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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. 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.

  3. 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 known...

  4. 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

  5. ABCA4 gene analysis in patients with autosomal recessive cone and cone rod dystrophies.

    Science.gov (United States)

    Kitiratschky, Veronique B D; Grau, Tanja; Bernd, Antje; Zrenner, Eberhart; Jägle, Herbert; Renner, Agnes B; Kellner, Ulrich; Rudolph, Günther; Jacobson, Samuel G; Cideciyan, Artur V; Schaich, Simone; Kohl, Susanne; Wissinger, Bernd

    2008-07-01

    The ATP-binding cassette (ABC) transporters constitute a family of large membrane proteins, which transport a variety of substrates across membranes. The ABCA4 protein is expressed in photoreceptors and possibly functions as a transporter for N-retinylidene-phosphatidylethanolamine (N-retinylidene-PE), the Schiff base adduct of all-trans-retinal with PE. Mutations in the ABCA4 gene have been initially associated with autosomal recessive Stargardt disease. Subsequent studies have shown that mutations in ABCA4 can also cause a variety of other retinal dystrophies including cone rod dystrophy and retinitis pigmentosa. To determine the prevalence and mutation spectrum of ABCA4 gene mutations in non-Stargardt phenotypes, we have screened 64 unrelated patients with autosomal recessive cone (arCD) and cone rod dystrophy (arCRD) applying the Asper Ophthalmics ABCR400 microarray followed by DNA sequencing of all coding exons of the ABCA4 gene in subjects with single heterozygous mutations. Disease-associated ABCA4 alleles were identified in 20 of 64 patients with arCD or arCRD. In four of 64 patients (6%) only one mutant ABCA4 allele was detected and in 16 patients (25%), mutations on both ABCA4 alleles were identified. Based on these data we estimate a prevalence of 31% for ABCA4 mutations in arCD and arCRD, supporting the concept that the ABCA4 gene is a major locus for various types of degenerative retinal diseases with abnormalities in cone or both cone and rod function.

  6. 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.

  7. 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。

  8. 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

  9. 全外显子组测序检测到一视网膜色素变性家系ABCA4基因致病剪切新突变%Whole exome sequencing reveals a novel splicing mutation in the ABCA4 gene in a Chinese family with retinitis pigmentosa

    Institute of Scientific and Technical Information of China (English)

    周玉; 朱雄; 黄璐琳; 张琳; 蒋志林; 陈辉; 朱献军

    2016-01-01

    Objective To investigate the genetic mutation in a Chinese family with retinitis pigmentosa disease.Methods In this experimental study,clinical features were evaluated by medical history,visual acuity measurement and multifocal electroretinogram (mfERG).Genomic DNA from peripheral blood samples of the family members was extracted.The DNA sample of the proband patient was subjected to whole exome sequencing (WES) and data analysis.Results Two affected persons were found among the five family members.Symptoms of the disease initially presented during childhood with night blindness and progressively impaired peripheral vision.Fundus examination showed retinal perivascular black bone-spicules.An electroretinogram showed a severely depressed peripheral waveform and significant loss of the paracentral retinal response.The hereditary characteristic in this family presented in two children but both of the parents were normal,suggesting an autosomal recessive pattern.Exome sequencing,mutation detection and Sanger variants validation revealed a novel homozygous splicing mutation c.1761-2A>G in the ABCA4 gene.Meanwhile,this homozygous splicing mutation was absent in 500 ethnically matched control samples screened by direct Sanger sequencing.Conclusion Our study revealed a novel homozygous splicing mutation c.1761-2A>G in the ABCA4 gene,expanding the ABCA4 mutation spectrums and may provide a new target locus for RP diagnosis and treatment.%目的 探讨一个中国视网膜色素变性(RP)家系的致病基因及其位点.方法 实验研究.对一个RP家系的成员进行病史采集、视力检查、眼底检查及多焦视网膜电图(mfERG)检查.绘制家系图,对家系成员采血,进行DNA提取、全外显子组测序、数据分析和Sanger测序验证,并在500例健康对照者中进行测序验证.结果 共纳入该家系成员5例,含2例患者.患者表现为青少年期发病,夜盲,进行性周边视力受损,逐渐累及中央区.眼底检查显示视

  10. The ABCA4 2588G > C Stargardt mutation : Single origin and increasing frequency from South-West to North-East Europe

    NARCIS (Netherlands)

    Maugeri, A; Flothmann, K; Hemmrich, N; Ingvast, S; Jorge, P; Paloma, E; Patel, R; Rozet, JM; Tammur, J; Testa, F; Balcells, S; Bird, AC; Brunner, HG; Hoyng, CB; Metspalu, A; Simonelli, F; Allikmets, R; Bhattacharya, SS; D'Urso, M; Gonzalez-Duarte, R; Kaplan, J; Meerman, GJT; Santoss, R; Schwartz, M; Van Camp, G; Wadelius, C; Weber, BHF; Cremers, FPM

    2002-01-01

    Inherited retinal dystrophies represent the most important cause of vision impairment in adolescence, affecting approximately 1 out of 3000 individuals. Mutations of the photoreceptor-specific gene ABCA4 (ABCR) are a common cause of retinal dystrophy. A number of mutations have been repeatedly repor

  11. 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.

  12. 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.

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

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    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...

  14. Factors influencing nurses' participation in clinical research.

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    Jacobson, Ann F; Warner, Andrea M; Fleming, Eileen; Schmidt, Bruce

    2008-01-01

    Clinical research is necessary for developing nursing's body of knowledge and improving the quality of gastroenterology nursing care. The support and participation of nursing staff are crucial to conducting interventional research. Identification of characteristics of nurses and their work settings that facilitate or impede participation in research is needed. The purpose of this descriptive correlational study was to examine the effect of personal and professional characteristics and attitudes about nursing research on staff nurses' participation in a clinical nursing research project. A questionnaire measuring nurses' attitudes, perceptions of availability of support, and research use was distributed to staff nurses working on an endoscopy lab and two same-day surgery units where a nursing research study had recently been conducted. Investigator-developed items measured nurses' attitudes about the utility and feasibility of the interventions tested in the original study. A total of 36 usable questionnaires comprised the sample. Factor analysis of the two questionnaires resulted in three-factor (Importance of Research, Interest in Research, and Environment Support of Research) and two-factor (Value of Cognitive-Behavioral Interventions [CBIs] and Participation in Study) solutions, respectively. There were no statistically significant differences in mean scores for the five factors between nurses who did (n = 19) and those who did not (n = 17) participate in the original study. The Participation in Research Factor was significantly negatively correlated with years in nursing (r = -.336, p body of knowledge about factors that facilitate or impede staff nurses' involvement in research. This knowledge will be useful for nurse researchers planning intervention studies to forecast and foster staff nurse involvement in their projects. Findings may also be useful to nurse managers, nurse educators, and staff development personnel in assessing and promoting staff nurses

  15. Factors influencing radiation therapy student clinical placement satisfaction

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    Bridge, Pete; Carmichael, Mary-Ann [School of Clinical Sciences, Queensland University of Technology, Brisbane (Australia)

    2014-02-15

    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.

  16. Characteristics of leadership that influence clinical learning: a narrative review.

    Science.gov (United States)

    Walker, Rachel; Cooke, Marie; Henderson, Amanda; Creedy, Debra K

    2011-11-01

    Leadership has been consistently implied in fostering clinical learning. However there is a lack of clarity about the form leadership should take. Limited quantitative research indicated a narrative approach to review literature from a broad perspective. A framework to guide the synthesis was developed to ensure a rigorous review process. Preliminary reading and review of papers using search terms nursing and leadership and clinical learning and learning culture narrowed the inclusion criteria to 245 papers published between 2000 and 2010. Given the diversity of the papers' focus, aim and context, a refined screening process justified the inclusion of twenty-six papers in the review. A critical appraisal of these peer-reviewed quantitative, qualitative and commentary papers identified factors/elements integral to effective leadership. Across the literature leadership was discussed in relation to two broad themes: influence of leadership on organisational learning and development and; influence of leadership on undergraduate clinical education. The factors central to leadership emerged as transformative principles, the role of the nurse unit/ward manager, collaboration and relationship building and role-modelling. The review has raised some suggestions for future research aimed at examining the impact of a leadership capacity building intervention that supports clinical learning.

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

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    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.

  18. Influences upon pediatricians’ willingness to refer patients to clinical research

    Directory of Open Access Journals (Sweden)

    Jeanne Dalen

    2010-03-01

    Full Text Available Jeanne Dalen1, Robert D Annett2, Janet L Brody1, Mandy L Perryman31Center for Family and Adolescent Research, Oregon Research Institute, Portland, OR, USA; 2University of New Mexico Health Sciences Center, Albuquerque, NM, USA; 3School of Education and Human Development, Lynchburg College, Lynchburg, UA, USAPurpose: The purpose of this brief report is to determine factors that influence the willingness of pediatricians to refer their patients to clinical research and to explore the relationship between pediatrician characteristics and self-reported number of patients referred to clinical research.Method: Forty-three pediatricians from an academic pediatrics department of a university children’s hospital in Albuquerque, New Mexico rated how influential 10 reasons would be in their decision to refer a patient to pediatric clinical research.Results: Differences among the influences for pediatrician referral to research were observed. The most influential consideration for referral was the scientific merit of the study, followed by patient benefit. Contextual factors and physician compensation were identified as the least important reasons pediatricians refer patients to research. Analyses also revealed significant relationships between referrals made and percentage of time spent in research activities.Conclusions: Pediatricians may be more likely to refer their patients to clinical research studies when they believe the purpose of the study is meaningful to patients as well as to future patient populations. In addition, characteristics of the individual pediatricians may play an important role in actual referral behavior.Keywords: recruitment, clinical research, adolescent research, pediatrician attitudes

  19. 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.

  20. Influence of cell quality on clinical outcome after autologous chondrocyte implantation

    DEFF Research Database (Denmark)

    Niemeyer, Philipp; Pestka, Jan M; Salzmann, Gian M;

    2012-01-01

    BACKGROUND: Several factors influence clinical outcome after autologous chondrocyte implantation (ACI) for the treatment of cartilage defects of the knee joint. HYPOTHESIS/PURPOSE: The aim of the present study was to investigate the influence of cell quality on clinical outcome after ACI. The hyp...

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

    DEFF Research Database (Denmark)

    Smed, Marie; Getz, Kenneth A.

    2014-01-01

    Investigative sites participating in clinical trials play an instrumental role in aiding market adoption. Site experiences in clinical research help physician investigators and research professionals gain familiarity with and exposure to investigational treatments. This knowledge may be passed on...

  2. 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

  3. 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…

  4. 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…

  5. The influence of neck thrombus on clinical outcome and aneurysm morphology after endovascular aneurysm repair

    NARCIS (Netherlands)

    Goncalves, Frederico Bastos; Verhagen, Hence J. M.; Chinsakchai, Khamin; van Keulen, Jasper W.; Voute, Michiel T.; Zandvoort, Herman J.; Moll, Frans L.; van Herwaarden, Joost A.

    2012-01-01

    Objective: This study investigated the influence of significant aneurysm neck thrombus in clinical and morphologic outcomes after endovascular aneurysm repair (EVAR). Methods: The patient population was derived from a prospective EVAR database from two university institutions in The Netherlands from

  6. Compassion in nursing. 2: Factors that influence compassionate care in clinical practice.

    Science.gov (United States)

    Davison, Neil; Williams, Katherine

    This second in a two-part unit on compassion examines the factors that influence the use of this quality in daily clinical practice. Part 1 examined the concept of compassion and how to identify and measure it.

  7. 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.

  8. Influence networks among substance abuse treatment clinics: implications for the dissemination of innovations.

    Science.gov (United States)

    Johnson, Kimberly; Quanbeck, Andrew; Maus, Adam; Gustafson, David H; Dearing, James W

    2015-09-01

    Understanding influence networks among substance abuse treatment clinics may speed the diffusion of innovations. The purpose of this study was to describe influence networks in Massachusetts, Michigan, New York, Oregon, and Washington and test two expectations, using social network analysis: (1) Social network measures can identify influential clinics; and (2) Within a network, some weakly connected clinics access out-of-network sources of innovative evidence-based practices and can spread these innovations through the network. A survey of 201 clinics in a parent study on quality improvement provided the data. Network measures and sociograms were obtained from adjacency matrixes created by UCINet. We used regression analysis to determine whether network status relates to clinics' adopting innovations. Findings suggest that influential clinics can be identified and that loosely linked clinics were likely to join the study sooner than more influential clinics but were not more likely to have improved outcomes than other organizations. Findings identify the structure of influence networks for SUD treatment organizations and have mixed results on how those structures impacted diffusion of the intervention under study. Further study is necessary to test whether use of knowledge of the network structure will have an effect on the pace and breadth of dissemination of innovations.

  9. 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.

  10. 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.

  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. 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.

  13. Evaluating factors influencing screening for pulmonary hypertension in systemic sclerosis: does disparity between available guidelines influence clinical practice?

    Science.gov (United States)

    Pauling, John D; McHugh, Neil J

    2012-02-01

    Pulmonary arterial hypertension (PAH) is one of the leading causes of mortality in systemic sclerosis (SSc). We audited adherence with available recommendations regarding cardiopulmonary screening for PAH in SSc and explored potential factors influencing clinical practice. A retrospective case note review of 108 patients with SSc who had attended outpatient clinic over the previous year was undertaken. Records were scrutinised for evidence of previous assessment with trans-thoracic echocardiography (TTE) and pulmonary function tests (PFT), along with information regarding clinical phenotype and serological subset. The proportion of patients for whom screening had been undertaken within the previous 12 months was low, with significantly fewer having TTE compared with PFT assessment (34.7% vs. 53.1%, p = 0.014). The majority of patients had undergone TTE and PFT assessment within the previous 2 years, but a lower proportion had undergone TTE compared with PFT (69.4% vs. 82.7%, p = 0.044). There were strong trends for more frequent PFT assessment in younger patients, limited cutaneous SSc and worse previous PFT results. In contrast, the frequency of TTE assessment was not associated with previous investigation results or disease subtype. Serological profile did not influence the frequency of either TTE or PFT assessments. Disparity between available published guidelines may influence both the frequency and preference of PAH screening in SSc in clinical practice. The higher frequency of PFT assessment might reflect a perceived superiority amongst clinicians of PFT over TTE in the early identification of SSc-PAH. SSc-specific guidelines, possibly incorporating additional independent risk factors, may improve the cost-effectiveness and clinical efficacy of screening recommendations designed to ensure the early identification of PAH in patients with SSc.

  14. 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.

  15. Factors influencing the participation of gastroenterologists and hepatologists in clinical research

    Directory of Open Access Journals (Sweden)

    Zekry Amany

    2008-10-01

    Full Text Available Abstract Background Although clinical research is integral to the advancement of medical knowledge, physicians face a variety of obstacles to their participation as investigators in clinical trials. We examined factors that influence the participation of gastroenterologists and hepatologists in clinical research. Methods We surveyed 1050 members of the American Association for the Study of Liver Diseases regarding their participation in clinical research. We compared the survey responses by specialty and level of clinical trial experience. Results A majority of the respondents (71.6% reported involvement in research activities. Factors most influential in clinical trial participation included funding and compensation (88.3% and intellectual pursuit (87.8%. Barriers to participation were similar between gastroenterologists (n = 160 and hepatologists (n = 189 and between highly experienced (n = 62 and less experienced (n = 159 clinical researchers. These barriers included uncompensated research costs and lack of specialized support. Industry marketing was a greater influence among respondents with less trial experience, compared to those with extensive experience (15.7% vs 1.6%; P Conclusion This study suggests that the greatest barrier to participation in clinical research is lack of adequate resources. Respondents also favored industry-sponsored research with less complex trial protocols and studies of relatively short duration.

  16. INFLUENCE OF THE SAGITTAL BALANCE ON THE CLINICAL OUTCOME IN SPINAL FUSION

    OpenAIRE

    2016-01-01

    ABSTRACT Objective: Evaluates which radiographic parameters of the sagittal and spinopelvic balance influence the clinical and functional outcomes of a sample of patients undergoing spinal fusion. Methods: We studied 32 patients who underwent spinal fusion. Radiographs of the total spine were obtained from all patients. The clinical and functional parameters studied were analysis of pain by visual analogic scale (VAS) and Oswestry and SRS-30 questionnaires. We analyzed the correlation bet...

  17. 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.

  18. The influence of punctural millimeter wave therapy on clinical presentation of patients with essential hypertention

    Directory of Open Access Journals (Sweden)

    Kotenko К.V.

    2013-12-01

    Full Text Available Aim: to estimate the influence of punctural millimeter wave therapy on clinical presentation. Material and methods. This study includes 102 patients with essential hypertension the I and II stage. Patients were divided into three equal groups depending on the method of treatment: some of them received procedures of punctural millimeter wave therapy, some of them received these procedures as the "placebo" and those who had not received specified procedures. Dynamics of clinical symptomatology and condition of eye bottom vessels was estimated. It was shown that addition of punctural millimeter wave therapy in complex therapy of patients with essential hypertension promotes the expressed regress of clinical symptomatology and state normalization the retinal vessels at these patients. Results. Addition of punctural millimeter wave therapy into the complex therapy was shown to lead to pronounced regress of clinical symptoms. Conclusion. The received results allow to recommend this method to be used in clinical practice for treating patients with essential hypertension.

  19. Influence of Septal Thickness on the Clinical Outcome After Alcohol Septal Alation in Hypertrophic Cardiomyopathy

    DEFF Research Database (Denmark)

    Jensen, Morten K; Jacobsson, Linda; Almaas, Vibeke;

    2016-01-01

    BACKGROUND: We assessed the influence of interventricular septal thickness (IVSd) on the clinical outcome and survival after alcohol septal ablation (ASA) in patient with hypertrophic cardiomyopathy. METHODS AND RESULTS: We analyzed 531 patients with hypertrophic cardiomyopathy (age: 56±14 years...

  20. 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...

  1. The influence of lithium on calcium homeostasis in older patients in daily clinical practice

    NARCIS (Netherlands)

    van Melick, Els Jacoba Maria; Wilting, Ingeborg; Ziere, Gijsbertus; Kok, Robert Martin; Egberts, Toine Cornelis Gerardus

    2014-01-01

    BACKGROUND: Lithium can influence calcium homeostasis resulting in changes in parathormone set point and renal calcium handling. The clinical significance of these changes in older patients is unknown. The objective of this study was to investigate the possible association between duration of lithiu

  2. 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

  3. The influence of neck thrombus on clinical outcome and aneurysm morphology after endovascular aneurysm repair

    NARCIS (Netherlands)

    F.M.V. Bastos Gonçalves (Frederico); H.J.M. Verhagen (Hence); K. Chinsakchai (Khamin); J.W. van Keulen (Jasper); M.T. Voûte (Michiel); H.J.A. Zandvoort (Herman); F.L. Moll (Frans); J.A. van Herwaarden (Joost)

    2012-01-01

    textabstractObjective: This study investigated the influence of significant aneurysm neck thrombus in clinical and morphologic outcomes after endovascular aneurysm repair (EVAR). Methods: The patient population was derived from a prospective EVAR database from two university institutions in The Neth

  4. Factors influencing the effectiveness of clinical learning environment in nursing education

    Directory of Open Access Journals (Sweden)

    Elena Gurková

    2016-08-01

    Full Text Available Aim: The purpose of the cross-sectional descriptive study was to investigate how nursing students evaluate particular factors of clinical learning environment during their professional placement in hospitals. We explored which factors of clinical environment contribute significantly to students' evaluation of it. Design: A descriptive cross-sectional study. Methods: The sample included 503 nursing students in their second or third year of study at six Slovak universities. A valid and reliable questionnaire, the Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale (CLES+T, was used to evaluate the student nurses' experiences and clinical placement. The data were analysed using descriptive statistics, Pearson's chi-square test, multifactorial ANOVA procedure and Pearsons' correlations, and p-value < 0.05 was taken to indicate statistical significance for all comparisons. Results: A significant proportion of students experienced a traditional model of group supervision. Supervision method, supervisory session frequency, and duration of clinical placement had a significant impact on their evaluation of clinical environments. Conclusion: Supervision methods are a significant factor influencing student evaluation of their clinical placement environment. Compared to other European studies, we found a less frequent application of individual supervision and that the Slovak university setting is dominated by a traditional group model of supervision. The study offers a valuable insight into the analysis of factors contributing to improvements in clinical learning environment and models of clinical or workplace training.

  5. Shared decision making does not influence physicians against clinical practice guidelines.

    Directory of Open Access Journals (Sweden)

    Mireille Guerrier

    Full Text Available While shared decision making (SDM and adherence to clinical practice guidelines (CPGs are important, some believe they are incompatible. This study explored the mutual influence between physicians' intention to engage in SDM and their intention to follow CPGs.Embedded within a clustered randomized trial to assess the impact of training physicians in SDM about using antibiotics to treat acute respiratory tract infections, this study evaluated physicians' intentions to both engage in SDM and follow CPGs. A self-administered questionnaire based on the theory of planned behavior evaluated both behavioral intentions and their respective determinants (attitude, subjective norm and perceived behavioral control at study entry and exit. We used path analysis to explore the relationships between the intentions. We conducted statistical analyses using the maximum likelihood method and the variance-covariance matrix. Goodness of fit indices encompassed the chi-square statistic, the comparative fit index and the root mean square error of approximation.We analyzed 244 responses at entry and 236 at exit. In the control group, at entry we observed that physicians' intention to engage in SDM (r = 0, t = 0.03 did not affect their intention to follow CPGs; however, their intention to follow CPGs (r = -0.31 t = -2.82 did negatively influence their intention to engage in SDM. At exit, neither behavioral intention influenced the other. In the experimental group, at entry neither behavioral intention influenced the other; at exit, the intention to engage in SDM still did not influence the intention to use CPGs, although the intention to follow CPGs (r = -0.15 t = -2.02 slightly negatively influenced the intention to engage in SDM, but this was not clinically significant.Physicians' intention to engage in SDM does not affect their intention to adopt CPGs even after SDM training. Physicians' intention to adopt CPGs had no clinically significant

  6. Influence of contact with schizophrenia on implicit attitudes towards schizophrenia patients held by clinical residents

    Directory of Open Access Journals (Sweden)

    Omori Ataru

    2012-11-01

    Full Text Available Abstract Background Patients with schizophrenia and their families have suffered greatly from stigmatizing effects. Although many efforts have been made to eradicate both prejudice and stigma, they still prevail even among medical professionals, and little is known about how contact with schizophrenia patients affects their attitudes towards schizophrenia. Methods We assessed the impact of the renaming of the Japanese term for schizophrenia on clinical residents and also evaluated the influence of contact with schizophrenia patients on attitudes toward schizophrenia by comparing the attitudes toward schizophrenia before and after a one-month clinical training period in psychiatry. Fifty-one clinical residents participated. Their attitudes toward schizophrenia were assessed twice, before and one month after clinical training in psychiatry using the Implicit Association Test (IAT as well as Link’s devaluation-discrimination scale. Results The old term for schizophrenia, “Seishin-Bunretsu-Byo”, was more congruent with criminal than the new term for schizophrenia, “Togo-Shitcho-Sho”, before clinical training. However, quite opposite to our expectation, after clinical training the new term had become even more congruent with criminal than the old term. There was no significant correlation between Link's scale and IAT effect. Conclusions Renaming the Japanese term for schizophrenia still reduced the negative images of schizophrenia among clinical residents. However, contact with schizophrenia patients unexpectedly changed clinical residents’ attitudes towards schizophrenia negatively. Our results might contribute to an understanding of the formation of negative attitudes about schizophrenia and assist in developing appropriate clinical training in psychiatry that could reduce prejudice and stigma concerning schizophrenia.

  7. Examining the Influence of Context and Professional Culture on Clinical Reasoning Through Rhetorical-Narrative Analysis.

    Science.gov (United States)

    Peters, Amanda; Vanstone, Meredith; Monteiro, Sandra; Norman, Geoff; Sherbino, Jonathan; Sibbald, Matthew

    2016-05-23

    According to the dual process model of reasoning, physicians make diagnostic decisions using two mental systems: System 1, which is rapid, unconscious, and intuitive, and System 2, which is slow, rational, and analytical. Currently, little is known about physicians' use of System 1 or intuitive reasoning in practice. In a qualitative study of clinical reasoning, physicians were asked to tell stories about times when they used intuitive reasoning while working up an acutely unwell patient, and we combine socio-narratology and rhetorical theory to analyze physicians' stories. Our analysis reveals that in describing their work, physicians draw on two competing narrative structures: one that is aligned with an evidence-based medicine approach valuing System 2 and one that is aligned with cooperative decision making involving others in the clinical environment valuing System 1. Our findings support an understanding of clinical reasoning as distributed, contextual, and influenced by professional culture.

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

    Science.gov (United States)

    Lise, Stefano; Broxholme, John; Cazier, Jean-Baptiste; Rimmer, Andy; Kanapin, Alexander; Lunter, Gerton; Fiddy, Simon; Allan, Chris; Aricescu, A. Radu; Attar, Moustafa; Babbs, Christian; Becq, Jennifer; Beeson, David; Bento, Celeste; Bignell, Patricia; Blair, Edward; Buckle, Veronica J; Bull, Katherine; Cais, Ondrej; Cario, Holger; Chapel, Helen; Copley, Richard R; Cornall, Richard; Craft, Jude; Dahan, Karin; Davenport, Emma E; Dendrou, Calliope; Devuyst, Olivier; Fenwick, Aimée L; Flint, Jonathan; Fugger, Lars; Gilbert, Rodney D; Goriely, Anne; Green, Angie; Greger, Ingo H.; Grocock, Russell; Gruszczyk, Anja V; Hastings, Robert; Hatton, Edouard; Higgs, Doug; Hill, Adrian; Holmes, Chris; Howard, Malcolm; Hughes, Linda; Humburg, Peter; Johnson, David; Karpe, Fredrik; Kingsbury, Zoya; Kini, Usha; Knight, Julian C; Krohn, Jonathan; Lamble, Sarah; Langman, Craig; Lonie, Lorne; Luck, Joshua; McCarthy, Davis; McGowan, Simon J; McMullin, Mary Frances; Miller, Kerry A; Murray, Lisa; Németh, Andrea H; Nesbit, M Andrew; Nutt, David; Ormondroyd, Elizabeth; Oturai, Annette Bang; Pagnamenta, Alistair; Patel, Smita Y; Percy, Melanie; Petousi, Nayia; Piazza, Paolo; Piret, Sian E; Polanco-Echeverry, Guadalupe; Popitsch, Niko; Powrie, Fiona; Pugh, Chris; Quek, Lynn; Robbins, Peter A; Robson, Kathryn; Russo, Alexandra; Sahgal, Natasha; van Schouwenburg, Pauline A; Schuh, Anna; Silverman, Earl; Simmons, Alison; Sørensen, Per Soelberg; Sweeney, Elizabeth; Taylor, John; Thakker, Rajesh V; Tomlinson, Ian; Trebes, Amy; Twigg, Stephen RF; Uhlig, Holm H; Vyas, Paresh; Vyse, Tim; Wall, Steven A; Watkins, Hugh; Whyte, Michael P; Witty, Lorna; Wright, Ben; Yau, Chris; Buck, David; Humphray, Sean; Ratcliffe, Peter J; Bell, John I; Wilkie, Andrew OM; Bentley, David; Donnelly, Peter; McVean, Gilean

    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 across a broad spectrum of disorders in whom prior screening had identified no pathogenic variants. We quantified the number of candidate variants identified using different strategies for variant calling, filtering, annotation and prioritisation. We found that jointly calling variants across samples, filtering against both local and external databases, deploying multiple annotation tools and using familial transmission above biological plausibility contributed to accuracy. Overall, we identified disease causing variants in 21% of cases, rising to 34% (23/68) for Mendelian disorders and 57% (8/14) in trios. We also discovered 32 potentially clinically actionable variants in 18 genes unrelated to the referral disorder, though only four were ultimately considered reportable. Our results demonstrate the value of genome sequencing for routine clinical diagnosis, but also highlight many outstanding challenges. PMID:25985138

  9. INFLUENCE OF THE SAGITTAL BALANCE ON THE CLINICAL OUTCOME IN SPINAL FUSION

    Directory of Open Access Journals (Sweden)

    Marcela Almeida Campos Coutinho

    2016-03-01

    Full Text Available ABSTRACT Objective: Evaluates which radiographic parameters of the sagittal and spinopelvic balance influence the clinical and functional outcomes of a sample of patients undergoing spinal fusion. Methods: We studied 32 patients who underwent spinal fusion. Radiographs of the total spine were obtained from all patients. The clinical and functional parameters studied were analysis of pain by visual analogic scale (VAS and Oswestry and SRS-30 questionnaires. We analyzed the correlation between the clinical and functional parameters and radiographic parameters of the sagittal and spinopelvic balance. Results: There was no significant correlation between parameters pelvic incidence (PI, pelvic tilt (PT, lumbar lordosis (LL and difference between PI and LL (PI-LL and clinical parameters (p > 0.05 and r <0.2. Significant correlation were identified only between Sagittal Vertical Axis (SVA and Satisfaction with Treatment domain of SRS-30 (r = 0.402 e p = 0.023 and between thoracic kyphosis (TK and the total SRS-30 (r = 0.419 and p = 0.017. Conclusions: According to the study results, it was not possible to precisely characterize the role of the parameters of the sagittal and spinopelvic balance in the post-operative analysis of the clinical outcome of spinal fusion. There was a significant correlation only between SVA and the Satisfaction with Treatment domain of SRS-30 and between TK and total SRS-30.

  10. 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

  11. 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.

  12. [Influence of Teamwork on Wellbeing And Emotional Exhaustion of Staff in German Rehabilitation Clinics].

    Science.gov (United States)

    Becker, S; Konrad, A; Zimmermann, L; Müller, C; Tomczyk, S; Reichler, L; Körner, M

    2016-06-09

    Aim: In the context of high prevalence rates of mental and psychosomatic disorders in the medical staff, emotional exhaustion and wellbeing are often considered as important indicators. Teamwork can have a positive influence on wellbeing of staff members. In the sector of rehabilitation, however, this is not sufficiently investigated. The aim of this study was to investigate aspects of teamwork as predictors of wellbeing and emotional exhaustion in staff at rehabilitation clinics in Germany. Methods: Data was collected in 10 rehabilitation clinics, 9 of them could be included in the data analysis (n=306, 70% female, 68% age 40-59). Data was analyzed with multiple linear regression analyses. Results: Staff reported moderate rates of emotional exhaustion and good rates of overall wellbeing. Results of the regression analysis show that cohesion (β=0.27, pwellbeing (F[3, 244]=19.38, pwellbeing and counteract emotional exhaustion of staff members.

  13. Clinical value and influencing factors of intraoperative monitoring of jugular venous oxygen saturation

    Directory of Open Access Journals (Sweden)

    Jie SONG

    2016-10-01

    Full Text Available Intraoperative jugular venous oxygen saturation (SjvO2 monitoring has been widely used in clinic, which can monitor cerebral blood flow (CBF and oxygen metabolism. Reverse puncture and catheterization through jugular vein for monitoring SjvO2 is easy to operate and can collect blood samples repeatedly. It is an effective method for real-time dynamic evaluation of cerebral oxygen supply-demand and neurological function. This article reviews the clinical significance and influencing factors of SjvO2 monitoring during operation. It notes in particular that SjvO2 can not be used as the only way to monitor CBF and oxygen metabolism, and a comprehensive evaluation should be done combining with the change of other parameters. DOI: 10.3969/j.issn.1672-6731.2016.10.014

  14. The influence of initial bipedal stance width on the clinical measurement of unipedal balance time

    Science.gov (United States)

    Richardson, James K.; Tang, Chi; Nwagwu, Chijioke; Nnodim, Joseph

    2012-01-01

    Objective To determine the effect of varying initial bipedal stance width (ISW) on the clinical measurement of unipedal balance time (UBT). Design Observational, cross sectional study. Setting Academic physiatric outpatient facility. Subjects Thirty-one clinic subjects with neuromuscular and/or musculoskeletal conditions known to influence mobility, and 30 similarly-aged healthy subjects. Methods Demographic and clinical information were recorded. UBT was determined under three distinct conditions by varying bipedal inter-malleolar distance: 1) ISW of 0.3 body height; 2) ISW of 0.05 body height; and 3) ISW of 0 body height. The last was accomplished by subjects assuming unipedal balance while using the hands on a horizontal surface for stabilization. Subjects lifted the contralateral foot (or hands in the case of 0 body height condition) in response to a cadenced command to minimize variation in rate of weight transfer Main Outcome Measurements UBT under each of the three ISW conditions. Results Mean UBT increased with decreasing ISW, and the differences were significant when comparing each ISW with the next smaller. Healthy subjects demonstrated greater UBT than clinic subjects at each ISW, but the magnitude of these group differences were similar across ISW condition. A UBT > 10 seconds in the 0.3 body height ISW was the best discriminator between clinic and healthy subjects. Conclusions Because UBT varies with ISW, standardization of ISW is necessary for accurate within subject, and between subject, comparisons in UBT. Healthy subjects were best differentiated from clinic subjects by UBT > 10 sec in the 0.3 body height ISW condition. PMID:20430326

  15. Factors influencing the confidence in core clinical skills among hospital nurses.

    Science.gov (United States)

    Yang, Young Ok; Kim, Minju; Park, Kyung-Yeon; Yang, Jin-Hyang

    2015-12-01

    The purpose of this study was to examine the confidence to perform 20 clinical skills and identify factors influencing the confidence of hospital nurses. A descriptive, cross-sectional study was conducted with 550 hospital nurses at four hospitals in B city, Korea. The confidence to perform, frequency of performance and educational needs on 20 clinical skills identified by Korean Accreditation Board of Nursing were measured with a self-reported questionnaire. Data were analysed by SPSS 19.0 (IBM Corporation, Armonk, New York, USA). Participants were 27 years old on average, and 49.5% had less than 3 years of total working experience. The most confident skill was measuring vital signs, whereas the least confident skill was using defibrillator. In results of stepwise regression, confidence to perform was associated with educational needs, total working experience, frequency of performance and position. It is necessary to give opportunities to practice clinical skills at both schools and clinics for producing well-prepared nurses.

  16. 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.

  17. 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.

  18. Factors influencing nursing students' academic and clinical performance and attrition: an integrative literature review.

    Science.gov (United States)

    Pitt, Victoria; Powis, David; Levett-Jones, Tracy; Hunter, Sharyn

    2012-11-01

    Predicted workforce shortages have resulted in government initiatives to increase student numbers in preregistration nursing education. In tandem schools of nursing need to ensure students' progress and complete. The aim of this review was to identify factors that influence preregistration nursing students' academic performance, clinical performance and attrition. An integrative review of both quantitative and qualitative literature was conducted using validated appraisal checklists. The review included studies published from 1999 to 2011 in the databases: MEDLINE, CINAHL, Proquest nursing, Proquest Education (via Proquest 5000), ERIC, Journals@Ovid, PsychINFO and ScienceDirect. Studies were categorised according to their impact on academic progression, clinical progression and attrition. Forty four studies were found; most used quantitative methodologies. The review identified that few studies explored factors that impact on students' clinical performance. The four categories that potentially impact on nursing students' academic performance and attrition were: demographic, academic, cognitive and personality/behavioural factors. The challenge for universities committed to students' success is to develop strategies aimed at addressing these factors that are appropriate to specific contexts and student cohorts.

  19. Influence of Fatty Liver on the Severity and Clinical Outcome in Acute Pancreatitis.

    Directory of Open Access Journals (Sweden)

    Chunfang Xu

    Full Text Available Acute pancreatitis (AP is a common disease in the department of gastroenterology with variable severity, from being mild and self-limited to severe and fatal. The early diagnosis and accurate prediction of AP severity are of great importance. Our primary observation showed that fatty liver (FL was frequently detected in patients with AP. In this retrospective study, we aimed to evaluate the relation between FL and the severity and outcomes of AP. The medical records of 2671 patients with AP were reviewed retrospectively, and characteristics of AP patients were recorded. FL was assessed by abdominal CT scan, and AP patients were categorized by the occurrence of FL for the analysis. The variation of mortality, clinical severity and the appearance of CT were analyzed between the non-FL group and FL groups. Compared with patients without FL, an obviously higher rate of death and higher frequency of severe AP (SAP and necrotizing AP (ANP were observed in patients with FL, as well as the incidence of local complications and systemic complications. Taking obesity into consideration, a higher rate of death and more severe AP were found in patients with FL, no matter whether they were obese or not. Alcoholic fatty liver (AFL and non-alcoholic fatty liver (NAFL were also separated for comparison in this study; the incidence of ANP and the clinical severity had no significant difference between the AFL and NAFL groups. In conclusion, FL could influence the severity and clinical outcome and may play a prognostic role in AP. This study is of clinical significance, because few reports have been previously issued on FL and AP.

  20. Common synonymous variants in ABCA4 are protective for chloroquine induced maculopathy (toxic maculopathy)

    OpenAIRE

    Weber, Bernhard H. F.; Bergholz, Richard; Mändl, Julia; Jägle, Herbert; Ruether, Klaus; Grassmann, Felix

    2015-01-01

    Background Chloroquine (CQ) and hydroxychloroquine (HCQ) are used to treat auto-immune related diseases such as rheumatoid arthritis (RA) or systemic lupus erythematosus. Both drugs however can cause retinal toxicity eventually leading to irreversible maculopathy and retinopathy. Established risk factors are duration and dosage of treatment while the involvement of genetic factors contributing to toxic maculopathy is largely unclear. To address the latter issue, this study aimed to expand on ...

  1. 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.

  2. 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

    BACKGROUND: Epidemiological studies have reported that a higher perceived age is associated with poor health and higher mortality. However, the method used for the assessment of perceived age differs between studies with regard to age, gender, the number and occupation of assessors as well...... 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...

  3. Influence of emotional states on inhibitory gating: animals models to clinical neurophysiology.

    Science.gov (United States)

    Cromwell, Howard C; Atchley, Rachel M

    2015-01-01

    Integrating research efforts using a cross-domain approach could redefine traditional constructs used in behavioral and clinical neuroscience by demonstrating that behavior and mental processes arise not from functional isolation but from integration. Our research group has been examining the interface between cognitive and emotional processes by studying inhibitory gating. Inhibitory gating can be measured via changes in behavior or neural signal processing. Sensorimotor gating of the startle response is a well-used measure. To study how emotion and cognition interact during startle modulation in the animal model, we examined ultrasonic vocalization (USV) emissions during acoustic startle and prepulse inhibition. We found high rates of USV emission during the sensorimotor gating paradigm and revealed links between prepulse inhibition (PPI) and USV emission that could reflect emotional and cognitive influences. Measuring inhibitory gating as P50 event-related potential suppression has also revealed possible connections between emotional states and cognitive processes. We have examined the single unit responses during the traditional gating paradigm and found that acute and chronic stress can alter gating of neural signals in regions such as amygdala, striatum and medial prefrontal cortex. Our findings point to the need for more cross-domain research on how shifting states of emotion can impact basic mechanisms of information processing. Results could inform clinical work with the development of tools that depend upon cross-domain communication, and enable a better understanding and evaluation of psychological impairment.

  4. 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.

  5. 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 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

  6. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  8. 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.

  9. 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

  10. The influence of digital filter type, amplitude normalisation method, and co-contraction algorithm on clinically relevant surface electromyography data during clinical movement assessments.

    Science.gov (United States)

    Devaprakash, Daniel; Weir, Gillian J; Dunne, James J; Alderson, Jacqueline A; Donnelly, Cyril J

    2016-12-01

    There is a large and growing body of surface electromyography (sEMG) research using laboratory-specific signal processing procedures (i.e., digital filter type and amplitude normalisation protocols) and data analyses methods (i.e., co-contraction algorithms) to acquire practically meaningful information from these data. As a result, the ability to compare sEMG results between studies is, and continues to be challenging. The aim of this study was to determine if digital filter type, amplitude normalisation method, and co-contraction algorithm could influence the practical or clinical interpretation of processed sEMG data. Sixteen elite female athletes were recruited. During data collection, sEMG data was recorded from nine lower limb muscles while completing a series of calibration and clinical movement assessment trials (running and sidestepping). Three analyses were conducted: (1) signal processing with two different digital filter types (Butterworth or critically damped), (2) three amplitude normalisation methods, and (3) three co-contraction ratio algorithms. Results showed the choice of digital filter did not influence the clinical interpretation of sEMG; however, choice of amplitude normalisation method and co-contraction algorithm did influence the clinical interpretation of the running and sidestepping task. Care is recommended when choosing amplitude normalisation method and co-contraction algorithms if researchers/clinicians are interested in comparing sEMG data between studies.

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

    NARCIS (Netherlands)

    Huang, H.; Wismeijer, D.; Shao, X.; Wu, G.

    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

  12. How Conceptual Frameworks Influence Clinical Practice: Evidence from the Writings of John Thelwall, a 19th-Century Speech Therapist

    Science.gov (United States)

    Duchan, Judith F.

    2006-01-01

    Background: The impact of speech therapists' conceptual frameworks on their clinical methods tends to be ignored or taken for granted by today's practitioners. One way to show the importance of such frameworks is to study how they were used previously. John Thelwall, a 19th-century elocutionist, offers a rich source for studying the influence of…

  13. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  15. The influence of obesity on inflammation and clinical symptoms in asthma.

    Science.gov (United States)

    Gruchała-Niedoszytko, M; Małgorzewicz, S; Niedoszytko, M; Gnacińska, M; Jassem, E

    2013-01-01

    Obesity and asthma are both important public health issues. Increasing number of studies suggest the association between obesity and asthma which may be causal or accidental. The studies on animal models show innate enhancement of airway hyper-responsiveness which suggest that chronic airway hyper-responsiveness may be related to chronic low-grade systemic inflammation occurring in obesity. These results are confirmed by studies on asthmatic patients which show that levels of inflammation markers were higher in obese asthma patients and are related to the parameters of obesity. However, adipokines secreted by adipose tissue have also been involved in the regulation of inflammation and allergic responses, and suggested to affect the risk of asthma, especially in obese female patients. The studies on the association between adiposity and atopy have conflicting results and the issue needs to be investigated in the future. Obesity also decreases lung volume and increases airway resistance inducing symptoms that could mimic asthma. Clinical studies suggest that asthma in obese subjects may differ from the classical phenotype of the disease. Obese patients referred for asthma exacerbation present a reduced response to standard asthma medications. The review indicates that mechanical and inflammatory effects of obesity may explain the influence on asthma. Further studies on the association between adiposity and atopy on airway inflammation may confirm the active role of fat tissue, not only simple mechanical impairment of the thorax movement. Longitudinal studies are needed to understand the association between asthma, and obesity, which may open new therapeutic options for asthma treatment in obese patients.

  16. Magnetic Resonance Image Evaluation of Temporomandibular Joint Osteophytes: Influence of Clinical Factors and Artrogenics Changes.

    Science.gov (United States)

    Grossmann, Eduardo; Remedi, Marcelo Pereira; Ferreira, Luciano Ambrosio; Carvalho, Antonio Carlos Pires

    2016-03-01

    This research aims to examine the presence of osteophyte in patients with arthrogenic temporomandibular disorders through magnetic resonance imaging (MRI); to investigate the influence of sex and clinical symptoms in its prevalence; and the position of the osteophytes in the condyle. The study was based on 100 MRI and on reports of patients, which corresponded to the evaluation of 200 joints. Patients of both sexes were aged from 18 to 82 years (average = 49.48) and were subjected to the aforementioned examination from January 2006 to March 2009. The assessment considered the type of disc displacement, the presence of effusion, bone marrow edema, condyle changes, joint noise and pain. The MRI machine used was the GE Signa HDX (General Electric, Milwaukee, WI), with T1 and T2-weighted, 1.5 T magnetic field, sagittal oblique (mouth closed, mouth open) and coronal (mouth closed) imaging, with spherical surface coil and an asymmetric matrix. All images were interpreted by an experienced radiologist. A total of 28% (n = 56) of the temporomandibular joints showed osteophytes on the anterior surface of the mandible. No relationship was found between sex and osteophytes. The authors found a statistically significant difference between osteophytes and disc displacement without reduction (P < 0.001). The presence of osteophytes suggested a possible cause and effect relationship between osteoarthritis and disc displacement without reduction; the osteophyte was always located in the anterior surface of condyle, regardless of the sex variable; no significant difference was found between osteophytes and the main complaints of the patient.

  17. 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

  18. 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

  19. [Factors influencing the course and duration of inpatient child and adolescent psychiatric treatment: between empiricism and clinical reality].

    Science.gov (United States)

    Branik, Emil

    2003-09-01

    In the last two decades considerable changes influenced the scope of inpatient treatment in child and adolescent psychiatry. Proceeding from a literature review dilemmas between available research data and clinical practice will be pointed out. Proposals will be made to take into account the complex developmental processes, the individuality and the social context by psychic impaired children and adolescents requiring hospitalisation. This could improve the transfer of research findings into the clinical practice. It will be argued against a confusion of economical interests with research findings.

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

    OpenAIRE

    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 nephropath...

  1. Does the choice of display system influence perception and visibility of clinically relevant features in digital pathology images?

    Science.gov (United States)

    Kimpe, Tom; Rostang, Johan; Avanaki, Ali; Espig, Kathryn; Xthona, Albert; Cocuranu, Ioan; Parwani, Anil V.; Pantanowitz, Liron

    2014-03-01

    Digital pathology systems typically consist of a slide scanner, processing software, visualization software, and finally a workstation with display for visualization of the digital slide images. This paper studies whether digital pathology images can look different when presenting them on different display systems, and whether these visual differences can result in different perceived contrast of clinically relevant features. By analyzing a set of four digital pathology images of different subspecialties on three different display systems, it was concluded that pathology images look different when visualized on different display systems. The importance of these visual differences is elucidated when they are located in areas of the digital slide that contain clinically relevant features. Based on a calculation of dE2000 differences between background and clinically relevant features, it was clear that perceived contrast of clinically relevant features is influenced by the choice of display system. Furthermore, it seems that the specific calibration target chosen for the display system has an important effect on the perceived contrast of clinically relevant features. Preliminary results suggest that calibrating to DICOM GSDF calibration performed slightly worse than sRGB, while a new experimental calibration target CSDF performed better than both DICOM GSDF and sRGB. This result is promising as it suggests that further research work could lead to better definition of an optimized calibration target for digital pathology images resulting in a positive effect on clinical performance.

  2. Social influences on the duration of antibiotic treatment of clinical mastitis in dairy cows

    NARCIS (Netherlands)

    Swinkels, J.M.; Hilkens, A.; Zoche-Golob, V.; Krömker, V.; Buddiger, M.; Jansen, J.; Lam, T.J.G.M.

    2015-01-01

    Clinical mastitis of dairy cows is a visible inflammation of the udder, which is usually caused by bacteria and treated with antibiotics. Although pressure is increasing to reduce antibiotic usage in livestock in the European Union, feedback from the field suggests that clinical mastitis treatmen

  3. Social influences on the duration of antibiotic treatment of clinical mastitis in dairy cows

    NARCIS (Netherlands)

    Swinkels, J M; Hilkens, A; Zoche-Golob, V; Krömker, V; Buddiger, M; Jansen, J; Lam, T J G M|info:eu-repo/dai/nl/14686820X

    2015-01-01

    Clinical mastitis of dairy cows is a visible inflammation of the udder, which is usually caused by bacteria and treated with antibiotics. Although pressure is increasing to reduce antibiotic usage in livestock in the European Union, feedback from the field suggests that clinical mastitis treatment i

  4. 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.

  5. 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

  6. 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 ...

  7. 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.

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

    OpenAIRE

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

    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 p...

  9. 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

  10. Factors Influencing Quality of Life in Caregivers of People with Parkinson's Disease and Implications for Clinical Guidelines

    Directory of Open Access Journals (Sweden)

    D. Morley

    2012-01-01

    Full Text Available The quality of life (QoL of informal caregivers can be adversely affected by a number of factors. This issue, however, has not been well explored for carers of people with Parkinson's (PwP, with research largely restricted to the assessment of caregiver burden and caregiver strain. This study aims to determine the main influences on carer QoL in this population and consider results in the context of current clinical guidelines for the management of Parkinson's disease (PD. Carers completed the newly validated PDQ-Carer, and PwP completed the PDQ-39. The sample comprised 238 carers (mean age 68.20 years and 238 PwP (mean age 71.64. Results suggest multiple influences on caregiver QoL. These include carer age, gender, health status, and duration of the caregiving role. PwP levels of mobility and cognitive impairment are also significant influences on carer QoL. Not only should practitioners and service providers be particularly aware of the heightened impact of PD on carers over time and as PwP symptoms deteriorate, but this should also be reflected in clinical guidelines for the management of PD.

  11. Factors Influencing Quality of Life in Caregivers of People with Parkinson's Disease and Implications for Clinical Guidelines

    Science.gov (United States)

    Morley, D.; Dummett, S.; Peters, M.; Kelly, L.; Hewitson, P.; Dawson, J.; Fitzpatrick, R.; Jenkinson, C.

    2012-01-01

    The quality of life (QoL) of informal caregivers can be adversely affected by a number of factors. This issue, however, has not been well explored for carers of people with Parkinson's (PwP), with research largely restricted to the assessment of caregiver burden and caregiver strain. This study aims to determine the main influences on carer QoL in this population and consider results in the context of current clinical guidelines for the management of Parkinson's disease (PD). Carers completed the newly validated PDQ-Carer, and PwP completed the PDQ-39. The sample comprised 238 carers (mean age 68.20 years) and 238 PwP (mean age 71.64). Results suggest multiple influences on caregiver QoL. These include carer age, gender, health status, and duration of the caregiving role. PwP levels of mobility and cognitive impairment are also significant influences on carer QoL. Not only should practitioners and service providers be particularly aware of the heightened impact of PD on carers over time and as PwP symptoms deteriorate, but this should also be reflected in clinical guidelines for the management of PD. PMID:23316414

  12. Factors influencing quality of life in caregivers of people with Parkinson's disease and implications for clinical guidelines.

    Science.gov (United States)

    Morley, D; Dummett, S; Peters, M; Kelly, L; Hewitson, P; Dawson, J; Fitzpatrick, R; Jenkinson, C

    2012-01-01

    The quality of life (QoL) of informal caregivers can be adversely affected by a number of factors. This issue, however, has not been well explored for carers of people with Parkinson's (PwP), with research largely restricted to the assessment of caregiver burden and caregiver strain. This study aims to determine the main influences on carer QoL in this population and consider results in the context of current clinical guidelines for the management of Parkinson's disease (PD). Carers completed the newly validated PDQ-Carer, and PwP completed the PDQ-39. The sample comprised 238 carers (mean age 68.20 years) and 238 PwP (mean age 71.64). Results suggest multiple influences on caregiver QoL. These include carer age, gender, health status, and duration of the caregiving role. PwP levels of mobility and cognitive impairment are also significant influences on carer QoL. Not only should practitioners and service providers be particularly aware of the heightened impact of PD on carers over time and as PwP symptoms deteriorate, but this should also be reflected in clinical guidelines for the management of PD.

  13. 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.

  14. The potential influence of Internet-based social networking on the conduct of clinical research studies.

    Science.gov (United States)

    Glickman, Seth W; Galhenage, Sam; McNair, Lindsay; Barber, Zachry; Patel, Keyur; Schulman, Kevin A; McHutchison, John G

    2012-02-01

    The rapid growth of internet usage has led to an explosion of social networking sites for discussion of health issues. This provides a forum for subjects to communicate with one another during the course of the studies. Previous studies have raised concerns about the quality of health information on social networking sites, although none have evaluated content related to ongoing clinical trials. We reviewed material posted in virtual communities by self-identified clinical trial participants. We identified material posted in online health forums that could introduce bias into clinical research studies; we believe that this issue warrants further study and discussion. Physicians and others who conduct clinical trials should be aware of this issue. Study investigators and research teams should also talk to their study subjects about where and how they are obtaining information in order to prevent behaviors and correct misinformation that could put a subject's safety or the study objectives at risk. Given the rapid increase in Internet use for health care, a broader evaluation of both the benefits and potential risks of social networking among research participants during the course of a clinical trial appears warranted.

  15. 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-

  16. Using instrumental variables to disentangle treatment and placebo effects in blinded and unblinded randomized clinical trials influenced by unmeasured confounders

    Science.gov (United States)

    Chaibub Neto, Elias

    2016-11-01

    Clinical trials traditionally employ blinding as a design mechanism to reduce the influence of placebo effects. In practice, however, it can be difficult or impossible to blind study participants and unblinded trials are common in medical research. Here we show how instrumental variables can be used to quantify and disentangle treatment and placebo effects in randomized clinical trials comparing control and active treatments in the presence of confounders. The key idea is to use randomization to separately manipulate treatment assignment and psychological encouragement conversations/interactions that increase the participants’ desire for improved symptoms. The proposed approach is able to improve the estimation of treatment effects in blinded studies and, most importantly, opens the doors to account for placebo effects in unblinded trials.

  17. Factors Influencing Quality of Life in Caregivers of People with Parkinson's Disease and Implications for Clinical Guidelines

    OpenAIRE

    MORLEY, D; S. Dummett; Peters, M.; Kelly, L; Hewitson, P.; Dawson, J; Fitzpatrick, R.; Jenkinson, C.

    2012-01-01

    The quality of life (QoL) of informal caregivers can be adversely affected by a number of factors. This issue, however, has not been well explored for carers of people with Parkinson's (PwP), with research largely restricted to the assessment of caregiver burden and caregiver strain. This study aims to determine the main influences on carer QoL in this population and consider results in the context of current clinical guidelines for the management of Parkinson's disease (PD). Carers completed...

  18. 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

  19. The Influences of Student and Standardized Patient Genders on Scoring an Objective Structured Clinical Examination.

    Science.gov (United States)

    Rutala, Paul J.; And Others

    1991-01-01

    A study investigating possible sex bias, concerning both student and standardized-patient genders, in an objective structured clinical examination found that neither men nor women were afforded an advantage by patient or test location. However, women's scores on tests administered by females were higher than corresponding men's scores. (MSE)

  20. 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

  1. [The influence of the training of the muscular component of the musculo-venous pump in the lower extremities on the clinical course of varicose vein disease].

    Science.gov (United States)

    Kravtsov, P F; Katorkin, S E; Volkovoi, V V; Sizonenko, Ya V

    2016-01-01

    Investigations of the influence of the training of the muscular component of the musculo-venous pump in the lower extremities on the clinical course of varicose vein disease and correction of the step cycle are currently underway.

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

    Science.gov (United States)

    Redelmeier, Donald A.; 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 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

  3. 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

  4. 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

    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...... the day, however, exercise significantly increased the plasma NOx (1.78±1.24 vs. 8.19±4.13 µM NOx before and after exercise, respectively, P

  5. [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.

  6. 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.

  7. Age of onset influences on clinical and laboratory profile of patients with systemic lupus erythematosus.

    Science.gov (United States)

    Sassi, Rafael Hennemann; Hendler, Jordana Vaz; Piccoli, Giovana Fagundes; Gasparin, Andrese Aline; da Silva Chakr, Rafael Mendonça; Brenol, João Carlos Tavares; Monticielo, Odirlei André

    2017-01-01

    The present study aims to evaluate differences in clinical and laboratory manifestations and medication use in the different ages of disease onset in patients with systemic lupus erythematosus (SLE). This cross-sectional study consisted of 598 SLE patients (550 female and 48 male), who attended the Rheumatology Clinic of the Hospital de Clínicas de Porto Alegre between 2003 and 2015. Demographic, clinical and laboratory data were collected. The patients were classified into three groups according to their ages at disease diagnosis. Mean age of diagnosis was 33.6 ± 14.3 years, and the median (25th-75th percentile) disease duration was 13 (7-20) years. Among the patients studied, 419 (70%) were adult-onset (aSLE), 90 (14.8%) were late-onset (lSLE) and 89 (14.8%) were childhood-onset (cSLE). The female to male ratio was higher in aSLE (18:1) compared to the other groups (p = 0.001). Arthritis was predominantly found in aSLE (78.5%) when compared with lSLE (57.7%) (p drugs.

  8. The influence of BMX gene polymorphisms on clinical symptoms after mild traumatic brain injury.

    Science.gov (United States)

    Wang, Yu-Jia; Hsu, Yu-Wen; Chang, Che-Mai; Wu, Chung-Che; Ou, Ju-Chi; Tsai, Yan-Rou; Chiu, Wen-Ta; Chang, Wei-Chiao; Chiang, Yung-Hsiao; Chen, Kai-Yun

    2014-01-01

    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.

  9. 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.

  10. Predictive Modeling of Physician-Patient Dynamics That Influence Sleep Medication Prescriptions and Clinical Decision-Making

    Science.gov (United States)

    Beam, Andrew L.; Kartoun, Uri; Pai, Jennifer K.; Chatterjee, Arnaub K.; Fitzgerald, Timothy P.; Shaw, Stanley Y.; Kohane, Isaac S.

    2017-02-01

    Insomnia remains under-diagnosed and poorly treated despite its high economic and social costs. Though previous work has examined how patient characteristics affect sleep medication prescriptions, the role of physician characteristics that influence this clinical decision remains unclear. We sought to understand patient and physician factors that influence sleep medication prescribing patterns by analyzing Electronic Medical Records (EMRs) including the narrative clinical notes as well as codified data. Zolpidem and trazodone were the most widely prescribed initial sleep medication in a cohort of 1,105 patients. Some providers showed a historical preference for one medication, which was highly predictive of their future prescribing behavior. Using a predictive model (AUC = 0.77), physician preference largely determined which medication a patient received (OR = 3.13 p = 3 × 10‑37). In addition to the dominant effect of empirically determined physician preference, discussion of depression in a patient’s note was found to have a statistically significant association with receiving a prescription for trazodone (OR = 1.38, p = 0.04). EMR data can yield insights into physician prescribing behavior based on real-world physician-patient interactions.

  11. Predictive Modeling of Physician-Patient Dynamics That Influence Sleep Medication Prescriptions and Clinical Decision-Making

    Science.gov (United States)

    Beam, Andrew L.; Kartoun, Uri; Pai, Jennifer K.; Chatterjee, Arnaub K.; Fitzgerald, Timothy P.; Shaw, Stanley Y.; Kohane, Isaac S.

    2017-01-01

    Insomnia remains under-diagnosed and poorly treated despite its high economic and social costs. Though previous work has examined how patient characteristics affect sleep medication prescriptions, the role of physician characteristics that influence this clinical decision remains unclear. We sought to understand patient and physician factors that influence sleep medication prescribing patterns by analyzing Electronic Medical Records (EMRs) including the narrative clinical notes as well as codified data. Zolpidem and trazodone were the most widely prescribed initial sleep medication in a cohort of 1,105 patients. Some providers showed a historical preference for one medication, which was highly predictive of their future prescribing behavior. Using a predictive model (AUC = 0.77), physician preference largely determined which medication a patient received (OR = 3.13; p = 3 × 10−37). In addition to the dominant effect of empirically determined physician preference, discussion of depression in a patient’s note was found to have a statistically significant association with receiving a prescription for trazodone (OR = 1.38, p = 0.04). EMR data can yield insights into physician prescribing behavior based on real-world physician-patient interactions. PMID:28181568

  12. Social, structural, behavioral and clinical factors influencing retention in Pre-Exposure Prophylaxis (PrEP) care in Mississippi

    Science.gov (United States)

    Arnold, Trisha; Brinkley-Rubinstein, Lauren; Chan, Philip A.; Perez-Brumer, Amaya; Bologna, Estefany S.; Beauchamps, Laura; Johnson, Kendra; Mena, Leandro; Nunn, Amy

    2017-01-01

    Pre-exposure prophylaxis (PrEP) is a biomedical intervention that can reduce rates of HIV transmission when taken once daily by HIV-negative individuals. Little is understood about PrEP uptake and retention in care among the populations most heavily impacted by the HIV epidemic, particularly among young men who have sex with men (YMSM) in the Deep South. Therefore, this study explored the structural, social, behavioral, and clinical factors that affect PrEP use and retention in care among YMSM in Jackson, Mississippi. Thirty MSM who were prescribed PrEP at an outpatient primary care clinic were interviewed and included 23 men who had been retained in PrEP care and seven who had not been retained. The mean age of participants was 26.6 years. Most (23) participants were African American. Major factors affecting PrEP use and retention in PrEP care included 1) structural factors such as cost and access to financial assistance for medications and clinical services; 2) social factors such as stigma and relationship status; 3) behavioral factors including sexual risk behaviors; and 4) clinical factors such as perceived and actual side effects. Many participants also discussed the positive spillover effects of PrEP use and reported that PrEP had a positive impact on their health. Four of the seven individuals who had not been retained re-enrolled in PrEP care after completing their interviews, suggesting that case management and ongoing outreach can enhance retention in PrEP care. Interventions to enhance retention in PrEP care among MSM in the Deep South will be most effective if they address the complex structural, social, clinical, and behavioral factors that influence PrEP uptake and retention in PrEP care. PMID:28222118

  13. 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.

  14. 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...

  15. Does commitment to rehabilitation influence clinical outcome of total hip resurfacing arthroplasty?

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    Zywiel Michael G

    2010-03-01

    Full Text Available Abstract Background The purpose of this study was to evaluate whether compliance and rehabilitative efforts were predictors of early clinical outcome of total hip resurfacing arthroplasty. Methods A cross-sectional survey was utilized to collect information from 147 resurfacing patients, who were operated on by a single surgeon, regarding their level of commitment to rehabilitation following surgery. Patients were followed for a mean of 52 months (range, 24 to 90 months. Clinical outcomes and functional capabilities were assessed utilizing the Harris hip objective rating system, the SF-12 Health Survey, and an eleven-point satisfaction score. A linear regression analysis was used to determine whether there was any correlation between the rehabilitation commitment scores and any of the outcome measures, and a multivariate regression model was used to control for potentially confounding factors. Results Overall, an increased level of commitment to rehabilitation was positively correlated with each of the following outcome measures: SF-12 Mental Component Score, SF-12 Physical Component Score, Harris Hip score, and satisfaction scores. These correlations remained statistically significant in the multivariate regression model. Conclusions Patients who were more committed to their therapy after hip resurfacing returned to higher levels of functionality and were more satisfied following their surgery.

  16. Persistent influence of maternal obesity on offspring health: Mechanisms from animal models and clinical studies.

    Science.gov (United States)

    Wankhade, Umesh D; Thakali, Keshari M; Shankar, Kartik

    2016-11-05

    The consequences of excessive maternal weight and adiposity at conception for the offspring are now well recognized. Maternal obesity increases the risk of overweight and obesity even in children born with appropriate-for-gestational age (AGA) birth weights. Studies in animal models have employed both caloric excess and manipulation of macronutrients (especially high-fat) to mimic hypercaloric intake present in obesity. Findings from these studies show transmission of susceptibility to obesity, metabolic dysfunction, alterations in glucose homeostasis, hepatic steatosis, skeletal muscle metabolism and neuroendocrine changes in the offspring. This review summarizes the essential literature in this area in both experimental and clinical domains and focuses on the translatable aspects of these experimental studies. Moreover this review highlights emerging mechanisms broadly explaining maternal obesity-associated developmental programming. The roles of early developmental alterations and placental adaptations are also reviewed. Increasing evidence also points to changes in the epigenome and other emerging mechanisms such as alterations in the microbiome that may contribute to persistent changes in the offspring. Finally, we examine potential interventions that have been employed in clinical cohorts.

  17. 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

  18. 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.

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

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    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.

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

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    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.

  1. Influence of fluvoxamine on plasma interleukin-6 or clinical improvement in patients with major depressive disorder

    Science.gov (United States)

    Yoshimura, Reiji; Katsuki, Asuka; Atake, Kiyokazu; Hori, Hikaru; Igata, Ryohei; Konishi, Yuki

    2017-01-01

    Objectives The etiology of depression remains unknown. There is, however, a growing body of evidence that cytokines are involved in the pathophysiology of depression. The aim of this study is to investigate the effects of fluvoxamine on plasma interleukin-6 (IL-6) levels and on clinical improvement of the depressive state. Subjects and methods Thirty patients who met the DSM-IV criteria for major depressive disorder (MDD) were enrolled in the study. Thirteen were male and 17 were female, and their ages ranged from 26 to 70 years (mean ± standard deviation 45.0±14.2). The patients were treated with fluvoxamine for 8 weeks. The dosages of fluvoxamine varied among the patients and, based on ethical considerations, were not fixed. Results The fluvoxamine doses were positively related to plasma fluvoxamine levels (r =0.8798, P<0.001). A significant correlation was observed between the patients’ plasma IL-6 levels and their 17-item Hamilton Rating Scale for Depression (HAMD17) scores (r =0.4555, P=0.0010). A positive correlation was found between the delta plasma IL-6 (week 0–week 8) and the delta HAMD17 (week 0–week 8) (r =0.5226, P=0.002). Conclusion Effect of fluvoxamine on IL-6 is partially associated with its clinical efficacy for MDD. PMID:28243095

  2. 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.

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

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    Stefano Pontone

    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.

  4. 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.

  5. The influence of clinical terminology on self-efficacy for voice.

    Science.gov (United States)

    Gillespie, Amanda I; Abbott, Katherine Verdolini

    2011-10-01

    Self-efficacy is defined as one's belief in one's ability to carry out a specific behavior successfully. The current study's objective is to obtain initial evidence in support of the hypothesis that the terms 'vocal abuse/misuse' have the potential to harm self-efficacy for voice and may impact adherence with therapeutic directives. Teachers with voice problems were exposed to the terms 'abuse/misuse' or 'phonotrauma/muscle tension' as describing the origin of common voice problems. Pre- and post-exposures, subjects completed a Voice Self-Efficacy Questionnaire that was specially designed for the study. Results provide preliminary support for the hypothesis that clinical exposure to 'abuse/misuse' terminology may harm normal increases in self-efficacy for voice that are generally expected following education about medical conditions.

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

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    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

  7. 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

  8. Influence of activated charcoal on the pharmacokinetics and the clinical features of carbamazepine poisoning.

    Science.gov (United States)

    Brahmi, Nozha; Kouraichi, Nadia; Thabet, Hafedh; Amamou, Mouldi

    2006-07-01

    Carbamazepine (CBZ) poisoning has been associated with cases of severe toxicity and death. Multiple-dose activated charcoal was proposed to enhance the clearance of CBZ elimination, but there are no prospective controlled studies that demonstrated a change in clinical outcome after the use of multiple-dose activated charcoal. The aim of this study was to determine the CBZ elimination kinetics and the evolution of clinical features according to the dose of activated charcoal in acute poisoning patients. It is a prospective study for 6 months, from January to June 2004, including all pure acute CBZ-poisoned patients. Twelve patients were randomized to receive a multiple-dose activated charcoal (G1) or a simple dose of 1 g/kg (G2). Their mean age was 27.6+/-12.2 years; the Simplified Acute Physiology Score (SAPS II), 16.37+/-8.46; and the Acute Physiology and Chronic Health Evaluation (APACHE II), 8+/-3.96. They were 8 men and 4 women. The mean concentration of blood CBZ at hospital admission was of 29.42+/-6.68 mg/L. Each group includes 6 patients. The peak value of blood CBZ was comparable in the 2 groups: 33+/-3.46 mg/L (G1) vs 32.6+/-5.63 (G2) (P=.5); the requirement of mechanical ventilation was similar also (3 in each group). The duration of both coma and mechanical ventilation was significantly decreased in the first group compared with the second: 20.33+/-3.05 vs 29.33+/-4.11 hours for coma (P=.02) and 24.1+/-4.2 vs 36.4+/-3.6 hours for mechanical ventilation (P=.001). The length of stay was also significantly decreased in the first group: 30.3+/-3.4 vs 39.7+/-7.3 hours in the second group (P=.000006). Concurrently, we have noted a significant constant reduction of the half-life of CBZ from serum in the first group: 12.56+/-3.5 hours after multiple dose vs 27.88+/-7.36 hours after a simple dose (P=.0004). This decrease was correlated to the dose of charcoal. In summary, we can conclude that multiple-dose activated charcoal is more efficient than simple

  9. The influence of warm ischemia elimination on kidney injury during transplantation – clinical and molecular study

    Science.gov (United States)

    Kamińska, Dorota; Kościelska-Kasprzak, Katarzyna; Chudoba, Paweł; Hałoń, Agnieszka; Mazanowska, Oktawia; Gomółkiewicz, Agnieszka; Dzięgiel, Piotr; Drulis-Fajdasz, Dominika; Myszka, Marta; Lepiesza, Agnieszka; Polak, Wojciech; Boratyńska, Maria; Klinger, Marian

    2016-01-01

    Kidney surface cooling was used during implantation to assess the effect of warm ischemia elimination on allograft function, histological changes and immune-related gene expression. 23 recipients were randomly assigned to a group operated on with kidney surface cooling during implantation (ice bag technique, IBT group), and the other 23 recipients receiving the contralateral kidney from the same donor were operated on with a standard technique. Three consecutive kidney core biopsies were obtained during the transplantation procedure: after organ recovery, after cold ischemia and after reperfusion. Gene expression levels were determined using low-density arrays (Format 32, TaqMan). The IBT group showed a significantly lower rate of detrimental events (delayed graft function and/or acute rejection, p = 0.015) as well as higher glomerular filtration rate on day 14 (p = 0.026). A greater decrease of MMP9 and LCN2 gene expression was seen in the IBT group during total ischemia (p = 0.003 and p = 0.018). Elimination of second warm ischemia reduced the number of detrimental events after kidney transplantation, and thus had influence on the short-term but not long-term allograft function. Surface cooling of the kidney during vascular anastomosis may reduce some detrimental effects of immune activation resulting from both brain death and ischemia-reperfusion injury. PMID:27808277

  10. 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.

  11. 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.

  12. Factors influencing the clinical expression of intermediate CAG repeat length mutations of the Huntington's disease gene.

    Science.gov (United States)

    Panegyres, Peter K; Shu, Chen-Chun; Chen, Huei-Yang; Paulsen, Jane S

    2015-02-01

    Our aim is to elucidate the clinical variables associated with the development of manifest HD in patients with intermediate CAG repeat lengths. 2,167 participants were seen throughout 44 research sites in the United States, Canada or Australia over a five-year natural history observational study (2006-2011) (Trial # NCT00313495). The Chi-square test and a generalised linear model were used to examine the differences in demographics and cognitive tests among three groups of CAG repeat length. The mixed model was then used to examine the time effect on cognitive assessments by CAG groups. No patient with CAG repeat length 27-35 developed manifest HD, whereas three patients with 36-39 did. Total motor score, maximal chorea score and maximal dystonia score were significantly different at baseline (p CAG 36-39; those with an associated university degree or higher education were less frequently diagnosed as manifest HD (OR 0.10, 95 % CI 0.02-0.54, p = 0.007). Age, smoking and lower education achievement were found to be significantly associated with higher odds of manifest HD in patients with intermediate CAG repeat length mutations.

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

    Directory of Open Access Journals (Sweden)

    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.

  14. 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

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

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    Ji-Chao Guan

    2015-01-01

    Full Text Available 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

  16. 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.

  17. 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.

  18. 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.

  19. An evaluation of factors influencing the assessment time in a nurse practitioner-led anaesthetic pre-operative assessment clinic.

    Science.gov (United States)

    Hawes, R H; Andrzejowski, J C; Goodhart, I M; Berthoud, M C; Wiles, M D

    2016-03-01

    Elective patients undergoing anaesthetic pre-operative assessment are usually allocated the same period of time with a nurse practitioner, leading to potential inefficiencies in patient flow through the clinic. We prospectively collected data on 8519 patients attending a pre-operative assessment clinic. The data set were split into derivation and validation cohorts. Standard multiple regressions were used to construct a model in the derivation cohort, which was then tested in the validation cohort. Due to missing data, 2457 patients were not studied, leaving 5892 for analysis (3870 in the derivation cohort and 2022 in the validation cohort). The mean (SD) pre-operative assessment time was 46 (12) min. Age, ASA physical status, nurse practitioner and surgical specialty all influenced the time spent in pre-operative assessment. The predictive equations calculated using the derivation cohort, based on age and ASA physical status, correctly estimated duration of consultation to within 20% of the maximum predicted time in 74.2% of the validation cohort. We conclude that if age and ASA physical status are known before the pre-operative assessment consultation, it could allow appointment times to be allocated more accurately.

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

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    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.

  1. HLA alleles influence the clinical signature of amoxicillin-clavulanate hepatotoxicity.

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    Camilla Stephens

    Full Text Available BACKGROUND AND AIM: The genotype-phenotype interaction in drug-induced liver injury (DILI is a subject of growing interest. Previous studies have linked amoxicillin-clavulanate (AC hepatotoxicity susceptibility to specific HLA alleles. In this study we aimed to examine potential associations between HLA class I and II alleles and AC DILI with regards to phenotypic characteristics, severity and time to onset in Spanish AC hepatotoxicity cases. METHODS: High resolution genotyping of HLA loci A, B, C, DRB1 and DQB1 was performed in 75 AC DILI cases and 885 controls. RESULTS: The distributions of class I alleles A*3002 (P/Pc = 2.6E-6/5E-5, OR 6.7 and B*1801 (P/Pc = 0.008/0.22, OR 2.9 were more frequently found in hepatocellular injury cases compared to controls. In addition, the presence of the class II allele combination DRB1*1501-DQB1*0602 (P/Pc = 5.1E-4/0.014, OR 3.0 was significantly increased in cholestatic/mixed cases. The A*3002 and/or B*1801 carriers were found to be younger (54 vs 65 years, P = 0.019 and were more frequently hospitalized than the DRB1*1501-DQB1*0602 carriers. No additional alleles outside those associated with liver injury patterns were found to affect potential severity as measured by Hy's Law criteria. The phenotype frequencies of B*1801 (P/Pc = 0.015/0.42, OR 5.2 and DRB1*0301-DQB1*0201 (P/Pc = 0.0026/0.07, OR 15 were increased in AC DILI cases with delayed onset compared to those corresponding to patients without delayed onset, while the opposite applied to DRB1*1302-DQB1*0604 (P/Pc = 0.005/0.13, OR 0.07. CONCLUSIONS: HLA class I and II alleles influence the AC DILI signature with regards to phenotypic expression, latency presentation and severity in Spanish patients.

  2. The influence of clinical and genetic factors on the development of obesity in children with type 1 diabetes.

    Science.gov (United States)

    Łuczyński, Włodzimierz; Głowińska-Olszewska, Barbara; Bossowski, Artur

    2016-10-01

    The exact cause of the obesity epidemic remains unknown; however, both environmental and genetic factors are involved. People at risk of developing obesity include children with type 1 diabetes mellitus (T1DM), which in turn increases their cardiovascular disease risk. Here, we discuss the clinical and genetic factors influencing weight in patients with T1DM. In children with T1DM, the presence of obesity depends mainly on sex, metabolic control, and disease duration. However, genetic factors, including the fat mass and obesity-associated (FTO) gene, are also associated with body weight. Indeed, children with the FTO gene rs9939609 obesity-risk allele (homozygous = AA or heterozygous = AT) are predisposed to a higher body mass index and have a greater risk of being overweight or obese. However, in this review, we show that FTO gene polymorphisms only have a small effect on body weight in children, much weaker than the effect of clinical factors. The association between FTO gene polymorphisms and body weight is only statistically significant in children without severe obesity. Moreover, other genetic factors had no effect on weight in patients with T1DM, and further research involving larger populations is required to confirm the genetic basis of diabetes and obesity. Therefore, identifying the clinical features of children with T1DM, such as their initial body mass index, sex, metabolic control, and disease duration, will still have the strongest effect on reducing risk factors for cardiovascular diseases. Physicians should pay close attention to modifiable elements of these relationships, for example, metabolic control and energy and insulin intake, when caring for patients with T1DM. Copyright © 2016 John Wiley & Sons, Ltd.

  3. Influence of an alloy addition on the physical and clinical behaviour of glass ionomer cement

    Science.gov (United States)

    Abour, Mohamed Abour Bashir

    These in vitro studies compared the various properties of an experimental high powder liquid content glass ionomer cement (EXPT) with those of a metal addition GIC (Hi-Dense) and disperse phase amalgam (Dispersalloy). Bi-axial, four point flexural and compressive tests were used to evaluate strength. Six groups of ten specimens were constructed for each test for each material and allowed to set in an oven at 37°C for 60 minutes. Specimens were stored in distilled water at 37°C until testing at one day, one week, one, three, six months and year. It was found that the strength of Hi-Dense increased and then maintained over extended time, whereas the strength of EXPT showed a declined at 3 months. The bond strengths of the materials to both enamel and dentine were also evaluated. Ten groups of ten teeth, five for each surface for each glass ionomer materials, were prepared. Teeth were aligned leaving the enamel and dentine surfaces exposed. The mixed material was condensed into a cylinder placed on the appropriate surface. These specimens were also stored in distilled water at 37°C. It was found that Hi-Dense had a higher bond strength to enamel that increased with time. The bond strength to dentine was maintained over the test period. The erosion rate of the materials was evaluated using the lactic acid erosion test. Three groups of six specimens for each material were constructed and tested after one hour, one day and at six months. Each specimen was subjected to an impinging jet of lactic acid solution. The erosion rate was determined by weight loss and dimensional change. It was found that Hi-Dense had a high erosion resistance which was slightly better than the experimental material. The microleakage, around restorations prepared, using the glass ionomer materials, was evaluated after cyclical loading the restoration-tooth complex. It was found that there was less leakage around Hi-Dense than EXPT at both the cervical and occlusal margins. In a clinical

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

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    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

  5. Influence of clinical characteristics and tumor size on symptoms of bladder leiomyoma: a pooled analysis of 61 cases

    Institute of Scientific and Technical Information of China (English)

    JIANG Xian-zhou; XU Chao; ZHANG Nian-zhao; XU Zhi-shun

    2012-01-01

    Background Bladder leiomyoma is an uncommon type of bladder neoplasms.Most publications are reports of isolated cases.The influence of tumor size on patients' early symptoms was seldom analyzed.We aim to investigate the clinical characteristics of bladder leiomyoma and the influence of tumor size on patients' symptoms in Chinese population.Methods We reviewed the medical records of eight patients diagnosed with bladder leiomyoma at our department,collected 53 cases from Chinese National Knowledge Infrastructure (CNKI),Wangfang data base,and Chinese Biological Medicine Disk,and performed a pooled analysis.The clinical characteristics of the patients were analyzed and then classified into symptomatic and asymptomatic groups.The association between tumor size and the occurrence of symptoms was evaluated.Furthermore,Logistic regression model was constructed to discriminate variables.Results Women comprised the majority of the patients (49/61,80.3% ).The mean age and tumor size were (42.3±14.0)years and (45.0±25.7) mm,respectively.Among all the symptoms,irritative symptoms occurred most frequently (37.7%,23/61 ),followed by obstructive urinary symptoms (31.1%,19/61),hematuria (24.6%,15/61),and abdominal bulge or pain (14.8%,9/61).In our study,patients who were 45 years old or younger tended to be asymptomatic compared with elder ones (14/36 vs.3/25,P=0.021).The histological,as well as anatomical,location of tumor,did not show significant differences between symptomatic and asymptomatic patients (P=0.306 and 0.700).Tumors larger than 30 mm in the greatest diameter would cause clinical symptoms such as obstructive urinary symptoms (P=0.048) and irritative symptoms (P=0.037).Logistic regression confirmed the association between tumor size and the occurrence of symptoms,which was related with age.Conclusions Bladder leiomyoma occurs mainly in women and most frequently with irritative symptoms.The occurrence of symptoms is related to tumor size rather than the

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

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    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

  7. Influence of tube voltage on digitized image qualityof patients exposed to occupational dust: phantoms and clinical studies

    Institute of Scientific and Technical Information of China (English)

    Wang Xiaohua; Liu Dongsheng; Xuan Xiao; Duan Jianghui; Yuan Huishu

    2014-01-01

    Background High-voltage analog X-ray examination is a main tool for pneumoconiosis,which is challenged by digital radiography (DR).The tube voltage of DR chest films required for diagnosis and staging of pneumoconiosis is concerned technically.We investigated the influence of the tube voltage on chest X-ray DR image quality of patients exposed to occupational dust.Methods DR images of the CDRAD2.0model,an anatomical chest phantom,and 136 exposed workers were analyzed at different tube voltages by threereaders.Image quality factors (IQF) were calculated and compared using the CDRAD2.0 model.DR images of ten anatomic positions were scored against those of the high-kilovolt chest films in anatomical phantom and clinical cases,and differences in scores were analyzed.Results In the CDRAD2.0 model,all three readers had a minimal IQF at 120 kV (mean:22.25 kV).The differences in the mean IQF of DR images at different tube voltages was significant (F=13.78,P<0.001).The IQF of DR imaging at 120 kV was similar to high kilovolt analog imaging (t=-0.58,P>0.05).In the anatomic phantom and clinical cases,the DR images at 120 kV were closest in anatomical detail to the high W analog images,and the means were similar (P>0.05).Conclusions Among different tube voltages,DR image quality is closest to the high kilovolt analog images at 120 kV in patients exposed to occupational dust.

  8. [Influence of genetic mutations on clinical presentation of subretinal neovascularization. Report 2: The impact of HTRA and VEGF genes polymorphism].

    Science.gov (United States)

    Budzinskaia, M V; Pogoda, T V; Strelkova, I D; Chikun, E A; Shchegoleva, I V; Kazarian, É É; Galoian, N S

    2011-01-01

    A detailed analysis of influence of HTRA (serine peptidase) and VEGF (vascular endothelial growth factor) genes mutations is presented. The presence of one gene copy with allele of A- polymorphism rs1120638 of HTRA1 gen, T- polymorphism rs10490924 and de11443in54 of ARMS2 gene increases the risk of CNV in patients with AMD. The feature of clinical presentation in patients with CNV associated with (-625) A mutation of promoter region of HTRA1 gene in two chromosomes was fulminant course of the disease from exudative to scarring processes with fibrous tissue formation not just with sub-, but also intra- and preretinal localization. Genetic screening showed that combination of studied mutations (402H, (-625) A and (-251) A in both gene copies of CFH, HTRA and IL-8) results in the most severe and rapidly progressing form of the disease. Two new mutations were revealed in promoter region of VEGF gene: G > A replacement in position of (-72) nucleotide from transcription start and G > A replacement in 5'-nontranslated region of the 1st gene exon in position of (+31) nucleotide from transcription start.

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

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    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

  10. Nursing scripts and the organizational influences on critical thinking: report of a study of neonatal nurses' clinical reasoning.

    Science.gov (United States)

    Greenwood, J; Sullivan, J; Spence, K; McDonald, M

    2000-05-01

    During 1995-1997 a study was undertaken to explore the extent to which theoretical knowledge acquired through a distance education programme in neonatal nursing was brought to bear in the real-world clinical reasoning of course participants. The study utilized a think aloud technique and included both concurrent (on-the-job) and retrospective verbal reports at 0, 6 and 12 months into the programme. Participants (n=4) were also interviewed individually on completion of the study. Results indicated that important inconsistencies existed between participants' theoretical knowledge and their practice; they also pointed to some organizational influences on these theory-practice inconsistencies. Script (or schema) theory provided a useful explanatory framework for these results. The paper includes a brief description of data collection and analysis techniques; its main emphasis, however, is on these theory-practice inconsistencies and their explanation in terms of the nature and acquisition of nursing practice scripts. The implications of nursing scripts for the promotion of critical thinking and evidence-based practice are discussed.

  11. 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)

    van Eijsden-Besseling, Marjon D.; van den Bergh, Karien A.; Staal, J. Bart; de Bie, Rob A.; van den Heuvel, Wim J.

    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

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

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    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

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

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    Evelyn Klein

    Full Text Available 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.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.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 < 0.0001.The use of the soluble fms-like tyrosine kinase 1/placental growth factor test influenced clinical decision making towards appropriate hospitalization in a considerable proportion of women with suspected preeclampsia. This is the first study to demonstrate the impact of angiogenic biomarkers on decision making in a routine clinical practice.

  14. 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

  15. Clinical Pharmacology of 3,4-Methylenedioxymethamphetamine (MDMA, “Ecstasy”): The Influence of Gender and Genetics (CYP2D6, COMT, 5-HTT)

    OpenAIRE

    Ricardo Pardo-Lozano; Magí Farré; Samanta Yubero-Lahoz; Brian O'Mathúna; Marta Torrens; Cristina Mustata; Clara Pérez-Mañá; Klaus Langohr; Elisabet Cuyàs; Marcel lí Carbó; Rafael de la Torre

    2012-01-01

    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 pharmac...

  16. 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.

  17. The influence of age, gender, lifestyle factors and sub-clinical neck pain on the cervical flexion-rotation test and cervical range of motion.

    Science.gov (United States)

    Smith, Kenric; Hall, Toby; Robinson, Kim

    2008-12-01

    The flexion-rotation test (FRT) is commonly used when assessing cervicogenic headache. Additionally, active range of motion (AROM) is frequently used to evaluate impairment in neck pain. No studies have investigated the interaction of the FRT and AROM with age, gender, pain and lifestyle factors. The purpose of this study was to determine the influence of these factors on the FRT and cervical AROM. A group of 66 participants (aged 20-78) were studied, 28 experienced sub-clinical neck pain (recurrent neck pain or discomfort which has not received treatment from a healthcare professional) while 38 did not. Age, gender, lifestyle factors and sub-clinical neck pain were assessed using a questionnaire. Measurement of AROM was performed by two examiners blind to the results of the questionnaire. Multiple linear regression analysis found that 59% of the variance in the FRT was explained by the presence of sub-clinical pain and cervical lateral flexion measures. Secondly, 58-72% of the variance in active cervical ROM measures was influenced by factors including the FRT, gender and movements of the neck in other planes. This study found that lifestyle factors do not influence the cervical FRT and AROM.

  18. 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.

  19. Influence of Anesthesiology Residents' Noncognitive Skills on the Occurrence of Critical Incidents and the Residents' Overall Clinical Performances.

    Science.gov (United States)

    Rhoton, M. Frances; And Others

    1991-01-01

    Analysis of medical residents' clinical performances in five teaching hospital anesthesiology departments revealed that noncognitive performance in some areas was a powerful predictor of overall clinical performance and was related to the occurrence of critical incidents. Noncognitive predictors included conscientiousness, management, confidence,…

  20. 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

  1. 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

  2. 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.

  3. Influence of Age on Clinical Performance of Mandibular Two-Implant Overdentures : A 10-Year Prospective Comparative Study

    NARCIS (Netherlands)

    Hoeksema, Arie R.; Visser, Anita; Raghoebar, Gerry M.; Vissink, Arjan; Meijer, Henny J. A.

    2016-01-01

    Purpose: The aim of this prospective comparative study was to assess whether age has influence on peri-implant health in patients treated with mandibular two-implant overdentures during a 10-year evaluation period. Materials and Methods: A prospective study was carried out with two groups of edentul

  4. Does electronic clinical microbiology results reporting influence medical decision making: A pre- and post-interview study of medical specialists

    NARCIS (Netherlands)

    M.J. Bruins (Marjan); G. Ruijs (G.); M.J.H.M. Wolfhagen; P. Bloembergen (Peter); J.E.C.M. Aarts (Jos)

    2011-01-01

    textabstractBackground: Clinicians view the accuracy of test results and the turnaround time as the two most important service aspects of the clinical microbiology laboratory. Because of the time needed for the culturing of infectious agents, final hardcopy culture results will often be available to

  5. 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

  6. Growth of Self-Perceived Clinical Competence in Postgraduate Training for General Practice and Its Relation to Potentially Influencing Factors

    Science.gov (United States)

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

    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 Postgraduate Training for General practice in the…

  7. 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

  8. The Influence of Acetyl Salicylic Acid (Aspirin) and Acetaminophen on Clinical and Histologic Aspects of Orthodontic Tooth Movement

    Science.gov (United States)

    1988-05-01

    Effect of pulsed electromagnetic fields on orthodontic tooth movement . Amer. J. Ortho. 91:91-102, 1987. 59. Botting, P. and...peripheral prostaglandin inhibitor aspirin have on certain clinical and histologic aspects of orthodontic tooth movement : 2) Similarly, what effect ... orthodontic adjustment with respect to minimizing the effects of a prostaglandin inhibitor on tooth movement .? SiS 3 REVIEW OF THE

  9. 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.

  10. Melatonin secretion and excretion : a clinical study focusing on factors and disease states which might influence melatonin

    OpenAIRE

    Wikner, Johan

    1998-01-01

    The overall aim of this thesis was to find out whether other factors than the the light-dark changes influence the function of the pineal gland. Since melatonin (MT) itself, or its precursor serotonin, are of importance for sleep, mood, and pain perception, disease states - or situations in which these functions are disturbed - should be of interest to investigate in this context. Altogether 100 individuals (51 men and 49 women) participated in the study. Seventy were he...

  11. Influence of the bacterial phenotypes on the clinical manifestations in Klebsiella pneumoniae bacteremia patients: A retrospective cohort study.

    Science.gov (United States)

    Togawa, Atsushi; Toh, Hiromi; Onozawa, Kyoko; Yoshimura, Michinobu; Tokushige, Chiemi; Shimono, Nobuyuki; Takata, Tohru; Tamura, Kazuo

    2015-07-01

    Ninety-four episodes of Klebsiella pneumoniae bloodstream infection were identified at a university hospital in Japan. After excluding extended-spectrum beta lactamase-producing strains, 83 blood isolates from these patients were assayed in terms of their bacterial phenotypes such as the mucoid and hypermucoviscosity phenotypes. Bacterial phenotypes were correlated with the patients' clinical manifestations. The hypermucoviscosity phenotype was significantly associated with septic shock at the onset of infections (odds ratio, 15.92; 95% confidence interval, 1.27-468.12), but was not associated with liver abscess formation. Mortality was determined by the presence of septic shock. RmpA gene was associated with the induction of the hypermucoviscosity phenotype. These results reveal unique roles of bacterial phenotypes on the patient's clinical condition in K. pneumoniae bacteremia.

  12. Does electronic clinical microbiology results reporting influence medical decision making: a pre- and post-interview study of medical specialists

    Directory of Open Access Journals (Sweden)

    Bloembergen Peter

    2011-03-01

    Full Text Available Abstract Background Clinicians view the accuracy of test results and the turnaround time as the two most important service aspects of the clinical microbiology laboratory. Because of the time needed for the culturing of infectious agents, final hardcopy culture results will often be available too late to have a significant impact on early antimicrobial therapy decisions, vital in infectious disease management. The clinical microbiologist therefore reports to the clinician clinically relevant preliminary results at any moment during the diagnostic process, mostly by telephone. Telephone reporting is error prone, however. Electronic reporting of culture results instead of reporting on paper may shorten the turnaround time and may ensure correct communication of results. The purpose of this study was to assess the impact of the implementation of electronic reporting of final microbiology results on medical decision making. Methods In a pre- and post-interview study using a semi-structured design we asked medical specialists in our hospital about their use and appreciation of clinical microbiology results reporting before and after the implementation of an electronic reporting system. Results Electronic reporting was highly appreciated by all interviewed clinicians. Major advantages were reduction of hardcopy handling and the possibility to review results in relation to other patient data. Use and meaning of microbiology reports differ significantly between medical specialties. Most clinicians need preliminary results for therapy decisions quickly. Therefore, after the implementation of electronic reporting, telephone consultation between clinician and microbiologist remained the key means of communication. Conclusions Overall, electronic reporting increased the workflow efficiency of the medical specialists, but did not have an impact on their decision-making.

  13. [Influence of dopamine receptors agonists on clinical and hemodynamic and neurohumoral indicators in hypertensive patients with concomitant obesity].

    Science.gov (United States)

    Lyzogub, V H; Sobol', V O; Moshkovs'ka, Iu O; Bondarchuk, O M

    2014-01-01

    The article analyzes the results of studying the effects of antihypertensive treatment with the use of agonists dopamine receptors on clinical and hemodynamic and neurohumoral indicators in hypertensive patients with concomitant obesity. Special role is given to the patogenetice factor as dopamine and his relationship with the renin - angiotensin.- aldosterone system, endothelial function, which are aimed at the regulation of blood pressure and obesity formation and progression.

  14. Influence of clinical features, serum antinuclear antibodies, and lung function on survival of patients with systemic sclerosis

    DEFF Research Database (Denmark)

    Jacobsen, Søren; Ullman, S; Shen, G Q;

    2001-01-01

    of all new patients with SSc. Disease onset was defined as the time of onset of cutaneous sclerosis. Vital status and causes of death were determined at the end of the observation period. Data on clinical status and pulmonary function were obtained. Antitopoisomerase I (anti-topo I), anticentromere, anti...... of 13.3 yrs; 16 died of an SSc related condition and 50 of other causes. Pulmonary fibrosis, DLCO reduction

  15. 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.

  16. Positive outcomes influence the rate and time to publication, but not the impact factor of publications of clinical trial results.

    Directory of Open Access Journals (Sweden)

    Pilar Suñé

    Full Text Available 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. Published articles were identified by searching Pubmed and other electronic databases. Clinical study final reports submitted to the ethics committee, final reports synopses available online and meeting abstracts were also considered as sources of study results. Study outcomes were classified as positive (when statistical significance favoring experimental drug was achieved, negative (when no statistical significance was achieved or it favored control drug and descriptive (for non-controlled studies. Time to publication was defined as time from study closure to publication. A survival analysis was performed using a Cox regression model to analyze time to publication. Journal impact factors of identified publications were recorded. Publication rate was 48·4% (380/785. Study results were identified for 68·9% of all completed clinical trials (541/785. Publication rate was 84·9% (180/212 for studies with results classified as positive and 68·9% (128/186 for studies with results classified as negative (p<0·001. Median time to publication was 2·09 years (IC95 1·61-2·56 for studies with results classified as positive and 3·21 years (IC95 2·69-3·70 for studies with results classified as negative (hazard ratio 1·99 (IC95 1·55-2·55. No differences were found in publication impact factor between positive (median 6·308, interquartile range: 3·141-28·409 and negative result studies (median 8·266, interquartile range: 4·135-17·157. CONCLUSIONS

  17. Influence of position and length of uterus on implantation and clinical pregnancy rates in IVF and embryo transfer treatment cycles.

    Science.gov (United States)

    Egbase, P E; Al-Sharhan, M; Grudzinskas, J G

    2000-09-01

    In a prospective study of 807 consecutive women shown to have an apparently normal uterus after hysterosalpingography, hysteroscopy or pelvic ultrasonography prior to IVF or intracytoplasmic sperm injection (ICSI) and embryo transfer, the position and length of the uterine cavity was measured routinely at a pre-treatment mock transfer procedure. The apparent length of the uterine cavity was 9 cm in 85 women (group 3). The uterus was noted to be retroverted in 38. 2% (308) women. The embryo transfer catheter was advanced to 5 mm from the uterine fundus based on the previously determined cavity length in all the embryo transfer procedures at 48 h after oocyte collection. Implantation and clinical pregnancy rates were not significantly different with respect to position of the uterus, difficulties encountered in passage of the catheter, mean age of the women, aetiology or duration of infertility or embryology events. An apparently greater cavity length was seen in older and/or parous women, but the difference was not statistically significant. Although the highest implantation and clinical pregnancy rates were seen in women with a cavity length of 7-9 cm (group 2) the differences were not statistically significant: group 1, 18.9 and 36. 7%; group 2, 21.0 and 46.5%; and group 3, 17.3 and 32.9% respectively. The incidence of ectopic pregnancy per reported clinical pregnancy was highest in group 1 women, being 14.9% (7/47) in comparison with group 2 (1.8%, 5/276) and group 3 (0%, 0/27) (P: size of the uterus is a critical factor in the aetiology of ectopic pregnancy in IVF/ICSI-embryo transfer.

  18. Nutritional status influences the length of stay and clinical outcomes in hospitalized patients in internal medicine wards

    Directory of Open Access Journals (Sweden)

    Ana Manuela Ordoñez

    2013-08-01

    Full Text Available Objective: The aim of this study was to investigate the relationship between the nutritional status (NS and clinical outcome and length of stay (LOS among patients admitted to the internal medicine ward. Methods: This is a retrospective observational study performed with the data of clinical patients collected during a one year period. The NS was assessed using: subjective global assessment (SGA, body mass index (BMI, triceps skinfold thickness (TST, muscle arm circumference (MAC and combined tools. Statistical analysis was performed with a confidence interval of 95% (p < 0.05. For categories comparison the chi-square test was used. To examine the association between length of stay and variables related to the NS Mann-Whitney and Kruskal-Wallis tests was used with multiple comparisons. Results: 396 patients were included in the study, 42.2% were over 60 years of age, what was associated with the presence of hypertension (p < 0.001, diabetes mellitus (p = 0.003 and required diet with modifications consistency (p = 0.003. According to combined diagnostic tools, 45.7% of patients were malnourished. Decreased food intake (p = 0.01, malnutrition according to SGA (p = 0.02 and MAC (p = 0.03 were associated with increased mortality. Patients with tertiary level of care (p = 0.01, decreased food intake (p = 0.001, who died (p = 0.004 and diagnosed with malnutrition by SGA (p = 0.001 and by the combined tools (p = 0.001 had a longer LOS. Conclusions: Patients who were malnourished by SGA and who presented decrease food intake at admission had longer LOS and poorer clinical outcomes (highest number of deaths. The diagnosis of malnutrition by MAC was also related to higher mortality.

  19. Influence of the nutritional status in the clinical and therapeutical evolution in adults and elderly with American Tegumentary Leishmaniasis.

    Science.gov (United States)

    Oliveira, A G L; Brito, P D; Schubach, A O; Oliveira, R V C; Saheki, M N; Lyra, M R; Salgueiro, M M; Terceiro, B F; Pimentel, M I F; Vasconcellos, E C; Valete-Rosalino, C M

    2013-10-01

    The objective of this study is to describe the nutritional status of adult and elderly patients with American Tegumentary Leishmaniasis (ATL). It was conducted a longitudinal study in 68 adult and elderly patients with ATL treating at the Surveillance Leishmaniasis Laboratory at the Evandro Chagas Clinical Research Institute, Oswaldo Cruz Foundation (Fiocruz), from 2009 to 2012. The nutritional assessment included the body mass index (BMI) and serum albumin levels. The clinical evolution (epithelialization and wound healing) was measured up to two years after ATL treatment. Most of the sample was composed of men (71%), adults (73%), with household income of 1-5 minimum wages (79%), and incomplete elementary school (48.5%). The predominant ATL form was cutaneous (72%), and 39% presented comorbidities, the most frequent was hypertension (30.8%). The most prevalent clinical and nutritional events were: recent decrease in food intake (23.9%); nasal obstruction (22.1%); oral ulcer (14.7%), anorexia and dysphagia (13.2% each) and odynophagia (10.3%). The total healing time was 115.00 (IR=80-230) days for skin lesions, and 120.00 (IR=104.50-223.50) days for mucous membrane lesions. Low body weight in 10%, and hypoalbuminemia in 12% of the patients have been observed. Low body weight was associated with age, mucosal leishmaniasis (ML), nasal obstruction, recent decrease in food intake and hypoalbuminemia. As for serum albumin depletion, association with the ML, dyspnea, dysphagia, odynophagia, recent decrease in food intake, absence of complete healing of the skin lesions, and increased healing time for mucous membrane lesions, was observed. The ML and their events that affect the alimentary intake have been related to the impairment of the nutritional status. Additionally, serum albumin depletion negatively affected the healing of the lesions, suggesting that a nutritional intervention can increase the effectiveness of the ATL treatment.

  20. Influence of clinical and laboratory variables on faecal antigen ELISA results in dogs with canine parvovirus infection.

    Science.gov (United States)

    Proksch, A L; Unterer, S; Speck, S; Truyen, U; Hartmann, K

    2015-06-01

    False negative faecal canine parvovirus (CPV) antigen ELISA results in dogs with CPV infection are common, but the factors that lead to these false negative results are still unknown. The aim of this study was to investigate whether dogs with a false negative faecal CPV antigen ELISA result have milder clinical signs and laboratory changes, a lower faecal virus load, higher faecal and serum CPV antibody titres and a faster recovery than dogs with a positive result. Eighty dogs with CPV infection, confirmed by the presence of clinical signs and a positive faecal CPV polymerase chain reaction (PCR), were assigned to two groups according to their faecal antigen ELISA result. Time until presentation, severity of symptoms, laboratory parameters, faecal virus load, faecal and serum antibody titres, and CPV sequencing data were compared between both groups. In 38/80 dogs that were hospitalised until recovery, the time to recovery, mortality, and the course of the disease were compared between dogs with positive and negative faecal antigen ELISA results. Of the 80 dogs included, 41 (51.3%) had a false negative faecal antigen ELISA result. ELISA-negative dogs had a significantly shorter time until presentation, lower frequency of defaecation, lower faecal virus load, and higher serum antibody concentrations than ELISA-positive dogs. Laboratory changes, CPV shedding, and outcomes were not associated with faecal antigen ELISA results. In conclusion, low faecal CPV load and antibodies binding to CPV antigen in faeces are likely to be important reasons for false negative faecal antigen ELISA results. Dogs with clinical signs of CPV infection should be retested by faecal PCR.

  1. Influence factor of pulmonary function test and its clinical apply%肺功能检查的影响因素及其临床应用

    Institute of Scientific and Technical Information of China (English)

    陈小玲

    2013-01-01

    In the area of respiratory diseases ,pulmonary function test for patients is more and more important .However ,in actual examination ,the accuracy of results is not only related to the accuracy of the instrument and criterion of tester ,but also related to understanding and cooperative degree of patients .Combined with the clinic ,this paper analysed the meaning of pulmonary function test and influence factor ,and discussed how to develop a better clinical apply of pulmonary function test in clinic .%在呼吸系统疾病领域,为患者进行肺功能检查已经越来越受到人们的重视。然而在实际检查中,结果的正确与否不仅与仪器的精确程度和测试者的技术规范程度有关,还与患者对测试者的讲解理解程度和自身的配合程度等因素有关。结合临床,本文通过肺功能检查意义、影响因素分析,就怎样更好开展临床肺功能检查应用工作进行了探讨。

  2. 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.

  3. 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.

  4. Influence of action of coal dust on metabolism of histamine and serotonin in the body (clinical and experimental study)

    Energy Technology Data Exchange (ETDEWEB)

    Gridneva, N.V.; Dainega, V.G.; Talakin, Yu.N.

    1982-04-01

    Because of the role assigned to the destruction of the metabolism of biogenic amines in the pathogenesis of pneumoconiosis in miners and lack of information on metabolism of histamine and serotonin in first contact with coal dust, it was considered expedient to study peculiarities of their metabolism in the development of dust-induced lung pathology. A table shows results of a clinical study of the changes in the indicators of histamine and serotonin metabolism in miners with pneumoconiosis, those with a long period of service and a healthy control group. Miners with various forms of pneumoconiosis all show a significant increase in the histamine level of blood which may be related to the development in the presence of dust-induced lung disease of autoimmune processes accompanied by the liberation of free histamine from cells. With the increase in histamine, an increase of serotonin appears in blood of diseased miners. Long exposure to dust inflow activates metabolism of serotonin. In addition to the clinical study of diseased miners, an experimental investigation was made of the content of serotonin and histamine in organs of white rats. Table 2 shows that after introduction of coal dust over 1-4 months, the accumulation of serotonin in lungs, brain, kidneys, liver, and small intestine increased and the accumulation of histamine in liver, kidneys and brain decreased. Inhalation of dust produces a greater change in content of serotonin in organs; the intratracheal introduction of dust changes content of histamine. Results of experiment confirm destruction of metabolism of histamine and serotonin by coal/rock dust which proves need to use antiserotonins to cure lung disease. High content of histamine in blood determines need for use of antihistamine preparations especially in the presence of bronchospasms caused by effect of histamine on smooth muscle of bronchi.

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

    Directory of Open Access Journals (Sweden)

    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.

  6. 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.

  7. 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.

  8. 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.

  9. Influence of body condition on plasma prednisolone and prednisone concentrations in clinically healthy cats after single oral dose administration.

    Science.gov (United States)

    Center, Sharon A; Randolph, John F; Warner, Karen L; Simpson, Kenneth W; Rishniw, Mark

    2013-08-01

    Influence of body condition (over-conditioned vs. normal-conditioned) on plasma glucocorticoid concentrations after single dose oral prednisolone or prednisone in 11 cats (5 normal-conditioned and 6-over-conditioned) was investigated using a two-drug crossover trial (3-week washout interval). Body condition was determined using criterion-referenced bioelectrical impedance together with plasma drug concentrations (prednisolone [active drug] and prednisone [pro-drug]) measured by HPLC. Although interconversion of each drug to the other was confirmed, a single 2mg/kg body weight oral dose of prednisolone produced significantly higher plasma prednisolone concentration (∼4-fold higher AUC) compared to prednisone. Significantly higher plasma drug concentrations in over-conditioned cats (∼2-fold) compared to normal-conditioned cats might explain their perceived increased risk for glucocorticoid associated side effects (hepatic lipidosis, diabetes mellitus). Findings suggest low comparative bioavailability of oral prednisone compared to prednisolone in cats and consideration of lean body mass or ideal body weight for dosing practices.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. 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.

  12. Factors influencing patient disclosure to physicians in birth control clinics: an application of the communication privacy management theory.

    Science.gov (United States)

    Lewis, Cara C; Matheson, Deborah H; Brimacombe, C A Elizabeth

    2011-09-01

    The focus of the current study is whether, and why, female patients limit or alter their personal histories when discussing sensitive subject matter with their physician in birth control clinics. Fifty-six female patients (M = 21.6 years, SD = 3.05) completed anonymous questionnaires exploring their comfort with and ability to disclose personal histories in the immediately preceding interview with the physician. The present study used communication privacy management (CPM) as the theoretical lens through which to view the interaction. Approximately one-half of the sample (46%) reported limiting or altering information. Patients with a highly permeable privacy orientation, as evidenced by a history of open communication regarding sexual issues, were those who reported fully disclosing to their physicians. Of the physician characteristics considered to map onto patient privacy rules, the physician's gender, hurriedness, friendliness, use of a first-name introduction, and open-ended questions were significantly related to patients' reported ease in fully disclosing personal information (p communication regarding sexual issues.

  13. 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

    as controls. Paired sample t-testand Pearson´s correlation analysis were used to analyze implant position, dimension of crownand papilla fill.Cohen’s ¿ andSpearman correlation were used to validate the PIS.The implant-supported crown was statistically longer than the contra-lateral tooth......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......, and there was significant correlation between the oro-facial position of the implant and the crown length difference (r=.607, p=.001). The distalpapilla was significantly shorter than the mesialpapilla at implant-supported crowns (p

  14. 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.

  15. Influence of Teaching Strategies and its Order of Exposure on Pre-Clinical Teeth Arrangement – A Pilot Study

    Science.gov (United States)

    Mani, Uma Maheswari; Christian, Jayanth; Seenivasan, Madhan Kumar; Natarajan, Parthasarathy; Vaidhyanathan, Anand Kumar

    2016-01-01

    Introduction Teeth arrangement is a vital skill for the undergraduate dental student. The attainment of skills depends largely on the methodology of teaching. In a dental curriculum, the students are exposed to a wide variety of inputs and teaching methodologies from different sources. The educational unit in dental school must identify the sequence of teaching methods that enhance the learning and practising ability of students. Aim The aim of this study was to evaluate the effectiveness of three different teaching methodologies for teeth arrangement and compare the differences between the orders of exposure to each teaching methodology on the development of teeth arrangement skills. Materials and Methods The first year B.D.S students were study participants and were divided into three groups A, B, C. They were exposed to three teaching patterns namely live demonstration with video assisted teaching, group discussion with hand-outs and lectures with power point presentation. After each teaching methodology, their skill was assessed. The groups were exposed to three methodologies in different order for three arrangements. The scores obtained were analysed using Kruskal Wallis rank sum test and Dunn test for statistical significance. Results Significantly higher scores in the teeth arrangement procedure were obtained by the Group A students who were exposed initially to live demonstration with video-assisted teaching. Difference in the scores was noted among and within the groups. The difference between Group A and Group C was statistically significant after both first and third teeth arrangement (p=0.0031, p=0.0057). Conclusion The study suggests each pre-clinical practice should begin with a live demonstration to enhance immediate learning absorption followed by lectures with power point presentation and group discussion for retention of knowledge and memory retrieval. PMID:27891468

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

    Directory of Open Access Journals (Sweden)

    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.

  17. 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.

  18. Clinical course of ophthalmic findings and potential influence factors of herpesvirus infections: 18 month follow-up of a closed herd of lipizzaners.

    Directory of Open Access Journals (Sweden)

    James O Rushton

    Full Text Available 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 at the same time and used for the detection of the equid gammaherpesviruses EHV-2 and EHV-5 using consensus herpesvirus PCR and type-specific qPCRs. Ophthalmic findings and results of herpesvirus PCRs were recorded and statistically analysed using one-way ANOVA, and multiple logistic regression analysis to determine the influence of herpesvirus infections and other contributing factors on the presence of ophthalmic findings. RESULTS: In the first, second, third and fourth examination period 266, 261, 249 and 230 horses were included, respectively. Ophthalmic findings consistent with herpesvirus infections included conjunctival- and corneal pathologies. Statistical analysis revealed that the probability of positive herpesvirus PCR results decreased with progressing age; however the presence of corneal findings increased over time. At the time of each examination 45.1%, 41.8%, 43.0%, and 57.0% of horses with conjunctival or corneal findings, respectively, were positive for EHV-2 and/or EHV-5. However, 31.6%, 17.6%, 20.1%, and 13.0% of clinically sound horses were positive for these herpesviruses at each examination period, too. CONCLUSION: Based on the results of our study there is a significant influence of young age on EHV-2 and/or EHV-5 infection. Corneal pathologies increased over time and with progressing age. Whether the identified findings were caused by herpesviruses could not be unequivocally determined.

  19. 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

  20. A clinical observation of the influence of deep brain stimulation on peripheral blood lymphocytes in patients with Parkinson's disease

    Directory of Open Access Journals (Sweden)

    LIU Jing

    2013-07-01

    Full Text Available Objective To study the changing in number of peripheral blood lymphocyte (PBL of patients with Parkinson's disease (PD after deep brain stimulation (DBS, and to explore the mechanism of DBS in treating PD. Methods One hundred and thirty PD patients were divided into 2 groups, namely, non-DBS group [N = 105; 68 males and 37 females; mean age (61.54 ± 10.44 years; mean duration (7.29 ± 4.57 years], and DBS group [N = 25; 16 males and 9 females; mean age (59.20 ± 10.67 years; mean disease duration (12.16 ± 4.79 years]. There were 73 healthy subjects [37 males and 36 females; mean age (61.89 ± 12.20 years] in control group. The differences of the number of PBL among the 3 groups were analyzed. Spearman's rank correlation analysis was used to assess the relationship between PBL number and influenzing factors [gender, age, disease duration, Unified Parkinson's Disease Rating Scale (UPDRS Ⅲ score, Hoehn-Yahr (H-Y stage, and drug equivalent daily dose]. Results The number of PBL in non-DBS group was less than that in control group (P = 0.000. There was significant correlation between UPDRS Ⅲ and PBL number (rs = - 0.403, P = 0.031. No correlation was found between PBL number and gender, age, disease duration, H-Y stage or drug equivalent daily dose (P > 0.05, for all. No difference was shown between PBL number in control group and in DBS group (P = 0.137 and no correlations were found with clinical variables (P > 0.05. The PBL number in non-DBS group was less than that in DBS group (P = 0.006. With the same H-Y stage, PBL number in non-DBS group was also less than that in DBS group in Mann-Whitney U test (H-Y 2.5: Z = - 2.197, P = 0.043; H-Y 3: Z = - 1.875, P = 0.027; H-Y 4: Z = - 3.760, P = 0.016. Conclusion The changing in the number of PBL is the specific feature of PD and may be correlated with the immuno-inflammation of central nervous system, which may be relieved by DBS.

  1. Clinical lymph node staging-Influence of slice thickness and reconstruction kernel on volumetry and RECIST measurements

    Energy Technology Data Exchange (ETDEWEB)

    Fabel, M., E-mail: m.fabel@rad.uni-kiel.de [Department of Diagnostic Radiology, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, Haus 23, D-24105 Kiel (Germany); Wulff, A., E-mail: a.wulff@rad.uni-kiel.de [Department of Diagnostic Radiology, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, Haus 23, D-24105 Kiel (Germany); Heckel, F., E-mail: frank.heckel@mevis.fraunhofer.de [Fraunhofer MeVis, Universitaetsallee 29, 28359 Bremen (Germany); Bornemann, L., E-mail: lars.bornemann@mevis.fraunhofer.de [Fraunhofer MeVis, Universitaetsallee 29, 28359 Bremen (Germany); Freitag-Wolf, S., E-mail: freitag@medinfo.uni-kiel.de [Institute of Medical Informatics and Statistics, Brunswiker Strasse 10, 24105 Kiel (Germany); Heller, M., E-mail: martin.heller@rad.uni-kiel.de [Department of Diagnostic Radiology, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, Haus 23, D-24105 Kiel (Germany); Biederer, J., E-mail: juergen.biederer@rad.uni-kiel.de [Department of Diagnostic Radiology, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, Haus 23, D-24105 Kiel (Germany); Bolte, H., E-mail: hendrik.bolte@ukmuenster.de [Department of Nuclear Medicine, University Hospital Muenster, Albert-Schweitzer-Campus 1, Gebaeude A1, D-48149 Muenster (Germany)

    2012-11-15

    significant differences were found. The most unsatisfactory segmentation results occurred in higher slice thickness (3 and 5 mm) and sharp tissue kernel. Conclusion: Volumetric analysis of lymph nodes works satisfying in a clinical setting. Thin slice reconstructions ({<=}3 mm) and a middle soft tissue reconstruction kernel are recommended. LAD and SAD did not show significant differences regarding APE. Automated RECIST measurement showed lower APE than manual measurement in trend.

  2. 美沙酮维持治疗影响因素%Influence Factors on Treatment of Drug Users in Methadone Maintenance Clinics in Chengdu

    Institute of Scientific and Technical Information of China (English)

    姜维华; 韩德琳; 施雅莹; 梁娴

    2011-01-01

    目的 了解美沙酮维持治疗门诊(MMT)服药人员坚持治疗的影响因素.方法 采用整群抽样的方法抽取成都市2家美沙酮门诊服药人员810人进行横断面问卷调查.结果 调查得到806份有效问卷,38.7%的人承认曾经中断过美沙酮维持治疗,23.6%的人承认曾经偷吸过,68%的人承认曾经注射过毒品,其中14.4%的承认与他人共用过注射器具.结论 MMT门诊患者治疗中断的因素为服用药物的量,服用药物的量越高越不容易中断治疗;MMT门诊患者偷吸的主要因素为工作情况和是否共用针具,工作情况越不稳定越容易偷吸,共用过针具的人偷吸的概率是没有共用针具的人的2倍左右.%Objective To analyze the influence factors on the adherence of treatment of drug users in methadone maintenance clinics in Chengdu. Methods The questionnaire survey was conducted among 810 drug users selected by cluster sampling in 2 methadone maintenance clinics in Chengdu. Results Totally 806 valid questionnaires were retumed. Up to 38. 7% of the drug users admitted that they once had stop methadone maintenance treatment, 23. 6% of them once used drug during the treatment and 68% once had injection drug use,of which 14. 4% shared needle with others. Conclusion The dosage of medication was the influence factor of the interruption of methadone maintenance treatment. The higher of methadone dose is, the more difficult to interrupt the treatment is. The influence factors of re-use of drug included these drug users' job stability and needle sharing. Most re-use of drug was due to non-stability of their job. The probability of re-use of drug in those with needle sharing was 2 times higher than that in those without needle sharing.

  3. 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.

  4. Value as the key concept in the health care system: how it has influenced medical practice and clinical decision-making processes

    Directory of Open Access Journals (Sweden)

    Marzorati C

    2017-03-01

    Full Text Available Chiara Marzorati,1,2 Gabriella Pravettoni2,3 1Foundations of the Life Sciences, Bioethics and Cognitive Science, European School of Molecular Medicine (SEMM, 2Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, 3Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy Abstract: In the last 10 years, value has played a key role in the health care system. In this concept, innovations in medical practice and the increasing importance of patient centeredness have contributed to draw the attention of the medical community. Nonetheless, a large consensus on the meaning of “value” is still lacking: patients, physicians, policy makers, and other health care professionals have different ideas on which component of value may play a prominent role. Yet, shared clinical decision-making and patient empowerment have been recognized as fundamental features of the concept of value. Different paradigms of health care system embrace different meanings of value, and the absence of common and widely accepted definition does not help to identify a unique model of care in health care system. Our aim is to provide an overview of those paradigms that have considered value as a key theoretical concept and to investigate how the presence of value can influence the medical practice. This article may contribute to draw attention toward patients and propose a possible link between health care system based on “value” and new paradigms such as patient-centered system (PCS, patient empowerment, and P5 medicine, in order to create a predictive, personalized, preventive, participatory, and psycho-cognitive model to treat patients. Indeed, patient empowerment, value-based system, and P5 medicine seem to shed light on different aspects of a PCS, and this allows a better understanding of people under care. Keywords: health care system, value, value-based medicine, patient empowerment, clinical decision

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

    Directory of Open Access Journals (Sweden)

    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

  6. Value as the key concept in the health care system: how it has influenced medical practice and clinical decision-making processes.

    Science.gov (United States)

    Marzorati, Chiara; Pravettoni, Gabriella

    2017-01-01

    In the last 10 years, value has played a key role in the health care system. In this concept, innovations in medical practice and the increasing importance of patient centeredness have contributed to draw the attention of the medical community. Nonetheless, a large consensus on the meaning of "value" is still lacking: patients, physicians, policy makers, and other health care professionals have different ideas on which component of value may play a prominent role. Yet, shared clinical decision-making and patient empowerment have been recognized as fundamental features of the concept of value. Different paradigms of health care system embrace different meanings of value, and the absence of common and widely accepted definition does not help to identify a unique model of care in health care system. Our aim is to provide an overview of those paradigms that have considered value as a key theoretical concept and to investigate how the presence of value can influence the medical practice. This article may contribute to draw attention toward patients and propose a possible link between health care system based on "value" and new paradigms such as patient-centered system (PCS), patient empowerment, and P5 medicine, in order to create a predictive, personalized, preventive, participatory, and psycho-cognitive model to treat patients. Indeed, patient empowerment, value-based system, and P5 medicine seem to shed light on different aspects of a PCS, and this allows a better understanding of people under care.

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

    Directory of Open Access Journals (Sweden)

    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.

  8. Value as the key concept in the health care system: how it has influenced medical practice and clinical decision-making processes

    Science.gov (United States)

    Marzorati, Chiara; Pravettoni, Gabriella

    2017-01-01

    In the last 10 years, value has played a key role in the health care system. In this concept, innovations in medical practice and the increasing importance of patient centeredness have contributed to draw the attention of the medical community. Nonetheless, a large consensus on the meaning of “value” is still lacking: patients, physicians, policy makers, and other health care professionals have different ideas on which component of value may play a prominent role. Yet, shared clinical decision-making and patient empowerment have been recognized as fundamental features of the concept of value. Different paradigms of health care system embrace different meanings of value, and the absence of common and widely accepted definition does not help to identify a unique model of care in health care system. Our aim is to provide an overview of those paradigms that have considered value as a key theoretical concept and to investigate how the presence of value can influence the medical practice. This article may contribute to draw attention toward patients and propose a possible link between health care system based on “value” and new paradigms such as patient-centered system (PCS), patient empowerment, and P5 medicine, in order to create a predictive, personalized, preventive, participatory, and psycho-cognitive model to treat patients. Indeed, patient empowerment, value-based system, and P5 medicine seem to shed light on different aspects of a PCS, and this allows a better understanding of people under care. PMID:28356752

  9. The Influence of Oral Ginger before Operation on Nausea and Vomiting after Cataract Surgery under General Anesthesia: A double-blind placebo-controlled randomized clinical trial

    Science.gov (United States)

    Seidi, Jamal; Ebnerasooli, Shahrokh; Shahsawari, Sirous; Nzarian, Simin

    2017-01-01

    Background According to Iranian traditional medicine, using safe ginger may contribute to taking less chemical medicines and result in fewer side effects. Objective To determine the influence of using ginger before operation on nausea and vomiting, after cataract surgery under general anesthesia. Methods This study was a double-blind placebo-controlled randomized clinical trial conducted at Kurdistan University of Medical Sciences in 2015. 122 candidates of cataract surgery were randomly allocated in three groups. The first group received a ginger capsule in a single 1 g dose, the second received two separate doses of ginger capsule each containing 500 mg and the third group received placebo capsule before operation. The patients were examined and studied for the level of nausea and occurrence of vomiting for 6 hours after the operation. The intensity of nausea was scored from zero to ten, based upon Visual Analog Scale. SPSS version 20 was used to analyze the data. We used Chi square and Kruskal-Wallis test for the analyses of outcomes. Results The frequency and intensity of nausea and the frequency of vomiting after operation among those who had taken the ginger capsule in 2 separate 500 mg doses was less than the other 2 groups. This difference was significant (pKurdistan University of Medical Sciences, Sanandaj, Iran. PMID:28243400

  10. 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...

  11. 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.

  12. Influence of flexible work shift on clinical nurses' occupational satisfaction%弹性排班对护士工作职业满意度的影响

    Institute of Scientific and Technical Information of China (English)

    王新丽; 杨素玉; 朱智玲; 任胜杰

    2013-01-01

    Objective:To explore the influence of flexible work shift on clinical nurses' occupational satisfaction.Methods:From Match 2009 to March 2010, 204 nurses to implement the traditional scheduling as the control group.March 2011 to March 2012,207 nurses to implement flexible scheduling model as experimental group.The investigation of occupation satisfaction of nurses working survey homemade table,change of occupation satisfaction were compared between the two groups of nurses.Results:The experimental group nurses work occupation satisfaction was significantly higher than the control group, the two groups were statistically significant (P<0.05).Conclusion:Flexible work shift overcomes the lack of nursing resources, increases the number of nurses during the peak period,reduces the phenomenon of procrastination,guarantees the rest time of nurses,enhances the cooperation among colleagues and improves clinical nurses' occupational satisfaction.%目的:探讨弹性排班对临床护士工作职业满意度的影响.方法:将2009年3月~2010年3月实施传统排班模式的204名护士作为对照组;将2011年3月~2012年3月实施弹性排班模式的207名护士作为试验组.采用自制的调查量表对护士工作职业满意度进行调查,比较两组护士工作职业满意度的变化.结果:试验组护士各项工作职业满意度明显高于对照组,两组比较有统计学意义(P<0.05).结论:采用弹性排班模式弥补了护理人力资源相对不足的现状,增加了高峰时段的护士人数,减少了护士拖班现象,保证了护士的休息时间,增加了同事间的合作,提高了护士工作职业满意度.

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

    Directory of Open Access Journals (Sweden)

    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.

  14. Influence of meteorological parameters on the clinical presentation of cutaneous leishmaniasis in French Guiana and on the efficacy of pentamidine treatment of the disease.

    Science.gov (United States)

    Nacher, M; Couppié, P; Carme, B; Clyti, E; Sainte Marie, D; Guibert, P; Pradinaud, R

    2002-12-01

    In French Guiana, marked seasonal fluctuations have been observed in the numbers of individuals who present with cutaneous leishmaniasis (CL). To investigate the seasonal trends further, the clinical characteristics and responses to treatment of 455 cases of CL, who presented over a 3-year period (1995-1998), were compared against data on the weather for the calendar month of presentation (month 0) and for the month before presentation (month-1). Several statistically significant associations were observed. The number of sunlight hours in month -1 was lower for the treatment successes than for the treatment failures [adjusted odds ratio (AOR) for successful treatment=0.28; 95% confidence interval (CI)=0.13-0.6; P=0.001] and for those with long incubation periods than for those with relatively short incubation periods (multiple-regression coefficient=-0.003; P=0.002). However, the radiation intensity for month-1 was higher for the treatment successes than for the treatment failures (AOR=2.1; CI=1.1-3.8; P=0.02). Relatively high numbers of hours of sunlight on month-1 were associated with relatively high numbers of parasites on the skin smears (AOR=1.03; CI=1.01-1.04; P<0.001). Relatively high numbers of hours of sunlight during month 0 were associated with lymphangitis (AOR=0.4; CI=0.19-0.8; P=0.01). These results indicate that meteorological parameters may influence the evolution of CL, at least in French Guiana.

  15. Immunophenotypic heterogeneity of multiple myeloma: influence on the biology and clinical course of the disease. Castellano-Leones (Spain) Cooperative Group for the Study of Monoclonal Gammopathies.

    Science.gov (United States)

    San Miguel, J F; González, M; Gascón, A; Moro, M J; Hernández, J M; Ortega, F; Jimenez, R; Guerras, L; Romero, M; Casanova, F

    1991-02-01

    In 112 untreated myeloma patients we have analysed the immunophenotype of plasma cells both by immunofluorescence (IF) and immunocytochemistry (APAAP). Both techniques yielded similar results pointing to an important degree of heterogeneity in antigenic expression not only between different patients but also within the same patient. The expression of CD38 and Han-PC1 antigens (Ags) was almost constant (greater than 90% positive cases), while CD9 was detected in 66% of the cases. On the other hand, less than one third of patients were positive for CD10, CD20 and HLA-DR and generally with a weak expression (less than 30% positive plasma cells). In occasional cases plasma cells were weakly positive for the myelomonocytic markers CD13 (9%), CD15 (25%) and CD14 (6%). The possibility that this heterogeneity might be the result of different stages of differentiation of the neoplastic clone is suggested both by the positive correlation in the expression of some of these antigens (CD10, CD9, CD20, HLA-DR) and by the relationship between CD10 and myeloid antigens with immature plasma cell morphology. Finally, the cALLA antigen does not seem to be of significant value in predicting survival. Moreover, none of the other markers explored showed a clear influence in the course of the disease, although the tendency towards a lower survival found for the CD20+ cases as well as the association of the expression of some antigens and advanced clinical stage, may warrant further studies in a larger series of patients.

  16. DNA repair prognostic index modelling reveals an essential role for base excision repair in influencing clinical outcomes in ER negative and triple negative breast cancers

    Science.gov (United States)

    Abdel-Fatah, Tarek M.A.; Arora, Arvind; Moseley, Paul M.; Perry, Christina; Rakha, Emad A.; Green, Andrew R.; Chan, Stephen Y.T.; Ellis, Ian O.; Madhusudan, Srinivasan

    2015-01-01

    Stratification of oestrogen receptor (ER) negative and triple negative breast cancers (TNBCs) is urgently needed. In the current study, a cohort of 880 ER- (including 635 TNBCs) was immuno-profiled for a panel of DNA repair proteins including: Pol β, FEN1, APE1, XRCC1, SMUG1, PARP1, BRCA1, ATR, ATM, DNA-PKcs, Chk1, Chk2, p53, and TOPO2. Multivariate Cox proportional hazards models (with backward stepwise exclusion of these factors, using a criterion of p < 0.05 for retention of factors in the model) were used to identify factors that were independently associated with clinical outcomes. XRCC1 (p = 0.002), pol β (p = 0.032) FEN1 (p = 0.001) and BRCA1 (p = 0.040) levels were independently associated with poor BCSS. Subsequently, DNA repair index prognostic (DRPI) scores for breast cancer specific survival (BCSS) were calculated and two prognostic groups (DRPI-PGs) were identified. Patients in prognostic group 2 (DRPI-PG2) have higher risk of death (p < 0.001). Furthermore, in DRPI-PG2 patients, exposure to anthracycline reduced the risk of death [(HR (95% CI) = 0.79 (0.64–0.98), p = 0.032) by 21–26%. In addition, DRPI-PG2 patients have adverse clinicopathological features including higher grade, lympho-vascular invasion, Her-2 positive phenotype, compared to those in DRPI-PG1 (p < 0.01). Receiver operating characteristic (ROC) curves indicated that the DRPI outperformed the currently used prognostic factors and adding DRPI to lymph node stage significantly improved their performance as a predictor for BCSS [p < 0.00001, area under curve (AUC) = 0.70]. BER strongly influences pathogenesis of ER- and TNBCs. The DRPI accurately predicts BCSS and can also serve as a valuable prognostic and predictive tool for TNBCs. PMID:26267318

  17. 死亡态度的影响因素及临床护理个性化关怀影响%The influence factors of the attitudes toward death and clinical nursing personalized care effects

    Institute of Scientific and Technical Information of China (English)

    穆菊; 陈洁; 李萍

    2013-01-01

    目的了解死亡影响因素及癌症晚期患者临终个性化护理的意义和影响。方法通过90位临床癌症患者进行问卷调查和临床交流同时进行死亡教育和姑息治疗观察,并在临床对30位病人制定临终个性化护理模式,通过记录与观察,了解死亡影响因素及临终个性化护理的意义和影响。%Objective To understand death the influence factors and the terminal cancer patients dying the significance and influence of individualized nursing care. Methods 90 patients with cancer by clinical questionnaire investigation and clinical communication at the same time of death education and palliative care observation, and in the clinical 30 patients dying for individualized nursing mode, through the record and observation, understand death the influence factors and the terminal personalized nursing significance and influence.

  18. [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).

  19. 拔牙术后出血原因临床分析%Influence factors and clinical preventive measures of postoperative bleeding after tooth extraction

    Institute of Scientific and Technical Information of China (English)

    翁烈利; 邓伟斌; 王丽晶

    2013-01-01

    Objective To investigate The influence factors and clinical preventive measures of postoperative bleeding after tooth extraction. Methods 160 patients with postoperative bleeding bleeding from January 2009 to December 2011 were chosen, and postoperative bleeding bleeding time, the causes of bleeding were retrospectively analyzed. Results 98 patients with bleeding happened within 8 hours after surgery, with the proportion of 61.25%; followed for 8 to 12 hours after surgery, with the proportion of 16.88%; 12 to 24 hours postoperative bleeding with a ratio of 15.00%, and 6.87% over 24 hours. The leading causes of bleeding after tooth extraction were gum tear alveolar bone fracture, extraction sockets rupture of blood vessels, tissue residues after mishandling, and among them, the most common cause was tear the gums, with the rate of 41.88% (67 patients). Conclusion Number of factors maybe cause bleeding after tooth extraction, and local factors is main cause.%目的 探讨影响拔牙术后出血的因素及预防措施.方法 对2009 年1 月至2011 年12 月间在我院 接受拔牙手术并出现术后出血的160 例患者的出血时间、出血原因进行回顾性分析.结果 1)患者拔牙术后出 血时间多集中在术后8 h内,占61.25% (98 例);其次为术后8~12 h,占16.88%(27 例);术后12~24 h 占15.00%(24 例),超过24 h 者占6.87%(11 例).2)导致拔牙后出血的原因有牙龈撕裂、牙槽骨骨折、拔牙窝内血管破裂、组织 残留、术后处理不当等,其中最常见的原因为牙龈撕裂,有67 例,占41.88%.结论 多种因素均可造成拔牙后出 血,以局部因素为主,进行拔牙术时要做好预防工作.

  20. 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…

  1. 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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  2. 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

    Directory of Open Access Journals (Sweden)

    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

  3. 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.

  4. 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.

  5. 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。

  6. Ischemic hepatitis: influence factors and clinical features%缺血性肝炎的影响因素及临床特征

    Institute of Scientific and Technical Information of China (English)

    王艳荣; 齐艳荣; 韩志蕊; 张秋瓒

    2013-01-01

    目的 探讨缺血性肝炎的发生率、影响因素及临床特征. 方法 观察我院收治的各种休克、呼吸衰竭等重症患者转氨酶、乳酸脱氢酶变化,总结缺血性肝炎发生率,总结其临床资料及影响因素. 结果 观察重症患者317例,发生缺血性肝炎53例,70岁以上老年人、男性发病率高.患者于休克、呼吸衰竭后1~3 d内出现丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)明显增高,高峰出现时间1~5 d,平均(3.35±0.89)d.ALT 869~4354 U/L,AST773~4833 U/L,LDH 1021~2662 U/L.总胆红素升高16例,总胆红素14~54 μmol/L.AST恢复正常上限2倍以内时间为9~16 d,平均(13.0±1.6)d.转氨酶升高程度与性别、年龄及有无基础肝病无关,酶学变化时间与性别无关.年龄≥70岁的患者AST峰值出现晚,恢复时间长于年龄<70岁的患者,差异有统计学意义(P<0.01).有基础肝病的患者AST达高峰时间明显早于无肝病者,AST恢复时间略长于后者,差异有统计学意义. 结论 缺血性肝炎男性、老年人多发高龄、患有基础肝病可影响缺血性肝炎患者转氨酶恢复时间.%Objective To investigate the incidence,influencing factors and clinical features of ischemic hepatitis.Methods Changes of serum transaminase and lactate dehydrogenase in patients with shock and respiratory failure were recorded in our hospital.Ischemic hepatitis was identified according to diagnosis guidelines,and its incidence was counted.Clinical data of patients with ischemic hepatitis were recorded.Results There were 53 cases diagnosed as ischemic hepatitis in 317 severe patients,including hemorrhagic shock,heart failure,respiratory failure,et al.The incidence was high in elderly patients aged over 70 years and male.Levels of alanine aminotransferase (ALT),AST and lactic dehydrogenase (LDH) were significantly increased 1-3 days after shock and respiratory failure,then reached to peak value 1

  7. Enteroparasitosis prevalence and parasitism influence in clinical outcomes of tuberculosis patients with or without HIV co-infection in a reference hospital in Rio de Janeiro (2000-2006

    Directory of Open Access Journals (Sweden)

    Luanda M.S. Neto

    2009-12-01

    Full Text Available Tuberculosis and intestinal parasites affect primarily low social and economic level populations, living clustered in precarious habitational settings. One of the interesting aspects of this interaction is the parasitism influence in cellular response to tuberculosis. In the present study, we evaluated the prevalence of enteroparasitosis in tuberculosis patients, HIV-infected and non HIV infected, and we observed the influence of helminth presence in the response to tuberculin skin test (TST and tuberculosis clinical outcomes. From 607 clinical records reviewed, 327 individuals met the study inclusion criteria and did not present any exclusion criteria. The prevalence of enteroparasites observed was 19.6%. There was no significant association among TST result and the variables related to the presence of: helminthes, protozoa, and stool test for parasites result (p>0.5. Considering the survival of this cohort, we may observe that there is no significant difference (p>0.05 between the survival curves of parasited and non parasited individuals. Solely the variable "eosinophils" presents a statistically significant association (p<0.001 with helminthes, all other associations are considered not significant. Our findings neither show an association between helminthic infection and a favorable tuberculosis outcome, nor between parasitism and TST response, unlike other in vitro studies. Apparently, experimental data do not correspond to the clinical findings.

  8. Enteroparasitosis prevalence and parasitism influence in clinical outcomes of tuberculosis patients with or without HIV co-infection in a reference hospital in Rio de Janeiro (2000-2006).

    Science.gov (United States)

    Neto, Luanda M S; Oliveira, Raquel de Vasconcellos Carvalhaes de; Totino, Paulo Renato; Sant'Anna, Flavia Marinho; Coelho, Viviane de Oliveira; Rolla, Valeria Cavalcanti; Zanini, Graziela Maria

    2009-12-01

    Tuberculosis and intestinal parasites affect primarily low social and economic level populations, living clustered in precarious habitational settings. One of the interesting aspects of this interaction is the parasitism influence in cellular response to tuberculosis. In the present study, we evaluated the prevalence of enteroparasitosis in tuberculosis patients, HIV-infected and non HIV infected, and we observed the influence of helminth presence in the response to tuberculin skin test (TST) and tuberculosis clinical outcomes. From 607 clinical records reviewed, 327 individuals met the study inclusion criteria and did not present any exclusion criteria. The prevalence of enteroparasites observed was 19.6%. There was no significant association among TST result and the variables related to the presence of: helminthes, protozoa, and stool test for parasites result (p>0.5). Considering the survival of this cohort, we may observe that there is no significant difference (p>0.05) between the survival curves of parasited and non parasited individuals. Solely the variable "eosinophils" presents a statistically significant association (pparasitism and TST response, unlike other in vitro studies. Apparently, experimental data do not correspond to the clinical findings.

  9. The influence of individual socioeconomic status on the clinical outcomes in ischemic stroke patients with different neighborhood status in Shanghai, China

    Science.gov (United States)

    Yan, Han; Liu, Baoxin; Meng, Guilin; Shang, Bo; Jie, Qiqiang; Wei, Yidong; Liu, Xueyuan

    2017-01-01

    Objective: Socioeconomic status (SES) is being recognized as an important factor in both social and medical problems. The aim of present study is to examine the relationship between SES and ischemic stroke and investigate whether SES is a predictor of clinical outcomes among patients with different neighborhood status from Shanghai, China. Methods: A total of 471 first-ever ischemic stroke patients aged 18-80 years were enrolled in this retrospective study. The personal SES of each patient was evaluated using a summed score derived from his or her educational level, household income, occupation, and medical reimbursement rate. Clinical adverse events and all-cause mortality were analyzed to determine whether SES was a prognostic factor, its prognostic impact was then assessed based on different neighborhood status using multivariable Cox proportional hazard models after adjusting for other covariates. Results: The individual SES showed a significant positive correlation with neighborhood status (r = 0.370; P < 0.001). The incidence of clinical adverse events and mortality were significantly higher in low SES patients compared with middle and high SES patients (P = 0.001 and P = 0.037, respectively). After adjusting other risk factors and neighborhood status, Kaplan-Meier analysis showed clinical adverse events and deaths were still higher in the low SES patients (all P < 0.05). Multivariate Cox regression analysis demonstrated that both personal SES and neighborhood status are independent prognostic factors for ischemic stroke (all P < 0.05). Besides, among patients with low and middle neighborhood status, lower individual SES was significantly associated with clinical adverse events and mortality (all P < 0.05). Conclusion: Both individual SES and neighborhood status are significantly associated with the prognosis after ischemic stroke. A lower personal SES as well as poorer neighborhood status may significantly increase risk for adverse clinical outcomes among

  10. 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.

    Science.gov (United States)

    Fheodoroff, Klemens; Ashford, Stephen; Jacinto, Jorge; Maisonobe, Pascal; Balcaitiene, Jovita; Turner-Stokes, Lynne

    2015-04-08

    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 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.

  11. 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

  12. 老年人餐后低血压的相关因素%The clinical characteristics of elderly postprandial hypotension and its influencing factors

    Institute of Scientific and Technical Information of China (English)

    富春; 刘玄长; 胡晓雷

    2015-01-01

    目的:探讨老年人餐后低血压( PPH )的临床特点和影响因素。方法该院心血管门诊患者273例,按年龄大小分为高龄组(≥80岁)96例,普通组(60~80岁)177例,给予标准化的餐饮方案。采用24 h动态血压监测仪测定患者右上肢血压,每隔30 min检测一次。同时记录患者的身高、体重等基本资料,以及患者的基础疾病和用药情况。比较分析不同情况下两组患者的PPH检出率及药物等因素的影响。结果高龄组的高血压及心脑血管事件发生率明显高于普通组( P<0.01)。高龄组早、中、晚餐后PPH检出率均显著高于普通组( P<0.01);且三餐后血压降低幅度均大于普通组,但只有中餐后有统计学差异( P<0.01)。对于应用利尿剂和硝酸酯类降压药的老年人,高龄组 PPH发生率显著高于普通组(P<0.01,P<0.05)。年龄、高血压、降压药与PPH正相关。结论高龄老年人PPH的发生率高于普通老年人,且血压降低幅度较大;利尿剂和硝酸酯类降压药可增加高龄老年人PPH的发生率;高血压、降压药可影响PPH的检出率。%Objective To investigate the clinical characteristics and influencing factors of the elderly postprandial hypotension (PPH).Methods 273 cases of patients were divided into two groups according to their age,with 96 cases in elder group(>80 years old) and 177 cases in normal group (60~80 years old).Blood pressures were determined by 24-hour ambulatory monitoring in patients with right upper limb,once every 30 minutes.At the same time,the patient's basic information such as height,weight and medications were recorded. Results The occurrence rate of hypertension and cardiovascular and cerebrovascular events in elder group were significantly higher than those of normal group (P<0.01).The rates of PPH in elder group were significantly higher than those of normal group after breakfast,lunch and dinner

  13. Influence of house dust mite impermeable covers on health-related quality of life of adult patients with asthma: results of a randomized clinical trial.

    NARCIS (Netherlands)

    Bemt, L. van den; Vries, M.P. de; Cloosterman, S.G.M.; Thoonen, B.P.A.; Muris, J.W.M.; Goossens, M.; Wesseling, G.; Schayck, C.P. van

    2007-01-01

    The aim of this study was to evaluate the effect of house dust mite impermeable covers on asthma-specific health-related quality of life in adult asthmatic patients that were trained in guided self-management. In a 2-year randomized placebo-controlled clinical trial, information on the quality of li

  14. 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...

  15. 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.

  16. Influence of family history of major depression, bipolar disorder, and suicide on clinical features in patients with major depression and bipolar disorder.

    Science.gov (United States)

    Serretti, Alessandro; Chiesa, Alberto; Calati, Raffaella; Linotte, Sylvie; Sentissi, Othman; Papageorgiou, Konstantinos; Kasper, Siegfried; Zohar, Joseph; De Ronchi, Diana; Mendlewicz, Julien; Amital, Daniela; Montgomery, Stuart; Souery, Daniel

    2013-03-01

    The extent to which a family history of mood disorders and suicide could impact on clinical features of patients suffering from major depression (MD) and bipolar disorder (BD) has received relatively little attention so far. The aim of the present work is, therefore, to assess the clinical implications of the presence of at least one first- and/or second-degree relative with a history of MD, BD and suicide in a large sample of patients with MD or BD. One thousand one hundred and fifty-seven subjects with MD and 686 subjects with BD were recruited within the context of two large projects. The impact of a family history of MD, BD, and suicide-considered both separately and together-on clinical and socio-demographic variables was investigated. A family history of MD, BD, and suicide was more common in BD patients than in MD patients. A positive family history of mood disorders and/or suicide as well as a positive family history of MD and BD separately considered, but not a positive history of suicide alone, were significantly associated with a comorbidity with several anxiety disorders and inversely associated with age of onset. The clinical implications as well as the limitations of our findings are discussed.

  17. The Clinical Appearance of Pelvic Inflammatory Disease in Relation to Use of Intrauterine Device in Latvia : A Study with Special Emphasis on Factors Influencing the Clinical Course of PID in IUD Users

    OpenAIRE

    2006-01-01

    The objectives of this case-control study, investigating 51 in-patient women with acute pelvic inflammatory disease (PID) and 50 healthy women attending for routine gynecological check-up, were to investigate the background and reproductive history of women, who are considered at low risk of sexually transmitted infection presenting with PID, to examine whether intrauterine device (IUD) use per se and long use affects the microbiology and clinical course of the disease, to identify risk facto...

  18. 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

  19. Clinical grades: upward bound.

    Science.gov (United States)

    Walsh, Catherine M; Seldomridge, Lisa A

    2005-04-01

    This study examined the relationship of grades earned in paired theory and clinical courses. Data collected during academic years 1997 to 2002 confirmed that grade inflation exists in clinical nursing courses. Problems involved in awarding grades for clinical performance are discussed (e.g., standards of clinical performance, methods used in evaluation of clinical performance, the impossibility of faculty omnipresence, the influence of student effort in grading, the effect of recency, the challenges of keeping good anecdotal records). Solutions to grading problems are proposed, including dividing up performance into agreed-on elements, measurement of these elements on a grading scale that allows for more differentiation of quality in evaluating clinical performance, assigning grades from the beginning of a clinical course, emphasizing all three domains of clinical practice, and evaluating student performance in both laboratory and, clinical settings.

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

    Science.gov (United States)

    Stemkens, D; Roza, T; Verrij, L; Swaab, H; van Werkhoven, M K; Alizadeh, B Z; Sinke, R J; Giltay, J C

    2006-07-01

    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 Klinefelter syndrome (KS), who have a supernumerary X? We recorded anthropometric and psychomotor development parameters for 61 males with KS (age range 2-56 years). In 54 cases, we were able to assess intelligence quotient (IQ) and found that impaired speech - and motor developmental problems were reported significantly more often in the paternal X - than in the maternal X group (P = 0.02). We found some significant (P < 0.05) increased body size parameters in the paternal X group, which concurs with data reporting a growth promoting influence of paternally derived genes. Our results suggest X-chromosomal imprinting occurs in males with KS.

  1. 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

    -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......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...

  2. Patient-Related Factors Influencing Satisfaction in the Patient-Doctor Encounters at the General Outpatient Clinic of the University of Calabar Teaching Hospital, Calabar, Nigeria

    Directory of Open Access Journals (Sweden)

    Ndifreke E. Udonwa

    2012-01-01

    Full Text Available Medical consultation is at the centre of clinical practice. Satisfaction of a patient with this process is a major determinant of the clinical outcome. This study sought to determine the proportion of patients who were satisfied with their doctor-patient encounter and the patient-related factors that affected patients’ satisfaction with the consultation process. A clinic-based, cross-sectional study using a modified version of the General Practice Assessment Questionnaire (GPAQ, which employed a systematic sampling technique, was used. The questionnaires were administered on 430 patients within the ages of 18 years and 65 years. Among the 430 subjects within the ages of 18 years and 65 years studied, 200 (46.5% were males and 230 (53.5% were females. Only 59.3% were satisfied with their patient-doctor encounter. The patient’s perception of time spent in the consultation, illness understanding after the visit, ability to cope with the illness after the visit, and ability to maintain health after visit were the only factors that affected patient’s satisfaction with the consultation. In our environment, nonsatisfaction with the patient-doctor encounter is high. Only few factors considered to encourage a patients satisfaction at primary care consultation contributed to end-of-consultation satisfaction. This calls for refocusing so as to improve the overall patient care in our cultural context and meet the patient needs in our environment.

  3. 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.

  4. 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.

  5. Status and influencing factors of nursing students' professional identification during clinical practice%临床实习护生职业认同现状调查及其影响因素研究

    Institute of Scientific and Technical Information of China (English)

    孙焕芹; 李国英; 平春霞

    2013-01-01

    Objective To investigate the status of nursing students'professional identification during clinical practice,and to analyze the influencing factors.Methods Ninety-eight nursing students during clinical practice were investigated with the general information questionnaire and the professional identification questionnaire.Results The total score of professional identification was 23~34 (28.45±5.44).The application choice was the influencing factor.Conclusion The professional identification of nursing students differs according to the personal characters,nursing administrators should provide career guidance according to the students'characters.%目的 调查临床实习护生的职业认同现状,并分析其影响因素.方法 采用实习护生一般资料调查表和职业认同感问卷对98名实习护生进行调查.结果 实习护生职业认同感得分为23~34(28.45±5.44)分.职业认同感的影响因素为报考志愿.结论 不同特征的实习护生职业认同感不同,护理管理者应根据实习护生的自身特点对其进行针对性的职业引导.

  6. A fragmented adeno-associated viral dual vector strategy for treatment of diseases caused by mutations in large genes leads to expression of hybrid transcripts

    Science.gov (United States)

    McClements, Michelle E.; Charbel Issa, Peter; Blouin, Véronique; MacLaren, Robert E.

    2017-01-01

    Objective Dual vector AAV systems are being utilised to enable gene therapy for disorders in which the disease gene is too large to fit into a single capsid. Fragmented adeno-associated viral (fAAV) vectors containing single inverted terminal repeat truncated transgenes have been considered as one such gene replacement strategy. Here we aim to add to the current understanding of the molecular mechanisms employed by fAAV dual vector systems. Methods Oversized (>8kb) transgene constructs containing ABCA4 coding sequence were packaged as truncated fragments <5kb in size into various AAV serotypes. In vitro transductions with these fAAV vector preparations were conducted with mRNA and protein expression products assessed by way of RT-PCR, qPCR and western blot techniques. Results Transductions with fAAV vector preparations yielded ABCA4 mRNA, but did not generate detectable levels of protein. Sequencing of the transcript population revealed the presence of full length ABCA4 CDS with additional hybrid ABCA4 variants, indicating truncated transgenes without regions of overlap were joining and forming stable hybrid transgenes. In contrast, an ABCA4 overlapping dual vector system (OV) with a defined complementary region generated only full length mRNA transcripts plus detectable ABCA4 protein. Conclusion Despite previous success shown with the fAAV approach, the lack of repeatability and identification of stable hybrid transcripts capable of protein production suggests there is more refinement required before considering this approach in a clinical setting. PMID:28239514

  7. Steatosis influences the clinical profiles and long-term outcomes of interferon-treated chronic hepatitis C and liver cirrhosis patients

    Science.gov (United States)

    Nirei, Kazushige; Matsumura, Hiroshi; Kumakawa, Mariko; Matsumoto, Naoki; Nakamura, Hitomi; Yamagami, Hiroaki; Matsuoka, Shunichi; Moriyama, Mitsuhiko

    2017-01-01

    Objective: This study aimed to assess the relationship between steatosis and long-term outcomes of patients with chronic hepatitis C (CH) and liver cirrhosis (LC). Patients and methods: The study population included 282 subjects with CH or LC who underwent liver biopsy at our institute. All patients achieved a sustained virological response (SVR) to interferon (IFN). Clinical characteristics, including age, gender and body mass index (BMI), were compared. The liver biopsy specimens of all patients were examined and scores were assigned to indicate the severity of each of the following features: inflammatory cell infiltration in the periportal, parenchymal and portal areas; F (fibrosis) stage; portal sclerotic change; perivenular fibrosis; pericellular fibrosis; bile duct damage; hepatic steatosis. Results: Of the 282 patients, 112 (39.7%) were free of steatosis. The other 170 patients (60.3%) had steatosis. The blood biochemical parameters of the patients with hepatic steatosis were significantly poorer than those of patients free of steatosis. Inflammatory cell infiltration and F stage were both significantly more severe in patients with than in those without steatosis. The incidences of hepatocellular carcinoma differed significantly between the two groups. However, the incidences of hepatocellular carcinoma did not differ significantly between the groups with BMI above and below 25. Conclusion: We consider hepatic steatosis to potentially affect the blood biochemical parameters and clinical profiles of Japanese patients with CH due to hepatitis virus type C. Patients with this form of CH showed favorable clinical responses to IFN. Furthermore, fibrosis and steatosis appear to affect the long-term outcomes of these patients. However, BMI alone cannot be used to predict HCC development. PMID:28138308

  8. 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.

  9. 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

  10. Investigation and analysis of influencing factors of adverse events report intent among clinical nurses%临床护士不良事件报告习惯调查分析

    Institute of Scientific and Technical Information of China (English)

    毛秋云; 翟荣慧; 仲丽霞; 张伟

    2016-01-01

    Objective To investigate adverse events report intent and its influencing factors in clinical nurses. Methods Questionnaire investigation was conducted among 917 clinical nurses from ten hospitals in Tai'an city using the Intent to Report Questionnaire. Results The score of clinical nurses adverse events report intent was 36.80 ± 19.71. The score of each dimension in descending order were:nurses operation adverse events, system process adverse events, and patient care adverse events. Hospital levels were significant influencing factors of clinical nurses adverse events report intent. Pressure sores were the most frequently reported, and report of patient injury caused by unreasonable nurse manpower allocation was the lowest frequency. Conclusions The level of clinical nurses adverse events report intent need to be improved. Nursing managers should pay attention to improve nurse reporting adverse event in order to better promote the safety of patients and reduce occurrence of adverse event.%目的:调查临床护士不良事件报告习惯现况及其影响因素。方法采用护理不良事件报告习惯量表,对泰安市10所医院的917名临床护士进行问卷调查。结果临床护士不良事件报告习惯得分为(36.80±19.71)分;各类事件平均得分由高到低依次为:护士操作类不良事件、系统流程类不良事件和患者照护类不良事件;临床护士不良事件报告习惯的影响因素只有医院级别;压疮的报告频率最高,而护士人力配置不合理导致患者伤害的报告频率最低。结论临床护士不良事件报告习惯水平有待提高,护理管理者要注重提高护士不良事件报告习惯,主动上报不良事件,以更好地提高患者安全管理水平,降低不良事件的发生率。

  11. Ginger extracts influence the expression of IL-27 and IL-33 in the central nervous system in experimental autoimmune encephalomyelitis and ameliorates the clinical symptoms of disease.

    Science.gov (United States)

    Jafarzadeh, A; Mohammadi-Kordkhayli, M; Ahangar-Parvin, R; Azizi, V; Khoramdel-Azad, H; Shamsizadeh, A; Ayoobi, A; Nemati, M; Hassan, Z M; Moazeni, S M; Khaksari, M

    2014-11-15

    The immunomodulatory effects of the IL-27 and IL-33 and the anti-inflammatory effects of ginger have been reported in some studies. The aim was to evaluate the effects of the ginger extract on the expression of IL-27 and IL-33 in a model of experimental autoimmune encephalomyelitis (EAE). In PBS-treated EAE mice the expression of IL-27 P28 was significantly lower whereas the expression of IL-33 was significantly higher than unimmunized control mice. In 200 and 300 mg/kg ginger-treated EAE groups the expression of IL-27 P28 and IL-27 EBI3 was significantly higher whereas the expression of IL-33 was significantly lower than PBS-treated EAE mice. The EAE clinical symptoms and the pathological scores were significantly lower in ginger-treated EAE groups. These results showed that the ginger extract modulates the expression of the IL-27 and IL-33 in the spinal cord of EAE mice and ameliorates the clinical symptoms of disease.

  12. Clinical study on the influence of phloroglucinol on plasma angiotensin II and D-Dimer index in patients with severe pregnancy-induced hypertension.

    Science.gov (United States)

    Ai, Liang; Lan, Xinzhi; Wang, Limin; Xu, Yanjie; Zhang, Bin

    2016-07-01

    To observe the effect of phloroglucinol on plasma angiotensin II and D-dimer index when it was applied to patients with severe pregnancy-induced hypertension. 212 cases of severe pregnancy-induced hypertension patients diagnosed clinically were selected to be randomly divided into the research group and the control group. The research groups were given phloroglucinol, while the control groups were given magnesium sulfate. The plasma angiotensin II and D-dimer index in patients were detected before treatment and after 7 days respectively with statistical analysis of results. The diffidence after treatment was statistically significant (P0.05). It showed that the research group could reduce the plasma D-dimer and angiotensin II index in severe pregnancy-induced hypertension patients, and its effect was significantly better than the control group according to the plasma D-dimer and angiotensin II index changes in patients, it indicated that it was effective of phloroglucinol treatment for patients with pregnancy-induced hypertension disease and superior to the western medicine conventional treatment, worth clinical promotion.

  13. 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.

  14. 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.

  15. Factors influencing dengue virus isolation by C6/36 cell culture and mosquito inoculation of nested PCR-positive clinical samples.

    Science.gov (United States)

    Jarman, Richard G; Nisalak, Ananda; Anderson, Kathryn B; Klungthong, Chonticha; Thaisomboonsuk, Butsaya; Kaneechit, Winai; Kalayanarooj, Siripen; Gibbons, Robert V

    2011-02-01

    Dengue viral isolation is necessary for definitive diagnosis, pathogenesis and evolutionary research, vaccine candidates, and diagnostic materials. Using standardized techniques, we analyzed isolation rates of 1,544 randomly selected polymerase chain reaction (PCR)-positive samples, representing all four dengue serotypes, from patients with serologically confirmed dengue infections and evaluated whether clinical and laboratory results could be predictive of isolation using standard and mosquito isolation techniques. Viruses were isolated from 62.5% of the samples by direct application to C6/36 cells and increased to 79.4% when amplifying C6/36 negative samples by intrathorasic inoculation in Toxyrhynchites splendens mosquitoes. High viremia, measured by reverse transcriptase (RT)-PCR, was a strong predictor for viral isolation by either method. Isolation was most successful in samples collected early in the disease, had low antibody levels, temperatures greater than 38°C, and had a final clinical diagnosis of dengue fever. Dengue serotypes also played a role in the success of viral isolation.

  16. Using an open source observational tool to measure the influence of the doctor's consulting style and the computer system on the outcomes of the clinical consultation.

    Science.gov (United States)

    De Lusignan, Simon; Kumarapeli, Pushpa; Debar, Safia; Kushniruk, Andre W; Pearce, Chris

    2009-01-01

    Computerization of general practice is an international phenomenon. Many of the Electronic Patient Record (EPR) systems have developed organically with considerable variation in their interface and functionality. Consequently they have differing impact on the clinical consultation. There is a dearth of tools available to study their impact on the consultation. The objective is to use ALFA to film and analyze a simulated clinical consultation. We used the ALFA (Activity Log File Aggregation) open source toolkit, to make video based observation and analysis of the computer mediated consultation. ALFA enables precise comparison of core elements of EPR systems. It allows multiple video channels including screen capture, data about computer use, and verbal interactions to be synchronized, timed and navigated through for analysis. The toolkit is free and can be downloaded under an open source license from www.biomedicalinformatics.info/alfa/. Its outputs, which include Unified Modelling Language (UML), provide the evidence-base for assessing the impact of the computer on the consultation the designing of EPR systems. ALFA has been used to compare different brands of primary care computer systems; nurse case-load selection and consultation in psychiatry.

  17. [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.

  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. 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.).

  20. Neospora caninum infection during early pregnancy in cattle: how the isolate influences infection dynamics, clinical outcome and peripheral and local immune responses.

    Science.gov (United States)

    Regidor-Cerrillo, Javier; Arranz-Solís, David; Benavides, Julio; Gómez-Bautista, Mercedes; Castro-Hermida, José Antonio; Mezo, Mercedes; Pérez, Valentín; Ortega-Mora, Luis Miguel; González-Warleta, Marta

    2014-01-30

    This work studies the influence of Neospora caninum intra-species diversity on abortion outcome, infection dynamics in terms of parasite dissemination and peripheral-local immune responses in pregnant cattle. Animals were intravenously inoculated at day 70 of pregnancy with 10⁷ tachyzoites of two isolates showing marked differences in virulence in vitro and in pregnant mouse models: Nc-Spain7, a high virulence isolate, and Nc-Spain8, a low-to-moderate virulence isolate. After inoculation, pregnancy was monitored, and dams were culled when foetal death was detected. Foetal mortality occurred in all infected heifers between days 24 and 49 post-infection (pi), however, it was detected sooner in Nc-Spain7-infected animals (median day = 34) than those inoculated with Nc-Spain8 (median day = 41) with a trend towards significance (P < 0.11). Similar histological lesions were observed in placentomes and in most of the foetuses from the two infected groups. However, parasites were more frequently detected in the placenta and foetuses by PCR and in the foetal brain by immunohistochemistry in Nc-Spain7-infected animals. Specific antibodies were detected starting at day 13 post-infection in all infected cattle, with higher IgG levels in Nc-Spain7-infected group. IFN-γ and IL-4 profiles also varied between infected groups in PBMC stimulation assays. Infected animals showed significant increases in their cytokine mRNA levels (IFN-γ, IL-4, IL-10, IL-12p40 and TNF-α) in the caruncle at time of foetal death. Differences between the infected groups were also observed for cytokine profiles. These results demonstrate the influence of the N. caninum isolate on foetal death outcome, infection dynamics and immune responses in cattle.

  1. [Influence of genetic mutations on clinical presentation of subretinal neovascularization. Report 1: The impact of CFH and IL-8 genes polymorphism].

    Science.gov (United States)

    Budzinskaia, M V; Pogoda, T V; Generozov, É V; Chikun, E A; Shchegoleva, I V; Kazarian, É É; Galoian, N S

    2011-01-01

    Genetic analysis was performed in patients with subretinal neovascularization (CNV). The results showed significant association of CFH (compliment factor H) gene polymorphism with increase (rs1061170, rs514943 and rs380390) or decrease (rs529825, rs7524776, rs1831281, rs2274700, rs1576340, rs12144939, rs7540032) of CNV development risk. The incidence of IL-8 gene mutation was significantly (p = 0.008) higher in patients after chorioretinitis. Apparently -125 > A polymorphism in patients with chorioretinitis increases risk of CNV development, thus promoting raise of proangiogenic factors concentration in eyes with inflammatory background. The clinical presentation in patients with AMD and myopic disease associated with (-125) A mutation of promoter region of IL-8 gene was similar to that of patients with chorioretinitis. The features are the following: focal pattern, no drusen and RPE detachment, predominantly classic form of CNV (without occult pattern), formation of well-organized newly developed vessels.

  2. 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.

  3. The influence of different contrast medium concentrations and injection protocols on quantitative and clinical assessment of FDG–PET/CT in lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Verburg, Frederik A., E-mail: fverburg@ukaachen.de [RWTH Aachen University Hospital, Department of Nuclear Medicine, Pauwelsstraße 30, 52074 Aachen (Germany); Maastricht University Medical Center, Department of Nuclear Medicine, P. Debyelaan 25, 6229 HX Maastricht (Netherlands); Kuhl, Christiane K. [RWTH Aachen University Hospital, Department of Diagnostic and Interventional Radiology, Pauwelsstraße 30, 52074 Aachen (Germany); Pietsch, Hubertus [Bayer Pharma AG, Berlin, Müllerstrasse 178, 13353 Berlin (Germany); Palmowski, Moritz [RWTH Aachen University Hospital, Department of Nuclear Medicine, Pauwelsstraße 30, 52074 Aachen (Germany); Mottaghy, Felix M. [RWTH Aachen University Hospital, Department of Nuclear Medicine, Pauwelsstraße 30, 52074 Aachen (Germany); Maastricht University Medical Center, Department of Nuclear Medicine, P. Debyelaan 25, 6229 HX Maastricht (Netherlands); Behrendt, Florian F. [RWTH Aachen University Hospital, Department of Nuclear Medicine, Pauwelsstraße 30, 52074 Aachen (Germany)

    2013-10-01

    Objectives: To compare the effects of two different contrast medium concentrations for use in computed X-ray tomography (CT) employing two different injection protocols on positron emission tomography (PET) reconstruction in combined 2-{sup 18}F-desoxyglucose (FDG) PET/CT in patients with a suspicion of lung cancer. Methods: 120 patients with a suspicion of lung cancer were enrolled prospectively. PET images were reconstructed with the non-enhanced and venous phase contrast CT obtained after injection of iopromide 300 mg/ml or 370 mg/ml using either a fixed-dose or a body surface area adapted injection protocol. Maximum and mean standardized uptake values (SUVmax and SUVmean) and contrast enhancement (HU) were determined in the subclavian vein, ascending aorta, abdominal aorta, inferior vena cava, portal vein, liver and kidney and in the suspicious lung lesion. PET data were evaluated visually for the presence of malignancy and image quality. Results: At none of the sites a significant difference in the extent of the contrast enhancement between the four different protocols was found. However, the variability of the contrast enhancement at several anatomical sites was significantly greater in the fixed dose groups than in the BSA groups for both contrast medium concentrations. At none of the sites a significant difference was found in the extent of the SUVmax and SUVmean increase as a result of the use of the venous phase contrast enhanced CT for attenuation. Visual clinical evaluation of lesions showed no differences between contrast and non-contrast PET/CT (P = 0.32). Conclusions: Contrast enhanced CT for attenuation correction in combined PET/CT in lung cancer affects neither the clinical assessment nor image quality of the PET-images. A body surface adapted contrast medium protocol reduces the interpatient variability in contrast enhancement.

  4. 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。

  5. Factors Influencing the Placebo Effect in Patients with Primary Open-Angle Glaucoma or Ocular Hypertension: An Analysis of Two Randomized Clinical Trials.

    Directory of Open Access Journals (Sweden)

    Taichi Kawamura

    Full Text Available To explore factors related to the placebo effect in patients with primary open-angle glaucoma (POAG or ocular hypertension (OH.This was a retrospective cohort study of patients with POAG and patients with OH who were treated with placebo. The patients' data were extracted from two randomized, double-masked, parallel, multicenter clinical trials (trial 1 and trial 2 in Japan. We explored the baseline factors that were associated with the intraocular pressure (IOP-lowering effect of placebo ophthalmic solution after 4 weeks of instillation treatment at two time points by using multivariable models. The time points were Hour 0 (between 08:30 and 10:30 before instillation and Hour 2 (within 1.5 to 2.5 h after instillation and by 12:30 at the baseline date and after 4 weeks. The changes in IOP from baseline to 4 weeks at the two time points were evaluated for the IOP-lowering effect induced by placebo instillation.Of the 330 patients included in the two trials, 89 patients were eligible for the analysis. The results of the multivariable analysis for Hour 0 indicated a high IOP at the baseline date (coefficient: 0.24, 95% confidence interval (CI: 0.02 to 0.46, P = 0.03, and the magnitude of the IOP fluctuation at the baseline date (coefficient: 0.57, 95% CI: 0.24 to 0.90, P = 0.001 was associated with the IOP-lowering effect after 4 weeks. With respect to Hour 2, the trial type was associated with the IOP-lowering effect (coefficient: -1.15, 95% CI: -2.14 to -0.16, P = 0.02.A large fluctuation in IOP during the day is associated with the IOP-lowering effect induced by placebo in patients with POAG or OH. This finding would be helpful to researchers when designing studies related to glaucoma in the early stages of clinical development of drugs.

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

    Directory of Open Access Journals (Sweden)

    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

  7. 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.

  8. [Changing views on the place of loop and thiazide diuretics in the treatment of chronic heart failure. Part II. Influence on outcomes and clinical application].

    Science.gov (United States)

    Sidorenko, B A; Preobrazhesnkiĭ, D V; Bataraliev, T A; Pershukov, I V; Makhmutkhodzhaev, S A

    2005-01-01

    Results of studies of effects of loop and thiazide diuretics on clinical outcomes in patients with chronic heart failure (CHF) are discussed. A number of prospective trials have shown that in patients with CHF not receiving angiotensin converting enzyme inhibitors (ACEI) diuretics lessen considerably probability of decompensation. At the same time retrospective analysis of some large randomized trials revealed elevated mortality among patients with CHF receiving high doses of loop diuretics without potassium sparing diuretics. Especially significant during treatment with high doses of loop diuretics is elevated risk of sudden (or arrhythmic) death which according to data from SOLVD and PRAISE trials increases 30-50%. Current recommendations on the use of loop and thiazide diuretics in complex therapy of patients with CHF are given. An attention is paid to that therapy of CHF should be started with prescription of ACEI and diuretic added in the presence of symptoms and signs of congestion. In moderate and severe CHF as basic therapy it is recommended to use combination of ACEI, b-adrenoblocker and spironolactone, which allow to confine to medium doses of loop diuretics (furosemide not more than 80 mg/day). Mechanisms of diuretic resistance in CHF and methods of its management are also reviewed in detail.

  9. Use of Information and Communication Technologies in Clinical Practice Related to the Treatment of Pain. Influence on the Professional Activity and the Doctor-Patient Relationship.

    Science.gov (United States)

    Fernandez, Jorge Muriel; Cenador, Maria Begoña García; Manuel López Millan, J; Méndez, Juan Antonio Juanes; Ledesma, María José Sánchez

    2017-05-01

    The increasing relevance of Information and Communication Technologies (ICTs) in medical care is indisputable. This evidence makes it necessary to start studies that analyse the scope these new forms of access to information and understanding of medicine have on the professional activity of the physician, on the attitude and on the knowledge of patients or, on the doctor-patient relationship. The purpose of this study is to explore some of these aspects in a group of physicians whose clinical activity is related to one of the greatest social impact health problems which is the treatment of chronic pain. Starting with the completion of a questionnaire, in the study group it is observed that the interaction between social structure, increase of information flows and ICTs generate transformations in social practices and behaviour of the actors of the health system. Internet is confirmed as an information space on the subject, but is shown as an underutilized space of interaction between the doctor and his patient.

  10. Clinical factors influencing phenotype of HCMV-specific CD8+ T cells and HCMV-induced interferon-gamma production after allogeneic stem cells transplantation.

    Science.gov (United States)

    Gayoso, Inmaculada; Cantisán, Sara; Cerrato, Carolina; Sánchez-García, Joaquín; Martin, Carmen; Solana, Rafael; Torres-Gomez, Antonio; Torre-Cisneros, Julian

    2013-01-01

    Human cytomegalovirus (HCMV) infection causes significant morbidity and mortality after hematopoietic stem cell transplantation (HSCT). In this work, we characterized the phenotype and interferon-gamma (INF-γ) production of HCMV-specific T cells using QuantiFERON-HCMV assay in 26 patients 6 months after HSCT. We analysed whether these two parameters were associated with clinical variables. Our results showed that the patients receiving stem cells from donors ≥40 years old were 12 times more likely to have HCMV-specific CD8+ T cells with "differentiated phenotype" (CD45RA+CCR7+ ≤6.7% and CD28+ ≤30%) than patients grafted from donors <40 years old (OR = 12; P = 0.014). In addition, a detectable IFN-γ production in response to HCMV peptides (cutoff 0.2 IU/mL IFN-γ; "reactive" QuantiFERON-HCMV test) was statistically associated with HCMV replication after transplantation (OR = 11; P = 0.026), recipients ≥40 versus <40 years old (OR = 11; P = 0.026), and the use of peripheral blood versus bone marrow as stem cell source (OR = 17.5; P = 0.024). In conclusion, donor age is the only factor significantly associated with the presence of the "differentiated phenotype" in HCMV-specific CD8+ T cells, whereas HCMV replication after transplantation, recipient age, and stem cell source are the factors associated with the production of IFN-γ in response to HCMV epitopes.

  11. Clinical effect of conservative drug treatment for ectopic pregnancy and the influencing factors%异位妊娠药物保守治疗效果及其影响因素分析

    Institute of Scientific and Technical Information of China (English)

    李婵娟; 凌斌

    2013-01-01

    目的 分析影响异位妊娠药物保守治疗效果的因素.方法 对我院妇产科2008年6月至2011年6月收治的100例异位妊娠患者进行药物保守治疗,将所有患者根据药物治疗是否成功分为成功组与失败组,比较两组患者的停经时间、腹痛天数、血HCG水平、血孕酮水平、彩超结果,并用Logistic回归分析影响异位妊娠药物治疗成功率的因素.结果 单因素分析显示,停经时间、血HCG水平、血孕酮水平、彩超显示包块大小影响药物保守治疗的成功率,停经时间越短、血HCG水平与孕酮水平越低,包块直径越小成功率越高(P<0.05);腹痛时间、盆腔积液量对药物治疗成功率影响不明显(P>0.05).Logistic多因素分析显示,血HCG水平、包块大小是影响药物保守治疗成功率的因素.结论 患者血HCG水平、停经天数、包块大小是影响药物保守治疗成功与否的关键因素,停经时间也是因素之一,治疗时应根据患者临床表现及辅助检查结果选择治疗方案,提高成功率,以免给患者造成不必要的负担.%Objective To analyze the factors influencing the clinical effect of conservative drug treatment for ectopic pregnancy. Methods One hundred patients with ectopic pregnancy admitted in our hospital from June, 2008 to June, 2011 received conservative drug treatment, which were divided into the success group and the fail group according to the outcome of treatment The days of amenorrhea, days of pain, levels of human chorionic gonadotrophin (HCG) and blood progesterone, as well as the sonographic results were compared between the two groups. The factors influencing the clinical effect of the treatment were analyzed by logistic regression analysis. Results Single factor analysis showed mat days of amenorrhea, HCG level, mass diameter, progesterone level were the factors that influence the outcome of die treatment The success of the treatment was correlated with shorter

  12. Three families displaying the combination of Stargardt's disease with cone-rod dystrophy or retinitis pigmentosa.

    NARCIS (Netherlands)

    Klevering, B.J.; Maugeri, A.; Wagner, A.; Go, S.L.; Vink, C.W.; Cremers, F.P.M.; Hoyng, C.B.

    2004-01-01

    OBJECTIVE: To investigate the clinical spectrum and molecular causes of retinal dystrophies in 3 families. DESIGN: Family molecular genetics study. PARTICIPANTS: Sixteen patients and 15 relatives in 3 families. METHODS: Members of 3 families with multiple ABCA4-associated retinal disorders were clin

  13. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  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

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    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. The influence of resistance exercise with emphasis on specific contractions (concentric vs. eccentric on muscle strength and post-exercise autonomic modulation: a randomized clinical trial

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    Mariana O. Gois

    2014-01-01

    Full Text Available Background: Compared to eccentric contractions, concentric contractions result in higher cardiovascular stress. However, we do not know how these two types of contractions influence cardiac autonomic modulation during the post-exercise recovery period. Objective: to compare the effect of resistance training that is performed with concentric vs. eccentric emphasis on muscle strength and on post-exercise recovery which was assessed by examining heart rate variability (HRV, for the knee extensor muscle group in young healthy adults. Methods: For this study, 105 men between 18 and 30 years of age were randomized into 4 groups: concentric control (CONCC, eccentric control (ECCC, concentric training (CONCT and eccentric training (ECCT. The CONCC and ECCC groups underwent one session of resistance exercise (RE using the knee extensor muscle group (3 sets of 1 repetition at 100% of the maximal repetition [1MR] and the CONCT and ECCT groups performed 10 training sessions. The HRV was analyzed at baseline and across four recovery periods (T1, T2, T3 and T4. Results: The ECCT group exhibited increased muscle strength at the end of the study. Regarding cardiac autonomic modulation, the CONCC and ECCC groups exhibited increases in overall variability (SDNN and SD2 at T1 compared to baseline, and the ECCT group demonstrated increases in variables reflecting vagal modulation and the recovery process (RMSSD, SD1 and HF [ms2] at T1, T2 and T4 compared to baseline. Conclusions: Resistance training with emphasis on eccentric contractions promoted strength gain and an increase in cardiac vagal modulation during recovery compared to baseline.

  17. BRCA1 and BRCA2 missense variants of high and low clinical significance influence lymphoblastoid cell line post-irradiation gene expression.

    Directory of Open Access Journals (Sweden)

    Nic Waddell

    2008-05-01

    Full Text Available The functional consequences of missense variants in disease genes are difficult to predict. We assessed if gene expression profiles could distinguish between BRCA1 or BRCA2 pathogenic truncating and missense mutation carriers and familial breast cancer cases whose disease was not attributable to BRCA1 or BRCA2 mutations (BRCAX cases. 72 cell lines from affected women in high-risk breast ovarian families were assayed after exposure to ionising irradiation, including 23 BRCA1 carriers, 22 BRCA2 carriers, and 27 BRCAX individuals. A subset of 10 BRCAX individuals carried rare BRCA1/2 sequence variants considered to be of low clinical significance (LCS. BRCA1 and BRCA2 mutation carriers had similar expression profiles, with some subclustering of missense mutation carriers. The majority of BRCAX individuals formed a distinct cluster, but BRCAX individuals with LCS variants had expression profiles similar to BRCA1/2 mutation carriers. Gaussian Process Classifier predicted BRCA1, BRCA2 and BRCAX status, with a maximum of 62% accuracy, and prediction accuracy decreased with inclusion of BRCAX samples carrying an LCS variant, and inclusion of pathogenic missense carriers. Similarly, prediction of mutation status with gene lists derived using Support Vector Machines was good for BRCAX samples without an LCS variant (82-94%, poor for BRCAX with an LCS (40-50%, and improved for pathogenic BRCA1/2 mutation carriers when the gene list used for prediction was appropriate to mutation effect being tested (71-100%. This study indicates that mutation effect, and presence of rare variants possibly associated with a low risk of cancer, must be considered in the development of array-based assays of variant pathogenicity.

  18. Clinical Factors Influencing Phenotype of HCMV-Specific CD8+ T Cells and HCMV-Induced Interferon-Gamma Production after Allogeneic Stem Cells Transplantation

    Directory of Open Access Journals (Sweden)

    Inmaculada Gayoso

    2013-01-01

    Full Text Available Human cytomegalovirus (HCMV infection causes significant morbidity and mortality after hematopoietic stem cell transplantation (HSCT. In this work, we characterized the phenotype and interferon-gamma (INF-γ production of HCMV-specific T cells using QuantiFERON-HCMV assay in 26 patients 6 months after HSCT. We analysed whether these two parameters were associated with clinical variables. Our results showed that the patients receiving stem cells from donors ≥40 years old were 12 times more likely to have HCMV-specific CD8+ T cells with “differentiated phenotype” (CD45RA+CCR7+ ≤6.7% and CD28+ ≤30% than patients grafted from donors <40 years old (OR=12; P=0.014. In addition, a detectable IFN-γ production in response to HCMV peptides (cutoff 0.2 IU/mL IFN-γ; “reactive” QuantiFERON-HCMV test was statistically associated with HCMV replication after transplantation (OR=11; P=0.026, recipients ≥40 versus <40 years old (OR=11; P=0.026, and the use of peripheral blood versus bone marrow as stem cell source (OR=17.5; P=0.024. In conclusion, donor age is the only factor significantly associated with the presence of the “differentiated phenotype” in HCMV-specific CD8+ T cells, whereas HCMV replication after transplantation, recipient age, and stem cell source are the factors associated with the production of IFN-γ in response to HCMV epitopes.

  19. 信息系统平台下临床路径管理对医疗费用影响研究%Research on Medical Expenses Influenced by Clinical Pathway Management under Information System Platform

    Institute of Scientific and Technical Information of China (English)

    俞小萍; 俞慧强

    2011-01-01

    以母婴 ABO 血型不合溶血病为例,依托医院信息系统管理该路径病人,提取病历首页信息,分析以临床路径为基础的疾病治疗模式对疾病医疗费用的影响.结果显示:疾病的临床路径管理能降低医疗费用,在一定程度上有效地控制了医疗费用的上涨.%Take mother-fetus ABO blood type incompatible hemolytic disease for an example, it relies on the hospitalinformation system to manage patients in the pathway, extracts the homepage information of medical record, andanalyzes the influence of mend ailment mode based on the clinical pathway on medical expenses. The result showsthat the clinical pathway management of disease could reduce the medical expenses, and effectively control its rising tosome extent.

  20. 不同专业对医学毕业生就业违约的影响分析%Analysis of major influencing on clinical medicine graduates' employment breach

    Institute of Scientific and Technical Information of China (English)

    段链; 王晶桐; 叶丽娜

    2012-01-01

    Objective To explore major influencing on employment breach of clinical medicine graduates.Methods Descriptive methods were used to explore the reason of employment breach,chisquare test was used to explore major category and major-post match degree that influencing on employment breach.Results Major is an important factor influencing on employment breach,ophthalmology graduates and surgical graduates have higher rates of employment breach and are more vulnerable to major-post match degree.Conclusions Measures should be taken to guide graduates to choose employment in related majors and strengthen the cultivation of compound talents.%目的 探寻专业对医学毕业生就业违约的影响.方法 通过描述性研究揭示医学毕业生就业违约的原因,用卡方检验探寻专业类别及专业一岗位匹配度对就业违约的影响.结果 专业是影响医学毕业生就业违约的重要因素;眼科学及外科学专业毕业生的违约率较高,且较易受专业一岗位不匹配的影响;“想从事与专业更匹配的工作”是导致违约的重要原因.结论 需要从引导热门专业毕业生选择相关专业就业及加强对一专多能的复合型人才的培养两方面人手,降低医学毕业生的就业违约率.

  1. 临床分析影响破伤风治疗护理的相关因素%Clinical analysis of related factors influencing tetanus care

    Institute of Scientific and Technical Information of China (English)

    沈若凤

    2015-01-01

    Objective:To study the importance of tetanus patients and nursing related factors.Methods:our department were retro-spectively analyzed the clinical data of 12 cases tetanus patients nursing.Results:antibiotics and T the AT use time and the length of hos-pital stay, efficacy had close relations, observation group of patients with fewer complications, good curative effect, short of such confine-ment, all hospital cure;Control group much complications and poorer prognosis, such confinement was longer, 1 case death, the rest were for improved or cured discharged from hospital.Conclusion:tetanus patients difficult, fast development, treatment, care, early and effec-tive application of antibiotics on the basis of nursing might be an important guarantee of treated patients with tetanus.%目的:探讨破伤风患者治疗与护理相关因素的重要性。方法:回顾性分析我科12例破伤风患者治疗护理的临床资料。结果:抗生素与T AT使用时间和住院时间的长短、疗效有着密切关系,观察组患者并发症少、疗效好、住院日短,全部治愈出院;对照组并发症多、预后差、住院日较长、1例死亡、其余为好转出院或治愈出院。结论:破伤风患者病情重、发展快、治疗护理难度大、及早的应用抗生素和有效的做好各项基础护理工作是救治破伤风患者的重要保证。

  2. 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.

  3. 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

  4. DiscussiOn Of the influence factOrs Of the cultivatiOn Of residents' clinical ability thrOugh the clinical ability cOmpetitiOn%由临床能力大赛谈住院医师临床能力培养影响因素

    Institute of Scientific and Technical Information of China (English)

    陈丽芬; 王亚军; 樊洁; 康骅; 贾建国; 王晓辉

    2014-01-01

    目的:分析北京市住院医师临床能力大赛结果,探讨住院医师临床能力培养的影响因素。方法对北京市外科住院医师临床能力大赛250名参赛者的基本情况和考核结果进行统计分析。结果住院医师辅助检查判读、接诊患者成绩及对医疗法律法规的知晓程度较低(67.59±13.87、69.21±16.28、64.45±5.36);修改实习学生病历、书写病理申请单、危重病通知书和出院医嘱的能力较差(30.31±16.84、70.26±7.51、75.15±14.68、63.49±18.27)。结论住院医师临床能力大赛有利于检验住院医师水平,结业考核、指导老师带教意识、住院医师培训的积极性和主动性等影响住院医师临床能力培养。%Objective To analyze the results of the residents' clinical competency competition,and discuss the influ-ence factors of the cultivation of the residents' clinical ability. MethOd We made statistic analysis of the general condition and the performance of the competition of the 250 residents. Result The score of the auxiliary examination interpretation,dealing with patients and the awareness of health law and regulations were low ( 67. 59 ± 13. 87, 69. 21±16. 28,64. 45±5. 36). The ability of modifying the students' records,writing pathology application,critically ill noticing and writing discharge instructions were bad(30. 31±16. 84,70. 26±7. 51,75. 15±14. 68,63. 49± 18. 27). COnclusiOn The clinical competency competition of residents is helpful to test the residents' clinical abili-ty. System,social factors,the graduation examination,the teachers' teaching consciousness and the enthusiasm and initiative of the residents influence the cultivation of clinical ability of the residents.

  5. 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.

  6. 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

  7. Clinical research on the mutual influence between diabetes and periodontitis treatments%糖尿病与牙周炎治疗效果的相互影响

    Institute of Scientific and Technical Information of China (English)

    李立芳; 张勇

    2015-01-01

    目的:探讨2型糖尿病与牙周炎治疗的相互影响。方法:随机选择患2型糖尿病伴中、重度慢性牙周炎的患者66名,其中联合治疗组(n=34)进行降糖和牙周基础治疗;糖尿病治疗组(n=32)进行单纯降糖治疗。观察比较两组治疗8周后牙周炎及糖尿病各相关指标。结果:治疗8周后,联合治疗组牙周炎症状明显改善,白细胞介素-1β降低,糖尿病症状也有明显改善,较治疗前相比均有显著性差异(P<0.05);糖尿病治疗组糖尿病与牙周炎症状均明显改善(P<0.05);联合治疗组牙周指标的改善明显优于糖尿病治疗组(P<0.05),但两组糖尿病指标的改善无显著差异(P>0.05)。结论:对于糖尿病伴慢性牙周炎的患者,糖尿病的有效控制有利于牙周炎症状的改善,糖尿病牙周联合治疗更有利于患者牙周炎症状的改善。%AIM:To investigate the mutual influence of diabetes mellitus and periodontitis.METHODS:66 diabetic patients with intermediate to severe chronic periodontitis were randomly divided into 2 groups,those in one group (n=34)received combined treatment for periodontal therapy and blood sugar control,in other group (n=32) received only diabetic treatment.8 weeks after treatment,periodontal parameters and diabetic parameters were meas-ured.RESULTS:Patients in the 2 groups all showed significant improvement in periodontal parameters and diabetic parameters (P0.05).CONCLUSION:Effective diabetic treatment may improve the symptoms of periodontitis in the patients with diabetes mellitus and peri-odontitis,combined treatment for periodontal therapy and blood sugar control is more effective.

  8. 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

  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. 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.

  11. 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.

  12. 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.

  13. Study on Clinical Effect of Alprostadil on Patients with Myocardial Infarction and its Influence Towards Hemorheology%前列地尔治疗心肌梗死疗效和对血液流变学的影响

    Institute of Scientific and Technical Information of China (English)

    梁裕聪; 梁嘉辉; 胡经航; 揭英彪

    2016-01-01

    Objective To study the clinical effect of Alprostadil on the patients with coronary heart disease ( CHD) and its influ-ence towards hemorhrology. Methods 106 CHD patients treated from March 2014 to March 2015 in our hospital were selected and randomly divided into two groups, 53 cases in each group. The patients in the control group were treated with the conventional thera-py, while those in the observation group were given Alprostadil on the basis of the conventional therapy. The clinical effect, blood lip-id, hemorheology and adverse reactions of two groups were observed. Results The total effective rate of observation group (86. 79%) was significantly higher than that of control group (69. 81%, P0. 05 ) . Conclusion Alprostadil has an obvious effect on the patients with myocardial infarction, effectively reducing the blood lipid level and improving the abnormal blood stream. It is safe and worthy of clinical application and promotion.%目的:研究冠心病心肌缺血患者采用前列地尔治疗对血液流变学的影响及疗效。方法临床纳入106例我院2014年3月至2015年3月期间收治的心肌梗死患者,所有患者按随机数字表法分为两组各53例。其中53例患者采用常规治疗作为对照组,另53例患者在上述基础上加用前列地尔治疗作为观察组。观察两组患者治疗效果、治疗前后血脂差值情况、治疗前后血液流变学差值情况以及不良反应情况等。结果观察组、对照组总有效率分别为86.79%、69.81%,观察组高于对照组, P0.05。结论前列地尔对心肌梗死患者治疗效果显著,有效降低血脂水平,改善血流异常情况,安全性高,值得临床应用及推广。

  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. 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。

  16. 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。

  17. Research on work engagement and its influencing factors of clinical nurses%临床护士工作投入及其影响因素的研究

    Institute of Scientific and Technical Information of China (English)

    王雪; 卜秀梅; 赵晓霜; 金红梅

    2015-01-01

    Objective To know about the current status of the work engagement of the clinical nurses and its influencing factors,to explore the influencing factors of work engagement of clinical nurses so as to provide basis for improving the level of the work engagement of the clinical nurses.Methods The work engagement scale,hardiness scale,role pressure scale,perceived organizational support scale and questionnaire of family care index were used to investigate a total of 630 clinical nurses.The results were analyzed.Results The average score of work engagement,hardiness,role pressure and perceived organizational support were showed respectively as following:(3.28±0.51),(2.60±0.53),(3.00±0.50),(3.43± 1.04) scores.Clinical nurses number of the total point between 7 and 10 of family support accounted for 70.9%(447/630).Hardiness,perceived organizational support,family support and work engagement were in obvious positive correlation,whereas role pressure was in obvious negative correlation with work engagement.Hierarchical regression analysis showed after the variable of demographic was controlled,the hardiness and perceived organizational support respectively had significant positive predictive function on work engagement as respective independent variables.Role pressure had obvious negative predicative function on work engagement.Conclusions Hospital managers should create a good working environment for clinical nurses,measures should be taken from individual and organizational aspects so as to improve the hardiness and perceived organizational support,reduce role pressure and the work positivity of the clinical nurses,so that the nurse more positively devoted to their work.It has important practical significance to improving the quality of their services and stabilizing nursing troop.%目的 了解临床护士工作投入及其影响因素的现状,探讨临床护士工作投入的影响因素,为提高临床护士的工作投入水平提供依据.方法 采用工作

  18. 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.

  19. Clinical Research and Clinical Trials

    Science.gov (United States)

    ... NICHD Publications Data Sharing and Other Resources Research Clinical Trials & Clinical Research Skip sharing on social media links ... health care providers, and researchers. Find NICHD-Supported Clinical Trials Use this link to find a list of ...

  20. Clinical Competence/Clinical Credibility.

    Science.gov (United States)

    Goorapah, David

    1997-01-01

    In interviews with 10 nurse teachers and 10 clinicians, respondents could describe clinical competence more fluently than clinical credibility. Responses raised the question of whether nursing teachers must be clinically competent/credible to teach nursing. (SK)

  1. 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

  2. Analysis of status quo of clinical nurses’core competency and its influencing factors%临床护士核心能力现状及影响因素分析

    Institute of Scientific and Technical Information of China (English)

    李颖雅; 江志潇; 冯晓玲

    2016-01-01

    Objective:To know about the level of clinical nurses’core competency and to analyze the influencing factors,so as to provide the basis for nursing management.Methods:A total of 120 clinical nurses were investiga-ted with Competency Inventory for Registered Nurses and by using stratified sampling method.Results:The to-tal score and mean score of clinical nurses’core competency were 184.96±35.35 and 3.17±0.71,respectively, which were the higher level.The highest mean score was the dimension of legal and ethical practice(3.52±0.62) while the lowest was critical thinking and research (3.17±0.71).Multivariate regression analysis showed that nurses’titles and parenting status were the main influencing factors of core competency and were positive relat-ed to core competency.Conclusion:Managers should combine the practice to pay attention to strengthen the cul-tivation of nurses’critical thinking and research ability,especially for nurses who has lower professional title and the nurses who were unmarried and not pregnant.%[目的]了解临床护士核心能力水平,分析其影响因素,为护理管理提供依据。[方法]采用分层抽样的方法,对120名护士应用注册护士核心能力量表进行调查。[结果]护士核心能力总分为184.96分±35.35分,均分为3.36分,处于高能力水平。伦理和法律实践得分最高(3.52分±0.62分),评判性思维和科研得分最低(3.17分±0.71分)。多元回归分析显示,护士职称及养育孩子情况是影响临床护士核心能力的主要因素并与临床护士的核心能力呈正相关。[结论]管理者结合实际情况,在护士培训中应注重评判性思维和科研能力的培养,加强对低职称及未婚未孕护士的培养,以提升护士的核心能力。

  3. 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

  4. 全科医生临床能力培训效果评价及影响因素分析%Effect of clinical competence training for general practitioners and influencing factors

    Institute of Scientific and Technical Information of China (English)

    刘瑶; 江孙芳; 顾杰; 寿涓; 夏慧玲; 祝墡珠

    2013-01-01

    目的 评估全科医生临床能力培训的效果,为今后进一步完善培训方案、提高培训质量提供科学依据.方法 以2011年7月至2012年10月期间参加上海市全科医生临床能力培训的759名学员为研究对象,比较这些学员参加培训前后的理论和操作成绩,分析影响培训效果的因素,评价培训的实施效果.结果 759名学员中,男性260名(34.26%),女性499名(65.74%);平均工作年限(13.6±7.1)年.学员培训前后理论和实际操作的总成绩分别为(67.40±8.57)分和(73.61±7.20)分,培训前后成绩的差异具有统计学意义(=17.96,P<0.01).培训后实际操作成绩的提高更为明显,培训前后体格检查的成绩分别为(12.90±3.76)分和(14.00±3.51)分,而临床技能成绩分别为(9.41±4.80)分和(13.40±4.02)分,前后成绩的差异均有统计学意义(t值分别为6.31和19.01,均P<0.01).在体格检查项目中,心肺体检、腹部体检、甲状腺检查和神经系统体检4个项目的培训后成绩高于培训前,且差异具有统计学意义(均P <0.05或0.01);而临床技能的所有7个项目的培训后成绩均明显高于培训前(均P<0.01).多元线性回归分析显示,学员培训效果影响因素包括性别、教育程度、专业类别及培训前成绩(P<0.01或<0.05).结论 全科医生培训后理论知识和实际操作能力都有提高,尤其是临床技能操作水平提高更为明显.今后的培训内容应结合社区全科医生实际工作特点,注重临床技能培训,提高社区全科医师的综合素养.%Objective To evaluate the effect of clinical competence training for general practitioners in Shanghai.Methods Total 759 general practitioners participated in clinical competence training from July 2011 to October 2012 in Shanghai.The theoretical and practical operation scores of all the 759 trainees were compared before and after the training and the influencing factors of training effect were analyzed

  5. Influence of clinical nursing pathway on rehabilitation effect in patients with cerebral hemorrhage hemiparalysis%临床护理路径对脑出血偏瘫患者康复效果的影响

    Institute of Scientific and Technical Information of China (English)

    尚金红

    2016-01-01

    目的 探究与分析临床护理路径对脑出血偏瘫患者康复效果的影响.方法 选取本院自2013年7月至2015年7月收治的90例脑出血偏瘫患者,按照就诊时间顺序分为常规护理组与临床护理路径组,每组45例.常规护理组给予基础护理对策,包括入院时宣教、介绍病情、观察病情变化等;临床护理路径组指派至少由1名护士长及3名以上护理人员建立临床护理路径小组,由护士长组织组内人员系统性的学习并加强脑出血偏瘫后康复护理的相关知识,根据每位患者的个体情况给予评估,并对每个阶段后的康复护理效果给予评价.对比两组患者康复护理效果、活动能力、肢体功能及负面情绪评分.结果 临床护理路径组的护理效果总有效率明显高于常规护理组,差异具有统计学意义(P<0.05).两组患者治疗后较治疗前相比Barthel评分及Harris评分均明显升高,临床护理路径组较常规护理组相比Barthel评分及Harris评分升高更加明显,差异具有统计学意义(P<0.05).两组患者治疗后较治疗前相比HAMA评分及HAMD评分评分均明显降低,临床护理路径组较常规护理组相比HAMA评分及HAMD评分降低更加明显,差异具有统计学意义(P<0.05).结论 临床护理路径可有效提高脑出血偏瘫患者的护理效果,促进改善日常活动能力及肢体功能,降低负面情绪.%Objective To explore and analyze the influence of clinical nursing pathway on rehabilitation effect in patients with cerebral hemorrhage hemiplegia.Methods 90 cerebral hemorrhage patients with hemiplegia treated at our hospital from July,2013 to July,2015 were selected and divided into a routine nursing and a clinical nursing pathway group according to the hospitalization time sequence,45 cases for each group.The routine nursing group were given basic nursing countermeasures,including propaganda and education on admission,introducing disease conditions

  6. Study on Clinical Nursing and Influencing Factors of Sleep Disorders in Patients With Parkinson Disease%帕金森病患者睡眠障碍影响因素及临床护理研究

    Institute of Scientific and Technical Information of China (English)

    梁淑燕; 余玉银; 李金叶

    2015-01-01

    Objective To explore the influence factors of Parkinson’s diseases (PD) of patients with sleep disorders and their correlation, put forward the method of clinical nursing. Methods Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS) were used to review and analyze related factors of 34 cases of PD in patients with sleep disorders. Results Patients cases with PD was 34, of 25 patients with sleep disorder, sleep disorder was 73.5%.Through multiple stepwise linear regression analysis showed a correlation between PSQ I score and UPDRS- Ⅲscore,HAD score, average daily dose of levodopa, MMSE score and age. Conclusion The incidence of sleep disorders was high in Parkinson’s disease, the level of sleep disorders was associated with the severity of the disease, depression, cognitive status, age, dopaminergic drug applications. To strengthen the clinical treatment and nursing, can improve sleep disorder patients and the quality of life of PD.%目的:探讨帕金森病患者睡眠障碍的影响因素及相关性,提出针对性的临床护理方法。方法应用匹兹堡睡眠质量指数量表、爱泼沃斯嗜睡量表等调查表分别对34例PD患者睡眠障碍及相关因素进行评估和分析。结果34例PD患者中,合并睡眠障碍者25例,睡眠障碍发生率为73.5%。采用多因素逐步线性回归分析法对帕金森病患者睡眠障碍的影响因素进行分析,结果显示:PSQI总分与HAD评分、UPDRS-Ⅲ评分、左旋多巴日平均剂量、MMSE评分、年龄具有相关性。结论PD患者合并睡眠障碍多见,其状况与病情严重程度、认知状态、抑郁、年龄、多巴胺能药物应用等因素相关。加强临床治疗与针对性护理,可改善患者睡眠障碍状况,提高PD生活质量。

  7. 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

  8. Influencing factors of clinical decision of family members of end of life patients in intensive care unit%重症监护室生命末期病人家属临床决策的影响因素

    Institute of Scientific and Technical Information of China (English)

    刘梦婕; 周厚秀; 朱京慈

    2016-01-01

    Objective:To about influencing factors of clinical decision of family members of end of life patients in intensive care unit(ICU).Methods:The phenomenological method was used to conduct semi structured deep interviews for ten family members of end of life patients in ICU from a third grade A hospital.Results:Influen-cing factors of clinical decision of family members of end of life patients in ICU were extracted as 3 elements and 9 sub elements:obj ective factor (quality of life,prognosis of the disease,lifetime wishes,deathbed place),fami-ly factors(economic conditions,whether family members’views unified or not),social and cultural factors (filial piety,fallen leaves return to the roots,and death attitude).Conclusion:The effective coping mechanism should be established from medical education training,medical institutions construction,medical legal guidelines and medical insurance system so as to arouse the attention to the quality of life of life of end patients in ICU.%[目的]了解重症监护室(ICU)生命末期病人家属临床决策的影响因素。[方法]采用现象学方法对某三级甲等医院的10名ICU生命末期病人家属进行半结构式深度访谈。[结果]ICU生命末期病人家属临床决策的影响因素提炼为3个要素9个亚要素:客观因素(生存质量、病情预后、生前意愿、临终场所)、家庭因素(经济条件、家属意见是否统一)、社会文化因素(孝道观、落叶归根、死亡态度)。[结论]应从医学教育培训、医疗机构设置、医学法律指南、医疗保险体制等方面建立有效的应对机制,唤起对 ICU 临终病人生命质量的重视。

  9. 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。

  10. 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.

  11. 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

  12. Study on the Influences of Comprehensive Clinical Treatments in COPD Patients%实施综合性临床治疗对COPD患者的影响研究

    Institute of Scientific and Technical Information of China (English)

    彭军; 林常青

    2011-01-01

    Objective:Analyze the influences of comprehensive treatments in COPD patients so as to improve efficacy and patients' life quality. Methods:Comprehensive treatments including medication, oxygen therapy, expectorant and steam inhalation treatments,rehabilitation and psychotherapy etc. were applied to 70 qualified cases;observe and investigate the clinical efficacy, blood gas analysis as well as amelioration of pulmonary function at the same time,and perform correlation studies on the results. Results:The total effective ratio for these COPD patients was 92.86%,and the overall pulmonary function was improved in comparison to its former level before the treatments (()P<0. 05).Conclusion:Comprehensive treatments were of crucial importance to COPD patients.%目的:分析实施综合性治疗措施对慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者的影响,以期提高治疗效果、改善患者生活质量.方法:对符合条件的70例患者实施综含性治疗措施,包括药物治疗、给氧治疗、排痰和雾化治疗、康复治疗及心理治疗等,并对患者进行临床疗效观察、血气分析及肺功能改善情况调查,对其结果进行相关研究.结果:COPD患者临床总有效率为92.86%、并且患者血气分析及肺功能与治疗前相比均得以改善(P<0.5).结论:实臆综合性临床治疗措施对COPD患者至关重要.

  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. 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

  15. Influence of vancomycin on clinical outcomes and immune function of neonatal sepsis%万古霉素对新生儿败血症患儿的临床预后及免疫功能的影响

    Institute of Scientific and Technical Information of China (English)

    陈兴月

    2015-01-01

    Objective To study the influence of vancomycin on clinical effects and immune function of neonatal sepsis.Methods A total of 53 neonatal sepsis treated in our hospital were selected as the test group, and 53 health normal newborns in the same period in our hospital were selected as the control group.All neonatal sepsis were treated with cefa-thiamidine combined with piperacillin sulbactam, and neonatal sepsis that infected by methicillin-resistant Staphylococcus aureus were treated with vancomycin 15 mg·kg-1 , 1 times a day, and 7 -10 d was a course.After treatment, clinical efficacy and adverse reactions of chil-dren in test group were observed. Soluble interleukin -2 receptor ( sIL-2R) , immunoglobulin G ( IgG ) , immunoglobulin M ( IgM ) , membrance interleukin -2 receptor ( mIL -2 R ) of children changes before and after treatment were compared in two groups.Results After treatment, immune function indicators of neonatal sepsis and normal newborns were compared which showed no significant difference (P>0.05).After vancomycin treatment, total effective rate of neonatal sepsis was 85.72%, which was higher than that before treated with vancomycin (28.57%, P0.05).The incidence of adverse reactions such as rash, nausea, vomiting, diarrhea and phlebitis before and after treatmemt with vancomycin had no significant difference ( P >0.05 ) . Conclusion Vancomycin can effectively improve the immune function in children with neonatal sepsis and reduce ad-verse drug reactions, which can be also conducive to clinical outcomes of children.%目的 评价万古霉素对新生儿败血症患儿的临床预后及免疫功能的影响.方法 入选53例新生儿败血症患儿为试验组,选取同期在我院产科出生的53例正常新生儿作为对照组. 新生儿败血症患儿用头孢硫脒加哌拉西林/舒巴坦进行治疗,明确耐甲氧西林金黄色葡萄球菌败血症患儿改为静脉滴注万古霉素15 mg·kg-1 ,每天1次,治疗7~10 d,观察新生儿败

  16. 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 ...

  17. 不同类型震颤的临床特点、发生机制及影响因素%Clinical characters, pathogenesis and influencing factors of different tremors

    Institute of Scientific and Technical Information of China (English)

    孙丽君; 顾平; 王铭维

    2006-01-01

    目的:总结并分析各类震颤的特点及其机制和影响因素,为临床上各类震颤的鉴别及防治提供依据.资料来源:应用计算机检索Medline 1998-01/2005-05关于震颤的文章.检索词"tremor"并限定文章的语种类为English.同时利用计算机检索中国期刊全文数据库1994-01/2005-05的相关文章,限定文章语言种类为中文,检索词"震颤".资料选择:对资料进行初审,纳入标准:①关于震颤的分类、病因、影响因素.②对具体事件的回顾调查研究.排除标准:排除重复性研究.资料提炼:共收集到符合上述要求的文献48篇,排除31篇重复性研究.17篇符合纳入标准:其中9篇关于震颤的调查研究,8篇关于震颤的具体案例.资料综合:震颤的分型主要有依据震颤表现形式及根据基础疾病的病因学分类.其中机械性震颤、中枢神经系统的反射、中枢性振荡器是震颤的发生机制.依据震颤表现形式分为静止性震颤、运动性震颤、特定性震颤、姿势性震颤、无定型震颤.依据震颤的不同病因又分为增强的生理性震颤、特发性震颤综合征(经典的特发性震颤、直立性震颤、任务和姿位特异性震颤、不能分类的震颤)、肌张力障碍性震颤、帕金森病震颤、小脑性震颤、红核震颤、周围神经病性震颤、药物及有毒物质诱发的震颤和心因性震颤,临床上应根据不同的病因采取不同的治疗措施.结论:震颤虽表现形式类似,但发生原因各不相同,临床上应根据不同的病因采取不同的治疗措施.%OBJECTIVE: To summarize and analyze the characters, pathogenesis and influencing factors of various tremors, so as to provide evidence for the identification, prevention and treatment of various tremors in clinic.DATA SOURCES: A computer-based online search of Medline database was undertaken to identify articles about tremor published in English between January 1998 and May 2005 with the

  18. 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

  19. 妊娠代谢综合征对母儿结局的影响研究%Clinical influence of the pregnancy metabolic syndrome on maternal and fetal outcomes

    Institute of Scientific and Technical Information of China (English)

    何玉冰

    2011-01-01

    目的:探讨妊娠代谢综合征对母儿结局的影响.方法:回顾性分析了我院2008年1月~2009年12月经确诊的40例患有代谢综合征孕妇的临床资料,定义为研究组,选择正常孕妇40例作为对照组,观察两组孕妇的妊娠结局,进行相关资料的分析.结果:研究组孕妇产后即时出血、剖宫产、妊娠期高血压综合征(妊高征)、会阴裂伤、胎膜早破、羊水过多的发生率高于对照组,两组比较差异均有统计学意义(均P<0.05).研究组孕妇出现巨大儿、早产儿、颅内出血、新生儿低血糖的发生率高于对照组,两组比较差异均有统计学意义(均P<0.05).结论:妊娠代谢综合征对母儿结局都会产生不良的结果.应加强对代谢综合征孕妇早期诊断、及时预防,并采取必要的护理措施.%Objective: To discuss the influence of the pregnancy metabolic syndrome on maternal and fetal outcomes. Methods: Clinical data of 40 pregnant women who were diagnosed as pregnancy metabolic syndrome from January 2008 to December 2009 in our hospital was retrospectively analyzed. They were defined as the research group. 40 normal pregnant women were chosen as the control group. The pregnancy outcomes of two groups were observed and the relative information was analyzed. Results: The incidences of immediate postpartum hemorrhage, the cesarean section, the pregnancy hyperten -sion syndrome, the perinea laceration, premature rupture of membranes broken, the incidence of hydramnios of the research group were significantly higher than those of the control group, and there were all statistically significant between two groups (all P<0.05). The pregnant women of the research group appeared great child, premature babies, intracranial bleeding, the incidence of hypoglycemia were significantly higher than those of the control group pregnant women, and there was all statistically significant between two groups (all P<0.05). Conclusion: Pregnancy metabolic

  20. 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

  1. Status of psychological capital of clinical nurses in tertiary hospitals and its influencing factors%三甲医院临床护士心理资本现状及其影响因素的研究

    Institute of Scientific and Technical Information of China (English)

    刘卓; 尚文涵; 王兰; 谷洪涛; 李晶

    2016-01-01

    目的:调查临床一线护士心理资本现状,分析影响心理资本的因素,为临床护理管理者提供提高护士心理资本的理论依据。方法采用自行编制的一般情况调查表和心理资本问卷( PCQ)中文修订版,对北京市某三级甲等医院的1095名临床护士进行问卷调查,应用方差分析及多元线性回归探讨护士心理资本的影响因素。结果临床护士心理资本平均得分为(4.15±0.68)分,各维度得分由高到低依次为自我效能(4.26±0.92)分、希望(4.21±0.89)分、韧性(4.20±0.70)分、乐观(3.93±0.61)分;不同职称、编制、工作年限、科室、年龄的护士心理资本得分比较差异有统计学意义(F值分别为8.688,7.028,2.709,3.986,3.852;P<0.01)。多元线性回归显示,职称、科室、年龄是影响护士心理资本的因素。结论护士心理资本处于中等水平以上,护理管理者应重点关注特定年龄群体、儿科、监护室护士的心理资本水平,并采取相关措施提高其心理资本水平。%Objective To investigate the status of nurses′ psychological capital and analyze its influencing factors, to provide theoretical basis for improving nurses′ psychological capital for clinical nursing managers. Methods A total of 1 095 nurses in a Beijing tertiary hospital were investigated by a self-designed questionnaire about general information and psychological capital questionnaire ( PCQ ) of Chinese version. Variance analysis and multiple linear regression were used to explore the influencing factors of nurses′psychological capital.Results The mean score of psychological capital was (4.15±0.68), and the scores of dimensions from high to low were:self-efficacy (4.26±0.92), hope (4.21±0.89), toughness (4.20±0.70) and optimism (3.93±0.61). Multiple regression analysis indicated that the score of psychological capital in nurses with different titles, authorized strength, working time, departments and ages were

  2. 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

  3. 慢性湿疹患者生活质量及其影响因素的临床研究%Quality of Life of Patients with Chronic Eczema and Its Influencing Factors:A clinical study

    Institute of Scientific and Technical Information of China (English)

    章承中; 徐小英; 颜美秋

    2011-01-01

    目的 探讨慢性湿疹患者的生活质量状况及其影响因素,为提高患者的生活质量和临床疗效提供帮助.方法 以2009年8月-2010年8月在温岭市第一人民医院皮肤科门诊就诊、临床确诊的慢性湿疹患者为研究对象,以同期健康体检者为对照.应用世界卫生组织生活质量测定量表简表(WHOQOL-BREF)以及皮肤病生活质量指数量表(DLQI)对200例慢性湿疹患者及100例体检者进行生活质量评价,并应用多元回归分析方法寻找影响慢性湿疹患者生活质量的因素.结果 (1)湿疹组的DLQI总分为(14.56±5.43)分,高于对照组的(0.13±0.05)分,差异有统计学意义(P<0.01).对其六个方面分别进行比较,发现湿疹组患者症状与情感、社会交际、治疗等六个方面的得分均比对照组高,差异均有统计学意义(P<0.01).(2)比较湿疹组和对照组的WHOQOL-BREF得分,对总体感受及生理、心理、社会、环境四个领域的比较发现差异均有统计学意义(P<0.01).(3)多元逐步回归表明,影响DLQI总分的因素为病情、受教育程度和经济状况;影响WHOQOL-BREF得分的因素为病情和受教育程度.结论 慢性湿疹患者生活质量较差,病情、受教育程度、经济状态是影响慢性湿疹患者生活质量的重要因素.%Objective To explore the quality of life of Patients with chronic eczema ( CE ) and its influencing factors.Methods Totally 200 patients presenting in our hospital from August 2009 to August 2010 and being diagnosed clinically with CE were recruited as the trial group, and 100 healthy people who concurrently took physical examination were enrolled as the controls.Dermatology Life Quality Index ( DLQI ) and World Health Organization Quality of Life Assessment Instrument - Brief ( WHOQOL- BREF ) were used to evaluate the quality of life.Multiple regression analysis was used to search the risk factors influencing the quality of life.Results ( 1 ) The total mean DLQI

  4. 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

  5. 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

  6. 带教老师性格对大批量新调入护士带教质量的影响%Influence of teacher's characters on the quality of clinical nursing teaching for large number of redeployed nurses

    Institute of Scientific and Technical Information of China (English)

    杨丽

    2008-01-01

    0bjective To explore the influence of teacher's character on the teaching effect of newredeployed nurses,and then to improve the quality of clinical nursing teaching.Methods Eighty-six nurses who were redeployed during January to August in 2007 were randomly divided into the control group and the experiment group.All the teachers for the two groups had at least junior college diplomas.The nurses in the control group were supervised by teachers selected as usual,while the nurses in the experiment group were supervised by teachers with extroversion or middle characters.The nursing manipulation,first-aid technique, achievement of professional theory,the teaching time and the satisfactory grades were compared and analyzed. Results The achievement of nursing manipulation,first-aid technique.professional theory and the satisfactory grades in the experiment group were higher than those in the control group(P<0.01).Conclusions The teachers with extroversion or middle characters ale helpful in teaching the redeployed nurses.%目的 探讨性格对大批量临床新调入护士带教效果的影响,以提高临床带教质量.方法 选取2007年1-8月86名带教教员和科室新调入护士随机分成对照组和改进组,两组教员均为大专以上学历,对照组使用常规随机科室带教教员的方法,改进组选用性格外向型或中间型性格的带教教员进行带教,对两组带教对象在护理操作、急救技术、专科理论、带教时间、学员对教员的满意度等方面分别进行对比.结果 改进组新调入护士护理操作、急救技术、专科理论考核成绩及学员对教员的满意度均显著高于对照组,P<0.01.结论 性格外向型或中间型性格的带教教员有利于临床新调入护士的带教.

  7. 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。

  8. 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.

  9. 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。

  10. 新疆地区不同临床分型帕金森病患者影响因素分析%The Influencing Factors for Parkinson' s Disease Patients with Different Clinical Type in Xinjiang

    Institute of Scientific and Technical Information of China (English)

    王艳艳; 阿克博塔·阿历戈伐; 杨新玲

    2015-01-01

    Objective To investigate the influencing factors for Parkinsion's disease( PD)patients with different clinical type in Xinjiang,to provide a theoretical basis for early prevention and treatment of disease. Methods By using the method of retrospective study,259 patients who were diagnosed with PD in the First Affiliated Hospital of Xinjiang Medical University from January 2004 to December 2013, were selected as study subjects. The age, gender, nationality, smoking history,drinking history,history of tea drinking,history of pesticide contact,positive family history,history of hypertension, history of diabetes,the degree of education,occupation and body mass index( BMI)of patients were investigated. Results 142 cases were classified as tremor type,90 cases were classified as akinetic - rigid type,27 cases were classified as mixed type. There were significant differences in age among tremor type PD patient group,akinetic-rigid type PD patient group and mixed type PD patient group(P﹤0. 05). The PD patients' clinical type with different nationality,smoking history,history of tea drinking,history of pesticide contact and occupation showed statistical differences( P﹤0. 05 ) . The patients' clinical type with different gender,drinking history,positive family history,history of hypertension,history of diabetes,education degree and BMI showed no statistical difference( P ﹥0. 05 ) . According to the results of multivariate logistic regression analysis, nationality,and history of tea drinking had a regressive relationship with tremor type,respectively;age and smoking history had a regressive relationship with akinetic - rigid type, respectively;nationality had a regressive relationship with mixed type, respectively(P﹤0. 05). Conclusion The most common PD types are tremor type and akinetic-rigid type,PD patients with different clinical type has different age,few tremor type PD patients are Han or tea drinkers,the most common type among old PD patients or smoker PD

  11. 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

  12. Clinical Trials

    Science.gov (United States)

    ... they are receiving. Other clinical trials involve a crossover design, where participants are randomly assigned to take a new treatment, a treatment already in use, and/or a placebo for a specified time ... If I am involved in a "crossover" clinical trial, can I go back to the ...

  13. 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

  14. 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

  15. 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

  16. Clinical Research

    DEFF Research Database (Denmark)

    Christensen, Irene

    2016-01-01

    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 s...... 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....

  17. 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.

  18. Clinical Investigation.

    Science.gov (United States)

    1979-09-30

    Hiller, D.A., Elliott, J.P.: Tubal Ligation Syndrome Myth or Reality. Presented: Armed Forces Division of ACOG, New Orleans, Louisiana, October 1977...Molecular Weight Immunoreactive Glucagon Levels in Patients with the Post Prandial Syndrome . (Abst.) Western Society for Clinical Research, 1979. (3...Glucagon Levels in Patients witl the Post Prandial Syndrome . Presented: Western Society Meetings, Western Society for Clinical Research, February 1979. (3

  19. 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.

  20. Developing Global Nurse Influencers.

    Science.gov (United States)

    Spies, Lori A

    2016-01-01

    How can universities create engaged citizens and global leaders? Each year, a select group of advanced practice nursing students at Baylor University Louise Herrington School of Nursing travel to Africa for a month-long clinical mission experience. Students work alongside local and missionary healthcare providers in a comprehensive Christian outreach to the community at a high-volume clinic. Creating rich learning experiences in a global setting in significant and sustainable ways is difficult, but intentionally focusing on what we are called to do and who we serve provides ballast for faculty and students. The success of the trip in preparing students to be global influencers is evident by the work graduates elect to do around the world, following graduation.

  1. 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

  2. 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

  3. 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)

  4. 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.

  5. Dementia in the movies: the clinical picture

    NARCIS (Netherlands)

    Gerritsen, D.; Kuin, Y.; Nijboer, J.

    2014-01-01

    Objectives: Visual media influence the general public's perceptions and attitudes regarding people with mental conditions. This qualitative study investigates the depiction accuracy of dementia's clinical features in motion pictures.Method: Using the search terms dementia', Alzheimer's disease' and

  6. Dementia in the movies: The clinical picture

    NARCIS (Netherlands)

    Gerritsen, D.L.; Kuin, Y.; Nijboer, J.

    2014-01-01

    Objectives: Visual media influence the general public's perceptions and attitudes regarding people with mental conditions. This qualitative study investigates the depiction accuracy of dementia's clinical features in motion pictures.Method: Using the search terms 'dementia', 'Alzheimer's disease' an

  7. Clinical Trials

    Science.gov (United States)

    ... and her initial results. Nueva Esperanza Para Las Enfermedades Del Corazón 09/23/2014 Milena tuvo un ... Story 09/23/2014 Nueva Esperanza Para Las Enfermedades Del Corazón 09/23/2014 Children and Clinical ...

  8. Study on the psychological health status of clinical interns and its influencing factors%临床医学实习生心理健康状况及影响因素分析

    Institute of Scientific and Technical Information of China (English)

    程鹏; 朋文佳

    2015-01-01

    目的:通过问卷调查和数据分析探讨临床专业实习生的总体心理状况.方法:采用问卷调查法(包括基本情况调查表和SCL-90量表),对蚌埠医学院临床专业2010年级进入医院实习的学生共457人进行人口学资料的调查和心理健康状况的测试.结果:临床实习生SCL-90各项指标中躯体化、焦虑、恐怖因子的评分均高于全国大学生常模和青年组常模(P0.05).结论:蚌埠医学院临床医学实习生心理健康水平略低于全国青年常模和全国大学生常模;临床实习生的心理健康水平在性别、生源地、家庭结构方面均存在不同.%Objective:To analyze the overall psychological health status of clinical interns by the questionnaire survey and data analysis. Methods:The demographic data and psychological health status of 457 clinical interns from Bengbu Medical College were surveyed using the questionnaire methods ( including the Basic-Data-Company and SCL-90 scale ) . Results:The scores of the somatization,anxiety and phobic factors of SCL-90 in clinical interns were higher than those in national college norm and youth norm (P0. 05). Conclusions:The levels of psychological health status of clinical interns from the second department of clinical medicine of Bengbu Medical College are slightly lower than those in national college norm and national youth norm,and the levels of psychological health status of clinical interns in different gender,origin and family structure are different.

  9. 脑梗死患者自我感受负担影响因素的临床研究%Clinical research in influencing factors of self-perceived burden among patients with cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    颜雅伟

    2013-01-01

    Objective To explore the influencing factors of self-perceived burden(SPB) among patients with cerebral infarction.Methods A total of 108 patients were included in the study,they were investigated by a self-designed demographic questionnaire and Self-Perceived Burden Scale(SPBS).Chisquare analysis,t test and multiple regression analysis were used to explore the influencing factors of SPB.Results The SPB of patients with cerebral infarction was (36.72±4.23) points.Self-care ability,hemiple-gia,language barriers and times of hospitslization were the influencing factors of SPB according to the mul-tiple regression analysis.Conclusions The patients with cerebral infarction have obvious SPB,which is influenced by multiple factors.Nurses should take proper measures to alleviate the patients' SPB.%目的 探讨脑梗死患者自我感受负担(SPB)的影响因素.方法 采用自我感受负担量表对108例脑梗死患者进行横断面调查,首先对可能的影响因素进行单因素分析,然后以SPB为应变量,以单因素分析有统计学意义的因素为自变量,进行多元回归分析.结果 脑梗死患者SPB平均分为(36.72±4.23)分;多元回归分析显示,生活自理能力、偏瘫、语言障碍、住院次数是脑梗死患者SPB的影响因素.结论 脑梗死患者存在SPB,护理人员应采取相应护理措施.

  10. 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.

  11. Clinical Studies

    DEFF Research Database (Denmark)

    Pallesen, Ulla

    and repair? Have new materials improved longevity? Are there still clinical and material problems to be solved? And what has the highest impact on longevity of posterior resin restorations – the material, the dentist, the patient or the tooth? These matters will be discussed on the basis of the literature......Within the last 25 years composite resin materials have in many countries successively replaced amalgam as a restorative for posterior teeth. Resin materials and bonding systems are continuously being improved by the manufactures, adhesive procedures are now included in the curriculum of most...... universities and practicing dentists restore millions of teeth throughout the World with composite resin materials. Do we know enough about the clinical performance of these restorations over time? Numerous in vitro studies are being published on resin materials and adhesion, some of them attempting to imitate...

  12. Memory clinics

    OpenAIRE

    Jolley, D; Benbow, S M; Grizzell, M

    2006-01-01

    Memory clinics were first described in the 1980s. They have become accepted worldwide as useful vehicles for improving practice in the identification, investigation, and treatment of memory disorders, including dementia. They are provided in various settings, the setting determining clientele and practice. All aim to facilitate referral from GPs, other specialists, or by self referral, in the early stages of impairment, and to avoid the stigma associated with psychiatric services. They bring ...

  13. Clinical practice

    OpenAIRE

    2011-01-01

    Cerebral palsy (CP) is the most common physical disability in early childhood. The worldwide prevalence of CP is approximately 2–2.5 per 1,000 live births. It has been clinically defined as a group of motor, cognitive, and perceptive impairments secondary to a non-progressive defect or lesion of the developing brain. Children with CP can have swallowing problems with severe drooling as one of the consequences. Malnutrition and recurrent aspiration pneumonia can increase the risk of morbidity ...

  14. 深圳市三级医院临床护士组织承诺及影响因素调查分析%Survey and analysis in organizational commitment and influencing factors of clinical nurses at tertiary hospital in Shenzhen

    Institute of Scientific and Technical Information of China (English)

    吴清香; 彭卫群; 王琦; 丁小容

    2009-01-01

    Objective To study the organizational commitment and influencing factors of clinical nurses at tertiary hospital in Shenzhen. Methods 347 clinical nurses from a tertiary hospital were select-ed by stratified random sampling and investigated and analyzed for organizational commitment with ques-tionnaires. Results Total score for organizational commitment of clinical nurses was (60.45±9.99),in which, from the highest to the lowest, the scores for five aspects were normative commitment (14.49±2.97), affective commitment (13.50±3.57), ideal commitment (11.69±3.20), economic commitment (11.27±3.23), opportunity commitment (9.50±3.30),respectively, their influencing factors included age, nursing age, mari-tal status, professional tide. Conclusions The organizational commitment of clinical nurses is at higher-middle level, their influencing factors are multi-dimensional, demographic characteristics have different im-pact on five aspects of organizational commitment.%目的 了解深圳市三级医院临床护士组织承诺现状及其影响因素.方法 采用问卷调查法,分层随机抽取深圳市某三级医院347名临床护士进行组织承诺测定,并对调查结果进行分析.结果 临床护士组织承诺总分为(60.45±9.99)分,5个维度的得分以规范承诺得分最高(14.49±2.97)分,其他依次为感情承诺(13.50±3.57)分,理想承诺(11.69±3.20)分,经济承诺(11.27±3.23)分,机会承诺(9.50±3.30)分;组织承诺各维度受年龄、护龄、婚姻状况、职称等人口特征因素的影响.结论 临床护士组织承诺处于中等偏上水平;影响临床护士组织承诺的因素是多维的;人口特征因素对5种组织承诺类型分别有不同的影响.

  15. 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.

  16. 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

    OpenAIRE

    Fheodoroff, Klemens; Ashford, Stephen; Jacinto, Jorge; Maisonobe, Pascal; Balcaitiene, Jovita; Turner-Stokes, Lynne

    2015-01-01

    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...

  17. 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

    OpenAIRE

    Klemens Fheodoroff; Stephen Ashford; Jorge Jacinto; Pascal Maisonobe; Jovita Balcaitiene; Lynne Turner-Stokes

    2015-01-01

    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 act...

  18. Mobile technology in clinical teaching.

    Science.gov (United States)

    Mackay, B J; Anderson, J; Harding, T

    2017-01-01

    Technology is having a profound effect on education in the 21st century and nurse educators are being challenged to integrate technological innovation to assist students in their learning. This paper reports a study on the introduction of smart mobile technology to support student learning in the clinical environment. In a climate of collaborative inquiry, clinical lecturers and two researchers from the same department carried out a project in three phases: formation, implementation and analysis. Following the formation phase, six clinical lecturers adopted iPads to support their clinical teaching (implementation phase). At this time they also kept reflective journals. In the analysis phase a thematic analysis of the data from the journals and from a focus group found both enabling and constraining factors influenced the use of iPads by clinical lecturers. The themes categorised as enablers were: resources and technology; and, management and technology support. Those identified as barriers or constraining factors were: clinical staff engagement; and lecturer experience with technology. Student engagement and learning, and connectivity were both enabling and constraining factors. This paper concludes that the use of a mobile device such as an iPad can enhance teaching in clinical settings but that in order for such devices to be successfully integrated into clinical teaching consideration needs to be given to professional development needs, adequate resourcing and technology support.

  19. Somatic symptoms in patients with acute stroke: clinical features and influencing factors%急性卒中患者的躯体化症状:临床特征和影响因素

    Institute of Scientific and Technical Information of China (English)

    陈奕雄; 王冬梅; 刘晓加; 刘帅

    2016-01-01

    Objective To investigate the clinical features and influencing factors of somatic symptoms in patients with acute stroke.Methods Patients with acute stroke were enrolled in the study.Using the scores of symptom checklist 90 (SCL-90)-somatization factor part,the patients were divided into either a somatic symptom group (≥24) or a control group (<24).Their age,gender,economic level,education level,underlying diseases,Hamilton Anxiety Scale (HAMA),Hamilton Depression Scale (HAMD),NEO Five-Factor Inventory scores,Social Support Rating Scale scores-simplified Chinese version,Mini-Mental StateExamination (MMSE) scores,National Institute of Health Stroke Scale (NIHSS) scores were documented and analyzed.Results A total of 70 patients with acute stroke were enrolled,and 33 (47.1%) of them had somatic symptoms.There were no significant differences in demographic characteristics,education level,family income,occupation,marital status,living alone,residence,medical expenses payment methods and social support scores between the somatic symptom group and the control group.There were also no significant differences in the types of stroke,lesion side,baseline NIHSS score,MMSE score,and NEO Five-Factor Inventory score between the 2 groups.There was significant difference in lesion side between the somatic symptom group and the control group (x2 =0.161,P=0.006).The comparison of neuropsychological test results showed that the proportion of patients with an anxiety state of the somatic symptom group was significantly higher than that of the control group (24.2% vs.5.4%;x2 =5.055,P =0.025),but there was no significant difference in the proportion of patients with depression status;after excluding the cases who met the anxiety and depression criteria,HAMA (8.08 ± 3.12 vs.5.58 ± 3.06;t =-3.059,P =0.003) and HAMD (10.80 ± 4.81 vs.7.73 ± 3.88;t =-2.694,P =0.009) scores of the somatic symptom group (n =25) were significantly higher than those of the control group (n =33).The

  20. What Are Clinical Trials?

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: Clinical Trials What Are Clinical Trials? Past Issues / Fall 2010 Table of Contents Clinical ... conducted all the time. The Different Phases of Clinical Trials Clinical trials related to drugs are classified into ...

  1. 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 ...

  2. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... Z > Participating in Clinical Trials: About Clinical Trials In This Topic About Clinical Trials Risks and Benefits ... of this page please turn Javascript on. Participating in Clinical Trials About Clinical Trials A Research Study ...

  3. 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

  4. The level and influencing factors of self-compassion among clinical nurses%临床护士自我同情能力现状及影响因素分析

    Institute of Scientific and Technical Information of China (English)

    高霞; 刘晓丹; 王雪莲; 于爽

    2016-01-01

    目的 了解临床护士自我同情能力现状,为护理管理者掌握临床护士心理健康状况,提高自我同情水平提供参考依据.方法 选择某市4所三级甲等综合医院的临床护士383名,采用自悯量表(SCS量表)和人口学资料问卷进行调查,运用统计学描述、单因素方差分析对结果进行分析.结果 临床护士自我同情总分为(87.61±9.293)分,52.7%的护士自我同情得分低于总均分,68.29%的护士自我同情得分在80~95分之间.临床护士人口学特征对自我同情能力的影响分析显示,婚姻在孤立感维度具有统计学意义(F=0.049,P<0.05),不同编制在普遍人性感维度具有统计学意义(F=0.016,P<0.05).结论 临床护士自我同情处于中等水平,负性情绪情感较多,应对负性事件时缺乏心理调节方法;医院管理者应重视培养护士个体的自我同情能力,有针对性地开展拓展训练,提高护理质量.%Objective To investigate the current situation of self-compassion among clinical nurses and explore the way to improve the ability of self-compassion. Methods A total of 383 clinical nurses from 4 different First-class Hospital at Grade 3 hospitals were investigated using the self-compassion scale ( SCS) and demographic data questionnaire between May and July 2014. The results were analyzed using statistical description and single factor analysis of variance. Results The total score of clinical nurses′ self-compassion was (87. 61 ± 9. 293). There were 52. 7% nurses whose self-compassion score were lower than the average total score and 68. 29% nurses whose self-compassion score were between 80 and 95. The marital status was significantly associated with isolation (F=0. 049,P<0. 05) and formal staff or not was significantly associated with common humanity (F =0. 016,P <0. 05). Conclusions The clinical nurses′ self-compassion is in moderate level. They often suffer from negative emotions and are lack of psychological adjustment

  5. Research on the Influence of Some Drugs on Commonly Used Clinical Biochemistry Inspection Items%部分药物对常用临床生物化学检验项目的影响研究

    Institute of Scientific and Technical Information of China (English)

    李香云

    2016-01-01

    Objective To study the effect of some drugs on the commonly used clinical biochemical test items.Methods From February 2015 to February 2016, 26 volunteers who participated in this trial were selected as the research subjects, to select drugs for adrenaline and rifampicin, biochemical examination of the patients, to analysed the test results. ResultsThe positive phase disturbance was formed by the determination of epinephrine in FMN, the Cr, HDL-C, DBIL, TCH, TG were determined to form a negative phase interference. Determination of Rifampicin on FMN, TBIL, DBIL formed a positive interference, negative phase interference was formed on the determination of Cr.Conclusion Some drugs have a certain impact on the results of commonly used clinical biochemical test items, we should take full account of the situation when carrying out clinical examination, and avoid miscarriage of justice.%目的:分析部分药物对常用临床生物化学检验项目的影响。方法选取2015年2月~2016年2月自愿参加本次试验的志愿者26名作为研究对象,选取药物为肾上腺素和利福平,对患者进行生物化学检验,对检验结果进行分析。结果肾上腺素对FMN的测定形成正相干扰,对Cr、HDL-C、DBIL、TCH、TG的测定形成负相干扰;利福平对FMN、TBIL、DBIL的测定形成正相干扰,对Cr的测定形成负相干扰。结论部分药物会对常用临床生物化学检验项目结果产生一定的影响,开展临床检验时需充分考虑该情况,避免误判。

  6. 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

  7. 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。

  8. 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

  9. 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.

  10. 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

  11. 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.

  12. The Influence of Respiratory Muscle Function Exercise on Clinical Symptoms and Pulmonary Functions of Con-valescent COPD Patients%呼吸肌功能锻炼对COPD康复期患者临床症状及肺功能的影响

    Institute of Scientific and Technical Information of China (English)

    毛维

    2016-01-01

    目的:探讨呼吸肌功能训练对COPD康复期患者临床症状及肺功能的影响。方法:50例COPD康复期患者进行呼吸肌功能锻炼,对比患者锻炼前后临床症状及肺功能。结果:锻炼后膈肌活动度明显高于锻炼前(P<0.05),锻炼后患者发绀情况及FVCmax、FEV1、FEV1/FVC、MMEF、PEF等肺部功能明显优于锻炼前(P<0.05)。结论:呼吸肌功能训练能明显改善COPD康复期患者的临床症状及肺功能,适合临床推广应用。%Objective:To investigate the influence of respiratory muscle function exercise on the clinical symptoms and pulmonary functions of con-valescent COPD patients. Methods:50 cases of convalescent COPD patients were all trained by respiratory muscle function exercise, and compared the situation of clinical symptoms and pulmonary functions before and after training. Results:The diaphragm activity after training was significantly higher than that of before training (P<0.05), the situation of cyanosis and pulmonary functions of FVCmax, FEV1, FEV1/FVC, MMEF, PEF were sig-nificantly better than those of before training (P<0.05). Conclusion:Respiratory muscle function exercise can significantly improve the clinical symp-toms and pulmonary functions of convalescent COPD patients, suits to clinical promotion and application.

  13. Analysis of regulatory-ethical framework of clinical trials

    OpenAIRE

    Milošević-Georgiev Andrijana; Krajnović Dušanka; Milovanović Srđan; Ignjatović Svetlana; Đurić Dušan; Marinković Valentina

    2013-01-01

    Introduction. Every clinical trial has to meet all ethical criteria in addition to the scientific ones. The basic ethical principles in the clinical trials are the following: nonmaleficence, beneficence, respect for autonomy and the principle of justice. Objective. The aim of the study was to analyze clinical cases with the outcomes leading to the changes in regulatory­ethical framework related to the clinical trials, as well as the outcomes of key clinical trials that influenced the in...

  14. Clinical guidelines.

    Science.gov (United States)

    Uppal, Elaine

    2016-01-01

    This article is part of the Advancing practice series which is aimed at exploring practice issues in more depth, considering topics that are frequently encountered and facilitating the development of new insights. Elaine Uppal focuses on the importance of all midwives developing guideline writing skills to ensure that local, national and international midwifery/maternity guidelines are up to date, relevant and reflect midwifery knowledge alongside 'gold' standard evidence. The article aims to consider the development, use and critical appraisal of clinical guidelines. It will define and explain guidelines; discuss their development and dissemination; and consider issues relating to their use in practice. Techniques to critique and develop guidelines using the AGREE tool will be outlined in the form of practice challenges to be undertaken by the individual or in a group.

  15. Research on influence of PBL teaching mode on critical thinking ability of clinical practice nursing students%基于 PBL 教学模式对临床实践护生批判性思维能力影响的研究

    Institute of Scientific and Technical Information of China (English)

    杨淑梅; 于亮; 陈姗姗; 李志茹

    2016-01-01

    Objective To discuss the influence of PBL teaching mode on the critical thinking ability of clinical practice nursing students.Methods Using comparative study, the control group students accepted traditional clinical teaching methods;Experimental group accepted PBL teaching method in 6 month.Used critical thinking before and after the test intention scale ( CCTDI) measured critical thinking ability of nursing students in both groups.Results Test before the critical thinking ability of nursing students obvious difference between the two groups, there was no statistically significant difference ( P >0.05 ); Application of PBL group after the clinical teaching critical thinking ability of nursing students score higher than the control group, the difference was statistically significant (P<0.05).Conclusions In the clinical practice teaching in the application of PBL teaching method to improve the critical thinking ability of nursing students had higher influence to the patient's illness was reasonable and accurate analysis, judgment, and take effective measures, for future jobs laid a good foundation.%目的:探讨PBL教学模式对临床实践护生批判性思维能力的影响。方法采用随机分组的方法,随机分为对照组和试验组。对照组学生接受传统临床带教法;试验组接受6个月的PBL教学实践法。试验前后用批判性思维意向量表( CCTDI)分别测量两组护生的批判性思维能力。结果试验前两组护生批判性思维能力无明显区别,差异无统计学意义(P>0.05);应用PBL临床带教法后试验组护生批判性思维能力评分高于对照组,差异有统计学意义( P<0.05)。结论在临床实践教学中应用PBL教学法对提高护生的批判性思维能力有较高的影响,能够对患者的病情进行合理、准确的进行分析、判断,并采取有效的措施,为今后走上工作岗位奠定了良好的基础。

  16. 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

  17. 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

  18. Influence of Humanized Nursing Intervention on the Emotional Response of Abortion Patients in Gynecologic Clinic%人性化护理干预对妇科门诊人流手术患者情绪反应的影响

    Institute of Scientific and Technical Information of China (English)

    梁权芳; 刘银清; 何树惠

    2016-01-01

    Objective To explore the impact of humanized nursing intervention on the emotional response of abortion patients in gynecologic clinic. Methods 102 cases of abortion in gynecologic clinic of our hospital from August 2013 to June 2015 were selected as research objects, and randomly divided into two groups, with 51 cases in each group. The control group received routine nursing, while the research group received humanized nursing on the basis of routine nursing. The heart rate and blood pressure were recorded, and the differences in emotional response, satisfaction degree to nursing, heart rate and blood pressure between two groups were analyzed. Results The rate of normal emotion of research group was 49.0%(25/51), significantly higher than 31.4%(16/51) of control group (P<0.05), and the rate of fear of research group was significantly lower than that of control group (P <0.05). The satisfaction degree to nursing of research group was 98.0%(50/51), significantly higher than 78.4% (40/51) of control group (P<0.05). The systolic blood pressure, diastolic blood pressure and heart rate of research group were significantly lower than those of control group (P<0.05). Conclusions Humanized nursing intervention for abortion patients in gynecologic clinic can significantly improve patients' emotional response, and reduce the incidence of anxiety and fear, which has positive effect for patients' post-rehabilitation.%目的 探讨人性化护理干预对妇科门诊人流手术患者情绪反应的影响. 方法 选取2013年8月至2015年6月我院收治的102例妇科门诊人流患者作为研究对象, 采用随机数字表法将患者分为研究组和对照组, 每组51例. 对照组进行常规护理,研究组在常规护理基础上进行人性化护理, 记录就诊过程中患者的心率、 血压情况, 分析两组患者就诊过程中情绪反应情况、 护理满意度、 血压及心率的差异. 结果 研究组情绪正常率为49.0% (25/51),

  19. 根治性前列腺切除术后Gleason评分升级的危险因素分析%Influence of clinical factors on Gleason score upgrade in patients undergoing radical prostatectomy

    Institute of Scientific and Technical Information of China (English)

    张桂铭; 秦晓健; 韩成涛; 顾成元; 万方宁; 瞿元元; 顾伟杰; 马春光; 朱耀

    2015-01-01

    目的 探讨影响前列腺癌患者行根治性前列腺切除术(RP术)后Gleason评分升级的因素.方法 回顾性分析2012年1月至2013年12月在复旦大学附属肿瘤医院泌尿外科行RP术的322例前列腺癌患者资料,统计其穿刺Gleason评分及RP术后Gleason评分的差异,将其分为Gleason评分升级组和未升级组.回顾性分析年龄、体重指数(BMI)、前列腺特异性抗原(PSA)、前列腺体积、穿刺的阳性比例、临床分期及术后病理特征等临床病理资料.采用t检验或x2检验比较两组患者的临床病理特征的差异.Logistic回归分析评估各临床因素对GS升级的影响.结果 共有107例患者出现Gleason评分升级,发生率为33.2%.升级患者的年龄、BMI和临床分期与未出现升级的患者相比无明显差异.两组患者PSA水平、前列腺体积和穿刺的阳性比例存在显著差异,与未升级患者相比,Gleason评分升级患者PSA为10.0~ 19.9 μg/L及≥20.0 μg/L的比例明显更高(x2=6.740,P =0.034),前列腺体积明显减小(t=3.481,P=0.002),且穿刺阳性比例明显升高(t=-2.097,P =0.037).此外,升级的患者中淋巴结转移(x2=4.193,P=0.041)和包膜外侵犯(x2=4.747,P=0.029)的发生率高于非升级患者.Logistic回归分析则显示,PSA水平(OR=2.451,95% CI:1.290 ~4.660)、前列腺体积(OR=0.982,95%CI:0.969 ~0.995)和穿刺阳性比例(OR=2.756,95% CI:1.033~7.357)是Gleason评分升级的独立危险因素.结论 PSA、前列腺体积和穿刺阳性比例是影响Gleason评分升级的重要因素.%Objective To evaluate clinical factors affecting Gleason score upgrade in patients receiving radical prostatectomy (RP).Methods A total of 322 patients with prostate cancer who received RP from January 2012 to December 2013 at Department of Urology at Fudan University Shanghai Cancer Center were included,and their data of age,body mass index (BMI),prostate-specific antigen (PSA),prostate volume,percentage core,clinical

  20. 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。

  1. 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

  2. Key considerations for conducting Chinese medicine clinical trials in hospitals

    OpenAIRE

    Shergis Johannah L; Parker Shefton; Coyle Meaghan E; Zhang Anthony L; Xue Charlie C

    2013-01-01

    Abstract Conducting clinical trials of Chinese medicines (CM) in hospitals presents challenges for researchers. The success of hospital-based CM clinical trials may be influenced by the protocol design, including the maintenance of CM theory in compliance with scientific rigour and hospital guidelines and justified treatment approaches with results that can translate into clinical practice. Other influences include personnel and resources such as a dedicated team open to CM with an establishe...

  3. 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.

  4. Analysis of incidence and influence factor on clinical idiopathic optic neuritis in Guangxi ophthalmic outpatient%广西眼科门诊特发性视神经炎发病情况及影响因素分析

    Institute of Scientific and Technical Information of China (English)

    陈尽好; 郝小波; 陈洁秀; 赖小玲; 赵建英; 徐辉; 梁俊

    2011-01-01

    OBJECTIVE To understand the incidence of Idiopathic Optic Neuritis of Guangxi ophthalmic outpatient clinic, and to describe the distribution characteristics and provide the relevant factors to further development and analysis epidemiological studies.METHODS The third week of every month in 2008.8~2009.7, 7602 patients of The First Affiliated Hospital of Guangxi Traditional Chinese Medical University and Guangxi People's Hospital were investigated through effective questionnaires by randomly stratified cluster sampling method, then epidemiology investigation in the 18 confirmed cases was done.RESULTS The Age distribution of Idiopathic Optic Neuritis: 5 male, average age was 42.00± 11.113; 13 female, average age was 42.62± 12.901 (P<0.05); Relevant factors :gender(x2=4.697 2,P=0.0302),age(x2=11.390 0,P=0.003 0),educational level(x2=9.195 5 ,P=0.026 8),vocational distribution (x2=23.208 2,P=0.000 1 ).CONCLUSIONA The incidence of Idiopathic Optic Neuritis of Guangxi ophthalmic outpatient clinic was 2.367%.And this disease was relevant to gender, age, educational level and vocational distribution.Higher incidence was among female, young, middle school educational level and farmers.It had no relevance to the nation, the residential area, the past medical history and the systemic diseases.%目的 了解广西眼科门诊就诊患者特发性视神经炎的发病率,描述其分布特点,为进一步开展分析流行病学研究提供相关因素的线索.方法 采用分层随机整群抽样方法,将2008年8月至2009年7月每月第3周,广西壮族自治区中医院、区人民医院的眼科门诊就诊的初诊病人进行问卷调查,对确诊特发性视神经炎的病例进行流行病学调查分析.结果 有效调查7 602人,其中男4 047人,女3 555人.特发性视神经炎确诊病例18人,男5人,女13人.相关因素有:性别(χ2=4.697 2,P=0.030 2),年龄(χ2=11.390 0,P=0.003 0),文化程度(χ2=9.195 5,P=0.026 8)和职业分布(χ2=23.208 2,P=0

  5. 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、

  6. 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.

  7. 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

  8. 鼻内窥镜手术治疗慢性鼻-鼻窦炎临床疗效及影响因素分析%Clinical Curative Effect and Analysis of Influence Factors of Endoscopic Nasal Surgery in Treatment of Chronic Rhinosinusitis

    Institute of Scientific and Technical Information of China (English)

    汪向阳

    2016-01-01

    目的:对鼻内窥镜手术治疗慢性鼻-鼻窦炎的临床疗效及影响因素进行回顾性分析。方法随机选取该院收治的慢性鼻-鼻窦炎患者共60例,患者收治年限均在2013年2月-2015年4月之间,对60例慢性鼻-鼻窦炎患者通过鼻内窥镜手术进行治疗,对其各项临床治疗数据进行统计,并根据统计结果评价鼻内窥镜手术的临床治疗效果。结果鼻内窥镜手术治疗的60例慢性鼻-鼻窦炎患者中,有46例痊愈,10例好转,4例无效,疗效总有效率为93.33%(56/60﹚;1例鼻塞,2例头痛,不良发应发生率为5%(3/60﹚。结论鼻内窥镜手术不仅能有效对慢性鼻-鼻窦炎患者的临床症状进行缓解,还具有较高的疗效总有效率,值得临床推荐应用。%Objective To retrospectively analyze the clinical curative effect and influence factors of endoscopic nasal surgery in treatment of chronic rhinosinusitis. Methods 60 cases of patients with chronic rhinosinusitis treated in our hospi-tal from February 2013 to April 2015 were selected and treated with endoscopic nasal surgery, the various clinical treatment data were given statistics, and the clinical treatment effect of the endoscopic nasal surgery was evaluated according to the statistical results. Results In the 60 cases, 46 cases were healed, 10 cases were improved, 4 cases were inefficient, the total effective rate of the curative effect was 93.33%(56/60﹚; 1 case had a stuffy nose, 2 cases had a headache, the incidence of adverse reaction was 5%(3/60﹚. Conclusion The endoscopic nasal surgery can not only effectively relieve the clinical symptoms of patients with chronic rhinosinusitis, but also has a higher total effective rate of curative effect, which is worthy of recommendation and application in clinic.

  9. The Influence of Nursing Intervention to the Prevention of Falls in Outpatient Clinic%导医护士在门诊患者跌倒的护理干预

    Institute of Scientific and Technical Information of China (English)

    戚旻; 侯晓群; 李莉

    2015-01-01

    目的:探讨加强导医护士在门诊患者跌倒的护理干预效果。方法用SPSS 17.0统计软件包统计分析2013年~2015年的门诊患者跌倒事件的发生现状以及导医护士对预防跌倒相关知识的实施措施。结果进行护理干预后,患者发生跌倒的次数少于护理干预前(P<0.01)。导医护士对预防跌倒相关知识实施前后的比较(P<0.01),差异具有统计学意义。结论针对门诊患者跌倒原因采取有效的护理干预,护士的责任心增强,主动迎前式服务,门诊患者跌倒的发生率降低,患者满意度升高,经济赔偿减少。%ObjectiveTo discuss the influence of strengthening the nursing intervention to the prevention of the outpatient’fall.Methods Making statistics’analysis and comparison on the fals from 2011 to 2013 with SPSS 17.0 software of statistical package. The differences in fal prevention knowledge in nurses before and after intervention were analyzed.Results Fal events happened in treatment group was obviously less than that in control group(P<0.01). The differences in fal prevention knowledge in nurses before and after intervention were analyzed,with statisncal significance difference(P<0.01).Conclusion According to the reasons of fals in outpatients to take effective nursing intervention. Nurses ' sense enhanced, after active service,reduce the incidence of fals,improve patients’satisfaction,improve hospital and social bendfits.

  10. Clinical research of influence by chronic alcoholism on blood glucose and induced diabetes mellitus%慢性酒精中毒对血糖的影响及引发糖尿病的临床研究

    Institute of Scientific and Technical Information of China (English)

    骆钻芳; 吴琼

    2016-01-01

    目的:探讨慢性酒精中毒对血糖的影响,分析其与糖尿病的关系。方法135例慢性酒精中毒者作为观察组,80例不饮酒或偶尔饮酒者作为对照组,比较两组糖尿病、糖耐量减低(IGT)、空腹血糖受损(IFG)发生情况,分析糖尿病患病的危险因素。结果观察组糖尿病、IGT、IFG 发生率35.56%、25.93%、17.04%均明显高于对照组10.00%、13.75%、7.50%,差异具有统计学意义(P<0.05);多因素 Logistic 回归分析显示,年龄、BMI、糖尿病家族史、慢性酒精中毒为糖尿病患病危险因素(P<0.05)。结论慢性酒精中毒可导致较高的糖耐量异常和糖尿病发病率,需加强对该类人群进行健康教育,建议控制饮酒量,以降低糖耐量异常和糖尿病发病率。%Objective To investigate influence by chronic alcoholism on blood glucose, and to analyze its relationship with diabetes mellitus. Methods There were 135 patients with chronic alcoholism as observation group and 80 non or occasionally drinking people as control group. Comparison was made on diabetes mellitus, impaired glucose tolerance (IGT), and impaired fasting glucose (IFG) between the two groups to analyze risk factors of diabetes mellitus. Results The observation group had obviously higher incidences of diabetes mellitus, IGT and IFT as 35.56%, 25.93% and 17.04% than 10.00%, 13.75% and 7.50% of the control group, and the difference had statistical significance (P<0.05). Multivariate Logistic regression analysis showed age, BMI, family history of diabetes mellitus, and chronic alcoholism as risk factors of diabetes mellitus (P<0.05). Conclusion Due to high incidences of impaired glucose tolerance and diabetes mellitus induced by chronic alcoholism, it is necessary to enhance specific health education to control drinking volume and reduce incidences of impaired glucose tolerance and diabetes mellitus.

  11. rt-PA 早期静脉溶栓24h 疗效的相关因素临床分析%Clinical analysis of factors influencing the efficay of rt-PA earlystage intravenous thrombolysis treatment

    Institute of Scientific and Technical Information of China (English)

    毕晓霞; 汪慧; 陈黔妹; 周翠萍; 吴大鹏; 刘芳

    2015-01-01

    、溶栓前血糖水平无明显升高( OR=0.98,95%Cl 0.94~1.02,P<0.01)是影响静脉溶栓治疗24h后症状改善情况的独立预测因素。%Objective To discuss the related factors of clinical symptoms improved after intravenous thrombolysis treatment on acute ischemic stroke patients .Methods Clinical data of all acute ischemic stroke patients admitted to Huaxin hospital from January 2013 to March 2015 receiving intravenous thrombolysis were analyzed retrospectively .The patients were divided into two groups according to NIHSS rubric markings:an effective group and an ineffective group .The clinical data of the two groups of patients were compared to analyze the contributory factors of prognosis .Results 27 consecutive acute ischemic stroke patients were included in the analysis .Single-factor analysis indicated that by comparing the effective group ( 11 cases ) with the ineffective group ( 16 cases ) , blood glucose level prior to thrombolysis (6.54±1.81 vs 10.06±3.75,P<0.05), total serum cholesterol(4.02±0.90 vs 4.93± 1.09,P<0.05), baseline NIHSS score prior to thrombolysis (7.64±2.73 vs 12.25±5.0,P<0.05), timespan from beginning of treatment to stroke onset (2.17±0.75 vs 3.00±0.98,P<0.05), fibrinogen level(2.34±0.56,vs 3.04± 0.64,P<0.05), were statistically significant .Early-stage recovery was not related to age , smoking, blood pressure levels, history of cerebral infarction, atrium fibrillation, low-density lipoprotein, platelets and INR.Logistic regression analysis indicated that lower NIHSS score , shorter timespan from beginning of treatment to stroke onset and lower blood glucose level were the independent prognostic factors of the treatment .Conclusion Pre-thrombolysis blood glucose level , total cholesterol , pre-thrombolysis NIHSS score , timespan from beginning of thrombolysis to stroke onset, fibrinogen, etc.Are factors that affect earlystage recovery in thrombolysis treatment .Lower NIHSS score, shorter

  12. 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.

  13. Does treatment of intestinal helminth infections influence malaria? Background and methodology of a longitudinal study of clinical, parasitological and immunological parameters in Nangapanda, Flores, Indonesia (ImmunoSPIN Study

    Directory of Open Access Journals (Sweden)

    Sutanto Inge

    2010-03-01

    develop evidence-based policymaking. Trial registration This study was approved by The Ethical Committee of Faculty of Medicine, University of Indonesia, ref:194/PT02.FK/Etik/2006 and has been filed by ethics committee of the Leiden University Medical Center. Clinical trial number:ISRCTN83830814. The study is reported in accordance with the CONSORT guidelines for cluster-randomized studies.

  14. 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

  15. [Scientific concepts in clinical medicine].

    Science.gov (United States)

    Rogler, G

    2003-11-28

    The understanding of the scientific basis and the theory of knowledge are surprisingly heterogeneous in practical and clinical medicine. It is frequently influenced or based on the philosophical theory of critical rationalism founded by Sir Karl Popper. Because the theory of knowledge and the understanding of scientific truth is the central basis for cautious and good clinical practise it is necessary to discuss both points to avoid unscientific auto-immunisation against critique in a type of medicine that regards herself as science-based. Evidence-based medicine would not be possible without interpretation and explanation of existing data into the individual treatment context. Besides an inductive or deductive logic the historical and situative side-conditions of the gathering of knowledge and of experiments are of central importance for their interpretation and their relevance in clinical practice. This historical and situative context warrants reflection but must also be paid attention to in the reflections on medical ethics.

  16. [Clinical aspects of witchcraft delusions].

    Science.gov (United States)

    Pashkovskiĭ, V E

    2005-01-01

    To distinguish clinical variants and to specify nosologic entity of witchcraft delusions, 69 patients (10 males, aged 15-72 years) have been examined. It was found that witchcraft delusions exist in passive and active forms. In a passive form, the patient is sure that unknown (mystic) power damaged him/her; in an active form the patient, possessing a gift for unusual abilities, can influence the others (bewitches, heals, etc). Five clinical syndromes, in the structure of which the above delusions were found, namely, paranoiac-hypochondriac, hallucination-paranoid, depressive-paranoid, paraphrenic and delirious, were identified. Psychoses of schizophrenia spectrum were diagnosed in 52 patients, organic--in 8, alcoholic--in 7 and recurrent depressive disorder--in 2. Clinical significance of witchcraft delusions is closely related to its social aspect. Being combined with ideas of persecution, poisoning and damage, it results in the brutal forms of delusions defense and may be considered as an unfavorable prognostic trait.

  17. [Clinical research VI. Clinical relevance].

    Science.gov (United States)

    Talavera, Juan O; Rivas-Ruiz, Rodolfo

    2011-01-01

    Usually, in clinical practice the maneuver selected is the one that achieves a favorable outcome with a direct percentage of superiority of at least 10 %, or when the number needed to treat is approximately equal to 10. While this percentage difference is practical for estimating the magnitude of an association, we need to differentiate the impact measures (attributable risk, preventable fraction), measures of association (RR, OR, HR), and frequency measures (incidence and prevalence) applicable when the outcome is nominal. And we must identify ways to measure the strength of association and the magnitude of the association when the outcome variable is quantitative. It is not uncommon to interpret the measures of association as if they were impact measures. For example, for a RR of 0.68, it is common to assume a 32 % reduction of the outcome, but we must consider that this is a relative reduction, which comes from relations of 0.4/0.6, 0.04/0.06, or 0.00004/0.00006. However the direct reduction is 20 % (60 % - 40 %), 2 %, and 2 per 100,000, respectively. Therefore, to estimate the impact of a maneuver it is important to have the direct difference and/or NNT.

  18. 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…

  19. 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

  20. 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

  1. Clinical evaluation of influence of aspirin on post-operative bleeding after tooth extraction in the elderly%阿司匹林对老年人拔牙术后出血影响的临床观察

    Institute of Scientific and Technical Information of China (English)

    王文英; 崔念晖; 王恩博; 张伟

    2013-01-01

    Objective To investigate the feasibility of continuation of aspirin before tooth extraction in the elderly.Methods The patients enrolled in this study were the elderly requiring a single non-impacted tooth extraction.300 elderly outpatients used lidocaine local infiltration anesthesia,200 patients without using aspirin before tooth extraction served as control group Ⅰ,100 patients with prolong use of aspirin before tooth extraction as observation group Ⅰ.300 elderly outpatients used compound articaine local infiltration anesthesia,200 patients without using aspirin before tooth extraction served as control group Ⅱ,100 patients with prolong use of aspirin before tooth extraction as observation group Ⅱ.Bleedings at 5,10,30 min,24 h after tooth extraction were observed and the relationship between postoperative bleeding and intake of aspirin was analyzed.Results There was no significant difference at 5,10,30 min,24 h in postoperative bleeding after extraction between control group Ⅰ and observation group.The incidence of bleeding of observation group Ⅱ after tooth extraction at 5 min was higher than that of control group Ⅱ and there was no significant difference at 10,30 min,24 h between the two groups.Conclusions Continuation of aspirin have no influence on postoperative bleeding.Therefore we suggest that there was no indication to discontinue aspirin for the elderly before a single non-impacted tooth extraction.%目的 探讨老年人拔牙术前不停服阿司匹林的可行性.方法 600例均为拔除非阻生单颗牙的60岁以上患者,300例使用利多卡因局麻,其中200例未服用阿司匹林者为空白对照组Ⅰ,100例长期服用阿司匹林且术前不停药者为观察组Ⅰ;300例使用复方阿替卡因局麻,其中200例未服用阿司匹林者为空白对照组Ⅱ,100例长期服用阿司匹林且拔牙术前不停药者为观察组Ⅱ.观察研究对象拔牙创不同时间段出血情况,分析口服阿司匹林对拔牙术

  2. 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

  3. 妊娠合并脑出血的临床特征和影响预后的相关因素分析%Clinical characteristics and influencing factors on prognosis of pregnancy complicated with intracerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    梁竹巍; 蔺莉; 冯力民; 高婉丽

    2016-01-01

    Objective To analyze the clinical features and factors affecting prognosis for intracerebral hemorrhage (ICH) during pregnancy and postpartum.Methods A study of ICH was performed on 61 women in Beijing Tiantan Hospital,Capital Medical University between January 1997 and December 2014,and all cases were diagnosed with cerebral hemorrhage or subarachnoid hemorrhage during pregnancy or six weeks after delivery with CT or MRI after exclusion of ICH due to craniocerebral trauma.The subjects were divided into surgery (n=26) and conservative treatment (n=35) groups according to different ways of treatment;pregnancy associated problems (n=11) and cerebrovascular diseases groups according to the aetiology of ICH;low (n=13) and high score group (n=48) according their Glasgow score at the first visit;and short clinical onset to diagnosis time (O-D time) group (≤ 24 h,n=33) and long O-D time (>24 h) group (n=28).We compared the maternal clinical features and prognosis between different groups with t,Mann-Whitney U or Chi-square tests.A stratified logistic regression was used to assess the effect of factors affecting the prognosis.Results The average gestational age at the onset of ICH of the 61 cases was (28.8±8.3) weeks (6-40 weeks),the Glasgow score was (11.3±4.8),the median O-D time was 24.0 h,the modified Rankin scale (mRS) was 2.7,and 14 maternal deaths were reported (23.0%).Among the 61 women,three were terminated in early trimester,12 terminated in second trimester,and the rest 46 delivered in late term among which two fetal deaths,44 live births,and four neonatal deaths.Thus the perinatal infant death rate was 13.0% (6/46).The difference of maternal clinical features and prognosis between the surgery and conservative treatment group was not significant (all P>0.05).However,comparison between the cerebrovascular disease and pregnancy associated diseases group showed the latter had a lower Glasgow score and Apgar score [12.2(3.0) vs 7.5(12.0),(8.9±1.9) vs (7

  4. Influence of Nursing Students' Communication Consciousness in Clinical Teaching on Nursing Professional Quality%临床教学中培养护生沟通意识对护理职业素养的影响

    Institute of Scientific and Technical Information of China (English)

    付菊

    2015-01-01

    Objective To analyze the ef ect of nursing students'communication consciousness in clinical teaching.Methods Selection in dif erent grade hospital internship nursing students,using the same teaching plan,investigation communication in dif erent populations in tension,Occupational Literacy score analysis to the factors af ecting Occupational Literacy score.Results The nursing students and doctors to communicate the most tense,was significantly higher than that of patients and teachers,and fourth year undergraduate nursing students and doctors,patients,teacher communication,stress level was significantly lower than that of the three years of col ege nursing students,three years of col ege nursing students,the dif erence is statistical y significant ( <0.05);Four year undergraduate nursing students professionalism scores and professional value outlook,professional ethics and cognitive aspects,significantly higher than the three years of col ege nursing students,three years of col ege nursing students,the dif erence was statistical y significant ( <0.05);The professional values of nursing students,professional ethics,professional behavior and the teacher teaching methods,behavior training program,the sur ounding environmental impact was positively cor elated ( <0.05).Conclusion Nurse in work in communication with the doctor wil have obvious mental strain,by teachers to create a good teaching method,establish a standardized training program, to promote the cultivation of good professional quality.%目的:分析在临床教学中,培养护生的沟通意识,对其护理职业素养的影响。方法选择在我院实习的不同年级护生,采用相同的教学计划,加强沟通意识教育,调查其面对不同人群沟通时紧张状态、职业素养评分,分析影响职业素养评分的因素。结果护生与医生沟通时最紧张,明显高于患者及带教老师,且四年级本科护生在与医生、患者、带教老师沟通时

  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. 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

  7. 人工流产术后药物干预对子宫内膜影响的临床观察%Clinic Observation of Medicine Influence to Endometrium after Induced Abortion

    Institute of Scientific and Technical Information of China (English)

    包迎来; 夏松云; 李秀琴; 李敏; 赵勇; 闫玲; 白桂芳; 吴海燕; 王蔼明

    2012-01-01

    目的:评价在人工流产术后口服短效避孕药优思明及单纯雌激素补佳乐对减少术后阴道流血时间、促进术后子宫内膜恢复、缩短首次月经恢复时间及减少术后并发症的临床疗效.方法:选择来我院因非意愿妊娠者要求行无痛人工流产者为研究对象,随机分为对照组即未用药组(n=200),优思明组(n=100)和补佳乐组(n=100).3组均于术后2周及月经转归后1个月、3个月后随诊.观察术后阴道流血时间、术后2周子宫内膜厚度、首次月经恢复时间及术后3个月内并发症的发生情况.结果:①优思明组术后阴道流血时间短于对照组和补佳乐组,差异均有统计学意义(P<0.05);②优思明组术后2周子宫内膜略厚于对照组,但差异无统计学意义(P>0.05),补佳乐组术后2周子宫内膜厚度大于对照组和优思明组,差异有统计学意义(P<0.05).③优思明组术后首次月经恢复时间短于对照组和补佳乐组,差异有统计学意义(P<0.05).④用药组(优思明组和补佳乐组)术后并发症发生率均低于对照组,差异有统计学意义(P<0.05);用药组宫腔积液发生率低于对照组,差异有统计学意义(P<0.05).结论:人工流产术后立即服用单纯雌激素对子宫内膜厚度的恢复优于避孕药,术后并发症的发生率更低.%Objective: To access the clinical curative effect of reducing bleeding period of vagina, accelerating endometrium recovery, shortening recovery time of first menstrual cycle and reducing the incidence of postoperative complications by taking Yasmin and Progynova after induced abortion. Methods: The cases who received the painless abortion were selected and divided into threesgroups randomly: control group (without medicines, n=200), Yasmin group (n=100) and Progynova group (n=100). All cases were observed at the following time: 2 weeks after operation, the first menstrual cycle and the third emmenia cycle. The vagina bleeding

  8. 台州市艾滋病患者服药依从性及影响因素的临床研究%Clinical studies in patients with AIDS medication compliance and influencing factors of Taizhou

    Institute of Scientific and Technical Information of China (English)

    蔡夏叶; 蔡天国

    2015-01-01

    Objectives:To investigate the AIDS medication compliance factors,intervention patients im-prove patient medication compliance.Methods:577 cases of AIDS,according to their medication adherence were divided into two groups.For sociodemographic factors,drug factors,and treatment factors were investigated and the two groups were statistically and compared.Results:The age of good compliance group,duration,types of medica-tion and drug use were significantly lower than the compliance time difference between groups was significantly high-er than the annual income of poor adherence group.The difference was statistically significant (P <0.05).Good compliance female patient group,high school education or less,married,disease knowledge and knowledge about drugs,mental health person,medical services and doctor -patient relationships,families with good and caught his own expense significantly more than non -poor compliance persons;alcoholism,drug abuse,and there is signifi-cantly less adverse drug reactions caught with poor medication compliance.The comparison between the two groups was statistically significant (P <0.05).Logistic regression multivariate analysis,age,annual income,type and timing of drug use,disease and drug knowledge to grasp the situation,the existence of adverse reactions,as well as with the families of the extent of the impact of payment of medical expenses AIDS medication compliance independ-ence risk factors (P <0.05).Conclusions:Most patients with AIDS medication compliance is good,and factors affecting medication adherence and more want,including the patient’s own factors,including drug factors and treat-ment factors in clinical work carried out by the intervention of factors improve patient medication compliance.%目的:探讨艾滋病患者服药依从性的影响因素,对患者进行干预提高患者用药依从性。方法:选取艾滋病患者577例,根据其用药依从情况分为两组。对两组患者

  9. 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。

  10. 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

  11. Types of Treatment: Clinical Trials

    Science.gov (United States)

    ... Disease Information Treatment Types of Treatment Clinical Trials Clinical Trials Clinical Trials SHARE: Print Glossary Taking part in a clinical ... for cancer are based on previous clinical trials. Clinical Trial Service: LLS provides personalized clinical trial navigation when ...

  12. 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.

  13. 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.

  14. Influência da gestação na evolução clínica materno-fetal de portadoras de cardiomiopatia hipertrófica Influence of pregnancy on clinical course and fetal outcome of women with hypertrophic cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Walkiria Samuel Avila

    2007-04-01

    Full Text Available OBJETIVOS: Estudar a evolução clínica de gestantes com CMH, a influência da gestação sobre o curso natural da CMH e a freqüência da doença nos filhos dessas mulheres no início da infância. MÉTODOS: Foi realizado um estudo prospectivo em 35 portadoras de CMH com a mesma idade e classe funcional (CF. Vinte e três estavam grávidas (grupo G, e 12 pacientes que não estavam grávidas serviram como controle (grupo NG. Foram realizadas avaliações clínicas mensais, bem como eletrocardiograma e ecocardiograma transtorácico Os desfechos para os filhos foram taxas de natimortalidade e prematuridade e investigação de CMH durante a infância. RESULTADOS: Não houve mortes em nenhum dos dois grupos. A ocorrência de arritmias cardíacas foi significantemente maior (p 0,05. No grupo NG, a necessidade de hospitalização para tratamento de complicações cardíacas foi mais freqüente (p = 0,05 em pacientes com história familiar de CMH (71,4% vs. 25,0%. Doze pacientes (52% foram submetidas à cesariana por razões obstétricas, sete bebês (30,4% nasceram prematuramente e um bebê (4,3% teve morte neonatal. Uma criança teve diagnóstico clínico de CMH, e seu estudo genético identificou mutação no gene da cadeia pesada da b-miosina, situado no cromossomo 14. CONCLUSÃO: Insuficiência cardíaca é uma complicação freqüente em portadoras de CMH durante a gravidez, principalmente em pacientes com antecedentes familiares da doença, mas não altera o curso natural da CMH. Em uma criança, o exame clínico identificou HMC no início da infância.OBJECTIVES: To study clinical evolution of women with HCM during pregnancy; the influencing factors of gestation on natural course of HCM and the frequency of HCM in their children in early childhood. METHODS: A prospective study was conducted in 35 women with HCM; there were 23 pregnant women (PG group and 12 nonpregnant control patients (NP group, matched for age and functional class (FC

  15. 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

  16. Key considerations for conducting Chinese medicine clinical trials in hospitals

    Directory of Open Access Journals (Sweden)

    Shergis Johannah L

    2013-02-01

    Full Text Available Abstract Conducting clinical trials of Chinese medicines (CM in hospitals presents challenges for researchers. The success of hospital-based CM clinical trials may be influenced by the protocol design, including the maintenance of CM theory in compliance with scientific rigour and hospital guidelines and justified treatment approaches with results that can translate into clinical practice. Other influences include personnel and resources such as a dedicated team open to CM with an established research culture and the ability to maximise participant recruitment. This article identifies the key challenges and limitations of conducting CM clinical trials in Australian hospitals.

  17. 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...

  18. 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.

  19. 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.

  20. 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.

  1. 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

  2. Exploring the factors influencing clinical students' self-regulated learning

    NARCIS (Netherlands)

    Berkhout, J.J.; Helmich, E.; Teunissen, P.W.; Berg, J.W. Ten; Vleuten, C.P.M. van der; Jaarsma, A.D.

    2015-01-01

    OBJECTIVES: The importance of self-regulated learning (SRL) has been broadly recognised by medical education institutions and regulatory bodies. Supporting the development of SRL skills has proven difficult because self-regulation is a complex interactive process and we know relatively little about

  3. Clinical toxicology: clinical science to public health.

    Science.gov (United States)

    Bateman, D N

    2005-11-01

    1. The aims of the present paper are to: (i) review progress in clinical toxicology over the past 40 years and to place it in the context of modern health care by describing its development; and (ii) illustrate the use of clinical toxicology data from Scotland, in particular, as a tool for informing clinical care and public health policy with respect to drugs. 2. A historical literature review was conducted with amalgamation and comparison of a series of published and unpublished clinical toxicology datasets from NPIS Edinburgh and other sources. 3. Clinical databases within poisons treatment centres offer an important method of collecting data on the clinical effects of drugs in overdose. These data can be used to increase knowledge on drug toxicity mechanisms that inform licensing decisions, contribute to evidence-based care and clinical management. Combination of this material with national morbidity datasets provides another valuable approach that can inform public health prevention strategies. 4. In conclusion, clinical toxicology datasets offer clinical pharmacologists a new study area. Clinical toxicology treatment units and poisons information services offer an important health resource.

  4. Uses of clinical algorithms.

    Science.gov (United States)

    Margolis, C Z

    1983-02-04

    The clinical algorithm (flow chart) is a text format that is specially suited for representing a sequence of clinical decisions, for teaching clinical decision making, and for guiding patient care. A representative clinical algorithm is described in detail; five steps for writing an algorithm and seven steps for writing a set of algorithms are outlined. Five clinical education and patient care uses of algorithms are then discussed, including a map for teaching clinical decision making and protocol charts for guiding step-by-step care of specific problems. Clinical algorithms are compared as to their clinical usefulness with decision analysis. Three objections to clinical algorithms are answered, including the one that they restrict thinking. It is concluded that methods should be sought for writing clinical algorithms that represent expert consensus. A clinical algorithm could then be written for any area of medical decision making that can be standardized. Medical practice could then be taught more effectively, monitored accurately, and understood better.

  5. Diagnostic discrepancies in clinical practice

    Science.gov (United States)

    Issa, Victor Sarli; Dinardi, Layara Fernanda Lipari; Pereira, Thiago Vicente; de Almeida, Lyna Kyria Rodrigues; Barbosa, Thaisa Silveira; Benvenutti, Luiz Alberto; Ayub-Ferreira, Silvia Moreira; Bocchi, Edimar Alcides

    2017-01-01

    Abstract Autopsies are the gold standard for diagnostic accuracy; however, no recent study has analyzed autopsies in heart failure (HF). We reviewed 1241 autopsies (January 2000–May 2005) and selected 232 patients with HF. Clinical and autopsy diagnoses were analyzed and discrepancies categorized according to their importance regarding therapy and prognosis. Mean age was 63.3 ± 15.9 years; 154 (66.4%) patients were male. The causes of death at autopsy were end-stage HF (40.9%), acute myocardial infarction (17.2%), infection (15.9), and pulmonary embolism 36 (15.5). Diagnostic discrepancies occurred in 191 (82.3%) cases; in 56 (24.1%), discrepancies were related to major diagnoses with potential influence on survival or treatment; pulmonary embolism was the cause of death for 24 (42.9%) of these patients. In 35 (15.1%), discrepancies were related to a major diagnosis with equivocal influence on survival or treatment; in 100 (43.1%), discrepancies did not influence survival or treatment. In multivariate analysis, age (OR: 1.03, 95% CI: 1.008–1.052, P = 0.007) and presence of diabetes mellitus (OR: 0.359, 95% CI: 0.168–0.767, P = 0.008) influenced the occurrence discrepancies. Diagnostic discrepancies with a potential impact on prognosis are frequent in HF. These findings warrant reconsideration in diagnostic and therapeutic practices with HF patients. PMID:28121951

  6. Clinical Trials in Vision Research

    Science.gov (United States)

    ... Eye Health Information > Clinical Trials in Vision Research Clinical Trials in Vision Research Clinical studies depend on people ... vision research in the United States. Basics of Clinical Trials What is a clinical trial? Clinical trials are ...

  7. Supporting Placement Supervision in Clinical Exercise Physiology

    Science.gov (United States)

    Sealey, Rebecca M.; Raymond, Jacqueline; Groeller, Herb; Rooney, Kieron; Crabb, Meagan; Watt, Kerrianne

    2015-01-01

    The continued engagement of the professional workforce as supervisors is critical for the sustainability and growth of work-integrated learning activities in university degrees. This study investigated factors that influence the willingness and ability of clinicians to continue to supervise clinical exercise physiology work-integrated learning…

  8. Clinical Decision Making of Rural Novice Nurses

    Science.gov (United States)

    Seright, Teresa J.

    2010-01-01

    The purpose of this study was to develop substantive theory regarding decision making by the novice nurse in a rural hospital setting. Interviews were guided by the following research questions: What cues were used by novice rural registered nurses in order to make clinical decisions? What were the sources of feedback which influenced subsequent…

  9. 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)

  10. 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....

  11. How clinical decisions are made.

    Science.gov (United States)

    Bate, Louise; Hutchinson, Andrew; Underhill, Jonathan; Maskrey, Neal

    2012-10-01

    There is much variation in the implementation of the best available evidence into clinical practice. These gaps between evidence and practice are often a result of multiple individual decisions. When making a decision, there is so much potentially relevant information available, it is impossible to know or process it all (so called 'bounded rationality'). Usually, a limited amount of information is selected to reach a sufficiently satisfactory decision, a process known as satisficing. There are two key processes used in decision making: System 1 and System 2. System 1 involves fast, intuitive decisions; System 2 is a deliberate analytical approach, used to locate information which is not instantly recalled. Human beings unconsciously use System 1 processing whenever possible because it is quicker and requires less effort than System 2. In clinical practice, gaps between evidence and practice can occur when a clinician develops a pattern of knowledge, which is then relied on for decisions using System 1 processing, without the activation of a System 2 check against the best available evidence from high quality research. The processing of information and decision making may be influenced by a number of cognitive biases, of which the decision maker may be unaware. Interventions to encourage appropriate use of System 1 and System 2 processing have been shown to improve clinical decision making. Increased understanding of decision making processes and common sources of error should help clinical decision makers to minimize avoidable mistakes and increase the proportion of decisions that are better.

  12. History of clinical pharmacy and clinical pharmacology.

    Science.gov (United States)

    Miller, R R

    1981-04-01

    The purpose of the Symposium on Clinical Pharmacy and Clinical Pharmacology is to describe the present and future functional roles of clinical pharmacists and clinical pharmacologists in drug research, professional education, and patient care. Clinical pharmacy is a relatively new professional discipline, being only about 15 years old. This new breed of pharmacists is patient rather than drug product oriented. The discipline arose out of dissatisfaction with old practice norms and the pressing need for a health professional with a comprehensive knowledge of the therapeutic use of drugs. The clinical pharmacy movement began at the University of Michigan in the early 1960s, but much of the pioneering work was done by David Burkholder, Paul Parker, and Charles Walton at the University of Kentucky in the latter part of the 1960s. Clinical pharmacology is a professional discipline that combines basic pharmacology and clinical medicine. Its development began in the early 1950s, primarily as a result of the efforts of Harry Gold. It has had a slower growth than clinical pharmacy but it has made many important contributions to our knowledge of human pharmacology and the rational use of drugs.

  13. Development of clinical scientists.

    Science.gov (United States)

    Smith, R V

    1987-01-01

    The education and training of clinical scientists has served society in several ways. For academic pharmacy, the emergence of clinical science has provided research and scholarship opportunities for clinical faculty development. Clinical scientists have also begun to play important roles in industrial drug research and development. For all faculty and students, clinical science research reinforces a "research mindset" that will become increasingly important as our society moves from a production/extraction to an information-based economy. Pharmacy will best evolve by increasing its commitment to clinical science research. In the process, academic pharmacy must continue to improve and support excellent education and training programs for clinical scientists.

  14. Clinical placements and nursing students' career planning: a qualitative exploration.

    Science.gov (United States)

    McKenna, Lisa; McCall, Louise; Wray, Natalie

    2010-04-01

    Many nursing students enter undergraduate programmes with preconceived ideas about their future nursing careers, and intend to practice in particular areas such as midwifery or paediatrics. Through clinical placements, students are exposed to different clinical areas and professional socialization is facilitated. However, little is known about the influence of clinical placements on students' career intentions. This paper reports nursing findings drawn from a large qualitative study conducted in Victoria, Australia that sought to explore the influence of health professional students' clinical placements on their future career intentions. Participants were invited to be involved in either face-to-face or focus group interviews depending upon their own preference. Thematic data analysis revealed three main themes: 're-affirming career choice', 'working in a particular area' and 'work location'. Findings from the study add to our understanding of factors influencing nursing students' planning for their future careers including the impact of clinical placements.

  15. 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

    According to the Council of Europe, clinical dietitians should assume a more central role in nutritional support. The aim of this study was to assess the opinions among doctors, nurses and clinical dietitians regarding the use of clinical dietitians' expertise in the hospital units and, further......, 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......, as well as to 678 clinical dietitians working in Scandinavian hospitals. The response rate of clinical dietitians, nurses and doctors were 53%, 46% and 29%, respectively. Nurses and doctors who saw clinical dietitians often found it less difficult to identify undernourished patients and found that insight...

  16. Influence of Shengjingsan(Traditional Chinese Medicine) Prescription on Spermatozoa DNA Integrity and Clinical Effects on IVF-ET Treatment%中药生精散对精子DNA完整性的影响及其在IVF-ET治疗中的临床疗效

    Institute of Scientific and Technical Information of China (English)

    孙伟; 杨丽霞; 于艳; 管群; 张琪瑶; 营福琴

    2011-01-01

    目的:观察中药生精散对不育患者精子DNA完整性的影响及其在IVF-ET治疗中的临床疗效.方法:因少、弱精子症行IVF/ICSI-ET治疗的患者49例,随机分为中药组(22例,服用生精散治疗)和对照组(27例,未经生精散治疗).观察比较中药组和对照组精液常规分析(精子密度、活率、活力)、DNA碎片指数(DNA fragmentation index,DFI)、受精率、卵裂率、种植率及临床妊娠率.结果:中药治疗后精子活率及活力显著提高(P<0.05),且中药组DFI值较治疗前及对照组明显下降((P<0.05).中药组胚胎种植率((31.11%)及临床妊娠率(45.45%)明显高于对照组(13.73%和18.51%)(P<0.05).结论:中药生精散可通过降低不育患者精子DNA损伤程度,改善精子质量,提高IVF-ET的治疗效果.%ObjectiverTo observe the influence of Traditional Chinese Medicine(TCM)--Shengjingsanon infertile spermatozoa DNA integrity and clinical effects in IVF-ET treatment. Methods: A total 49 cases were recruited, patients in TCM group underwent 22 cases treated by Shengjingsan for 2-3 courses, patients in control group underwent 27 cases without any medicine. Outcome parameters were conventional semen parameters (sperm density, motility rate and vitality), DNA fragmentation index(DFI), the number of retrieved oocytes, the number of mature eggs, the rates of fertilization, cleavage, implantation and clinical pregnancy. Results: For TCM group, sperm motility rate and vitality were significantly higher after treating by Shengjingsan as compared with them before (P<0.05), and DFI was significantly lower in TCM group than that in control (P<0.05). Implantation rate (31.11% vs 13.73%, P<0.05) and clinical pregnancy rate (45.45% vsl8.51%, P<0.05) were significantly higher inTCM group than those in the control, respectively. Conclusion: The Traditional Chinese Medicine--Shengjingsanprescription can reduce sperm DFI of the infertile patients and improve the sperm quality, and also increase

  17. 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

  18. 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

  19. 超高龄后循环缺血性脑卒中患者的临床特点及其预后影响因素研究%Clinical Features and Influencing Factors of Prognosis in Super - aged Patients with Posterior Circulation Ischemic Stroke

    Institute of Scientific and Technical Information of China (English)

    刘扣琴

    2015-01-01

    Objective To investigate the clinical features and influencing factors of prognosis in super - aged patients with posterior circulation ischemic stroke. Methods A total of 82 super - aged patients with posterior circulation ischemic stroke (equal or over 80 years old) were selected in Traditional Chinese Medicine Hospital of Zhangjiagang from 2010 to 2014,and their clinical data was immediately collected after admission,including gender,age,past medical history,symptoms and signs, NIHSS; related influencing factors of prognosis were recorded, including hypertension, diabetes, elevated LDL, hyperhomocysteinemia,coronary heart disease,atrial fibrillation,coronary heart disease,smoking history,drinking history and stroke history. All of the patients were followed up for 3 months,modified Rankin scale was used to evaluate the prognosis,and multivariate Logistic regression analysis was used to analyze the influencing factors of prognosis. Results The main clinical symptoms were dizziness/ vertigo( accounted for 69. 5% ) and weakness of extremities( accounted for 68. 3% ),the main clinical signs were acroparalysis( accounted for 54. 9% ),positive Babinski sign/ Chaddock sign( accounted for 46. 3% ), ataxia(accounted for 43. 9% )and central facial paralysis(accounted for 40. 2% ). After 3 - month fellow - up,56 patients got good prognosis( accounted for 68. 3% ),26 patients got bad prognosis( accounted for 31. 7% ). Multivariate Logistic regression analysis showed that,lower NIHSS at admission〔OR = 2. 648,95% CI(1. 552,4. 463)〕,longer time for seeing a doctor after attack〔 OR = 1. 784,95% CI(1. 142,2. 864)〕,stroke history〔 OR = 4. 402,95% CI(1. 165,16. 458)〕, hyperhomocysteinemia〔OR = 3. 624,95% CI(2. 360,5. 714)〕,hypertension〔OR = 2. 991,95% CI(1. 886,4. 705)〕, diabetes〔OR = 5. 903,95% CI ( 3. 884,9. 025 )〕, elevated LDL 〔 OR = 3. 052,95% CI ( 1. 663,7. 152 )〕 were independent risk factors of the bad prognosis. Conclusion The main clinical

  20. 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.

  1. Clinical approach to clinical herbal toxicity.

    Science.gov (United States)

    Tovar, Richard T

    2009-02-01

    This article is a review of the history and current status of herbs in the United States. The clinical effects of herbs and herbal medicine will be reviewed with respect to side effects and clinical toxicity. Treatment of herbal toxicity will be described where indicated.

  2. 甲氨蝶呤妊娠囊内注射联合清宫术治疗子宫瘢痕处妊娠的效果%Influence of Methotrexate Gestation Injection Combined with Curettage Treating Cesarean Scar Pregnancy on Clinical Efficacy,β-hCG and Adverse Reactions

    Institute of Scientific and Technical Information of China (English)

    颜红丽; 田燕妮; 刘嗣超; 王彩英

    2016-01-01

    Objective:To research the influence of methotrexate gestation injection combined with curet-tage treating cesarean scar pregnancy on clinical efficacy,β-hCG and adverse reactions. Methods:The clini-cal data of 150 patients with cesarean scar pregnancy treated in our hospital from April 2015 to April 2016 were analyzed retrospectively. The control group was treated with methotrexate gestation injection, based on which, the observation group was treated with curettage. The efficacy of two groups was compared. Results:The fertile function, efficacy indicators andβ-hCG of the observation group was better than that of the control group , and the total incidence rate of adverse reactions of the observation group was lower than that of the con-trol group( P<0.05) . Conclusion:Methotrexate gestation injection combined with curettage in treating cesare-an scar pregnancy has evident effect.%目的::研究子宫瘢痕处妊娠患者行甲氨蝶呤妊娠囊内注射和清宫术联合治疗对临床疗效、β-hCG及不良反应的影响。方法:资料取本院2015年4月至2016年4月收治子宫瘢痕处妊娠150例患者予回顾分析,对照组行甲氨蝶呤妊娠囊内注射治疗,观察组联合清宫术,对比两组疗效。结果:观察组生育功能及相关疗效指标、β-hCG比对照组优,且总不良反应率比对照组低,差异具有统计学意义( P<0.05)。结论:子宫瘢痕处妊娠行甲氨蝶呤妊娠囊内注射和清宫术联合治疗效果显著。

  3. Avaliação clínica e radiográfica da influência do fenobarbital (Gardenal® na movimentação ortodôntica: estudo em coelhos Clinical and radiographic evaluation of phenobarbital (Gardenal® influence on orthodontic movement: a study in rabbits

    Directory of Open Access Journals (Sweden)

    Matheus Melo Pithon

    2008-02-01

    Full Text Available OBJETIVO: Deste estudo foi avaliar clínica e radiograficamente a influência do Fenobarbital na movimentação ortodôntica. METODOLOGIA: Foram utilizados 22 coelhos da raça Nova Zelândia (Oryctolagus cuniculus, distribuídos em três grupos: normal (N, controle (C e experimental (E. O grupo N (n=2 não foi tratado, apenas certificada a condição de normalidade. Nos grupos C (n=10 e E (n=10, foi montado aparelho ortodôntico entre os primeiros molares e incisivos inferiores para promover a movimentação para mesial dos molares. No grupo E, foi administrado conjuntamente à movimentação dentária induzida, o medicamento Fenobarbial. Após os períodos de 7 e 14 dias os animais foram sacrificados para análise clínica e radiográfica. CONCLUSÕES: Os resultados demonstraram não haver diferenças na extensão do movimento nem alterações radiográficas entre os animais do grupo controle e experimental.The objective of the present study was to evaluate the clinical and radiographic phenobarbital influence on orthodontic movement. 22 New Zealand rabbits (Oryctolagus cuniculus have been used for study, all divided into three groups: N = normal rabbits; C = control rabbits; and E = experimental rabbits. No procedure was performed in Group N (n = 2, except a certification of the normal condition. In Groups C (n = 10 and E (n = 10, orthodontic device was placed between the lower first molars and the lower incisors in order to promote a mesial molar movement. In Group E, phenobarbital was administered together the treatment. Following the periods of 7 and 14 days, the animals were sacrificed for clinical and radiographic analysis. By comparing the control animals with the experimental ones, the results showed no difference on the rate of orthodontic tooth moment as well no radiographic change.

  4. 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,…

  5. 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

  6. 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

  7. 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

    2016-01-01

    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

  8. 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

  9. 甲型H1N1流感发热门诊患者自我效能感及其影响因素的研究%Research on self-efficiency sense of patients in clinic for type H1N1 influenza and Its influencing factors

    Institute of Scientific and Technical Information of China (English)

    焦卫红; 蒋海兰; 刘海容; 于梅

    2009-01-01

    目的 了解甲型H1N1流感发热门诊患者自我效能感状况及其影响因素.方法 运用一般情况调查表、一般自我效能感昔表、甲型H1N1流感认知调查表、社会支持评定量表对来我院发热门诊就诊的826例患者进行问卷调查.结果 调查对象一般自我效能感得分为(2.44±0.63)分,低于常模(P<0.05);调查对象的一般自我效能感得分受其年龄、性别、婚姻状况、文化程度、社会支持程度、甲型H1N1流感认知程度的影响(P<0.05);与年龄、文化程度、社会支持程度、甲型H1N1流感认知程度呈正相关(P<0.05).结论 甲型H1N1流感发热门诊患者一般自我效能感得分较低,护理人员在接诊发热患者时,应了解其自我效能感状况,分析影响因素,给予有效的护理干预,提高自我效能感,增强流感防控效果.%Objective To understand patient's self-efficiency sense in fever clinic of first type HIN1 influenza and its influencing factors. Methods Totally 826 patients coming to the fever clinic of our academy were investigated by the general situation questionnaire, the general self-efficacy scale, first type HI NI influenza cognitive questionnaire, the social support rating scale. Results The scores (2.44 +0.63 ) of the general self- efficacy scale by the fevering patients were lower than the norm notably ( P < 0. 05 ). The scores of the general self-efficacy scale were affected by the years of age, gender, marital status, education background, the degree of social support, the degree of the disease cognition and positively correlated with the age, education background, the degree of social support and the degree of the disease cognition( P <0. 05 ). Conclusions The scores of the general self-efficacy scale getting from the levering patients were low generally. Nursing stuffs should understand the state of the self-efficacy sense and analyze the influence factors, adopt positive intervention to help patients improving the

  10. 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

  11. Influence of medication-education-oriented pharmaceutical intervention by clinical pharmacist on cancer pain and chemotherapy of patients%临床药师以用药教育为核心的药学干预对癌痛和化疗的影响

    Institute of Scientific and Technical Information of China (English)

    刘丽华; 王卫星

    2016-01-01

    目的:探讨临床药师以用药教育为核心的药学干预在癌症患者癌痛和化疗中的作用。方法选择2013年5月至2015年5月我院肿瘤内科收治的癌痛患者70例,采用随机数字法分为观察组和对照组各35例。对照组患者仅给予常规化疗,观察组患者在此基础上,由临床药师以用药教育为核心进行药学干预。干预后1个月,比较两组患者的治疗效果、使用止痛药以及对癌痛和止痛知识的了解情况,并评价两组患者的疼痛强度,记录两组患者的生活质量疼痛影响评分。结果观察组患者化疗的总有效率为88.6%(31/35),明显高于对照组的68.6%(24/35),差异有统计学意义(P<0.05);观察组使用止痛药患者占42.9%(15/35),明显低于对照组的71.4%(25/35),差异有统计学意义(P<0.05);观察组患者对癌痛知识和止痛知识的了解评分分别为(8.2±1.5)分和(8.0±1.1)分,明显高于对照组的(5.3±2.4)分和(5.8±1.8)分,差异均具有统计学意义(P<0.05);与对照组第2次比较,观察组在最严重疼痛强度、当前疼痛强度、活动时疼痛强度方面评分均显著降低,差异均具有统计学意义(P<0.05)。此外,观察组疼痛影响生活质量的各项评分亦均显著低于对照组差异均具有统计学意义(P<0.05)。结论临床药师对癌痛患者实施以用药教育为核心的药学干预,在化疗效果、癌症疼痛强度以及生活质量方面均有积极的意义。%Objective To investigate the influence of medication-education-oriented pharmaceutical interven-tion by clinical pharmacist on cancer pain and chemotherapy of patients. Methods A total of 70 patients with cancer pain, who admitted to Department of Medical Oncology in our hospital from May 2013 to May 2015, were enrolled and randomly divided into the observation group (n=35) and the control group (n=35) according to random number ta-ble. The control group was given

  12. 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....

  13. A influência de variáveis sociodemográficas, clínicas e funcionais sobre a qualidade de vida de idosos com artroplastia total do quadril The influence of sociodemographic, clinical and functional variables on the quality of life of elderly people with total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Mariana K. Rampazo

    2010-06-01

    Full Text Available OBJETIVOS: Avaliar a qualidade de vida relacionada à saúde (QVRS de idosos com Artroplastia Total de Quadril (ATQ e investigar a relação e a influência de variáveis sociodemográficas, clínicas e funcionais nesses sujeitos. MÉTODOS: A QVRS foi avaliada por meio das versões brasileiras dos instrumentos genérico The Medical Outcomes Study 36-item Short-Form Health Survey (SF-36 e específico Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC em 88 idosos com ATQ primária e unilateral de ambos os gêneros. Os dados foram submetidos às análises estatísiticas: descritiva; análise de variância univariada (ANOVA e multivariada (MANOVA para verificar a influência das variáveis estudadas nas dimensões do SF-36 e do WOMAC e testes de Mann-Whitney e Kruskal-Wallis para comparação dos escores dos instrumentos entre as variáveis. RESULTADOS: A amostra estudada teve predomínio das mulheres, e a média de idade foi de 68,8(±7,4 anos. A função do quadril, avaliada pelo Harris Hip Score, foi a variável que apresentou influência significativa na QVRS sob a perspectiva do instrumento genérico e do específico. O uso de acessórios para a locomoção, a função do quadril e a satisfação com a cirurgia foram as principais variáveis que apresentaram diferenças significativas nas dimensões do SF-36 e do WOMAC. CONCLUSÕES: Investimentos no âmbito funcional e programas de reabilitação direcionados às peculiaridades dos idosos com ATQ podem beneficiar essa população.OBJECTIVES: To evaluate the health-related quality of life (HRQOL of elderly people with total hip arthroplasty (THA and to investigate the relationships and influences of the sociodemographic, clinical and functional variables of these subjects. METHODS: The HRQOL was evaluated by means of the Brazilian versions of the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36, a general instrument, and the Western Ontario and Mc

  14. How Do Clinical Trials Work?

    Science.gov (United States)

    ... Studies NHLBI Trials Clinical Trial Websites How Do Clinical Trials Work? If you take part in a clinical ... protect patients and help produce reliable study results. Clinical Trial Protocol Each clinical trial has a master plan ...

  15. Clinical aspects of telemedicine

    Science.gov (United States)

    Merrell, Ronald C.

    1991-01-01

    Communication among physicians is an essential in order to combine our experiences for the elucidation and application of new knowledge and for the accurate and uniform application of established medical practice. This communication requires an adequate understanding of the culture of the patient and the social context of disease and indeed the culture of the physician. Malnutrition in Bangladesh means caloric insufficiency, and a program to lower cholesterol would be impertinent, while a program to enhance the nutrition of patients in Texas by an international effort to import more grain would be ludicrous. In the same vein a public health effort to combat alcoholic cirrhosis in Mecca would be as silly as a program to increase fiber in the diet of the Bantu. Clinical communication must acknowledge the culture of the issue at hand and the differences in the experiential base of the physicians. Not only do geography and culture affect the potential differences in the experiential bases, but the world utilizes very different traditions of education and science in training physicians. We are influenced by the diseases we treat, and learn to look for the expected at least as much as we are attentive to the unexpected. A physician in Siberia would be much more likely to recognize frostbite than one from Buenos Aires, and the Argentine doctor would much more likely consider Chaga's Disease to explain abdominal pain than a colleague in Zurich. Beyond these obvious issues in communication among physicians we must deal with the many languages and idioms used in the world. An overview of using Telemedicine SpaceBridge after the earthquake in the Republic of Armenia in 1988 is presented.

  16. Informed Consent (Clinical Trials)

    Science.gov (United States)

    ... Research Cancer Treatment Types of Treatment Side Effects Clinical Trials Information A to Z List of Cancer Drugs ... Staging Prognosis Treatment Types of Treatment Side Effects Clinical Trials Cancer Drugs Complementary & Alternative Medicine Coping Feelings & Cancer ...

  17. 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.

  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. 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,...

  20. Evidence of clinical competence.

    Science.gov (United States)

    Lejonqvist, Gun-Britt; Eriksson, Katie; Meretoja, Riitta

    2012-06-01

    This cross-sectional research used a qualitative questionnaire to explore clinical competence in nursing. The aim was to look for evidence of how clinical competence showed itself in practice. In the research, the views from both education and working life are combined to broadly explore and describe clinical competence from the perspective of students, clinical preceptors and teachers. The questions were formulated on how clinical competence is characterised and experienced, what contributes to it and how it is maintained, and on the relation between clinical competence and evidence-based care. The answers were analysed by inductive content analysis. The results showed that clinical competence in practice is encountering, knowing, performing, maturing and improving. Clinical competence is an ongoing process, rather than a state and manifests itself in an ontological and a contextual dimension.

  1. 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 ...

  2. 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...

  3. Spina Bifida Clinic Directory

    Science.gov (United States)

    ... edu Special Health Care Services Spinal Cord Clinic Wesley Medical Arts Tower Building (pediatric-will refer adults) ... to age 25) Clinic 6L, One Medical Center Dr. Lebanon, NH 03756 (603) 653-9623 http://chad. ...

  4. Clinical efficacy of phacoemulsificatioll in treatment of uveitis combined with cataract and the influence on blood-aqueous barrier%超声乳化手术治疗葡萄膜炎并发白内障的疗效及对血-房水屏障功能的影响

    Institute of Scientific and Technical Information of China (English)

    孙昊

    2013-01-01

    OBJECTIVE To investigate the clinical efficacy of phacoemulsificatioll in the treatment of uveitis combined with cataract and its influence on the blood-aqueous barrier. METHODS A total of 100 children with the uveitis combined with cataract were selected from Feb 2008 to Feb 2011, and they were divided into the control group and the treatment group, with 50 cases. The control group was given the conventional treatment while the treatment group was given the phacoemulsificatioll. The clinical efficacy, the vision and the aqueous protein concentration were compared between the two groups. RESULTS After the treatment, the proportion of the eyes with best corrected visual acuity more than 0. 5 were 76. 0% , 90. 0% , 92. 0% and 98. 0% respectively on the first, seventh, thirtieth, and ninetieth day after the surgery, which were significantly higher than that of the control group, the differences were statistically significant (P<0. 05). The aqueous protein concentration was significantly higher in the treatment group (7. 88 ± 0. 05) than in the control group (9. 66±0. 01), the difference was statistically significant (P < 0. 05). No adverse reactions occurred in both groups of the patients. CONCLUSION Phacoemulsificatioll, with less adverse reactions, can effectively treat the uveitis combined with cataract, which is worthy of the clinical promotion.%目的 探讨超声乳化手术治疗葡萄膜炎并发白内障的临床疗效及其对血-房水屏障功能的影响研究.方法 选择医院2008年2月-2011年2月收治的100例葡萄膜炎并发白内障患者,分为对照组与治疗组,每组各50例;治疗组给予超声乳化手术治疗,对照组给予常规治疗方法,观察两组患者的治疗效果,测定两组患者治疗前后的视力及房水蛋白浓度.结果 治疗后,治疗组患者术后1、7、30、90 d最佳矫正视力>0.5的眼数比例分别为76.0%、90.0%、92.0%、98.0%均明显高于对照组,差异有统计学意义(P<0

  5. 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.

  6. 脾氨肽口服冻干粉对小儿支原体感染肺炎伴哮喘临床效果及C反应蛋白的影响%The Clinical Effect and the Influence of CRP of Spleen Peptide Oral Ammonia Producing for Pediatric Pneumonia Mycoplasma Infection Associated with Asthma

    Institute of Scientific and Technical Information of China (English)

    陈克娅; 冯涛

    2016-01-01

    Objective:To observe the clinical effect and the influence of c-reactive protein of ( CRP ) spleen peptide oral ammonia producing for pediatric pneumonia mycoplasma infection associated with asthma. Methods:The data of 124 children with mycoplasma pneumonia with asthma admitted in our hospital from June 2015 to June 2016 were analyzed. According to the different treatment schemes, all the children were di-vided into controll group and observe group. The control group were treated with anti-inflammatory treatment with azithromycin, and the observation group were treated with spleen peptide oral ammonia producing. The clinical effects and c-reactive protein ( CRP ) expression of two groups were compared. Results: The impro-ving effects of IgA, IgG and T lymphocyte subgroup after cure in the observation group were better than that in the control group. The difference was statistically significant (P<0.05). The level of CRP, WBC and creati-nine in the observation group were lower than the control group ( P<0.05) . Conclusion:Mycoplasma pneumo-nia infection associated with asthma role of spleen peptide oral ammonia producing heal can optimize clinical effect, reduce the children c-reactive protein (CRP) levels, it is worth promoting.%目的:研究支原体感染肺炎伴哮喘患儿行脾氨肽口服冻干粉医治对临床效果和C反应蛋白的影响.方法:前瞻性取2015年6月至2016年6月本院收治支原体感染肺炎伴哮喘124例患儿资料进行分析,按不同医治方案分两组,对照组行阿奇霉素抗炎医治,观察组行脾氨肽口服冻干粉医治,比较两组临床效果和C反应蛋白.结果:两组临床效果比较差异显著具统计意义(P<0.05);观察组医治后IgA、IgG与T淋巴细胞亚群改善效果均比对照组优,比较差异具有统计学意义(P<0.05),且C反应蛋白、白细胞与肌酐水平均比对照组低,差异具有统计学意义(P<0.05).结论:支原体感染肺炎伴哮喘患儿行

  7. 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