, Dietmar; Ramoni, Angela; Langer, Elena; Bahlmann, Franz; Grill, Sabine; Schaffenrath, Helene; van der Does, Reinhard; Messinger, Diethelm; Verhagen-Kamerbeek, Wilma D. J.; Reim, Manfred; Hund, Martin; Stepan, Holger

    2016-01-01

    Objective To evaluate the influence of the soluble fms-like tyrosine kinase 1/placental growth factor ratio in physicians’ decision making in pregnant women with signs and symptoms of preeclampsia in routine clinical practice. Methods A multicenter, prospective, open, non-interventional study enrolled pregnant women presenting with preeclampsia signs and symptoms in several European perinatal care centers. Before the soluble fms-like tyrosine kinase 1/placental growth factor ratio result was known, physicians documented intended clinical procedures using an iPad® application (data locked/time stamped). After the result was available, clinical decisions were confirmed or revised and documented. An independent adjudication committee evaluated the appropriateness of decisions based on maternal/fetal outcomes. Clinician decision making with regard to hospitalization was the primary outcome. Results In 16.9% of mothers (20/118) the hospitalization decision was changed after knowledge of the ratio. In 13 women (11.0%), the initial decision to hospitalize was changed to no hospitalization. In seven women (5.9%) the revised decision was hospitalization. All revised decisions were considered appropriate by the panel of adjudicators (McNemar test; p preeclampsia. This is the first study to demonstrate the impact of angiogenic biomarkers on decision making in a routine clinical practice. PMID:27243815

  11. Comparative Genomics Reveal That Host-Innate Immune Responses Influence the Clinical Prevalence of Legionella pneumophila Serogroups.

    Directory of Open Access Journals (Sweden)

    Mohammad Adil Khan

    Full Text Available Legionella pneumophila is the primary etiologic agent of legionellosis, a potentially fatal respiratory illness. Amongst the sixteen described L. pneumophila serogroups, a majority of the clinical infections diagnosed using standard methods are serogroup 1 (Sg1. This high clinical prevalence of Sg1 is hypothesized to be linked to environmental specific advantages and/or to increased virulence of strains belonging to Sg1. The genetic determinants for this prevalence remain unknown primarily due to the limited genomic information available for non-Sg1 clinical strains. Through a systematic attempt to culture Legionella from patient respiratory samples, we have previously reported that 34% of all culture confirmed legionellosis cases in Ontario (n = 351 are caused by non-Sg1 Legionella. Phylogenetic analysis combining multiple-locus variable number tandem repeat analysis and sequence based typing profiles of all non-Sg1 identified that L. pneumophila clinical strains (n = 73 belonging to the two most prevalent molecular types were Sg6. We conducted whole genome sequencing of two strains representative of these sequence types and one distant neighbour. Comparative genomics of the three L. pneumophila Sg6 genomes reported here with published L. pneumophila serogroup 1 genomes identified genetic differences in the O-antigen biosynthetic cluster. Comparative optical mapping analysis between Sg6 and Sg1 further corroborated this finding. We confirmed an altered O-antigen profile of Sg6, and tested its possible effects on growth and replication in in vitro biological models and experimental murine infections. Our data indicates that while clinical Sg1 might not be better suited than Sg6 in colonizing environmental niches, increased bloodstream dissemination through resistance to the alternative pathway of complement mediated killing in the human host may explain its higher prevalence.

  12. Influencing risk behavior of sexually transmitted infection clinic visitors: efficacy of a new methodology of motivational preventive counseling.

    Science.gov (United States)

    Kuyper, Lisette; de Wit, John; Heijman, Titia; Fennema, Han; van Bergen, Jan; Vanwesenbeeck, Ine

    2009-06-01

    A quasi-experimental study was conducted at a Dutch sexually transmitted infection (STI) clinic to compare the effects of educational counseling and motivational interviewing (MI)-based HIV/STI counseling on determinants of condom use and partner notification at 6-month follow-up. It also examined the feasibility of MI-based counseling in a busy real-life clinic. The counseling approaches were historically compared: respondents in the control condition were recruited between April and July 2005, those in the experimental condition between September and December 2005. The study involved 428 participants. These were all high-risk clients of the STI clinic. Their mean age was 33.7 years, and 39.6% were female. The study showed that MI-based counseling had a more positive effect on self-efficacy, intentions to use condoms with casual partners, and long-term condom use with steady partners. It had no adversarial outcomes on other social cognitions or behaviors compared to educational counseling. Furthermore, MI-based counseling is experienced as a more respectful and structured way of counseling. MI-based counseling was relatively easily implemented into the current clinic procedures. In addition to the implementation of the training, neither specialized staff nor additional or longer client visits were needed. However, some nurses indicated that the new method required more personal investment and effort. Limitations of the current study are the low response rates, the high educational level of most participants, and the small sample size regarding partner notification. Nonetheless, we conclude that MI-based counseling was a more effective approach to preventive counseling compared to educational counseling and feasible in the busy real-life setting.

  13. INHALED NITRIC OXIDE: CLINICAL EFFECTS AND INFLUENCE ON THE PROFILE OF INFLAMMATORY MARKERS IN PATIENTS WITH IDIOPATHIC PULMONARY HYPERTENSION

    OpenAIRE

    T. V. Martynyuk; S. N. Nakonechnikov; V P Masenko; I. E. Chazova

    2015-01-01

    Aim. To study the effect of treatment with inhaled nitric oxide (iNO) on the clinical status of patients with idiopathic pulmonary hypertension (IPH), and the profile of proinflammatory cytokines in peripheral blood. Material and methods. Patients with IPH (n=48) were included into the study. Evaluation of the IPH functional class (FC), the 6-minute walk test (6MWT) with the assessment of the Borg index, echocardiography , laboratory tests [blood count, evaluation of high-sensitivity C-reacti...

  14. The influence of genetic variation in thirty selected genes on the clinical characteristics of early onset breast cancer

    OpenAIRE

    Tapper, William; Hammond, Victoria; Gerty, Sue; Ennis, Sarah; Simmonds, Peter; Collins, Andrew; Eccles, Diana

    2008-01-01

    Introduction: common variants that alter breast cancer risk are being discovered. Here, we determine how these variants influence breast cancer prognosis, risk and tumour characteristics. Methods: we selected 1,001 women with early onset nonfamilial invasive breast cancer from the Prospective study of Outcomes in Sporadic versus Hereditary breast cancer (POSH) cohort and genotyped 206 single nucleotide polymorphisms (SNPs) across 30 candidate genes. After quality control, 899 cases and 13...

  15. Cultures in hospitals and their influence on attitudes to, and satisfaction with, the use of clinical information systems.

    Science.gov (United States)

    Callen, Joanne L; Braithwaite, Jeffrey; Westbrook, Johanna I

    2007-08-01

    Studies have identified the importance of hospitals' organisational culture in clinical information system diffusion, but few have quantified its role. This study measured organisational culture in two Australian hospitals to explore whether clinicians' perceptions of culture related to their attitudes to, and satisfaction with, a computerised provider order entry system (CPOE). Data were collected using the Organisational Culture Inventory and a user-satisfaction survey administered to a population of 249 clinicians from the two hospitals. One hospital used CPOE to order clinical laboratory and radiology tests and view results, and the other used the test viewing function only, the ordering facility being planned for later implementation. We found a relationship between culture and clinicians' attitudes, with those in the constructive culture hospital more likely to express positive attitudes towards CPOE, whereas those in the aggressive/defensive hospital were more likely to be negative. The relationship between culture and attitudes towards clinical information systems should be taken into account when planning for their adoption. PMID:17475380

  16. Influence of Clinical Status and Parasite Load on Erythropoiesis and Leucopoiesis in Dogs Naturally Infected with Leishmania (Leishmania) chagasi

    Science.gov (United States)

    Trópia de Abreu, Raquel; Carvalho, Maria das Graças; Carneiro, Cláudia Martins; Giunchetti, Rodolfo Cordeiro; Teixeira-Carvalho, Andréa; Martins-Filho, Olindo Assis; Coura-Vital, Wendel; Corrêa-Oliveira, Rodrigo; Reis, Alexandre Barbosa

    2011-01-01

    Background The bone marrow is considered to be an important storage of parasites in Leishmania-infected dogs, although little is known about cellular genesis in this organ during canine visceral leishmaniasis (CVL). Methodology/Principal Findings The aim of the present study was to evaluate changes in erythropoiesis and leucopoiesis in bone marrow aspirates from dogs naturally infected with Leishmania chagasi and presenting different clinical statuses and bone marrow parasite densities. The evolution of CVL from asymptomatic to symptomatic status was accompanied by increasing parasite density in the bone marrow. The impact of bone marrow parasite density on cellularity was similar in dogs at different clinical stages, with animals in the high parasite density group. Erythroid and eosinophilic hypoplasia, proliferation of neutrophilic precursor cells and significant increases in lymphocytes and plasma cell numbers were the major alterations observed. Differential bone marrow cell counts revealed increases in the myeloid:erythroid ratio associated to increased numbers of granulopoietic cells in the different clinical groups compared with non-infected dogs. Conclusions Analysis of the data obtained indicated that the assessment of bone marrow constitutes an additional and useful tool by which to elaborate a prognosis for CVL. PMID:21572995

  17. Individual- and area-level unemployment influence smoking cessation among African Americans participating in a randomized clinical trial.

    Science.gov (United States)

    Kendzor, Darla E; Reitzel, Lorraine R; Mazas, Carlos A; Cofta-Woerpel, Ludmila M; Cao, Yumei; Ji, Lingyun; Costello, Tracy J; Vidrine, Jennifer Irvin; Businelle, Michael S; Li, Yisheng; Castro, Yessenia; Ahluwalia, Jasjit S; Cinciripini, Paul M; Wetter, David W

    2012-05-01

    African Americans suffer disproportionately from the adverse health consequences of smoking, and also report substantially lower socioeconomic status than Whites and other racial/ethnic groups in the U.S. Although socioeconomic disadvantage is known to have a negative influence on smoking cessation rates and overall health, little is known about the influence of socioeconomic status on smoking cessation specifically among African Americans. Thus, the purpose of the current study was to characterize the impact of several individual- and area-level indicators of socioeconomic status on smoking cessation among African Americans. Data were collected as part of a smoking cessation intervention study for African American smokers (N = 379) recruited from the Houston, Texas, metropolitan area, who participated in the study between 2005 and 2007. The separate and combined influences of individual-level (insurance status, unemployment, education, and income) and area-level (neighborhood unemployment, education, income, and poverty) indicators of socioeconomic status on continuous smoking abstinence were examined across time intervals using continuation ratio logit modeling. Individual-level analyses indicated that unemployment was significantly associated with reduced odds of smoking abstinence, while higher income was associated with greater odds of abstinence. However, only unemployment remained a significant predictor of abstinence when unemployment and income were included in the model together. Area-level analyses indicated that greater neighborhood unemployment and poverty were associated with reduced odds of smoking abstinence, while greater neighborhood education was associated with higher odds of abstinence. However, only neighborhood unemployment remained significantly associated with abstinence status when individual-level income and unemployment were included in the model. Overall, findings suggest that individual- and area-level unemployment have a negative

  18. Influence of volatile constituents of fruit peels of Citrus reticulata Blanco on clinically isolated pathogenic microorganisms under In-vitro

    Institute of Scientific and Technical Information of China (English)

    Husain Shahnaz Sultana; Mohammed Ali; Bibhu Prasad Panda

    2012-01-01

    Objective: To investigate the antimicrobial activity of volatile constituents of fruit peels of Citrus reticulata Blanco on clinically isolated pathogenic microorganisms. Methods: Extraction of volatile oil was carried out by Clevenger’s apparatus. Volatile chemical components were measured by GC-MS. Antimicrobial activity was carried by Agar well diffusion assay with reference to standard fluconazole and tetracycline. Results: The chemical composition of volatile oil of the fruit peels of Citrus reticulata Blanco (Rutaceae) of Delhi Region was composed mainly monoterpenes (99.1 %) constituting l-limonene (92.4 %), γ-terpene (2.6 %) andβ-phellandrene (1.8 %). The volatile oil showed antibacterial and antifungal activities against the clinically isolated pathogenic microbial strains Escherichia coli, Staphylococcus aureus, Aspergillus flavus, Aspergillus niger, Aspergillus fumigatus and Candida albicans under in vitro condition. Conclusions: The potential antimicrobial activity of volatile oil present in fruit peels of C. reticulata can be useful for treatment of skin disorder and/or in aroma. Therapy, it can be incorporated into cosmetic formulations.

  19. Influence of renal dysfunction on clinical outcomes in patients with congestive heart failure complicating acute myocardial infarction.

    Science.gov (United States)

    Kim, Chang Seong; Kim, Min Jee; Kang, Yong Un; Choi, Joon Seok; Bae, Eun Hui; Ma, Seong Kwon; Ahn, Young-Keun; Jeong, Myung Ho; Kim, Young Jo; Cho, Myeong Chan; Kim, Chong Jin; Kim, Soo Wan

    2013-01-01

    The clinical course and medical treatment of patients with congestive heart failure (CHF) complicating acute myocardial infarction (AMI) are not well established, especially in patients with concomitant renal dysfunction. We performed a retrospective analysis of the prospective Korean Acute Myocardial Infarction Registry to assess the medical treatments and clinical outcomes of patients with CHF (Killip classes II or III) complicated by AMI, in the presence or absence of renal dysfunction. Of 13,498 patients with AMI, 2769 (20.5%) had CHF on admission. Compared to CHF patients with preserved renal function, in-hospital mortality and major adverse cardiac events were increased both at 1 month and at 1 year after discharge in patients with renal dysfunction (1154; 41.7%). Postdischarge use of aspirin, betablockers, calcium channel blockers, angiotensin-converting enzyme inhibitors, or angiotensin II receptor blockers and statins significantly reduced the 1-year mortality rate for CHF patients with renal dysfunction; such reduction was not observed for those without renal dysfunction, except in the case of aspirin. Patients with CHF complicating AMI, which is accompanied by renal dysfunction, are at higher risk for adverse cardiovascular outcomes than patients without renal dysfunction. However, they receive fewer medications proven to reduce mortality rates.

  20. Viral competition and maternal immunity influence the clinical disease caused by very virulent infectious bursal disease virus.

    Science.gov (United States)

    Jackwood, Daral J

    2011-09-01

    The very virulent form of infectious bursal disease virus (vvIBDV) causes an immunosuppressive disease that is further characterized by the rapid onset of morbidity and high mortality in susceptible chickens. In 2009, vvIBDV was first reported in California, U. S. A., and since that time only a few cases of acute infectious bursal disease attributed to vvIBDV have been recognized in California. In other countries where vvIBDV has become established, it rapidly spreads to most poultry-producing regions. Two factors that may be involved in limiting the spread or reducing the severity of the clinical disease caused by vvIBDV in the U. S. A. are maternal immunity and competition with endemic variant strains of the virus. In this study, the ability of vvIBDV to infect and cause disease in maternally immune layer chickens was examined at weekly intervals over a 5-wk period during which their neutralizing maternal antibodies waned. Birds inoculated with vvIBDV at 2, 3, and 4 wk of age seemed healthy throughout the duration of the experiment, but macroscopic and microscopic lesions were observed in their bursa tissues. A real-time reverse transcriptase-polymerase chain reaction (RT-PCR) assay also confirmed the presence of vvIBDV RNA in their bursa tissues, indicating this virus was infecting the birds even at 2 wk of age when neutralizing maternal antibodies to infectious bursal disease virus were still relatively high (> 2000 geometric mean antibody titer). No mortality was observed in any birds when inoculated at 2, 3, or 4 wk of age; however, inoculation at 5 and 6 wk of age resulted in 10% and 20% mortality, respectively. Three experiments on the competition between vvIBDV and the two variant viruses T1 and FF6 were conducted. In all three experiments, specific-pathogen-free (SPF) birds that were inoculated with only the vvIBDV became acutely moribund, and except for Experiment 1 (62% mortality) all succumbed to the infection within 4 days of being exposed. When the

  1. PRISMA-Compliant Article: Clinical Characteristics and Factors Influencing Prognosis of Patients With Hepatoid Adenocarcinoma of the Stomach in China.

    Science.gov (United States)

    Qu, Bao-Ge; Bi, Wei-Min; Qu, Bao-Teng; Qu, Tao; Han, Xing-Hai; Wang, Hui; Liu, Yuan-Xun; Jia, Yi-Guo

    2016-04-01

    Most previous studies have been single case reports, and studies with large samples are presently lacking. In addition, no studies have investigated the associations between the clinical characteristics and prognosis of hepatoid adenocarcinoma of the stomach (HAS).The aim of this study was to explore the associations of different clinical characteristics with the ages, serum alpha-fetoprotein (AFP) levels, and survival times of HAS patients.The present study was conducted using the CBM disc, HowNet, Wanfang and VIP data resource systems, and PubMed. According to the PRISMA Flow Diagram, certain case reports from the same center, those that did not provide patient age or sex, and those that did not report serum AFP levels or AFP immunohistochemistry results were excluded. A total of 131 relevant articles, including 124 case reports, 5 reviews, and 2 postgraduate Master's theses, were reported in the above-mentioned five databases. We applied inclusion criteria to case reports on the clinical characteristics and prognosis of HAS, which resulted in the ultimate inclusion of 180 patients from 62 case reports for statistical analyses.The main finding was that the age of the men was significantly higher than that of the women (P = 0.004). In addition, the serum AFP levels of the participants with antral disease were significantly higher than those with nonantral disease (P = 0.001). The median serum AFP levels and survival times significantly differed among the patients with the three lesion types (P = 0.001 and 0.019, respectively). The serum AFP levels of the participants with ulcerative-upheaval-type tumors and purely ulcerative tumors were significantly higher than those with upheaval-type tumors (P = 0.000 and 0.017, respectively). In addition, the serum AFP levels of the participants with ulcerative-upheaval-type tumors were significantly higher than those with ulcerative-type tumors (P = 0.019), and their survival time was also significantly

  2. Both baseline clinical factors and genetic polymorphisms influence the development of severe functional status in ankylosing spondylitis.

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    Ruxandra Schiotis

    Full Text Available Functional severity in ankylosing spondylitis (AS patients is variable and difficult to predict early. The aim of our study was to assess whether a combination of baseline clinical factors and genetic markers may predict the development of severe functional status in AS. We performed a cross-sectional association study on AS patients included in the Spanish National Registry of Spondyloarthropathies--REGISPONSER. Bath Ankylosing Spondylitis Functional Index (BASFI was standardized by adjusting for disease duration since the first symptoms (BASFI/t. We considered as severe functional status the values of BASFI/t in the top of the 60th (p60, 65th (p65, 70th (p70, and 75th (p75 percentile. We selected 384 single nucleotide polymorphisms (SNPs distributed in 190 genes to be analyzed. The study cohort included 456 patients with mean age 50.8(± 10.5 years and with mean disease duration since first symptoms 24.7 (± 10.1 years. Older age at disease onset and neck pain at baseline showed statistical significant association with severe BASFI/t. Polymorphisms associated in the allele frequencies test with severe BASFI/t in all classifications were: rs2542151 (p60 [P = .04], p65 [P = .04], p70 [P = .001] and p75 [P = .001] and rs2254441 (p60 [P = .004], p65 [P = .02], p70 [P = .01] and p75 [P<.001].. Genotype association, after adjustment for covariates, found an association in three of the four patients' classifications for rs2542151 and in two of the classifications for rs2254441.Forward logistic regression did not identify any model with a good predictive power for severe functional development.In our study we identified clinical factors and 24 polymorphisms associated with development of severe functional status in AS patients. Validation of these results in other cohorts is required.

  3. The influence of Multiwave Locked System (MLS) laser therapy on clinical features, microcirculatory abnormalities and selected modulators of angiogenesis in patients with Raynaud's phenomenon.

    Science.gov (United States)

    Kuryliszyn-Moskal, Anna; Kita, Jacek; Dakowicz, Agnieszka; Chwieśko-Minarowska, Sylwia; Moskal, Diana; Kosztyła-Hojna, Bożena; Jabłońska, Ewa; Klimiuk, Piotr Adrian

    2015-03-01

    The aim of this study was to investigate the influence of the Multiwave Locked System (MLS) laser therapy on clinical features, microvascular changes in nailfold videocapillaroscopy (NVC) and circulating modulators releasing as a consequence of vascular endothelium injury such as vascular endothelial growth factor (VEGF) and angiopoietin 2 (Ang-2) in patients with primary and secondary Raynaud's phenomenon. Seventy-eight RP patients and 30 healthy volunteers were recruited into the study. All patients with RP received MLS laser irradiation for 3 weeks. Clinical, NVC and laboratory investigations were performed before and after the MLS laser therapy. The serum concentration of VEGF and Ang-2 were determined by an enzyme-linked immunosorbent assay (ELISA). After 3 weeks of MLS laser therapy, the clinical improvement manifested by decreasing of the number of RP attacks, mean duration of Raynaud's attack and pain intensity in RP patients was observed. After MLS laser therapy in 65% of patients with primary and in 35% with secondary RP, an increase in the loop number and/or a reduction in avascular areas in NVC were observed. In comparison with a control group, higher serum concentration of VEGF and Ang-2 in RP patients was demonstrated. After MLS laser therapy, a reduction of Ang-2 in both groups of RP patients was found. Our results suggest that NVC may reflect microvascular changes associated with clinical improvement after MLS laser therapy in patients with primary and secondary RP. Ang-2 serum levels may be a useful marker of microvascular abnormalities in RP patients treated with MLS laser therapy.

  4. Data calibration and reduction allows to visualize behavioural profiles of psychosocial influences in mice towards clinical domains.

    Science.gov (United States)

    Badowska, Dorota M; Brzózka, Magdalena M; Chowdhury, Ananya; Malzahn, Dörthe; Rossner, Moritz J

    2015-09-01

    Psychosocial stress-particularly in combination with genetic vulnerability-is a critical environmental risk factor for psychiatric diseases in humans. Isolation rearing (IR) and social defeat (SD) paradigms model psychosocial risk factors in rodents, while enriched environment (EE) protects them from behavioural deficits. Studying the influence of various environmental conditions, e.g., on genetic mouse models can help to dissect the complex gene-environment relationships underlying human psychiatric diseases. Such studies may require analysing multiple mouse cohorts; however, the comparability of behavioural experiments is challenging and often compromised by practical limitations such as group sizes and influences of handling. Therefore, protocol standardization as well as appropriate statistical normalization is necessary to compare different experiments. In this study, we analysed two independent cohorts to compare the behavioural profiles of wild-type male mice subjected to IR and SD. In both cases, EE conditions served as a reference. Multivariate statistics was applied to merge the data from individual measures into broader categories (such as curiosity, anxiety and fear memory) by estimating their calibrated joint effect within a category. Plotting and overlaying these calibrated effect sizes in a single graph allowed intuitive comparison of IR and SD behavioural profiles. This approach allows analysing multiple behavioural tests at once, which is more relevant to psychiatric syndromes than focusing on single behavioural measures. Our method revealed that motivation and fear memory are impaired by both conditions, whereas ambulation and pain sensitivity are affected only by IR and curiosity is mainly diminished upon SD. Thus, IR could be a paradigm of choice in studies focusing on positive symptoms, while SD might be more relevant for negative and cognitive symptoms. PMID:25236183

  5. Repair of oxidative DNA damage, cell-cycle regulation and neuronal death may influence the clinical manifestation of Alzheimer's disease.

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    Aderbal R T Silva

    Full Text Available Alzheimer's disease (AD is characterized by progressive cognitive decline associated with a featured neuropathology (neuritic plaques and neurofibrillary tangles. Several studies have implicated oxidative damage to DNA, DNA repair, and altered cell-cycle regulation in addition to cell death in AD post-mitotic neurons. However, there is a lack of studies that systematically assess those biological processes in patients with AD neuropathology but with no evidence of cognitive impairment. We evaluated markers of oxidative DNA damage (8-OHdG, H2AX, DNA repair (p53, BRCA1, PTEN, and cell-cycle (Cdk1, Cdk4, Cdk5, Cyclin B1, Cyclin D1, p27Kip1, phospho-Rb and E2F1 through immunohistochemistry and cell death through TUNEL in autopsy hippocampal tissue samples arrayed in a tissue microarray (TMA composed of three groups: I "clinical-pathological AD" (CP-AD--subjects with neuropathological AD (Braak ≥ IV and CERAD = B or C and clinical dementia (CDR ≥ 2, IQCODE>3.8; II "pathological AD" (P-AD--subjects with neuropathological AD (Braak ≥ IV and CERAD = B or C and without cognitive impairment (CDR 0, IQCODE<3.2; and III "normal aging" (N--subjects without neuropathological AD (Braak ≤ II and CERAD 0 or A and with normal cognitive function (CDR 0, IQCODE<3.2. Our results show that high levels of oxidative DNA damage are present in all groups. However, significant reductions in DNA repair and cell-cycle inhibition markers and increases in cell-cycle progression and cell death markers in subjects with CP-AD were detected when compared to both P-AD and N groups, whereas there were no significant differences in the studied markers between P-AD individuals and N subjects. This study indicates that, even in the setting of pathological AD, healthy cognition may be associated with a preserved repair to DNA damage, cell-cycle regulation, and cell death in post-mitotic neurons.

  6. Variable tellurite resistance profiles of clinically-relevant Shiga toxin-producing Escherichia coli (STEC) influence their recovery from foodstuffs.

    Science.gov (United States)

    Kerangart, Stéphane; Douëllou, Thomas; Delannoy, Sabine; Fach, Patrick; Beutin, Lothar; Sergentet-Thévenot, Delphine; Cournoyer, Benoit; Loukiadis, Estelle

    2016-10-01

    Tellurite (Tel)-amended selective media and resistance (Tel-R) are widely used for detecting Shiga toxin-producing Escherichia coli (STEC) from foodstuffs. Tel-R of 81 O157 and non-O157 STEC strains isolated from animal, food and human was thus investigated. Variations of STEC tellurite minimal inhibitory concentration (MIC) values have been observed and suggest a multifactorial and variable tellurite resistome between strains. Some clinically-relevant STEC were found highly susceptible and could not be recovered using a tellurite-based detection scheme. The ter operon was highly prevalent among highly Tel-R STEC but was not always detected among intermediately-resistant strains. Many STEC serogroup strains were found to harbor sublines showing a gradient of MIC values. These Tel-R sublines showed statistically significant log negative correlations with increasing tellurite concentration. Whatever the tellurite concentration, the highest number of resistant sublines was observed for STEC belonging to the O26 serogroup. Variations in the number of these Tel-R sublines could explain the poor recovery of some STEC serogroups on tellurite-amended media especially from food products with low levels of contamination. Comparison of tellurite MIC values and distribution of virulence-related genes showed Tel-R and virulence to be related.

  7. The influence of HCV coinfection on clinical, immunological and virological responses to HAART in HIV-patients

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    Ricardo A. Carmo

    2008-06-01

    Full Text Available The potential impact of the hepatitis C virus (HCV on clinical, immunological and virological responses to initial highly active antiretroviral therapy (HAART of patients infected with human immunodeficiency virus (HIV is important to evaluate due to the high prevalence of HIV-HCV coinfection. A historical cohort study was conducted among 824 HIV-infected patients starting HAART at a public referral service in Belo Horizonte, Brazil, to assess the impact of HCV seropositivity on appearance of a new AIDS-defining opportunistic illness, AIDS-related death, suppression of viral load, and an increase in CD4-cell count. A total of 76 patients (9.2% had a positive HCV test, 26 of whom (34.2% had a history of intravenous drug use. In multivariate analysis, HCV seropositivity was associated with a smaller CD4-cell recovery (RH=0.68; 95% CI [0.49-0.92], but not with progression to a new AIDS-defining opportunistic illness or to AIDS-related death (RH=1.08; 95% CI [0.66-1.77], nor to suppression of HIV-1 viral load (RH=0.81; 95% CI [0.56-1.17] after starting HAART. These results indicate that although associated with a blunted CD4-cell recovery, HCV coinfection did not affect the morbidity or mortality related to AIDS or the virological response to initial HAART.

  8. Clinical feasibility of Axillary Reverse Mapping and its influence on breast cancer related lymphedema: a systematic review.

    Science.gov (United States)

    Gebruers, Nick; Tjalma, Wiebren A A

    2016-05-01

    Breast cancer is the most common malignancy in women worldwide. Fortunately, the overall survival is good. Therefore it is important to focus on the morbidities related to breast cancer treatment. One of the most dreaded morbidities is lymphedema. In 2007 the Axillary Reverse Mapping (ARM) was introduced to limit the invasiveness in the axilla during breast cancer surgery. It is hypothesized that ARM is able to limit the incidence of breast cancer related lymphedema (BCRL) considerably. This systematic review aims to answer the following research questions: (1) which approaches for ARM are described? (2) Is ARM surgical feasible and oncological safe? (3) Does ARM decrease the incidence of lymphedema after sentinel lymph node biopsy (SLNB) and axillary lymph node dissection (ALND)? In total 27 papers were retrieved using four electronic databases (PubMed, Web of Science, Medline and Cochrane clinical trials; assessed until May 13, 2015. The level of evidence of these studies was low (mostly level 3). Therefore the conclusions are that the ARM procedure is feasible although ARM-node rates have a broad range. Additionally, from a theoretical point there is a clear benefit from ARM in terms of lymphedema prevention. From a practical point there is little scientific data to support this due to the lack of studies; and especially because of the different methods and definitions for lymphedema used in the different studies. PMID:27019287

  9. Variable tellurite resistance profiles of clinically-relevant Shiga toxin-producing Escherichia coli (STEC) influence their recovery from foodstuffs.

    Science.gov (United States)

    Kerangart, Stéphane; Douëllou, Thomas; Delannoy, Sabine; Fach, Patrick; Beutin, Lothar; Sergentet-Thévenot, Delphine; Cournoyer, Benoit; Loukiadis, Estelle

    2016-10-01

    Tellurite (Tel)-amended selective media and resistance (Tel-R) are widely used for detecting Shiga toxin-producing Escherichia coli (STEC) from foodstuffs. Tel-R of 81 O157 and non-O157 STEC strains isolated from animal, food and human was thus investigated. Variations of STEC tellurite minimal inhibitory concentration (MIC) values have been observed and suggest a multifactorial and variable tellurite resistome between strains. Some clinically-relevant STEC were found highly susceptible and could not be recovered using a tellurite-based detection scheme. The ter operon was highly prevalent among highly Tel-R STEC but was not always detected among intermediately-resistant strains. Many STEC serogroup strains were found to harbor sublines showing a gradient of MIC values. These Tel-R sublines showed statistically significant log negative correlations with increasing tellurite concentration. Whatever the tellurite concentration, the highest number of resistant sublines was observed for STEC belonging to the O26 serogroup. Variations in the number of these Tel-R sublines could explain the poor recovery of some STEC serogroups on tellurite-amended media especially from food products with low levels of contamination. Comparison of tellurite MIC values and distribution of virulence-related genes showed Tel-R and virulence to be related. PMID:27375242

  10. Severity of gastroesophageal reflux disease influences daytime somnolence:A clinical study of:t34 patients underwent upper panendoscopy

    Institute of Scientific and Technical Information of China (English)

    Pál Demeter; Katalin Várdi Visy; N(o)ra Gyulai; R(o)bert Sike; Tamás G T(o)th; János Novák; Pál Magyar

    2004-01-01

    AIM: To asses the relationship between severity of gastroesophageal refluxe disease and Epworth sleepiness scale as an indicator of daytime somnolence.METHODS: One hundred and thirty-four patients underwent an upper panendoscopy as indicated by the typical reflux symptoms and were also investigated with regard to somnolence. Sleepiness was evaluated by Epworth Sleepiness Scale, which was compared to the severity of endoscopic findings (Savary-Miller/modified by Siewert). Patients with psychiatric disorders or being on sedato-hypnotics as well as shift workers were excluded from the study. The relationship between the severity of the reflux disease and daytime somnolence was analyzed with the help of multivariate regression analysis.RESULTS: A positive tendency was found between the severity of the reflux disease and the corresponding Epworth Sleepiness Scale. In the case of the more severe type -Savary-Miller Ⅲ - at least a mild hypersomnia was found.For this group daytime somnolence was significantly higher than in the case of the non-erosive type of Gastroesophageal Reflux Disease representing the mildest stage of reflux disease.CONCLUSION: The severity of Gastroesophageal Reflux Disease influences daytime somnolence.

  11. The Influence of Sunlight Exposure on Serum Vitamin D Concentration and Bone Turnover; a controlled clinical trial

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    A Ataie-Jafari

    2008-11-01

    Full Text Available "nBackground: Sunlight exposure is one of the ways for vitamin D synthesis. However, its effect on vitamin D status via experimental studies is poorly understood. This study was undertaken to address the possibility that sunlight exposure may increase the levels of serum vitamin D, and alter bone turnover in healthy young girls."nMethods: In a controlled clinical trial, young girls were assigned to the test group (n= 45 or control group (n= 80. An out­door swimming pool was considered for this project and the test group was required to participate in these sessions at least for 8 sessions and to expose to direct sunlight at least for 20 minutes in each session. They were not allowed to use sun­screen during this time. Control group continued their usual manner of sun exposing. Serum levels of vitamin D, calcium, alkaline phosphatase, parathormone, osteocalcin and crossLaps were measured before and after duration of the study in both groups and compared between them."nResults: Subjects aged 27.46±8.78 years. Serum levels of vitamin D and bone markers were constant during the study in both groups. Changes of these variables were not significant between the groups after the study. Serum vitamin D in sub­jects with white skin color correlated with total time of direct sun exposing after the study (P= 0.002."nConclusion: Sunlight exposure did not affect the serum vitamin D and bone turnover in healthy young girls. However, sub­jects with bright skin complexion benefit from sunlight exposing more than those with a dark skin color in the case of vita­min D improvement.  

  12. Dietary approaches to stop hypertension influence on insulin receptor substrate-1gene expression: A randomized controlled clinical trial

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    Marzieh Kafeshani

    2015-01-01

    Full Text Available Background: Insulin receptor substrate (IRS Type 1 is a main substrate for the insulin receptor, controls insulin signaling in skeletal muscle, adipose tissue, and the vascular, so it is an important candidate gene for insulin resistance (IR. We aimed to compare the effects of the Dietary Approaches to Stop Hypertension (DASH and Usual Dietary Advices (UDA on IRS1 gene expression in women at risk for cardiovascular disease. Materials and Methods: A randomized controlled clinical trial was performed in 44 women at risk for cardiovascular disease. Participants were randomly assigned to a UDA diet or the DASH diet. The DASH diet was rich in fruits, vegetables, whole grains, and low-fat dairy products and low in saturated fat, total fat, cholesterol, refined grains, and sweets, with a total of 2400 mg/day sodium. The UDA diet was a regular diet with healthy dietary advice. Gene expression was assessed by the real-time polymerase chain reaction at the first of study and after 12 weeks. Independent sample t-test and paired-samples t-test were used to compare means of all variables within and between two groups respectively. Results: IRS1 gene expression was increased in DASH group compared with UDA diet (P = 0.00. Weight and waist circumference decreased in DASH group significantly compared to the UDA group (P < 0.05 but the results between the two groups showed no significant difference. Conclusion: DASH diet increased IRS1 gene expression and probably has beneficial effects on IR risks.

  13. Towards the clinical use of concentric electrodes in ECG recordings: influence of ring dimensions and electrode position

    Science.gov (United States)

    Prats-Boluda, G.; Ye-Lin, Y.; Bueno-Barrachina, JM; Rodriguez de Sanabria, R.; Garcia-Casado, J.

    2016-02-01

    To overcome the limited spatial resolution of standard 12-lead ECG recordings, concentric ring electrodes (CRE) have been proposed to provide valuable data for the diagnosis of a wide range of cardiac abnormalities, including infarction and arrhythmia. Although theoretical studies indicate that the dimensions of the CRE regulate the depth of the electric dipoles sensed by these electrodes, this has not been experimentally confirmed. The aim of this work was to analyze the influence of CRE dimensions and position of a wireless multi-CRE sensor node on the cardiac signal recorded. For this, four wireless multichannel ECG recording nodes based on flexible multi-ring electrodes were placed at positions CMV1 (position comparable to V1), CMV2, CMV4R and CMV5; each node providing three bipolar concentric ECG signals (BC-ECG). Standard 12-lead ECG and 12 BC-ECG signals were recorded in 29 volunteers. The results revealed that a ring with an outer diameter of 33.5 mm achieves a balance between the ease-of-use and spatial resolution of smaller electrodes and improved detectability and higher amplitudes of signals from larger ring electrodes. Although a standard 12-lead ECG outperforms BC-ECC recordings in detectability of cardiac waves, if the relative amplitude of the wave is also considered, BC-ECG at CMV1 proved superior at picking up atrial activity. In fact, in most of the BC-ECG signals picked up at CMV1, P1 and P2 atrial activity waves were more clearly identified than in simultaneous 12-Lead ECG signals. Likewise, BC-ECG signals revealed higher spatial resolution in detecting anomalous electrical activity in local regions, such as impaired intraventricular driving, or atrioventricular blocks. Finally, the wireless multi-CRE sensor node provides enhanced comfort and handling to both patient and clinician over wired systems.

  14. 护士职业倦怠的影响因素分析%Study on Clinical Nurses’ job Burnout and its Influencing Factors

    Institute of Scientific and Technical Information of China (English)

    夏晶

    2015-01-01

    目的:探讨杭州地区临床护士职业倦怠的现状及其影响因素。方法采用护士职业倦怠量表对浙江省杭州市3所三级甲等医院658名临床护士进行问卷调查。结果临床护士职业倦怠程度高于常模(P<0.05);职称、用工性质、月收入是影响护士职业倦怠的重要因素。结论被调查护士职业倦怠明显,护理管理者应加强组织支持,降低临床护士的职业倦怠,进而稳定护理队伍。%Objective To explore the nurses’ job burnout and its influencing factors in Hangzhou. Methods 658 clinical nurses from 3 hospitals in Hangzhou were interviewed with job burnout scale. Results The score of nurses’ job burnout was higher the norm (P<0.05). Professional title, nature of employment, monthly income were the influencing factors of job burnout. Conclusion The nurses’ job burnout were obvious in Hangzhou, the managers should build good organizational support in order to reduce nurses’ job burnout and stable care team.

  15. INHALED NITRIC OXIDE: CLINICAL EFFECTS AND INFLUENCE ON THE PROFILE OF INFLAMMATORY MARKERS IN PATIENTS WITH IDIOPATHIC PULMONARY HYPERTENSION

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    T. V. Martynyuk

    2015-12-01

    Full Text Available Aim. To study the effect of treatment with inhaled nitric oxide (iNO on the clinical status of patients with idiopathic pulmonary hypertension (IPH, and the profile of proinflammatory cytokines in peripheral blood. Material and methods. Patients with IPH (n=48 were included into the study. Evaluation of the IPH functional class (FC, the 6-minute walk test (6MWT with the assessment of the Borg index, echocardiography , laboratory tests [blood count, evaluation of high-sensitivity C-reactive protein (hsCRP, interleukins (IL, interferon-γ (INFγ, tumor necrosis factor a (TNFa, macrophage inflammatory protein a (MIP1 a, soluble adhesion molecules (sICAM-1, sVCAM-1 in peripheral blood] were performed at baseline and on day 21 of iNO therapy course. The iNO course 40 ppm during 5 hours a day for 21 days was carried out additionally to the standard IPH therapy under the toxicity control by the PrinterNOx (England. Results. Increase in exercise tolerance, improvement of IPH FC (from 3.35±0.52 to 2.71±0.56; p=0.008, reduction in systolic pulmonary artery pressure (SPAP by Doppler echocardiography (from 96.23±23.65 to 82.36±20.92 mmHg; p<0.05 were found in IPH patients as a result of iNo therapy. The significance of inflammation in IPH pathogenesis was confirmed due to assessment of the initial levels of proinflammatory cytokines. iNO therapy resulted in significant decrease in proinflammatory cytokines-IL-1β, IL-6, IL-8, TNFa levels. iNO induced significant dynamics of IL-1β and sVCAM in patients with IPH FC II. It reduced IL-8 and TNFa and increase INFγ (p<0.05 in patients with IPH FC III-IV. Changes in IL-1β and sVCAM levels (ΔIL-1β and ΔsVCAM by the 21 day of iNO therapy in comparison with these at baseline correlated with ΔSPAP , and ΔIL-6 correlated with ΔFC and Δ6MWT distance (30.5 [21.0; 53.0] m; p<0.001. This allows considering these indicators as markers of iNO treatment efficacy. Conclusions. 21-day iNO therapy in IPH patients

  16. INHALED NITRIC OXIDE: CLINICAL EFFECTS AND INFLUENCE ON THE PROFILE OF INFLAMMATORY MARKERS IN PATIENTS WITH IDIOPATHIC PULMONARY HYPERTENSION

    Directory of Open Access Journals (Sweden)

    T. V. Martynyuk

    2012-01-01

    Full Text Available Aim. To study the effect of treatment with inhaled nitric oxide (iNO on the clinical status of patients with idiopathic pulmonary hypertension (IPH, and the profile of proinflammatory cytokines in peripheral blood. Material and methods. Patients with IPH (n=48 were included into the study. Evaluation of the IPH functional class (FC, the 6-minute walk test (6MWT with the assessment of the Borg index, echocardiography , laboratory tests [blood count, evaluation of high-sensitivity C-reactive protein (hsCRP, interleukins (IL, interferon-γ (INFγ, tumor necrosis factor a (TNFa, macrophage inflammatory protein a (MIP1 a, soluble adhesion molecules (sICAM-1, sVCAM-1 in peripheral blood] were performed at baseline and on day 21 of iNO therapy course. The iNO course 40 ppm during 5 hours a day for 21 days was carried out additionally to the standard IPH therapy under the toxicity control by the PrinterNOx (England. Results. Increase in exercise tolerance, improvement of IPH FC (from 3.35±0.52 to 2.71±0.56; p=0.008, reduction in systolic pulmonary artery pressure (SPAP by Doppler echocardiography (from 96.23±23.65 to 82.36±20.92 mmHg; p<0.05 were found in IPH patients as a result of iNo therapy. The significance of inflammation in IPH pathogenesis was confirmed due to assessment of the initial levels of proinflammatory cytokines. iNO therapy resulted in significant decrease in proinflammatory cytokines-IL-1β, IL-6, IL-8, TNFa levels. iNO induced significant dynamics of IL-1β and sVCAM in patients with IPH FC II. It reduced IL-8 and TNFa and increase INFγ (p<0.05 in patients with IPH FC III-IV. Changes in IL-1β and sVCAM levels (ΔIL-1β and ΔsVCAM by the 21 day of iNO therapy in comparison with these at baseline correlated with ΔSPAP , and ΔIL-6 correlated with ΔFC and Δ6MWT distance (30.5 [21.0; 53.0] m; p<0.001. This allows considering these indicators as markers of iNO treatment efficacy. Conclusions. 21-day iNO therapy in IPH patients

  17. Nordic veterinarians' threshold for medical treatment of dairy cows, influence on disease recording and medicine use: mild clinical mastitis as an example.

    Science.gov (United States)

    Espetvedt, Mari N; Rintakoski, Simo; Wolff, Cecilia; Lind, Ann-Kristina; Lindberg, Ann; Virtala, Anna-Maija K

    2013-10-01

    National databases for dairy cows in the four Nordic countries, Denmark, Finland, Norway and Sweden, have been found to capture varying proportions of disease events on farm. A variation in the thresholds of veterinarians to initiate medical treatment may be a reason for this. Studying these thresholds may increase the understanding of prudent use of antibiotics. The primary objective of this study was to investigate whether Nordic veterinarians, on a between country-level, vary in their intention to start medical treatment of a dairy cow with mild clinical mastitis, on the same day as making the diagnosis. The threshold for initiating treatment was quantified as an intention score. Secondary, underlying behavioural components of the intention score was studied within each country. A social psychology model, the Theory of Planned Behaviour (TPB), was used to design a questionnaire that was distributed to 1047 veterinarians in cattle practice in the four countries during autumn 2010. The response rate was around 50% in all the countries, and 543 observations were retained for analysis. The between-country differences in intention were tested with one-way analysis of variance. Multivariable linear regression was used to estimate the proportion of variability in intention explained by the three behavioural components, attitude, subjective norm and perceived behavioural control. The Spearman rank correlations between specific beliefs about the behaviour and intention scores were estimated to find beliefs of high influence on the decision to treat or not. Intention scores differed between all countries (pmodels, the underlying behavioural components of the TPB explained 0.37, 0.41, 0.40 and 0.48 of the variation in intention scores in DK, FI, NO and SE, respectively. Attitude was the most important predictor in DK, NO and SE, but perceived behavioural control was most important in FI. In all countries the specific attitude belief of highest influence was that starting

  18. Influence of Clinical Nursing Students' Empathy Ability on Effect of Practice%实习护生共情能力对实习效果的影响

    Institute of Scientific and Technical Information of China (English)

    杨敏; 肖丽

    2013-01-01

    Objective To explore the correlation between the clinical nursing students' empathy ability and practice effect so as to determine the influencing factors of clinical practice to improve their clinical practice effect. Methods Self-designed empathy ability questionnaire and nursing department internship practice effect feedback questionnaire were used to assess the correlation between empathy ability and practice effect among the selected 98 nursing students. Results There is a relatively positive correlation between empathy ability and practice effect (r=0. 924,P0. 05). Conclusion According to the result of this study, empathy ability and practice effect of clinical nursing students are all relatively well. In order to improve the effect of practice, nursing administrators should train and improve the empathy ability of practice nursing students,especially the nursing knowledge and communicative skills.%目的 探讨实习护生共情能力与实习效果之间的关系,为培养护生的共情能力及提高其实习效果提供依据.方法 应用自行设计的共情能力调查问卷和护理部的实习效果反馈表,对98名护生进行调查,对共情能力与实习效果进行相关性分析.结果 实习护生共情能力与实习效果之间呈显著正相关(r=0.924,P<0.01),共情能力与实习效果中的理论知识(r=0.823,P0.05).结论 实习护生的共情能力及实习效果均相对较好,而加强实习护生的共情能力可进一步提高其临床实习质量,尤其是护生的理论知识及沟通能力.

  19. Influence of postoperative low-level laser therapy on the osseointegration of self-tapping implants in the posterior maxilla: A 6-week split-mouth clinical study

    Directory of Open Access Journals (Sweden)

    Mandić Borka

    2015-01-01

    Full Text Available Background/Aim. Low-level laser therapy (LLLT has been proven to stimulate bone repair, affecting cellular proliferation, differentiation and adhesion, and has shown a potential to reduce the healing time following implant placement. The aim of this clinical study was to investigate the influence of postoperative LLLT osseointegration and early success of self-tapping implants placed into low-density bone. Methods. Following the split-mouth design, self-tapping implants (n = 44 were inserted in the posterior maxilla of 12 patients. One jaw side randomly received LLLT (test group, while the other side was placebo (control group. For LLLT, a 637 nm gallium-aluminum-arsenide (GaAlAs laser (Medicolaser 637, Technoline, Belgrade, Serbia with an output power of 40 mW and continuous wave was used. Low-level laser treatment was performed immediately after the surgery and then repeated every day in the following 7 days. The total irradiation dose per treatment was 6.26 J/cm² per implant. The study outcomes were: implant stability, alkaline-phosphatase (ALP activity and early implant success rate. The follow-up took 6 weeks. Results. Irradiated implants achieved a higher stability compared with controls during the entire follow-up and the difference reached significance in the 5th postoperative week (paired t-test, p = 0.030. The difference in ALP activity between the groups was insignificant in any observation point (paired t-test, p > 0.05. The early implant success rate was 100%, regardless of LLLT usage. Conclusion. LLLT applied daily during the first postoperative week expressed no significant influence on the osseointegration of selftapping implants placed into low density bone of the posterior maxilla. Placement of self-tapping macro-designed implants into low density bone could be a predictable therapeutic procedure with a high early success rate regardless of LLLT usage.

  20. Clinical pharmacology of 3,4-methylenedioxymethamphetamine (MDMA, "ecstasy": the influence of gender and genetics (CYP2D6, COMT, 5-HTT.

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    Ricardo Pardo-Lozano

    Full Text Available The synthetic psychostimulant MDMA (± 3,4-methylenedioxymethamphetamine, ecstasy acts as an indirect serotonin, dopamine, and norepinephrine agonist and as a mechanism-based inhibitor of the cytochrome P-450 2D6 (CYP2D6. It has been suggested that women are more sensitive to MDMA effects than men but no clinical experimental studies have satisfactorily evaluated the factors contributing to such observations. There are no studies evaluating the influence of genetic polymorphism on the pharmacokinetics (CYP2D6; catechol-O-methyltransferase, COMT and pharmacological effects of MDMA (serotonin transporter, 5-HTT; COMT. This clinical study was designed to evaluate the pharmacokinetics and physiological and subjective effects of MDMA considering gender and the genetic polymorphisms of CYP2D6, COMT, and 5-HTT. A total of 27 (12 women healthy, recreational users of ecstasy were included (all extensive metabolizers for CYP2D6. A single oral weight-adjusted dose of MDMA was administered (1.4 mg/kg, range 75-100 mg which was similar to recreational doses. None of the women were taking oral contraceptives and the experimental session was performed during the early follicular phase of their menstrual cycle. Principal findings show that subjects reached similar MDMA plasma concentrations, and experienced similar positive effects, irrespective of gender or CYP2D6 (not taking into consideration poor or ultra-rapid metabolizers or COMT genotypes. However, HMMA plasma concentrations were linked to CYP2D6 genotype (higher with two functional alleles. Female subjects displayed more intense physiological (heart rate, and oral temperature and negative effects (dizziness, sedation, depression, and psychotic symptoms. Genotypes of COMT val158met or 5-HTTLPR with high functionality (val/val or l/* determined greater cardiovascular effects, and with low functionality (met/* or s/s negative subjective effects (dizziness, anxiety, sedation. In conclusion, the contribution

  1. Does the organizational model of the maternity health clinic have an influence on women’s and their partners’ experiences? A service evaluation survey in Southwest Finland

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    Tuominen Miia

    2012-09-01

    Full Text Available Abstract Background In high-income countries, great disparities exist in the organizational characteristics of maternity health services. In Finland, primary maternity care is provided at communal maternity health clinics (MHC. At these MHCs there are public health nurses and general practitioners providing care. The structure of services in MHCs varies largely. MHCs are maintained independently or merged with other primary health care sectors. A widely used organizational model of services is a combined maternity and child health clinic (MHC & CHC where the same public health nurse takes care of the family from pregnancy until the child is at school age. The aim of this study was to determine how organizational model, MHC independent or combined MHC & CHC, influence on women’s and their partners’ service experiences. Methods A comparative, cross-sectional service evaluation survey was used. Women (N = 995 and their partners (N = 789 were recruited from the MHCs in the area of Turku University Hospital. Four months postpartum, the participants were asked to evaluate the content and amount of the MHC services via a postal questionnaire. Comparisons were made between the clients of the separate MHCs and the MHCs combined to the child health clinics. Results Women who had used the combined MHC & CHCs generally evaluated services more positively than women who had used the separate MHCs. MHC’s model was related to several aspects of the service which were evaluated “good” (the content of the service or “much” (the amount of the service. Significant differences accumulated favoring the combined MHC & CHCs’ model. Twelve aspects of the service were ranked more often as “good” or “much” by the parents who had used the combined MHC & CHC, only group activities regarding delivery were evaluated better by women who had used the separate MHCs. Conclusions Based on the women’s and partners’ experiences an organizational

  2. Changes in Peripheral Hemodynamics and Clinical Symptoms in Patients With Arterial Hypertension and Abdominal Obesity Under the Influence of Treatment, Depending on Genes’ Polymorphism

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    Alina Sokolenko

    2015-03-01

    Full Text Available In 110 patients with essential arterial hypertension (EAH and overweight or abdominal obesity (AO analyzed changes of peripheral hemodynamics and clinical signs under the influence of treatment, depending on genes’ polymorphism of the Angiotensin-converting enzyme (ACE, I/D and the Peroxisome proliferator-activated receptor gamma-2 (PPAR-2, Pro12Ala. Under the combined treatment the "target" office blood pressure (BP was achieved in 72.8 % subjects, the "adequate" reduction of BP – in 82.6 % patients. Depending on the EAH severity: "target" BP achieved in 100% patients with EAH I stage vs 76.2 % in person with EAH II stage (p=0.019 and 53.1 % – with EAH III stage (p=0.002. "Target" average daily BP24, daily BPd and nighttime BPn were achieved in 70.0 % patients (prevail those with EAH I-II stages by 47.1 % and 21.2 % (p=0.049, respectively, in I-allele carriers of ACE gene – by 17,9% (p=0.048 and Ala-allele carriers of PPAR-2 gene by 38.9 % (p=0.036.

  3. A clinical study on influencing factors of removable denture malodor%可摘义齿异味的影响因素

    Institute of Scientific and Technical Information of China (English)

    柴治国; 杨彦伟; 张宏晨; 张雅丽; 吉兆华; 张少锋

    2012-01-01

    目的:了解可摘义齿的异味状况并探讨其影响因素,为可摘义齿的异味控制提供指导.方法:以226例可摘义齿佩戴者为对象,进行问卷调查和义齿临床检查,对调查结果进行单因素分析和Logistic回归分析.结果:可摘义齿异味率为76.5%;单因素分析显示,不同年龄组、文化程度、月收入、是否吸烟、是否喝咖啡、不同清洁方式、义齿夜间是否浸泡水中均对可摘义齿的异味发生有影响,差异有统计学意义(P<0.05);多因素Logistic回归分析显示,年龄和清洁方式是义齿异味发生的主要影响因素,OR值分别为5.092,29.451.结论:可摘义齿的异味发生率较高,高年龄人群的义齿较易产生异味,使用高效的清洁方式(如义齿清洁剂)可有效减少义齿异味的发生.%AIM: To investigate the malodor status of removable dentures and explore its influencing factors in order to provide a guide for malodor control. METHODS: A questionnaire survey and clinical examination of 226 patients with removable dentures were carried out, and multifactorial logistic regression analysis followed by monofacto-rial analysis was applied to analyze the survey results. RESULTS: The prevalence of denture malodor was 76. 5%. According to monofactorial analysis, age, education level, monthly income, smoking, drinking coffee, cleaning methods and immersing denture in water overnight all had significant effects on denture malodor( P < 0.05). Logistic regression analysis showed that age (OR =5.092) and cleaning methods (OR =29.451) were the main influencing factors. CONCLUSION: The prevalence of denture malodor is high. Malodor of denture is more prevalent in the elderly and efficient cleaning method such as denture cleanser is more efficient in reducing denture malodor.

  4. Beyond KRAS mutation status: influence of KRAS copy number status and microRNAs on clinical outcome to cetuximab in metastatic colorectal cancer patients

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    Mekenkamp Leonie JM

    2012-07-01

    Full Text Available Abstract Background KRAS mutation is a negative predictive factor for treatment with anti-epidermal growth factor receptor (EGFR antibodies in metastatic colorectal cancer (mCRC. Novel predictive markers are required to further improve the selection of patients for this treatment. We assessed the influence of modification of KRAS by gene copy number aberration (CNA and microRNAs (miRNAs in correlation to clinical outcome in mCRC patients treated with cetuximab in combination with chemotherapy and bevacizumab. Methods Formalin-fixed paraffin-embedded primary tumour tissue was used from 34 mCRC patients in a phase III trial, who were selected based upon their good (n = 17 or poor (n = 17 progression-free survival (PFS upon treatment with cetuximab in combination with capecitabine, oxaliplatin, and bevacizumab. Gene copy number at the KRAS locus was assessed using high resolution genome-wide array CGH and the expression levels of 17 miRNAs targeting KRAS were determined by real-time PCR. Results Copy number loss of the KRAS locus was observed in the tumour of 5 patients who were all good responders including patients with a KRAS mutation. Copy number gains in two wild-type KRAS tumours were associated with a poor PFS. In KRAS mutated tumours increased miR-200b and decreased miR-143 expression were associated with a good PFS. In wild-type KRAS patients, miRNA expression did not correlate with PFS in a multivariate model. Conclusions Our results indicate that the assessment of KRAS CNA and miRNAs targeting KRAS might further optimize the selection of mCRC eligible for anti-EGFR therapy.

  5. Clinical Holistic Medicine: Factors Influencing The Therapeutic Decision-Making. From Academic Knowledge to Emotional Intelligence and Spiritual “Crazy” Wisdom

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    Søren Ventegodt

    2007-01-01

    Full Text Available Scientific holistic medicine is built on holistic medical theory, on therapeutic and ethical principles. The rationale is that the therapist can take the patient into a state of salutogenesis, or existential healing, using his skills and knowledge. But how ever much we want to make therapy a science it remains partly an art, and the more developed the therapist becomes, the more of his/her decisions will be based on intuition, feeling and even inspiration that is more based on love and human concern and other spiritual motivations than on mental reason and rationality in a simple sense of the word. The provocative and paradoxal medieval western concept of the “truth telling clown”, or the eastern concepts of “crazy wisdom” and “holy madness” seems highly relevant here. The problem is how we can ethically justify this kind of highly “irrational” therapeutic behavior in the rational setting of a medical institution. We argue here that holistic therapy has a very high success rate and is doing no harm to the patient, and encourage therapists, psychiatrists, psychologist and other academically trained “helpers” to constantly measure their own success-rate. This paper discusses many of the important factors that influence clinical holistic decision-making. Sexuality could, as many psychoanalysts from Freud to Reich and Searles have believed, be the most healing power that exists and also the most difficult for the mind to comprehend, and thus the most “crazy-wise” tool of therapy.

  6. The Pitfalls of Collegial Coaching: An Analysis of Collegial Coaching in Medical Education and Its Influence on Stimulating Reflection and Performance of Novice Clinical Teachers

    Science.gov (United States)

    Truijen, Karin J. P.; van Woerkom, Marianne

    2008-01-01

    Purpose: Competent clinical teachers are essential for clinical teaching. According to the literature, coaching can contribute to improved levels of reflection and better performance of clinical teachers. By engaging in a dialogue about coachee's teaching behaviour, coaches can stimulate reflection of novice teachers. This study aims to gain…

  7. [Influence of a low-calorie diet with inclusion of probiotic product containing bacterias Lactobacillus plantarum Tensia DSM 21380 on clinical and metabolic characteristics in patients with obesity and arterial hypertension].

    Science.gov (United States)

    Sharafetdinov, Kh Kh; Plotnikova, O A; Alekseeva, R I; Sentsova, T B; Kaganov, B S

    2012-01-01

    In a number of studies it is shown that regular use of the probiotic products containing Lactobacillus plantarum Tensia DSM 21380 in complex dietary treatment, not only modulates intestinal microflora, but also has a positive influence on a functional condition of cardiovascular system including levelels of systolic and diastolic blood pressure. The aim of this research was to study the influence of dietotherapy with inclusion of the probiotic product containing Lactobacillus plantarum Tensia DSM 21380, on clinical and metabolic characteristics in patients with obesity and accompanying arterial hypertension (AH).

  8. [Influence of a low-calorie diet with inclusion of probiotic product containing bacterias Lactobacillus plantarum Tensia DSM 21380 on clinical and metabolic characteristics in patients with obesity and arterial hypertension].

    Science.gov (United States)

    Sharafetdinov, Kh Kh; Plotnikova, O A; Alekseeva, R I; Sentsova, T B; Kaganov, B S

    2012-01-01

    In a number of studies it is shown that regular use of the probiotic products containing Lactobacillus plantarum Tensia DSM 21380 in complex dietary treatment, not only modulates intestinal microflora, but also has a positive influence on a functional condition of cardiovascular system including levelels of systolic and diastolic blood pressure. The aim of this research was to study the influence of dietotherapy with inclusion of the probiotic product containing Lactobacillus plantarum Tensia DSM 21380, on clinical and metabolic characteristics in patients with obesity and accompanying arterial hypertension (AH). PMID:22642170

  9. Factors influencing clinical trial site selection in Europe: the Survey of Attitudes towards Trial sites in Europe (the SAT-EU Study)

    OpenAIRE

    Gehring, Marta; Taylor, Rod S; Mellody, Marie; Casteels, Brigitte; Piazzi, Angela; Gensini, Gianfranco; Ambrosio, Giuseppe

    2013-01-01

    Objectives Applications to run clinical trials in Europe fell 25% between 2007 and 2011. Costs, speed of approvals and shortcomings of European Clinical Trial Directive are commonly invoked to explain this unsatisfactory performance. However, no hard evidence is available on the actual weight of these factors or has it been previously investigated whether other criteria may also impact clinical trial site selection. Design The Survey of Attitudes towards Trial sites in Europe (SAT-EU Study) w...

  10. Clinical and virological factors influencing the performance of a NS1 antigen-capture assay and potential use as a marker of dengue disease severity.

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    Veasna Duong

    2011-07-01

    Full Text Available BACKGROUND: Detection of dengue NS1 antigen in acute infection has been proposed for early diagnosis of dengue disease. The aim of this study was to evaluate the clinical and virological factors influencing the performance of the Platelia NS1 Ag kit (BioRad and to assess the potential use of NS1 antigen and dengue viral loads as markers of dengue disease severity. METHODOLOGY/PRINCIPAL FINDINGS: Blood specimens were collected from patients hospitalized at the Kampong Cham hospital during the 2006 and 2007 dengue epidemics in Cambodia. Dengue infection was confirmed in 243/339 symptomatic patients and in 17 asymptomatic individuals out of 214 household members tested. Overall sensitivity and specificity of Platelia NS1 Ag kit were 57.5% and 100% respectively. NS1 Ag assay combined with IgM antibody capture ELISA significantly increased the sensitivity for dengue diagnosis. NS1 Ag positivity rate was found significantly higher in DF than in DHF/DSS, in primary than in secondary infections, in patients with a high viremia (>5 log/mL and in patients infected with DENV-1. In asymptomatic individuals, the NS1 Ag capture sensitivity tends to be lower than that in symptomatic patients. Milder disease severity was observed independently in patients with RNA copy number >5 log10 cDNA equivalents/mL or in high level of NS1 antigen ratio or in DENV-1 infection. CONCLUSIONS: Overall sensitivity of NS1 Ag detection kit varied widely across the various forms of dengue infection or disease. Sensitivity was highest in patients sampled during the first 3 days after onset of fever, in patients with primary infection, DENV-1 infection, with high level of viremia and in DF rather than DHF/DSS. In asymptomatic patients, RT-PCR assay has proved to be more sensitive than NS1 antigen detection. The NS1 antigen level correlated significantly with viremia and a low NS1 antigen ratio was associated with more severe disease.

  11. The Influence of Family and Significant Others on Women's Decisions to Obtain an Abortion: A Study of a Northwest Louisiana Abortion Clinic

    Science.gov (United States)

    Solomon, Bertina Loutrice

    2011-01-01

    This study researched whether family members and significant others influence a woman's decision to obtain an abortion. Influence is defined by Merriam-Webster (2011) as the power or capacity of causing an effect in indirect or intangible ways; power exerted over the minds or behaviors of others. The theoretical framework that will be used in…

  12. Multivariable analysis of clinical influence factors on liver enhancement of Gd-EOB-DTPA-enhanced 3T MRI; Multivariable Analyse klinischer Einflussfaktoren auf die Signalintensitaet bei Gd-EOB-DTPA 3T-MRT der Leber

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    Verloh, N.; Haimerl, M.; Stroszczynski, C.; Fellner, C.; Wiggermann, P. [University Hospital Regensburg (Germany). Dept. of Radiology; Zeman, F. [University Hospital Regensburg (Germany). Center for Clinical Trials; Teufel, A. [University Hospital Regensburg (Germany). Dept. of Gastroenterology; Lang, S. [University Hospital Regensburg (Germany). Dept. of Surgery

    2015-01-15

    The purpose of this study was to identify clinical factors influencing Gd-EOB-DTPA liver uptake in patients with healthy liver parenchyma. A total of 124 patients underwent contrast-enhanced MRI with a hepatocyte-specific contrast agent at 3T. T1-weighted volume interpolated breath-hold examination (VIBE) sequences with fat suppression were acquired before and 20 minutes after contrast injection. The relative enhancement (RE) between plain and contrast-enhanced signal intensity was calculated. Simple and multiple linear regression analyses were performed to evaluate clinical factors influencing the relative enhancement. Patients were subdivided into three groups according to their relative liver enhancement (HRE, RE ≥ 100 %; MRE, 100 % > RE > 50 %; NRE, RE ≤ 50 %) and were analyzed according to the relevant risk factors. Simple regression analyses revealed patient age, transaminases (AST, ALT, GGT), liver, spleen and delta-liver volume (the difference between the volumetrically measured liver volume and the estimated liver volume based on body weight) as significant factors influencing relative enhancement. In the multiple analysis the transaminase AST, spleen and delta liver volume remained significant factors influencing relative enhancement. Delta liver volume showed a significant difference between all analyzed groups. Liver enhancement in the hepatobiliary phase depends on a variety of factors. Body weight-adapted administration of Gd-EOB-DTPA may lead to inadequate liver enhancement after 20 minutes especially when the actual liver volume differs from the expected volume.

  13. Examining Factors Influencing Colorectal Cancer Screening of Rural Nebraskans Using Data from Clinics Participating in an Accountable Care Organization: A Study Protocol [v1; ref status: indexed, http://f1000r.es/5me

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    Lufei Young

    2015-07-01

    Full Text Available Background: Although mortality rates of colorectal cancer (CRC can be significantly reduced through increased screening, rural communities are still experiencing lower rates of screening compared to urban counterparts. Understanding and eliminating barriers to cancer screening will decrease cancer burden and lead to substantial gains in quality and quantity of life for rural populations. However, existing studies have shown inconsistent findings and fail to address how contextual and provider-level factors impact CRC screening in addition to individual-level factors.  Purpose: The purpose of the study is to examine multi-level factors related to CRC screening, and providers’ perception of barriers and facilitators of CRC screening in rural patients cared for by accountable care organization (ACO clinics. Methods/Design: This is a convergent mixed method design. For the quantitative component, multiple data sources, such as electronic health records (EHRs, Area Resource File (ARF, and provider survey data, will be used to examine patient-, provider-, clinic-, and county-level factors. About 21,729 rural patients aged between 50 and 75 years who visited the participating ACO clinics in the past 12 months are included in the quantitative analysis. The qualitative methods include semi-structured in-depth interviews with healthcare professionals in selected rural clinics. Both quantitative and qualitative data will be merged for result interpretation. Quantitative data identifies “what” factors influence CRC screening, while qualitative data explores “how” these factors interact with CRC screening. The study setting is 10 ACO clinics located in nine rural Nebraska counties. Discussion: This will be the first study examining multi-level factors related to CRC screening in the new healthcare delivery system (i.e., ACO clinics in rural communities. The study findings will enhance our understanding of how the ACO model, particularly in rural

  14. Use of Drop-In Clinic Versus Appointment-Based Care for LGBT Youth: Influences on the Likelihood to Access Different Health-Care Structures.

    Science.gov (United States)

    Newman, Bernie S; Passidomo, Kim; Gormley, Kate; Manley, Alecia

    2014-06-01

    The structure of health-care service delivery can address barriers that make it difficult for lesbian, gay, bisexual, and transgender (LGBT) adolescents to use health services. This study explores the differences among youth who access care in one of two service delivery structures in an LGBT health-care center: the drop-in clinic or the traditional appointment-based model. Analysis of 578 records of LGBT and straight youth (aged 14-24) who accessed health care either through a drop-in clinic or appointment-based care within the first year of offering the drop-in clinic reveals patterns of use when both models are available. We studied demographic variables previously shown to be associated with general health-care access to determine how each correlated with a tendency to use the drop-in structure versus routine appointments. Once the covariates were identified, we conducted a logistic regression analysis to identify its association with likelihood of using the drop-in clinic. Insurance status, housing stability, education, race, and gender identity were most strongly associated with the type of clinic used. Youth who relied on Medicaid, those in unstable housing, and African Americans were most likely to use the drop-in clinic. Transgender youth and those with higher education were more likely to use the appointment-based clinic. Although sexual orientation and HIV status were not related to type of clinic used, youth who were HIV positive used the appointment-based clinic more frequently. Both routes to health care served distinct populations who often experience barriers to accessible, affordable, and knowledgeable care. Further study of the factors related to accessing health care may clarify the extent to which drop-in hours in a youth-friendly context may increase the use of health care by the most socially marginalized youth.

  15. Use of Drop-In Clinic Versus Appointment-Based Care for LGBT Youth: Influences on the Likelihood to Access Different Health-Care Structures.

    Science.gov (United States)

    Newman, Bernie S; Passidomo, Kim; Gormley, Kate; Manley, Alecia

    2014-06-01

    The structure of health-care service delivery can address barriers that make it difficult for lesbian, gay, bisexual, and transgender (LGBT) adolescents to use health services. This study explores the differences among youth who access care in one of two service delivery structures in an LGBT health-care center: the drop-in clinic or the traditional appointment-based model. Analysis of 578 records of LGBT and straight youth (aged 14-24) who accessed health care either through a drop-in clinic or appointment-based care within the first year of offering the drop-in clinic reveals patterns of use when both models are available. We studied demographic variables previously shown to be associated with general health-care access to determine how each correlated with a tendency to use the drop-in structure versus routine appointments. Once the covariates were identified, we conducted a logistic regression analysis to identify its association with likelihood of using the drop-in clinic. Insurance status, housing stability, education, race, and gender identity were most strongly associated with the type of clinic used. Youth who relied on Medicaid, those in unstable housing, and African Americans were most likely to use the drop-in clinic. Transgender youth and those with higher education were more likely to use the appointment-based clinic. Although sexual orientation and HIV status were not related to type of clinic used, youth who were HIV positive used the appointment-based clinic more frequently. Both routes to health care served distinct populations who often experience barriers to accessible, affordable, and knowledgeable care. Further study of the factors related to accessing health care may clarify the extent to which drop-in hours in a youth-friendly context may increase the use of health care by the most socially marginalized youth. PMID:26789623

  16. Influence of scaffolding instruction on clinical communication skills of nursing students in clinical practice%支架式教学对专科实习护生临床沟通能力影响的研究

    Institute of Scientific and Technical Information of China (English)

    任秀红; 韩向东; 石素宁

    2015-01-01

    Objective To study the effects of scaffolding instruction on clinical communication skills of nursing students in clinical practice of neurology.Methods A total of 40 undergraduate nursing students of Grade 2011 in Zibo medical colledge taking part in the clinical practice were randomly divided into two groups .Twenty students in hospital A as the intervention group took scaffolding instruction on the basis of routine clinical practice,while the other 20 students in hospital B as the control group took routine clinical practice. After 2 months′clinical practice,clinical communication skills and confidence in communication of two groups were respectively measured by questionnaire.Results After 2 months of clinical practice,the score of clinical communication in intervention group was higher than that in control group(t=4.763,P<0.01).The confidence in communication in intervention group was higher than that in control group (t=2.184,P<0.05). Conclusion Communication skills training based on scaffolding instruction can effectively improve clinical communication and confidence in communication for nursing students in praxis.%目的:探讨神经内科运用支架式教学在实习护生临床沟通能力中的应用效果。方法采用方便抽样法选取淄博市某医学院校在 A医院神经内科实习的20名护生为干预组,实习期间在传统带教基础上采用支架式教学开展沟通技能培训,同时选取同校在 B医院神经内科实习的20名护生为对照组,采用传统带教模式,实习时间为2个月。在干预前后同时进行沟通能力测评和沟通技能自信问卷调查。结果实习2个月后,干预组临床沟通能力明显好于对照组(t=4.763,P<0.01)。干预组沟通自信得分高于对照组(t=2.184,P<0.05)。结论支架式教学模式能有效提高实习护生的临床沟通能力和沟通自信心。

  17. An exploration of family therapists' beliefs about the ethics of conversion therapy: the influence of negative beliefs and clinical competence with lesbian, gay, and bisexual clients.

    Science.gov (United States)

    McGeorge, Christi R; Carlson, Thomas Stone; Toomey, Russell B

    2015-01-01

    The majority of the literature on conversion therapy has focused on clients' experiences and rationales for seeking such therapy. This study sought to explore differences in the beliefs and clinical competence of therapists who practice and believe in the ethics of conversion therapy and those who do not. The sample for this study included 762 family therapists who were members of the American Association of Marriage and Family Therapy. Data were collected using electronic surveys that assessed participants' negative beliefs about and perceived clinical competence with lesbian, gay, and bisexual (LGB) individuals. Results indicate that those who believe in the ethics of and/or practice conversion therapy report statistically higher levels of negative beliefs about LGB individuals and lower levels of clinical competence working with LGB clients. Implications for clinical practice and organizational policy are discussed. PMID:24750074

  18. No (Wo)Man Is an Island-The Influence of Physicians' Personal Predisposition to Labia Minora Appearance on Their Clinical Decision Making : A Cross-Sectional Survey

    NARCIS (Netherlands)

    Reitsma, Welmoed; Mourits, Marian J. E.; Koning, Merel; Pascal, Astrid; van der Lei, Berend

    2011-01-01

    Introduction. Physicians are increasingly presented with women requesting a labia minora reduction procedure. Aim. To assess the influencing factor of personal predisposition in general practitioners, gynecologists, and plastic surgeons to labia minora appearance in relation to their willingness to

  19. The influence of variations in eating disorder-related symptoms on processing of emotional faces in a non-clinical female sample: An eye-tracking study.

    Science.gov (United States)

    Sharpe, Emma; Wallis, Deborah J; Ridout, Nathan

    2016-06-30

    This study aimed to: (i) determine if the attention bias towards angry faces reported in eating disorders generalises to a non-clinical sample varying in eating disorder-related symptoms; (ii) examine if the bias occurs during initial orientation or later strategic processing; and (iii) confirm previous findings of impaired facial emotion recognition in non-clinical disordered eating. Fifty-two females viewed a series of face-pairs (happy or angry paired with neutral) whilst their attentional deployment was continuously monitored using an eye-tracker. They subsequently identified the emotion portrayed in a separate series of faces. The highest (n=18) and lowest scorers (n=17) on the Eating Disorders Inventory (EDI) were compared on the attention and facial emotion recognition tasks. Those with relatively high scores exhibited impaired facial emotion recognition, confirming previous findings in similar non-clinical samples. They also displayed biased attention away from emotional faces during later strategic processing, which is consistent with previously observed impairments in clinical samples. These differences were related to drive-for-thinness. Although we found no evidence of a bias towards angry faces, it is plausible that the observed impairments in emotion recognition and avoidance of emotional faces could disrupt social functioning and act as a risk factor for the development of eating disorders. PMID:27138825

  20. Interplay between patient global assessment, pain, and fatigue and influence of other clinical disease activity measures in patients with active rheumatoid arthritis

    DEFF Research Database (Denmark)

    Egsmose, Emilie Lund; Madsen, Ole Rintek

    2015-01-01

    analog scales (VAS) in the daily clinic by patients with active rheumatoid arthritis (RA). Associations with other measures of disease activity were also examined. Traditional disease activity data on 221 RA patients with active disease planned to initiate biological treatment were extracted from...

  1. Is there an influence of X-chromosomal imprinting on the phenotype in Klinefelter syndrome? A clinical and molecular genetic study of 61 cases

    NARCIS (Netherlands)

    Stemkens, D; Roza, T; Verrij, L; Swaab, H; van Werkhoven, MK; Alizadeh, BZ; Sinke, RJ; Giltay, JC

    2006-01-01

    Studies on Turner syndrome suggested the presence of X-chromosomal-imprinted genes involved in social and verbal cognition. Imprinted genes on autosomes were shown to affect growth. Could imprinting of such genes on the X chromosome also influence psychomotor development and growth in men with Kline

  2. Analysis of factors influencing quality of clinical practice and countermeasures%临床实习质量影响因素分析及对策

    Institute of Scientific and Technical Information of China (English)

    田素霞

    2009-01-01

    Objective: To discuss the countermeasures of enhancing the practice quality in order to guarantee quality of medicine personne training. It is necessary in the present landslide situation of the clinical practice quality because of the recruitment of students scale's unceasing in medicine colleges or universities, the personnel system's reform of the sanitation system and the stem employment environment and so on. Methods: In the light of existing problems in clinical practice, the relating data were collected and corresponding countermeasures for improving quality of the current clinical practice were proposed.Results: The important methods to improve the quality of clinical practice included strength-erring psychological education for medical students, teacher's management and quality monitoring, reforming practice management patterns and raising occupational ethics, and enhancing legal knowledge learning. Conclusion: The countermeasures to the problem of the clinical practice and teaching were reasonable and effective and have guaranteed the practice efficiency, and also improved medico's practice quality.%目的:探讨提高实习质量的对策,以保证医学人才培养的质量.方法:对当前临床实习存在的问题,作认真调查分析并提出对策,予以改进.结果:加强医学生心理素质教育和带教老师的管理及教学质量监控,改善实习教学管理模式及培养职业道德,加强法律知识的学习是提高临床实习质量的重要方法.结论:对实习带教中存在问题采取的对策合理有效,保证了实习效率,提高了医学生的实习质量.

  3. Mediterranean diet or extended fasting's influence on changing the intestinal microflora, immunoglobulin A secretion and clinical outcome in patients with rheumatoid arthritis and fibromyalgia: an observational study

    Directory of Open Access Journals (Sweden)

    Schwickert Myriam

    2005-12-01

    Full Text Available Abstract Background Alterations in the intestinal bacterial flora are believed to be contributing factors to many chronic inflammatory and degenerative diseases including rheumatic diseases. While microbiological fecal culture analysis is now increasingly used, little is known about the relationship of changes in intestinal flora, dietary patterns and clinical outcome in specific diseases. To clarify the role of microbiological culture analysis we aimed to evaluate whether in patients with rheumatoid arthritis (RA or fibromyalgia (FM a Mediterranean diet or an 8-day fasting period are associated with changes in fecal flora and whether changes in fecal flora are associated with clinical outcome. Methods During a two-months-period 51 consecutive patients from an Integrative Medicine hospital department with an established diagnosis of RA (n = 16 or FM (n = 35 were included in the study. According to predefined clinical criteria and the subjects' choice the patients received a mostly vegetarian Mediterranean diet (n = 21; mean age 50.9 +/-13.3 y or participated in an intermittent modified 8-day fasting therapy (n = 30; mean age 53.7 +/- 9.4 y. Quantitative aerob and anaerob bacterial flora, stool pH and concentrations of secretory immunoglobulin A (sIgA were analysed from stool samples at the beginning, at the end of the 2-week hospital stay and at a 3-months follow-up. Clinical outcome was assessed with the DAS 28 for RA patients and with a disease severity rating scale in FM patients. Results We found no significant changes in the fecal bacterial counts following the two dietary interventions within and between groups, nor were significant differences found in the analysis of sIgA and stool ph. Clinical improvement at the end of the hospital stay tended to be greater in fasting vs. non-fasting patients with RA (p = 0.09. Clinical outcome was not related to alterations in the intestinal flora. Conclusion Neither Mediterranean diet nor fasting

  4. 浅谈临床护理教学质量的影响因素及对策%Influence of Clinic Nursing Teaching Quality and Measure

    Institute of Scientific and Technical Information of China (English)

    朱爱华

    2012-01-01

    临床实习是学校护理教育的深化和延续,要为护理队伍培养出品德高尚、心理素质好、业务精的接班人,就必须不断提高护理临床教学质量,去除不良影响因素。%Clinic practice is an integral part of college nursing education.To educate nurse with noble character,good mental quality and profession it is to improve the quality of nursing teaching with the method of improving clinic teaching,inspiring student nurse motivation to learn,improved teacher comprehensive quality.

  5. A randomised clinical trial on the influence of splinted and unsplinted oral implants in mandibular overdenture therapy. A 3-year report.

    Science.gov (United States)

    Naert, I E; Gizani, S; Vuylsteke, M; van Steenberghe, D

    1997-06-01

    A randomised clinical trial was performed to investigate whether there is a need or advantage to splint two implants in the mandible retaining a hinging overdenture. Furthermore, patient satisfaction was evaluated for different attachment systems retaining the overdenture. Thirty-six edentulous patients were randomised into three groups of equal size and treated with either magnets, ball attachments or straight bars (reference group). After 3 years of observation no implants were lost in any of the groups. Besides, no statistically significant differences were noted for the peri-implant outcome. Although the bar group presented the highest retention force, the general satisfaction of the patients in the three groups did not differ. The patients with bar retentions showed less prosthetic complications of the retention elements but more at the level of the denture-supporting mucosa. Finally, the clinical outcome of all groups confirms that overdenture treatment demands regular controls with limited time intervals. PMID:9552823

  6. Clinical Course of Ophthalmic Findings and Potential Influence Factors of Herpesvirus Infections: 18 Month Follow-Up of a Closed Herd of Lipizzaners

    OpenAIRE

    Rushton, James O.; Jolanta Kolodziejek; Alexander Tichy; Norbert Nowotny; Barbara Nell

    2013-01-01

    BACKGROUND: To date the influence of herpesviruses on the development of equine ocular diseases has not been clearly determined. OBJECTIVE: The purpose of this study was to illustrate the course of equine ocular findings over a period of 18 months at 6 month intervals, in correlation with the results of herpesvirus detection. METHODS: 266 Lipizzaners in 3 federal states of Austria underwent complete ophthalmologic examination 4 times. Blood samples, nasal- and conjunctival swabs were obtained...

  7. Influence of carrier cells on the clinical outcome of children with neuroblastoma treated with high dose of oncolytic adenovirus delivered in mesenchymal stem cells.

    Science.gov (United States)

    Melen, Gustavo J; Franco-Luzón, Lidia; Ruano, David; González-Murillo, África; Alfranca, Arantzazu; Casco, Fernando; Lassaletta, Álvaro; Alonso, Mercedes; Madero, Luís; Alemany, Ramón; García-Castro, Javier; Ramírez, Manuel

    2016-02-28

    We report here our clinical experience of a program of compassionate use of Celyvir--autologous marrow-derived mesenchymal stem cells (MSCs) carrying an oncolytic adenovirus--for treating children with advanced metastatic neuroblastoma. Children received weekly doses of Celyvir with no concomitant treatments. The tolerance was excellent, with very mild and self-limited viral-related symptoms. Patients could be distinguished based on their response to therapy: those who had a clinical response (either complete, partial or stabilization) and those who did not respond. We found differences between patients who responded versus those who did not when analyzing their respective MSCs, at the expression levels of adhesion molecules (CCR1, CXCR1 and CXCR4) and in migration capacities in transwell assays, and in immune-related molecules (IFNγ, HLA-DR). These results suggest interpatient differences in the homing and immune modulation capacities of the therapy administered. In addition, the pretherapy immune T cell status and the T effector response were markedly different between responders and non-responders. We conclude that multidoses of Celyvir have an excellent safety profile in children with metastatic neuroblastoma. Intrinsic patients' and MSCs' factors appear to be related to clinical outcome.

  8. Standardized manual palpation of myofascial trigger points in relation to neck/shoulder pain; the influence of clinical experience on inter-examiner reproducibility.

    Science.gov (United States)

    Myburgh, Corrie; Lauridsen, Henrik Hein; Larsen, Anders H; Hartvigsen, Jan

    2011-04-01

    A diagnosis of Myofascial Pain Syndrome (MPS) requires palpation for the identification of at least one clinically relevant trigger point (TP). However, few comparable, high quality studies currently exist from which to draw firm conclusions regarding the robustness of TP examination. An inter-observer agreement study was conducted using two experienced and two inexperienced clinicians. All performed standardized palpation of the upper Trapezius musculature, judging the clinical relevance of TP(s) using clinician global assessment (GA). A random case mix of 81 female participants was examined, 14 asymptomatic and the remainder suffering from neck/shoulder pain. Examiners received psychomotor skills training and video feedback analysis to improve protocol standardization. Kappa co-efficient calculations indicated good agreement between the experienced pairing (κ = 0.63), moderate agreement between the mixed pairings (κ = 0.35 and 0.47) and poor agreement between the inexperienced pairing (κ = 0.22). Inter-observer agreement was not stable with the experienced pairing exhibiting a sharp decline in agreement during the latter portion of the study. Identification of clinically relevant TPs of the upper Trapezius musculature is reproducible when performed by two experienced clinicians, however, a mixed observer pairing can yield acceptable agreement. A protracted period of data collection may be detrimental to inter-observer agreement; more investigation is needed in this regard.

  9. Clinical predictors of severe cerebral amyloid angiopathy and influence of APOE genotype in persons with pathologically-verified Alzheimer’s disease

    Science.gov (United States)

    Ringman, John M.; Sachs, Michael C.; Zhou, Yan; Monsell, Sarah E.; Saver, Jeffrey L.; Vinters, Harry V.

    2014-01-01

    Importance Though cerebral amyloid angiopathy (CAA) has important clinical implications, our understanding of it and ability to diagnose it is limited. Objective We sought to determine pathological correlates and clinical factors identifiable during life that predict the presence of severe CAA in persons with pathologically-confirmed Alzheimer’s disease (AD). Design We compared demographic and clinical variables at the earliest visit during life at which subjects were found to have cognitive impairment, and pathological variables between persons ultimately found to have no or severe CAA at autopsy using logistic regression. Analyses were repeated separately for carriers and non-carriers of the APOE ε4 allele. Setting Data were obtained from the Uniform Data Set that comprises longitudinal clinical assessments performed in the Alzheimer’s Disease Centers funded by the National Institute on Aging. Participants 193 persons with severe CAA and 232 persons with no CAA. All subjects had cognitive impairment and met NIA-Reagan neuropathological criteria for AD. Main Outcome Measures Prevalence of demographic characteristics and the APOE ε4 allele and odds ratios of clinical variables for the prediction of severe CAA. Results Persons with severe CAA were more likely to carry an APOE ε4 allele (64.9% vs. 42.8%), to be Hispanic (6.8% vs. 1.3%, p = 0.003), to have had a transient ischemic attack (TIA, 12.5% vs. 6.1%, OR = 2.1, 95% CI = 1 – 4.4), and had lower degrees of diffuse amyloid plaque pathology (mean CERAD scores 1.2 vs. 1.4, p = 0.01) than persons with no CAA. Intracerebral hemorrhage (9.3% vs. 3.5%, p = 0.01), cortical microinfarcts (20.7% vs. 12.9%, p = 0.03), and subcortical leukoencephalopathy (20.5% vs. 12.1%, p = 0.02) were more common in persons with CAA. A higher prevalence of stroke (11.1% vs. 3.9%, OR = 3.8, 95% CI 1.0 – 14.6) and hypercholesterolemia (50% vs. 33.3%, OR = 2.3, CI 1.1 – 4.7) were found in non-carriers of the ε4 allele with

  10. Influence of HIV infection on the clinical presentation and outcome of adults with acute community-acquired pneumonia in Yaounde, Cameroon: a retrospective hospital-based study

    Directory of Open Access Journals (Sweden)

    Yone Eric Walter

    2012-08-01

    Full Text Available Abstract Background The impact of HIV infection on the evolution of acute community-acquired pneumonia (CAP is still controversial. The aim of this study was to investigate possible differences in the clinical presentation and in-hospital outcomes of patients with CAP with and without HIV infection in a specialised service in Yaounde. Methods Medical files of 106 patients (51 men aged 15 years and above, admitted to the Pneumology service of the Yaounde Jamot Hospital between January 2008 and May 2012, were retrospectively studied. Results Sixty-two (58.5% patients were HIV infected. The median age of all patients was 40 years (interquartile range: 31.75-53 and there was no difference in the clinical and radiological profile of patients with and without HIV infection. The median leukocyte count (interquartile range was 14,600/mm3 (10,900-20,600 and 10,450/mm3 (6,400-16,850 respectively in HIV negative and HIV positive patients (p = 0.002. Median haemoglobin level (interquartile range was 10.8 g/dl (8.9-12 in HIV negative and 9.7 g/dl (8–11.6 in HIV positive patients (p = 0.025. In-hospital treatment failure on third day (39.5% vs. 25.5.1%, p = 0.137 and mortality rates (9% vs. 14.5%, p = 0.401 were similar between HIV negative and HIV positive patients. Conclusion Clinical and radiological features as well as response to treatment and in hospital fatal outcomes are similar in adult patients hospitalised with acute community-acquired pneumonia in Yaounde. In contrast, HIV infected patients tend to be more anaemic and have lower white cell counts than HIV negative patients. Larger prospective studies are needed to consolidate these findings.

  11. Hydrocortisone concentration influences time to clinically significant healing of acute inflammation of the ocular surface and adnexa – results from a double-blind randomized controlled trial

    OpenAIRE

    Sergiyenko, Nikolay; Sukhina, Ludmila; Bezdetko, Pavel; Kovalenko, Yuriy; Nikitin, Nikolai; Merzberger, Matthias; Groß, Dorothea; Kohnen, Ralf

    2014-01-01

    Background The efficacy of topical ophthalmic corticosteroids depends upon small modifications in preparations, such as drug concentration. The aim of this study was to confirm that hydrocortisone acetate (HC-ac) ophthalmic ointments of 2.5% and 1% are more effective than a 0.5% eye ointment. Methods In this randomized, double-blind, placebo-controlled, parallel-group clinical study, the change of signs and symptoms of acute inflammation of the ocular surface and adnexa was evaluated in 411 s...

  12. Influence of interleukin-8 (IL-8) and IL-8 receptors on the migration of human keratinocytes, the role of PLC-γ and potential clinical implications

    OpenAIRE

    Jiang, Wen G; Sanders, Andrew J.; Ruge, Fiona; HARDING, KEITH G.

    2011-01-01

    Interleukin (IL)-8 is a pro-inflammatory cytokine that has a direct effect on immune cells, including polymorphonuclear cells. Keratinocytes are a rich source of IL-8. However, there is little knowledge on the role of IL-8 in clinical wound healing and the direct biological effect of IL-8 on keratinocytes. In this study, the effect of recombinant human IL-8 (rhIL-8) on migration and adhesion was tested using HaCaT keratinocytes as a cell model. The cell functions were evaluated using impedanc...

  13. Standardized manual palpation of myofascial trigger points in relation to neck/shoulder pain; the influence of clinical experience on inter-examiner reproducibility

    DEFF Research Database (Denmark)

    Myburgh, Corrie; Lauridsen, Henrik Hein; Larsen, Anders H;

    2011-01-01

    A diagnosis of Myofascial Pain Syndrome (MPS) requires palpation for the identification of at least one clinically relevant trigger point (TP). However, few comparable, high quality studies currently exist from which to draw firm conclusions regarding the robustness of TP examination. An inter...... asymptomatic and the remainder suffering from neck/shoulder pain. Examiners received psychomotor skills training and video feedback analysis to improve protocol standardization. Kappa co-efficient calculations indicated good agreement between the experienced pairing (κ = 0.63), moderate agreement between...

  14. Dietary beliefs and eating patterns influence metabolic health in type 2 diabetes: A clinic-based study in urban North India

    OpenAIRE

    Colles, Susan L.; Shweta Singh; Chhavi Kohli; Ambrish Mithal

    2013-01-01

    Background: Almost 15% of India′s urban adult populace now lives with type 2 diabetes. This study aimed to characterize the eating patterns, knowledge, beliefs, and determinants of food choice, and assess associations with the metabolic health among urban Asian Indians with type 2 diabetes. Materials and Methods: A cross-sectional study of 258 individuals (mean age 55.7 ± 10 years; body mass index 27.1 ± 4.8 kg/m 2 ; diabetes duration 10.1 ± 6.5 years) attending two out-patient clinics in New...

  15. Influence of treatment with alendronate on the speed of sound, an ultrasound parameter, of the calcaneus in postmenopausal Japanese women with osteoporosis: a clinical practice-based observational study

    Directory of Open Access Journals (Sweden)

    Iwamoto J

    2012-06-01

    Full Text Available Jun Iwamoto,1 Tetsuya Takada,2 Yoshihiro Sato,3 Hideo Matsumoto11Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, 2Department of Internal Medicine, Hiyoshi Medical Clinic, Kanagawa, 3Department of Neurology, Mitate Hospital, Fukuoka, JapanPurpose: The influence of alendronate (ALN treatment on the quantitative ultrasound parameters of the calcaneus remains to be established in Japanese patients. The aim of the present clinical practice-based observational study was to examine the influence of ALN treatment for 1 year on the speed of sound (SOS of the calcaneus and bone turnover markers in postmenopausal Japanese women with osteoporosis.Patients and methods: Forty-five postmenopausal Japanese women with osteoporosis who had received treatment with ALN for more than 1 year were enrolled in the study. The SOS and bone turnover markers were monitored over 1 year of ALN treatment.Results: The urinary levels of cross-linked N-terminal telopeptides of type I collagen and serum levels of alkaline phosphatase decreased significantly from the baseline values (–44.9% at 3 months and –22.2% at 12 months, respectively. The SOS increased modestly, but significantly, from the baseline value (0.6% at both 6 and 12 months. The percentage decrease in the urinary levels of cross-linked N-terminal telopeptides of type I collagen at 3 months was significantly correlated with the percentage increase in the SOS only at 6 months (correlation coefficient, 0.299.Conclusion: The present study confirmed that ALN treatment suppressed bone turnover, producing a clinically significant increase in the SOS of the calcaneus in postmenopausal Japanese women with osteoporosis.Keywords: postmenopausal osteoporosis, quantitative ultrasound (QUS, SOS, bone turnover, biochemical markers

  16. Investigation of the clinical communication competency and its influencing factors among nursing students%护生实习前临床沟通能力及影响因素分析

    Institute of Scientific and Technical Information of China (English)

    周冬梅

    2014-01-01

    Objective To explore the clinical communication competency and its influencing factors among nursing students .Methods The clinical communication competency and its influencing factors were investigated among 263 nursing students , using the self-efficacy scale and the evaluation on clinical communication ability of nursing students scale .Results The total score of the clinical communication competency was (82.56 ±8.87).Among them, the score of participation was the lowest .The total score of self-efficacy was (2.37 ±0.49).The influencing factors of clinical communication competency included the relationship between the students and teachers , self-efficacy , whether being a student leader or not , the relationship between the students and patients , and the willingness to be a nurse , which accounted for 20.7%of the total variation of clinical communication competency .Conclusions The clinical communication competency of nursing students should be improved .Nursing teachers should take measures to enhance self-efficacy, encourage students to be a leader and improve the relationship between students and patients , in order to develop students’ professional identity for the nursing profession .%目的:调查护生实习前临床沟通能力现状,并分析其影响因素。方法选取2012年7月即将进入实习的中职和高职学生共263名作为研究对象,采用一般资料调查表、一般自我效能量表和护生临床沟通能力测评量表进行调查。结果护生临床沟通能力总分为(82.56±8.87)分,其中共同参与得分率最低,验证感受和传递信息次之,敏锐倾听得分率最高。学生一般自我效能总分为(2.37±0.49)分。影响护生临床沟通能力的主要因素有与老师的关系、一般自我效能、是否为学生干部、与患者的关系和报考意愿5项,可解释临床沟通能力总变异量的20.7%。结论护生实习前临床沟通能力处于中等水平

  17. The influence of reduced oxygen availability on gene expression in laboratory (H37Rv) and clinical strains (S7 and S10) of Mycobacterium tuberculosis.

    Science.gov (United States)

    Devasundaram, Santhi; Khan, Imran; Kumar, Neeraj; Das, Sulochana; Raja, Alamelu

    2015-09-20

    Mycobacterium tuberculosis has the ability to persist within the host in a dormant stage. One important condition believed to contribute to dormancy is reduced access to oxygen known as hypoxia. However, the response of M. tuberculosis to such hypoxia condition is not fully characterized. Virtually all dormant models against tuberculosis tested in animals used laboratory strain H37Rv or Erdman strain. But major outbreaks of tuberculosis (TB) occur with the strains that have widely different genotypes and phenotypes compared to H37Rv. In this study, we used a custom oligonucleotide microarray to determine the overall transcriptional response of laboratory strain (H37Rv) and most prevalent clinical strains (S7 and S10) of M. tuberculosis from South India to hypoxia. Analysis of microarray results revealed that a total of 1161 genes were differentially regulated (≥1.5 fold change) in H37Rv, among them 659 genes upregulated and 502 genes down regulated. Microarray data of clinical isolates showed that a total of 790 genes were differentially regulated in S7 among which 453 genes were upregulated and 337 down regulated. Interestingly, numerous genes were also differentially regulated in S10 (total 2805 genes) of which 1463 genes upregulated and 1342 genes down regulated during reduced oxygen condition (Wayne's model). One hundred and thirty-four genes were found common and upregulated among all three strains (H37Rv, S7, and S10) and can be targeted for drug/vaccine development against TB.

  18. The influence of number of high risk factors on clinical outcomes in patients with early-stage cervical cancer after radical hysterectomy and adjuvant chemoradiation

    Science.gov (United States)

    Lim, Soyi; Lee, Seok-Ho; Park, Chan-Yong

    2016-01-01

    Objective The purpose of this study was to evaluate the prognosis according to the number of high risk factors in patients with high risk factors after radical hysterectomy and adjuvant chemoradiation therapy for early stage cervical cancer. Methods Clinicopathological variables and clinical outcomes of patients with FIGO (International Federation of Gynecology and Obstetrics) stage IB1 to IIA cervical cancer who had one or more high risk factors after radical hysterectomy and adjuvant chemoradiation therapy were retrospectively analyzed. Patients were divided into two groups according to the number of high risk factors (group 1, single high risk factor; group 2, two or more high risk factors). Results A total of 93 patients were enrolled in the present study. Forty nine out of 93 (52.7%) patients had a single high risk factor, and 44 (47.3%) had two or more high risk factors. Statistically significant differences in stage and stromal invasion were observed between group 1 and group 2. However, age, histology, tumor size, and lymphovascular space invasion did not differ significantly between the groups. Distant recurrence occurred more frequently in group 2, and the probability of recurrence and death was higher in group 2. Conclusion Patients with two or more high risk factors had worse prognosis in early stage cervical cancer. For these patients, consideration of new strategies to improve survival may be worthwhile. Conduct of further clinical trials is warranted for development of adjuvant treatment strategies individualized to each risk group. PMID:27200308

  19. INFLUENCE OF LOCAL RONKOLEIKIN TREATMENT UPON CLINICAL COURSE OF PURULENT WOUNDS AND FUNCTIONAL ACTIVITY OF WOUND PHAGOCYTES IN PATIENTS WITH ODONTOGENIC PHLEGMONAE

    Directory of Open Access Journals (Sweden)

    I. I. Dolgushin

    2009-01-01

    Full Text Available Abstract. The aim of the work was to evaluate clinical features of purulent wounds trend and functional activity of local wound phagocytes in the patients with odontogenic phlegmones in the course of local treatment with Ronkoleukin. A randomized clinical study was performed which included sixty-five patients with odontogenic phlegmones. Their age ranged from 18 to 74 years old. The group was divided in two parts, i.e., patients of a comparison group (n = 33 receiving a conventional combined drug therapy, and the persons from study group (n = 32 who were subject to local immunotherapy with Ronkoleukin, applied along with conventional therapy. It was established that the local therapy with Ronkoleikin exerts distinct positive effects, i.e., increase in wound-located lymphocytes and macrophages, acceleration of phasic dynamics of inflammatory events, augmentation of an lysosomal luminescence index (2.3-fold, enhancement of phagocytosis intensity in wound neutrophiles and macrophages (1.9-2-fold, strengthening the reserve abilities of wound neutrophils (1.3-fold. These effects create favorable conditions for elimination of pathogen and optimal healing of purulent wounds in the patients with odontogenic phlegmones.

  20. Dosimetry, clinical factors and medication intake influencing urinary symptoms after prostate radiotherapy: An analysis of data from the RADAR prostate radiotherapy trial

    International Nuclear Information System (INIS)

    Purpose/objective: To identify dosimetry, clinical factors and medication intake impacting urinary symptoms after prostate radiotherapy. Material and methods: Data describing clinical factors and bladder dosimetry (reduced with principal component (PC) analysis) for 754 patients treated with external beam radiotherapy accrued by TROG 03.04 RADAR prostate radiotherapy trial were available for analysis. Urinary symptoms (frequency, incontinence, dysuria and haematuria) were prospectively assessed using LENT-SOMA to a median of 72 months. The endpoints assessed were prevalence (grade ⩾1) at the end of radiotherapy (representing acute symptoms), at 18-, 36- and 54-month follow-ups (representing late symptoms) and peak late incidence including only grade ⩾2. Impact of factors was assessed using multivariate logistic regression models with correction for over-optimism. Results: Baseline symptoms, non-insulin dependent diabetes mellitus, age and PC1 (correlated to the mean dose) impact symptoms at >1 timepoints. Associations at a single timepoint were found for cerebrovascular condition, ECOG status and non-steroidal anti-inflammatory drug intake. Peak incidence analysis shows the impact of baseline, bowel and cerebrovascular condition and smoking status. Conclusions: The prevalence and incidence analysis provide a complementary view for urinary symptom prediction. Sustained impacts across time points were found for several factors while some associations were not repeated at different time points suggesting poorer or transient impact

  1. [Influence of three point mutations in TNF-alpha promoter gene in clinical manifestations and complications of stomach and duodenal ulcer].

    Science.gov (United States)

    Polonikov, A V; Ivanov, V P; Solodilova, M A; Shveĭnov, A I; Manuĭlova, O S; Kozhukhov, M A; Tutochkina, M P; Stepchenko, A A; Bulgakova, I V

    2009-01-01

    The purpose of our study was to investigate whether polymorphisms -238G/A, -308G/A, and -863C/A within the promoter of the TNF-alpha gene are associated with clinical features of gastric and duodenal ulcer disease in a Russian population. DNA samples of 381 unrelated patients with gastric and duodenal ulcer disease and 216 sex- and age-matched healthy controls were used to determine the TNF-alpha gene polymorphisms by PCR-RFLP assay. Logistic regression analysis has revealed significant associations of polymorphism -308G/A with size of ulcerous defect (p=0.03) and intestinal dyspepsia (p=0.05), polymorphism -238G/A with gastric dyspepsia (p=0.04) and reflux-esophagitis (p=0.05), polymorphism -863C/A with perforation of ulcer (p=0.04). The study results highlight impact of the TNF-alpha gene polymorphisms on various clinical features in patients with peptic ulcer disease.

  2. The influence of psychoeducation on regulating biological rhythm in a sample of patients with bipolar II disorder: a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Faria AD

    2014-06-01

    Full Text Available Augusto Duarte Faria,1 Luciano Dias de Mattos Souza,2 Taiane de Azevedo Cardoso,2 Karen Amaral Tavares Pinheiro,2 Ricardo Tavares Pinheiro,2 Ricardo Azevedo da Silva,2 Karen Jansen21Department of Clinical and Health Psychology, Universidade Federal do Rio Grande – FURG, Rio Grande, RS, Brazil; 2Health and Behavior Postgraduate Program, Universidade Católica de Pelotas – UCPEL, Pelotas, RS, BrazilIntroduction: Changes in biological rhythm are among the various characteristics of bipolar disorder, and have long been associated with the functional impairment of the disease. There are only a few viable options of psychosocial interventions that deal with this specific topic; one of them is psychoeducation, a model that, although it has been used by practitioners for some time, only recently have studies shown its efficacy in clinical practice.Aim: To assess if patients undergoing psychosocial intervention in addition to a pharmacological treatment have better regulation of their biological rhythm than those only using medication.Method: This study is a randomized clinical trial that compares a standard medication intervention to an intervention combined with drugs and psychoeducation. The evaluation of the biological rhythm was made using the Biological Rhythm Interview of Assessment in Neuropsychiatry, an 18-item scale divided in four areas (sleep, activity, social rhythm, and eating pattern. The combined intervention consisted of medication and a short-term psychoeducation model summarized in a protocol of six individual sessions of 1 hour each.Results: The sample consisted of 61 patients with bipolar II disorder, but during the study, there were 14 losses to follow-up. Therefore, the final sample consisted of 45 individuals (26 for standard intervention and 19 for combined. The results showed that, in this sample and time period evaluated, the combined treatment of medication and psychoeducation had no statistically significant impact on the

  3. Mitochondrial tRNAArg T10454C variant may not influence the clinical expression of deafness associated 12S rRNA A1555G mutation.

    Science.gov (United States)

    Luo, Zhiyi

    2016-01-01

    In this study, we examined the "pathogenic" role of the T10454C mutation in mitochondrial tRNA(Arg) gene in deafness expression as increasing reports provided an active role of this mutation in clinical manifestation of deafness associated 12S rRNA A1555G mutation. For this purpose, we reanalyzed the complete mitochondrial DNA (mtDNA) sequence data containing the T10454C mutation. Moreover, we analyzed the reported "polymorphisms" of mtDNA in the proband using the phylogentic approach. To our surprise, other mutations which occurred at protein-coding genes played more important roles in resulting mitochondrial dysfunctions by using the bioinformatic tool. In addition, evolutionary conservation analysis of the T10454C mutation indicated that this mutation was not conserved between different species. To our knowledge, this is the first report that the T10454C variant may not modulate the phenotypic expression of the deafness associated A1555G mutation.

  4. Clinical study of non-specific cell mediated immunity in the patients with esophageal cancer. Influence of preoperative irradiation and surgical intervention

    Energy Technology Data Exchange (ETDEWEB)

    Nakata, Yoshitaka

    1987-06-01

    Few data are available to elucidate the influence of combined preoperative irradiation and surgery on the non-specific cell mediated immunity of patients with esophageal cancer. In vitro and in vivo examinations of the non-specific cell mediated immunity were made before and after irradiation and surgery in 108 patients with esophageal cancer. Decreased immune competence was noticeable one month after surgery in the irradiated group, as compared with the non-irradiated group. Simultaneously, the ratio of concanavalin A to phytohemagglutinin was significantly higher in the irradiated group than the non-irradiated group (p < 0.01). Two months later, both findings in the two groups were similar. There was no consistent tendency toward altered immune competence between the group with curative surgery and the group with non-curative surgery. (Namekawa, K.).

  5. Dietary beliefs and eating patterns influence metabolic health in type 2 diabetes: A clinic-based study in urban North India

    Directory of Open Access Journals (Sweden)

    Susan L Colles

    2013-01-01

    Full Text Available Background: Almost 15% of India′s urban adult populace now lives with type 2 diabetes. This study aimed to characterize the eating patterns, knowledge, beliefs, and determinants of food choice, and assess associations with the metabolic health among urban Asian Indians with type 2 diabetes. Materials and Methods: A cross-sectional study of 258 individuals (mean age 55.7 ± 10 years; body mass index 27.1 ± 4.8 kg/m 2 ; diabetes duration 10.1 ± 6.5 years attending two out-patient clinics in New Delhi, India. Food-related information was collected during a semi-structured interview. Clinical, anthropometric, and biochemical data were recorded. Results: Beliefs related to health and diabetes played a role determining food choice and dietary patterns; erroneous views were associated with the poor food choices and greater metabolic perturbations. Average consumption of fruits/vegetables was low. Intakes were positively associated with intentions to manage diabetes; inversely associated with the waist circumference and negatively correlated with one′s degree of personal responsibility for food choice. Household saturated fat usage was common. High fat intakes were positively associated with the taste preference, ratings of perceived "health-value;" waist circumference, glycosylated haemoglobin percentage (HbA1c% and lipids. Conclusions: Strategies to enhance diabetes control among Asian Indians are required and should encourage fruit/vegetable intake, personal accountability, and consider individual beliefs and preferences. Greater emphasis and resources directed to regular dietary and behavioral counseling may assist.`

  6. 运用自我SWOT分析模型对实习生临床护理能力影响的研究%Study on influence of self SWOT analysis model on clinical nursing ability of interns

    Institute of Scientific and Technical Information of China (English)

    黎剑云; 韦丽华; 吴彬; 徐冬英; 黄秋萍; 陈文玲; 黄柱英; 刘礼礼; 蒙金

    2014-01-01

    [目的]探讨运用自我 SWOT 分析模型对实习生临床护理能力的影响。[方法]将护理实习生84人按照分层随机分配原则,分为试验组与对照组,每组42人;对照组采用常规临床护理实习生培养计划进行培养,试验组则在培养过程中对实习生使用自我 SWOT 分析模型进行带教。[结果]两组临床护理能力、病人满意度、理论考试成绩差异有统计学意义(P<0.05)。[结论]在临床带教过程中运用自我 SWOT 分析模型可提高护理实习生临床护理能力,增加实习生对临床护理的认识,得到病人的认可。%Obj ective:To probe into the influence of self SWOT analysis model on the clinical nursing ability of interns.Methods:A total of 84 nursing interns were randomly divided into experimental group and con-trol group based on stratified random allocation principles,42 cases in each.The patients in control group were trained with the routine training program of clinical nursing interns,while in experimental group the self SWOT analysis model was used for teaching of interns during the train-ing.Results:There was statistically significant difference in clinical nurs-ing ability,patients’satisfaction and the examination marks between ex-perimental group and control group(P<0.05).Conclusion:During clini-cal teaching,self SWOT analysis model can promote the clinical nursing ability of nursing interns,increase the cognition of interns on clinical nursing,and make the nursing interns get the patients’approval.

  7. Interaction of MIF Family Proteins in Myocardial Ischemia/Reperfusion Damage and Their Influence on Clinical Outcome of Cardiac Surgery Patients

    Science.gov (United States)

    Rex, Steffen; Goetzenich, Andreas; Kraemer, Sandra; Emontzpohl, Christoph; Soppert, Josefin; Averdunk, Luisa; Sun, Yu; Rossaint, Rolf; Lue, Hongqi; Huang, Caleb; Song, Yan; Pantouris, Georgios; Lolis, Elias; Leng, Lin; Schulte, Wibke; Bucala, Richard; Weber, Christian

    2015-01-01

    Abstract Aims: Cardiac surgery involves myocardial ischemia/reperfusion (I/R) with potentially deleterious consequences. Macrophage migration inhibitory factor (MIF) is a stress-regulating chemokine-like cytokine that protects against I/R damage, but functional links with its homolog, d-dopachrome tautomerase (MIF-2), and the circulating soluble receptor CD74 (sCD74) are unknown. In this study, we investigate the role of MIF, MIF-2, sCD74, and MIF genotypes in patients scheduled for elective single or complex surgical procedures such as coronary artery bypass grafting or valve replacement. Results: MIF and MIF-2 levels significantly increased intraoperatively, whereas measured sCD74 decreased correspondingly. Circulating sCD74/MIF complexes were detectable in 50% of patients and enhanced MIF antioxidant activity. Intraoperative MIF levels were independently associated with a reduced risk for the development of atrial fibrillation (AF) (odds ratio 0.99 [0.98–1.00]; p=0.007). Circulating levels of MIF-2, but not MIF, were associated with an increased frequency of organ dysfunction and predicted the occurrence of AF (area under the curve [AUC]=0.663; p=0.041) and pneumonia (AUC=0.708; p=0.040). Patients with a high-expression MIF genotype exhibited a reduced incidence of organ dysfunction compared with patients with low-expression MIF genotypes (3 vs. 25; p=0.042). Innovation: The current study comprehensively highlights the kinetics and clinical relevance of MIF family proteins and the MIF genotype in cardiac surgery patients. Conclusion: Our findings suggest that increased MIF levels during cardiac surgery feature organ-protective properties during myocardial I/R, while the soluble MIF receptor, sCD74, may enhance MIF antioxidant activity. In contrast, high MIF-2 levels are predictive of the development of organ dysfunction. Importantly, we provide first evidence for a gene–phenotype relationship between variant MIF alleles and clinical outcome in cardiac

  8. Influence of the CYP2D6 isoenzyme in patients treated with venlafaxine for major depressive disorder: clinical and economic consequences.

    Directory of Open Access Journals (Sweden)

    Antoni Sicras-Mainar

    Full Text Available Antidepressant drugs are the mainstay of drug therapy for sustained remission of symptoms. However, the clinical results are not encouraging. This lack of response could be due, among other causes, to factors that alter the metabolism of the antidepressant drug.to evaluate the impact of concomitant administration of CYP2D6 inhibitors or substrates on the efficacy, tolerability and costs of patients treated with venlafaxine for major depressive disorder in clinical practice.We designed an observational study using the medical records of outpatients. Subjects aged ≥ 18 years who started taking venlafaxine during 2008-2010 were included. Three study groups were considered: no combinations (reference, venlafaxine-substrate, and venlafaxine-inhibitor. The follow-up period was 12 months. The main variables were: demographic data, comorbidity, remission (Hamilton <7, response to treatment, adverse events and costs. The statistical analysis included logistic regression models and ANCOVA, with p values <0.05 considered significant.A total of 1,115 subjects were recruited. The mean age was 61.7 years and 75.1% were female. Approximately 33.3% (95% CI: 30.5 to 36.1 were receiving some kind of drug combination (venlafaxine-substrate: 23.0%, and venlafaxine-inhibitor: 10.3%. Compared with the venlafaxine-substrate and venlafaxine-inhibitor groups, patients not taking concomitant drugs had a better response to therapy (49.1% vs. 39.9% and 34.3%, p<0.01, greater remission of symptoms (59.9% vs. 50.2% and 43.8%, p<0.001, fewer adverse events (1.9% vs. 7.0% and 6.1%, p<0.05 and a lower mean adjusted cost (€2,881.7 vs. €4,963.3 and €7,389.1, p<0.001, respectively. All cost components showed these differences.The patients treated with venlafaxine alone showed a better response to anti-depressant treatment, greater remission of symptoms, a lower incidence of adverse events and lower healthcare costs.

  9. Influence of vitamin D status and vitamin D3 supplementation on genome wide expression of white blood cells: a randomized double-blind clinical trial.

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    Arash Hossein-nezhad

    Full Text Available BACKGROUND: Although there have been numerous observations of vitamin D deficiency and its links to chronic diseases, no studies have reported on how vitamin D status and vitamin D3 supplementation affects broad gene expression in humans. The objective of this study was to determine the effect of vitamin D status and subsequent vitamin D supplementation on broad gene expression in healthy adults. (Trial registration: ClinicalTrials.gov NCT01696409. METHODS AND FINDINGS: A randomized, double-blind, single center pilot trial was conducted for comparing vitamin D supplementation with either 400 IUs (n = 3 or 2000 IUs (n = 5 vitamin D3 daily for 2 months on broad gene expression in the white blood cells collected from 8 healthy adults in the winter. Microarrays of the 16 buffy coats from eight subjects passed the quality control filters and normalized with the RMA method. Vitamin D3 supplementation that improved serum 25-hydroxyvitamin D concentrations was associated with at least a 1.5 fold alteration in the expression of 291 genes. There was a significant difference in the expression of 66 genes between subjects at baseline with vitamin D deficiency (25(OHD20 ng/ml. After vitamin D3 supplementation gene expression of these 66 genes was similar for both groups. Seventeen vitamin D-regulated genes with new candidate vitamin D response elements including TRIM27, CD83, COPB2, YRNA and CETN3 which have been shown to be important for transcriptional regulation, immune function, response to stress and DNA repair were identified. CONCLUSION/SIGNIFICANCE: Our data suggest that any improvement in vitamin D status will significantly affect expression of genes that have a wide variety of biologic functions of more than 160 pathways linked to cancer, autoimmune disorders and cardiovascular disease with have been associated with vitamin D deficiency. This study reveals for the first time molecular finger prints that help explain the nonskeletal health

  10. 全麻对剖宫产胎儿影响的临床研究%Clinical study of the influence of general anesthesia on cesarean delivery fetus

    Institute of Scientific and Technical Information of China (English)

    李莉; 苏利

    2014-01-01

    Objective To compare the influence of general anesthesia and combined spinal-epidural anesthesia on neonatal Apgar score. Methods A total of 65 cases of single pregnancy to full term undergone cesarean section were taken as study subjects. There were 32 cases in the general anesthesia group received general anesthesia due to intraspinal anesthesia taboo, and the other 33 cases in the combined spinal-epidural anesthesia group received combined spinal-epidural anesthesia. The fetal childbirth time, birth weight, and apgar score at 1 min and 5 min were recorded. Results Apgar score at 1 min of general anesthesia group and combined spinal-epidural anesthesia group were (9.5±0.8) points and (9.8±0.6) points respectively, and there was no significant difference between the two groups (P>0.05). Apgar scores at 5 min were all 10 points in the two groups. Conclusion General anesthesia and combined spinal-epidural anesthesia have no obviously variant influences on fetus.%目的:比较剖宫产施行全身麻醉(全麻)和腰硬联合麻醉对新生儿Apgar评分的影响。方法选择足月单胎妊娠行择期剖宫产的产妇65例,椎管内麻醉禁忌而需使用全麻的剖宫产为全麻组32例,其余33例行腰硬联合麻醉作为腰硬联合麻醉组。记录胎儿娩出时间,新生儿体重和1、5 min的Apgar评分。结果全麻组和腰硬联合麻醉组新生儿1 min的Apgar评分分别为(9.5±0.8)分、(9.8±0.6)分,两组差异无统计学意义(P>0.05)。5 min Apgar评分均为10分。结论全麻和硬联合麻醉对胎儿的影响没有明显差异。

  11. Clinical Observation on Influence of Chinese Medicines for Promoting Blood Circulation to Remove Blood Stasis on FIB and DD in Plasma of Patients with Cerebral Thrombosis

    Institute of Scientific and Technical Information of China (English)

    梁晖; 陈甦; 陈少芳

    2002-01-01

    Objective: to study the influence of Chinese medicines for promoting blood circulation to remove blood stasis on fibrinogen (FIB) and D-dimer (DD) in plasma of patients with cerebral thrombosis. Method: 73 inpatients with acute cerebral thrombosis were randomly divided into a control group of 34 cases and a treatment group of 39 cases. The content of FIB and DD in plasma was detected before treatment and on the 7th and 14th days after treatment. Result: FIB content in plasma after treatment was lower than that before treatment in the control group (P<0.01) and more remarkable in the treatment group (P<0.001). There was an obvious difference in DD content before and after treatment in both groups. DD content on the 7th and 14th days after treatment in the treatment group was obviously higher than that in the control group (P<0.01 and P<0.05 respectively). Conclusion: Chinese medicines for promoting blood circulation to remove blood stasis can reduce the FIB content in plasma of patients with cerebral thrombosis, raise the DD content in plasma, cause the peak of DD content appear earlier and obviously improve hypercoagulability of blood in patients with cerebral thrombosis.

  12. 影响药物非临床安全性评价的供试品相关问题%Factors Related to Test Articles Influencing Non-clinical Safety Evaluation of Drugs

    Institute of Scientific and Technical Information of China (English)

    苏敏; 王京昆

    2015-01-01

    Objective:To promote the effective management of test articles to avoid unnecessary mistakes and losses in the process of new drug research and development. Methods:Based on work experience and peer exchanges, the main issues related to test articles and inlfuencing factors in non-clinical safety evaluation were summarized and sorted.Results:In this paper, the influence of issues related to test articles and influencing factors in drug safety evaluation were revealed from different aspects.Conclusion:Only by attaching importance to the problems in all links of test article management and constantly improving the management, can the accuracy and reliability of results of non-clinical safety evaluation be guaranteed.%目的:促进供试品有效管理,避免新药研发过程中不必要的失误和损失。方法:通过自身工作实践及同行交流,对主要影响药物非临床安全性评价的供试品相关问题及因素进行梳理和总结。结果:从不同角度揭示了影响药物安全性评价的供试品相关问题。结论:只有全面重视供试品管理中各个环节的问题,并不断提高和完善,才能真正保障新药安全性评价结果的准确和可靠。

  13. A prospective randomized clinical study of the influence of primary closure or dressing on post-operative morbidity after mandibular third molar surgery

    Directory of Open Access Journals (Sweden)

    Peter E Egbor

    2014-01-01

    Full Text Available Objective: The aim of the following study is to determine the effect of primary closure or dressing on post-operative morbidity after impacted lower third molar surgery. Materials and Methods: This was a randomized clinical study of 72 patients who had surgical extraction of impacted mandibular third molars. The subjects were divided into two groups of A and B. Group A had total closure (primary closure and Group B had whitehead varnish dressing of the socket. Pain, swelling and trismus were evaluated pre-operatively using visual analogue scale, flexible tape measuring method and inter-incisal distance measurement with Vernier Callipers respectively as well as post-operatively on 1 st , 2 nd , 3 rd , 5 th and 7 th day. Results: The study participants consisted of 27 males and 45 females in a ratio 1:1.7. With a mean age of 24.7 ± 4.9 years (range 19-33 years for Group A and 25.5 ± 4.3 years (range 20-39 years for Group B. Post-operative pain was not significantly affected by the closure techniques (P > 0.05. Dressing was found to significantly reduce the degree of swelling and trismus peaking on the 2 nd day (P = 0.0207 and P = 0.010 respectively. Conclusion: The use of dressing was more effective than primary closure to reduce the degree of swelling and trismus though its effect on post-operative pain reduction was not significant.

  14. Syncope as a health risk for soldiers:Influence of medical history and clinical findings on the sensitivity of head-up tilt table testing

    Institute of Scientific and Technical Information of China (English)

    Hans-Joachim Gilfrich; Lena Marie Heidelmann; Franziska Grube; Hagen Frickmann; Sven Andreas Jungblut

    2015-01-01

    Background: Syncope is a relevant health problem in military environments. Reliable diagnosis is challenging. Tilt table testing is an important tool for syncope diagnosis. The aim of this study was to determine whether signs such as prodromal symptoms, co-morbidity, frequency of syncopal events, body length, body mass index, and electrocardiography (ECG) abnormalities can be used to predict the success of tilt table testing at diagnosing syncope. Methods: Data from 100 patients with histories of syncope or pre-syncope, who were diagnosed using head-up tilt table testing, were retrospectively analyzed in a cross-sectional analysis. The diagnostic procedure was based upon a modified version of the Westminster protocol without any pharmacological provocation. Results: Patients showing pathological reaction patterns during tilt table testing suffered from prodromal symptoms, such as dizziness and sweating, significantly more often. The patients reported more injuries resulting from syncopal events and more previous syncopal events, and the prevalence of co-morbidity was greater among patients presenting negative findings during tilt testing. An asthenic-leptosomal physique was not confirmed as a risk factor for syncopal events as is the case for idiopathic arterial hypotension. However, patients with pathological reaction patterns during tilt table testing were significantly taller. This finding was detected for both females and males. No significant predictors were found in the ECG patterns of patients showing syncope during tilt table testing. Conclusions: Frequency of prior syncope and prodromal symptoms, and increased body length with an otherwise good state of health influence the predictive value of tilt table testing for syncope diagnosis. In particular, if these factors are present, tilt table testing should be considered part of the diagnostic algorithm for soldiers with recurrent syncope.

  15. Factors that influence the choice to work in rural township health centers among 4,669 clinical medical students from five medical universities in Guangxi, China

    Directory of Open Access Journals (Sweden)

    Yunbo Qing

    2015-07-01

    Full Text Available Purpose: To produce competent undergraduate-level medical doctors for rural township health centers (THCs, the Chinese government mandated that medical colleges in Central and Western China recruit rural-oriented, tuition-waived medical students (RTMSs starting in 2010. This study aimed to identify and assess factors that influence the choice to work in rural township health centers among both RTMSs and other students from five medical universities in Guangxi, China. Methods: An internet-based self-administered questionnaire survey was conducted with medical students in Guangxi province. Multinomial logistic regression was used to identify factors related to the attitudes toward work in a rural township health center. Results: Among 4,669 medical students, 1,523 (33% had a positive attitude and 2,574 (55% had a neutral attitude toward working in THCs. Demographic characteristics, personal job concerns, and knowledge of THCs were associated with the choice of a career in THCs. The factors related to a positive attitude included the following: three-year program, a rural-oriented medical program, being male, an expectation of working in a county or township, a focus on medical career development, some perceived difficulty of getting a job, having family support, sufficient knowledge of THCs, optimism toward THC development, seeking lower working pressure, and a lower expected monthly salary. Conclusion: Male students in a three-year program or a rural-oriented tuition-waived medical education program were more likely to work in THCs. Selecting medical students through interviews to identify their family support and intentions to work in THCs would increase recruitment and retention. Establishing favorable policies and financial incentives to improve living conditions and the social status of rural physicians is necessary.

  16. Influence of human urine to antimicrobial susceptibility of clinical isolates of Klebsiella pneumoniae and Escherichia coli producing β-lactamase of different types

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    Ž. Žagar

    2007-02-01

    Full Text Available The purpose of the study was to determine the influence of human urine on the antibiotic susceptibilities of Klebsiella pneumoniae and Escherichia coli strains producing different types of extended-spectrum β-lactamases (ESBL. The study was performed on 26 ESBL negative strains of K. pneumoniae, 80 K. pneumoniae strains producing SHV-ESBLs (52-SHV-5, 31- SHV-2 and 7- SHV-12, 94 E. coli strains harbouring TEM- ESBLs and 14 E. coli strains possessing CTX-M group 1 β-lactamases. The minimum inhibitory concentrations of amoxycillin alone and combined with clavulanate (co-amoxilcav, cephalexin, cefuroxime, ceftazidime, cefotaxime, ceftriaxone, cefepime, gentamicin and ciprofloxacin were performed in parallel in Mueller-Hinton broth and urine by broth microdilution method. With ESBL negative strains, urine increased MIC90 of amoxycillin alone and combined with clavulanate, cephalexin, cefuroxime, ceftazidime, cefotaxime, ceftriaxone, cefepime, gentamicin and ciprofloxacin. Against SHV-5 producers, an increase in MIC90 was observed with cefotaxime, cefepime and ciprofloxacin when the test was performed in urine. SHV-2 producers showed elevated MIC90 of ceftazidime, cefotaxime, ceftriaxone and cefepime in the presence of urine, in contrast to SHV-12 producers which displayed elevated MIC90 only for cefotaxime. Urine increased MIC90 of amoxycillin/clavulanate, ceftazidime and cefepime against CTX-M producers, and of amoxycillin/clavulanate, cefotaxime, ceftriaxone, cefepime and ciprofloxacin for TEM producers. According to our results the activity of antibiotics used for the treatment of urinary tract infection could be overestimated by a standard in vitro testing. However, most of antibiotics used for the treatment of urinary tract infection achieve very high concentration in urine and that could abrogate the reduction of antimicrobial activity by biological fluid.

  17. OBSERVATION ON CLINICAL THERAPEUTIC EFFECT OF MRI-AIDED ENCLOSURE NEEDLING IN THE TREATMENT OF STROKE AND ITS INFLUENCE ON BLOOD RHEOLOGY

    Institute of Scientific and Technical Information of China (English)

    江钢辉; 李艳慧; 庄子齐; 潘文宇; 黄勇; 李健萍

    2003-01-01

    Objective: To observe clinical therapeutic effect of magnetic resonance imaging (MRl)-aided enclosure needling in the treatment of stroke patients and changes of the related blood rheology. Methods: A total of 61stroke patients were randomized into MR I-aided enclosure needling group (MRI-aided acupuncture group) (n = 31 ) and conventional acupuncture group (n= 30). For patients of MRl-aided acupuncture group, acupuncture needles were inserted into the subcutaneous tissues around the focus-projection scalp area displayed by MRI, with the needle tips toward the center of the projection region and with two needles being about 2 crn apart, combined with other acupoints according to the concrete syndromes or symptoms. For patients of conventional acupuncture group, Motor Area (MS 6)and Sensory Area (MS 7) on the contralateral side of the focus were punctured. The treatment was conducted once daily, continuously for 30 days. Results: After treatment, of the 31 cases in MRl-aided acupuncture group, 20 werecured basically, 10 responded with significant improvement of symptoms and signs, one case had some improvement.While in conventional acupuncture group, of the 30 cases, 11 were cured basically, 15 responded with striking amelioration of symptoms and signs and 4 had some amelioration. Ridit analysis showed that the therapeutic effect of MRI-aided acupuncture group was significantly superior to that of conventional acupuncture group (P < 0.05). After treatment,the whole blood viscosity, plasma viscosity, hematocrit, whole blood reduction viscosity, hemagglutination index, and the total score of the two groups all decreased significantly in comparison with those of pre-treatment of each group,while whole blood viscosity, hematocrit, vascular sclerosis index and the total score of MRl-aided acupuncture group were obviously lower than those of conventional acupuncture group ( P< 0.05- 0.01 ), suggesting that the effect of theformer group in bettering blood rheology was

  18. The influence of freeze drying and ϒ-irradiation in pre-clinical studies of flurbiprofen polymeric nanoparticles for ocular delivery using D-(+-trehalose and polyethylene glycol

    Directory of Open Access Journals (Sweden)

    Ramos Yacasi GR

    2016-08-01

    , could be used as a feasible alternative to a flurbiprofen solution for ocular application in clinical trials. Keywords: nanoparticles, flurbiprofen, polyethylene glycol 3350, d-(+-trehalose, freeze-drying, γ-irradiation

  19. Specialty clinic's influence on parents' asthma knowledge%专科门诊对患儿家长哮喘知识掌握的影响

    Institute of Scientific and Technical Information of China (English)

    王娟梅; 李云; 方亦兵

    2011-01-01

    Objective: To explore the most effective control methods of asthma in the comparison between the parents of the first visit children and the return visit children, who had known well in the asthma knowledge. Methods: We made a investigation of the parents' asthma knowledge and behavior between 62 first visit children and 85 return visit children who have been done treatment for more than 3 months, the differences of two groups were evaluated and compared. Results: On the nature of the asthma, symptoms, incitingfactors, acute performance and the connections between asthma and rhinitis, passive smoking and access to plush toys, as well as whether they could participate in sports during asthma control period and whether to insist in using medicines, the parents of the return visit children knew more and done better than the parents of the first visit children (ρ<0.05). But parents of two groups did not know enough about the knowledge of whether regular use of inhaled steroid would affect the growth and development of the children and how to do emergency treatment of acute attacks, there was no significant differences in the groups (ρ>0.05). Conclusion: Continuous education on the parents of asthma children in the specialty clinic can deepen the understanding about asthma, but strengthen education repeatedly is necessary.%目的:通过对比哮喘门诊复诊与首诊患儿家长对哮喘知识的掌握,探索有利的哮喘防治方式.方法:对85例治疗>3个月的复诊患儿家长及62例首诊患儿家长进行哮喘知识及行为调查,评价并比较两组的差异.结果:通过调查家长对哮喘本质、症状、诱发因素、急性发作表现,其与鼻炎、被动吸烟、接触毛绒玩具的关系及哮喘控制可否参加运动、是否坚持用药等方面的知识的掌握情况,两组比较差异有统计学意义(P0.05).结论:哮喘门诊的不断教育可加深患儿家长对哮喘的认识,但仍需反复加强教育.

  20. Analysis the influencing factors on the clinical pregnancy rate of intrauterine insemination with husband sperm%夫精宫腔内人工授精影响因素与临床妊娠率关系分析

    Institute of Scientific and Technical Information of China (English)

    周军英; 朱立华; 孙秀芬; 周瑾; 许玉刚; 欧建平

    2011-01-01

    目的 探讨宫腔内人工授精(IUI)影响因素与临床妊娠率的关系,以提高IUI治疗的临床效果.方法 对252个IUI治疗周期的159例患者的年龄、不孕年限、促排卵方案、人工授精时机、IUI治疗周期数、不孕原因与临床妊娠率的关系进行分析.结果 促排卵周期显著提高临床妊娠率(P<0.05);小于等于30岁组临床妊娠率显著高于30以上组(P<0.05);随不孕年限延长临床妊娠率降低、单次排卵前、单次排卵后和双次授精妊娠率无统计学差异;IUI治疗周期数以3个周期为宜、不孕原因与临床妊娠率有关但无统计学差异.结论 促排卵方案和年龄是影响临床妊娠率的主要因素.%Objective: To investigate the influencing factors of intrauterine insemination (IUI) in order to improve the clinical outcome of IUI treatment. Methods: 159 couples in 252 cycles who underwent IUI treatment were collected. The correlation between pregnancy rate and the following factors were analyzed, such as the stimulation protocols, age of women, the duration of infertility,timing of intrauterine insemination, treatment cycles of IUI, causes of infertility. Results: IUI treatment with ovarian stimulation significantly increased clinical pregnancy rate ( P < 0. 05). The pregnancy rate was significantly higher in younger women group (less than 30 years old) than those women whose were more than 30 years old ( P < 0. 05). With the increase in duration of infertility,the pregnancy rate was decreased. There was no significant difference in the pregnancy rate between single insemination and twice inseminations before and/after ovulation. 3 cycles was suitable for IUI treatment. There was no significant difference in the pregnancy rate between primary and secondary infertility, the same to reasons of infertility. Conclusion: The protocols of ovarian stimulation and age of women were two major influencing factors for clinical pregnancy rate in IUI treatment.

  1. Investigation and Analysis of Life Satisfaction of Nurses in Clinic and Its Influencing Factors%临床护士生活满意度及其影响因素的调查分析

    Institute of Scientific and Technical Information of China (English)

    许梅; 唐媛; 陈美娇

    2012-01-01

    Objective To survey the life satisfaction of nurses in clinic and its influencing factors,and analyze the relationships between them. Methods Life satisfaction assessment form was used to surrey the life satisfaction of clinical nurses of 318 nurses in two municipal hospitals in our city. Spearman rank correlation was use to analyze the life satisfaction and its influencing factors. Logistic regression model was performed to analyze the influence of relevant factors on life satisfaction. Results All 170 (53. 5% ) nurses had a high life satisfaction and 148(46.5% ) nurses had low life satisfaction. Individual characteristics had impact on the life satisfaction. The spearman correlation analysis showed that the correlation coefficient between the fatigue score,the pressure score,negative coping,positive coping and life satisfaction were separately r1 = -0.602,r2 = -0.395,r3 = -0.407, r4 = 0.368 (P < 0.01). The results of logistic regression analysis showed the fatigue, pressure and negative were the risk factors of nurse life satisfaction, and their OR values were respectively 1.239,1.646 and 1.116. Conclusion The life satisfaction of clinical nurse is disappointed. 46.5% of the nurses in clinic shards low life satisfaction. Life satisfaction is affected by fatigue, pressure and coping styles. There is a positive correlation between life satisfaction and positive response and negative correlation between life satisfaction and work stress, negative coping and fatigue.%目的 调查临床护士生活满意度,分析其影响因素,探讨生活满意度与其影响因素的相关性.方法 采用《生活满意度评定表》对湛江市2家市级医院的318名临床护士进行问卷调查,了解临床护士的生活满意度,用Spearman等级相关分析法分析临床护士生活满意度及其影响因素的相关性,用Logistic回归模型分析相关因素对生活满意度的影响.结果 318名被调查的临床护士中,170人(53.5%)生活满意度高,148人

  2. CLINICAL BIOCHEMISTRY

    Science.gov (United States)

    Assessment of the health status of animals through measurement of cellular, biochemical, and macromolecular constituents in blood, secretions, and excretions has been variously referred to as clinical chemistry, clinical biochemistry, or clinical pathology. he genesis of this dis...

  3. Observation on the influence factors of pregnancy induced hypertension syndrome and its clinical therapeutic effect%妊娠高血压综合征的影响因素及临床治疗效果观察

    Institute of Scientific and Technical Information of China (English)

    孙光宇

    2014-01-01

    Objective:To investigate the influence factors of pregnancy induced hypertension syndrome and its clinical therapeutic effect.Methods:23 patients with pregnancy induced hypertension syndrome were selected from October 2010 to October 2013,and 50 healthy pregnant women were selected during the same period as the control group.We observed the clinical data of the pregnant women in two groups,and then analyzed main influencing factors of this disease.The observation group samples were carried out comprehensive treatment,and summarized their clinical therapeutic effect.Results:Through the questionnaire and experiment result of pregnant women in two groups,we found that pre pregnancy BMI<25 kg/m2,serum β2-MG≥1.5 mg/L,serum IL-6≥20 pg/L,family history of hypertension,the firstborn of per unit area yield and calcium were all risk factors of this disease. When compared with the control group,the differences in those indexs were statistically significant(P<0.05).After the treatment, systolic and diastolic blood pressure in 23 patients were significantly improved when compared with before treatment,and the difference was statistically significant(P<0.05).Conclusion:There are many factors that can affect patients with hypertension of pregnancy.Application of comprehensive therapy in the clinical treatment can significantly reduce the blood pressure level,and also can effectively improve the life quality of pregnant women.It has an exactly value to apply in the clinical.%目的:探讨妊娠期高血压综合征的相关影响因素,并观察开展临床治疗的效果。方法:2010年10月-2013年10月收治妊高征患者23例,并以同期的50例健康孕妇作为对照组,观察两组孕妇的临床资料,分析该疾病的主要影响因素。并对观察组样本开展综合治疗,总结其临床治疗效果。结果:通过两组孕妇的问卷与试验的结果发现,孕前BMI<25 kg/m2、血清β2-MG≥1.5 mg/L、血清 IL-6≥20 pg/L、高血

  4. Clinical biophysics

    Energy Technology Data Exchange (ETDEWEB)

    Anbar, M.; Spangler, R.A.; Scott, P.

    1985-01-01

    Chapters are included on clinical decision making, principles of biomedical engineering, computers and their medical uses, clinical radiobiology, diagnostic x-ray radiology, clinical applications of ultrasonics, nuclear medicine, NMR imaging, diagnostic imaging, bioelectric techniques in diagnosis and therapy, biophysical aspects of the clinical laboratory, and biophysical aspects of modern surgery.

  5. 临床护士手套使用依从性现状及影响因素%Status quo of gloves use compliance of clinical nurses and its influencing factors

    Institute of Scientific and Technical Information of China (English)

    卢瑛

    2015-01-01

    Objective:To know about the status quo of gloves use compliance of clinical nurses,and analyze the related influencing factors,so as to provide certain references for improving the clinical nurses’gloves use com-pliance.Methods:A total of 1 18 clinical registered nurses received survey by using the general information ques-tionnaire,the gloves use behavior compliance questionnaire and the health belief of gloves use questionnaire.Re-sults:The score of nurses’gloves use compliance questionnaire was 43.74 ± 5.62,the score of health belief of gloves use questionnaire was 67.92 ±5.31.The age and positional title were the influencing factors of nurses' gloves use compliance.The analysis found that there was the correlation between behavioral barriers items and behavioral cues items and of gloves usage compilance by using health belief model(P <0.05).Conclusion:The clinical nurses’gloves use compliance is lower,that should cause the relevant departments and hospitals'atten-tion.It should guarantee nurses’occupation safety,at the same time to ensure the control of hospital infection.%[目的]了解临床护士手套使用的现状,分析影响护士手套使用依从性的相关因素,为改善临床护士手套使用依从性提供一定的参考依据。[方法]采用一般资料问卷、手套使用行为依从性问卷、手套使用健康信念问卷对118名临床注册护士进行调查。[结果]护士手套使用依从性问卷得分为43.74分±5.62分,手套使用健康信念问卷得分为67.92分±5.31分。年龄及职称是护士手套使用依从性的影响因素。采用健康信念模式进行分析后发现,行为障碍条目与行为线索条目与手套使用依从性存在相关性(P <0.05)。[结论]临床护士手套使用依从性较低,应该引起有关部门及医院的重视,保障护士职业安全的同时保证医院感染的控制。

  6. Analysis of situation and influencing factors in learning motivation of continuing education in clinical nurses%临床护士继续教育学习动机现状及影响因素分析

    Institute of Scientific and Technical Information of China (English)

    常燕; 周文琦; 刘晓霞; 高泽宇

    2013-01-01

    目的 调查影响临床护士学习的动机因素,为临床护理管理者制定培养策略提供依据,促进护理人员自主学习.方法 采用“临床护士学习动机调查问卷”对469名临床护士进行学习动机问卷调查,并分析其影响因素.结果 共发放问卷469份,回收有效问卷428份,回收有效率为91.2%.临床护士学习动机6个维度的得分由高到低的排序依次为:职业发展、利他服务、认知兴趣、外界期望、社会接触、社会刺激,总分为(114.34±20.95)分;学习动机排在前3位的条目分别是为晋升奠定基础(4.01±0.97)分,更加胜任自己的工作(3.95±0.95)分,获取知识(3.92±1.02)分.多元回归分析显示职称和工作年限为临床护士学习动机的影响因素,差异有统计学意义(t分别为-2.949,-2.037;P<0.05).结论 继续教育管理部门需加强对社会刺激方面的管理,对不同职称和工作年限的护士进行针对性的干预,提高护士参与继续教育的主动性.%Objective To investigate the effects of clinical nurses learning motivation factors,provide the basis for the formulation of strategies for cultivating clinical nurses,promote autonomous learning in nursing staff.Methods Four hundreds and sixty-nine clinical nurses were surveyed by the "clinical nurses learning motivation questionnaire".The influencing factors in learning motivation of continuing education in clinical nurses were analyzed by the SPSS 16.0 software package,including descriptive statistics,multiple regression analysis.Results Tatals of 469 questionnaires were sent out,and 428 were recycled,the effective responsive rate was 91.2%.The scores of six dimensions of learning motivation of continuing education in clinical nurses were from high to low in order occupation development,altruistic service,cognitive interests,expectations from outside,social contact and social stimuli.The occupation development motivation got the highest score (3.68 ± 0

  7. Influence of team-based learning on critical thinking of clinical nurse students%TBL教学法对临床护生评判性思维能力的影响

    Institute of Scientific and Technical Information of China (English)

    高传英

    2011-01-01

    目的 探讨团队合作为基础的教学法(TBL)对临床实习护生评判性思维能力的影响.方法 采用类实验研究方法,对照组接受传统带教法,干预组采用团队合作为基础的带教法,调查两组学生在实习前后的评判性思维能力的变化情况.结果 实习后干预组学生判断性思维能力总分为(302.87±19.89)分,对照组为(289.65±21.02)分,组间比较差异具有统计学意义(t=2.111,P<0.05).结论 TBL教学法应用到临床带教中,可以对临床实习护生评判性思维能力产生积极的影响.%Objective to explore the influence of team-based learning on critical thinking of clinical nurse students.Methods This study was a Quasi-Experimental Research Design,The experimental group adopted team-based teaching and the control group was only given the traditional teaching,their critical thinking ability were evaluated before and after 2 months' internship period.Results Total score of critical thinking in experimental group was(302.87 ± 19.89),and(289.65 ± 21.02)in control group,there was significant differences on the score(t =2.111,P<0.05).Conclusions The team-based learning applied in clinical has a positive effect in improving critical thinking of nursing internship students.

  8. Factors influencing patients' satisfaction on the esthetics of anterior restorations and their clinic implications%前牙美容修复满意度的影响因素及临床美学指导

    Institute of Scientific and Technical Information of China (English)

    石亚红

    2011-01-01

    随着美容口腔科学的兴起以及人们审美观念的提升,前牙美容修复在临床中的应用日益增加,逐渐成为患者主动选择的治疗方式;同时,前牙美容修复的效果也越发受到患者的重视.然而,许多患者对修复体不满意,希望能够改善其美学效果,临床医生对此应予以重视.进行美容修复时,要同时从患者和专业角度出发,以实现成功修复.本文就影响患者对修复体满意度的因素及美学参数在临床中的应用作一综述.%Dental esthetics has become an increasingly important and rewarding discipline in dentistry as patients have began to request anterior restorations of high esthetic quality. Many patients were dissatisfied with their restorations and desired the improvement of dental esthetics. Therefore, dentists should pay much attention to it Practically, dentists should try to consider both patients and clinical factors in order to achieve esthetic restorations. This article is to review factors influencing patients satisfaction on the esthetics of anterior restorations, and the use of these esthetic parameters in clinic.

  9. Factors Influencing Goal Attainment in Patients with Post-Stroke Upper Limb Spasticity Following Treatment with Botulinum Toxin A in Real-Life Clinical Practice: Sub-Analyses from the Upper Limb International Spasticity (ULIS-II Study

    Directory of Open Access Journals (Sweden)

    Klemens Fheodoroff

    2015-04-01

    Full Text Available In this post-hoc analysis of the ULIS-II study, we investigated factors influencing person-centred goal setting and achievement following botulinum toxin-A (BoNT-A treatment in 456 adults with post-stroke upper limb spasticity (ULS. Patients with primary goals categorised as passive function had greater motor impairment (p < 0.001, contractures (soft tissue shortening [STS] (p = 0.006 and spasticity (p = 0.02 than those setting other goal types. Patients with goals categorised as active function had less motor impairment (0.0001, contracture (p < 0.0001, spasticity (p < 0.001 and shorter time since stroke (p = 0.001. Patients setting goals for pain were older (p = 0.01 with more contractures (p = 0.008. The proportion of patients achieving their primary goal was not impacted by timing of first-ever BoNT-A injection (medium-term (≤1 year vs. longer-term (>1 year post-stroke (80.0% vs. 79.2% or presence or absence of severe contractures (76.7% vs. 80.6%, although goal types differed. Earlier BoNT-A intervention was associated with greater achievement of active function goals. Severe contractures impacted negatively on goal achievement except in pain and passive function. Goal setting by patients with ULS is influenced by impairment severity, age and time since stroke. Our findings resonate with clinical experience and may assist patients and clinicians in selecting realistic, achievable goals for treatment.

  10. Clinical and Translational Epidemiology Branch (CTEB)

    Science.gov (United States)

    The Clinical and Translational Epidemiology Branch focuses on factors that influence cancer progression, recurrence, survival, and other treatment outcomes, and factors associated with cancer development.

  11. 临床药学信息管理系统对医院抗菌药管理的影响%Influence of Clinical Pharmacy Information Management System on Antimicrobial Stewardship in a Hospital

    Institute of Scientific and Technical Information of China (English)

    程虹; 吴东方

    2014-01-01

    Objective:To study the impact of clinical pharmacy information management system on antimicrobial stewardship in a general teaching hospital. Methods:The main function, deficiencies and aspects needing improvement of clinical pharmacy information management system, and its influence on antimicrobial stewardship were introduced. Results:The information system had such functions as antimicrobial usage statistics, evaluation of antimicrobial prescription, and the use intensity calculation of antimicrobials. By using the information system, manpower of antimicrobial stewardship was saved, antimicrobial statistics became more comprehensive and objective, and dynamic real-time monitoring of antimicrobial drugs management was realized. However, the system still had some shortcomings needing improvement. Conclusion:Clinical pharmacy information system can promote the implementation and efficiency of antimicrobial stewardship.%目的::研究临床药学信息管理系统对医院抗菌药管理的影响。方法:介绍临床药学信息管理系统的主要功能、对医院抗菌药管理的影响、需改进的方面。结果:通过临床药学信息管理系统,能够统计原卫生部菌药专项整治涉及控制的抗菌药指标,包括门急诊和住院患者的抗菌药使用率、住院患者抗菌药使用强度、抗菌药处方点评、微生物送检率、围手术期抗菌药使用率。临床药学信息管理系统实施后,节省抗菌药管理工作人力,抗菌药统计数据全面客观,实行抗菌药管理动态实时监控,促进了抗菌药管理的依从性。该系统也存在不足和需改进的方面。结论:临床药学信息管理系统有效促进了医院抗菌药管理的实施。

  12. 小儿心肺复苏的临床特点及预后的影响因素%Clinical characteristics and the influence factors of prognosis of pediatric cardiopulmonary resuscitation

    Institute of Scientific and Technical Information of China (English)

    王昕

    2015-01-01

    Objective:To analyze the clinical characteristics and the influence factors of prognosis of pediatric cardiopulmonary resuscitation.Methods:46 patients with pediatric cardiopulmonary resuscitation treatment were selected from May 2010 to May 2014.18 cases used cardiopulmonary resuscitation because of cardiac arrest;28 cases used cardiopulmonary resuscitation because of respiratory arrest.The clinical characteristics and prognosis of pediatric cardiopulmonary resuscitation were detailedly analyzed. Results:The cardiopulmonary resuscitation rate 42.9% of respiratory arrest children was higher than the cardiopulmonary resuscitation rate 16.7% of cardiac arrest children,and the difference was statistically significant(P<0.05).The children common diseases caused pediatric cardiopulmonary resuscitation were accidental injuries,infectious diseases and cardiovascular diseases and so on.Conclusion:More attention should be paid to the causes and clinical characteristics of pediatric cardiopulmonary resuscitation.Popularization of pediatric first-aid knowledge and doing a good job in the publicity and education work can effectively improve the rescue success rate of pediatric cardiopulmonary resuscitation and improve prognosis.%目的:分析小儿心肺复苏的临床特点及预后的影响因素。方法:2010年5月-2014年5月收治小儿心肺复苏治疗患者46例,其中因心跳停止采用心肺复苏18例,因呼吸停止采用心肺复苏28例,详细分析小儿心肺复苏的临床特点和预后。结果:呼吸停止患儿的心肺复苏率42.9%高于心跳停止患儿的心肺复苏率16.7%,差异具有统计学意义(P<0.05);引起小儿心肺复苏的患儿常见疾病有意外伤害、感染性疾病以及心血管疾病等。结论:应更加重视引起小儿心肺复苏的原因和临床特点,普及儿科急救的相关知识,做好宣传教育工作,有效提高小儿心肺复苏抢救成功率,改善预后。

  13. The mairl factors of influence quality in clinical nursing students and its countermeasures%影响护生临床实习质量的主要因素及对策

    Institute of Scientific and Technical Information of China (English)

    吴丹凤; 陆祥兰; 高书琴; 芮立美

    2013-01-01

    Objective:To investigate the main factors of influence quality of clinical practice of nursing students,to improve the quality of teaching.Methods:A questionnaire from February 2011 to July 2012 in our hospital,randomly selected 80 nursing students,took the principle of voluntary near before the end of clinical practice were investigated.Results:It sends out questionnaire 80,recovered 68 copies,the effective rate was 85 %.Impact factors:teachers attitude was to 98.52%,the teacher's knowledge level was 91.18%,nursing students learn seriously enthusiasm was not high for 58.82%.Conclusion:The effect of clinical nursing quality of the major factors for the teachers and the students own internship,nursing students needed and teachers to communicate with each other,adopt corresponding countermeasures,in order to improve the teaching quality,to improve the quality of nursing students.%目的:探讨影响护生实习质量的主要因素,以提高带教质量.方法:选择2011年2月~2012年7月本院护理实习生80名,采取自愿原则在临近实习结束前进行问卷调查.结果:发出问卷80份,收回有效问卷68份,有效回收率85%.影响因素中:带教老师的态度98.52%,带教老师专业知识程度91.18%,实习生学习不认真积极性不高为58.82%.结论:当前影响临床护理实习质量的主要因素为带教老师和实习护生自身方面,护生需要与带教老师相互沟通,采取相应对策,以提高带教质量,从而提高护生实习质量.

  14. 医院护士工作绩效现状及其影响因素的调查分析%Status quo of job performance and its influencing factors among clinical nurses

    Institute of Scientific and Technical Information of China (English)

    尹吉善; 史沙沙; 崔文香

    2013-01-01

    Objective To explore the status quo of job performance and its influencing factors among clinical nurses.Methods 903 of clinical registered nurses from 5 comprehensive hospitals in Jilin province were investigated by the questionnaire.Results The level of job performance of clinical nurses from these 5 comprehensive hospitals in Jilin province was high,the average score of it was (3.345±0.442).The score of six dimensions followed by high and low were as followed:critical care,leadership,professional development,communication,planning and teaching.Some factors such as the title of a technical post,possession of spouse,classification of hospital,empowerment and organizational support were considered as the related factors via multiple regression analysis.Conclusions The leader should pay attention to empowerment and organizational support,so as to promote the job performance.%目的 探讨医院护士工作绩效的现状及其影响因素.方法 采用便利抽样法对吉林省5所综合医院的903名临床注册护士进行问卷调查,了解其工作绩效现状及影响因素情况.结果 护士工作绩效得分为(3.345±0.442)分,以重症护理能力和人际/沟通能力2个维度得分最高.经过多元回归分析得出影响护士工作绩效的主要因素有:职称、配偶情况、医院级别、授权赋能行为和组织支持感.其中授权赋能行为、组织支持感对护士工作绩效影响较大.结论 护理管理者应创造良好的组织支持系统,以利于护士授权赋能行为环境的形成,进而提升护士的工作绩效.

  15. 头痛门诊偏头痛患者睡眠质量及影响因素分析%Analysis of sleep quality and influence factors in migraine patients in headache clinic

    Institute of Scientific and Technical Information of China (English)

    朱洲; 周冀英; 范小平; 李雪莲; 冉丽

    2012-01-01

    To investigate sleep quality of migraineurs in headache clinic and the influence factors of sleep quality. Methods We used Visual Analogue Scale (VAS) , Pittsburgh Sleep Quality Index (PSQI) and Hospital Anxiety and Depression Scale CHADS) to assess headache intensity,sleep quality,anxiety and depression symptoms. Descriptive statistics,Chi-square test, Binary logistic regression were used to analyze the sleep quality and its impact factors. Results A total of 211 subjects, 130 (61. 61%) migraineurs had a poor sleep quality. Sleep quality mainly influenced by course of migraine and whether comorbid with anxiety and/or depression. Conclusion Over half of migraineurs comorbid with poor sleep quality,and most patients' poor sleep did not get effective improvement. So control influence factors of sleep quality may improve the poor sleep quality of migraineurs.%目的 分析神经内科头痛门诊偏头痛患者睡眠质量情况,并探讨睡眠质量的影响因素.方法 采用疼痛视觉模拟评分、匹兹堡睡眠质量指数和医院焦虑抑郁量表,评估偏头痛患者的头痛程度、睡眠质量及焦虑抑郁症状.利用描述性统计、χ2检验、回归分析等方法分析偏头痛患者睡眠质量及影响因素.结果 在211例偏头痛患者中有130例(61.61%)患者存在睡眠质量障碍.睡眠质量主要受偏头痛病程和是否伴有焦虑抑郁症状影响.结论 偏头痛患者大多伴有睡眠障碍,而且睡眠障碍有效控制率低.控制睡眠质量的影响因素,有望改善偏头痛患者的睡眠质量.

  16. Influence of Various Bases on Clinical Efficacy and Safety of Drugs%不同盐基对药物临床效果和安全性的影响分析

    Institute of Scientific and Technical Information of China (English)

    方松; 廖祥茹

    2014-01-01

    成盐是改善活性药物分子( API)成药性的一个重要手段,目前活性成分相同而盐基不同的药物不断出现,本文就盐基对药物药动学、药效学及药物不良反应三个方面的影响作简要综述,以对临床遴选治疗药物及新药盐基的选择提供参考。%Salt formation is the most important method for increasing druggability of active pharmaceutical ingredients ( API) . Nowadays, API containing different bases are emerging continuously. In this paper, the influence of various bases on the pharmacokinetics, pharmacodynamics and side effects of drugs was reviewed, which can provide reference for the selection of clinical therapeutic drugs and the base choice for new drugs.

  17. The Influence of Plantar Short Foot Muscle Exercises on Foot Posture and Fundamental Movement Patterns in Long-Distance Runners, a Non-Randomized, Non-Blinded Clinical Trial.

    Directory of Open Access Journals (Sweden)

    Iwona Sulowska

    Full Text Available The objective of this study was to evaluate the influence of two kinds of plantar short foot muscles exercise on foot posture and fundamental movement patterns in long-distance runners.A parallel group non-blinded trial with 6-week follow-up.Twenty five long-distance runners aged 22-35 years. They were divided into two groups. In group 1 (n = 13 subjects performed the exercise "Vele's Forward Lean" and "Reverse Tandem Gait" and in Group 2 (n = 12 the "Short Foot Exercise." The runners performed the exercises daily for 6 weeks. The Foot Posture Index (FPI-6 and The Functional Movement Screen (FMS tests were performed twice: at baseline and after 6 weeks of the exercise.A significant improvement was observed in FPI -6 (talar head palpation in Group 1, and inversion/eversion of the calcaneus in Group 2. Also in Group 1 a significant improvement was noted in FMS tests: deep squat, active straight leg raise and in total score.Short foot muscles strengthening exercises have beneficial effect on functional movement patterns and on foot posture, therefore they should be included as a part of daily training program of runners.Australian New Zealand Clinical Trials Registry ACTRN12615001200572.

  18. Positive psychological qualities of nursing students during clinical practice and influencing factors analysis%实习护生积极心理品质水平及其影响因素研究

    Institute of Scientific and Technical Information of China (English)

    曹洁

    2014-01-01

    目的:调查护生临床实习期间的积极心理品质水平,并分析其影响因素,为提高实习护生积极心理品质水平提供理论依据。方法采用一般资料调查表、中国大学生积极心理品质量表对232名实习护生进行问卷调查。结果实习护生积极心理品质6个维度得分从高到低分别为人际、超越、公正、节制、认知、情感,其中情感、人际、超越得分分别为(3.24±0.66),(3.62±0.52),(3.52±0.48)分,与大学生常模比较差异有统计学意义(t值分别为-8.54,-2.45,-3.61;P<0.05)。经多元线性逐步回归分析,结果显示父母教育程度、带教老师的沟通和关注、择业动机、与其他护生的关系、父母的关注、带教老师和患者的肯定、性格、就业压力等影响实习护生的积极心理品质水平。结论实习护生积极心理品质总体水平低于大学生常模,受多种因素影响,因此临床护理教育者应制订相应措施,提高护生实习期间积极心理品质水平,促进实习护生的身心健康。%Objective To explore the positive psychological qualities of nursing students during clinical practice, and analyze its influencing factors , to provide a theoretical basis for improving the positive psychological quality level of nursing students .Methods Totals of 232 nursing students were enrolled in this study, and investigated with a related demographic information questionnaire and Positive Psychological Qualities Questionnaire.SPSS 17.0 statistical software was used to analyze the data .Results These nursing students got the highest score in the dimension of interpersonal relationship , followed by transcendence , justice, temperance, cognition, and emotion.The score of emotion, interpersonal relationship and transcendence were ( 3.24 ± 0.66), (3.62 ±0.52) and (3.52 ±0.48), respectively, which were significantly lower than the norm of college

  19. Influência da classe social nas razões clínicas das perdas dentárias Influence of social class on clinical reasons for tooth loss

    Directory of Open Access Journals (Sweden)

    Renata Cimões

    2007-12-01

    Full Text Available Com o objetivo de determinar a influência da classe social nas razões clínicas das perdas dentárias na cidade de Maceió, Alagoas, foi realizado um estudo transversal que envolveu 466 indivíduos adultos, com idade entre 18 a 76 anos. Foram coletados dados socioeconômicos e demográficos através de um formulário. O exame clínico determinou a razão pela qual o dente seria extraído e houve registro do CPO-D de todos os pacientes. Os pacientes foram incluídos em classes sociais com base nos dados coletados dos formulários. 54,1% dos indivíduos que participaram da pesquisa eram do sexo feminino, a idade teve média de 33,73 ± 13,68 anos, observou-se que 369 (79,2% não tinham completado o segundo grau e 385 (82,6 apresentaram renda familiar de até quatro salários mínimos, com média de 3,4 ± 5,4. A principal razão das perdas dos dentes permanentes foi a cárie dentária. Os pacientes apresentaram em média 16,59 ± 6,96 dentes cariados, perdidos ou obturados, a maioria dos pacientes 219 (47,0% apresentaram CPO-D entre onze a vinte dentes. Observou-se associação estatisticamente significante entre a razão da perda e o grupo social a que pertencia o paciente (PIn order to determine the influence of social class on clinical reasons for tooth loss in Maceió, the Alagoas State capital in Northeast Brazil, a cross-sectional study was conducted of 466 adults whose ages ranged from 18 to 76 years. Socioeconomic and demographic data were collected through a questionnaire. Clinical examinations determined the reason for extracting teeth, recording the DMF-T of all patients, who were divided into social classes on the basis of the data gathered from the questionnaire: 54.1% of the subjects were female with a mean age of 33.73 ± 13.68 years; 369 (79.2% of them had not completed their secondary education and 385 (82.6% had family incomes no more than four times the official minimum wage (mean 3.4 ± 5.4. The main reason for the loss of

  20. Analysis of influencing factors on clinical curative effect of operative therapy for high-energy tibia Pilon fracture%高能量Pilon骨折手术疗效的影响因素分析

    Institute of Scientific and Technical Information of China (English)

    唐华; 吴慧敏; 刘治

    2013-01-01

    Objective To explore the influencing factors on clinical curative effect of operative therapy for high-energy tibia Pilon fracture. Methods A total of 41 patients with high-energy tibia Pilon fractures were retrospectively analyzed to reveal the relationship between age, gender, education, income, fracture types, surgery techniques, timing for surgery, quality of fracture reduction, complications, timing for postoperative functional exercise and Mazur ankle function score. Results All of them were followed up for 13~27(21. 3 ±5. 2) months after operation. In the sigle-factor analysis, the influencing factor of Mazur ankle function score with statistical significance were: age ( P < 0. 05 ) , education ( P < 0. 05 ) , fracture types ( P < 0. 05 ) , quality of fracture reduction ( P < 0. 01) , and timing for postoperative functional exercise (P <0. 01 ). The parameters of the age, gender, education, income, fracture types, surgery techniques, timing for surgery, quality of fracture reduction, complications, timing for postoperative functional exercise of patients were analyzed to establish a statistic model by means of multiple linear regression, which showed that the P values of quality of fracture reduction (X3) , fracture type (X4) , timing for postoperative functional exercise (X5 ) were statistically significant (P < 0. 05 ). The regression equation was Y= 70.586 + 4.060X3-3. 562X4+11.585X5. Conclusions Quality of fracture reduction, fracture type, timing for postoperative functional exercise are the influencing factors on clinical curative effect of operative therapy for high-energy tibia Pilon fracture.%目的 探讨高能量Pilon骨折手术疗效的主要影响因素.方法 回顾性分析41例高能量Pilon骨折患者的年龄、性别、学历、收入、骨折分型、手术时机、手术方式、骨折复位质量、术后并发症、术后功能锻炼时机与其术后Mazur踝关节功能评分间关系.结果 41例均获得回访,时间13 ~ 27

  1. Analysis Negative Influence on the Clinical Pregnancy Rate of Intrauterine Insemination in Infertility Women with Advancing Age%高龄不孕妇女IUI临床妊娠的不利影响因素分析

    Institute of Scientific and Technical Information of China (English)

    陈孟循; 马文敏; 朱莉; 吴雅琴; 司徒艳球; 谭晓慧

    2014-01-01

    目的:分析影响高龄不孕妇女IUI获临床妊娠的不利因素,并找出高龄妇女转变助孕方式的时机。方法回顾佛山市妇幼保健院生殖中心自2008年1月~2012年1月行IUI助孕325对夫妇550个IUI周期的资料,统计分析女方不同年龄段、不孕类型、不孕年限、接受IUI的周期数、3种促排卵周期和自然周期对高龄妇女IUI临床妊娠率的影响。结果≧40岁组临床妊娠率明显低于35~36岁组(=0.028);≧5年组临床妊娠率明显低于1~2年组(=0.037);HMG/丽申宝促排卵周期临床妊娠率明显高于自然周期和CC/CC+HMG周期(P值分别为0.012、0.020),40岁及以上患者使用CC/CC+HMG促排卵共21周期,未见有临床妊娠,而HMG/丽申宝促排卵周期临床妊娠率为9.0%(6/67);≧40岁且不孕年限≧5年妇女行IUI助孕共有33周期,仅有1例获临床妊娠,妊娠率为3.0%(1/33);≧40岁妇女接受第3次及以上助孕周期共15周期,未有获临床妊娠者。结论不孕年限及促排卵方案是影响高龄妇女IUI获临床妊娠的重要因素,40岁以上患者通过IUI的获临床妊娠率机会低下。高龄妇女行IUI建议使用Gn促排卵,避免使用CC,进行2个周期的IUI助孕治疗后可考虑转其他助孕方式,特别是对不孕年限≧5年或40岁及以上妇女;不孕年限达5年或者以上,并且患者≧40岁,则建议直接行IVF/ICSI助孕。%Objective To investigate and analyze factors that influence pregnancy rate of intrauterine insemination (IUI)with husband sperm in women of advancing age,to find the best timing to change assisted reproductive technology.Methods The clinical data of 325 infertile couples undergoing 550 IUI were analyzed in Center,Foshan Maternal &Children Health Hospital.Relationships between pregnancy rate and maternal age,infertile types,infertile time,natural cycle and 3 types of ovulation induction cycle were investigated.Results The clinical pregnancy rate was significantly lower in

  2. Clinical Trials

    Science.gov (United States)

    Clinical trials are research studies that test how well new medical approaches work in people. Each study answers ... prevent, screen for, diagnose, or treat a disease. Clinical trials may also compare a new treatment to a ...

  3. Clinical Wisdom among Proficient Nurses

    DEFF Research Database (Denmark)

    Uhrenfeldt, Lisbeth; Hall, Elisabeth

    2007-01-01

    This paperexamines clinical wisdom which has emerged from a broader study anout nurse managers´influence on proficient registered nurse turnover and retention. The purpose of the study was to increase understanding of proficient nurses´experience and clinical practice by giving voice to the nurses...

  4. Survey of characteristics and influencing factors of the adolescent with anxiety disorders in psychological clinic%心理门诊青少年焦虑症患者的特征及影响因素调查

    Institute of Scientific and Technical Information of China (English)

    张昌; 王永柏; 李柳; 杨妍; 杨丹

    2015-01-01

    目的::探索心理门诊青少年焦虑症患者的影响因素及其特征。方法:采用自编的一般情况调查表、汉密尔顿焦虑量表、自尊量表、青少年生活事件量表、父母养育方式评价量表、艾森克人格测验,对170名青少年焦虑症患者进行调查。结果:青少年焦虑症患者在年龄、性别等人口学特征均无显著性差异。与汉密尔顿焦虑相关的因素:自尊、健康适应、内向外向和神经质。与躯体焦虑相关的因素:母亲惩罚、严厉、神经质。与精神焦虑相关的因素:自尊、受惩罚、健康适应、其他:母亲过分干涉、过分保护、精神质、内向外向、神经质。结论:自尊、健康适应、内向外向和神经质是青少年焦虑患者的相关因素。%Objective: To explore characteristics and influencing factors of the adolescent with anxiety disorders in psychologi-cal clinic. Methods: 170 cases of the adolescent with anxiety disorders in psychological clinic were investigated with general condition questionnaire, Hamilton anxiety scale (HAMA), self-esteem scale (SES), adolescent self-rating life events check List (ASLEC), Egma Minnen av Bardndosna uppforstran (EMBU), and Eysenck Personality Questionnaire (EPQ). Results: There were no signifi-cant differences of the adolescent with anxiety disorders in demographic characteristics, such as age, gender, and so on. The related factors of HAMA were: self-esteem, healthy adaptation, introversion and extroversion, and neuroticism. The related factors of somatic anxiety were: mother's punishment, stringency, and neuroticism. The related factors of Psychic anxiety were: self-esteem, punish-ment, and healthy adaptation. The other factors were too much interference and too much protection of the mother, psychoticism, psy-choticism, introversion and extroversion, and neuroticism. Conclusions: Self-esteem, healthy adaptation, extraversion and introver-sion, and neuroticism

  5. 连续助产护理模式对初产妇剖宫产率的影响%The clinical influence of continuous midwifery nursing on caesarean section rate of unipara

    Institute of Scientific and Technical Information of China (English)

    罗玉媚; 利伟江

    2015-01-01

    Objective:To explore the clinical influence of continuous midwifery nursing on caesarean section rate of unipara. Methods:220 cases of unipara with relative contraindication indications of vaginal delivery were randomly divided into observation group and control group. Control group was given routine midwifery nursing,and observation group was given continuous midwifery nursing. Results:Caesarean section rate,time of first stage labor,blooding amount during the delivery in experimental group were significantly lower than that in control group,nursing satisfaction was significantly higher than that in control group (P < 0. 05). Conclusion:Continuous midwifery nursing used for unipara that trying to vaginal delivery,can let unipara enjoy more continuous and proper physical and mental support,and maintain more steadier physical and mental support,so it deserves considering in clinical work.%目的::探讨连续助产护理模式对初产妇剖宫产率的影响。方法:将具有顺产相对禁忌指征的220例初产妇随机等分为观察组和对照组,所有患者均行阴道试产,对照组给予常规护理,观察组实施连续助产护理。比较两组患者的剖宫产情况、第一产程时间、产时出血量及护理满意度。结果:观察组剖宫产率、第一产程时间和产时出血量均显著低于对照组,护理满意度显著高于对照组(P <0.05)。两组产妇在分娩期间均未出现严重并发症,新生儿均顺利存活。结论:对于试行顺产的初产妇实施连续助产护理,能够让产妇得到更为连续的、合适的身心支持,从而维持相对更为稳定的身心状态,并降低剖宫产率,值得临床推广应用。

  6. 注入前向运动精子数对人工授精临床妊娠率的影响%The influence of processed total motile sperm count on clinical pregnancy rate of intrauterine insemination

    Institute of Scientific and Technical Information of China (English)

    王明勇; 付莉; 廖运梅; 陈绍威; 王芳; 黄桂英; 毛熙光

    2014-01-01

    Objective To investigate the influence of processed total motile sperm (PTMS) count of husband on clinical pregnan-cy rate of intrauterine insemination(IUI) .Methods We retrospectively analyzed a total of 229 cycles of IUI among 131 patients in our hospital during the past three years .The cycles were divided into 5 groups according to the PTMS count :group A(0 .05) among five groups .Conclusion Ideal clinical pregnancy can be achieved when the PTMS count is between 3 × 106 and 5 × 106 .%目的:探讨注入前向运动精子总数对丈夫精液宫腔内人工授精(IUI)临床妊娠率的影响。方法回顾分析2010年4月至2013年4月在该院行IUI助孕治疗的不孕症夫妇131例患者,229个IUI周期,按宫腔内注入前向运动精子数(PTMS)分为5组:A组(<5×106),B组(5×106~<10×106),C组(10×106~<20×106),D组(20×106~<30×106),E组(≥30×106),比较组间临床妊娠率。结果131例患者IUI治疗,临床妊娠率为26.72%,229个周期,周期临床妊娠率为15.28%。周期临床妊娠率分别为A组23.08%、B组15%、C组18.18%、D组13.46%、E组13.48%。各组间差异无统计学意义(P>0.05)。

  7. 有创血压与无创血压准确性的评价以及对治疗的影响%The accuracy evaluation of invasive and noninvasive blood pressure monitoring and its influence on clinical use

    Institute of Scientific and Technical Information of China (English)

    王丽霞; 沈健; 丁正年

    2013-01-01

    背景 血压监测在麻醉诱导期至关重要,准确及时地监测血压对指导麻醉期间用药和保障患者的安全具有重要意义.在临床中同一患者的有创血压(invasive blood pressure,IBP)值和无创血压(non-invasive blood pressure,NIBP)值存在一定差异. 目的 就不同患者IBP及NIBP值的差异以及对治疗的影响作一综述. 内容 当患者血压较高时IBP值高于NIBP值,血压较低时IBP值低于NIBP值,使用NIBP和IBP同时监测能降低患者围手术期血管活性药物以及血液制品的使用率. 趋向 围手术期同时使用NIBP和IBP监测,可以帮助我们得到更可靠的血流动力学信息,及时发现病情变化,做出准确及时的处理.%Background Blood pressure monitoring is a part of the standard of care for anesthesia induction,which is also very important for the guidance of clinical medication and the safety of patients.Objective This review summarizes the difference between non-invasive blood pressure (NIBP) and invasive blood pressure (IBP) of different patients and its influence on clinical application.Content Compared with IBP,NIBP is likely to be higher than IBP at lower pressure,and lower than IBP at higher pressures.Concomitant use of NIBP with IBP is associated with decreased use of transfusion,vasopressors,and antihypertensives compared with the use of IBP alone.Trend Compared with the use of IBP measurement alone,the use of NIBP monitoring to supplement IBP measurement is usually associated with getting more reliable hemodynamic information and dealing with relevant problem in a more timely manner.

  8. Clinical Research and Clinical Trials

    Science.gov (United States)

    ... Meetings, Conferences & Events Partnering & Donating to the NICHD Staff Directory ... Clinical Research Skip sharing on social media links Share this: Page Content Clinical research is research that directly involves a ...

  9. 影响抑郁症患者精神专科门诊治疗的相关因素研究%Research on relatively factors which influence depressions' therapy in psychosis clinic

    Institute of Scientific and Technical Information of China (English)

    刘霞; 杨金华; 高玉娥

    2009-01-01

    目的 探讨影响抑郁症患者在精神专科门诊治疗的相关因素,为提高治疗依从性提供科学依据.方法 采用简明精神病量表(BPRS)和自制问卷调查79例精神专科医院门诊就诊的抑郁症患者,分析影响在专科治疗的因素,进行健康指导,采取预约复诊或电话回访随访1年.结果 63.29%的抑郁症患者首诊选择非精神科诊治;53.16%的患者未到精神科就诊的原因是不知道患抑郁症;首诊于精神专科的患者诊断、首次连续治疗时间、用药、疗效均明显优于首诊于非精神科患者(P<0.01);系统健康教育后治疗依从性提高,差异有统计学意义(P<0.01).结论 对医护人员、患者及家属开展积极有效的精神卫生知识宣传与普及是提高早期诊断、早期治疗、提高疗效、防止复发的关键.%Objective To investigate the factors which influence the depressions' therapy in psychosis clinic,provide Scientific basis for improving the level of treatment compliance.Methods The Brief Psychiatric Rating Scale and home-made questionnaire were used to investigate 79 depressions patients who took treatment in psychosis clinic,to analyse the influencing factors,and to give them the Health guide.Appointment for further consultation or call to follow up were carried out for 1 year.Results There were 63.29% depressions chose the general hospital to see the doctor at first time,53.16% patients did not go to the psychiatric hospital because they didn' t know their disease feature;the diagnosis,treatment session,medication,effect are obviously prior in the patients seeing the psychiatrists at first time(P < 0.01);patients' therapeutic compliance improved after Systemic health education,the discrepancy is statistically significant.(P < 0.01).Condnsions To make active and valid propaganda on mental healthy is the key points to diagnosis and therapy prophase,can also prevent the recrudesce.

  10. The Clinical Value of the Influence of Maternal BMI on Birth Weight%体重指数对新生儿体重影响的临床价值分析

    Institute of Scientific and Technical Information of China (English)

    覃利美; 许建玉; 陈静芬

    2012-01-01

    目的:分析体重指数(BMI)对新生儿体重影响的临床价值.方法:收集2008年6月至2011年6月在我院产科分娩的BMI≥28的孕妇359例作为产前肥胖组,同期分娩的BMI<28的孕妇359例作为产前体重正常组,分析其分娩前BMI与新生儿体重的相关性.结果:产前肥胖组新生儿体重及巨大儿的发生率高于产前体重正常组,两者比较差异均具有显著性(P<0.05).结论:分娩前BMI与新生儿体重密切相关,高BMI增加巨大儿的发生风险.%Objective:To analyze the clinical value of the influence of maternal BMI on birth weight.Methods:359 cases of pregnant women with BMI>28 for regular prenatal care and laboring in our hospital between Mar.2008 and Jun.2011 were collected as the antenatal obesity group, 359 cases of pregnant women with BMK28 as antenatal normal weight group. Analyzing the correlation between the BMI and birth weight.Resuits:The birth weight of the antenatal obesity group were higher than that of the antenatal normal weight group, the difference were statistically significant (P<0.05); The incidence of fetal growth of the antenatal obesity group were higher than that of the antenatal normal weight group, the difference were statistically significant (P<0.05). Conclusion:The birth weight is closely related to BMI, high BMI can increase the risk of fetal growth.

  11. 心血管疾病患者参与临床决策倾向性的影响因素研究%The influence factors of clinical decision making in patients with cardiovascular disease

    Institute of Scientific and Technical Information of China (English)

    刘金涛; 杜昕; 马长生; 张萍; 吴雪松

    2014-01-01

    目的 分析影响心血管疾病患者参与临床决策倾向性的因素.方法 抽取符合入选标准的心血管疾病患者258例,采用问卷调查方法,对患者的就医过程及对其临床决策倾向性的影响进行探讨.问卷调查的具体内容包括:①一般人口学资料;②疾病状况;③患者心理健康状况评估;④患者参与临床决策的意愿.结果 患者平均年龄(64±13)岁;男性占55.8%(144/258),女性占44.2%(114/258);88.0%(227/258)的患者可以报销医疗费用;82.2%的患者家庭月收入≥3 000元;89例(34.5%)患者在做临床决策时倾向于"医生根据医学知识做出决策",61例(23.7%)患者在做临床决策时倾向于"医生在询问患者需求后做出决策",94例(36.4%)患者倾向于"和医生共同做出决策",14例(5.4%)患者倾向于"和医生讨论后自己做出决策".无患者依据自己的知识独立做出决策.患者对医生的信任评分:最低7分,最高10分,平均(9.7±0.5)分;文化程度(OR=4.052,95%CI:1.800~9.126)是患者和医生做出共同决策的危险因素,对医生的信任评分(OR=0.071,95%CI:0.016~0.309)是患者和医生做出共同决策的保护因素.结论 心血管疾病患者对医生的信任度很高,患者的临床决策倾向性主要取决于患者对医生的信任程度.%Objective To analyze the influence factors of clinical decision making in patients with cardiovascular disease. Methods Totally 258 patients with cardiovascular disease were selected; the treatment process of patients and its effect on clinical decision preference were discussed by questionnaire investigation. The specific content of questionnaire included: ①general demographic data; ②the disease status; ③assessment of mental health status for patients; ④the willingness of clinical decision making participating in patients. Results The average age of patients was (64±13) years; there were 55.8%(144/258)of males, 44.2%(114/258)of female; 88.0%(227/258) of the

  12. Influences of clinical nurses' occupational stress, anxiety and depression on serum cortisol levels%临床护士工作应激及焦虑抑郁对血清总皮质醇的影响

    Institute of Scientific and Technical Information of China (English)

    陈偶英; 焦娜; 彭芳; 叶曼; 张静平

    2011-01-01

    目的 探讨临床护士工作应激及焦虑抑郁情绪对其血清总皮质醇的影响.方法 对104名临床护士采用护士工作应激源量表及Zung焦虑、抑郁自评量表进行调查,同时检测其血清总皮质醇.结果 临床护士工作应激源总评分为(529.85±176.87)分,SAS评分(36.84±7.20)分,SDS评分(41.21±7.22)分;血清总皮质醇正常12人,高于正常值92人;护理工作量过大、护患关系紧张等12项负性事件评分与临床护士血清总皮质醇呈正相关(P<0.05,P<0.01),血清总皮质醇与抑郁呈正相关,护士应激源进入血清总皮质醇的回归方程.结论 临床护士的工作应激及焦虑抑郁水平可影响血清总皮质醇.护理管理者应采取合理配置人力资源,提高护士的社会地位,更新护士知识层次,建立同事支持系统,加强对护士心理知识的培训等措施帮助护士降低各种应激源,以保持临床护士的身心健康,提高护理服务质量.%Objective To explore the influences of clinical nurses' occupational stress, anxiety and depression on serum cortisol levels. Methods Totally, 104 nurses were surveyed with the Nursing Occupational Stressor Scale, Zung Self-rating Anxiety Scale and Zung Self-rating Depression Scale. At the same time, nurses' serum eortisol levels were detected. Results The total score of clinical nurses' occupational stressor was 529.85 ± 176.87, SAS and SDS scored 36.84 ± 7.20 and 41.21 ± 7.22 respectively. There were 12 nurses with serum cortisol levels at normal level, and 92 nurses beyond normal. The scores of 12 negative events including over workload and strained nurse-patient relationship, ect. were positively related with nurses' serum cortisol levels (P<0.05,P< 0.01)4 Besides, the serum cortisol levels were also positively correlated with depression. Nurses' stressor entered the regression equation of serum cortisol. Conclusion Clinical nurses' occupational stress, anxiety and depression

  13. 玻璃化冷冻对冻融卵裂期胚胎移植周期结局的影响%Influence of vitrification method on clinical outcome of human frozen-thawed cleaved embryo transfer

    Institute of Scientific and Technical Information of China (English)

    柳倩茹; 黄绮云; 池霖生; 张静雯; 朱莉

    2014-01-01

    Objective To investigate the influence of vitrification method on clinical outcome of human frozen-thawed cleaved embryo transfer.Methods In the in vitro fertilization and embryo transfer cycles,supernumerary embryos were cryopreserved by vitrification or slow-freezing sequencing method.The embryo survival rate,intact survival rate,pregnant rate and implantation rate were compared after thawing.Results In 248 vitrified embryo thaw cycles,746 vitrified embryos were thawed,and 643(86.2%) of them survived and 594(79.4%) of them intactly survived after the thawing.In 244 women,632 embryos were transferred,and 107(43.9%) of them got clinical pregnancy,the implantation rate was 26.1% (165/632).As to slow-freezing method,in 225 embryo thaw cycles,818 embryos were thawed,598 (73.1%) of them survived,436(53.3%) of them intactly survived,and 594 embryos were transferred in 225 cycles,and 74 (32.9%) of them got clinical pregnancy,the implantation rate was 15.2%(90/594).The embryo survival rate,intact survival rate,pregnant rate,implantation rate were higher in vitrification group than those in slow-freezing group (P < 0.05).Conclusion Vitrification is a more effective method of cryopreserving the human embryo than conventional slow freezing.%目的 探讨玻璃化冷冻法对卵裂期冻融胚胎移植周期结局的影响.方法 将接受体外受精-胚胎移植患者剩余的可利用胚胎进行玻璃化冷冻或者慢速程序化冷冻,比较胚胎复苏后的复苏率、胚胎存活率、完整存活率、种植率、妊娠率等指标.结果 玻璃化冷冻复苏248个周期、746个胚胎,存活643个(86.2%),完整存活594个(79.4%),移植244个周期,临床妊娠107个周期(43.9%),种植率26.1%,流产9个周期(8.5%).慢速程序冷冻复苏225个周期、818个胚胎,存活598个(73.1%),完整存活436个(53.3%),移植225个周期,临床妊娠74个周期(32.9%),种植率15.2%,流产7个周期(9.5%).玻璃化法冷冻后的

  14. 临床护士针刺伤后自我效能水平及其影响因素分析%Self-efficacy and influencing factors of clinical nurses with needlestick injuries

    Institute of Scientific and Technical Information of China (English)

    梁培荣; 薛小玲; 孟红燕; 阮爱超; 王姗姗

    2013-01-01

    目的 了解发生针刺伤临床护士自我效能状况及其相关影响因素,探讨提高临床护士自我效能的有效途径.方法 采用便利及分层抽样相结合的方法,用一般资料问卷和自我效能感量表对713名发生过针刺伤的临床护士进行问卷调查.结果 针刺伤后护士的自我效能感平均得分为(2.70--0.52)分,69.1%的护士具有中等水平的自我效能,仅19.1%的护士具有高水平的自我效能.性别、职称、科室、主动报告、职业环境、职业安全培训与针刺伤护士的自我效能水平显著相关.结论 发生针刺伤的临床护士自我效能大多数处于中等水平,有待进一步提高.应寻找其他影响针刺伤后护士自我效能的因素,以便针对其主要影响因素采取相应的管理措施,从而提高其自我效能.%Objective To investigate the level and influencing factors of self-efficacy among nurses with needlestick injuries and explore effective strategies to improve self-efficacy.Methods 713 clinical nurses with needlestick injuries had been enrolled by convenience and stratified sampling method to comphte the investigation using the self-designed demographic questionnaire and General Self-Efficacy Scale.Results The average score of the self-efficacy was (2.70 ±0.52) points.69.1% of the needlestick injury nurses had the sclf-efficacy score at the middle level; only 19.1% of them had a higher level score on self-efficacy.Gender,title,section,initiative report,work environment,and occupational safety training were identified as the influencing factors of the self-efficiency.Conclusions Even though more than half of the nurses with needlestick injuries had a middle level self-efficacy,they need further improvement.Other influencing factors should be explored in future in order to develop the corresponding management intervention which can strengthen the self-efficacy of nurses with needlestick injuries.

  15. Influencing Up

    CERN Document Server

    Cohen, Allan R

    2012-01-01

    The authors of the classic Influence Without Authority explain the unique challenges of influencing powerful people Learn to overcome your difficulties with a boss who is uninterested in your concerns, or resistant to giving needed support. Or discover how to win the cooperation of senior managers who are hard to reach, and hard to sell on your ideas, products, or services. In their classic book, Influence Without Authority, Allan Cohen and David Bradford provided a universal model of how to influence someone you don't control. Influencing Up applies those ideas to problematic bosses and other

  16. 氨磺必利对老年精神分裂症临床疗效及认知功能的影响%The influence of amisulpride on clinical effect and cognitive function of senile schizophrenia

    Institute of Scientific and Technical Information of China (English)

    马衡; 孙群星; 王永学; 刘向阳; 银贺

    2015-01-01

    目的:探讨氨磺必利对老年精神分裂症患者临床疗效及认知功能的影响。方法将90例老年精神分裂症患者随机分为A组与B组,同期抽取健康体检退休职工45名设为对照组。A组与B组分别口服氨磺必利与利培酮治疗,观察12周。采用阳性与阴性症状量表、简明精神病量表评定临床疗效,副反应量表评定不良反应,采用威斯康星卡片分类测验评定认知功能。结果治疗后两组患者阳性与阴性症状量表及简明精神病量表评分均较治疗前显著下降(P<0.05或0.01)。治疗12末两组患者威斯康星卡片分类测验的持续错误数、持续应答数、完成第1个分类所需应答数因子分均较治疗前显著下降(P<0.05),但仍显著高于对照组(P<0.05);完成分类数因子分均较治疗前显著升高,但仍显著低于对照组(P<0.01)。两组总体不良反应发生率比较差异无显著性(χ2=2.47,P>0.05)。结论氨磺必利能显著改善老年精神分裂症患者的各种精神症状及认知功能,且安全性高,与利培酮相当。%Objective To explore the influence of amisulpride on clinical effect and cognitive function of se‐nile schizophrenia .Methods Ninety senile schizophrenics were randomly assigned to group A and B ,re‐tired employees selected from health examination in the corresponding period to control group .Group A took orally amisulpride and B did risperidone for 12 weeks .Clinical efficacy were assessed with the Positive and Negative Syndrome Scale (PANSS) and Brief Psychiatric Rating Scale (BPRS) ,adverse reactions with the Treatment Emergent Symptom Scale (TESS) ,and cognitive functions with the Wisconsin Card Sorting Test (WCST) .Results After treatment the PANSS and BPRS scores of group A and B lowered more sig‐nificantly compared with pretreatment (P0 .05) .Conclusion Amisulpride equivalent to risperi‐done could notably improve

  17. 充血性心力衰竭患者地高辛临床药动学及影响因素研究%Digoxin clinical pharmacokinetics and its influence factors in patients with congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    孙增先; 谈恒山; 张骞峰; 李恭润; 沈来龙

    1998-01-01

    OBJECTIVE: To study clinical pharmacokinetics of digoxin and its influence factors in patients with congestive heart failure. METHOD: Radioimmunoassay was used to measure serum digoxin concentration, the method of one point of Bayesian to calculate digoxin clinical pharmacokinetics parameters as well as dosage regimens, and the minitab software to analyse data statistically. RESULTS: CrCl was (54.2±18.2)mlmin-1, Cl (73.4±27.5)mlh-1kg-1, Vd (6.95±1.07)Lkg-1, t1/2(73.7±23.5)h, K(0.010 4±0.003 3)h-1. Every parameter varied greatly, and their variations were all above 30% except Vd. There was a very significantly negative correlation between age and any of CrCl, Cl and Vd (P<0.001), and a strong positive correlation between CrCl and Cl or Vd (P<0.001), especially Vd (r=0.913). CrCl was approximately 25 mlmin-1 less than normal persons at different age of CHF patients. CONCLUSION: Kidney function droped gradually, Cl and Vd also lessened with age. A strong correlation of CrCl and Vd involved heart function failure, kidney function damaged and the slow contracting external blood vessels resisted the distribution and eliminaton of digoxin. Kidney function damage of CHF patients aggravated with the worsening of heart function.%目的:研究充血性心力衰竭病人地高辛(DG)临床药动学及影响因素。方法:用RIA法测定DG血药浓度。用Bayesian一点法拟合DG个体药动学参数及给药方案。用Minitab软件进行统计学分析。结果:CrCl为(54.2±18.2)mlmin-1,Cl为(73.4±27.5)mlh-1kg-1,Vd为(6.95±1.07)Lkg-1,t1/2为(73.7±23.5)h,K为(0.010 4±0.003 3)h-1;各参数波动范围大,变异均在30%以上(Vd除外)。年龄与CrCl,Cl和Vd存在极显著性负相关(P<0.001),CrCl与Cl,Vd存在高度的正相关(P<0.001),尤其是Vd,r=0.913。不同年龄段CHF患者的CrCl较正常人减少约25 mlmin-1。结论:随着年龄的增长,肾功能逐渐下降,DG的Cl和Vd也随之相应减少。CrCl和Vd的

  18. Clinical Influence of Tangshenan Prescription on Inflammation Factors in Diabetic Nephropathy%糖肾安对糖尿病肾病炎症因子影响的临床研究

    Institute of Scientific and Technical Information of China (English)

    冯天保; 陈灯德; 王倩; 谢桂权

    2012-01-01

    Objective: To observe the clinical influence of Tangshenan, a compound prescription of supplementing qi and nourishing yin and dispelling stasis to promote regeneration, on inflammation factors in diabetic nephropathy (DN). Method: Forty-five DN patients were divided into treatment group ( n = 30) and control group ( n = 15 ) at random. And each of the two groups was treated with western medicine routinely, and the treatment group was combined with Tangshenan on this basis of western medicine. The two groups were both for a treatment course of 8 weeks. Then the variations of patients' clinical responses, fasting blood glucose (FBG) , serum total cholesterol ( TC ) , Triglyceride ( TG) , the inflammation factors of high-sensitivity c-reactive protein ( hs-CRP) , tumor necrosis factor (TNF-α) and interleukin-6 (IL-6) , were investigated. Result: After treatment, the total effectiveness of treatment group was 86. 7% , and the control group was 53. 3% , with significant difference (P < 0. 05). For both the two teams, FBG, TC and TG were decreased significantly ( P < 0. 05 , P < 0. 01) after treatment. And the treatment group' s TC and TG' s decreasement was better than that in the control group. The treatment group's Hs-CRP, IL-6 and TNF-a were decreased significantly (P<0. 05, P <0. 01) after treatment. The control group' s Hs-CRP level was also decreased significantly (P < 0.01 ) after treatment, but the improvement of IL-6 and TNF-a were not obvious. Conclusion: On the basis of western medicine, if combined with Tangshenan, the curative effect can be improved, the blood lipid metabolism can be improved, and the regular inflammation factors can be down-regulated.%目的:观察益气养阴、祛瘀生新复方(糖肾安)对糖尿病肾病(DN)炎症因子的影响.方法:将45例DN患者随机分为治疗组30例,对照组15例,两组均予西医常规治疗,治疗组在此基础上配合糖肾安治疗,疗程均为8周.观察患者临床疗效及空腹血糖(FBG)、

  19. 心理护理干预对抑郁症患者临床疗效的影响%The influence of psychological nursing intervention to effect of clinic therapy on depression.

    Institute of Scientific and Technical Information of China (English)

    许丽霞; 王秀芬; 孙惠萍; 曹志坤; 周策

    2011-01-01

    目的:探讨心理护理干预对抑郁症患者临床疗效的影响.方法:对我院住院治疗的76例抑郁症患者随机分成治疗组和对照组各38例,两组同时服用相同的抗抑郁药舍曲林25~75 mg,每日1次,并给予常规护理,治疗组增加心理护理干预措施,包括精神分析、认知疗法、音乐疗法等,同时给患者讲解抑郁症的相关知识,做好健康教育,督促患者定期复查,做好随访工作.分别在治疗前后2、4、8周末用汉密顿抑郁量表(HAMD)评分和四级疗效评定、服药依从性比较.结果:心理干预前两组HAMD评分无统计学差异(P>0.05),护理干预8周末HAMD评分治疗组明显低于对照组,服药依从性明显高于对照组,具有显著性差异(P<0.01),两组疗效评定治疗组显效率明显高于对照组(P<0.05).结论:心理护理干预可提高临床疗效及服药依从性,降低复发率,提高生活质量.%Objective :To explore the influence of pchcological nursing intervention to effect of clinic therapy on depression.Methods :76 cases with depression who were treated in our hospital from were randomly divided into therapy group and control group with 38 cased respectively.Two group inpatients takod the same midicine at the same time (Sertralin 25 -75 mg,PO once a day) and routine nursing care.In therapy group, the inpatients were increased psychcological nursing intervention measures.The intervention measurs included psychological analysis, cognitive therapy and music therapy etc.Meanwhile doctors instructed the study inpatients the relative knowladge ,gave heathy education and arranged the patients to check up regularly.Two groups patients were evaluated before intervention and after intervention by HAMD and compared with the compliance.Results:There was no significant statistic difference between two groups before intervention evaluated by HAMD (P > 0.05 ).After 8 weeks intervention, the therapy group patients had a higher scores by HAM D and

  20. 院前急救护理对脑出血患者预后质量的临床影响分析%Clinical Influence of Prognosis of Pre-hospital Emergency Care on Patients with Cerebral Hemorrhage

    Institute of Scientific and Technical Information of China (English)

    蒙敏华

    2015-01-01

    目的:探究院前急救护理对于脑出血患者预后质量的临床效果,并分析其作用价值。方法:选取2013年1月-2014年12月笔者所在医院收治的急救脑出血患者82例,按照随机数字表法将其分为对照组和观察组,每组41例。对照组患者未采取院前急救护理,而观察组患者采取院前急救护理,统计两组患者的治疗结果和并发症情况。结果:对照组患者治疗的总有效率为70.73%,12例患者出现并发症,观察组患者治疗的总有效率为92.68%,4例患者出现并发症,即观察组的总体有效率明显要高于对照组,并发症例数少于对照组,差异有统计学意义(P<0.05)。结论:院前急救护理对于脑出血患者预后质量影响显著,能够明显改善患者的治疗结果,降低并发症的发生率,适合在临床上推广使用,应引起广大医学卫生工作者的关注。%Objective:To explore the clinical influence on prognosis of pre-hospital emergency care of patients with cerebral hemorrhage,and analyze its function value.Method:82 patients with emergency cerebral hemorrhage from January 2013 to December 2014 in our hospital were selected, they were randomly divided into the control group and the observation group,41 cases in each group.Patients in the control group did not take pre-hospital emergency care,the observation group was given pre-hospital emergency care,counted treatment results and complications of two groups. Result:The treatment effective rate of the Control group was 70.73%,12 patients occurred complications,the total effective rate of the observation group was 92.68%,4 patients occurred complications,the total effective rate of the observation group was significantly higher than that of the control group, complications were less than that of the control group,the differences were statistically significant(P<0.05).Conclusion:Pre-hospital emergency care can significantly improvement prognosis

  1. 氨磺必利对首发精神分裂症临床疗效及糖脂代谢的影响%The influence of amisulpride on clinical efficacy and glucolipid metabolism of first-episode schizophrenia

    Institute of Scientific and Technical Information of China (English)

    邓良华; 许世欢; 徐健; 唐立岩

    2015-01-01

    Objective Objective To explore the influence of amisulpride on clinical efficacy and glucolipid metabolism of first‐episode schizophrenia .Methods Seventy first‐episode schizophrenics were randomly divided into two groups of 35 ones each ,research group took orally amisulpride and control group did ris‐peridone for 8 weeks .Efficacies were assessed with the Positive And Negative Syndrome Scale (PANSS) before and after treatment and adverse reactions with the Treatment Emergent Symptom Scale (TESS) , and changes of blood‐fasting sugar ,cholesterol total ,triacylglycerol ,serum insulin and body mass index (BMI) detected at the same time .Results After treatment the total and each factor scores of the PANSS of both groups significantly lowered compared with pretreatment (P 0 .05) ,but those heightened more significantly after treatment com‐pared with pretreatment in control group (P0 .05) .Conclusion Amisulpride has an evident effect in schizophrenia and less influence on glucolipid metabolism .%目的:探讨氨磺必利对首发精神分裂症患者的临床疗效及糖脂代谢的影响。方法将70例首发精神分裂症患者随机分为两组,每组35例,研究组口服氨磺必利治疗,对照组口服利培酮治疗,观察8周。于治疗前后采用阳性与阴性症状量表评定临床疗效,副反应量表评定不良反应,同时检测空腹血糖、总胆固醇、三酰甘油、血清胰岛素及体质量指数的变化。结果治疗后两组阳性与阴性症状量表总分及各因子分均较治疗前显著下降(P<0.01)。治疗8周末研究组糖脂代谢各项指标检测结果与治疗前比较均无显著变化(P>0.05),而对照组各项指标检测结果均较治疗前显著升高(P<0.05或0.01),研究组各项指标检测结果均显著低于对照组(P<0.05或 P<0.01);两组其他不良反应发生率比较差异无显著性(χ2=0.32,P>0.05)。结论氨磺必

  2. Clinical analysis of 30 cases in the treatment of gestational diabetes mellitus for influence on pregnancy outcome%妊娠期糖尿病治疗对妊娠结局影响30例临床分析

    Institute of Scientific and Technical Information of China (English)

    王亚

    2014-01-01

    目的:探讨、分析中短效胰岛素合用、预混胰岛素两类胰岛素治疗方法对妊娠期糖尿病患者的妊娠结局的影响,以指导临床上对妊娠糖尿病的进行有效的治疗.方法:选取2013年在我院诊治的妊娠期糖尿病(GDM)患者30例,随机分为两组,各15例.两组均施以积极地干预措施:糖尿病健康教育、严格规划营养饮食、运动治疗、病情监测和高血糖的药物治疗,以控制高血糖.第一组以中短效胰岛素合用进行药物治疗,每日皮下注射四次;第二组以预混胰岛素进行药物治疗,每日两次.产后定期随访,观察两组孕妇妊娠结局.运用统计学方法,比较两组妊娠不良事件的发生有无统计学差异.结果:两组相比,孕期和产期并发症、婴儿情况有统计学差异(P<0.05),第二组治疗对妊娠糖尿病的妊娠结局的改善情况更为明显.结论:预混胰岛素治疗方法对妊娠期糖尿病患者的妊娠结局的影响较中短效胰岛素合用更佳,能更好地改善妊娠期糖尿病患者的妊娠结局.%AIM:To investigate and analyze the influence on pregnancy outcome of patients with gestational diabetes mellitus by two ways of insulin treatment including intermediate-acting and short-acting insulin share and premixed insulin,in order to guide the clinical treatment of gestational diabetes mellitus effectively. METHODS:Chosen 30 cases with gestational diabetes mellitus (GDM)in our hospital 201 3,who were randomly divided into two groups,each group with 1 5 cases.They all received active inter-ventions including diabetes health education,strict planning nutri-tion diet,exercise therapy,drug treatment,condition monitoring and medication for hyperglycemia to control blood sugar.The first group received intermediate-acting and short-acting insulin thera-py,hypodermic injection four times a day,while the second group received premixed insulin

  3. Clinical study on influence of human papillomavirus infection on cervical lesions%人乳头状瘤病毒感染对宫颈病变影响的临床研究

    Institute of Scientific and Technical Information of China (English)

    赵颖辉; 梁贤; 李慧; 高凤萍

    2014-01-01

    目的:研究人乳头状瘤病毒单一感染与多重感染对宫颈病变的影响,以期为临床诊治宫颈病变提供参考依据。方法选取2012年1月-2013年3月入院诊治并应用导流杂交人乳头状瘤病毒分型检测技术确诊的人乳头状瘤病毒感染患者120例,回顾性分析其临床资料,分为人乳头状瘤病毒单一感染组73例与多重感染组47例,观察并比较两组感染对宫颈病变的影响,采用SPSS16.0进行统计分析。结果 HPV单一感染与多重感染高危型亚型分布均以16型为主,分别占35.62%、25.53%,各型分布差异有统计学意义( P<0.05),细胞学结果,诊断高度鳞状上皮内病变单一感染组与多重感染组分别占23.29%与8.51%,差异有统计学意义( P<0.05);病理学结果,单一感染组与多重感染组在诊断患者正常、CIN病变病理学结果差异有统计学意义( P<0.05)。结论单一高危人乳头状瘤病毒亚型对宫颈病变的严重程度有一定的诊断意义;多重人乳头状瘤病毒亚型感染多变现象为低级别宫颈病变。%OBJECTIVE To study the influence of single and multiple infections with human papillomavirus on cervi‐cal lesions ,in order to provide a reference for the clinical diagnosis of cervical lesions .METHODS Totally 120 patients who were admitted to hospital during Jan .2012 to Mar .2013 and confirmed with human papillomavirus infection by flow‐through hybridization detection of human papillomavirus genotyping were enrolled and their clini‐cal data were retrospectively analyzed .The patients were divided into the single infection group (n=73) and the multi‐infection group (n=47) .The two groups were observed and compared for influence of infections on cervical lesions .The software SPSS16 .0 was used for statistical analysis .RESULTS The HPV high‐risk subtype of type 16 was predominant ,accounting for 31 .67% and 25 .53% in

  4. 再发心肌梗死的临床特点及其对一年预后的影响%The Characteristics and Influences of Recurrent Myocardial Infarction on 1 Year Clinical Outcomes

    Institute of Scientific and Technical Information of China (English)

    王林; 孙根义; Seung-Woon Rha

    2012-01-01

    Objective: To investigate the characteristics of recurrent myocardial infarction (MI) and the influence of prior MI on the clinical outcomes in patients with myocardial recurrent MI. Methods: The current data came from the Korea Acute Myocardial Infarction Registry (KAMIR) study, which consisted of 10 384 consecutive acute MI patients from May 2005 to April 2008. According to the medical history, patients were divided into two groups, the first MI group (n=9 450) and recurrent MI group (n=934). The clinical data were recorded including age, gender, cardiovascular disease risk factors (hypertension, diabetes, dyslipidemia), smoking history, family history, comorbidities, admission vital signs, body mass index (BMI), heart function (KILLIP' s classification), routine blood test, blood lipids, myocardial enzymes, renal function, left ventricular ejection fraction (LVEF) and medication. The occurrence of adverse cardiovascular events (MACE) in 12 months after operation, recurrent myocardial infarction and the clinical features, and their prognostic impact in one year were recorded by clinic or telephone follow-up. Results: Patients were older in recurrent MI group than those in the first MI group. A high proportion of men, a high proportion of those with cardiovascular disease risk factors and those with combined peripheral arterial diseases and cerebrovascular diseases were found in recurrent MI group (P< 0.05). The poor cardiac functions were found in patients at admission with LVEF 0.471 9±0.1167νs0.512 l±0.1074and 17.77% νs 10.28% of KILLIP's Ⅲ-Ⅳ(P< 0.05). The incidence of major adverse cardiovascular events was significantly higher in patients with recurrent MI than that of patients with the first MI (12.63%νs 8.78%, P < 0.05). Compared with patients with the first MI, OR was 1.481(95% CI 1.222-1.796, P < 0.05) in patients with recurrent MI. After adjusting for age, gender, KILLIP's grade, diabetes and percutaneous coronary intervention (PCI) treatment

  5. 腹腔镜下电器械对卵巢组织热损伤的临床观察%Clinical Observation of Electro-surgical Unit’s Influence on the Heat Injury of Ovarian Tissue under Laparoscopy

    Institute of Scientific and Technical Information of China (English)

    林碧娟; 林松波; 黄春玲; 颜青

    2015-01-01

    Objective:To study the electro-surgical unit’s clinical influence on the heat injury of ovarian tissue under laparoscope,for reference.Method:150 ovarian tumor patients were involved in the study,and grouped according to the random principle.They were divided into three groups:group of monopolar electrocoagulation (50 cases),group of bipolar electrocoagulation (50 cases),group of electrocoagulation ultrasonic scalpel (50 cases).The surgical procedures of three groups were compared.Result:Compared the length of surgery under Laparoscopy,length of activities,length of gas passing,length of hospital stays and the usage rate of painkiller of three groups,the differences were not statistically significant (P>0.05). Though the study of the depth and width of the zone of thermal necrosis’s heat injury of ovarian tissue,we concluded that electrocoagulation ultrasonic scalpel imposed the minimum damages,bipolar electrocoagulation the second,and monopolar electrocoagulation the maximum,the differences were statistically significant (P0.05)。从卵巢组织热损伤坏死带深度和宽度来看,超声刀组损伤最小,其次为双极电凝组,损伤最大的为单极电凝组,差异有统计学意义(P<0.05)。结论:不同电器械对卵巢组织所产生的热损伤不同,超声刀带来的热损伤最小,其次是双极电凝,单极电凝带来的热损伤最大,临床上治疗时需根据实际情况考虑,尽量选用热损伤范围小的PK刀。最好选用缝合止血,从而减少卵巢组织的损伤,保护患者术后卵巢排卵的生育功能。

  6. Influence of Work Family Conflict on Quality of Work Life of Clinical Nurses%工作家庭冲突对护士工作生活质量的影响

    Institute of Scientific and Technical Information of China (English)

    邵亚; 廖少玲; 钟慧琴

    2014-01-01

    Objective To explore the relationship between work family conflict and quality of work life. Methods Totally 1 250 nurse from 6 hospitals was investigated by Work Family Conflict Scale and the Work-related Quality of Life Scale. Results The average score of work-family conflict was 4.36±1.41, and that of family-work conflict 2.81±1.10. Work-family conflict was negatively correlated with quality of work life (r=-0.43, P<0.01)and family-work conflict (r=-0.28, P<0.01, respectively. Regression analysis showed that work-family conflict could explain 22 percent of the variance of quality of work life after controlling demographic variables. Conclusion Work family conflict has certain influence on quality of working life of clinical nurses. Hospital managers should make flexible arrangements for duty shift and harmonize the relationship between work and family for nurses thus to improve the quality of work life for nurses.%目的:探讨工作家庭冲突对护士工作生活质量的影响。方法采用工作家庭冲突量表和工作相关生活质量量表对某市6家医院1250名护士进行了调查。结果护士工作-家庭冲突平均得分为(4.36±1.41)分,家庭-工作冲突得分为(2.81±1.10)分。工作-家庭冲突与工作生活质量呈负相关(r=-0.43,P<0.01),家庭-工作冲突也与工作生活质量负相关(r=-0.28,P<0.01)。回归分析显示,控制基本资料后,工作家庭冲突可预测护士工作生活质量的22%方差变异量。结论工作家庭冲突对护士工作生活质量有一定影响。管理者应合理安排工作,弹性排班,促进护士工作与家庭之间的平衡,提高护士工作生活质量。

  7. 护理实习生人际交往效能感的调查分析%The level and influencing factors of nursing students' sense of interpersonal relations efficacy during clinical practice

    Institute of Scientific and Technical Information of China (English)

    乔祎; 戈晓华; 章雅青

    2012-01-01

    Objective To investigate the level and influencing factors of nursing students' interpersonal relations efficacy during clinical practice. Method Totally 81 full-time baccalaureate nursing students in grade four and 91 full-time associate degree nursing students in grade three were recruited from 8 universities by convenience sampling method. They were investigated with the College Students Sense of Interpersonal Relations Efficacy Questionnaire. Results The average score of interpersonal relations efficacy was (14428± 1537) points. There was significant difference between male and female students(P0,05). Conclusion Nursing students need to shape good individual characters and the teachers should improve the curriculum design to train nurses with skills in interpersonal interaction.%目的 调查护理实习生人际交往效能感现状,并分析其在性别、学历等一般资料上的差异.方法 方便抽取8所护理院校(系)全日制四年级本科生81名和三年级大专生91名,采用大学生人际交往效能感问卷对其进行调查.结果 护理实习生人际交往效能感得分为(144.28±15.37)分;人际交往效能感得分在学历、生源地、家庭来源、临床实习时间等方面差异无统计学意义(P>0.05),但在性别上差异有统计学意义(P<0.05).结论 护理实习生人际交往效能感有待提高.护理实习生应注重塑造良好的个性品质,而学校应完善课程设置,培养学生人际交往的相关技巧.

  8. Clinical factors influencing surgical approach selection of robotic-enhanced minimally invasive coronary artery bypass grafting%机器人冠状动脉旁路移植术微创术式选择影响因素研究

    Institute of Scientific and Technical Information of China (English)

    成楠; 高长青; 杨明; 吴扬

    2013-01-01

    Objective To investigate clinical factors that influence the selection of minimally approach between minimally invasive direct coronary artery bypass (MIDCAB) and totally endoscopic coronary artery bypass (TECAB).Methods From February 2007 to January 2013,patients were selected under uniform criteria.A total of 202 patients including 142 male and 60 female patients with age range from 33 to 80 years and average age of (59 ± 10) years were included and were all routinely prepared for TECAB.Either TECAB or MIDCAB was performed based on the intraoperative condition.There were 90 patients who underwent TECAB (TECAB group) and 112 patients who received MIDCAB surgery (MIDCAB group).Univariate analysis was used to compare preoperative,intraoperative and early postoperative parameters.Logistic multivariate regression analysis was used to discuss independent influencing factors of minimally invasive approach selection.Results All of the patients successfully received TECAB or MIDCAB surgery without mortality,severe complications or conversion to sternotomy.The early and midterm follow up of graft patency (by computed tomography angiography) was satisfactory.The mean operative time was (160 ±64) minutes,mean graft flow was (27 ± 18) ml/min.Univariate analysis showed that sex ratio (3.5 vs.1.8,t=4.350,P=0.037),weight [(69 ±11)kgvs.(72±11)kg,t =-1.979,P=0.049],multivessel coronary disease (43.3% vs.60.7%,t =6.051,P =0.014),and learning curve case (4.4% vs.14.3%,t =5.418,P =0.02) were significant predictors of conversion to MIDCAB.By multivariate analysis,multivessel coronary disease (HR =1.964,95% CI:1.049-3.680,P =0.035) and learning curve case (HR =4.538,95% CI:1.219-16.891,P =0.024) were independent influencing factors of MIDCAB approach.Conclusions Robotic-assisted minimally invasive coronary artery bypass grafting can be performed safely and effectively either by TECAB or MIDCAB.Multivessel coronary disease and early learning curve cases are independent

  9. Clinical Research

    DEFF Research Database (Denmark)

    Christensen, Irene

    2016-01-01

    for years to come. This paper seeks to provide insights into ramp-up management studies through providing an agenda for conducting collaborative clinical research and extend this area by proposing how clinical research could be designed and executed in the Ramp- up management setting.......This paper is about the logic of problem solving and the production of scientific knowledge through the utilisation of clinical research perspective. Ramp-up effectiveness, productivity, efficiency and organizational excellence are topics that continue to engage research and will continue doing so...

  10. Clinical photography.

    Science.gov (United States)

    Jakowenko, Janelle

    2009-01-01

    Digital cameras, when used correctly, can provide the basis for telemedicine services. The increasing sophistication of digital cameras, combined with the improved speed and availability of the Internet, make them an instrument that every health-care professional should be familiar with. Taking satisfactory images of patients requires clinical photography skills. Photographing charts, monitors, X-ray films and specimens also requires expertise. Image capture using digital cameras is often done with insufficient attention, which can lead to inaccurate study results. The procedures in clinical photography should not vary from camera to camera, or from country to country. Taking a photograph should be a standardised process. There are seven main scenarios in clinical photography and health professionals who use cameras should be familiar with all of them. Obtaining informed consent prior to photography should be a normal part of the clinical photography routine.

  11. Stress Influences on Anoikis

    OpenAIRE

    Sood, Anil K; Lutgendorf, Susan K.

    2011-01-01

    It long has been suspected that psychosocial factors affect cancer development and progression. Although the connections between stress and cancer causation are not strong, epidemiological and clinical studies have provided strong links between cancer progression and several stress-related factors including chronic stress, depression, and social isolation. Recent molecular and biological studies have identified specific signaling pathways that influence cancer growth and metastasis. In partic...

  12. Clinical supervision.

    Science.gov (United States)

    Goorapah, D

    1997-05-01

    The introduction of clinical supervision to a wider sphere of nursing is being considered from a professional and organizational point of view. Positive views are being expressed about adopting this concept, although there are indications to suggest that there are also strong reservations. This paper examines the potential for its success amidst the scepticism that exists. One important question raised is whether clinical supervision will replace or run alongside other support systems.

  13. The influence of oocyte maturation on embryo development and clinical outcomes in intracytoplasmicsperm injection cycles%ICSI 周期卵子成熟度对胚胎发育与临床结局的影响

    Institute of Scientific and Technical Information of China (English)

    蒋益群; 王珊珊; 张宁媛; 徐志鹏; 孙海翔

    2015-01-01

    Objectives:To investigate the influence of oocyte maturation on fertilization,embryo develop-ment and clinical outcomes in intracytoplasmic sperm injection (ICSI)cycles.Methods:33 patients with immature oocyte (MI oocytes or GV oocytes)accounted for more than half of the total in fresh cycle of ICSI cycles,from March 201 2 to December 201 3,were selected as group A.1 38 patients,of whom the number of immature oocyte was less than 20% of the number of retrieved oocytes of ICSI cycles,from September 201 2 to December 201 2,were selected as group B.Fertilization rate,naomal fertilization rate,multinuclear rate,high quality embryos rate,clini-cal pregnancy rate and embryo implantation rate of the two groups were compared.Results:From group A,261 oo-cytes were obtained;the number of mature oocytes was 1 1 8;the fertilization rate was 80.51 %;normal fertilization rate was 72.88%;multinuclear rate was 6.78%;high quality embryos rate was 47.37%;clinical pregnancy rate was 30.30% and embryo implantation rate was 1 9.30%.From group B in,1 330 oocytes were obtained;the num-ber of mature oocyte was 1 1 46;the fertilization rate was 89.97%;normal fertilization rate was 86.39%;multinu-clear rate was 1 .1 3%;high quality embryos rate was 61 .64%;clinical pregnancy rate was 59.42% and embryo implantation rate was 40.88%.The level of fertilization rate,normal fertilization,high quality embryos rate,clini-cal pregnancy rate and embryo implantation rate in group A were obviously higher than those of group B,while the level of multinuclear rate in group A was lower.Conclusion:The overabundance of immature oocyte in ICSI cycles will decrease the embryo utility rate and affect the pregnancy outcome.%目的:研究卵胞浆内单精子注射(ICSI)周期中卵子成熟度对受精、胚胎发育以及临床结局的影响。方法:收集我院从2012年3月至2013年12月,新鲜周期中未成熟卵子(MⅠ或 GV)占获卵数50%及以上的 ICSI 周期为 A 组(n =33

  14. CME ON CLINICAL RESEARCH

    Directory of Open Access Journals (Sweden)

    Suneel. I. Majagi

    2012-06-01

    , monitor and supervise the clinical trials or the research projects. Ethical decision is taken without coercion, influence, inducement and intimidation. Dr.S.S.Torgal (JNMC spoke on “Introduction to clinical trials”. A systematic study of a new drug in human subjects to generate data for discovering and/or verifying the clinical, pharmacological (pharmacodynamic / pharmacokinetic and/or adverse effects with the objective of determining safety and/or efficacy of the new drug is known as clinical trial (Phase I, II, III and IV. There are many types of trials viz., Prevention trials, Screening trials, Diagnostic trials, Treatment trials, Quality of life trials and Compassionate use trials. The Clinical Trials Registry-India (CTRI is an online register of clinical trials being conducted in India.In the second scientific session, Dr.A.Shrivastav (KLE Hospital talked on “Conducting clinical trials-Investigators perspective”. He explained about good clinical practice, role of primary investigator, CROs, DCGI, site management office (SMO, regulatory requirements and data management. Essential trial documents include protocol, informed consent form, investigators brochure etc. Study team at site consists of investigator, co/sub-investigator, clinical research/study coordinator, research nurse, pharmacist, unblinded personnel etc. Dr.S.I.Majagi (JNMC gave a lecture on “Pharmacovigilance” which is a science of activities relating to the detection, assessment, understanding and prevention of adverse drug reactions (ADR or any other medicine related problem. He explained about history, need, objectives, applications, methods (spontaneous reports etc, organizations involved (WHO, National pharmacovigilance center etc in pharmacovigilance, Risk assessment, Risk management (RM, goals of RM, Risk minimization action plan(Risk MAP, tools of RM process and Signal: detection, sources, data, data interpretation, selection or rejection, strengthening (by assessment criteria

  15. Amisulpride’s influence on clinical efficacy and quality of life of schizophrenics%氨磺必利对精神分裂症患者临床疗效及生活质量的影响

    Institute of Scientific and Technical Information of China (English)

    储文革; 胡凤领; 刘翔宇; 邱睿; 梁涛; 伍帮荣

    2014-01-01

    Objective To explore amisulpride’s influence on clinical efficacy and quality of life of schizo-phrenics .Methods A total of 125 chizophrenics were randomly divided into two groups ,they respectively took orally amisulpride and risperidone for 24 weeks .Efficacies were assessed with the Positive and Nega-tive Syndrome Scale (PANSS) ,adverse reactions with the Treatment Emergent Symptom Scale (TESS) and qualities of life with the Generic Quality of Life Inventory-74 (GQOLI-74) .Results Since the end of the 4th week the PANSS scores of both groups lowered more significantly compared with pretreatment (P<0 .01) ,since the end of the 8th week negative symptoms scores were significantly lower (P<0 .05 or 0 .01) and at the end of 24th week physical ,mental and social function score of the GQOLI-74 higher (P<0 .01)in amisulpride than risperidone group .The incidences of menstrual disorder ,abnormal blood lipid and glucose were significantly lower in amisulpride than risperidone group (P< 0 .05) .Conclusion both amisulpride and risperidone have an evident in schizophrenia ,but amisulpride improves negative symptoms and quality of life better and has higher safety .%目的:探讨氨磺必利对精神分裂症患者临床疗效及生活质量的影响。方法将125例精神分裂症患者随机分为两组,分别口服氨磺必利和利培酮治疗,观察24周。采用阳性与阴性症状量表评定临床疗效,副反应量表评定不良反应,生活质量综合评定问卷评定生活质量。结果治疗4周末起两组阳性与阴性症状量表评分均较治疗前显著降低(P<0.01),氨磺必利组治疗8周末起阴性症状因子分显著低于利培酮组( P<0.05或0.01),治疗24周末生活质量综合评定问卷躯体功能、心理功能、社会功能维度分均显著高于利培酮组(P<0.01)。氨磺必利组月经紊乱、血脂异常、血糖异常等不良反应发生率显著低于利培酮组(P<0.05

  16. Handicaps for Evidence-based Practice and Its Influencing Factors in Clinical Nurses in Zhejiang Province%浙江省临床护士循证实践障碍及影响因素分析

    Institute of Scientific and Technical Information of China (English)

    李春燕; 黄丽华; 叶向红; 叶旭琴

    2013-01-01

    Objective To fully understand the handicaps for evidence-based practice and its influencing factors and to provide evidence for intervention. Methods With Chinese version of Handicap Inventory Short Form about Evaluation of Evidence-Based Nursing Practice developed by LIU Xiao-hua, a cross-sectional survey was conducted among 831 clinical nurses in Zhejiang Province. Results Though with well knowledge of evidence-based practice in nursing, 70.7%of the nurses proposed there existed handicaps in evidence-based practice. Insufficient resources of implementing evidence-based practice and low quality of nursing search report scored higher. There were less handicaps among nurses after training of evidence-based practice in nursing, those with senior positions and those in department of nursing administration, emergency and ICU (P<0.05). Conclusion There are many handicaps for evidence-based practice in nursing. Great emphasis should be laid to scientific research of nursing. Sufficient evidence-based practice resources and various evidence-based practice in nursing education for nurses would contribute to the development of evidence-based nursing practice.%  目的全面了解浙江省临床护士的循证实践障碍现状,并分析其影响因素,为护理管理者实施干预提供可靠的参考依据.方法采用刘晓华等研制的中文版循证护理实践障碍量表,对浙江全省11个行政区22所医院共831名临床护士进行横断面调查.结果70.7%的临床护士认为自己循证实践存在障碍,但对循证护理的认识较好,得分较高的是开展循证护理的资源条件不足和护理研究报道的质量不高.参加过循证护理培训、职务较高和在护理部、急诊室、ICU等部门工作的护士循证实践障碍较小(P<0.05).结论浙江省临床护士循证实践障碍较严重,管理者应重视护理科研,营造良好的科研氛围;提供简单有效的循证资源,完善图书馆、数据库

  17. 综合医院老年住院患者谵妄影响因素及临床特点分析%Analysis on clinical features and influence factors of elderly in-patients' delirium in general hospitals

    Institute of Scientific and Technical Information of China (English)

    周敏; 刘中华; 佘子瑜; 梁群娣; 周霭婷

    2014-01-01

    目的 探讨综合医院老年住院患者发生谵妄的相关因素及临床特点.方法 回顾性分析2011年1月至2012年12月收治的年龄≥65岁、住院期间发生谵妄的33例患者的临床资料,同期年龄≥65岁的住院患者40例为对照组,将单因素分析差异有统计学意义的指标进行logistic回归分析,研究谵妄发生的影响因素并分析临床特点.结果 研究显示,低氧、机械通气、睡眠障碍、疼痛、电解质紊乱、低血压、重症监护室治疗≥24 h是发生谵妄的主要危险因素(P<0.05),两种以上疾病同时存在时谵妄发生的风险增加.结论 老年患者谵妄发生风险高,综合医院老年住院患者发生谵妄与多重因素相关,同时存在2种或2种以上疾病时风险明显增加,早期识别、控制危险因素、药物治疗是治疗谵妄的有效措施,尽早处理,多数患者可以改善,临床医生对高风险患者及低觉醒型谵妄应给予重视.%Objective To investigate the clinical features and relative factors of elderly inpatients' delirium in general hospitals.Methods A total of 73 elderly in-patients aged over 65 years from our hospital from January 2011 to December 2012 were randomly enrolled in the study.33 cases with the episode of delirium were assigned to the observation group,and 40 cases without delirium were subjected in the control group.The significant influencing factors from single factor analysis for delirium were investigated by logistic regression analysis.Results Multiple logistic repression analysis showed that the major risk factors for delirium were as follows:hypoxia,mechanical ventilation,dyssomnia,pain,electrolyte disorder,and hypotension intensive care time over 24 hours.Moreover,the risk of delirium was increased in the cases with more than one risk factor concurrently.Conclusion The elderly in-patients in general hospital are with higher risk of delirium related to multiple factors.When it comes more than one risk

  18. Clinical Resaerch on Influence of Acupuncture on Morphous and Hemodynamics of Carotid Atherosclerosis%针灸对颈动脉粥样硬化形态和血流动力学影响的临床研究

    Institute of Scientific and Technical Information of China (English)

    蔡劲; 施园

    2013-01-01

    目的:观察针灸对颈动脉粥样硬化形态和血流动力学的影响.方法:以颈动脉粥样硬化患者为研究对象,将60例患者随机分为两组,治疗组采用穴位针灸结合立普妥(阿托伐他汀钙片)口服,对照组采用立普妥口服治疗,观察两组患者的颈动脉血流动力学指标的变化、斑块的消退情况以及TC、TG等相应生化指标的变化情况.结果:治疗后两组患者的颈动脉斑块形态改变和血流动力学数值与治疗前相比,差异均具有显著性意义(P<0.05),治疗组在治疗后的斑块形态良性改变以及PSV(峰值流速)、EDV(舒张末期流速)、PI(搏动指数)数值明显高于对照组,RI(阻力指数)数值明显低于对照组(P<0.05).结论:针灸对颈动脉粥样硬化斑块中的扁平斑和软斑有消退作用,能够明显减小此类斑块的厚度和面积,是一种安全、有效、经济、便捷且值得临床推广的新方法.%Objective:To observe the influence of acupuncture to the carotid atherosclerosis with the variation on the morphous and hemodynamics.Methods:60 cases were selected and randomly divided into two categories:the treatment group and the control group.The former was dealed with acupuncture and Lipitor(Atorvastatin) for oral use while the latter took Lipitor orally.The diversity of the carotid atherosclerosis hemodynamics's index,the regression condition of the plaque and the variation of the homologus biochemistry targets such as serum total cholesterol and triglyceride were observed in two groups.Results:The morphous change of carotid plaque and hemodynamics numerus of two groups were both more differential after treatment(P <0.05).And that of the treatment group was much higher than the control group on the aspects of the optimal change on morphous plaque and the fig.on PSV(peak value),EDV(diastasis flow rate) and PI (pulsatility index) while RI (resistant index) was much lower after acupuncture (P < 0.05).Conclusion

  19. Clinical research on influence of chronic pain on sleep quality in patients with Parkinson′s disease%慢性疼痛对帕金森患者睡眠质量影响的临床研究

    Institute of Scientific and Technical Information of China (English)

    杨建波; 林晓静; 孙薇; 张倩; 徐金凤; 邹全; 张震中

    2015-01-01

    scores of PSQI and FS‐4 had statistically significant differences among 3 groups (P<0 .05) ,in which the differences in the aspects of sleep latency ,subjective sleep quality ,sleep continuity ,habitual sleep efficiency and sleep disorders also were statistically significant (P<0 .05) .The influencing factors of sleeping disorders were the Hoehn‐Yahr stage (r = -0 .79 ,P<0 .05) ,dopamine dose (r = -0 .38 ,P=0 .04) ,presence of pain (r = -0 .57 ,P<0 .05) and severity of de‐pression (r = -0 .63 ,P<0 .05) .Conclusion The PD patients accompanying pain are more susceptible to develop sleep disorders , the sleep quality accompanying pain is worse than that without accompanying pain .Therefore the early intervention should be well conducted in clinic .

  20. Clinical cases

    International Nuclear Information System (INIS)

    This presentation is about clinical cases and the contribution of the PET - CT Fag application in the diagnosis and treatment of different types of cancer. The cases presented were: neck diseases, epidermoid carcinoma, liver damage and metastasize, lymphoma, thrombosis, colonic cancer and lung disease

  1. [Clinical pathology].

    Science.gov (United States)

    Dimitrijević, Jovan

    2006-05-01

    This work describes the basic elements of pathology used in clinical practice. Pathology plays an important role in clinical and scientific work, but only a few areas of pathology will be covered. Although the contribution of oncological and surgical pathology to therapy is the most well known, the cases chosen here will involve infectious pathology, diseases of the kidney and the liver, autoimmune diseases, as well as organ transplantation. Especially important is the description of methods that enable more accurate morphological diagnoses, such as histochemistry, immunohistochemistry, immunofluorescence, and electronic microscopy. Previous experience and joint work with clinical doctors have enabled the definition of significant morphological elements as well as of essential methods of pathohistological diagnosis. Besides, as is often the case, although disease symptoms are difficult to discern and biochemical results do not show significant changes compared to normal values, the results of biopsy come as a surprise to clinical doctors. For example, in virus hepatitis B involving so-called asymptomatic HBsAg carriers, we discovered every morphological form of hepatitis, from minimal lesions to chronic, persistent, and active hepatitis. With hepatitis C, certain morphological lesions point to the etiopathogenesis of this disease and thus help to confirm the diagnosis and to instigate therapy on time. Another significant experience involves kidney biopsies in cases when clinical findings are asymptomatic. Often, in such cases, morphological findings point to glomerulonephritis and glomerulopathy at different stages. Timely and subtle morphological diagnostics offer a more precise explanation for the pathological injury of tissues than other diagnostic methods. In this way, by adopting new methods, the work of pathologists is included more and more in everyday clinical practice. The inclusion of pathologists in a transplantation team makes sure a proper selection of

  2. Pulse Pressure in Clinical Practice

    Directory of Open Access Journals (Sweden)

    Jiri Parenica

    2012-02-01

    Full Text Available The review presents basic information about the pulse pressure. The variables related to pulse pressure are briefly explained - arterial stiffness, arterial compliance, pulse wave velocity, pulse pressure amplification and augmentation index. We present some recent trials and observational studies that show the importance of pulse pressure in clinical practice. Briefly the possibilities of influencing the pulse pressure are discussed.

  3. The Future of Clinical Dentistry.

    Science.gov (United States)

    Slavkin, Harold C.

    1998-01-01

    Discussion of the future of clinical dentistry looks at a variety of influences, including historical development factors; demographic trends; the role of the Human Genome Project in the development of scientific knowledge; a paradigm shift in approaches to oral infection and systemic disease; advancing technology; and reforms resulting from these…

  4. Clinical biochemistry

    Science.gov (United States)

    Alexander, W. C.; Leach, C. S.; Fischer, C. L.

    1975-01-01

    The objectives of the biochemical studies conducted for the Apollo program were (1) to provide routine laboratory data for assessment of preflight crew physical status and for postflight comparisons; (2) to detect clinical or pathological abnormalities which might have required remedial action preflight; (3) to discover as early as possible any infectious disease process during the postflight quarantine periods following certain missions; and (4) to obtain fundamental medical knowledge relative to man's adjustment to and return from the space flight environment. The accumulated data presented suggest that these requirements were met by the program described. All changes ascribed to the space flight environment were subtle, whereas clinically significant changes were consistent with infrequent illnesses unrelated to the space flight exposure.

  5. Influence of the curve density relative electron in dosimetry clinic in treatments stereo tactics; Influencia de la curva de densidad electronica relativa en la dosimetria clinica en tratamientos estereotaxicos

    Energy Technology Data Exchange (ETDEWEB)

    Moreno Saiz, C.; Benitez Villegas, E. M.; Casado Villalon, F. J.; Parra Osorio, V.; Bodineau Gil, C.; Garcia Pareja, S.

    2013-07-01

    The objective of this study is to analyze the difference between clinical dosimetry in the treatments with radiosurgery and stereotactic radiotherapy fractional obtained from the relative Electron density curve (Schneider 1996) tabulated and provided with the scanner's radiation therapy. (Author)

  6. Clinical study of the influence of laryngopharyngeal reflux on quality of life in patients with dysphonia%咽喉反流对嗓音疾病患者生活质量影响的临床研究

    Institute of Scientific and Technical Information of China (English)

    王宇光; 张立红; 余力生; 李晶兢; 李进让; 赵一馨; 曹杰

    2015-01-01

    目的 研究咽喉反流(laryngopharyngal reflux,LPR)在嗓音疾病患者中的患病率;探讨咽喉反流对嗓音疾病患者SF-36健康调查(36-item shortform health survey,SF-36)量表及嗓音障碍指数(voice handicap index,VHI)量表各项指标的影响.方法 选取因嗓音疾病来北京大学人民医院耳鼻咽喉科门诊就诊及住院手术的患者127例,填写反流症状指数(reflux symptom index,RSI)量表、反流体征评分(reflux finding score,RFS)量表、VHI量表及SF-36健康调查量表,并进行24 h双探头pH监测.另外,通过体检、门诊、病房及网络微信平台等途径收集RSI资料2 643例.结果 经24 h pH监测的127例嗓音疾病患者中,LPR的患病率为46.4%(59/127);收集RSI量表2 643例中,第一条目"声嘶或发音障碍"得分大于0的有1 241例,初步诊断咽喉反流性疾病(laryngopharyngal reflux disease,LPRD)(RSI得分>13)807例,占"声嘶或发音障碍"患者的65.0%(807/1 241);在127例嗓音疾病患者中,以24 h双探头pH监测作为诊断依据,LPR 阳性组与 LPR阴性组在VHI量表得分中,总分和情感方面得分差异有统计学意义(P<0.05),而功能和生理方面得分差异无统计学意义(P>0.05),SF-36健康调查量表的生理职能、总体健康、活力、社会功能、情感职能和精神健康等方面得分差异有统计学意义(P<0.05),而在生理功能、躯体疼痛等方面差异无统计学意义(P>0.05).结论 嗓音疾病中LPR患病率较高,治疗同时要关注患者生活质量.%Objective To explore the morbidity of laryngopharyngeal reflux in patients with dysphonic diseases and to investigate the influence of LPR on the patients.Methods One hundred and twenty-seven patients with dysphonic diseases were encountered in Peking University of the People Hospital.Under the agreement, the patients were asked to fill in the scales of RSI, RFS, VHI and SF-36.24-hour ambulatory double pH monitoring was applied to diagnose LPR

  7. The ethical and moral behavior of nurse students during clinical practice and its influence factors%护生临床实习中伦理道德行为调查及影响因素分析

    Institute of Scientific and Technical Information of China (English)

    周春兰; 吴艳妮; 何丽君; 乔惠

    2011-01-01

    Objective: To investigate the ethical and moral behavior of nurse students during clinical practice and its influence factors. Methods: Totally 287 nurse students who practice in a upper first-class hospital in April 2010 were investigated. Results: The score of ethical and moral behavior was 3.12±0.31. The items with high score were: talking private matters or calling during nursing procedure (3.57±0.80). The items with low score were:noticing patients nursing arrangement (2.22±0.61), changing contaminated bedding and clothes actively (2.78±0.65), discovering patients' need and provide help such as turning over,putting on a quilt and feeding (2.78±0.76). Multivariate analysis showed that student nurses'ethical and moral behavior positively correlated with age (OR=6.885), education background (OR=3.041), and negatively correlated with whether attending college entrance examination (OR=8.776). Conclusion: Among student nurses' ethical and moral behavior, those paying more attention, rules stated, and having serious results are good, and those needing selfsupervision and paying less attention during teaching are bad. It is important to pay more attention to student nurses' ethical and moral behavior training.%目的:了解护生临床实习中伦理道德行为表现及相关影响因察,为临床实习教学及护生伦理道德素质培养提供借鉴与参考.方法:对2010年4月广东省某三级甲等医院实习护生共287名,应用伦理道德行为问卷进行调查,各影响因素分析采用多元线性回归分析.结果:该组护生实习期间伦理道德行为得分为(3.12±0.31)分,"在护理操作中谈论私事或接电话"条目得分最高,为(3.57±0.80)分,得分低的条目依次为"告知病人当天的护理安排",仅为(2.22±0.61)分,"主动及时为病人更换被污染的被服",得分为(2.78+0.65)分,"能及时发现病人的需要并予以帮助,如为病人翻身、盖被、喂水等",为(2.78±0.76)分.多因素分析结果

  8. 围绝经期妇女焦虑、抑郁障碍的临床特征及影响因素分析%Clinical features of depression and anxiety disorders and their influence factors in perimenopausal women

    Institute of Scientific and Technical Information of China (English)

    郭珍; 刘飞; 张欣尚; 陆峥

    2015-01-01

    Objective To investigate the clinical features of depression and anxiety disorders and their influence factors in women during perimenopause .Methods Fifty-seven cases of first hospitalized perimenopausal patients with anxiety and depression symptoms evaluated by Hamilton Depression Rating Scale for Depression (HAMD) ,Hamilton Anxiety Scale for Anxiety (HAMA) and Life Event Scale (LES) ,and detected of hormone levels .All of the data were input into a database and analyzed with de‐scriptive statistics ,Spearman correlation analysis and multiple linear regression analysis .Results All 57 patients in the HAMD total score of (22 .56 ± 8 .48) ,HAMA total score of (15 .21 ± 7 .88) ,mainly mild or moderate depression and definite anxiety .Most of the patients affected by life events ,especial the negative life events .Linear correlation analysis showed that the incidence of postmenopausal was posi‐tively correlated with depressive disorder ,the correlation coefficient was 0 .275;there was no significant correlation factor with anxiety disorders .Linear regression analysis showed that estradiol was negatively correlation with depressive disorders;pituitary prolactin ,economically disadvantaged families ,children long - term leaving home was positively correlated with depression (the regression coefficients were-0 .823 ,0 .230 ,1 .017 ,0 .783 ,respectively);economically disadvantaged families ,bad marital relations was positively correlated with anxiety disorders (the regression coefficient were 0 .802 ,0 .553) .Conclu‐sions Perimenopausal women were mainly in mild or moderate anxiety and depression ,were affected by hormones and social family factors .%目的:探讨围绝经期妇女焦虑、抑郁障碍的主要临床特征及相关影响因素。方法采用HAMD和HAMA对57例首次入院治疗的围绝经期焦虑、抑郁障碍患者进行临床症状评估,生活事件量表(LES)评估,以及检测每位患者体内激素水平,并用描述性统

  9. Participating in Clinical Trials

    Science.gov (United States)

    ... this page please turn Javascript on. Participating in Clinical Trials About Clinical Trials A Research Study With Human Subjects A clinical ... to treat or cure a disease. Phases of Clinical Trials Clinical trials of drugs are usually described based ...

  10. Towards clinical bioethics (or a return to clinical ethics?).

    Science.gov (United States)

    Petrini, C

    2013-01-01

    Medical ethics has traditionally been oriented towards the clinical setting. Since the middle of the last century, however, various circumstances (associated mainly, though not exclusively, with rapid advances in technology and knowledge) have considerably broadened both the field of enquiry and the scope of this discipline. This is due partly to the overlap between medical ethics and bioethics, which in recent decades has acquired its own identity and concerns a multitude of ethical aspects in the biomedical field. Clinical ethics taps into the vast wealth of deontology, so that it has no need for additional criteria or principles, or for the definition of new values: rather, it recognizes the need to apply existing criteria, principles and values to contingent circumstances and contexts. A special role is reserved for ethics committees and, above all, for clinical ethics consultants, although in some countries the former are concerned mainly with authorisations for clinical trials. Clinical ethics consultants, however, may have a more incisive influence in clinical decisions: the special requisites and skills they need have been defined and discussed in various documents which are mentioned briefly in the present article. The presence of these consultants does not exonerate clinical physicians from their responsibilities or from liability for their decisions, in the formation of which they must refer constantly to codes of professional ethics. PMID:24424236

  11. 他克莫司联合窄谱中波紫外线治疗白癜风的临床效果及其影响因素分析%Clinical effects and influence factors of tacrolimus combined with narrow band ultraviolet B in patients with vitiligo

    Institute of Scientific and Technical Information of China (English)

    侯占英; 刘芳; 黄珍; 刘万红

    2015-01-01

    目的:探讨他克莫司软膏联合窄谱中波紫外线治疗白癜风的临床效果及其影响因素。方法172例白癜风患者随机分为观察组与对照组各86例,观察组给予他克莫司软膏联合窄谱中波紫外线治疗,对照组仅给予窄谱中波紫外线照射治疗,对比两组患者的临床效果。根据治疗效果,分析性别、年龄、病程、病变类型、皮损位置等因素对观察组患者疗效的影响。结果观察组有效率为76.7%(66/86),显著高于对照组的52.3%(45/86)(P0.05)。结论他克莫司软膏联合窄谱中波紫外线照射能够快速、有效的恢复白癜风患者患处肤色、缩小皮损面积,但患者年龄、病程、皮损位置、病变类型等因素对疗效影响较大。%Objective To discuss the clinical effects and influence factors of tacrolimus combined with (NB-UVB) in patients with vitiligo. Methods A total of 172 patients with vitiligo were randomly divided into the ob-servation group (n=86) and the control group (n=86). The observation group were treated with tacrolimus combined with NB-UVB, while the control group were treated with NB-UVB only. Clinical effects were contrasted between the two groups. Then gender, age, course of disease, pathological type, vitiligo patches were analyzed according to the clinical effects to discuss the influence to the clinical effects. Results The effective rate of the observation group was 76.7%(66/86), significantly higher than 52.3%(45/86) in the control group (P0.05). Conclusion Tacrolimus ointment com-bined with NB-UVB can rapidly, effectively recover skin color and shrink lesion area in patient's with vitiligo, but pa-tient's age, course of disease, lesion location, pathological type and other factors would influence the curative effect to a large extent.

  12. Clinical signs and progression of lesions in the gizzard are not influenced by inclusion of ground oats or whole wheat in the diet following experimental infection with pathogenic fowl adenovirus serotype 1.

    Science.gov (United States)

    Grafl, B; Prokofieva, I; Wernsdorf, P; Dublecz, K; Hess, M

    2015-01-01

    In the present study the effects of dietary gizzard stimulation on the development and severity of adenoviral gizzard erosion were investigated. For this purpose, specific pathogen-free broilers were divided into six groups, investigating the influence of an oat-containing diet with higher fibre content, a whole wheat-containing diet and a control diet of nearly identical composition, but containing ground wheat. For each feed administered, one group of birds was experimentally infected on the 10th day of age by the oral route with virulent fowl adenovirus serotype 1 (FAdV-1), recently proven to induce gizzard erosions, while the respective negative control groups remained uninfected. Experimental feed was administered from 2 days post-infection onwards. No significant differences on gizzard health or in weight gain could be detected between uninfected control groups or between FAdV-1 infected groups that received different experimental feed. However, independent of the supplied diet, a significantly reduced weight gain was noted from 7 days post-infection onwards in FAdV-1 infected broilers compared to uninfected birds that received the same diet. Macroscopically, discolouration and erosion of the koilin layer and inflammation of the gizzard mucosa were observed in all FAdV-1 infected groups. Histologically, necrosis, degeneration of gizzard epithelial cells and multiple basophilic intranuclear inclusion bodies were observed. In summary, after experimental infection with FAdV-1 development of gizzard erosion in chickens was not influenced by the feeding regimes investigated. Therefore, it is unlikely that dietary gizzard stimulation influences the outcome of adenoviral gizzard erosion in vertically infected broilers.

  13. 产前门诊对孕妇心理状态、满意度及分娩的影响%The Influence of Psychological State,Satisfaction and Childbirth for Pregnant Women Attending Antenatal Clinics

    Institute of Scientific and Technical Information of China (English)

    王文敏

    2014-01-01

    Objective:To analyze and discuss the role of nurse-midwives and antenatal clinics satisfaction with their impact on the psychological state of pregnant women and childbirth.Method:In this example,the normal maternity hospital maternity patients regularly for check-in for the survey were selected, they were divided into observation group and control groups,60 cases in each group.The control group was only given general prenatal clinic regularly,the observation group was regularly attended antenatal clinics in general on the basis of the control group.The questionnaire was used to observe and record the two maternal mental state and satisfaction,birth outcomes of patients.Result:The observation group with more stable mental state,the lower anxiety level than the control group of pregnant women,the differences were statistically significant(P<0.05),satisfaction of pregnant women in observation group was significantly higher than the control group,the difference was statistically significant(P<0.05),the differences of the planning pregnant cesarean rate,the total amount of bleeding and delivery in the observation group and control group were statistically significant(P<0.05).Conclusion:Maternal regularly attend antenatal clinics midwives on maternal heart to stabilize maternal mental state,improve their satisfaction and help smooth delivery,improve the success rate of natural childbirth, should be further promoted in clinical work.%目的:分析并探讨助产护士产前门诊的作用以及其对孕妇心理状态、满意度及分娩的影响。方法:本例中,选取在笔者所在医院妇产科定期产检的正常产妇例为调查对象,分为观察组及对照组,每组各60例。观察组在一般产前门诊的基础上定期参加助产护士产前门诊,对照组仅定期进行一般产检门诊。问卷调查两组产妇的心理状态及满意度;观察和记录患者的分娩结局。结果:观察组孕妇心理状态较对照组稳定

  14. 慢性肾功能衰竭临床路径对患者生存质量影响的临床分析%Clinical Analysis the Clinical Pathway Influence of Quality Life for Patients With Chronic Renal Failure

    Institute of Scientific and Technical Information of China (English)

    芮彦兰

    2015-01-01

    目的 研究临床路径对于慢性肾功能衰竭患者生存质量的影响.方法 选取我院收治的128例慢性肾功能衰竭患者随机分成观察组和对照组,各64例,对照组给予常规疗法,观察组给予临床路径治疗.结果 观察组总有效率为92.19%,高于对照组的76.56%,且观察组生存质量各个指标评分均高于对照组,P<0.05,差异具有统计学意义.结论 临床路径从患者的具体症状出发,用于CRF临床治疗有助于提高临床治疗效果和生存质量.%Objective To study the clinical pathway for chronic renal failure patients quality of life.Methods Selected 128 cases of chronic renal failure patients in our hospital were randomly divided into the observation group and the control group, each group had 64 cases, the control group patients' routine therapy, the observation group patients' clinical path management. Results The observation group the total effective rate was 92.19%, higher than the control group 76.56%, patients quality of life score each target and observation group were higher than that of control group,P<0.05, was difference had statistically significance.Conclusion The clinical pathway from the patient's specific symptoms, used in the clinical treatment of CRF is helpful to improve the effect of clinical treatment, improve the quality of life of patients.

  15. Let-7 miRNA-binding site polymorphism in the KRAS 3′UTR; colorectal cancer screening population prevalence and influence on clinical outcome in patients with metastatic colorectal cancer treated with 5-fluorouracil and oxaliplatin +/− cetuximab

    Directory of Open Access Journals (Sweden)

    Kjersem Janne B

    2012-11-01

    Full Text Available Abstract Background Recent studies have reported associations between a variant allele in a let-7 microRNA complementary site (LCS6 within the 3′untranslated region (3′UTR of KRAS (rs61764370 and clinical outcome in metastatic colorectal cancer (mCRC patients receiving cetuximab. The variant allele has also been associated with increased cancer risk. We aimed to reveal the incidence of the variant allele in a colorectal cancer screening population and to investigate the clinical relevance of the variant allele in mCRC patients treated with 1st line Nordic FLOX (bolus 5-fluorouracil/folinic acid and oxaliplatin +/− cetuximab. Methods The feasibility of the variant allele as a risk factor for CRC was investigated by comparing the LCS6 gene frequencies in 197 CRC patients, 1060 individuals with colorectal polyps, and 358 healthy controls. The relationship between clinical outcome and LCS6 genotype was analyzed in 180 mCRC patients receiving Nordic FLOX and 355 patients receiving Nordic FLOX + cetuximab in the NORDIC-VII trial (NCT00145314. Results LCS6 frequencies did not vary between CRC patients (23%, individuals with polyps (20%, and healthy controls (20% (P = 0.50. No statistically significant differences were demonstrated in the NORDIC-VII cohort even if numerically increased progression-free survival (PFS and overall survival (OS were found in patients with the LCS6 variant allele (8.5 (95% CI: 7.3-9.7 months versus 7.8 months (95% CI: 7.4-8.3 months, P = 0.16 and 23.5 (95% CI: 21.6-25.4 months versus 19.5 months (95% CI: 17.8-21.2 months, P = 0.31, respectively. Addition of cetuximab seemed to improve response rate more in variant carriers than in wild-type carriers (from 35% to 57% versus 44% to 47%, however the difference was not statistically significant (interaction P = 0.16. Conclusions The LCS6 variant allele does not seem to be a risk factor for development of colorectal polyps or CRC. No statistically significant effect of the

  16. 2~6岁儿童牙科诊室行为影响因素研究%2~6 Years Old Children's Dental Clinic Behavior Influence Factor

    Institute of Scientific and Technical Information of China (English)

    赵娟

    2015-01-01

    Objective To study the effect of 2~6 years old children's dental clinic behavior factors. Methods Choose 71 cases of 2~6 years old children, were divided into group A (group) and group B (don't deserve to form); For children's emotional types and daily behavior characteristic, the children's mother dental anxiety, children's parent materials of oral health awareness. Results A, B two groups of children with age, emotional stress, significant difference (P<0.05);Parents of children with children's oral diseases responsibility, performance, treatment duration in the park and children's dental clinic behavior correlation (P<0.05). Conclusion The degree of parental responsibility, children in performance, treatment duration is 2~6 years old children's dental clinic behavior of the main factors.%目的:探讨影响2~6岁儿童牙科诊室行为的因素。方法选取71例2~6岁儿童,分为A组(配合组)、B组(不配合组);获取儿童的情绪类型以及日常的行为特点、儿童母亲的牙科焦虑状况、儿童家长的口腔健康意识等资料。结果A、B两组患儿的年龄、情绪应激性差异有统计学意义(P<0.05);家长对儿童口腔疾病的责任承担度、患儿入园表现、治疗持续时间与儿童的牙科诊室行为存在相关性(P<0.05)。结论家长的责任承担度、患儿入园表现、治疗的持续时间是影响2~6岁儿童牙科诊室行为的主要因素。

  17. Clinical research on effect of microendoscopic discectomy through posterior approach in old patients with multilevel lumber spinal stenosis and its influence factors%后路椎间盘镜治疗老年腰椎管狭窄症中的应用及相关影响因素研究

    Institute of Scientific and Technical Information of China (English)

    孙华峰; 王文斌; 王永久

    2013-01-01

    Objective To explore the clinical effect of microendoscopic discectomy through posterior approach in old patients with multilevel lumber spinal stenosis and analyze the influence factors that related to clinical effect .Methods 64 old patients with multilevel lumber spinal stenosis were selected and divided into microendoscopic group and open group based on different operation method ,each group contained 32 patients .Comparison was made between two groups in respects of operation time ,amount of bleed-ing ,hospital time post-operation and Nakai scores .Analyzed the influence factors that related to clinical effect .Results The opera-tion time ,amount of bleeding ,hospital time post-operation in microendoscopic group were lower than open group ,the differences had statistical significance .Based on the Nakei score ,the curative effect in microendoscopic group was slightly lower than open group ,but the differences had no statistical significance .The JOA score pre-operation ,walking distances and complication were rela-tive factors that could influence the clinical effect of microendoscopic discectomy through posterior approach method .Conclusion Microendoscopic discectomy through posterior approach in old patients with multilevel lumber spinal stenosis had quicker postoper-ative recovery than conventional operation ,and the JOA score pre-operation ,walking distances and complication were relative fac-tors that could influence the clinical effect of microendoscopic discectomy through posterior approach method .%目的:研究后路椎间盘镜下有限减压在老年腰椎管狭窄症(LSS )患者中的治疗应用,并探讨影响疗效的相关因素。方法选择该院收治的老年腰椎管狭窄症患者共64例,按照治疗方式不同分为椎间盘镜组及开放手术组,每组32例,对比两组患者手术时间、出血量、术后住院时间及Nakai评分,探讨影响后路椎间盘镜手术疗效的相关因素。结果两组患者手

  18. Influence of quality control in clinical detectability of microcalcifications and fibers in several mammographic units; Influencia do controle de qualidade na detectabilidade clinica de fibras e microcalcificacoes em diversas unidades mamograficas

    Energy Technology Data Exchange (ETDEWEB)

    Medeiros, R.B.; Alves, F.F.R.; Ruberti, E.M.; Fingerman, F.; Elias, S.; Pavani, C.; Pires, S.R. [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil)]. E-mail: rbitelli@cfhr.epm.br

    2001-07-01

    Our goal is to know the clinical detectability (Pdet) of fibers and microcalcifications in several mammographic units. Images under routine techniques conditions were done in 8 equipment using the quality control and statistical phantoms. The Pdet was computed from the ALVIM's images that were read by 3 specialists, on the basis of levels reliable. The images have allowed to identify microcalcifications, fibers and masses {>=} 0.165; 0.53 and 3.16 mm, respectively for 0.86{<=}D.O{<=}2,05. The results of the Pdet have varied from 0.786 to 0.864 and have demonstrated the importance of the quality assurance program in the microcalcifications detection. (author)

  19. Community Nursing Willingness and Its Influencing Factors of Clinical Nurses in Wenzhou%温州市部分临床护士从事社区护理工作的意愿及其影响因素

    Institute of Scientific and Technical Information of China (English)

    胡晓秋; 严笑金

    2011-01-01

    目的 了解临床护士从事社区护理的意愿,分析影响临床护士从事社区护理的因素,为上级行政部门在建设社区护士队伍的过程中提供政策依据.方法 2010年3-7月,采取分层抽样与整群抽样结合的方式,选取温州地区3所医院的393名临床护士为调查对象,对其进行自填式问卷调查,对临床护士从事社区护理工作的意愿进行Logistic回归分析.结果 温州市49.10%的护士愿意从事社区护理工作,当前温州市社区护理工作的客观条件满意度总评分为3.07分.医院等级、工作年限、职称、年薪、是否参加过有关学习或培训这5个变量对温州市临床护士从事社区护理工作的意愿具有显著影响(P<0.05).结论 较小的工作压力、良好的行业发展前景是吸引临床护士从事社区护理工作的主要因素,而较低的社会认同度、一般的工作环境和不太高的薪资待遇则是临床护士不愿意从事社区护理工作的主要原因.%Objective To comprehend the community nursing willingness of clinical nurses, and analyze the factors affecting the community nursing willingness,so as to provide the policy basis for the administrative department in the process of developping community nurses. Methods Using the stratified sampling and cluster sampling methods,393 nurses from three hospitals in Wenzhou were selected for the investigation of the community care willingness from March to July 2010. A self-administered questionnaire was adopted for the community nursing willingness in clinical nurses and the results were analyzed by Logistic regression. Results Totally 49. 10% of the nurses were willing to engage in community nursing work. The total score of objective conditions was 3. 07 points for current wenzhou community nursing work. The five variables of hospital level,service year,title,salary,whether attending the learning or training have significant effect in the community nursing willingness of

  20. Should the host reaction to anisakiasis influence the treatment?: Different clinical presentations in two cases ¿Debe la reacción frente la anisakiasis influir sobre el tratamiento?: Presentación clínica

    Directory of Open Access Journals (Sweden)

    Stefano Pontone

    2012-12-01

    Full Text Available Gastrointestinal anisakiasis is a parasitic infection occurring in people that consume raw or inadequately cooked fish or squid. It is frequently characterized by severe epigastric pain, nausea and vomiting caused by the penetration of the larvae into the gastric wall. Acute gastric anisakiasis with severe chest discomfort is rarely reported in Italy. On the other hand, gastro-allergic anisakiasis with rash, urticaria and isolated angioedema or anaphylaxis is a clinical entity that has been described only recently. Also, if patients usually develop symptoms within 12 hours after raw seafood ingestion, not always endoscopic exploration can promptly identify the Anisakis larvae. Moreover, some authors consider the prevailing allergic reaction as a natural and effective defense against the parasitic attack. We report two cases of peculiar manifestations of anisakiasis in both acute and chronic forms (severe chest discomfort and anaphylactoid reaction.

  1. 临床药师药学干预呼吸内科抗生素使用的研究%Influence of clinical pharmacists’pharmaceutical intervention on reasonable use of antibiotics in department of respiratory medicine

    Institute of Scientific and Technical Information of China (English)

    朱惠新

    2015-01-01

    目的:探讨临床药师药学干预对呼吸内科合理使用抗生素的影响。方法随机抽取临床药师药学干预前后呼吸内科病例资料各300份,比较干预前后抗生素使用情况、抗感染效果、合理使用等差异。结果干预后抗生素使用率明显低于干预前(71.3%VS 95.7%,P=0.000);单联抗生素使用率明显高于干预前(28.7%VS 19.0%,P =0.028),三联及以上抗生素明显低于干预前(20.0%VS 43.3%,P =0.000);平均住院费用明显少于干预前[(1965.7±265.7) VS (2600.8±316.5)元,P<0.01];抗生素使用不合理性明显低于干预前(20.1%VS 34.2%,P<0.01)。结论临床药师药学干预可促进呼吸内科合理使用抗生素,指导医生用药行为。%Objective To investigate the effect of clinical pharmacists ’pharmaceutical intervention on reasonable use of antibi-otics in department of respiratory medicine .Methods The clinical data of 300 cases before and after clinical pharmacists ’pharmaceuti-cal intervention were randomly collected .The differences in application of antibiotics ,anti-infection effect and reasonable use before and after intervention were compared.Results After the intervention,antibiotics usage were significantly lower (71.3% vs 95.7%,P =0.000),single union antibiotics usage was significantly higher (28.7%vs 19.0%,P =0.028) and sanlian and above antibiotics were significantly lower(20.0%vs 43.3%,P =0.0001) when compared to before the intervention .The hospitalization cost was also signifi-cantly less than before intervention(1965.7 ±265.7)yuan vs (2600.8 ±316.5 yuan)].The irrational antibiotic use was significantly lower than before intervention(20.1% vs 34.2%).Conclusion Clinical pharmacists’pharmaceutical intervention can promote rea-sonable use of antibiotics ,and regulate behavior of doctor ’s medication .

  2. Clinical analysis of orthodontic treatment treating for periodontal health influence%正畸治疗对牙周组织健康影响的临床分析

    Institute of Scientific and Technical Information of China (English)

    朱涛; 刘燕燕

    2014-01-01

    Objective:To investigate the periodontal influence factors in orthodontic treatment .Methods: Periodontal tissue change of 55 cases with orthodontic treatment for 3 months after treatment were observed , the periodontal influence factors were analyzed .Results:The periodontal tissue health status of angel class 2,3 were obviously worse than patients with class 1.The periodontal tissue health status of young group were obviously worse than adults patients .Conclusion:Rectification process of periodontal tissue inflammation was present , as the end of malocclusion , periodontal tissue gradually returned to normal , but in the process of treatment for the prevention and treatment of some necessary measures should be taken .%目的:分析正畸治疗过程中影响牙周组织健康的因素。方法:通过55例矫治患者治疗3个月后牙周组织变化的临床观察,分析影响牙周组织健康的因素。结果:安氏2、3类错颌患者牙周组织健康状况明显差于安氏1类患者。青少年组牙周组织健康状况明显差于成人组患者。结论:矫治过程的牙周组织炎症是一时性的,随着矫治结束,牙周组织逐渐恢复正常,但在矫治过程中仍应采取一些必要的预防和治疗措施。

  3. Investigation of clinical nurses ’ perception of patient safety culture and its influencing factors%对临床护士患者安全文化认知及影响因素的调查研究

    Institute of Scientific and Technical Information of China (English)

    黎雪梅; 李继平

    2014-01-01

    Objective To explore the attitudes and perceptions of clinical nurses for patient safety culture.Methods Using Hospital Survey on Patient Safety Culture (HSPSC) to measure twelve dimensions of patient safety culture , for 378 nurses in a hospital included in the cross-sectional study .Results Totals of 57.2%of clinical nurses gave “excellent” (14.5%) and “very good” (42.7%) for overall grade on patient safety of their units and an average percentage of positive response of patient safety culture was 61%.The nurses ’ positive response ratios to “staffing”,“non-punitive response to errors”,“teamwork across units” were respectively 40.3%, 44.2%, 47.2%,and most (70.6%) had no event report in the past one year .The perceptions of clinical nurses for patient safety culture were affected by work unit , staff position , direct interaction with patients or not , and years of unit working .Conclusions There is a positive attitude towards the patient safety culture within their units , but staffing , non-punitive safety culture , teamwork across units and event report are still should be strengthened .%目的:了解临床护士的患者安全文化认知现状及影响因素。方法使用汉化的“医院患者安全文化调查表”(Cronbach’sα系数为0.88)对378名临床护士进行调查。结果57.2%的临床护士对所在科室的患者安全总体评价为“优秀”(14.5%)或“很好”(42.7%),70.6%在过去的1年里没有事件报告。患者安全文化平均积极应答率为61%,人员配置、对错误的非惩罚性反应、科室间协作3个维度平均积极应答率分别为40.3%,44.2%,47.2%。多元回归分析显示,工作科室、岗位、直接接触患者与否、科室工作年限影响临床护士对患者安全文化的认知。结论临床护士有积极的患者安全文化认知,但还须在护理人力补充、非惩罚性安全文化建设、科室间协作

  4. 感染性心内膜炎患者临床特征与预后影响因素分析%Clinical characteristics and influencing factors of prognosis of infective endocarditis

    Institute of Scientific and Technical Information of China (English)

    张苑; 任鹏涛; 杨婧; 刘婷婷; 闫庆辉; 张国建

    2016-01-01

    OBJECTIVE To investigate the clinical characteristics and prognostic factors of infective endocarditis ,so as to provide basis for improving the prognosis of patients with endocarditis .METHODS A total of 900 patients with infective endocarditis in the hospital from Jan .2010 to Dec .2014 were selected ,and their clinical data were retrospectively analyzed .Clinical characteristics of the patients and their performance were analyzed .The prognos‐tic factors were analyzed by univariate and multivariate logistic regression analyses ,the results were statistically analyzed by using SPSS 20 .0 software .RESULTS Totally 869 patients had underlying heart diseases among the 900 patients with infective endocarditis ,accounting for 96 .56% .The univariate analysis showed artificial valve , fever ≥39 ℃ ,hypersensitive C‐reactive protein ≥60 mg/L ,hemoglobin <90 g/L ,serum albumin <30 g/L and surgical treatment were the related prognostic factors (P< 0 .05) .The multivariate logistic regression analysis showed that hemoglobin <90 g/L ,serum albumin <30g/L and surgical treatment were the independent prognos‐tic factors (P<0 .05) .CONCLUSION The results show that most patients with infective endocarditis have under‐lying heart diseases ,the majority of patients have normal ECG .Levels of hemoglobin and serum albumin as well as surgical treatment are prognostic risk factors in infective endocarditis .%目的:探讨感染性心内膜炎患者的临床特征及预后影响因素,为提高心内膜炎患者预后提供参考依据。方法回顾性分析2010年1月-2014年12月医院收治的900例感染性心内膜炎患者临床资料,分析患者的临床特征及表现,预后影响因素进行单因素及多因素logistic回归分析,结果采用SPSS 20.0软件进行统计分析。结果900例感染性心内膜炎患者中有基础心脏疾病患者869例占96.56%;单因素分析显示,人工瓣膜、发热≥39

  5. International adaptations of the Millon Clinical Multiaxial Inventory: Construct validity and clinical applications

    NARCIS (Netherlands)

    Rossi, G.M.P.; Derksen, J.J.L.

    2015-01-01

    This article examines the influence of the Millon Clinical Multiaxial Inventory (MCMI) as a clinical and research instrument beyond the borders of the United States. The MCMI's theoretical and empirical grounding, its alignment with the Diagnostic and Statistical Manual of Mental Disorders (DSM), an

  6. Influence of Clinical Psychological Counseling on Preventing Postpartum Depression%临床心理疏导与支持对预防产后抑郁的分析

    Institute of Scientific and Technical Information of China (English)

    杨家爱

    2015-01-01

    218 puerperae were investigated about the psychological depression.The survey result showed the population characteristics which was prone to postpartum depression.The reason of postpartum depression was discussed.Finally,according to the psychological states of puerpera before and after the delivery, the clinical psychological counseling and strategies to prevent postpartum depression were put forward.The effective means,including the proper postpartum education,harmonious family relationship,efficient psychological counseling,had positive role to alleviate and eliminate the anxiety and depression of puerpera.%选取218例产妇进行心理抑郁调查,得出了易于发生产后抑郁的人群特征。讨论产妇发生产后抑郁的原因,分析产妇分娩前后的心理状态,提出了预防产后抑郁的临床心理疏导与支持策略。正确的产后教育、和谐的家庭及社会支持系统、有效的心理疏导、温馨的互换关系,具有减轻和消除产妇的焦虑和抑郁心情的作用。

  7. Clinical image quality evaluation for panoramic radiography in Korean dental clinics

    OpenAIRE

    Choi, Bo-ram; Choi, Da-Hye; Huh, Kyung-Hoe; Yi, Won-Jin; Heo, Min-Suk; Choi, Soon-Chul; Bae, Kwang-Hak; Lee, Sam-Sun

    2012-01-01

    Purpose The purpose of this study was to investigate the level of clinical image quality of panoramic radiographs and to analyze the parameters that influence the overall image quality. Materials and Methods Korean dental clinics were asked to provide three randomly selected panoramic radiographs. An oral and maxillofacial radiology specialist evaluated those images using our self-developed Clinical Image Quality Evaluation Chart. Three evaluators classified the overall image quality of the p...

  8. Influence of Nonverbal Behavior on Doctor-Patient Relationship in Clinical Activities——Based on the Survey Data of Five Top-Class Hospitals in X City%诊疗中非言语行为对医患关系的影响——基于某市5所三甲医院的调查研究

    Institute of Scientific and Technical Information of China (English)

    孙咏莉; 王晓燕; 梁立智; 关丽征; 宋晓霞; 焦峰

    2011-01-01

    There is a significant difference in expectation of speech tone, gestures, distance, eye contact, facial expressions, standing and sitting posture in clinical activities between doctors and patients, that was shown in this investigation. And these unmatched non - verbal elements to some extent influenced the construction of harmonious Doctor - Patient Relationship.%本次调查发现,在诊疗活动中,医患双方对医务人员讲话的语气、手势、问诊距离、眼神、表情、职业坐姿和职业站姿等非言语行为要素的期待存在明显差异,这些不匹配的非言语行为要素在一定程度上影响了和谐医患关系的构建.

  9. Philosophy of clinical psychopharmacology.

    Science.gov (United States)

    Aragona, Massimiliano

    2013-03-01

    The renewal of the philosophical debate in psychiatry is one exciting news of recent years. However, its use in psychopharmacology may be problematic, ranging from self-confinement into the realm of values (which leaves the evidence-based domain unchallenged) to complete rejection of scientific evidence. In this paper philosophy is conceived as a conceptual audit of clinical psychopharmacology. Its function is to criticise the epistemological and methodological problems of current neopositivist, ingenuously realist and evidence-servant psychiatry from within the scientific stance and with the aim of aiding psychopharmacologists in practicing a more self-aware, critical and possibly useful clinical practice. Three examples are discussed to suggest that psychopharmacological practice needs conceptual clarification. At the diagnostic level it is shown that the crisis of the current diagnostic system and the problem of comorbidity strongly influence psychopharmacological results, new conceptualizations more respondent to the psychopharmacological requirements being needed. Heterogeneity of research samples, lack of specificity of psychotropic drugs, difficult generalizability of results, need of a phenomenological study of drug-induced psychopathological changes are discussed herein. At the methodological level the merits and limits of evidence-based practice are considered, arguing that clinicians should know the best available evidence but that guidelines should not be constrictive (due to several methodological biases and rhetorical tricks of which the clinician should be aware, sometimes respondent to extra-scientific, economical requests). At the epistemological level it is shown that the clinical stance is shaped by implicit philosophical beliefs about the mind/body problem (reductionism, dualism, interactionism, pragmatism), and that philosophy can aid physicians to be more aware of their beliefs in order to choose the most useful view and to practice coherently

  10. Shared clinical decision making

    Science.gov (United States)

    AlHaqwi, Ali I.; AlDrees, Turki M.; AlRumayyan, Ahmad; AlFarhan, Ali I.; Alotaibi, Sultan S.; AlKhashan, Hesham I.; Badri, Motasim

    2015-01-01

    Objectives: To determine preferences of patients regarding their involvement in the clinical decision making process and the related factors in Saudi Arabia. Methods: This cross-sectional study was conducted in a major family practice center in King Abdulaziz Medical City, Riyadh, Saudi Arabia, between March and May 2012. Multivariate multinomial regression models were fitted to identify factors associated with patients preferences. Results: The study included 236 participants. The most preferred decision-making style was shared decision-making (57%), followed by paternalistic (28%), and informed consumerism (14%). The preference for shared clinical decision making was significantly higher among male patients and those with higher level of education, whereas paternalism was significantly higher among older patients and those with chronic health conditions, and consumerism was significantly higher in younger age groups. In multivariate multinomial regression analysis, compared with the shared group, the consumerism group were more likely to be female [adjusted odds ratio (AOR) =2.87, 95% confidence interval [CI] 1.31-6.27, p=0.008] and non-dyslipidemic (AOR=2.90, 95% CI: 1.03-8.09, p=0.04), and the paternalism group were more likely to be older (AOR=1.03, 95% CI: 1.01-1.05, p=0.04), and female (AOR=2.47, 95% CI: 1.32-4.06, p=0.008). Conclusion: Preferences of patients for involvement in the clinical decision-making varied considerably. In our setting, underlying factors that influence these preferences identified in this study should be considered and tailored individually to achieve optimal treatment outcomes. PMID:26620990

  11. Doctors and nurses on wards with greater access to clinical dietitians have better focus on clinical nutrition

    DEFF Research Database (Denmark)

    Thoresen, L.; Rothenberg, E.; Beck, Anne Marie;

    2008-01-01

    into the importance of adequate nutrition was better than those who saw clinical dietitians seldom. Clinical nutrition had a higher priority in units with frequent visits by clinical dietitians. The present study shows that doctors and nurses on wards with greater access to clinical dietitians had better focus......, to assess whether the presence of clinical dietitians in hospital departments influenced doctors and nurses focus on clinical nutrition. A questionnaire about the use of clinical nutrition was mailed to 6000 doctors and 6000 nurses working in hospital units where undernutrition is documented to be common...

  12. How Clinical Instructors Can Enhance the Learning Experience of Physical Therapy Students in an Introductory Clinical Placement

    Science.gov (United States)

    Cole, Beverley; Wessel, Jean

    2008-01-01

    Purpose: There is little understanding of how physical therapy students are influenced by clinical instructors (CIs) particularly at the outset of their clinical learning. The purpose of this study was to evaluate physical therapy students' perceptions of their learning experiences during an introductory clinical placement. Methods: Subjects were…

  13. Discussion on Influence of Physiques Bias on Treatment and Clinical Effect of Uveitis%针对葡萄膜炎患者体质偏畸在临床治疗及其疗效的探讨

    Institute of Scientific and Technical Information of China (English)

    赵建英; 郝小波

    2012-01-01

    目的:从中医纠正葡萄膜炎患者体质偏畸的方法,了解该方法在临床的试用情况.方法:在一定范围了解葡萄膜炎患者中医体质类型分布情况;运用相关干预体质偏畸的手段观察该病患者在不同时间段的复发情况.结果:调查中发现广西地区葡萄膜炎患者体质类型具有独有的偏畸性;所选患者在治疗中其体质均有所改善的同时临床复发率也明显降低.结论:祖国医学在临床治疗上讲究所谓的“三因制宜”,应用该理论指导临床,配合使用中药及中医的相关治疗手段,以达到在治疗上不但重视局部,更注重整体的理念,最终达到缩短葡萄膜炎患者病程或减少葡萄膜炎复发率,最终达到综合性提高葡萄膜炎患者治疗疗效的目的,该疗法进一步体现了中医治疗方向是“以人为本”而不是单纯以“病”入手的这样一种理念.%Objective: Though the TCM method of correcting physical bias of uveitis patients to understand the method in the clinical trial. Methods : To understand the distribution of Chinese constitutional types in a certain range of uveitis patients; the interventions were used to observe the recurrence at different times. Results:The survey found that uveitis patients in Guangxi had a unique physical type;the treatment of selected patients had improved their physical fitness,while significantly lowered the recurrence rate. Conclusion: TCM pays attention to the treatment which is so-called three conditions for clinical applications, in conjunction with the relevant Chinese medicine treatment in order to treat not only the local,but the whole,and to shorten the duration of uveitis or reduce the recurrence rate, and ultimately obtaining a comprehensive treatment of uveitis. The TCM treatment further demonstrates the direction of people-oriented, which is not simply to treat a disease.

  14. Clinical Features and Influencing Factors of Prognosis in Patients with Viral Encephalitis%病毒性脑炎的临床特点及预后影响因素研究

    Institute of Scientific and Technical Information of China (English)

    周晶; 秦新月

    2012-01-01

    Objective To explore the clinical and imaging features of viral encephalitis and to understand its short time prognosis. Methods Clinical data of 160 viral encephalitis inpatients diagnosed during January 2006 - May 2010, in the First Affiliated Hospital of Chongqing Medical University, were analyzed retrospectively. All patients were divided into good and poor prognosis groups according to the Glasgow Outcome Scale, and several factors were analyzed by Logistic regressive analysis. Results The univariate analysis showed that anomaly of cranial MRI, moderate or serious anomaly of EEG, abnormal consciousness, abnormal mental behaviors, abnormal muscular power, epilepsy, and headache may correlated with the prognosis. However, the multifactor analysis showed that only anomaly of cranial MRI and abnormal consciousness had a definite relation with the prognosis []P = 0.03, OR = 13.0, 95% CI (2.40, 70.46)]. Conclusion The prognosis of viral encephalitis is related to several factors. But anomaly of cranial MRI and abnormal consciousness are the most important factors to its short time prognosis of viral encephalitis, and the more the cranial lesions are, the worse the prognosis is.%目的 了解病毒性脑炎(VE)的临床特征和影像学特征,探讨VE近期预后的相关影响因素.方法 回顾性分析2006年1月-2010年5月重庆医科大学附属第一医院住院治疗的临床诊断为VE的160例患者的临床资料,应用格拉斯哥评分(GOS)将其分为预后良好组和预后不良组,对多个因素与预后的关系进行Logistic回归分析.结果 单因素分析显示颅脑MRI异常、脑电图中重度异常、意识状态异常、精神行为异常、肌力异常、癫痫、头痛与VE预后可能有关系.多因素分析显示仅颅脑MRI异常和意识状态异常与VE预后有明确关系,MRI多个病灶较单个病灶预后更差[P=0.03,OR =13.0,95%CI (2.40,70.46)].结论 VE的预后是多因素共同作用的结果,意识状态异常、

  15. The clinical course of non-muscle invasive bladder cancer after transuretral resection of the tumor with or without subsequent intravesical application of bacillus Calmette-Guérin: The influence of patients gender and age

    Directory of Open Access Journals (Sweden)

    Milošević Radovan

    2015-01-01

    Full Text Available Bacground/Aim. The therapy with intravesical instillation of bacillus Calmette-Guérin (BCG after transurethral resection (TUR of tumor is the gold standard of treatment of non-muscle invasive bladder cancer (NMIBC. The role and importance of BCG intravesical therapy in various shape of tumors, were confirmed by our previous investigation. The aim of this study was to examine whether incidence of recurrence and tumor regression differs depending on sex and age of patients. Methods. This study included a total of 899 patients suffering from NIMBC, treated at our institution from January 1, 2007 to March 1, 2013. Two groups of patients were formed: patients underwent TUR + BCG therapy (the group I and the group II with patients in whom TUR was performed as only therapy. These two groups of patients were divided into subgroups of respondents male and female, age 60 years or younger and older than 60 years. Statistical analysis was performed using χ2 test and the Kolmogorov-Smirnov test. Results. This research suggests that if the frequency of recurrence is seen as the only parameter, considering all the subjects, the lowest recurrence rate was determined in the male subjects, aged 60 years and younger who had received BCG after TUR. A high statistical significance was found in the incidence of recurrence in patients younger than 60 years, depending on the response to the therapy, while in those older than 60 years, the difference was at the level of statistical significance. This can be attributed to a certain degree of infravesical obstruction in older men. Conclusions. Sex and age of patients may have a significant influence on the course and outcome of NMIBC. The disease has the most malignant and most aggressive behavior when present in males older than 60 years.

  16. Blood cholesterol treatment guideline and influence on clinical practice in China%血脂防治指南述评及对我国临床实践的解析

    Institute of Scientific and Technical Information of China (English)

    刘淼; 何耀

    2015-01-01

    2013年ACC/AHA联合颁布了《降胆固醇治疗成人动脉粥样硬化性心血管疾病(ASCVD)风险指南》,2015年NLA发布了《以患者为中心的血脂异常管理建议》,引起了国内外广泛关注.与以往指南相比,新指南在降胆固醇治疗的思路上有较多更新,强调了他汀类药物在降低ASCVD风险方面的获益,不再设定降胆固醇治疗LDL-C的目标值,更新了一级预防风险评估模型等.如何对待这些新的指南,并结合我国国情开展血脂防治,是需要认真对待的问题.本文将简要介绍指南的要点,并对我国临床实践的影响进行剖析.%The American College of Cardiology and the American Heart Association released the 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults, and the National Lipid Association released national lipid association recommendations for patient-centered management of dyslipidemia: part 1—full report in 2015, which aroused wide attention at home and abroad. These new guidelines have many updates for the basic ideas and speciifc measures compared with the previous guidelines, including appropriate intensity of statin therapy, no longer achieving the intended target LDL-C levels, and the new pooled cohort equations to estimate 10-year ASCVD risk and so on. How to deal with these new guidelines, and to carry out the prevention and treatment of blood lipid combined with the Chinese national conditions, it's an issue that needs to be taken seriously. This paper will give a brief introduction to the main points of these guidelines, and analyze the inlfuence on clinical practice of lipid control in China.

  17. Second generation plant health clinics in Uganda

    DEFF Research Database (Denmark)

    Danielsen, Solveig; Matsiko, Frank; Mutebi, Emmanuel;

    to enhance the coverage of existing extension services. Many factors influenced the performance of plant health clinics, from practical, everyday concerns of clinic staff to the policy framework that shapes public sector activities and relationships with the NGO and private sectors. While the basic aspects...... of clinic operation were well understood by all organisations, there were no common standards for record keeping, data management, monitoring and reporting, either internally in the clinic organisations or externally from the backstopping institutions. There was also no functional system to refer samples....... Ownership was strengthened and clinic management improved with stronger local leadership. It was nonetheless evident that the clinic initiative expanded in a loose and unregulated way. It was not always clear who was leading the activities and providing the overall championship to guarantee that basic...

  18. The influence of spasmodic torticollis on the clinical prognosis of patients with neurogenic dysphagia%神经源性吞咽障碍伴痉挛性斜颈的临床治疗观察

    Institute of Scientific and Technical Information of China (English)

    郭钢花; 王国胜; 李哲

    2012-01-01

    目的 观察痉挛性斜颈对神经源性吞咽障碍患者康复预后的影响及不同治疗方法的疗效比较.方法 选取神经源性吞咽障碍患者103例,其中伴有痉挛性斜颈患者82例,采用随机数字表法分为单纯训练组(21例,仅给予常规吞咽康复训练)、药物训练组(21例,给予常规吞咽康复训练及药物治疗)、支持训练组(20例,给予常规吞咽康复训练及一般性支持治疗)及联合治疗组(20例,给予常规吞咽康复训练、药物及一般性支持治疗),余21例无痉挛性斜颈的神经源性吞咽障碍患者则归入无斜颈组(给予常规吞咽康复训练).于治疗前、治疗2个月对各组患者吞咽功能改善情况进行评定.结果 治疗前药物训练组、支持训练组、联合治疗组和单纯训练组吞咽功能均显著低于无斜颈组(P<0.05);各组患者分别经2个月治疗后,发现5组患者吞咽功能均较治疗前显著改善(P<0.05),其中药物训练组、支持训练组、联合治疗组和无斜颈组吞咽功能均显著优于单纯训练组(P<0.05);联合治疗组吞咽功能亦显著优于药物训练组及支持训练组(P<0.05);联合治疗组和无斜颈组吞咽功能组间差异无统计学意义(P>0.05).结论 痉挛性斜颈能影响神经源性吞咽障碍患者吞咽功能恢复,对痉挛性斜颈进行治疗可明显提高神经源性吞咽障碍患者吞咽功能.%Objective To observe the influence of spasmodic torticollis on the rehabilitation prognoses of patients with neurogenic dysphagia.Methods One hundred and three dysphagic patients were recruited,of which 82 had spasmodic torticollis and 21 did not.The subjects with spasmodic torticollis were divided randomly into a medication therapy group (21 cases) which accepted medication plus swallowing training,a common therapy group (20 cases) accepting common support treatment plus swallowing training,a combined therapy group (20 cases) accepting common support treatment

  19. Influencing factors of clinical nurses working for aged nursing basing on theory of planned behavior%基于计划行为理论的临床护士从事老年护理意愿的影响因素分析

    Institute of Scientific and Technical Information of China (English)

    孙亚男; 赵斌; 贺生; 于双成; 李玉玲; 安文秀

    2016-01-01

    Objective To investigate influencing factors of clinical nurses working for aged nursing basing on theory of planned behavior(TPB), so as to provide reference for motivating nurses to work on aged nursing, and to predict possibilities of clinical nurses to work on the industry of aged nursing. Methods Questionnaire scale was designed basing on TPB and characteristics of aged nursing industry, and was handed out to 172 nurse practitioners in 4 hospitals in a city of Sichuan. Results Determination coefficients of attitude towards the behavior, subjective norm, and perceived behavioral control of clinical nurses′intention to work on aged nursing industry, R2 were respectively 0. 32,0. 45 and 0. 01. Determination coefficient of attitude towards the behavior, subjective norm, and perceived behavioral control of nurses′intention to work on aged nursing, was R2 =0. 36 (P<0. 05). Conclusions Subjective norm has the most remarkable influences on nurses′intention to work on aged nursing industry, followed by attitude towards the behavior, with the least of perceived behavioral control;it is feasible to apply TPB in exploring influencing factors for clinical nurses working on aged nursing.%目的:应用计划行为理论研究影响护士从事老年护理意愿的因素,为促进护理人员投入老年护理工作提供参考,预测临床护士选择老年护理行业的可能性。方法依据计划行为理论结合老年护理行业自身特点设计问卷调查量表,对四川省某市4家医院的执业护士共计172人进行问卷调查。结果行为态度、主观规范和知觉行为控制对临床护士从事老年护理行业意愿的确定系数为R2值分别为0.32,0.45,0.01,行为态度、主观规范和知觉行为控制三者对护士从事老年护理的行为意向的确定系数为R2=0.36(P<0.05)。结论主观规范对医院护士从事老年护理行业意愿的影响最显著,行为态度影响次之,知觉行为控制影响程度不显著

  20. 儿童反复呼吸道感染相关因素的临床分析%Clinical analysis of influencing factors for recurrent respiratory tract infections in children

    Institute of Scientific and Technical Information of China (English)

    王玲玲; 俞秀英; 钟磊

    2014-01-01

    OBJECTIVE To explore the related influencing factors for recurrent respiratory tract infections in chil-dren so as to provide guidance for prevention and treatment of the disease .METHODS A total of 521 children with respiratory tract infections who were treated in the hospital from Feb 2009 to Jul 2012 were enrolled in the study , among which 165 children with recurrent respiratory tract infections were assigned as the observation group ,356 children with common respiratory tract infections as the control group ,then the medical records were recorded in detail during the treatment ,and the risk factors for infections were analyzed through the study of the medical re-cords .RESULTS The incidence of recurrent respiratory tract infections was relatively high in the preterm children , non-breastfed children ,and caesarean children .The serum iron content was (12 .51 ± 3 .26)μmol/L in the obser-vation group ,(16 .25 ± 6 .57)μmol/L in the control group ;the serum calcium content was (2 .12 ± 0 .52)μmol/L in the observation group ,(2 .54 ± 0 .63)μmol/L in the control group ;the serum zinc content was (19 .3 ± 14 .26)μmol/L in the observation group ,(31 .02 ± 19 .27)μmol/L in the control group ,and there were significant differ-ences between the two groups (P<0 .05) .CONCLUSION For the prevention and treatment of recurrent respiratory tract infections in the children ,attention should be paid to the supplement of serum iron ,calcium ,and zinc ,and breastfeeding should be given as much as possible .%目的:探讨小儿反复呼吸道感染的相关影响因素,为该病的预防和治疗提供参考依据。方法选取2009年2月-2012年7月医院收治的呼吸道感染患儿共521例,其中反复呼吸道感染患儿165例,设为观察组,同时选取普通呼吸道感染患儿356例,设为对照组;患儿治疗期间进行详细的病例记录,并通过病例资料对感染因素进行总结分析。结果早产儿、非母乳喂养及剖

  1. Barrett's esophagus: clinical features, obesity, and imaging.

    LENUS (Irish Health Repository)

    Quigley, Eamonn M M

    2011-09-01

    The following includes commentaries on clinical features and imaging of Barrett\\'s esophagus (BE); the clinical factors that influence the development of BE; the influence of body fat distribution and central obesity; the role of adipocytokines and proinflammatory markers in carcinogenesis; the role of body mass index (BMI) in healing of Barrett\\'s epithelium; the role of surgery in prevention of carcinogenesis in BE; the importance of double-contrast esophagography and cross-sectional images of the esophagus; and the value of positron emission tomography\\/computed tomography.

  2. Assisted Reproductive Technology and Related Clinical Factors

    Institute of Scientific and Technical Information of China (English)

    Zuan-chong FENG; Zhong-mei LI

    2004-01-01

    @@ As a widely-applied clinical therapy for infertility and sterility, ART has its own merits compared to other techniques and operations; however, the outcome of ART is influenced by various factors ranging from age, endometrial receptivity, reproductive system condition (e.g.uterus, fallopian tube and pelvic factors, etc.), immune system and so on. From our clinical experience and the literatures reviewd, it is strongly recommended that the situation of every infertile couple be evaluated thoroughly before applying therapy.

  3. Neurocognition: Clinical and Functional Outcomes in Schizophrenia

    OpenAIRE

    Lepage, Martin; Bodnar, Michael; Bowie, Christopher R.

    2014-01-01

    Schizophrenia is characterized by significant heterogeneity in outcome. The last decades have witnessed a significant interest in identifying factors that can moderate or influence clinical and functional outcomes in people with schizophrenia. One factor of particular interest is neurocognition, as performance on various measures of cognitive abilities, such as memory, attention, and executive functions, have been consistently related to functional outcome and, to a lesser extent, clinical ou...

  4. 山东省护理院校教学医院带教老师的核心能力及其影响因素%Core Competency and Its Influencing Factors of Clinical Teachers in Affiliated Teaching Hospitals of Universities in Shandong Province

    Institute of Scientific and Technical Information of China (English)

    高晖; 王贞慧; 冯晨秋; 娄凤兰

    2012-01-01

    目的 了解山东省本科护理院校教学医院临床带教老师的核心能力及其影响因素.方法 采用注册护士核心能力量表对山东省6所本科护理院校附属教学医院的358名带教老师(以多阶段抽样法选取)进行问卷调查,共发放问卷358份,回收有效问卷355份,问卷有效率回收率为99.2%.结果 山东省本科护理院校带教老师核心能力总均分为(3.06±0.47)分,法律/伦理实践评分最高,批判性思维/科研评分最低;不同年龄、工作年限、带教年限、职称、第一学历、科室、工作满意度护士核心能力评分差异均有统计学意义;带教老师核心能力受技术职称、工作满意度、带教年限等因素影响.结论 山东省护理院校临床带教老师核心能力水平中等偏上,医院管理部门应重视其批判性思维及科研能力的培养,主动关心带教老师的身心特点和从业心态,多角度地提高临床带教师资的核心能力.%Objective To know the core competency and its influencing factors of clinical teachers in the affiliated teaching hospitals of universities in Shandong Province. Methods Totally 358 clinical teachers in the affiliated hospitals of 6 universities were investigated with the competency inventory for registered nurses. Of the 358 questionnaires,355 were valid and the effective rate was 99. 2%. Results The mean score of core competency was 3. 06±0. 47,and the highest score was detected in dimensions of legal/ethical practice and the lowest score was in dimensions of critical thinking/research aptitude. The core competency of nurse was statistically different in the dimensions in terms of nurses with different age,working time,teaching time,job title,education,department and job satisfaction. The demographic influencing factors were job title,job satisfaction and teaching time. Conclusion The overall core competency is at the upper middle level for clinical teachers from the affiliated hospitals of

  5. Influence on the Job Qualification Rate and Clinical Satisfaction Rate by Application of CSSD Team Leader Responsibility System Management Mold%消毒供应中心应用组长负责制管理模式对工作合格率及临床满意率的影响

    Institute of Scientific and Technical Information of China (English)

    王东梅

    2015-01-01

    目的:观察消毒供应中心应用组长负责管理模式对工作合格率及临床满意率的影响。方法自2013年6月起于该院消毒供应中心应用组长负责制管理模式,对消毒供应中心每个环节开展管理与质量控制。将2012年6月—2013年5月未开展组长负责制前我院消毒供应中心的工作合格率与临床满意率作为对照,分析应用组长负责制对消毒供应中心工作合格率及临床满意率的影响。结果应用组长负责制管理模式后,该院消毒供应中心各环节工作合格率与临床满意率均明显高于应用前,不同时间段对比差异有统计学意义(P<0.05)。结论在医院消毒供应中心应用组长负责制管理模式,可提高消毒供应中心工作的合格率,提升临床科室对消毒质量的满意度,促进消毒供应中心服务质量的持续改进,值得推广。%Objectives To observe the influence on the job qualification rate and clinical satisfaction rate by the application of CSSD team leader responsibility system management mold.Methods Since June, 2013, our hospital CSSD has applied team leader responsibility system management mold, and implemented control and management on each link in CSSD. The job qualification rate and clinical satisfaction rate from June 2012 to the end of May 2013 before applying team leader responsibility system management mold were given contrast to the period when applying team leader responsibility system management mold, so as to research the influence on the job qualification rate and clinical satisfaction rate by applying CSSD team leader responsibility system management mold.Results After applying the CSSD team leader responsibility system management mold, the job qualification rate and clinical satisfaction rate of each link were obviously higher than the period when the system was not applied. The contrast differences of different time period had statistical significant differences (P< 0

  6. 消毒供应中心应用组长负责制管理模式对工作合格率及临床满意率的影响%Influence on the Job Qualification Rate and Clinical Satisfaction Rate by Application of CSSD Team Leader Responsibility System Management Mold

    Institute of Scientific and Technical Information of China (English)

    王东梅

    2015-01-01

    目的:观察消毒供应中心应用组长负责管理模式对工作合格率及临床满意率的影响。方法自2013年6月起于该院消毒供应中心应用组长负责制管理模式,对消毒供应中心每个环节开展管理与质量控制。将2012年6月—2013年5月未开展组长负责制前我院消毒供应中心的工作合格率与临床满意率作为对照,分析应用组长负责制对消毒供应中心工作合格率及临床满意率的影响。结果应用组长负责制管理模式后,该院消毒供应中心各环节工作合格率与临床满意率均明显高于应用前,不同时间段对比差异有统计学意义(P<0.05)。结论在医院消毒供应中心应用组长负责制管理模式,可提高消毒供应中心工作的合格率,提升临床科室对消毒质量的满意度,促进消毒供应中心服务质量的持续改进,值得推广。%Objectives To observe the influence on the job qualification rate and clinical satisfaction rate by the application of CSSD team leader responsibility system management mold.Methods Since June, 2013, our hospital CSSD has applied team leader responsibility system management mold, and implemented control and management on each link in CSSD. The job qualification rate and clinical satisfaction rate from June 2012 to the end of May 2013 before applying team leader responsibility system management mold were given contrast to the period when applying team leader responsibility system management mold, so as to research the influence on the job qualification rate and clinical satisfaction rate by applying CSSD team leader responsibility system management mold.Results After applying the CSSD team leader responsibility system management mold, the job qualification rate and clinical satisfaction rate of each link were obviously higher than the period when the system was not applied. The contrast differences of different time period had statistical significant differences (P< 0

  7. Influencing Factors of Disease-free Survival Rate and Clinical Significance of The Number of Axillary Lymph Node Detection in Breast Cancer%乳腺癌术后无瘤生存率的影响因素及腋窝淋巴结检测数目的临床意义

    Institute of Scientific and Technical Information of China (English)

    朱亚东

    2014-01-01

    Objective To investigate the relative factors influencing disease-free survival(DFS)rate in breast cancer and clinical significance of the number of axillary lymph node dissection .Methods Clinical data of 138 cases of breast cancer pa-tients who received modified radical mastectomy and axillary lymph node dissection were studied retrospectively .Positive axillary lymph nodes and disease-free survival time and influencing factors of patients with negative axillary lymph node were analyzed by Kaplan-Meier and multivariate logistic regression analysis .Results 5-year overall survival rate and DFS rate in patients with negative lymph nodes were 90.7% and 86.7%,respectively.5-year overall survival rate and DFS rate in patients with positive lymph nodes were 72.6%and 64.7%,respectively.There had statistical difference(P<0.05).Single factor analysis and multi-variate logistic regression analysis showed that the number of positive lymph node ,the number of lymph node dissection ,HER-2 were risk factors influencing the 5-year DFS of patients with positive lymph node .HER-2 was the main risk factor influencing the 5-year DFS of patients with negative lymph node .Conclusion Axillary lymph node metastasis and HER-2 are major factors in-fluencing the 5-year DFS of breast cancer patients .Increase the number of lymph nodes detection could improve the 5-year DFS of breast cancer patients .%目的:探讨乳腺癌术后无瘤生存率的影响因素及腋窝淋巴结清扫及检测个数的临床意义。方法回顾性分析138例行乳腺癌手术并腋窝淋巴结清扫患者的临床资料,采用Kaplan-Meier法和Logistic多因素回归分析腋窝淋巴结阳性和腋窝淋巴结阴性患者的无瘤生存时间及影响因素。结果淋巴结阴性患者5年总生存率为90.7%,5年无瘤生存率为86.7%,淋巴结阳性患者5年总生存率为72.6%,5年无瘤生存率为64.7%,2组差异具有统计学意义( P<0.05)。单因素分析

  8. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... Participating in Clinical Trials: About Clinical Trials In This Topic About Clinical Trials Risks and Benefits Terms ... with Your Doctor Taking Medicines The information in this topic was provided by the National Library of ...

  9. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... Participating in Clinical Trials About Clinical Trials A Research Study With Human Subjects A clinical trial is a research study that involves human subjects. The purpose of ...

  10. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... Clinical Trials In This Topic About Clinical Trials Risks and Benefits Terms to Know Finding a Clinical ... researchers may gather information about experimental treatments, their risks, and how well they work compare existing therapies ...

  11. Participating in Clinical Trials

    Medline Plus

    Full Text Available Home > Health topics A-Z > Participating in Clinical Trials: About Clinical Trials In This Topic About Clinical Trials Risks ... centers across the country. The National Institutes of Health funds much of this basic research. Screening Trials ...

  12. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... on. Participating in Clinical Trials About Clinical Trials A Research Study With Human Subjects A clinical trial is a research study that involves human subjects. The purpose ...

  13. Clinical study on the influence of corneal biomechanical properties on early-stage orthokeratology%角膜生物力学性能对角膜塑形术早期疗效的影响

    Institute of Scientific and Technical Information of China (English)

    周佳奇; 李梅; 钟元园; 周行涛; 褚仁远

    2014-01-01

    Objective To investigate the correlation between corneal biomechanical properties and the changes in corneal curvature when undergoing orthokeratology.Methods Fifty-seven eyes of 29 subjects with-1.00--4.75 D of myopia wore overnight reverse-geometry rigid gas-permeable lenses were included in this prospective study.The clinical examination included refractive error,uncorrected and best corrected visual acuity,and slit-lamp examination and were recorded in detail.Corneal resistance factor (CRF) and corneal hysteresis (CH) were measured with an ocular response analyzer.Corneal topography was measured with an Oculus Pentacam analysis system at pre-wear.Keratometric curvature (steep and fiat K values) was measured pre-wear,and 1 day and 7 days post-wear.A one-way ANOVA and correlation analysis were used for statistical analysis.Results The fiat keratornetric curvatures (K1) were significantly reduced from 42.76±0.78 D (baseline) to 41.78±0.86 D after one night of wear,and 40.52±1.26 D after 7 nights of wear (F=71.962,P<0.01).The steep keratometric curvatures (K2) were significantly reduced from 43.91±0.81 D (baseline) to 43.34±0.89 D after one night of wear,and 42.14±1.44 D after 7 nights of wear (F=40.602,P<0.01).CRF and CH did not correlate significantly with the reduction of K1 and K2,respectively,after 1 and 7 nights of wear.Conclusion This study indicates that the biomechanical properties CRF and CH did not correlate with the changes in corneal curvature while undergoing orthokeratology.%目的 探讨角膜生物力学性能与角膜塑形术后角膜曲率变化的相关性.方法 前瞻性研究.选取复旦大学附属眼耳鼻喉科医院接触镜室就诊的青少年近视患者29例(57眼),平均年龄(9.7±2.1)岁,等效球镜度范围-1.00~-4.75 D,验配前进行眼科常规检查、屈光检查、Oculus Pentacam 三维眼前节分析仪测量角膜地形图、Canon角膜曲率计测量角膜平坦K1及陡峭K2、眼反应分析仪测量角

  14. Future requirements. Clinical investigations

    DEFF Research Database (Denmark)

    Qvist, V.

    2002-01-01

    Biocompatability, Cariology, Clinical trials, Dental materials, Helath services research, Human, Pedodontics......Biocompatability, Cariology, Clinical trials, Dental materials, Helath services research, Human, Pedodontics...

  15. Clinical analysis of the influence of preoperative nutritional status on the long-term prognosis of patients with gastric cancer%胃癌患者术前营养状况对远期预后影响分析

    Institute of Scientific and Technical Information of China (English)

    余伦

    2016-01-01

    status could influence both quality of life and survival of patients with gastric cancer , and the quality of life and survival rate of patients with malnutrition might be worse .%目的:探讨术前营养状况对胃癌患者远期预后影响,为改善胃癌手术治疗提供参考。方法依据微营养评价法将140例行胃癌根治术治疗患者分为营养正常组(22例)、潜在营养不良组(75例)和营养不良组(43例)。应用SPSS 20.0软件包进行数据处理,年龄、肿瘤直径、躯体功能、心理功能、社会功能、共性症状与副作用、特异模块及总体生活质量等计量资料以( x珋±s)表示,采用t检验;性别、病变部位、TNM分期及分化程度等计数资料采用χ2检验。P<0.05为差异具有统计学意义。结果营养正常组、潜在营养不良组和营养不良组患者肿瘤直径分别为(5.56±1.70) cm、(5.65±1.81) cm、(6.64±1.17) cm,营养不良组显著高于其他2组(t=2.79,3.60, P<0.01);淋巴转移率分别为18.2%、24.0%、51.2%,营养不良组显著高于其他2组(χ2=6.60、9.004, P<0.01);三组患者术后1年生存率分别为86.4%、74.7%、55.8%,2年生存率分别为63.6%、52.0%、27.9%,正常组和潜在营养不良组均显著高于营养不良组,(χ2=8.762、7.786, P<0.05);三组患者生活质量各指标差异均具有统计学意义(F=3.342、3.687、4.892、4.021、3.554、4.336, P<0.05),正常组和潜在营养不良组均显著优于营养不良组,以上差异均有统计学意义。结论术前营养状况对胃癌患者生活质量和生存率具有显著影响,营养不良患者生活质量和生存率均明显降低。

  16. Clinical study of influence of bile reflux on gastric mucosa of different sexual patients%胆汁反流对不同性别患者胃黏膜影响的临床研究

    Institute of Scientific and Technical Information of China (English)

    常丽丽; 来文辉; 杨慧君; 张志红

    2015-01-01

    、胃溃疡发生率男性高于女性,差异有统计学意义(P<0.05);炎症+肠化+胃小凹增生、炎症+异型增生、肠化+异型增生、肠化+胃小凹增生、胃炎性增生性息肉、胃底腺息肉、胃癌、HP 感染二者之间检出率差异无统计学意义(P>0.05)。结论胆汁反流可造成胃黏膜各种损害,男性和女性之间胆汁反流高峰年龄、相关危险因素、内镜和病理表现有一定的差异;HP 感染发生率无性别差异。%Objective To investigate the influence of bile reflux on gastric mucosa of different sexual patients. Methods From January 2014 to January 2015, 664 patients with gastric bile reflux were selected through gastroscopy in the first hospital of Shijiazhuang city and their gender, age, hobby (include diet, alcohol, tobacco), past medical history, anxiety and/or depression state evaluation results were recorded, meanwhile endoscopic manifestation, pathological results and HP test results were observed; the difference of bile reflux peak age, related risk factors, the effects on the gastric mucosa between male patients and female patients were comparatively analyzed. Results (1) Among 664 patients with gastric bile reflux, male patients were 305 cases, which detection rate was 6.75%. meanwhile female patients were 359 cases, which detection rate was 7.02%; the difference between male and female was statistically significant(P0.05); before 70 years, whether the patients were male or female, bile reflux rate increased along with aging; after the 70 years old, bile reflux rate decreased along with aging; male reflux detection peak was at the age of 51 to 60 years, female reflux detection peak was at the age of 41 to 50 years; female bile reflux peak age was earlier than male’s (P0.05). (5) Pathological examination: the incidence of inflammation, inflammation accompany with hyperplasia of gastric pit in female was more than in male; the difference was statistically

  17. Motivation and influencing factors of the choice of the secondary disciplines by eight-year clinical medical students%八年制临床医学专业学生二级学科选择的动机与影响因素研究

    Institute of Scientific and Technical Information of China (English)

    韩侨宇; 胡梦雨; 李章来; 冉姗姗; 马利加; 于晨

    2015-01-01

    Objective To understand the intention, motivation and influencing factors of the choice of the secondary disciplines by eight-year clinical medical students, provide the theoratic basis for the rational choice of the secondary disciplines by undergraduate clinical students and provide references for the effective implementation of medical professional spirit education.Methods The eight-year clinical medical students in one medical college were surveyed with a self-made questionnaire.Results There were a total of 320 questionnaires released, of which 308 valid questionnaires were recovered, with an effective recovery rate of 96.3%.The survey results showed that :①The secondary disciplines most wanted by the eight-year clinical medical students to be engaged in were surgery (39.6%) and internal medicine (34.7%).②The major reasons for eight-year clinical medical students to choose the secondary disciplines were their interests(76.6%)and development prospects(38.3%).③A variety of factors including the individual, family and occupation had produced different effects on the choice of the secondary disciplines by eight-year clinical medical students.The influence of the three factors including different stages, the difficulty levels of getting a work position and employment pressure all had a statistical significance (P<0.05) on the choice of the secondary disciplines.And multiple factors in occupation factors had significant differences between different stages.Conclusions ① Eight-year clinical medical students have a variety of motives to choose the secondary disciplines, mainly personal interests and development prospects.② The choice motivation of the secondary disciplines is influenced by a number of factors including the individual, family and occupation.③ Professional spirit education and guidance provided by colleges and society is in much more demand by students of the second stage.%目的 了解八年制临床医学专业学生二级学

  18. 八年制临床医学专业学生二级学科选择的动机与影响因素研究%Motivation and influencing factors of the choice of the secondary disciplines by eight-year clinical medical students

    Institute of Scientific and Technical Information of China (English)

    韩侨宇; 胡梦雨; 李章来; 冉姗姗; 马利加; 于晨

    2015-01-01

    Objective To understand the intention, motivation and influencing factors of the choice of the secondary disciplines by eight-year clinical medical students, provide the theoratic basis for the rational choice of the secondary disciplines by undergraduate clinical students and provide references for the effective implementation of medical professional spirit education.Methods The eight-year clinical medical students in one medical college were surveyed with a self-made questionnaire.Results There were a total of 320 questionnaires released, of which 308 valid questionnaires were recovered, with an effective recovery rate of 96.3%.The survey results showed that :①The secondary disciplines most wanted by the eight-year clinical medical students to be engaged in were surgery (39.6%) and internal medicine (34.7%).②The major reasons for eight-year clinical medical students to choose the secondary disciplines were their interests(76.6%)and development prospects(38.3%).③A variety of factors including the individual, family and occupation had produced different effects on the choice of the secondary disciplines by eight-year clinical medical students.The influence of the three factors including different stages, the difficulty levels of getting a work position and employment pressure all had a statistical significance (P<0.05) on the choice of the secondary disciplines.And multiple factors in occupation factors had significant differences between different stages.Conclusions ① Eight-year clinical medical students have a variety of motives to choose the secondary disciplines, mainly personal interests and development prospects.② The choice motivation of the secondary disciplines is influenced by a number of factors including the individual, family and occupation.③ Professional spirit education and guidance provided by colleges and society is in much more demand by students of the second stage.%目的 了解八年制临床医学专业学生二级学

  19. Genetic and epigenetic influences on schizotypal cognition

    OpenAIRE

    Leach, Emma Leah

    2013-01-01

    Genetically-based risk for schizophrenia, a highly polygenic condition, may contribute to a continuum of schizophrenia-related phenotypes between clinical populations and healthy populations. Using data from the literature as well as novel genotype and methylation data, I present evidence that schizophrenia risk alleles influence cognition in non-clinical populations, both individually, and together. Additionally, I find evidence that these alleles may be maintained across evolutionary time d...

  20. [Social aspect of clinical research in Poland].

    Science.gov (United States)

    Masełbas, Wojciech; Czarkowski, Marek

    2007-12-01

    Each year more than 400 new clinical studies are registered in Poland. They gather above 50.000 of study participants. Social opinion on clinical trials is an important factor. The paper presents the review of actual opinions on clinical research in Poland. It provides the description of standards of protection of study participants, benefits and risks related to the participation in clinical research and the role of media in creating and influencing of the social perception of clinical trials. Results of conducted questionnaire studies imply that Poles correctly identify and assess the risk of participation in clinical experiments. The primary reason for the participation seams to be the possibility to help other patients, contribution to the progress of science and standards of medical care and potential benefits for other sufferers. The need of testing the safety and efficacy of the new medication in man is generally well recognized. At the same time a substantial part of the society is concerned with the possible corruption of investigators and unethical behaviour of sponsors. The social perception of clinical research in Poland is in majority of analyzed parameters not substantially different from opinions in other member states of EU. However, the medical society should be more active in influencing and changing some negative impressions. PMID:18432135

  1. Understanding change in clinical nursing practice.

    Science.gov (United States)

    Copnell, B

    1998-03-01

    The present paper employs a poststructural framework to explore the construction of change in clinical nursing practice, as portrayed in nursing literature. In it a critique of two specific bodies of literature is offered: that which deals with the 'abstract' conception of change (but which is heavily influenced by organizational discourses) and that which describes changes in the clinical setting of critical care nursing practice. It is argued that the discursive constitution of change that is revealed in this analysis disadvantages clinical nurses. Because the context in which change occurs is largely unacknowledged, clinical nursing practice, as experienced and understood by nurses, is also marginalized. Change in clinical practice is under-researched, and such inquiry should be undertaken from the perspective of nurses themselves, and requires an exploration of the discursive context of nursing work. PMID:9611575

  2. Nursing students in clinical practice--developing a model for clinical supervision.

    Science.gov (United States)

    Häggman-Laitila, Arja; Elina, Eriksson; Riitta, Meretoja; Kirsi, Sillanpää; Leena, Rekola

    2007-11-01

    The aim of this study was to develop a model for clinical supervision to promote the clinical practice of nursing students. The study was implemented in Finland and it was carried out in three phases. Firstly, data were collected by means of a literature review and focus group interviews. Secondly, the data were analysed and described in expert groups, and finally the model itself was evaluated by 23 nursing experts. The data of literature review and focus group interviews consisted of 27 studies and four groups from three organisations: nurses (n=7), managers (n=6), teachers (n=8) and students (n=6). The data were analysed by qualitative content analysis. The model devolved from the study includes the concepts describing prerequisites, content and influence of clinical supervision. The prerequisites are nursing skills, a holistic view of the nursing curriculum, pedagogical, organisational, development, cooperation and interaction competence and decision-making skills. The content of clinical supervision includes support of professional development, pedagogical competence, research and development activities and collaborative working. Clinical supervision has influence on students' professional and personal development and conception of the future of nursing profession, students' preparedness for career planning and the teacher's and preceptor's professional development. The model could unify the notions of all parties concerned of the prerequisites, content and influence of clinical supervision. Furthermore, the entire supervision process and its control could be clarified. The model may be utilised in selecting and educating preceptors and evaluating the quality of clinical supervision. PMID:17936544

  3. 江西省美沙酮维持治疗门诊工作人员职业倦怠现状及其相关影响因素%Status of Occupational Burnout and Its Influencing Factors in Staff of Methadone Maintenance Treatment Clinics in Jiangxi

    Institute of Scientific and Technical Information of China (English)

    李燕; 廖清华; 龚俊平; 周小军; 毛文飞; 赵雪; 罗芳

    2015-01-01

    目的:了解江西省美沙酮维持治疗门诊(以下简称 MMT 门诊)工作人员的职业倦怠现状及其相关影响因素,为有效降低职业倦怠和改善其身心健康提供依据。方法采用定量问卷调查法对江西省所有 MMT 门诊工作人员进行普查,职业倦怠影响因素采用χ2检验、非条件 Logistic 回归进行分析。结果江西省124名 MMT 门诊工作人员的职业倦怠发生率为48.39%,以轻度职业倦怠为主占45.97%,中度职业倦怠占2.42%,未见重度职业倦怠情况出现。工作倦怠状态以情感衰竭为主。单因素研究结果显示,年龄和工作年限对情感衰竭维度有一定影响,30~39岁年龄段、工作年限4~6年的工作人员情感衰竭倦怠情况显著(P <0.05)。多元逐步非条件 Logistic回归结果显示,学历、月平均收入对 MMT 门诊工作人员的职业倦怠有影响,学历越低、月收入越高,越容易发生职业倦怠。结论江西省 MMT 门诊工作人员整体处于轻度工作倦怠状态,主要表现为情感衰竭。提示应重点关注较年轻、工作年限相对较少、学历低和月收入高者等人群,并同时进行相应干预。%ABSTRACT:Objective To explore the status of occupational burnout and its influencing factors in staff of methadone maintenance treatment(MMT)clinics in Jiangxi province,and to provide a basis for effectively reducing occupational burnout and improving their physical and psychological health.Methods The medical staff of MMT clinics were surveyed using the quantitative ques-tionnaire.The factors influencing occupational burnout were analyzed usingχ2 test and uncondi-tional logistic regression.Results The prevalence of occupational burnout was 48.39% among the 124 staff of MMT clinics.The mild and moderate burnout accounted for 45.97% and 2.42%, respectively.No severe burnout occurred in the staff.The main job burnout status was emotional

  4. Broadening our understanding of clinical quality: from attribution error to situated cognition.

    Science.gov (United States)

    Artino, A R; Durning, S J; Waechter, D M; Leary, K L; Gilliland, W R

    2012-02-01

    The tendency to overestimate the influence of personal characteristics on outcomes, and to underestimate the influence of situational factors, is known as the fundamental attribution error. We argue that medical-education researchers and policy makers may be guilty of this error in their quest to understand clinical quality. We suggest that to truly understand clinical quality, they must examine situational factors, which often have a strong influence on the quality of clinical encounters.

  5. Hypothesis Formation and Testing in Clinical Judgment.

    Science.gov (United States)

    Strohmer, Douglas C.; And Others

    1983-01-01

    Examined the influence of cognitive complexity and client observation on the quality of clinical hypotheses counselors develop and the number of questions generated to test them. Results showed no effect of these variables on hypothesis quality; but a significant interaction between client observations on the number of questions developed. (LLL)

  6. Clinical Effectiveness and Influence on Adjacent Segments Degeneration after Single-level Anterior Cervical Fusion%单节段颈椎前路减压融合术对邻近节段退变的影响及疗效观察

    Institute of Scientific and Technical Information of China (English)

    郑兆君; 邱玉金; 刘文华; 李军磊; 曹亮波

    2013-01-01

    Objective To evaluate the clinical effectiveness and influence on adjacent segments degenera-tion after single-level anterior cervical fusion.Methods A retrospective study was given to 40 patients who underwent single-level anterior cervical fusion from Aug.2007 to Dec.2010 and 40 patients with cervical spondylosis of the same age for the same period(imaging showed only a single segment lesions ) underwent conservative therapypatient .The disc degeneration were evaluated using intervertebral disc height and disc Pfirrmann MRI degeneration score .The clinical ef-fectiveness were evaluated using cervical JOA score ,the neck disability index(NDI) .Results The surgical group and conservative group had a statistically significant difference (P0.05) in cervi-cal JOA score and NDI than 1 week after that.Conclusion Anterior cervical discectomy and fusion can lead to degener-ation at the adjacent segment,but the clinical effectiveness are worthy of recognition .%  目的探讨单节段颈椎前路减压融合术对邻近节段退变的影响及手术疗效.方法回顾性分析2007年8月~2010年12月我科收治的40例行单节段颈椎前路减压融合术患者及同期同年龄段颈椎病(影像学显示仅单节段病变)且行保守治疗的患者资料.采用椎间隙高度及椎间盘Pfirrmann MRI退变评分作为评价椎间盘退变指标;采用颈椎JOA评分、颈椎功能障碍指数(NDI)作为手术疗效评价指标.结果术后24个月时,与对照组相比,手术组邻近节段椎间隙高度明显降低,差异有统计学意义(P0.05).结论颈椎前路减压融合术后邻近节段易发生退变,但疗效值得肯定.

  7. 临床心灵关怀对癌症居家姑息护理病人焦虑及抑郁水平的影响%Influence of clinical spiritual care on anxiety and depression level of cancer patients receiving home palliative care

    Institute of Scientific and Technical Information of China (English)

    杨辉; 刘晓红; 黄旭芬

    2016-01-01

    [目的]探讨临床心灵关怀对癌症病人居家姑息护理过程中焦虑、抑郁情绪的影响。[方法]将90例癌症晚期病人随机分为两组,对照组给予常规居家姑息医疗服务,干预组在对照组的基础上进行系统的临床心灵关怀服务。采用 Zung 焦虑自评量表(SAS)和抑郁自评量表(SDS)对病人的焦虑和抑郁水平进行测评。[结果]两组干预后焦虑发生率、抑郁发生率比较差异有统计学意义(P<0.05)。[结论]对居家姑息护理的癌症病人进行系统的临床心灵关怀可以有效降低焦虑以及抑郁的发生率,缓解病人的焦虑、抑郁症状。%Objective:To probe into the influence of clinical spiritual care on anxiety and depression of cancer pa-tients during home palliative care.Methods:A total of 90 patients with advanced cancer were randomly divided into two groups.The patients in control group received conventional home palliative care services,and the pa-tients in intervention group received the systematic clinical care service on the basis of the conventional home palliative care services.Zung self Rating Anxiety Scale(SAS)and Self Rating Depression Scale(SDS)were used to evaluate the level of anxiety and depression in patients.Results:There was statistically significant difference in the incidence of anxiety and depression between both groups(P<0.05).Conclusion:The systematic clinical spiritual care for cancer patients receiving home palliative care could reduce the incidence of anxiety and depres-sion effectively,and relieve the symptoms of anxiety and depression of cancer patients.

  8. Genome-wide association study of clinical dimensions of schizophrenia

    DEFF Research Database (Denmark)

    Fanous, Ayman H; Zhou, Baiyu; Aggen, Steven H;

    2012-01-01

    Multiple sources of evidence suggest that genetic factors influence variation in clinical features of schizophrenia. The authors present the first genome-wide association study (GWAS) of dimensional symptom scores among individuals with schizophrenia....

  9. 75 FR 8368 - Advisory Committee for Pharmaceutical Science and Clinical Pharmacology; Notice of Meeting

    Science.gov (United States)

    2010-02-24

    ... Science and Clinical Pharmacology. General Function of the Committee: To provide advice and... examines the genetic differences that influence a person's responses, both beneficial and harmful,...

  10. 临床实习初期带教教师支持、个人应激、个人应对方式对护生身心健康的影响%Study on the influence of nursing students' perceptions of instructors' support, stress and coping strategies on their physiopsycho-social response in initial period of clinical practice

    Institute of Scientific and Technical Information of China (English)

    彭玉洁; 周兰姝; 张译文; 顾李妍; 冀鹏飞; 林莉; 李娟

    2013-01-01

    Objective: To explore the influence of nursing students' perceptions of clinical instructors' support, stress and coping strategy on their physio-psycho-social response in initial period of clinical practice. Methods: A convenient sample of 370 nursing students in a tertiary class-A hospital in Shanghai in initial period of clinical practice were surveyed with Nursing Students' Perceptions of Instructor Caring (NSPIC), Perceived Stress Scale(PSS), Coping Behavior Inventory (CBI) and Professional Identification Scale(PIS). Results: It showed a significant positive correlation between stress, avoidance and physio-psycho-social response (P<0.01), as well as a significant negative correlation between instructors' support, staying optimistic, problem solving and physio-psycho-social response (P<0.01). Multi-stepwise regression analysis showed instructors' support, stress and coping strategy are the predictors of physio-psycho-social response. Conclusion: The clinical instructors should strengthen the support for the nursing students in initial period of clinical practice, encourage them to develop positive and efficient coping strategies, and increase their problem solving ability, therefore to reduce their physio-psycho-social response, and improve their physio-psycho-social health status.%目的:了解护生在临床实习初期临床带教教师支持、个人应激、个人应对方式对其身心健康的影响.方法:采用《教师支持问卷》《护生临床学习应激量表》《应对行为问卷》《生理-心理-社会反应量表》,对在上海某三级甲等医院实习1~3个月的370名护生进行调查.结果:护生临床实习初期应激水平、回避行为与生理-心理-社会反应呈正相关(P<0.01),教师支持、乐观应对、解决问题与生理-心理-社会反应呈负相关(P<0.01);多元线性逐步同归分析显示,教师支持、个人应激、个人应对方式是生理-心理-社会反应的影响因素.结论:在

  11. Maternal characteristics and clinical diagnoses influence obstetrical outcomes in Indonesia.

    Science.gov (United States)

    Adisasmita, Asri; Smith, Carl V; El-Mohandes, Ayman A E; Deviany, Poppy Elvira; Ryon, Judith J; Kiely, Michele; Rogers-Bloch, Quail; Gipson, Reginald F

    2015-07-01

    This Indonesian study evaluates associations between near-miss status/death with maternal demographic, health care characteristics, and obstetrical complications, comparing results using retrospective and prospective data. The main outcome measures were obstetric conditions and socio-economic factors to predict near-miss/death. We abstracted all obstetric admissions (1,358 retrospective and 1,240 prospective) from two district hospitals in East Java, Indonesia between 4/1/2009 and 5/15/2010. Prospective data added socio-economic status, access to care and referral patterns. Reduced logistic models were constructed, and multivariate analyses used to assess association of risk variables to outcome. Using multivariate analysis, variables associated with risk of near-miss/death include postpartum hemorrhage (retrospective AOR 5.41, 95 % CI 2.64-11.08; prospective AOR 10.45, 95 % CI 5.59-19.52) and severe preeclampsia/eclampsia (retrospective AOR 1.94, 95 % CI 1.05-3.57; prospective AOR 3.26, 95 % CI 1.79-5.94). Associations with near-miss/death were seen for antepartum hemorrhage in retrospective data (AOR 9.34, 95 % CI 4.34-20.13), and prospectively for poverty (AOR 2.17, 95 % CI 1.33-3.54) and delivering outside the hospital (AOR 2.04, 95 % CI 1.08-3.82). Postpartum hemorrhage and severe preeclampsia/eclampsia are leading causes of near-miss/death in Indonesia. Poverty and delivery outside the hospital are significant risk factors. Prompt recognition of complications, timely referrals, standardized care protocols, prompt hospital triage, and structured provider education may reduce obstetric mortality and morbidity. Retrospective data were reliable, but prospective data provided valuable information about barriers to care and referral patterns. PMID:25656716

  12. SUITO Index for Evaluation of Clinical Islet Transplantation

    OpenAIRE

    Takita, Morihito; Matusmoto, Shinichi

    2012-01-01

    The major endpoints for clinical islet transplantation for type 1 diabetes are insulin independence and reduction of hypoglycemic episodes. Both endpoints are influenced by patients’ and physicians’ preferences regarding the use of exogenous insulin. Therefore, development of an objective endpoint for assessing clinical islet transplantation is desirable. HOMA-beta score is useful in assessing functional β-cell mass. However, this score uses blood insulin levels that are influenced by exogeno...

  13. Factors influencing dental decision making.

    Science.gov (United States)

    Grembowski, D; Milgrom, P; Fiset, L

    1988-01-01

    In clinical decision making, dentists routinely choose between alternative treatments such as crown vs amalgam/composite buildup, root canal vs extraction, fixed bridge vs removable partial denture, and prophylaxis vs subgingival curettage or periodontal scaling. A number of technical and patient factors can influence dentists' choice of treatment in these situations; however, little is known about their relative importance. To address this issue, a list of technical (e.g., periodontal status and caries rate) and patient (e.g., cost and patient preference) factors possibly influencing choice of treatment was developed for each pair of services. Responding to a mail questionnaire, 156 general dentists in Washington State listed the top three factors influencing their choice of service in each pair. Results revealed that dentists took different factors into account in choosing among alternative treatments. Technical factors dominated over patient concerns; only about 33 percent of the dentists considered patient factors important in choosing alternative therapies. The latter group was less preventively oriented, were solo practitioners, worked longer hours, and had lower prices. Results suggest patients may have little influence on prescriptions of therapy among experienced general dentists. PMID:3045303

  14. The Relationship between Clinical Competence and Clinical Self-efficacy among Nursing and Midwifery Students

    Directory of Open Access Journals (Sweden)

    Shahla Mohamadirizi

    2015-12-01

    Full Text Available Introduction  Self-efficacy in clinical performance had an important role in applying competencies; also competencies and self-efficacy in clinical performance influenced to quality care of nursing and midwifery students. So the present study aimed to define the relationship between clinical competencies and clinical self-efficacy among nursing and midwifery students. Materials and Methods  This is a cross-sectional study conducted on 150 of nursing and midwifery students in Isfahan University of Medical Science, selected through two stage sampling in 2014. The participant completed questionnaires about personal/ educational characteristics and nursing competencies questionnaire (18 items and clinical self-efficacy scale (37 items. The data were analyzed by, Pearson statistical test, t-test, variance analysis through SPSS version16. Results The results showed that 50% (n=75 and 37.4% (n=56 of nursing and midwifery students had good clinical competence and clinical Self-Efficacy, respectively. Also the mean competencies and self-efficacy in clinical performance scores were 35.05± 1.2 and 76.03± 0.4 respectively. Pearson correlation coefficient showed that there was a positive linear correlation between the score of clinical competence and clinical self-efficacy (P

  15. HISTIOCYTOSIS X: CLINICAL OBSERVATIONS

    Directory of Open Access Journals (Sweden)

    E. Y. Ponomareva

    2014-07-01

    Full Text Available Two clinical cases of pulmonary Langerhans cell histiocytosis X have been analyzed demonstrating lung and other inner organ pathology, common clinical and X-ray features but different life prognosis.

  16. HISTIOCYTOSIS X: CLINICAL OBSERVATIONS

    OpenAIRE

    E. Y. Ponomareva; A. P. Rebrov; E. E. Archangelskaja; A. A. Roshchina; R. N. Steshenko; A. S. Bukia; N. V. Dvornikova; N. N. Moskaleva

    2014-01-01

    Two clinical cases of pulmonary Langerhans cell histiocytosis X have been analyzed demonstrating lung and other inner organ pathology, common clinical and X-ray features but different life prognosis.

  17. Fertility Clinic Success Rates

    Science.gov (United States)

    ... and Autism 2013 Assisted Reproductive Technology Fertility Clinic Success Rates Report Recommend on Facebook Tweet Share Compartir 2013 ART Fertility Clinic Success Rates Report [PDF - 1MB] Bookmarks and thumbnails are ...

  18. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... trial is to find out if an experimental drug, therapy, medical device, lifestyle change, or test will ... disease. Phases of Clinical Trials Clinical trials of drugs are usually described based on their phase. The ...

  19. Clinical Laboratory Fee Schedule

    Data.gov (United States)

    U.S. Department of Health & Human Services — Outpatient clinical laboratory services are paid based on a fee schedule in accordance with Section 1833(h) of the Social Security Act. The clinical laboratory fee...

  20. Research Areas - Clinical Trials

    Science.gov (United States)

    Information about NCI programs and initiatives that sponsor, conduct, develop, or support clinical trials, including NCI’s Clinical Trial Network (NCTN) and NCI Community Oncology Research Program (NCORP) initiatives.

  1. NIH Clinical Centers

    Data.gov (United States)

    Federal Laboratory Consortium — The NIH Clinical Center consists of two main facilities: The Mark O. Hatfield Clinical Research Center, which opened in 2005, houses inpatient units, day hospitals,...

  2. Spina Bifida Clinic Directory

    Science.gov (United States)

    ... Bifida Clinic Children’s Hospital New Orleans 200 Henry Clay Avenue (Pediatric-22) New Orleans, LA 70118 504- ... www.reach-clinic.org Back to top Oregon Child Development & Rehabilitation Center Oregon Health & Science University (pediatric ...

  3. Improving Clinical Practices for Children with Language and Learning Disorders

    Science.gov (United States)

    Kamhi, Alan G.

    2014-01-01

    Purpose: This lead article of the Clinical Forum addresses some of the gaps that exist between clinical practice and current knowledge about instructional factors that influence learning and language development. Method: Topics reviewed and discussed include principles of learning, generalization, treatment intensity, processing interventions,…

  4. Clarifying students' feedback-seeking behaviour in clinical clerkships

    NARCIS (Netherlands)

    Bok, H.G.; Teunissen, P.W.; Spruijt, A.; Fokkema, J.P.; Beukelen, P. van; Jaarsma, D.A.; Vleuten, C.P.M. van der

    2013-01-01

    CONTEXT: Why and how do students seek feedback on their performance in the clinical workplace and which factors influence this? These questions have remained largely unanswered in research into workplace learning during clinical clerkships. Research on feedback has focused mainly on feedback provide

  5. Regional enteritis and gluten-free diet. A clinical study

    NARCIS (Netherlands)

    Merwe, Christiaan Frederik van der

    1974-01-01

    The purpose of this clinical study was to determine whether the use of a gluten-free diet influenced the course and prognosis of regional enteritis. Following a few clinical communications in the Dutch medical literature reporting favourable results obtained with the gluten-free diet in the treatmen

  6. Feedback-giving behaviour in performance evaluations during clinical clerkships

    NARCIS (Netherlands)

    Bok, Harold G J; Jaarsma, Debbie A D C; Spruijt, Annemarie; Van Beukelen, Peter; Van Der Vleuten, Cees P M; Teunissen, Pim W

    2015-01-01

    CONTEXT: Narrative feedback documented in performance evaluations by the teacher, i.e. the clinical supervisor, is generally accepted to be essential for workplace learning. Many studies have examined factors of influence on the usage of mini-clinical evaluation exercise (mini-CEX) instruments and p

  7. Influência das concavidades radiculares nas perdas clínicas de inserção, detectadas no exame clínico periodontal inicial The influence of root concavities on clinical attachment loss diagnosed at the initial evaluation of periodontal patients

    Directory of Open Access Journals (Sweden)

    Francisco Emilio PUSTIGLIONI

    1999-12-01

    Full Text Available O propósito deste estudo foi estabelecer a influência das concavidades radiculares na perda clínica de inserção (PCI diagnosticada no exame clínico periodontal inicial. Os dados de PCI foram obtidos dos primeiros e segundos pré-molares, caninos, incisivos laterais e centrais superiores e inferiores, de 163 pacientes. Os dados foram coletados das fichas periodontais dos pacientes que procuraram a Clínica do curso de Pós-Graduação em Periodontia da FOUSP. Foi realizada sondagem em todos os dentes para que se obtivesse as seguintes medidas: distância da linha esmalte cemento à margem gengival, profundidade clínica de sondagem (PCS nos sítios distovestibular (DV, centrovestibular (CV, mesiovestibular (MV, distolingual (DL, centrolingual (CL e mesiolingual (ML. Os dados foram incluídos no estudo quando pelo menos um dos sítios apresentasse PCI ³ 4 mm. Após a análise estatística (Friedman ANOVA test CV e CL mostraram valores de PCI estatisticamente menores para todos os dentes superiores e inferiores. Clinicamente CV mostrou os menores valores de perda clínica de inserção entre todos os dentes analisados, seguido de CL. Embora, baseados em nossos resultados, não exista correlação estatística entre PCI e a presença de concavidades radiculares, não podemos subestimar as últimas no exame clínico inicial, diagnóstico, prognóstico, planejamento cirúrgico e na fase de controle e manutenção do tratamento periodontal.The purpose of this study was to establish the influence of root concavities on clinical attachment loss (CAL that was diagnosed at the initial evaluation of periodontal patients. CAL data were analyzed in the following teeth of 163 patients: upper and lower second and first bicuspids, cuspids, lateral and central incisors. Data were retrieved from the initial dental chart of patients seeking treatment at the Periodontics Graduate Clinic, School of Dentistry, University of São Paulo. Probing was accomplished

  8. Influencing factors of mental health status of clinical medical students with different sexes in different grades of Yan'an university%某高校临床医学生心理健康状况及影响因素分析

    Institute of Scientific and Technical Information of China (English)

    赵菊梅; 惠毅博; 李万林

    2011-01-01

    Objective To study the mental health status and its influencing factors in clinical medical students I order to provide foundation to improve the mentality of clinical medical student. Methods 351 clinical medical student from medical college of Yan'an university were assessed with adolescent self-rating life events checklist(ASIEC).copini style questionnaire(CSQ). Eysenck personality questionnaire(EPQ) and symptomchecklist-90 scale (SCL-90). Result The rates of psychological symptoms were 0. 33% to 5. 82%, they were in turn compulsion, interpersonal sensitivity depression, bigoted, hostility, etc. The depression somatization, interpersonal sensitivity, and compulsion factors o scores on male are inferior to female. The bigoted factors of scores on female were inferior to male. There were signifi cant differences in compulsion, interpersonal sensitivity, somatization, depression among the three grades. There wa significant correlation among the factor scores of SCL - 90 and life events, coping style, steady emotion, neurotic ismconConclusion There are significant differences and characteristics in clinical medical students with different sexes I different grades. For the mental health, there are direct effects an d interaction among life events,coping style and personality.%目的 探讨临床医学生心理健康状况及其影响因素,为改善临床医学生的心理状况提供理论根据.方法 采用青少年生活事件量表(ASLEC),应对方式问卷(CSQ),艾森克个性问卷(EPQ),症状自测表(SCL-90),对某高校医学院351名临床医学生进行测查.结果 心理问题检出率为0.33%~5.82%,依次为偏执,人际敏感,强迫,抑郁,敌意,精神病性等.在偏执因子分中,男生高于女生;在躯体化,抑郁,人际敏感,强迫,因子分女生高于男生,其中躯体化高出显著.三个年级学生在强迫、人际关系敏感、躯体化、抑郁存在显著的差异性.生活事停,应对方式,情绪稳定,神经质,SCL-90

  9. Evolution of Clinical Enzymology

    OpenAIRE

    Büttner, J

    1981-01-01

    The evolution of clinical enzymology is discussed in relation to the history of general enzymology and clinical chemistry. The discussion is limited to the period from 1835 (definition of catalysis by Berzelius) to 1935 (description of the optical test by Warburg). In conclusion, a general account is given of the introduction of the concept of quantitative enzyme activity determination into clinical medicine.

  10. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... was provided by the National Library of Medicine Topic last reviewed: December 2013 For an enhanced version of this page please turn Javascript on. Participating in Clinical Trials About Clinical Trials A Research Study With Human Subjects A clinical trial is ...

  11. Clinical document architecture.

    Science.gov (United States)

    Heitmann, Kai

    2003-01-01

    The Clinical Document Architecture (CDA), a standard developed by the Health Level Seven organisation (HL7), is an ANSI approved document architecture for exchange of clinical information using XML. A CDA document is comprised of a header with associated vocabularies and a body containing the structural clinical information. PMID:15061557

  12. Conceptualizing clinical nurse leader practice: an interpretive synthesis.

    OpenAIRE

    Bender, M

    2015-01-01

    BACKGROUND: The Institute of Medicine's Future of Nursing report identifies the clinical nurse leader as an innovative new role for meeting higher health-care quality standards. However, specific clinical nurse leader practices influencing documented quality outcomes remain unclear. Lack of practice clarity limits the ability to articulate, implement and measure clinical nurse leader-specific practice and quality outcomes. PURPOSE AND METHODS: Interpretive synthesis design and grounded theory...

  13. Educational climate seems unrelated to leadership skills of clinical consultants responsible of postgraduate medical education in clinical departments

    DEFF Research Database (Denmark)

    Malling, Bente Vigh; Mortensen, Lene Sundahl; Scherpbier, Albert J J;

    2010-01-01

    The educational climate is crucial in postgraduate medical education. Although leaders are in the position to influence the educational climate, the relationship between leadership skills and educational climate is unknown. This study investigates the relationship between the educational climate...... in clinical departments and the leadership skills of clinical consultants responsible for education....

  14. 月经初潮年龄对中国女性乳腺癌临床病理特征及分子表型的影响%Influence of age at menarche on clinical pathological features and molecular phenotype in Chinese female breast cancer

    Institute of Scientific and Technical Information of China (English)

    孙刚; 王珂

    2015-01-01

    目的:探索中国女性月经初潮年龄对乳腺癌临床病理特征及分子表型的影响。方法:收集本院收治的女性乳腺癌临床资料共210例,按月经初潮年龄分为≤13岁组和>13岁组,采用卡方检验分别比较各组间临床病理特征及分子表型的差异。结果:月经初潮年龄越早(≤13岁),腋窝淋巴结转移几率越高,同时肿瘤分期越晚(P <0.05);初潮年龄越早,非 Luminal 型出现的比例越高(P <0.05)。结论:月经初潮越早,乳腺癌的恶性程度越高并且多呈现出非 Luminal 型的分子表型。%Objective:To investigate the influence of age at menarche on tumor clinical characteristics and molec-ular subtypes in Chinese females with breast cancer.Methods:The clinical findings of 2 1 0 Chinese females with breast cancer were divided into 2 groups:≤13 years old and >13 years old,then analyzed as age at menarche retro-spectively.Results:The age of menarche ≤13 years old was a higher risk factor of axillary lymph nodes metastasis, later TNMstaging and non -Luminal subtype than that of >13 years old(P <0.05).Conclusion:Earlier age at menarche might be related to higher grade malignancy,TNMstaging and appearance of non -Luminal subtype in Chi-nese females with breast cancer.

  15. University cardiology clinic.

    Science.gov (United States)

    Borozanov, V

    2013-01-01

    In distant 1972, within framework of the Internal Clinic, a cardiologic department was organized which was soon, on 29.XII.1974, transformed into the Cardiology Clinic, later the Institute for Heart Diseases, and in 2008 was renamed the University Cardiology Clinic. The greater part of its foundation was possible owing to Prof. Dimitar Arsov and Prof. Radovan Percinkovski, who was the clinic's first director in the period from 1974 to 1984. In 1985, the Clinic moved into its own new building, and in that way was physically detached from the Internal Clinics. Until its move to the new building, the Clinic functioned in the Internal Clinics building, organized as an outpatient polyclinic and inpatient infirmary department with clinical beds, a coronary intensive care unit and a haemodynamics laboratory equipped with the most modern equipment of that time. Today the Clinic functions through two integral divisions: an inpatient infirmary department which comprises an intensive coronary care unit and fourteen wards which altogether have 139 clinical beds, and the diagnostic centre which comprises an emergency clinic and day hospital, a communal and consultative outpatients' clinic functioning on a daily basis, through which some 300-350 patients pass every day, and diagnostic laboratories with a capacity of nearly 100 non-invasive and 20-30 invasive diagnostic procedures daily. The Clinic is a teaching base, and its doctors are educators of students at the Medical, Dental and Pharmacy Faculties, and also of students at the High School for Nurses and X-ray technicians, but also for those in Internal Medicine and especially Cardiology. The Clinic is also a base for scientific Masters' and post-doctoral studies, and such higher degrees are achieved not only by doctors who work here, but also by doctors from Medical Centres both in the country and abroad. Doctors working in this institution publish widely, not only a great number of books and monographs, but also original

  16. Clinical Process Intelligence

    DEFF Research Database (Denmark)

    Vilstrup Pedersen, Klaus

    2006-01-01

    knowledge to the point of care in a proactive manner. Attention has been on the translation of guidelines and the integration with the elec-tronic medical record (EMR). Less attention has been paid to the evaluation of clinical practice in relation to clinical guide-lines. I claim that single patient cases......, generalized processes de-ducted from many patient cases and clinical guidelines, are all guidelines that may be used in clinical reasoning. The differ-ence is the validity of the suggested actions and decisions. In the case of generalized processes deducted from EMRs, we have "what we usually do" practice i......Ideally, clinical guidelines are created from evidence based medicine. Translating the narrative semi-structured article for-mat of the clinical guidelines into a computable language makes it possible to utilize this information in IT-supported clinical reasoning, and thereby bring the relevant...

  17. Learning clinical reasoning.

    Science.gov (United States)

    Pinnock, Ralph; Welch, Paul

    2014-04-01

    Errors in clinical reasoning continue to account for significant morbidity and mortality, despite evidence-based guidelines and improved technology. Experts in clinical reasoning often use unconscious cognitive processes that they are not aware of unless they explain how they are thinking. Understanding the intuitive and analytical thinking processes provides a guide for instruction. How knowledge is stored is critical to expertise in clinical reasoning. Curricula should be designed so that trainees store knowledge in a way that is clinically relevant. Competence in clinical reasoning is acquired by supervised practice with effective feedback. Clinicians must recognise the common errors in clinical reasoning and how to avoid them. Trainees can learn clinical reasoning effectively in everyday practice if teachers provide guidance on the cognitive processes involved in making diagnostic decisions.

  18. The influence of biomaterials on inflammatory responses to cardiopulmonary bypass.

    Science.gov (United States)

    Courtney, J M; Matata, B M; Yin, H Q; Esposito, A; Mahiout, A; Taggart, D P; Lowe, G D

    1996-05-01

    The nature of cardiopulmonary bypass and the complexity of the inflammatory response make the detection and interpretation of a biomaterial influence difficult. However, if mediation of the inflammatory response is considered to be an appropriate clinical goal, alteration to the biomaterial influence merits further investigation.

  19. 苗族村寨留守老年患者门诊服务利用及影响因素分析%Utilization of out-patient clinic service and influencing factors among left-behind old people in Miao minority villages

    Institute of Scientific and Technical Information of China (English)

    胡健; 武飚; 武学丽; 冉晓鸣

    2012-01-01

    . Conclusion The level of out-patient clinic service utilization was low among the left-behind old people. The utilization was influenced by health care knowledge, severity of illness, and the distance from the residence to the medical facility.%目的 了解苗族村寨农村留守老年人患病时门诊服务利用状况,分析其影响因素.方法 2011年7月选取贵州省黔东南苗族侗族自治州施秉县梨山坪、屯上、板屯3个苗族村寨112例≥60岁留守老年患者进行面访问卷调查,采用多元logistic逐步回归方法分析影响因素.结果 留守老年人2周患者就诊率为47.3% (53/112),2周患者未就诊率为52.7% (59/112);53例农村留守老年人就诊地点为村卫生室占66.0%( 35/53),乡镇卫生院及以上医疗机构占34.0% (18/53);候诊时间≥1h占73.6% (39/53),<1h占26.4%( 14/53);医生在患者就诊时未告诉患者相关卫生保健知识占79.2% (42/53),告诉占20.8% (11/53);未向患者清晰解释病情占64.2%( 34/53),清晰解释病情占35.8%(19/53);医生未很好地介绍治疗方案占52.8% (28/53),很好地介绍治疗方案者占47.2% (25/53);就诊满意占52.8% (28/53),不满意占47.2% (25/53);留守老年人患者不同说汉语能力、医疗单位距离、卫生保健知识、自感患病严重2周患者就诊情况比较,差异均有统计学意义(x2=6.02、5.11、8.21、7.08,P<0.05或P<0.01);卫生保健知识(OR =4.13)、自感患病严重(OR=2.27)对门诊服务利用具有正向预测作用,医疗单位距离( OR =0.43)具有负向预测作用.结论 留守老年人门诊服务利用程度较低,卫生保健知识、自感患病严重、医疗单位距离对门诊服务利用有影响.

  20. Integrating clinical research into clinical decision making

    Directory of Open Access Journals (Sweden)

    Mark R Tonelli

    2011-01-01

    Full Text Available Evidence-based medicine has placed a general priority on knowledge gained from clinical research for clinical decision making. However, knowledge derived from empiric, population-based research, while valued for its ability to limit bias, is not directly applicable to the care of individual patients. The gap between clinical research and individual patient care centers on the fact that empiric research is not generally designed to answer questions of direct relevance to individual patients. Clinicians must utilize other forms of medical knowledge, including pathophysiologic rationale and clinical experience, in order to arrive at the best medical decision for a particular patient. In addition, clinicians must also elucidate and account for the goals and values of individual patients as well as barriers and facilitators of care inherent in the system in which they practice. Evidence-based guidelines and protocols, then, can never be prescriptive. Clinicians must continue to rely on clinical judgment, negotiating potentially conflicting warrants for action, in an effort to arrive at the best decision for a particular patient.

  1. Clinical photography among African cleft caregivers

    Directory of Open Access Journals (Sweden)

    Peter Babatunde Olaitan

    2011-01-01

    Full Text Available Objective: The aim of this paper is to document the practice of photography among clinicians whose daily work depends and is influenced so much by medical photography. Materials and Methods: Questionnaires documenting the bio data, place of practice, and experience of cleft caregivers with clinical photography were distributed. Knowledge of rules guiding clinical photography and adherence to them were also asked. Types of camera used were documented and knowledge of the value of clinical photographs were also inquired. Results: Plastic surgeons constitute the highest proportion of 27 (38.6%, followed by Oral and Maxillofacial surgeons with 14 (20.0%. Twenty one (30.0% of the respondents always, 21 (30.0% often, 12 (17.1% frequently, while 9 respondents sometimes took photographs of their patients. Suggested uses of clinical photographs included training, 52 (74.3%, education, 51 (72.9%, medicolegal, 44 (62.9% and advertisement, 44 (62.9% among others. Twenty two (31.4% did not know that there were standard guidelines for taking clinical photographs. Twenty three (32.9% of them did not seek the consent of the patients before taking clinical photographs. Conclusion: While the practice of clinical photography is high among African cleft caregivers, there is a need for further education on the issues of standard rules and obtaining consent from patients.

  2. Clinical photography among African cleft caregivers

    Science.gov (United States)

    Olaitan, Peter Babatunde; Oseni, Ganiyu Oladiran

    2011-01-01

    Objective: The aim of this paper is to document the practice of photography among clinicians whose daily work depends and is influenced so much by medical photography. Materials and Methods: Questionnaires documenting the bio data, place of practice, and experience of cleft caregivers with clinical photography were distributed. Knowledge of rules guiding clinical photography and adherence to them were also asked. Types of camera used were documented and knowledge of the value of clinical photographs were also inquired. Results: Plastic surgeons constitute the highest proportion of 27 (38.6%), followed by Oral and Maxillofacial surgeons with 14 (20.0%). Twenty one (30.0%) of the respondents always, 21 (30.0%) often, 12 (17.1%) frequently, while 9 respondents sometimes took photographs of their patients. Suggested uses of clinical photographs included training, 52 (74.3%), education, 51 (72.9%), medicolegal, 44 (62.9%) and advertisement, 44 (62.9%) among others. Twenty two (31.4%) did not know that there were standard guidelines for taking clinical photographs. Twenty three (32.9%) of them did not seek the consent of the patients before taking clinical photographs. Conclusion: While the practice of clinical photography is high among African cleft caregivers, there is a need for further education on the issues of standard rules and obtaining consent from patients. PMID:22279284

  3. Study on the influence of clinical nursing pathway for nursing satisfaction and self-care ability of patients with breast cancer%临床护理路径对乳腺癌患者护理满意度及自护能力的影响

    Institute of Scientific and Technical Information of China (English)

    马超慧; 呼敏; 郝桂琴

    2013-01-01

    Objective To investigate the influence of clinical nursing pathway for nursing satisfaction and self-care ability of patients with breast cancer. Methods 80 cases of breast cancer patients admitted to the affiliated hospital of Yan'an University from January 2010 to April 2011 were randomly divided into conventional group (n = 40) and intervention group (n = 40). The conventional group only received the routine nursing care, and the intervention group received clinical nursing pathway. The nursing satisfaction and self-care ability in 2 groups was observed and compared. Results The total rate of nursing satisfaction in the intervention group was 95.0%, the total rate of nursing satisfaction in the conventional group was 80.0%, so the nursing satisfaction in the intervention group was significantly higher than that of the conventional group (P < 0.05); the scores of the health care knowledge, self-concept, self-care responsibility, self-care skills and the total score of self-care ability in the intervention group was significantly higher than that of the conventional group (P < 0.05). Conclusion The clinical nursing pathway can improve the nursing satisfaction and self-care ability of patients with breast cancer.%目的 探讨临床护理路径对乳腺癌患者护理满意度和自护能力的影响.方法将2010年1月~2011年4月延安大学附属医院诊治的80例乳腺癌患者随机分成常规组(40例)和干预组(40例).常规组患者给予常规护理;干预组采用临床护理路径方案.观察比较两组患者的护理满意度和自护能力.结果干预组的总满意率为95.0%,常规组的总满意率为80.0%,干预组患者对护理工作的满意度明显高于常规组(P < 0.05);干预组患者的护理后的健康知识水平、自我概念、自护责任感、自我护理技能评分以及自护能力总分均显著高于常规组(P < 0.05).结论临床护理路径既可以提高患者对护理工作的满意度,又能够改善患者的自护能力.

  4. Influence of Cements for Bonding Fiber Posts and Clinical Experience of Dentists on the Coronal Microleakage of Post-core Restoration%不同粘结系统及操作者临床经验及对纤维桩冠方微渗漏的影响

    Institute of Scientific and Technical Information of China (English)

    张志闻; 何海波; 杭东跃

    2013-01-01

    Objective :To evaluate Influence of cements for bonding fiber posts and clinical experience of dentists on the coronal microleakage of post-core restoration .Methods :Selected 60 teeth were randomly divided into three groups ac-cording to the kind of cements .Each of the group was randomly divided into two subgroups according to the clinical ex-perience of dentists ,expert and resident doctor .Bongding the posts to prepared root canals and reconstruct cores .The specimens were immersed in distilled water for one month .After dye and transparent .Each tooth was observed under stereoscopic microscope and the dyeing scores were recorded .Results:The microleakage degrees among three resin bonding cements were significantly different ,and group Paracore 5ml showed the least microleakage compared with oth-er three cements .Group RelyX Unicem showed the biggest microleakage .Conclusion:Dinfferent kinds of resin bonding cement have different degrees of the cronal microleakage of post-core restoratios .When the instructions for use of the resin cements were followed strictly ,the microleakage degrees were not affected by the clinical experience of dentists .%目的:为了评价不同粘结系统及操作者临床经验及对纤维桩冠方微渗漏的影响。方法:60颗人上颌前牙经过根管预备处理后根据使用的粘结系统随机分为3组,RelyX Unicem组,Clearfil DC Core Automix 组,Paracore 5ml组,分别为每组20个样本。以上3组每组再根据粘结操作者的临床经验随机分为两个亚组,一组为专家组,一组为医师组。将纤维桩粘结至根管并制作树脂核后,将样本置入37℃水中存储1个月。经染色及透明化处理。在体式显微镜下记录各亚组的微渗漏得分。结果:RelyX Unicem组纤维桩冠方微渗漏最严重。Paracore 5ml组纤维桩冠方微渗漏最轻。Clearfil DC Core Automix组微渗漏程度位于两者之间。纤维桩的粘结后的微渗漏情况不受临床

  5. Fatores clínicos e anatomopatológicos que influenciam a sobrevida de pacientes com câncer de mama e derrame pleural neoplásico Clinical and pathological factors influencing the survival of breast cancer patients with malignant pleural effusion

    Directory of Open Access Journals (Sweden)

    Giovana Tavares dos Santos

    2012-08-01

    Full Text Available OBJETIVO: O objetivo deste estudo foi identificar os fatores clínicos e anatomopatológicos que possam influenciar o prognóstico de pacientes com câncer de mama e sintomas clínicos de derrame pleural neoplásico. MÉTODOS: Trata-se de um estudo clínico de coorte, no qual foram analisados os prontuários médicos de pacientes que receberam diagnóstico de derrame pleural neoplásico entre 2006 e 2010. Por meio da análise dos prontuários, identificamos as pacientes com história de câncer de mama. Para essas pacientes, coletamos dados anatomopatológicos relacionados ao tumor primário e dados citopatológicos relacionados à metástase pleural. RESULTADOS: Das 145 pacientes avaliadas, 87 (60% apresentaram, no exame citológico, resultado positivo para células neoplásicas no líquido pleural; além disso, 119 (82% apresentaram tipo histológico ductal. O fenótipo triplo-negativo foi observado em 25 pacientes (17%, as quais apresentaram o pior prognóstico, com queda acentuada na curva de sobrevida. Das 25 pacientes, 20 (80% evoluíram a óbito durante o período de seguimento (até junho de 2011. A sobrevida média após a identificação de derrame pleural neoplásico foi de 6 meses. CONCLUSÕES: Em pacientes com câncer de mama triplo-negativo e exame citológico com resultado positivo para células neoplásicas no líquido pleural, o prognóstico é ruim e a sobrevida é menor.OBJECTIVE: The objective of this study was to identify the clinical and pathological factors that can influence the prognosis of breast cancer patients with clinical symptoms of malignant pleural effusion. METHODS: This was a clinical cohort study, in which we analyzed the medical charts of patients diagnosed with malignant pleural effusion between 2006 and 2010. By examining the charts, we identified the female patients with a history of breast cancer. For those patients, we collected pathology data related to the primary tumor and cytopathology data related

  6. Clinical effect and influenc e of immune function of gatifloxacin sequential therapy in the treatment of elderly patients with lower respiratory tract infection%加替沙星序贯治疗对老年下呼吸道感染患者免疫功能的影响及疗效

    Institute of Scientific and Technical Information of China (English)

    杜昆玉; 刘汉坤; 黄正有

    2015-01-01

    Objective:To inquiry the effect of Gatifloxacin Sequential Therapy`s influence on immune function and clinical effect in elderly patients with respiratory tract infection. Methods:76 patients were randomly divided into observation group and control group with 38 cases in each group. The observation group received Gatifloxacin Sequential therapy treatment scheme, the control group received routine treatment schemes of levofloxacin. Clinical effect and changes of laboratory index of immune function were compared between the two groups during the treatment. Results:The observation group were treated with a total effective rate of 92.1%, higher than that in the control groups of 81.6%(P0.05), but in the observation group of bacterial clearance rate(89.2%) was significantly higher than that in control group(P<80.6%; 0.05); and adverse reaction in observation group was less than that in the control group (P<0.05). Conclusion:The effect of Gatifloxacin Sequential Therapy on immune function and clinical effect in patients with lower respiratory tract infection in elderly patients is more effective , which has higher rate on the bacterial clearance and less adverse reaction.%目的:探究加替沙星序贯疗法在老年下呼吸道感染治疗过程中对患者免疫功能影响及临床疗效。方法:将患者按照随机数字表法分为观察组和治疗组。观察组接受加替沙星序贯疗法治疗,对照组接受左氧氟沙星常规治疗。比较两组患者药物治疗前后免疫功能实验室指标变化及临床疗效。结果:观察组治疗的总有效率为92.1%,高于对照组的81.6%(P<0.05);两组患者痰培养病原菌的阳性率差异无统计学意义(P>0.05),但观察组对细菌清除率(89.2%)显著高于对照组(80.6%;P<0.05);用药期间出现各类不良反应观察组较对照组少(P<0.05)。结论:加替沙星序贯疗法对于老年下呼吸道感染较常规左氧氟沙星治疗对

  7. Uterine artery embolization of uterine flesh tumour clinical curative effect and influence of ovarian function%子宫动脉栓塞术治疗子宫肌瘤的临床疗效及对卵巢功能的影响

    Institute of Scientific and Technical Information of China (English)

    冯桂松; 薛振美; 韩淑臻

    2013-01-01

    Objective To discuss the uterus artery embolization of uterine flesh tumour clinical curative effect and influence of ovarian function.Methods Participants included 52 routine uterine artery embolization of uterine flesh tumour patients,all patients were followed up for one year,observed the curative effects of all subjects and the influence of the rightness of ovarian function.Results After treatment,the results showed that the curative effects,after 3 months,6 months,12 months compared with the preoperative,uterine tumor size,volume were significantly smaller,menstrual cycle extended,menstrual quantity increased,uterine fibroids oppression,anemia patients were significantly reduced,the difference was statistically significant (t =3.23,3.18,x2 =2.98,4.57,4.42,2.18,respectively,P < 0.05) ; And after treatment with the extension of time,the symptoms and signs of patients were distinct improvement,the difference was statistically significant (t =2.66,2.57,x2 =3.45,5.12,6.54,3.67,respectively,P < 0.05).After treatment of ovarian function results showed that the effects,after 3 months,6 months,12 months compared with the preoperative,serum levels of estradiol (E2),progesterone (P),follicle-stimulating hormone (FSH),corpus luteum erythropoietin (LH),prolactin (PRL) level had no change,there were no statistically significant differences (P > 0.05).Conclusion Uterine artery embolization for treatment in patients with uterine fibroids has obvious curative effect,and the influence of ovarian function is not obvious.%目的 探讨子宫动脉栓塞术治疗子宫肌瘤的临床疗效及对卵巢功能的影响.方法 52例行子宫动脉栓塞术治疗的子宫肌瘤患者,均随访1年,观察所有受试者的疗效及术后对卵巢功能的影响.结果 术后3个月、6个月、12个月与术前比较,子宫体积、肿瘤体积均明显变小(t =3.23、3.18,均P<0.05),月经周期延长、月经量增多,子宫肌瘤压迫、贫血患者均明显减少(x2=2.98

  8. 左乙拉西坦对癫痫患者认知功能及情绪影响的临床研究%The Clinical Study about Levetiracetam of Cognitive Function and Emotional Influence in the Patients with Epilepsy

    Institute of Scientific and Technical Information of China (English)

    赵建法; 赵汉清; 乔莉霞; 陈升东; 于苏文

    2012-01-01

    目的:探讨左乙拉西坦对癫痫患者认知功能及情绪的临床影响.方法:选择同期癫痫患者60例,随机均分为对照组(n=30例)和观察组(n=30例),对照组患者给予丙戊酸钠治疗,观察组患者给予左乙拉西坦治疗,治疗第4w、8w、12w、16w比较两组患者蒙特利尔认知评估量表(MoCA)、神经电生理P300电位检查、焦虑自评量表(SAS)和抑郁自评量表(SDS)情况.结果:两组患者治疗第4w、第8w、第12w和第16w的MoCA评分和P300电位潜伏期时长比较,差异均具有统计学意义(P<0.05),观察组显著优于对照组;治疗第12w和第16w的SAS评分和SDS评分比较,差异均具有统计学意义(P<0.05),对照组显著优于观察组.结论:在癫痫患者的药物治疗过程中,左乙拉西坦对患者认知功能的改善优于丙戊酸钠,但对情绪的负性影响较丙戊酸钠明显.%Objective: To investigate the clinical influence about Levetiracetam of cognitive function and emotional influence in the patients with epilepsy. Method: 60 patients with epilepsy were collected. 30 patients were divided into the control group treated by Valproate, while 30 patients were divided into the observation group treated by Levetiracetam. MoCA Scale, Neuroelectrophysiological P300 potentials, SAS Scale and SDS Scale was detected at the 4th week's, 8th week's, 12th week's and 16th week's treatment. Result: There was significantdifference (P<0.05) in the MoCA score and P300 potential latency duration after the 4th week's, 8th week's,12th week's and 16th week's treatment, which was better in observation group than in control group. There was significantdifference(P<0.05) in the SAS Scale and SDS Scale after the 12th week's and 16th week's treatment, the control group showed better result than the observation group. Conclusion: In the process of treating the patients with epilepsy by drug, Levetiracetam is superior to Valproate on the improvement of cognitive function, but Levetiracetam

  9. Clinical Research Methodology 3: Randomized Controlled Trials.

    Science.gov (United States)

    Sessler, Daniel I; Imrey, Peter B

    2015-10-01

    Randomized assignment of treatment excludes reverse causation and selection bias and, in sufficiently large studies, effectively prevents confounding. Well-implemented blinding prevents measurement bias. Studies that include these protections are called randomized, blinded clinical trials and, when conducted with sufficient numbers of patients, provide the most valid results. Although conceptually straightforward, design of clinical trials requires thoughtful trade-offs among competing approaches-all of which influence the number of patients required, enrollment time, internal and external validity, ability to evaluate interactions among treatments, and cost.

  10. Thinking About Clinical Outcomes in Medicaid.

    Science.gov (United States)

    Quinn, Kevin; Weimar, Dawn; Gray, Jeffrey; Davies, Bud

    2016-01-01

    As Medicaid expands in scope and influence, it is evolving toward being a "purchaser" of quality health care. This commentary discusses measurement and incentivization of clinical outcomes in Medicaid. Advantages and disadvantages of outcome versus process measures are discussed. Distinctions are drawn between the roles of Medicare and Medicaid, including the implications of the growth in Medicaid managed care. Medicaid's influence is particularly notable for obstetric, pediatric, newborn, and long-term care. We provide data on 3 Medicaid outcomes: potentially preventable hospital admissions, readmissions, and complications. The commentary concludes with suggestions for choosing and implementing outcome-oriented value-based purchasing initiatives in Medicaid.

  11. Children and Clinical Studies: Why Clinical Studies Are Important

    Medline Plus

    Full Text Available ... NHLBI Trials Clinical Trial Websites Children and Clinical Studies Learn more about Children and Clinical Studies Importance of Children in Clinical Studies Children have often had to accept medicines and ...

  12. CME ON CLINICAL RESEARCH

    OpenAIRE

    Suneel. I. Majagi; S. S. Torgal; S. V. Hiremath

    2012-01-01

    Safety and efficacy are the two major concerns for any drug therapy. Globally clinical research plays an inevitable role in bringing a new molecule into the market after its synthesis by the pharmaceutical industries. Availability of large patient population, highly educated and skilled manpower, wide spectrum of diseases and favorable economic environment imply India’s potential as a global hub for clinical research. Pharmaceutical companies and Clinical Research Organization (CRO)s will req...

  13. Determinantes clínicos com influência no prognóstico da discectomia lombar: análise multifatorial Determinantes clínicos que influyen en el pronóstico de la disectomía lumbar: análisis multifactorial Clinical determinants' influence on lumbar discectomy prognosis: multi-factor analysis

    Directory of Open Access Journals (Sweden)

    Paulo Jorge Da Rocha Carvalho

    2010-03-01

    lumbares, los cuales fueron sometidos a la discectomía entre 2003 y 2007. El seguimiento promedio fue de 3.9±0.1 años. Los resultados clínicos fueron evaluados utilizando el JOA (Japonese Orthopaedic Association Assessment Scoring System score (JOA=29. RESULTADOS: los resultados postoperatorios buenos y excelentes fueron obtenidos en 75% de los pacientes. Enfermos del sexo masculino y la preponderancia de síntomas subjetivos sobre síntomas clínicos estuvieron asociados con los mejores resultados clínicos y con el regreso más precoz a la actividad laboral. El tiempo de espera para la cirugía no influyó en el resultado final. La necesidad de cirugía fue cuestionada en la ausencia de déficits neurológicos significativos (JOA para resultados clínicos >3/6. Un valor JOA preoperatorio > 15 (debilidad inicial baja está correlacionado con los peores resultados clínicos postoperatorios. CONCLUSIONES: el JOA score se presenta de fácil aplicación para clínicos y enfermos, uniformiza datos subjetivos y presenta un valor predictivo para los resultados de los pacientes sometidos a la discectomía lumbar.Inappropriate patient selection and timing for lumbar disc surgery are still the the major causes of failures. OBJECTIVE: We evaluated the clinical outcome and predictive factors that influence the prognosis of patients submitted to lumbar discectomy using a multivariate analysis model. METHODS: We report a prospective series of 68 patients with herniated lumbar disc who underwent limited discectomy during 2003 to 2007. The average follow-up period was 3.9±0.1 years. Clinical findings were evaluated using Japonese Orthopaedic Association Assessment Scoring System (JOA=29. RESULTS: Excellent and good postoperative improvement rates were obtained in 75% of the patients. Male gender and preponderance of subjective symptoms over clinical signs were associated with better clinical outcomes and faster return to work. Waiting time for surgery had no consistent effect on the

  14. Developing an empirical base for clinical nurse specialist education.

    Science.gov (United States)

    Stahl, Arleen M; Nardi, Deena; Lewandowski, Margaret A

    2008-01-01

    This article reports on the design of a clinical nurse specialist (CNS) education program using National Association of Clinical Nurse Specialists (NACNS) CNS competencies to guide CNS program clinical competency expectations and curriculum outcomes. The purpose is to contribute to the development of an empirical base for education and credentialing of CNSs. The NACNS CNS core competencies and practice competencies in all 3 spheres of influence guided the creation of clinical competency grids for this university's practicum courses. This project describes the development, testing, and application of these clinical competency grids that link the program's CNS clinical courses with the NACNS CNS competencies. These documents guide identification, tracking, measurement, and evaluation of the competencies throughout the clinical practice portion of the CNS program. This ongoing project will continue to provide data necessary to the benchmarking of CNS practice competencies, which is needed to evaluate the effectiveness of direct practice performance and the currency of graduate nursing education. PMID:18438164

  15. Clinical research informatics

    CERN Document Server

    Richesson, Rachel L

    2012-01-01

    This book provides foundational coverage of key areas, concepts, constructs, and approaches of medical informatics as it applies to clinical research activities, in both current settings and in light of emerging policies. The field of clinical research is fully characterized (in terms of study design and overarching business processes), and there is emphasis on information management aspects and informatics implications (including needed activities) within various clinical research environments. The purpose of the book is to provide an overview of clinical research (types), activities, and are

  16. Clinical management of progressive myopia.

    Science.gov (United States)

    Aller, T A

    2014-02-01

    Myopia has been increasing in prevalence throughout the world, reaching over 90% in some East Asian populations. There is increasing evidence that whereas genetics clearly have an important role, the type of visual environment to which one is exposed to likely influences the onset, progression, and cessation of myopia. Consequently, attempts to either modify the environment or to reduce the exposure of the eye to various environmental stimuli to eye growth through the use of various optical devices are well under way at research centers around the globe. The most promising of current treatments include low-percentage atropine, bifocal soft contact lenses, orthokeratology, and multifocal spectacles. These methods are discussed briefly and are then categorized in terms of their expected degree of myopia progression control. A clinical strategy is presented for selecting the most effective treatment for the appropriate type of patient at the optimal stage of refractive development to achieve the maximum control of myopia progression. PMID:24357844

  17. Influência das características sociodemográficas e clínicas e do nível de dependência na qualidade de vida de pacientes com DPOC em oxigenoterapia domiciliar prolongada Influence that sociodemographic variables, clinical characteristics, and level of dependence have on quality of life in COPD patients on long-term home oxygen therapy

    Directory of Open Access Journals (Sweden)

    Simone Cedano

    2012-06-01

    of dependence. METHODS: This was a cross-sectional analytical study involving COPD patients on LTOT followed at the Oxygen Therapy Outpatient Clinic of the Federal University of São Paulo Hospital São Paulo, in the city of São Paulo, Brazil. Sociodemographic, clinical, and biochemical data were collected. We assessed QoL and level of dependence using the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36 and the Katz index, respectively. Multiple linear regression models were constructed in order to determine the influence of these variables on QoL. RESULTS: We included 80 patients in the study. The mean age was 69.6 ± 9.1 years, and 51.3% were female. The lowest SF-36 scores were for the physical functioning and role-physical domains. All sociodemographic characteristics (except gender were found to correlate significantly with the SF-36 domains mental health, vitality, role-physical, and social functioning. We also found that body mass index, PaO2, post-bronchodilator FEV1, hemoglobin, and Katz index correlated significantly with the physical functioning, mental health, role-physical, and bodily pain domains. In addition, oxygen flows were found to correlate negatively with the physical functioning, mental health, vitality, and role-emotional domains. CONCLUSIONS: Low scores for SF-36 domains, as well as the variables that negatively influence them, should be considered and analyzed during the development and implementation of strategies for improving the QoL of COPD patients on LTOT.

  18. TARGET POPULATION FOR CLINICAL TRIALS ON SARCOPENIA

    OpenAIRE

    Cesari, Matteo; Pahor, Marco

    2008-01-01

    The term “sarcopenia” describes the progressive decline of muscle mass, strength and function occurring with aging. It is not considered a disease, but the direct consequence of the aging process on the skeletal muscle. Multiple demographic (e.g. gender, race), biological (e.g. inflammatory status) and clinical (e.g. diabetes, metabolic syndrome, congestive heart failure, medications) factors are able to influence (positively or negatively) the skeletal muscle quality and quantity. The extrem...

  19. Pharmacogenetics : the science of predictive clinical pharmacology

    OpenAIRE

    Fenech, Anthony G; Grech, Godfrey

    2014-01-01

    The study of pharmacogenetics has expanded from what were initially casual family-based clinical drug response observations, to a fully-fledged science with direct therapeutic applications, all within a time-span of less than 60 years. A wide spectrum of polymorphisms, located within several genes, are now recognised to influence the pharmacokinetics and pharmacodynamics of the majority of drugs within our therapeutic armamentarium. This information forms the basis for the new development of ...

  20. Clinical decision making in veterinary practice

    OpenAIRE

    Everitt, Sally

    2011-01-01

    Aim The aim of this study is to develop an understanding of the factors which influence veterinary surgeons’ clinical decision making during routine consultations. Methods The research takes a qualitative approach using video-cued interviews, in which one of the veterinary surgeon’s own consultations is used as the basis of a semi-structured interview exploring decision making in real cases. The research focuses primarily on small animal consultations in first opinion practice, how...

  1. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... In This Topic About Clinical Trials Risks and Benefits Terms to Know Finding a Clinical Trial Informed ... for more information Scientists usually do years of experiments in the laboratory and in animals before they even consider testing an experimental treatment ...

  2. Developing Clinical Competence

    NARCIS (Netherlands)

    P.F. Wimmers (Paul)

    2006-01-01

    textabstractThe development of clinical competence is the main purpose of medical education. The long road to become clinically competent starts on the first day of medical school, and every institution strives to select the best students. The responsibility of medical schools is to train th

  3. Clinical Supervision in Denmark

    DEFF Research Database (Denmark)

    Jacobsen, Claus Haugaard

    2011-01-01

    on giving and receiving clinical supervision as reported by therapists in Denmark. Method: Currently, the Danish sample consists of 350 clinical psychologist doing psychotherapy who completed DPCCQ. Data are currently being prepared for statistical analysis. Results: This paper will focus primarily...

  4. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... In This Topic About Clinical Trials Risks and Benefits Terms to Know Finding a Clinical Trial Informed ... years of experiments in the laboratory and in animals before they even ... this early research occurs at universities and medical centers across the ...

  5. Influência dos antígenos de histocompatibilidade humanos na susceptibilidade e expressão clínica de doenças psiquiátricas Influence of human histocompatibility antigens on susceptibility to and clinical expression of psychiatric diseases

    Directory of Open Access Journals (Sweden)

    Crésio Alves

    2006-08-01

    the pathogenesis of some psychiatric disorders. Development of new molecular methods to typify HLA alleles and recent nomenclature updates have been contributing to a better understanding of this system. Unfortunately, this information has not been adequately disclosed in the medical literature. This article aims to review HLA structure, antigen function, detection methods, and current nomenclature, as well as to describe its association with schizophrenia, bipolar disorder, and autism. Articles published between 1995 and 2005 (to reflect the most recent knowledge of the subject were searched in the MEDLINE and LILACS databases. It is concluded that HLA antigens influence risk, clinical status, and therapeutic response of some mental disorders, even if they do not act alone on these pathologic processes. Although HLA has been associated with schizophrenia (HLA-DRB1*0101, autism (HLA-DR4, and bipolar disorder (HLA class I, these associations vary across different ethnicities and clinical manifestations. The best definition of genetic markers associated with mental disorders is important to understand possible pathogenic mechanisms, predict individual risk of developing these diseases, and contribute to future prophylactic or therapeutic interventions.

  6. 正念行为训练联合音乐疗法对围绝经期临床护士心理状态及睡眠质量的影响%THE INFLUENCE OF MINDFULNESS TRAINING COMBINED WITH MUSIC BEHAVIORAL THERAPY TO THE PSYCHOLOGICAL STATUS AND SLEEP QUALITY OF PERIMENOPAUSAL CLINICAL NURSES

    Institute of Scientific and Technical Information of China (English)

    郝晶; 李淑杏; 陈长香; 王素娟; 雷鹏琼

    2016-01-01

    Objective To discusses the influence of mindfulness behavior training combined with music ther‐apy to the psychological status and sleep quality of perimenopausal clinical nurses .Method 110 perimeno‐pausal clinical nurses were randomly divided into two groups ,control group (55 cases) and the experimen‐tal group (55 cases) .The control group adopted music therapy ,and the experimental group adopted mind‐fulness behavior training on the basis of music therapy .After 6 weeks intervention ,all nurses'depression and anxiety were evaluated with depression scale (GDS) and Zung self rating anxiety scale (SAS);their sleep quality were evaluated with Pittsburgh sleep quality index scale (PSQI) and their mindfulness level were evaluated with Mindful Athention Awareness Scale (MAAS) .Result Before the intervention ,the differences of GDS ,Zung ,PSQI and MAAS score between the two groups had no statistical significance (P>0 .05);After the intervention ,the GDS ,Zung ,PSQI and MAAS score were improved ,and the differ‐ences had statistical significance (P<0 .05) .Compared with the control group after treatment ,the score of GDS and Zung decreased ,the PSQI and MAAS scores improved ,and the differences were statistically sig‐nificant different (P< 0 .05) .Conclusion The mindfulness behavior training combined with music therapy can effectively improve the nurses'psychological state of menopause ,improve their sleep quality .%目的:探讨正念行为训练联合音乐疗法对围绝经期临床护士的心理状态及睡眠质量的干预效果。方法选取110例围绝经期临床护士随机分为对照组(55例)和观察组(55例)。对照组采用音乐疗法,观察组在此基础上加以正念行为训练。所有护士在干预6周后,均采用抑郁量表和Zung焦虑自评量表评测抑郁、焦虑;匹兹堡睡眠质量指数量表评价睡眠质量情况;正念注意知觉量表评价正念尿平。结果干预前,二组焦虑、抑郁

  7. Influência dos níveis de prolactina e tamanho tumoral na função hipofisária pós-operatória em macroadenomas hipofisários clinicamente não-funcionantes Influence of hyperprolactinemia and tumoral size in the postoperative pituitary function in clinically nonfuncioning pituitary macroadenomas

    Directory of Open Access Journals (Sweden)

    Ana Luiza Vidal Fonseca

    2002-09-01

    Full Text Available OBJETIVO: Estudar a influência da hiperprolactinemia e de tamanho tumoral na função hipofisária em macroadenomas hipofisários clinicamente não funcionantes. MÉTODOS: Foram analisados 23 pacientes com macroadenomas hipofisários clinicamente não funcionantes, com exames de imagem (tomografia computadorizada ou ressonância magnética e dosagens hormonais basais; 16 tinham provas de função hipotálamo-hipofisária (megateste pré-operatórios. Todos os tumores tiveram diagnóstico histológico e em 17 foi realizado também estudo imuno-histoquímico para os hormônios adeno-hipofisários. A análise estatística foi feita por meio dos testes t de Student, qui-quadrado, exato de Fisher e de Mc Neman. O nível de significância adotado foi 5% (pOBJECTIVE: To study the influence of hyperprolactinemia and tumoral size in the pituitary function in clinically nonfuncioning pituitary macroadenomas. METHODS: Twenty three patients with clinically nonfuncioning pituitary macroadenomas were evaluated by image studies (computed tomography or magnetic resonance and basal hormonal level; 16 had preoperative hypothalamus-hypophysial function tests (megatests. All tumors had histological diagnosis and in seventeen immunohistochemical study for adenohypophysial hormones was also performed. Student's t test, chi square test, exact test of Fisher and Mc Neman test were used for the statistics analysis . The level of significance adopted was 5% (p<0.05. RESULTS: Tumoral diameter varied of 1.1 to 4.7 cm (average=2.99 cm ± 1.04. In the preoperative, 5 (21.7% patients did not show laboratorial hormonal deficit, 9 (39.1% developed hyperprolactinemia, 13 (56,5% normal levels of prolactin (PRL and 1 (4.3% subnormal; 18 (78.3% patients developed hypopituitarism (4 pan-hypopituitarism. Nineteen patients (82.6% underwent transsfenoidal approach, 3 (13% craniotomy and 1 (4.4% combined access. Only 6 patients had total tumoral resection. Of the 17 immunohistochemical

  8. 阿法骨化醇对维持性血液透析患者甲状旁腺激素的影响及临床意义%Clinical significance and influence of alfacalcidol on intact parathyroid hormone in maintenance hemodialysis patients

    Institute of Scientific and Technical Information of China (English)

    王东辉; 杜娟; 高寒; 胡曼丽; 田小海

    2015-01-01

    Objective To observe the influence of alfacalcidol on intact parathyroid hormone (iPTH) in maintenance hemodialysis patients, and to investigate its clinical significance.Methods Hemodialysis group (HD group) contained 24 patients with maintenance hemodialysis of chronic renal failure uremia for more than 6 months, and health control group (Con group) contained 22 health people in the same time period. HD group received 1μg/d of alfacalcidol and 2000 mg of calcium through oral administration. The observation lasted for 12 weeks. The renal function and blood electrolytes were detected in the two groups before and after treatment. Intact parathyroid hormone and bone gla protein (BGP) were detected by radioimmunoassay method.Results HD group had higher iPTH, BGP and serum creatinine (Cre), decreased blood calcium (Ca), and increased serum phosphate (P) than the Con group before treatment. The difference had statistical significance (P<0.05). The iPTH and BGP decreased and blood calcium increased in HG group after treatment, and the difference had statistical significance (P<0.05).Conclusion Supplement of alfacalcidol can reduce iPTH level in maintenance hemodialysis patients, therefore their renal osteopathy can be improved. This method provides a new idea for clinical treatment.%目的:观察阿法骨化醇对维持性血液透析患者甲状旁腺激素(iPTH)的影响,并探讨其临床意义。方法24例慢性肾衰竭尿毒症期行维持性血液透析治疗6个月以上患者作为血液透析组(HD组),同期体检健康人群22例作为健康对照组(Con组)。治疗开始HD组患者口服阿法骨化醇,1μg/d,元素钙2000 mg。共观察12周。Con组患者及HD组患者用药前后均查肾功能及血电解质,用放免法检测iPTH和骨钙素(BGP)。结果用药前HD组与Con组比较, iPTH, BGP及血肌酐(Cre)明显升高,血钙(Ca)降低,血磷(P)升高,差异有统计学意义(P<0.05)。用药后HD组iPTH和BGP明显下降,血钙升

  9. Gait analysis: clinical facts.

    Science.gov (United States)

    Baker, Richard; Esquenazi, Alberto; Benedetti, Maria G; Desloovere, Kaat

    2016-08-01

    Gait analysis is a well-established tool for the quantitative assessment of gait disturbances providing functional diagnosis, assessment for treatment planning, and monitoring of disease progress. There is a large volume of literature on the research use of gait analysis, but evidence on its clinical routine use supports a favorable cost-benefit ratio in a limited number of conditions. Initially gait analysis was introduced to clinical practice to improve the management of children with cerebral palsy. However, there is good evidence to extend its use to patients with various upper motor neuron diseases, and to lower limb amputation. Thereby, the methodology for properly conducting and interpreting the exam is of paramount relevance. Appropriateness of gait analysis prescription and reliability of data obtained are required in the clinical environment. This paper provides an overview on guidelines for managing a clinical gait analysis service and on the principal clinical domains of its application: cerebral palsy, stroke, traumatic brain injury and lower limb amputation.

  10. Clinical Pathway for Thyroidectomy.

    Science.gov (United States)

    Villar del Moral, Jesús María; Soria Aledo, Víctor; Colina Alonso, Alberto; Flores Pastor, Benito; Gutiérrez Rodríguez, María Teresa; Ortega Serrano, Joaquín; Parra Hidalgo, Pedro; Ros López, Susana

    2015-05-01

    Clinical pathways are care plans applicable to patient care procedures that present variations in practice and a predictable clinical course. They are designed not as a substitute for clinical judgment, but rather as a means to improve the effectiveness and efficiency of the procedures. This clinical pathway is the result of a collaborative work of the Sections of Endocrine Surgery and Quality Management of the Spanish Association of Surgeons. It attempts to provide a framework for standardizing the performance of thyroidectomy, the most frequently performed operation in endocrine surgery. Along with the usual documents of clinical pathways (temporary matrix, variance tracking and information sheets, assessment indicators and a satisfaction questionnaire) it includes a review of the scientific evidence around different aspects of pre, intra and postoperative management. Among others, antibiotic and antithrombotic prophylaxis, preoperative preparation in hyperthyroidism, intraoperative neuromonitoring and systems for obtaining hemostasis are included, along with management of postoperative hypocalcemia.

  11. Situated clinical cognition.

    Science.gov (United States)

    Timpka, T

    1995-10-01

    The features characterizing study of clinical cognition in situ are formulated as: Re-cognition of context, culture, history and affect. Socializing and phenomenalistic elements are again included in the research agenda. Interest for representations: an analysis level is reserved for the symbols, rules and images relevant to define in models of clinical cognition. De-emphasis on computer modeling: investigations focus on the 'functional systems' in which computers are involved. Rootedness in classical philosophical problems: issues concerning situated clinical cognition are connected to the width of available theoretical literature. Belief in interdisciplinary studies: productive interactions between the new and traditional disciplines is anticipated, implying that new shared methods have to be developed. When scientific perspectives are broadened, a new balance has to be found between the relevance of the subject of study and methodological rigor. The situated clinical cognition framework is to allow for moving between models, theories, and perspectives, as it does not presuppose a singular model of clinical thinking.

  12. Clinical PET application

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Sang-Moo; Hong, S. W.; Choi, C. W.; Yang, S. D.; Choi, J. S.; Kweon, O. J. et al. [Korea Cancer Center Hospital, Seoul (Korea)

    2000-12-01

    PET gives various metabolic images, and is very important, new diagnostic modality in clinical oncology. In Korea Cancer Center Hospital, PET is installed as a research tool of long-mid-term atomic research project. For the efficient use of PET for clinical and research projects, income from the patients should be managed to get the raw material, equipment, manpower, and also for the clinical PET research. 1. Support the clinical application of PET in oncology. 2. Budgetary management of income, costs for raw material, equipment, manpower, and the clinical PET research project. In this year, 1,327 cases of PET images were obtained, which resulted total income of 829,770,000won. Increased demand for {sup 18}FDG in and outside KCCH need more than 2 times production of {sup 18} in a day. Manpower should be added for the second PET operation and RI production. 10 figs., 4 tabs. (Author)

  13. Observation of influence of clozapine combined with lithium carbonate on clinical electroencephalogram of patients with refractory schizophrenia%氯氮平联合碳酸锂对难治性精神分裂症患者临床脑电图的影响观察

    Institute of Scientific and Technical Information of China (English)

    高改风

    2015-01-01

    Objective To investigate the influence of clozapine combined with lithium carbonate on clinical electroen-cephalogram (EEG) of patients with refractory schizophrenia. Methods 80 patients with refractory schizophrenia treated in Mental Hospital of Henan Province from January 2010 to January 2014 were selected,and they were divided into the two groups.The control group (n=40) was only given clozapine,the observation group (n=40) was given clozapine com-bined with lithium carbonate.All patients were treated for 8 weeks.The treatment effect in the two groups was compared. Results The total effective rate was 82.5% in the observation group,and it was 65.0% in the control group,and there was a statistical difference of clinical curative effect in the two groups (P0.05);there were 3 cases with mild extrapyramidal reaction (blurred vision,drowsi-ness,irritability,insomnia,weight gain) and 2 cases with abnormal liver function and so on in the observation group,there were 2 cases with mild abnormal liver function,1 case with mild reduction of white blood cell and 2 cases with weight gain,1 case with salivation and lethargy,2 cases with irritability and so on,and there was no staistical differences of oc-currence of adverse reaction in the two groups (P>0.05). Conclusion Clozapine combined with lithium carbonate treat-ing refractory schizophrenia can effectively improve the clinical symptoms,improve the therapeutic effect,and does not occur serious adverse reaction.It is worthy of clinical promotion and application.%目的:探讨氯氮平联合碳酸锂对难治性精神分裂症患者临床脑电图的影响。方法抽取河南省精神病院2010年1月~2014年1月接受住院治疗的难治性精神分裂症患者80例,将其随机分为两组,对照组40例单纯给予氯氮平治疗,观察组40例给予氯氮平联合碳酸锂治疗,所有患者进行为期8周的治疗,比较两组的治疗效果。结果观察组的总有效率为82.5%,对照组为65.0%

  14. Body composition in clinical practice.

    Science.gov (United States)

    Andreoli, Angela; Garaci, Francesco; Cafarelli, Francesco Pio; Guglielmi, Giuseppe

    2016-08-01

    Nutritional status is the results of nutrients intake, absorption and utilization, able to influence physiological and pathological conditions. Nutritional status can be measured for individuals with different techniques, such as CT Body Composition, quantitative Magnetic Resonance Imaging, Ultrasound, Dual-Energy X-Ray Absorptiometry and Bioimpendance. Because obesity is becoming a worldwide epidemic, there is an increasing interest in the study of body composition to monitor conditions and delay in development of obesity-related diseases. The emergence of these evidence demonstrates the need of standard assessment of nutritional status based on body weight changes, playing an important role in several clinical setting, such as in quantitative measurement of tissues and their fluctuations in body composition, in survival rate, in pathologic condition and illnesses. Since body mass index has been shown to be an imprecise measurement of fat-free and fat mass, body cell mass and fluids, providing no information if weight changes, consequently there is the need to find a better way to evaluate body composition, in order to assess fat-free and fat mass with weight gain and loss, and during ageing. Monitoring body composition can be very useful for nutritional and medical interventional. This review is focused on the use of Body Composition in Clinical Practice. PMID:26971404

  15. Body composition in clinical practice.

    Science.gov (United States)

    Andreoli, Angela; Garaci, Francesco; Cafarelli, Francesco Pio; Guglielmi, Giuseppe

    2016-08-01

    Nutritional status is the results of nutrients intake, absorption and utilization, able to influence physiological and pathological conditions. Nutritional status can be measured for individuals with different techniques, such as CT Body Composition, quantitative Magnetic Resonance Imaging, Ultrasound, Dual-Energy X-Ray Absorptiometry and Bioimpendance. Because obesity is becoming a worldwide epidemic, there is an increasing interest in the study of body composition to monitor conditions and delay in development of obesity-related diseases. The emergence of these evidence demonstrates the need of standard assessment of nutritional status based on body weight changes, playing an important role in several clinical setting, such as in quantitative measurement of tissues and their fluctuations in body composition, in survival rate, in pathologic condition and illnesses. Since body mass index has been shown to be an imprecise measurement of fat-free and fat mass, body cell mass and fluids, providing no information if weight changes, consequently there is the need to find a better way to evaluate body composition, in order to assess fat-free and fat mass with weight gain and loss, and during ageing. Monitoring body composition can be very useful for nutritional and medical interventional. This review is focused on the use of Body Composition in Clinical Practice.

  16. Issues about the nocebo phenomena in clinics

    Institute of Scientific and Technical Information of China (English)

    WU Zhen-yu; LI Kang

    2009-01-01

    @@ During clinical work, some side-effects may occur to patients, part of which are caused by the specific pharmacological effects of drugs and some of which are non-specific. Although these phenomena happen from time to time, burdening the anguish and expenditure of patients, their nature is still less understood. Recently, as the research of the placebo effect become deeper and deeper, clinicians and researchers have gradually realized that mind plays an important role in the occurrence of non-specific side-effects, which is called "nocebo effect" professionally, the evil side of placebo effect. This article would expatiate on nocebo effect in detail from several aspects, such as its mechanism, effect, influencing factors and discuss how to make it known and treated in clinical practice and clinical trials.

  17. Clinical Research Methodology 2: Observational Clinical Research.

    Science.gov (United States)

    Sessler, Daniel I; Imrey, Peter B

    2015-10-01

    Case-control and cohort studies are invaluable research tools and provide the strongest feasible research designs for addressing some questions. Case-control studies usually involve retrospective data collection. Cohort studies can involve retrospective, ambidirectional, or prospective data collection. Observational studies are subject to errors attributable to selection bias, confounding, measurement bias, and reverse causation-in addition to errors of chance. Confounding can be statistically controlled to the extent that potential factors are known and accurately measured, but, in practice, bias and unknown confounders usually remain additional potential sources of error, often of unknown magnitude and clinical impact. Causality-the most clinically useful relation between exposure and outcome-can rarely be definitively determined from observational studies because intentional, controlled manipulations of exposures are not involved. In this article, we review several types of observational clinical research: case series, comparative case-control and cohort studies, and hybrid designs in which case-control analyses are performed on selected members of cohorts. We also discuss the analytic issues that arise when groups to be compared in an observational study, such as patients receiving different therapies, are not comparable in other respects.

  18. Enhancing quantity and quality of clinical experiences in a baccalaureate nursing program.

    Science.gov (United States)

    Andresen, Kathleen; Levin, Pamela

    2014-01-01

    Nursing programs encounter barriers to clinical education, which may include limited clinical capacity for nursing students. Congestion of clinical placements compounded by multiple external influences prompted a need to develop an alternative approach for meeting program standards pertaining to clinical education. A curriculum improvement project was implemented within a school of nursing with the primary goal of expanding clinical learning opportunities while maintaining program quality. The unique aspect of this project was a comprehensive evaluative design, including qualitative responses from students, faculty, and clinical site stakeholders, as well as standardized student test scores. Augmenting the tools and processes for evaluation of clinical learning required collaboration from the faculty. Project outcomes include expanded clinical capacity, increased variety of clinical learning experiences, and improved quality of the clinical experiences. Collaborative partnerships yielded valuable lessons, which have implications for other nursing programs challenged with clinical placements. PMID:25205733

  19. Clinical PET application

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Sang Moo; Hong, Song W.; Choi, Chang W.; Yang, Seong Dae [Korea Cancer Center Hospital, Seoul (Korea)

    1997-12-01

    PET gives various methabolic images, and is very important, new diagnostic modality in clinical oncology. In Korea Cancer Center Hospital, PET is installed as a research tool of long-mid-term atomic research project. For the efficient use of PET for clinical and research projects, income from the patients should be managed to get the raw material, equipment, manpower, and also for the clinical PET research. 1. Support the clinical application of PET in oncology. 2. Budgetary management of income, costs for raw material, equipment, manpower, and the clinical PET research project. In this year, 250 cases of PET images were obtained, which resulted total income of 180,000,000 won. 50,000,000 won was deposited for the 1998 PET clinical research. Second year PET clinical research should be managed under unified project. Increased demand for {sup 18}FDG in and outside KCCH need more than 2 times production of {sup 18}FDG in a day purchase of HPLC pump and {sup 68}Ga pin source which was delayed due to economic crisis, should be done early in 1998. (author). 2 figs., 3 tabs.

  20. Clinical microbiology informatics.

    Science.gov (United States)

    Rhoads, Daniel D; Sintchenko, Vitali; Rauch, Carol A; Pantanowitz, Liron

    2014-10-01

    The clinical microbiology laboratory has responsibilities ranging from characterizing the causative agent in a patient's infection to helping detect global disease outbreaks. All of these processes are increasingly becoming partnered more intimately with informatics. Effective application of informatics tools can increase the accuracy, timeliness, and completeness of microbiology testing while decreasing the laboratory workload, which can lead to optimized laboratory workflow and decreased costs. Informatics is poised to be increasingly relevant in clinical microbiology, with the advent of total laboratory automation, complex instrument interfaces, electronic health records, clinical decision support tools, and the clinical implementation of microbial genome sequencing. This review discusses the diverse informatics aspects that are relevant to the clinical microbiology laboratory, including the following: the microbiology laboratory information system, decision support tools, expert systems, instrument interfaces, total laboratory automation, telemicrobiology, automated image analysis, nucleic acid sequence databases, electronic reporting of infectious agents to public health agencies, and disease outbreak surveillance. The breadth and utility of informatics tools used in clinical microbiology have made them indispensable to contemporary clinical and laboratory practice. Continued advances in technology and development of these informatics tools will further improve patient and public health care in the future.

  1. 低分子量肝素对胸外科高龄患者术后凝血功能影响的临床研究%Clinical study of influence of low molecular weight heparin on coagulation function in elderly patients after thoracic surgery

    Institute of Scientific and Technical Information of China (English)

    张霓; 付向宁; 徐沁孜

    2010-01-01

    Objective To compare the changes of blood coagulation system and the clinical interventional effect of low molecular weight heparin (LMWH) in elderly patients who had received thoracic surgery. Methods Ninety-six thoracic surgery patients (age≥70 years) were divided into control group ( 54 cases ) and experimental group ( 42 cases ) ( postoperative 1-7 days, subcutaneous injection with LMWH ) from September 2007 to December 2009 by random digits table. Observed perioperative changes in prothrombin time (PT),activated partial thromboplastin time (APTT),platelet (Plt),D-dimer (D-D),fibrinogen (Fib), anti- X a activity, and clinical performances. Also observed the influence of diabetes mellitus of surgery coagulation function. Results The preoperative indexes of coagulation function were no significant (P > 0.05 ). In control group PT prolonged, Fib and D-D increased, the differences between preoperative and postoperative each time were significant (P < 0.05 ). Fib and D-D in control group increased than those in experimental group postoperative each time (P < 0.05 ). In experimental group anti- X a activity increased postoperative each time (P < 0.05 ),compared with control group was also significant (P < 0.05 ). Diabetes mellitus had no significant influence on coagulation function. One patient appeared pulmonary thromboembolism in control group,and no one appeared venous thromboembelism and bleeding adverse reactions in experimental group. Conclusion Thoracic surgery in elderly patients have high blood coagulation state, prone to venous thromboembolism, LMWH given early postoperative prophylactic treatment is beneficial to improve the hypercoagulable state and have better security.%目的 对比研究胸外科高龄患者术后凝血功能变化及低分子量肝素的临床干预效果.方法 选取2007年9月至2009年12月接受开胸手术的96例高龄患者,用随机数字表法分为对照组54例和试验组42例(术后第1~7天皮下注射

  2. Marking out the clinical expert/clinical leader/clinical scholar: perspectives from nurses in the clinical arena

    OpenAIRE

    Mannix, Judy; Wilkes, Lesley; Jackson, Debra

    2013-01-01

    Background Clinical scholarship has been conceptualised and theorised in the nursing literature for over 30 years but no research has captured nurses’ clinicians’ views on how it differs or is the same as clinical expertise and clinical leadership. The aim of this study was to determine clinical nurses’ understanding of the differences and similarities between the clinical expert, clinical leader and clinical scholar. Methods A descriptive interpretative qualitative approach using semi-struct...

  3. Mindfulness and clinical psychology.

    Science.gov (United States)

    Childs, David

    2011-09-01

    Does mindfulness offer more to psychology than a useful therapeutic technique? This paper argues that it can also establish a state of presence which is understood in relation to the practice of phenomenology. Mindfulness is then both linked to a Western intellectual tradition and offers that tradition a systematic method. This is an opening for psychological investigation of the non-conceptual basis of everyday experience. The combination of this theoretical stance with the increasingly widespread practical training of clinical psychologists in mindfulness has broad implications for clinical practice; this is illustrated in relation to the descriptive approach to clinical problems, qualitative research, and reflective practice.

  4. [Midwifery clinical practicum education].

    Science.gov (United States)

    Kao, Chien-Huei; Gau, Meei-Ling

    2013-06-01

    Midwifery is a practical facet of the health sciences that emphasizes professional competence-oriented teaching and learning. Cognitive and practical processes integrate and build midwifery student professional knowledge, attitudes, and skills. Clinical education is a teaching method and strategy used to prepare midwifery students for professional practice. Midwifery clinical teaching plans are designed using literature review, expert opinions, and student comments and determine total required hours and caseloads. Midwifery clinical teaching activities and methods promote self-reflection, childbirth education fundamentals, learning by role model observation, and learning role function through overseas observership programs. This paper discusses midwifery education dilemmas and coping methods in Taiwan.

  5. Manufacturing process influences properties of probiotic bacteria

    OpenAIRE

    Grzeskowiak, Lukasz; Isolauri, Erika; Salminen, Seppo; Gueimonde Fernández, Miguel

    2011-01-01

    Production and manufacturing methods and the food carrier may influence the properties of probiotic strains, and have an impact on the outcome of clinical intervention studies. The aim of the present study was to establish whether the properties of a specific probiotic strain, Lactobacillus rhamnosus GG, may differ depending on the product and source of the strain. In total, fifteen different L. rhamnosus isolates, among them fourteen labelled as L. rhamnosus GG, were isolated from specific p...

  6. Interprofessional clinical education: clinicians' views on the importance of leadership.

    Science.gov (United States)

    Missen, Karen; Jacob, Elisabeth R; Barnett, Tony; Walker, Lorraine; Cross, Merylin

    2012-01-01

    The current shortage of health professionals necessitates new approaches to clinical education that can expand the number of undergraduate students undertaking clinical placements without increasing the burden on clinical staff or placing patients at risk. Interprofessional education has the potential to help increase clinical capacity whilst enriching students' clinical experience. This paper reports on a project which investigated the potential for interprofessional education to increase undergraduate clinical placement capacity in clinical settings. The project utilised an exploratory descriptive methodology to obtain the views of health care professionals about the use of interprofessional education in clinical education at three rural health facilities in Victoria, Australia. Participants (n = 57) had a key role with each health care facility in coordinating and facilitating undergraduate clinical placements. This paper examines the clinicians' views about the central role that leadership plays in actioning interprofessional education in the clinical setting. Whilst interprofessional education was regarded favourably by the majority of participants, data indicated that leadership from education providers, health services, and regulatory authorities was crucial to enable interprofessional education to be implemented and sustained within the clinical learning environment. Without leadership from each of these three spheres of influence, interprofessional education will continue to be difficult to implement for undergraduate students and compromise their exposure to an important aspect of the working life of health care professionals. Such a failure will limit graduates' readiness for collaborative and cross-disciplinary practice.

  7. International Adaptations of the Millon Clinical Multiaxial Inventory: Construct Validity and Clinical Applications.

    Science.gov (United States)

    Rossi, Gina; Derksen, Jan

    2015-01-01

    This article examines the influence of the Millon Clinical Multiaxial Inventory (MCMI) as a clinical and research instrument beyond the borders of the United States. The MCMI's theoretical and empirical grounding, its alignment with the Diagnostic and Statistical Manual of Mental Disorders (DSM), and scales that can be interpreted both categorically and dimensionally, are the primary features that make the test attractive. We begin with studies that evaluated the construct equivalence of the different language adaptations. Data from the most widely researched non English-language forms (Danish, Dutch, and Spanish) show excellent comparability with Millon's original. Nevertheless, significant problems were noted in efforts to create clinical groups that would allow for equivalence of diagnostic accuracy when using the cutoff scores. Although dimensional aspects of the scale scores were not affected by this, the adapted measures might show attenuated diagnostic accuracy compared with Millon's original. Next, we present MCMI studies conducted in clinical settings to document where the adapted tests have made their greatest impact in the international literature. A wide variety of clinical applications demonstrated broad utility, and given the high number of issues addressed, we think Millon's influence will certainly stand the test of time in different domains and settings.

  8. Clinical trials in Huntington's disease: Interventions in early clinical development and newer methodological approaches.

    Science.gov (United States)

    Sampaio, Cristina; Borowsky, Beth; Reilmann, Ralf

    2014-09-15

    Since the identification of the Huntington's disease (HD) gene, knowledge has accumulated about mechanisms directly or indirectly affected by the mutated Huntingtin protein. Transgenic and knock-in animal models of HD facilitate the preclinical evaluation of these targets. Several treatment approaches with varying, but growing, preclinical evidence have been translated into clinical trials. We review major landmarks in clinical development and report on the main clinical trials that are ongoing or have been recently completed. We also review clinical trial settings and designs that influence drug-development decisions, particularly given that HD is an orphan disease. In addition, we provide a critical analysis of the evolution of the methodology of HD clinical trials to identify trends toward new processes and endpoints. Biomarker studies, such as TRACK-HD and PREDICT-HD, have generated evidence for the potential usefulness of novel outcome measures for HD clinical trials, such as volumetric imaging, quantitative motor (Q-Motor) measures, and novel cognitive endpoints. All of these endpoints are currently applied in ongoing clinical trials, which will provide insight into their reliability, sensitivity, and validity, and their use may expedite proof-of-concept studies. We also outline the specific opportunities that could provide a framework for a successful avenue toward identifying and efficiently testing and translating novel mechanisms of action in the HD field.

  9. Clinical trials in Huntington's disease: Interventions in early clinical development and newer methodological approaches.

    Science.gov (United States)

    Sampaio, Cristina; Borowsky, Beth; Reilmann, Ralf

    2014-09-15

    Since the identification of the Huntington's disease (HD) gene, knowledge has accumulated about mechanisms directly or indirectly affected by the mutated Huntingtin protein. Transgenic and knock-in animal models of HD facilitate the preclinical evaluation of these targets. Several treatment approaches with varying, but growing, preclinical evidence have been translated into clinical trials. We review major landmarks in clinical development and report on the main clinical trials that are ongoing or have been recently completed. We also review clinical trial settings and designs that influence drug-development decisions, particularly given that HD is an orphan disease. In addition, we provide a critical analysis of the evolution of the methodology of HD clinical trials to identify trends toward new processes and endpoints. Biomarker studies, such as TRACK-HD and PREDICT-HD, have generated evidence for the potential usefulness of novel outcome measures for HD clinical trials, such as volumetric imaging, quantitative motor (Q-Motor) measures, and novel cognitive endpoints. All of these endpoints are currently applied in ongoing clinical trials, which will provide insight into their reliability, sensitivity, and validity, and their use may expedite proof-of-concept studies. We also outline the specific opportunities that could provide a framework for a successful avenue toward identifying and efficiently testing and translating novel mechanisms of action in the HD field. PMID:25216371

  10. Influência da extensão da artrodese lombossacra nos resultados clínicos e funcionais Influencia de la extensión de la artrodesis lumbosacra en los resultados clínicos y funcionales Influence of the extent of lumbosacral arthrodesis in clinical and functional outcomes

    Directory of Open Access Journals (Sweden)

    Alberto Ofenhejm Gotfryd

    2012-01-01

    de medicamentos analgésicos y satisfacción con el tratamiento y la escala analógica visual para el dolor lumbar y la ciática. Por otra parte, se aplicaran los cuestionarios Oswestry y SF-36 para evaluar la calidad de vida. RESULTADOS: El SF-36 mostró resultados de buenos niveles de calidad de vida en ambos grupos, excepto en el campo "Aspectos Físicos". No hubo correlación significativa entre la magnitud de la artrodesis y los resultados clínicos. CONCLUSIONES: Los pacientes que fueron sometidos a artrodesis posterolateral mostraron calidad de vida satisfactoria, con excepción de disminución de la aptitud física. Sin embargo, el mayor número de niveles fusionados no tuvo un impacto negativo en los aspectos clínicos y funcionales.OBJECTIVE: Investigate the influence of the extent of posterolateral lumbosacral fusion and its impact on clinical and functional results. METHODS: We evaluated 22 patients with central or foraminal stenosis or lumbar disc herniation associated with segmental instability that underwent to surgery for nerve decompression and posterolateral arthrodesis. Patients were divided into two groups according to the number of levels fused: Group 1: fusion at one level and Group 2: fusion of two or more levels. Patients completed questionnaires regarding postoperative follow-up (use of analgesic medications and treatment satisfaction and visual analog scale for lumbar pain and sciatica. Moreover, the questionnaires Oswestry and SF-36 were administered to assess quality of life. RESULTS: SF-36 showed good levels of quality of life in both groups, except the field "Physical Aspects". There was no significant correlation between the extent of the arthrodesis and clinical outcomes. CONCLUSIONS: Patients who underwent posterolateral arthrodesis showed satisfactory quality of life, except for a decrease of physical fitness. However, the higher number of levels fused did not have negative impact on clinical and functional aspects.

  11. 维持治疗期间不同剂量氨磺必利对精神分裂症认知功能及临床疗效的影响%Different Doses of Amisulpride's Influence on the Cognitive Function and the Clinical Curative Effect for Schizophrenia during Maintaining Treatment

    Institute of Scientific and Technical Information of China (English)

    聂所成; 刘长成; 张新风; 蒋平; 涂哲明; 刘波

    2015-01-01

    目的:探讨维持治疗期间不同剂量氨磺必利对精神分裂症认知功能及远期疗效的影响。方法:采用2012年3月-2013年3月在我院住院采用氨磺必利治疗并获得临床痊愈的精神分裂症患者,共96例。随机分为全剂量组和半剂量组,急性期治疗3个月后,全剂量组(46例)维持原治疗剂量600~800 mg/d;半剂量组(50例)给予原治疗量的一半作维持量300~400mg/d,纳入病例在出院后持续随访1年,采用韦氏成人智力量表(WAIS)、临床记忆量表评价认知功能,采用阳性与阴性症状量表( PANSS)、大体评定量表( GAS)来衡量评价临床疗效。结果:1年随访后两组认知功能比较差异显著,WAIS量表:言语智商、操作智商、总智商(t=6.1276,3.2526,5.1423;P<0.05);记忆量表:联想学习、图像自由回忆、人像特点回忆及记忆商数( t=3.0972,3.3938,3.0565,2.8937;P<0.05)。两组临床疗效比较:PANSS总分(t=3.6915,P<0.05);GAS量表评分(t=9.5153,P<0.05);1年累计缓解率分别为82.2%和60.4%(χ2=5.32,P<0.05);复发率分别为15.22%和34.00%(χ2=4.51,P<0.05)。副作用发生率分别为45.65%和34.00%(χ2=1.36,P>0.05)。结论:采用氨磺必利全治疗剂量维持治疗对认知功能改善明显,远期疗效较好、复发率较少。%Objective:To explore the influence of different doses of amisulpride on cognitive function for schizophrenia and long -term curative effect during maintaining treatment .Methods:From March 2012 to March 2013 ,a total of 96 cases of schizophrenia inpatients who got clinical cure with amisulpride treatment ,were randomly divided into the total dose and half dose group .After three months of acute treat-ment,the total dose group(46 cases)which maintained 600-800mg/d of the original treatment

  12. Fidelity in clinical simulation

    DEFF Research Database (Denmark)

    Jensen, Sanne; Nøhr, Christian; Rasmussen, Stine Loft

    2013-01-01

    Clinical simulation may be used to identify user needs for context sensitive functionalities in e-Health. The objective with this paper is to describe how user requirements and use cases in a large EHR-platform procurement may be validated by clinical simulation using a very low-fidelity prototype...... without any existing test data. Instead of using test scenarios and use cases, the healthcare professionals who are participating in the clinical simulation are generating both scenario and patient data themselves. We found that this approach allows for an imaginative discussion, not restricted by known...... functionalities and limitations, of the ideal EHR-platform. Subsequently, we discuss benefits and challenges of using an extremely low fidelity environment and discuss the degree of fidelity necessary for conducting clinical simulation....

  13. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... experimental drug, therapy, medical device, lifestyle change, or test will help treat, find, or prevent a disease. A clinical trial may compare experimental products or tests to those already available or may compare existing ...

  14. Clinical Case Registries (CCR)

    Data.gov (United States)

    Department of Veterans Affairs — The Clinical Case Registries (CCR) replaced the former Immunology Case Registry and the Hepatitis C Case Registry with local and national databases. The CCR:HIV and...

  15. Clinical specular microscopy

    Energy Technology Data Exchange (ETDEWEB)

    Hirst, L.W.; Laing, R.A.

    1987-01-01

    This book provides the general ophthalmologist with a guide to the clinical applications of specular microscopy. Important material is included on laser injury, cataract surgery, corneal transplants, glaucoma, uveitis, and trauma.

  16. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... Clinical Trials Videos quiz yourself MedlinePlus for More Information National Institute on Aging Related Topics Talking with Your Doctor Taking Medicines The information in this topic was provided by the National ...

  17. Health Clinic Cost Reports

    Data.gov (United States)

    U.S. Department of Health & Human Services — Healthcare Cost Report Information System (HCRIS) Dataset - Independent Rural Health Clinic and Freestanding Federally Qualified Health Center (HCLINIC).This data...

  18. Leprosy neuropathy: clinical presentations.

    Science.gov (United States)

    Nascimento, Osvaldo J M

    2013-09-01

    Leprosy is a chronic infectious peripheral neuropathy caused by Mycobacterium leprae. The different clinical presentations of the disease are determined by the quality of the host immune response. Early detection of leprosy and treatment by multidrug therapy are the most important steps in preventing deformity and disability. Thus the early recognition of the clinical leprosy presentation is essential. Mononeuritis, mononeuritis multiplex (MM), polyneuritis (MM summation) are the most frequent. The frequent anesthetic skin lesions are absent in the pure neuritic leprosy presentation form. Isolated peripheral nerve involvement is common, including the cranial ones. Arthritic presentation is occasionally seen, usually misdiagnosed as rheumatoid arthritis. Attention should be given to autonomic dysfunctions in leprosy. There are clinical presentations with severe neuropathic pain - painful small-fiber neuropathy. Leprous late-onset neuropathy (LLON) clinical presentation should be considered facing a patient who develop an inflammatory neuropathy many years after a previous skin leprosy treatment. PMID:24141500

  19. Understanding Clinical Alarm Safety.

    Science.gov (United States)

    Lukasewicz, Carol L; Mattox, Elizabeth Andersson

    2015-08-01

    Patient safety organizations and health care accreditation agencies recognize the significance of clinical alarm hazards. The Association for the Advancement of Medical Instrumentation, a nonprofit organization focused on development and use of safe and effective medical equipment, identifies alarm management as a major issue for health care organizations. ECRI Institute, a nonprofit organization that researches approaches for improving patient safety and quality of care, identifies alarm hazards as the most significant of the "Top Ten Health Technology Hazards" for 2014. A new Joint Commission National Patient Safety Goal focusing on clinical alarm safety contains new requirements for accredited hospitals to be fully implemented by 2016. Through a fictional unfolding case study, this article reviews selected contributing factors to clinical alarm hazards present in inpatient, high-acuity settings. Understanding these factors improves contributions by nurses to clinical alarm safety practice.

  20. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... that could identify a disease in its early stages. Usually, trial participants must show signs of the ... Trials Clinical trials of drugs are usually described based on their phase. The U.S. Food and Drug ...

  1. Transgressive first clinical experiences

    DEFF Research Database (Denmark)

    Jensen, Carsten Juul; Jeppesen, Lise Kofoed; Drachmann, Merete

    2014-01-01

    . The nursing students’ learning seems to be oriented towards socialization in the clinic as a workplace. This means that the nursing students seek to deal with overwhelming experiences concerning the naked bodies of patients and death, useful application of theoretical knowledge, the path from novice...... to advanced beginner, and adjusting to the workplace community. The conclusion is that the learning of nursing students during their first clinical in-service placement appears informal and not founded on evident best practice.......This Study seeks to comprehend learning experiences of nursing students during their first clinical in-service placement. This Paper is part of a longitudinal development project interviewing the Student Nurse after each one of the five clinical in-service placements and then one year after...

  2. OARSI Clinical Trials Recommendations

    DEFF Research Database (Denmark)

    Kraus, V B; Blanco, F J; Englund, M;

    2015-01-01

    The objective of this work was to describe requirements for inclusion of soluble biomarkers in osteoarthritis (OA) clinical trials and progress toward OA-related biomarker qualification. The Guidelines for Biomarkers Working Group, representing experts in the field of OA biomarker research from...... both academia and industry, convened to discuss issues related to soluble biomarkers and to make recommendations for their use in OA clinical trials based on current knowledge and anticipated benefits. This document summarizes current guidance on use of biomarkers in OA clinical trials...... and their utility at five stages, including preclinical development and phase I to phase IV trials. As demonstrated by this summary, biomarkers can provide value at all stages of therapeutics development. When resources permit, we recommend collection of biospecimens in all OA clinical trials for a wide variety...

  3. ClinicalTrials.gov

    Data.gov (United States)

    U.S. Department of Health & Human Services — Provides patients, family members, health care professionals, and members of the public easy access to information on clinical trials for a wide range of diseases...

  4. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... Learn More Participating in Clinical Trials Videos quiz yourself MedlinePlus for More Information National Institute on Aging Related Topics Talking with Your Doctor Taking Medicines The information in ...

  5. The clinical nanomedicine handbook

    CERN Document Server

    Brenner, Sara

    2013-01-01

    Designed to foster a stronger awareness and exploration of the subject by practicing clinicians, medical researchers and scientists, The Clinical Nanomedicine Handbook discusses the integration of nanotechnology, biology, and medicine from a clinical point of view. The book highlights relevant research and applications by specialty; it examines nanotechnology in depth, and the potential to solve medical problems. It also increases literacy in nanotechnology, and allows for more effective communication and collaboration between disciplines. Details worldwide developments in nanomedicine Provide

  6. Clinical careers film.

    Science.gov (United States)

    2015-09-01

    Those interested in developing clinical academic careers might be interested in a short animated film by Health Education England (HEE) and the National Institute for Health Research. The three-minute film, a frame from which is shown below, describes the sort of opportunities that are on offer to all professionals as part of the HEE's clinical academic careers framework. You can view the film on YouTube at tinyurl.com/pelb95c. PMID:26309005

  7. Clinical Applications for Estetrol

    OpenAIRE

    Visser M; Coelingh Bennink HJT

    2010-01-01

    In this paper the potential clinical applications for the human fetal estrogen estetrol (E4) are presented based on recently obtained data in preclinical and clinical studies. In the past E4 has been classified as a weak estrogen due to its rather low estrogen receptor affinity. However, recent research has demonstrated that due to its favorable pharmacokinetic properties, especially the slow elimination and long half-life, E4 is an effective orally bioavailable estrogen agonist with estro...

  8. Clinical toxinology specialty training.

    Science.gov (United States)

    White, Julian

    2013-07-01

    Clinical toxinology is the medical discipline dealing with the diagnosis, treatment and prevention of toxin diseases caused by exposure to venomous animals and poisonous animals, plants and mushrooms. Currently there is no national or international organisation accrediting or training doctors in this discipline, but the role of the IST in this area is the subject of a recently approved revised Constitution. A few courses covering some aspects of clinical toxinology exist, either with limited curricula, or with only a minor clinical focus, or with a very regional, non-global focus. The only comprehensive clinical toxinology course is the one provided in Adelaide, Australia, running regularly since 1997. This course may form the nucleus from which IST can develop a global accredited training scheme in clinical toxinology. Such a scheme will require input from diverse global regions and will be far more comprehensive and over a much longer time than the current Short Course, though may incorporate the Short Course in some way, or a derivative of it. Accreditation of medical expertise in clinical toxinology will be required at the national level and this might be accomplished by the IST working with existing national medical specialty organisations and governments, with the IST supervising the training and accreditation requirements and the national organisations providing the framework for registration of medical expertise at the local level. PMID:23524067

  9. Clinical Studies with Epothilones

    Science.gov (United States)

    Altmann, Karl-Heinz

    As indicated in previous chapters, epothilone research so far has delivered seven new chemical entities that have been advanced to clinical trials in humans (Fig. 1). However, the amount of clinical data publicly available at this time strongly varies between individual compounds, depending on their development stage, but also on the general publication policy of the developing company. The compound that has been most comprehensively characterized in the clinical literature is ixabepilone (BMS-247550), for which trial results have been described in a number of articles in peer-reviewed journals and which has been granted FDA approval for two clinical indications on Oct. 16, 2007. For all other compounds, most of the information on clinical trials is available only in abstract form. In all these cases it remains uncertain, whether the content of these abstracts fully reflects the content of the subsequent (poster or oral) presentations at the corresponding meeting; in fact, it seems likely that additional data will have been included in the actual meeting presentations that may not have been available at the time of abstract submission. As this is unknown to the author, such additional information cannot be considered in this chapter, which is solely based on information documented in accessible abstracts or journal publications. It should also be kept in mind that the interpretation of data from ongoing clinical trials or forward looking statements based on data from completed trials are always preliminary in character.

  10. Fundamentals of clinical trials

    CERN Document Server

    Friedman, Lawrence M; DeMets, David L; Reboussin, David M; Granger, Christopher B

    2015-01-01

    This is the fifth edition of a very successful textbook on clinical trials methodology, written by recognized leaders who have long and extensive experience in all areas of clinical trials. The three authors of the first four editions have been joined by two others who add great expertise.  Most chapters have been revised considerably from the fourth edition.  A chapter on regulatory issues has been included and the chapter on data monitoring has been split into two and expanded.  Many contemporary clinical trial examples have been added.  There is much new material on adverse events, adherence, issues in analysis, electronic data, data sharing, and international trials.  This book is intended for the clinical researcher who is interested in designing a clinical trial and developing a protocol. It is also of value to researchers and practitioners who must critically evaluate the literature of published clinical trials and assess the merits of each trial and the implications for the care and treatment of ...

  11. Children and Clinical Studies: Why Clinical Studies Are Important

    Medline Plus

    Full Text Available ... Systematic Evidence Reviews & Clinical Practice Guidelines Resources Continuing Education Researchers Funding Training & Career Development Division of Intramural Research Research Resources Research Meeting Summaries Technology Transfer Clinical Trials What Are Clinical Trials? Children & ...

  12. Clinical effect and influence in cognitive function of aripiprazole and risperidone in patients with schizophrenia%阿立哌唑与利培酮对精神分裂症患者的临床疗效及认知功能的影响

    Institute of Scientific and Technical Information of China (English)

    刘旭; 程哲; 杨芳; 程传宝

    2013-01-01

    [Objective]To explore the clinical effect and safety of aripiprazole and risperidone in patients with schizophrenia, and the influence in cognitive function of patients. [ Methods] 156 schizophrenia patients were randomly divided into two groups, 78 cases in each group. The research group was treated with aripiprazole orally, and the control group was given risperidone, for 8 weeks. Before treatment and at the end of the 4th and 8th week of treatment, the clinical effect was assessed with the Positive and Negative Syndrome Scale (PANSS) and the Clinical Global Impression ( CGIS) , and the adverse reactions were evaluated with the Treatment Emergent Symptom Scale (TESS). Before treatment and at the end of the 8th week of treatment, the cognitive functions of patients was assessed with the Wechsler Adult Intelligence Scale (WAIS) , the Wechsler memory scale (WMS) and the Wisconsin Card Sorting Test (WCST). The evaluation results of two groups were analyzed and compared. [ Results] At the end of 4th week of treatment, the total and each factors scores of PANSS, as well as CGIS score decreased significantly as compared with those before treatment (P 0.05). At the end of 8th week of treatment, the obvious effective rate and effective rate in the research group was 73.08% and 96.15% respectively, and that in the control group was 71. 79% and 92. 31% respectively, which showed no significantly difference (X2 = 0. 032, 0. 806,P >0.05). At the end of 8th week, the error answers and non-persistent error of WCST of two groups decreased significantly than those before treatment, while factor scores of WMS in the recognition, regeneration, comprehension, memory quotient were significantly higher than those before treatment (P 0.05). Adverse reactions of both groups were mild, and appeared at the beginning of treatment. The incidence rates of extrapyramidal reactions, menstrual disorders, lactation and weight gain in the research group were significantly lower than those in the

  13. [Changing surgical therapy because of clinical studies?].

    Science.gov (United States)

    Schwenk, W; Haase, O; Müller, J M

    2002-04-01

    The randomised controlled clinical trial (RCT) is a powerful instrument to evaluate different therapeutic regimens. In a survey among 115 physicians visiting the 25th annual meeting of the Surgical Society of Berlin and Brandenburg, the RCT was judged to be very important when changes of therapeutic strategies are discussed. 90 % of all participants claimed to use data from RCTs in the clinical routine and 89 % would participate in such a trial. In official (e. g. discussions during coffee breaks at scientific meetings) or non-medical (e. g. non-scientific press or media) sources of information were assessed as irrelevant for decisions regarding therapeutic strategies. However, in contrast to this view laparoscopic cholecystectomy was introduced into clinical practice rapidly because patients informed by external (non-medical) sources preferred to be operated on with the "modern" technique. Clinical trials with a high level of evidence had no relevant influence on the rapid distribution of laparoscopic cholecystectomy. Controversial discussions concerning the extent of lymphadenectomy with gastric resection for carcinoma demonstrate that the value of excellent clinical RCTs is low if their results challenge a stable paradigma of the surgical scientific society. To allow a rational judgement, new surgical technologies should undergo a scientific gradual evaluation in agreement with the principles of evidence based medicine. PMID:12085271

  14. [Changing surgical therapy because of clinical studies?].

    Science.gov (United States)

    Schwenk, W; Haase, O; Müller, J M

    2002-04-01

    The randomised controlled clinical trial (RCT) is a powerful instrument to evaluate different therapeutic regimens. In a survey among 115 physicians visiting the 25th annual meeting of the Surgical Society of Berlin and Brandenburg, the RCT was judged to be very important when changes of therapeutic strategies are discussed. 90 % of all participants claimed to use data from RCTs in the clinical routine and 89 % would participate in such a trial. In official (e. g. discussions during coffee breaks at scientific meetings) or non-medical (e. g. non-scientific press or media) sources of information were assessed as irrelevant for decisions regarding therapeutic strategies. However, in contrast to this view laparoscopic cholecystectomy was introduced into clinical practice rapidly because patients informed by external (non-medical) sources preferred to be operated on with the "modern" technique. Clinical trials with a high level of evidence had no relevant influence on the rapid distribution of laparoscopic cholecystectomy. Controversial discussions concerning the extent of lymphadenectomy with gastric resection for carcinoma demonstrate that the value of excellent clinical RCTs is low if their results challenge a stable paradigma of the surgical scientific society. To allow a rational judgement, new surgical technologies should undergo a scientific gradual evaluation in agreement with the principles of evidence based medicine.

  15. Noah Webster's Linguistic Influences.

    Science.gov (United States)

    Kreidler, Charles W.

    1998-01-01

    Examines ways in which Noah Webster's linguistic theories and work on dictionaries influenced North American English lexicography, arguing that his impact on American education was great because his spellers and dictionaries monopolized a rapidly growing market, and influence on lexicography was substantial because he insisted on the validity of…

  16. THE INFLUENCED FLOW REGIMES

    Directory of Open Access Journals (Sweden)

    Gavril PANDI

    2011-03-01

    Full Text Available The influenced flow regimes. The presence and activities ofhumanity influences the uniform environmental system, and in this context, therivers water resources. In concordance with this, the natural runoff regime suffersbigger and deeper changes. The nature of these changes depending on the type anddegree of water uses. The multitude of the use cause different types of influence,whit different quantitative aspects. In the same time, the influences havequalitative connotations, too, regarding to the modifications of the yearly watervolume runoff. So the natural runoff regime is modified. After analyzing thedistribution laws of the monthly runoff, there have been differenced four types ofinfluenced runoff regimes. In the excess type the influenced runoff is bigger thanthe natural, continuously in the whole year. The deficient type is characterized byinverse rapports like the first type, in the whole year. In the sinusoidal type, theinfluenced runoff is smaller than the natural in the period when the water isretained in the lake reservoirs, and in the depletion period the situation inverts. Atthe irregular type the ratio between influenced and natural runoff is changeable ina random meaner monthly. The recognition of the influenced regime and the gradeof influence are necessary in the evaluation and analysis of the usable hydrologicalriver resources, in the flood defence activities, in the complex scheme of thehydrographic basins, in the environment design and so on.

  17. Effects of feedback of information on clinical practice: a review.

    OpenAIRE

    Mugford, M; Banfield, P; O'Hanlon, M

    1991-01-01

    OBJECTIVE--To establish what is known about the role of feedback of statistical information in changing clinical practice. DESIGN--Review of 36 studies of interventions entailing the use of statistical information for audit or practice review, which used a formal research design. SUBJECTS--Papers identified from computer searches of medical and health service management publications, of which 36 describing studies of interventions designed to influence clinical care and including information ...

  18. How Do Clinical Trials Work?

    Science.gov (United States)

    ... Trials Clinical Trial Websites How Do Clinical Trials Work? If you take part in a clinical trial, ... kol). This plan explains how the trial will work. The trial is led by a principal investigator ( ...

  19. 2种间隙保持器的临床应用效果及对牙周健康状况的影响研究%Research on clinical application effects of two space maintainers as well as their influence on periodontal health

    Institute of Scientific and Technical Information of China (English)

    黄优; 陆史俊; 王林

    2015-01-01

    Objective To study the clinical satisfaction and the success rateof a new style improved vacuum formed space maintainer and its influence on periodontal tissue compared with traditional band and loop space maintainer .Methods 40 patients with the need of maintaining space were divided into 2 groups randomly ,each wearing one kind of space maintainers .Visual Analogue Scales ( VAS) was used to evaluate the degree of comfort wearing different space maintainers after 4 weeks.Plaque indexes,gingival indexes and probe depth of the lower first molar ,and the success rate of the space maintainer were recorded after 4 weeks,8 weeks and 12 weeks respec-tively.All data were subject to t-test and χ2 analysis.Results The degree of comfort when wearing improved vacuum formed space maintainer was obviously higher than that when wearing traditional band and loop space maintainer and the periodontal index was also better (P0.05).Conclusions Improved vacuum formed space maintainer is more favorable compared with traditional band and loop space maintainer and is more effective in reducing the influ -ence on periodontal health .%目的:比较改良压膜间隙保持器与传统丝圈式间隙保持器在临床上的使用舒适度、成功率和对牙周健康状况的影响。方法40例下颌第二乳磨牙早失的患者分为2组,随机戴用改良压膜间隙保持器与传统丝圈式间隙保持器,1个月后使用VAS量表法评价佩戴舒适,并分别于第1、3、6个月检查2组患者缺隙侧第一磨牙的菌斑指数、牙龈指数和探诊深度及成功率,t检验与χ2检测2组间差异。结果戴用改良压膜间隙保持器在舒适度和牙周健康维护上显著优于传统丝圈式间隙保持器组(P<0.05)。在成功率上2组没有明显差异(P>0.05)。结论改良式压膜间隙保持器相比于传统丝圈式间隙保持器,戴用更为舒适,并能显著减少对牙周健康的影响,

  20. Influences of doctor - nurse integrated management mode on self - efficacy and sense of job control of clinical nurses%医护一体化管理模式对临床护士自我效能及工作控制感的影响

    Institute of Scientific and Technical Information of China (English)

    彭叶莲

    2016-01-01

    Objective:To discuss influences of doctor - nurse integrated management mode on self - efficacy and sense of job control of clinical nurses. Meth-ods:Selected 80 registered nurses from January 2014 to January 2015 as objects of investigation,and randomly divided them into observation group and con-trol group equally. Doctor - nurse integrated management mode was adopted for observation group,while usual nursing management mode was adopted for control group. Patients from both groups were assessed with Self - Efficacy Scale and Sense of Job Control Scale. Nurse satisfaction degree with doctor -nurse integrated management mode,doctor satisfaction degree with nursing work and patient satisfaction degree were assessed as well. Results:Self - efficacy and sense of job control of observation group were higher than those of control group significantly(P < 0. 05). Nurse satisfaction degree with doctor - nurse integrated management mode,doctor satisfaction degree with nursing work and patient satisfaction degree of observation group were higher than those of con-trol group(P < 0. 05). Conclusion:Doctor - nurse integrated management mode can help nurses to increase self - efficacy and sense of job control,promote cooperation between doctors and nurses,and improve satisfaction degrees of doctors and patients.%目的:探讨医护一体化管理模式对临床护士自我效能及工作控制感的影响。方法:2014年1月~2015年1月选择80名注册护理人员进行调查,随机等分为观察组和对照组,观察组实施医护一体化管理模式,对照组采用常规的护理管理模式,两组采用自我效能量表和工作控制感量表对两组患者进行测定,并对护理人员对医护一体化管理的满意度、医师对护理工作的满意度和患者满意度进行评测。结果:观察组自我效能和工作控制感明显高于对照组(P <0.05);护理人员对医护一体化管理的满意度、医师对护理工作的满

  1. Influence of Compliance of Patients with Chronic Periodontitis on Clinical Effect during Periodontal Maintenance%慢性牙周炎患者牙周维护期间依从性不同对临床疗效的影响分析

    Institute of Scientific and Technical Information of China (English)

    关天燕

    2015-01-01

    Objective:To observe the different influence of compliance of patients with chronic periodontitis on clinical effect during periodontal maintenance.Methods:70 cases of patients with chronic periodontitis were selected in our hospital.According to patient compliance,they were divided into complete compliance group and incomplete compliance group,35 cases in each group.All patients were given the foundation treatment for 4 weeks and patients without operation indication were given periodontal maintenance therapy and regular reexamination.Before treatment and after 12 months of treatment in patients with plaque index (Plaque,index,PI),gingival index (Gingival,index,GI) and the depth of periodontal pocket (Probing depth,PD) and other indicators.Results:Before treatment,PI,GI and PD of two groups of patients had no significant difference.After 12 months of treatment,PI,GI and PD of the complete compliance group were (0.23±0.14),(0.84±0.23) and (0.23±0.14),PI,GI and PD of incomplete compliance group were (0.81±0.19),(1.12±0.30) and (0.81±0.19),(P<0.05).Conclusion:Better compliance of the chronic periodontitis patients had better curative effect than the poor compliance of patients.%目的:观察慢性牙周炎患者牙周维护期间依从性不同对临床疗效的影响.方法:临床纳入慢性牙周炎患者70例,根据患者依从性差异分为完全依从性组以及不完全依从性组,每组35例.所有患者均首先进行为期4周的基础治疗,对于无手术指征者给予牙周维护治疗,并进行定期复查.观察治疗前与治疗12个月后患者菌斑指数(Plaque index,PI)、牙龈指数(Gingival index,GI)以及牙周袋深度(Probing depth,PD)、探针出血(BOP)阳性率、临床附着水平(CAL)等指标.结果:治疗前,两组患者PI、GI、PD、BOP阳性率、CAL水平等差异无显著性;完全依从性组患者治疗6个月、12个月的PI、GI、PD评分、BOP阳性率、CAL水平均明显优于不完全依从性组(P<0.05),

  2. Clinical significance and influencing factors of serum level of AFP,uE3 and Free β-hCG in woman at intermediate stage of pregnancy%中期孕妇血清中AFP、uE3、游离β-hCG检测的临床意义及影响因素分析

    Institute of Scientific and Technical Information of China (English)

    刘爱胜; 陈荣贵; 文艳

    2011-01-01

    Objective To investigate the clinical significance and influencing factors of serum level of alpha fetoproteinC AFP) , free estriol(Ue3) and free (3-human chorionic gonadotropin(free (3-Hcg) in woman at intermediate stage of pregnancy. Methods Completely automatic immunity illumination analysis was performed for the detection of serum AFP,Ue3 and free-(3-HCG in 5 308 cases of woman at 14 - 20 week during pregnancy. The diagnostic criterion of high-risk was 1 : 380 for Down's syndrome(DS) ,1 : 334 for Trisomy 18 and 1 : 1 000 for open spina bifida (OSB). Amniotic fluid puncture or ultrasound inspection were performed for high-risk group. Follow-up visit was carried out for all 5 308 cases of pregnant women during whole process of pregnancy. Results Among all subjects, 5. 2%(275/5 308) were positive for DS screening, among which 5. 8% C16/275) were definitely diagnosed for DS by amniotic fluid puncture, ultrasound inspection or follow-up visit after parturition. In low-risk group, 3 cases were definitely diagnosed for DS with the false negative rate of 0. 06% (3/5 033). Subjects in high-risk group were mainly above 35 years old, and the positive rate of screening increased with the raise of age. There was significant difference of positive rate of screening between pregnant women more than 35 years old[12. 9%(174/1 345)] and those less than 35 years old[2. 5% C101/3 963)] (P0. 05). The difference of incidence rate of DS during high-risk and low-risk group was significant (P0.05).高危、低危组间唐氏综合征发病率比较,两组差异有统计学意义(P<0.01).结论 中期孕妇血清中AFP、uE3、游离β-hCG指标联合检测是筛查唐氏综合征、18-三体综合征、开放性脊柱裂准确且无创伤性的方法,可作为较理想的产前检查模式,但有一定的假阳性率.为了减少假阳性,高危孕妇要及时进行羊水和B超检查.孕妇年龄与检出阳性率呈正相关.因此,建议在30岁前计划生育,减少或杜绝高危出生的缺陷患儿.

  3. 安络化纤丸治疗乙型肝炎肝纤维化疗效观察及治疗前后FibroScan值变化%Observation the influence and investigate the clinical value of FibroScan of Anluohuaxian capsule on hepatic fibrosis of chronic hepatitis B patients

    Institute of Scientific and Technical Information of China (English)

    吕俊旭

    2013-01-01

    Objective To observe the influence of Anluohuaxian capsule on hepatic fibrosis of chronic hepatitis B patients,and investigate the clinical value of FibroScan on patients with liver failure induced by HBV inection.Methods One hundred and twenty patients were randomly divided into treatment group (n =60)and control group (n =60).The treatment group was treated with Anluohuaxian capsule,the control group was given conventional therapy.The levels of serum HA,PC-m,Ⅳ-C were compared before and after treatment.The internal diameter of portal vein,A/P in the period of contraction of arteria hepatica and thickness of spleen were detected by color Doppler and liver stiffness measure (FibroScan).Results The levels of serum HA,PC-Ⅲ,Ⅳ-C,the internal diameter of portal vein and thickness of spleen in the treatment group after treatment were obviously lower than those in control group.Liver stiffness measure (FibroScan),A/P in the period of contraction of arteria hepatica improved obviously (P < 0.05).Conclusions Anluohuaxian capsule can prevent and deteriorate the hepatic fibrosis of chronic hepatitis,and FibroScan has diagnostic value in predicting patients with liver failure induced by HBV infection.%目的 安络化纤丸对慢性肝炎患者肝纤维化指标的影响.并初步分析FibroScan弹性值测定在乙型肝炎后肝纤维化患者中的应用价值.方法 将120例慢性乙肝患者随机分为两组.对照组60例,予常规护肝治疗;治疗组60例,在对照组用药的基础上给予安络化纤丸6g/次,早晚各1次,服用6个月.对比分析治疗前后血清透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(Ⅳ-C)水平的变化及采用彩色多普勒超声仪检测门静脉内径、肝动脉收缩期最大流速/门静脉流速(A/P)、脾脏厚度及FibroScan值.结果 治疗组治疗后血清PCⅢ、HA、Ⅳ-C及门静脉内径、脾脏厚度与治疗前相比有显著降低(P<0.05),Fibro

  4. The influence of gestational age and birth weight in the clinical assesment of the muscle tone of healthy term and preterm newborns A influência da idade gestacional e do peso ao nascimento na avaliação clínica do tono muscular de recém nascidos a termo e prematuros hígidos

    Directory of Open Access Journals (Sweden)

    Edla S. da Silva

    2005-12-01

    Full Text Available OBJECTIVE: To evaluate the influence of gestational age (GA and birth weight (BW in the clinical assessment of the muscle tone of healthy term and preterm newborns. METHOD: Cross sectional study. The muscle tone of healthy 42 preterm and 47 term newborns was quantified and measured with a goniometer (an instrument for measuring angles respectively between 7th-14th day of life and 24-48 hours of life. Newborns were grouped according to GA and BW and evaluated at fixed time intervals by one examiner. Preterm newborns were matched to term at 40 weeks postconceptional age (PCA. RESULTS: The evolution of muscle tone in the preterm occurred gradually, following PCA, independent of birth weight. Preterm newborns had lower scores in all muscle tone indicators when compared to term at the first assessment. Differences were observed among preterm small for GA and adequate to GA for the indicator heel to ear (pOBJETIVO: Verificar a influência da idade gestacional (IG e do peso ao nascimento (PN na avaliação do tono muscular de recém nascidos (RN a termo e prematuros hígidos. MÉTODO: Estudo transversal. O tono muscular de 42 RN prematuros e 47 termo foi quantificado e mensurado com goniômetro (instrumento para medir ângulos, respectivamente entre 7-14 dias de vida e 24-48 horas de vida. Os RN foram agrupados de acordo com IG e PN, sendo avaliados em intervalos fixos. RN prematuros foram comparados aos a termo na 40ª semana de idade concepcional (IC. RESULTADOS: A evolução do tono muscular nos RN prematuros ocorreu de forma gradual de acordo com IC e independente do PN. RN prematuros, na primeira avaliação apresentaram escores de tono muscular inferiores aos de RN a termo em todos os indicadores. Foram observadas diferenças entre RN prematuros pequenos e adequados para a IG em relação ao indicador calcanhar-orelha (p<0,001. O pareamento dos grupos na 40ª semana de IC mostra, exceto pela postura, diferença significativa entre os grupos (p< 0

  5. Influences of depressive emotions on clinical symptoms of pa-tients with diarrhea-predominant irritable bowel syndrome%抑郁情绪对腹泻型肠易激综合征患者临床症状的影响

    Institute of Scientific and Technical Information of China (English)

    苏秀丽; 张英剑; 金建军

    2016-01-01

    目的:探讨抑郁情绪对腹泻型肠易激综合征患者临床症状的影响。方法对84例腹泻型肠易激综合征患者进行生活一般状况、症状程度、抑郁状况筛查,依据汉密顿抑郁量表评分结果将其分为抑郁组和非抑郁组,对两组临床典型症状特征及躯体症状发生率进行对比分析。结果抑郁组临床典型症状严重程度显著重于非抑郁组(P<0.05),两组发作频率及每次持续时间比较差异有显著性( P<0.05或0.01)。抑郁组躯体症状发生率为100%,非抑郁组为33.3%,抑郁组显著高于非抑郁组(χ2=43.45,P<0.01)。患者典型症状严重程度、发作频率、持续时间与汉密顿抑郁量表评分呈显著正相关( P<0.05或0.01)。结论抑郁情绪可加重腹泻型肠易激综合征患者的典型症状,常表现为明显的躯体症状。%Objective To explore the influences of depressive emotions on clinical symptoms of patients with diarrhea‐predominant irritable bowel syndrome (D‐IBS) .Methods General living status ,symptom degrees and depressive status were screened in 84 D‐IBS patients ,they assigned to depression and non‐de‐pression group according to the Hamilton Depression Scale (HAMD) scores ,and contrastive analyses of typical and physical symptoms incidences conducted between 2 groups .Results The severities of typical symptoms were significantly greater (P< 0 .05) and episode frequencies and duration/time longer (P<0 .05 or 0 .01) in depression than in non‐depression group .The incidence of physical symptoms were re‐spectively 100% in depression and 33 .3% in non‐depression group ,the former significantly higher than the latter (χ2 = 43 .45 ,P< 0 .01) .Patients’ severity of typical symptoms ,episode frequencies and duration were positively related to the HAMD score notably (P<0 .05 or 0 .01) .Conclusion Depressive emotions could aggravate the typical symptoms of D

  6. 2009-2014年我院抗菌药物临床应用对鲍曼不动杆菌耐药性变迁的影响%Influence of clinical use of antibiotics on drug resistance of acinetobacter baumannii at our hospital from 2009 to 2014

    Institute of Scientific and Technical Information of China (English)

    蒋陆霞; 贾秀芹; 庞峰; 陈建忠

    2016-01-01

    Objective To explore the influence of the clinical use of antibiotics on the drug resistance of acinetobacter baumannii and to provide a theoretical basis for the rational use of antimicrobial drugs.Methods The annual consumption of antimicrobial agents and the change trend of drug resistance of acinetobacter baumannii in our hospital from 2009 to 2014 were retrospectively analyzed.And the DDDs of antibiotics were calculated.The correlation between the drug resistance of A.baumannii and the DDDs of antibiotics were analyzed by Pearson analysis.Results 2 859 strains of A.baumannii had a trend of multidrug resistance to common antimicrobial agents.The resistance rate of most beta lactam,enzyme inhibitors,aminoglycosides,quinolones,carbapenems,and sulfonamides were over 65.0%.The resistance rate of cefoperazone/sulbactam and minocycline were relatively low,fluctuating between 32.1% and 54.2%.The DDDs of different antimicrobial drugs had different degrees of rises and falls from 2009 to 2014.There was a high positive correlation between the resistance rates of A.baumannii and the DDDs of gentamicin,cefepime,levofloxacin,and imipenem (r>0.800,P<0.05).Conclusions The resistance of acinetobacter baumannii to commonly used antibacterials is relatively serious.The drug resistance of A.baumannii associates with the consumption of antibiotics;and the integrated management of antimicrobial applications should be strengthened.%目的 研究鲍曼不动杆菌耐药性变迁趋势,探讨抗菌药物使用对鲍曼不动杆菌耐药率变化的影响,为临床合理使用抗菌药物提供理论依据.方法 回顾性分析2009-2014年鲍曼不动杆菌耐药率变化趋势及抗菌药物年用量,计算用药频度(DDDs),采用Pearson相关分析法对耐药率与DDDs进行分析.结果 2 859株鲍曼不动杆菌菌株对常用抗菌药物呈多重耐药趋势,对β-内酰胺类、大多β-内酰胺类加酶抑制剂、氨基糖苷类、喹诺酮类、碳青霉烯类

  7. Educational climate seems unrelated to leadership skills of clinical consultants responsible of postgraduate medical education in clinical departments

    DEFF Research Database (Denmark)

    Malling, Bente Vigh; Mortensen, Lene S.; Scherpbier, Albert J J;

    2010-01-01

    The educational climate is crucial in postgraduate medical education. Although leaders are in the position to influence the educational climate, the relationship between leadership skills and educational climate is unknown. This study investigates the relationship between the educational climate ...... clinical departments and the leadership skills of clinical consultants responsible for education.......The educational climate is crucial in postgraduate medical education. Although leaders are in the position to influence the educational climate, the relationship between leadership skills and educational climate is unknown. This study investigates the relationship between the educational climate in...

  8. Computerizing clinical practice guidelines

    DEFF Research Database (Denmark)

    Lyng, Karen Marie

    It is well described that hospitals have problems with sustaining high quality of care and expedient introduction of new medical knowledge. Clinical practice guidelines (CPGs) have been promoted as a remedy to deal with these problems. It is, however, also well described that application and comp......It is well described that hospitals have problems with sustaining high quality of care and expedient introduction of new medical knowledge. Clinical practice guidelines (CPGs) have been promoted as a remedy to deal with these problems. It is, however, also well described that application...... and compliance with CPGs in most areas of clinical practice are deficient. Computerization of CPGs has been brought forward as a method to disseminate and to support application of CPGs. Until now, CPG-computerization has focused on development of formal expressions of CPGs. The developed systems have, however......, not gained any extensive application in clinical practice. The basic assumption in this thesis is that the scanty penetration is due to an inappropriate design process when designing computerized CPGs for clinical work practice. This thesis examines the application of guidance within areas where CPG...

  9. Educational climate seems unrelated to leadership skills of clinical consultants responsible of postgraduate medical education in clinical departments

    OpenAIRE

    Scherpbier Albert JJ; Mortensen Lene S; Malling Bente; Ringsted Charlotte

    2010-01-01

    Abstract Background The educational climate is crucial in postgraduate medical education. Although leaders are in the position to influence the educational climate, the relationship between leadership skills and educational climate is unknown. This study investigates the relationship between the educational climate in clinical departments and the leadership skills of clinical consultants responsible for education. Methods The study was a trans-sectional correlation study. The educational clim...

  10. Influence of clinical characteristics on health-related quality of life after mid-low rectal cancer surgery%临床因素对中下段直肠癌患者术后生存质量的影响

    Institute of Scientific and Technical Information of China (English)

    李欣欣; 宋新明; 陈志辉; 李明哲; 陈冬连; 徐英; 詹文华; 何裕隆

    2012-01-01

    -38 questionnaires(n =330).The impact of clinical characteristics on HRQoL were assessed and compared by univariate and multivariate regression analyses.Results Two hundred and four effective responses were received.Patients with stoma were more impaired in HRQoL than those without stoma,especially in the field of social psychology,such as emotional function (M50 =91.67,U =2668.5,P =0.026),social function (M50 =83.33,U =2095.5,P < 0.001),financial difficulties (M50=0,U=2240.5,P<0.001) and body image (M50=88.89,U=2507.0,P=0.013).Only in the constipation scale (M50 =14.29,U =2376.0,P =0.001),nonstoma patients had a better score.The analysis in different types of surgical procedure paralleled those of stoma.Patients with complication had a poorer function in some symptom scales such as dyspnoea (M50 =O,U =1505.O,P < 0.001),gastrointestinal symptom (M50 =6.67,U =1766.0,P =0.034) and financial difficulties (M50 =33.33,U =1795.5,P =0.044),and in some functioning scales such as emotional function (M50 =83.33,U =1608.5,P =0.009),cognitive function (M50 =66.67,U =1612.5,P =0.010) and body image (M50 =66.67,U =1617.0,P =0.012).In our study,HRQoL after rectal cancer surgery improved with time.Our multivariate analysis displayed that stoma and postoperative time were the most significant characteristics.Variables associated with worse financial status were less postoperative months,occurrence of complications and presence of stoma.Conclusions Different scales of HRQoL in patients of China after curative surgery for mid-low rectal cancer are significantly influenced by different clinical characteristics.

  11. Influences of amisulpride on clinical effect and social function of schizophrenic characterized by negative symptoms%氨磺必利对阴性症状为主的精神分裂症患者临床疗效及社会功能影响

    Institute of Scientific and Technical Information of China (English)

    曹月梅; 董伟; 丛小兵; 顾佩华

    2015-01-01

    Objective To explore amisulpride’s clinical effect ,safety and influences on social function in schizophrenic characterized by negative symptoms (NS) .Methods Sixty‐four NS schizophrenics were ran‐domly assigned to two groups ,research group took orally amisulpride and control group did risperidone for 12 weeks .Before and after treatment clinical effects were assessed with the Brief Psychiatric Rating Scale (BPRS) and Scale for the Assessment of Negative Symptoms (SANS) ,adverse reactions with the Treat‐ment Emergent Symptom Scale (TESS) ,and social function with the Scale of Social Function in Psychosis Inpatients (SSPI) and Social‐Adaptive Functioning Evaluation (SAFE) .Results At the end of the 12th week the BPRS and SANS scores of both groups lowered more significantly comparing with pretreatment (P 0.05) .The SSPI and SAFE scores of both groups improved more signifi‐cantly compared with pretreatment (P<0.01) ,so did those in research than control group (P<0.01) . Adverse reactions of both groups were mild ,the incidence of sinus tachycardia/ST segment change ,patho‐glycemia ,weight gain ,tremor ,menstrual disorder etc .was significantly lower in research than control group (P<0.05 or 0.01) .Conclusion Amisulpride has an evident effect equivalent to risperidone in NS schizophrenic ,but the former does an advantage over the latter in improving abulia ,social disinterest and social function as well as in safety .%目的:探讨氨磺必利治疗以阴性症状为主的精神分裂症患者的临床疗效和安全性以及对社会功能的影响。方法将64例以阴性症状为主的精神分裂症患者随机分为两组,研究组口服氨磺必利治疗,对照组口服利培酮治疗,观察12周。治疗前后采用简明精神病量表、阴性症状量表评定临床疗效,副反应量表评定不良反应,住院精神病人社会功能评定量表和社会适应功能评估量表评定社会功能。结果治疗12周末两组简

  12. The influence factors of fixation failure in the proximal femoral and the clinical effect total hip arthroplasty treatment%股骨转子间骨折内固定失败的相关因素及全髋关节置换术治疗效果分析

    Institute of Scientific and Technical Information of China (English)

    张喜海; 叶俊武; 卓乃强

    2015-01-01

    Objective To investigate the influence factors of fixation failure in the proximal femoral and the clinical effect total hip arthro-plasty treatment. Methods A retrospective analysis were performed in our hospital from 2010 to 2012. Total 119 cases of femoral intertrochanteric fractures and tibial fractures were admitted. The information in all patients were collected included basic information and clinical data. A statisti-cally significant indicators were choosen into multiple Logistic regression model,adjusting for confounding variables,and exploring the factors that may affect patients with hip fracture fixation failure. Results Univariate analysis showed that the medial bone type,bone mass,fractures reason, a fixed location,extent and reset after cortical distance were the main risk factors affecting the patient fixation failure. A significant factors were in-cluded in the Logistic regression model. The results showed that the type of fracture,bone mass,bone fixation failure reset extent the impact of hip fracture patients were the main risk factors. Among them,the fracture type is the biggest factor( OR = 5. 331). After fixation failure,patients were treated with total hip arthroplasty. The results showed that Harris score,pain score,walking score,score,activity scores were significantly higher compared with patients before surgery( P ﹤ 0. 05). Conclusion The type of fracture,bone mass,bone reset extent were the main risk factors for hip fracture patient fixation. Among them,the fracture type is the biggest factor(OR = 5. 331). After fixation failure in the patients with total hip arthroplasty for re - treatment can obtain satisfactory results.%目的:探讨股骨转子间骨折内固定失败的相关因素及全髋关节置换术的治疗效果。方法回顾性分析2010~2012年收治得股骨转子间骨折及股骨胫骨骨折患者119例,收集其基本信息及临床资料,将单因素分析结果具有统计学意义的指标纳入到 Logistic

  13. 透刺电针治疗神经根型颈椎病临床观察及对患者血浆TNF-α和IL1β的影响%Clinical Observation of Electroacupuncture Point-through-point Treatment of Nerve Root Type of Cervical Spondylosis and Influence of TNF-α and IL1β

    Institute of Scientific and Technical Information of China (English)

    万碧江; 黄伟; 张压西; 陈汉跃; 张荒生; 陈培红; 肖凤英; 付兰萍; 张蕾

    2013-01-01

    xObjective: To observe the effect of point - through - point electroacupuncture on nerve root type of cervical disease (CSR) patients and the influence on plasma levels of TNF - a and ILlβ. Methods: 160 cases of CSR patients were randomly divided into 3 groups. 60 cases of point — through — point electroacupuncture group which was treated point — through - point electroacupuncture; 60 cases were treated with penetration needling Jiaji points; 40 cases in Jingfukang group were treated with oral Jingfukang treatment. Assessment of clinical efficacy, and the changes of TNF - a and IL1β were observed before and after treatment. Results: (1) The cure rate of point - through - point electroacupuncture group was 68.9% , the total efficiency was 100% ; in electroacupuncture at Jiaji acupoints group, the cure rate was 39. 2% , the total efficiency was 91.61% ; in Jingfukang group, the cure rate was 22. 8% , the total effective rate was 82. 8% ; comparison of cure rate and the total efficiency among the three groups had significant difference(x2 =20. 1, 9. 7, P < 0. 01). (2) In three groups after the treatment, plasma levels of TNF - a and IL1 p were decreased, but the point -through - point electroacupuncture group were significantly decreased, compared with that before treatment, there was a significant difference ( P < 0.01) , compared with electroacupuncture at Jiaji acupoints group and Jingfukang group, there was significant difference ( P < 0. 05 ). Jingfukang group was superior to the Jiaji acupoints group on plasma TNF - a level decrease, and ILlp regulation in electroacupuncture at Jiaji group was better than that in Jingfukang group. Conclusion-. The clinical efficacy of acupuncture is better than electroacupuncture Jiaji group and Jingfukang group; penetration acupuncture can regulate levels of TNF — a and IL1 β of the nerve root type of cervical spondylosis patients to restore balance , thereby it can reduce inflammatory reaction and obtain the anti

  14. 痰液中MPB64蛋白检测在肺结核诊断中的临床应用及其常见菌对检测影响的研究%The study on the clinical value of MPB64 detection for diagnosing pulmonary tuberculosis and the influence of common pathogen bacteria on MPB64 test

    Institute of Scientific and Technical Information of China (English)

    刘少娟; 孟繁荣; 刘志辉; 彭湘明; 赖艳榕; 秦娟

    2012-01-01

    Objective To explore the clinical value of MPB64 detection for diagnosing pulmonary tuberculosis and the influence of common pathogen bacteria on MPB64 detection.Methods 11 sputum samples separated from the patients who presented positive acid fast stain and had spots found on their lungs in chest X-ray were taken as experimental group.11 sputum samples separated from the patients who presented negative acid fast stain and had found no spots on their lungs in chest X-ray were taken as control group.These samples were tested by Gold-immunochromatography assay,Real-time Quantitative PCR,and smear acid-fast staining respectively.Then the results tested by these 3 methods were compared and analyzed.The 65 strains of common pathogen bacterias isolated from clinical sputum samples were cultured with peptone water for 24 hours.MPB64 were tested by Gold-immunochromatography essay.Results The sensitivity of Gold-immunochromatography assay for testing MPB64 (72.72%) was significantly higher than that of Real-time Quantitative PCR for testing DNA (45.45%).However,the specifity (45.45%) and accuracy (59.09%) of Goldimmunochromatography assay were lower than that of Real-time Quantitative PC R( specifity:100.00%; accuracy:72.73% ).The Coincidence rate of Gold-immunochromatography assay with Real-time Quantitative PCR and smear acid-fast staining were 50.00%、59.09%,respectively.The MPB64 test was positive in cultured bacteria liquid of 25 strains Staphylococcus bacteria.The positive rate was 100%.The MPB64 test was negative in the other microbial strains.Conclusions The method of MPB64 test in samples is fast,easy,and highly sensitive but has a low specifity.The existence of staphylococcus bacteria may lead to a false positive result in MPB64 detection.%目的 探讨痰液MPB64蛋白检测在临床诊断肺结核的价值及常见菌对MPB64检测的影响.方法 以11例涂片抗酸染色阳性且胸片出现肺部阴影的患

  15. Pediatric anthrax clinical management.

    Science.gov (United States)

    Bradley, John S; Peacock, Georgina; Krug, Steven E; Bower, William A; Cohn, Amanda C; Meaney-Delman, Dana; Pavia, Andrew T

    2014-05-01

    Anthrax is a zoonotic disease caused by Bacillus anthracis, which has multiple routes of infection in humans, manifesting in different initial presentations of disease. Because B anthracis has the potential to be used as a biological weapon and can rapidly progress to systemic anthrax with high mortality in those who are exposed and untreated, clinical guidance that can be quickly implemented must be in place before any intentional release of the agent. This document provides clinical guidance for the prophylaxis and treatment of neonates, infants, children, adolescents, and young adults up to the age of 21 (referred to as "children") in the event of a deliberate B anthracis release and offers guidance in areas where the unique characteristics of children dictate a different clinical recommendation from adults.

  16. OARSI Clinical Trials Recommendations

    DEFF Research Database (Denmark)

    McAlindon, T. E.; Driban, J. B.; Henrotin, Y.;

    2015-01-01

    The goal of this document is to update the original OARSI recommendations specifically for the design, conduct, and reporting of clinical trials that target symptom or structure modification among individuals with knee osteoarthritis (OA). To develop recommendations for the design, conduct......, and reporting of clinical trials for knee OA we initially drafted recommendations through an iterative process. Members of the working group included representatives from industry and academia. After the working group members reviewed a final draft, they scored the appropriateness for recommendations. After...... and index knee, describing interventions, patient-reported and physical performance measures, structural outcome measures, biochemical biomarkers, and reporting recommendations. In summary, the working group identified 25 recommendations that represent the current best practices regarding clinical trials...

  17. Social Influence for Security

    Directory of Open Access Journals (Sweden)

    Florin Iftode

    2014-08-01

    Full Text Available The main aim of this work marks the reveling of scientific premises intended to structure the issue of social influence for security. The approach has as aim the identification of those elements that define and characterize the social influence in order to manage conflict, from the perspective of public communication. The proposed approach establishes some synthetic, clear boundaries through the method of research and analysis of the concept of security, social influence, revealing the specifics of public communication in conflict management.

  18. Toward transparent clinical policies.

    Science.gov (United States)

    Shiffman, Richard N; Marcuse, Edgar K; Moyer, Virginia A; Neuspiel, Daniel R; Hodgson, Elizabeth Susan; Glade, Gordon; Harbaugh, Norman; Miller, Marlene R; Sevilla, Xavier; Simpson, Lisa; Takata, Glenn

    2008-03-01

    Clinical policies of professional societies such as the American Academy of Pediatrics are valued highly, not only by clinicians who provide direct health care to children but also by many others who rely on the professional expertise of these organizations, including parents, employers, insurers, and legislators. The utility of a policy depends, in large part, on the degree to which its purpose and basis are clear to policy users, an attribute known as the policy's transparency. This statement describes the critical importance and special value of transparency in clinical policies, guidelines, and recommendations; helps identify obstacles to achieving transparency; and suggests several approaches to overcome these obstacles.

  19. Clinical reasoning of nursing students on clinical placement: Clinical educators' perceptions.

    Science.gov (United States)

    Hunter, Sharyn; Arthur, Carol

    2016-05-01

    Graduate nurses may have knowledge and adequate clinical psychomotor skills however they have been identified as lacking the clinical reasoning skills to deliver safe, effective care suggesting contemporary educational approaches do not always facilitate the development of nursing students' clinical reasoning. While nursing literature explicates the concept of clinical reasoning and develops models that demonstrate clinical reasoning, there is very little published about nursing students and clinical reasoning during clinical placements. Semi-structured interviews were conducted with ten clinical educators to gain an understanding of how they recognised, developed and appraised nursing students' clinical reasoning while on clinical placement. This study found variability in the clinical educators' conceptualisation, recognition, and facilitation of students' clinical reasoning. Although most of the clinical educators conceptualised clinical reasoning as a process those who did not demonstrated the greatest variability in the recognition and facilitation of students' clinical reasoning. The clinical educators in this study also described being unable to adequately appraise a student's clinical reasoning during clinical placement with the use of the current performance assessment tool. PMID:27235568

  20. Social media influencer marketing