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1危重患者安全转运的研究现状和展望显示文摘危重患者转运往往是为了进一步检查诊断或为了得到更有效的救治。然而,转运过程中环境的变化、仪器设备、人员等因素可增加患者的转运风险^[1-4],影响呼吸和循环功能的稳定,导致低血压和低氧血症等不利后果,甚至发生心搏呼吸骤停。有效提高危重患者的转运安全^[5-7]已引起国内外研究者的关注。毋庸置疑,训练有素的专业团队、赵伟英 Greaney Brendan 陈三妹 徐凤娇 金静芬 2013中华急诊医学杂志2013,22,2:77
2Hepatocellular carcinoma surveillance:An evidence-based approach显示文摘Hepatocellular carcinoma(HCC) makes up 75%-85% of all primary liver cancers and is the fourth most common cause of cancer related death worldwide. Chronic liver disease is the most significant risk factor for HCC with 80%-90% of new cases occurring in the background of cirrhosis. Studies have shown that early diagnosis of HCC through surveillance programs improve prognosis and availability of curative therapies. All patients with cirrhosis and high-risk hepatitis B patients are at risk for HCC and should undergo surveillance. The recommended surveillance modality is abdominal ultrasound(US) given that it is cost effective and noninvasive with good sensitivity. However, US is limited in obese patients and those with non-alcoholic fatty liver disease(NAFLD). With the current obesity epidemic and rise in the prevalence of NAFLD, abdominal computed tomography or magnetic resonance imaging may be indicated as the primary screening modality in these patients. The addition of alpha-fetoprotein to a surveillance regimen is thought to improve the sensitivity of HCC detection.Further investigation of serum biomarkers is needed. Semiannual screening is the suggested surveillance interval. Surveillance for HCC is underutilized and low adherence disproportionately affects certain demographics such as nonCaucasian race and low socioeconomic status.Patrick S Harris Ross M Hansen Meagan E Gray Omar I Massoud Brendan M McGuire Mohamed G Shoreibah 2019World Journal of Gastroenterology2019,25,13:31
3Management and prevention of acute and chronic lateral ankle instability in athletic patient populations显示文摘Acute and chronic lateral ankle instability are common in high-demand patient populations. If not managed appropriately, patients may experience recurrent instability, chronic pain, osteochondral lesions of the talus, premature osteoarthritis, and other significantlong-term disability. Certain populations, including young athletes, military personnel and those involved in frequent running, jumping, and cutting motions, are at increased risk. Proposed risk factors include prior ankle sprain, elevated body weight or body mass index, female gender, neuromuscular deficits, postural imbalance, foot/ankle malalignment, and exposure to at-risk athletic activity. Prompt, accurate diagnosis is crucial, and evidence-based, functional rehabilitation regimens have a proven track record in returning active patients to work and sport. When patients fail to improve with physical therapy and external bracing, multiple surgical techniques have been described with reliable results, including both anatomic and nonanatomic reconstructive methods. Anatomic repair of the lateral ligamentous complex remains the gold standard for recurrent ankle instability, and it effectively restores native ankle anatomy and joint kinematics while preserving physiologic ankle and subtalar motion. Further preventative measures may minimize the risk of ankle instability in athletic cohorts, including prophylactic bracing and combined neuromuscular and proprioceptive training programs. These interventions have demonstrated benefit in patients at heightened risk for lateral ankle sprain and allow active cohorts to return to full activity without adversely affecting athletic performance.Brendan J Mc Criskin Kenneth L Cameron Justin D Orr Brian R Waterman 2015World Journal of Orthopedics2015,6,2:20
4Evolving concepts in bone infection: redefining “biofilm”,“acute vs. chronic osteomyelitis”, “the immune proteome” and “local antibiotic therapy”显示文摘Osteomyelitis is a devastating disease caused by microbial infection of bone. While the frequency of infection following elective orthopedic surgery is low, rates of reinfection are disturbingly high. Staphylococcus aureus is responsible for the majority of chronic osteomyelitis cases and is often considered to be incurable due to bacterial persistence deep within bone. Unfortunately, there is no consensus on clinical classifications of osteomyelitis and the ensuing treatment algorithm. Given the high patient morbidity,mortality, and economic burden caused by osteomyelitis, it is important to elucidate mechanisms of bone infection to inform novel strategies for prevention and curative treatment. Recent discoveries in this field have identified three distinct reservoirs of bacterial biofilm including: Staphylococcal abscess communities in the local soft tissue and bone marrow, glycocalyx formation on implant hardware and necrotic tissue, and colonization of the osteocyte-lacuno canalicular network(OLCN) of cortical bone. In contrast, S.aureus intracellular persistence in bone cells has not been substantiated in vivo, which challenges this mode of chronic osteomyelitis. There have also been major advances in our understanding of the immune proteome against S. aureus, from clinical studies of serum antibodies and media enriched for newly synthesized antibodies(MENSA), which may provide new opportunities for osteomyelitis diagnosis, prognosis, and vaccine development. Finally, novel therapies such as antimicrobial implant coatings and antibiotic impregnated 3D-printed scaffolds represent promising strategies for preventing and managing this devastating disease. Here, we review these recent advances and highlight translational opportunities towards a cure.Elysia A. Masters Ryan P. Trombetta Karen L. de Mesy Bentley Brendan F Boyce Ann Lindley Gill Steven R. Gill Kohei Nishitani Masahiro Ishikawa Yugo Morita Hiromu Ito Sheila N. Bello-Irizarry Mark Ninomiya James D. Brodell Jr. Charles C. Lee Stephanie P. Hao Irvin Oh Chao Xie Hani A. Awad John L. Daiss John R. Owen Stephen L. Kates Edward M. Schwarz Gowrishankar Muthukrishnan 2019Bone Research2019,7,3:19
5Accuracy of the ultrasonic cardiac output monitor in healthy term neonates during postnatal circulatory adaptation显示文摘背景 Echocardiography 为测量血液动力学的价值被认为是一个标准答案。超声的心脏的输出监视器(USCOM ) 是为测量 hemodynamics 的一个新方法并且能提供照顾指导的非侵略的点。到目前为止,为出生不满一月的婴儿没有出版 USCOM 参考价值, USCOM 的精确性也没在这张人口被建立。我们试图相对出版 echocardiographic 数据在健康出生不满一月的婴儿决定精确性和 USCOM 的临床的用途,并且作为一个趋势监视器作为 echocardiography 的一种选择估计 USCOM 的可能的角色,到建立它测量的正常血液动力学的参数。90 个正常出生不满一月的婴儿的方法正确、左的心 hemodynamics 用 USCOM 在生活的开始的三天在循环改编期间被测量并且自动化了 oscillotonometry。结果心率从天显示出重要衰落一~三,从 126 ~ 120 (P < 0.001 ) 。收缩、心脏舒张、吝啬的动脉的压力都从 66 ~ 71 mmHg, 33 ~ 38 mmHg 和 44 ~ 49 mmHg 显著地增加了,分别地(P < 0.001 在每种情况中) 。恰好室的心脏的索引(RV-CI ) 没与 5.07 LHE Shao-ru ZHANG Cheng LIU Yu-mei SUN Yun-xia ZHUANG Jian CHEN Ji-mei Veronica M. Madigan Brendan E. Smith SUN Xin 2011Chinese Medical Journal2011,,15:14
6Gene Duplication and the Evolution of Plant MADS-box Transcription Factors显示文摘Since the first MADS-box transcription factor genes were implicated in the establishment of floral organ identity in a couple of model plants,the size and scope of this gene family has begun to be appreciated in a much wider range of species.Over the course of millions of years the number of MADS-box genes in plants has increased to the point that the Arabidopsis genome contains more than 100.The understanding gained from studying the evolution,regulation and function of multiple MADS-box genes in an increasing set of species, makes this large plant transcription factor gene family an ideal subject to study the processes that lead to an increase in gene number and the selective birth,death and repurposing of its component members.Here we will use examples taken from the MADS-box gene family to review what is known about the factors that influence the loss and retention of genes duplicated in different ways and examine the varied fates of the retained genes and their associated biological outcomes.Chiara A.Airoldi Brendan Davies 2012Journal of Genetics and Genomics2012,39,4:14
7Osteoclast fusion and regulation by RANKL-dependent and independent factors显示文摘Osteoclasts are the bone resorbing cells essential for bone remodeling.Osteoclasts are formed from hematopoietic progenitors in the monocyte/macrophage lineage.Osteoclastogenesis is composed of several steps including progenitor survival,differentiation to mononuclear pre-osteoclasts,fusion to multi-nuclear mature osteoclasts,and activation to bone resorbing osteoclasts.The regulation of osteoclastogenesis has been extensively studied,in which the receptor activator of NF-κB ligand(RANKL)-mediated signaling pathway and downstream transcription factors play essential roles.However,less is known about osteoclast fusion,which is a property of mature osteoclasts and is required for osteoclasts to resorb bone.Several proteins that affect cell fusion have been identified.Among them,dritic cell-specific transmembrane protein(DC-STAMP)is directly associated to osteoclast fusion in vivo.Cytokines and factors influence osteoclast fusion through regula-tion of DC-STAMP.Here we review the recently discovered new factors that regulate osteoclast fusion with specific focus on DC-STAMP.A better understanding of the mechanistic basis of osteoclast fusion will lead to the development of a new therapeutic strategy for bone disorders due to elevated osteoclast bone resorption.Cell-cell fusion is essential for a variety of cellular biological processes.In mammals,there is a limited number of cell types that fuse to form multinucleated cells,such as the fusion of myoblasts for the formation of skeletal muscle and the fusion of cells of the monocyte/macrophage lineage for the formation of multinucleated osteoclasts and giant cells.In most cases,cellcell fusion is beneficial for cells by enhancing function.Myoblast fusion increases myofiber size and diameter and thereby increases contractile strength.Multinucleated osteoclasts have far more bone resorbing activity than their mono-nuclear counterparts.Multinucleated giant cells are much more efficient in the removal of implanted materials and bacteria due to chronic infection than macrophages.Therefore,they are also called foreign-body giant cells.Cell fusion is a complicated process involving cell migration,chemotaxis,cell-cell recognition and attachment,as well as changes into a fusion-competent status.All of these steps are regulated by multiple factors.In this review,we will discuss osteoclast fusion and regulation.Lianping Xing Yan Xiu Brendan F Boyce 2012World Journal of Orthopedics2012,3,12:14
8Quantifying geological uncertainty in metamorphic phase equilibria modelling;a Monte Carlo assessment and implications for tectonic interpretations显示文摘Pseudosection modelling is rapidly becoming an essential part of a petrologist's toolkit and often forms the basis of interpreting the tectonothermal evolution of a rock sample,outcrop,or geological region.Of the several factors that can affect the accuracy and precision of such calculated phase diagrams, 'geological' uncertainty related to natural petrographic variation at the hand sample- and/or thin section-scale is rarely considered.Such uncertainty influences the sample's bulk composition,which is the primary control on its equilibrium phase relationships and thus the interpreted pressure-temperature(P-T) conditions of formation.Two case study examples-a garnet-cordierite granofels and a garnet-staurolite-kyanite schist-are used to compare the relative importance that geological uncertainty has on bulk compositions determined via(1) X-ray fluorescence(XRF) or(2) point counting techniques.We show that only minor mineralogical variation at the thin-section scale propagates through the phase equilibria modelling procedure and affects the absolute P-T conditions at which key assemblages are stable.Absolute displacements of equilibria can approach ±1 kbar for only a moderate degree of modal proportion uncertainty,thus being essentially similar to the magnitudes reported for analytical uncertainties in conventional thermobarometry.Bulk compositions determined from multiple thin sections of a heterogeneous garnet-staurolite-kyanite schist show a wide range in major-element oxides,owing to notable variation in mineral proportions.Pseudosections constructed for individual point count-derived bulks accurately reproduce this variability on a case-by-case basis,though averaged proportions do not correlate with those calculated at equivalent peak P-T conditions for a whole-rock XRF-derived bulk composition.The main discrepancies relate to varying proportions of matrix phases(primarily mica) relative to porphyroblasts(primarily staurolite and kyanite),indicating that point counting preserves small-scale petrographic features that are otherwise averaged out in XRF analysis of a larger sample.Careful consideration of the size of the equilibration volume,the constituents that comprise the effective bulk composition,and the best technique to employ for its determination based on rock type and petrographic character,offer the best chance to produce trustworthy data from pseudosection analysis.Richard M.Palin Owen M.Weller David J.Waters Brendan Dyck 2016Geoscience Frontiers2016,7,4:13
9Duodenal adenocarcinoma: Advances in diagnosis and surgical management显示文摘Duodenal adenocarcinoma is a rare but aggressive malignancy. Given its rarity, previous studies have traditionally combined duodenal adenocarcinoma(DA) with either other periampullary cancers or small bowel adenocarcinomas, limiting the available data to guide treatment decisions. Nevertheless, management primarily involves complete surgical resection when technically feasible. Surgery may require pancreaticoduodenectomy or segmental duodenal resection; either are acceptable options as long as negative margins are achievable and an adequate lymphadenectomy can be performed. Adjuvant chemotherapy and radiation are important components of multi-modality treatment for patients at high risk of recurrence. Further research would benefit from multiinstitutional trials that do not combine DA with other periampullary or small bowel malignancies. The purpose of this article is to perform a comprehensive review of DA with special focus on the surgical management and principles.Jordan M Cloyd Elizabeth George Brendan C Visser 2016World Journal of Gastrointestinal Surgery2016,8,3:13
10Stem Cell Regulation by Arabidopsis WOX Genes显示文摘功能的多样化跟随的基因扩大是在进化的主要力量。这的一个典型例子在 WUSCHEL 相关的 HOMEOBOX (WOX ) 基因家庭被看见,依照 Arabidopsis 干细胞管理者 WUSCHEL 命名。这里,我们在 WOX 基因家庭分析功能的分叉。除了形成层干细胞管理者 WOX4, WUS clade 的成员能在射击和花的干细胞维护代替 WUS 功能到不同的度。WUS 的干细胞功能要求正规 WUS 盒子,为和 TPL/TPR 合作抑压者的相互作用必要,而压抑的耳朵领域是非必需的,酸的领域仅仅似乎为女富饶被要求。与 WUS clade 相对照,古老的 WOX13 和 WOX9 clades 的成员不能支持干细胞维护。尽管 homeodomains 在 WUS 和 WOX9 clade 成员之间是可互换的,和正规 WUS 盒子的 WUS 兼容的 homeodomain 不为干细胞维护是足够的。我们的结果建议在射击和 Arabidopsis 的花的分裂组织的那个 WOX 函数被限制为现代 WUS clade,建议干细胞控制是一个导出的函数。除了 homeodomain 和 WUS 盒子的然而未被发现的功能的领域为这功能是必要的。Alicja Dolzblasz Judith Nardmann Elena Clerici Barry Causier Eric van der Graaff Jinhui Chen Brendan Davies Wolfgang Werr Thomas Laux 2016Molecular Plant2016,9,7:11
11Systematic review of nutrition screening and assessment in inflammatory bowel disease显示文摘BACKGROUND Malnutrition is prevalent in inflammatory bowel disease (IBD). Multiple nutrition screening (NST) and assessment tools (NAT) have been developed for general populations, but the evidence in patients with IBD remains unclear. AIM To systematically review the prevalence of abnormalities on NSTs and NATs, whether NSTs are associated with NATs, and whether they predict clinical outcomes in patients with IBD. METHODS Comprehensive searches performed in Medline, CINAHL Plus and PubMed. Included: English language studies correlating NSTs with NATs or NSTs/NATs with clinical outcomes in IBD. Excluded: Review articles/case studies;use of body mass index/laboratory values as sole NST/NAT;age<16. RESULTS Of 16 studies and 1618 patients were included, 72% Crohn’s disease and 28% ulcerative colitis. Four NSTs (the Malnutrition Universal Screening Tool, Malnutrition Inflammation Risk Tool (MIRT), Saskatchewan Inflammatory Bowel Disease Nutrition Risk Tool (SaskIBD-NRT) and Nutrition Risk Screening 2002 (NRS-2002) were significantly associated with nutritional assessment measures of sarcopenia and the Subjective Global Assessment (SGA). Three NSTs (MIRT, NRS-2002 and Nutritional Risk Index) were associated with clinical outcomes including hospitalizations, need for surgery, disease flares, and length of stay (LOS). Sarcopenia was the most commonly evaluated NAT associated with outcomes including the need for surgery and post-operative complications. The SGA was not associated with clinical outcomes aside from LOS. CONCLUSION There is limited evidence correlating NSTs, NATs and clinical outcomes in IBD. Although studies support the association of NSTs/NATs with relevant outcomes, the heterogeneity calls for further studies before an optimal tool can be recommended. The NRS-2002, measures of sarcopenia and developments of novel NSTs/NATs, such as the MIRT, represent key, clinically-relevant areas for future exploration.Suqing Li Michael Ney Tannaz Eslamparast Ben Vandermeer Kathleen P Ismond Karen Kroeker Brendan Halloran Maitreyi Raman Puneeta Tandon 2019World Journal of Gastroenterology2019,25,28:9
12Factors that mediate colonization of the human stomach by Helicobacter pylori显示文摘Helicobacter pylori(H.pylori)colonizes the stomach of humans and causes chronic infection.The majority of bacteria live in the mucus layer overlying the gastric epithelial cells and only a small proportion of bacteria are found interacting with the epithelial cells.The bacteria living in the gastric mucus may act as a reservoir of infection for the underlying cells which is essential for the development of disease.Colonization of gastric mucus is likely to be key to the establishment of chronic infection.How H.pylori manages to colonise and survive in the hostile environment of the human stomach and avoid removal by mucus flow and killing by gastric acid is the subject of this review.We also discuss how bacterial and host factors may together go some way to explaining the susceptibility to colonization and the outcome of infection in different individuals.H.pylori infection of the gastric mucosa has become a paradigm for chronic infection.Understanding of why H.pylori is such a successful pathogen may help us understand how other bacterial species colonise mucosal surfaces and cause disease.Ciara Dunne Brendan Dolan Marguerite Clyne 2014World Journal of Gastroenterology2014,20,19:8
13Consideration of corneal biomechanics in the diagnosis and management of keratoconus: is it important?显示文摘Keratoconus is a bilateral,non-inflammatory,degenerative corneal disease.The occurrence and development of keratoconus is associated with corneal thinning and conical protrusion,which causes irregular astigmatism.With the disruption of the collagen organization,the cornea loses its shape and function resulting in progressive visual degradation.Currently,corneal topography is the most important tool for the diagnosis of keratoconus,which may lead to false negatives among the patient population in the subclinical phase.However,it is now hypothesised that biomechanical destabilisation of the cornea may take place ahead of the topographic evidence of keratoconus,hence possibly assisting with disease diagnosis and management.This article provides a review of the definition,diagnosis,and management strategies for keratoconus based on corneal biomechanics.FangJun Bao Brendan Geraghty QinMei Wang Ahmed Elsheikh 2016Eye and Vision2016,3,1:8
14Cytoreductive surgery and intraperitoneal chemotherapy for colorectal peritoneal metastases显示文摘AIM:To systematically review the available evidence regarding cytoreductive surgery(CRS) and intraperitoneal chemotherapy(IPC) for colorectal peritoneal metastases(CPM).METHODS:An electronic literature search was carried out to identify publications reporting oncological outcome data(overall survival and/or disease free survival and/or recurrence rates)following CRS and IPC for treatment of CPM.Studies reporting outcomes following CRS and IPC for cancer subtypes other than colorectal were only included if data were reported independently for colorectal cancer-associated cases;in addition studies reporting outcomes for peritoneal carcinomatosis of appendiceal origin were excluded.RESULTS:Twenty seven studies,published between1999 and 2013 with a combined population of 2838patients met the predefined inclusion criteria.Included studies comprised 21 case series,5 case-control studies and 1 randomised controlled trial.Four studies provided comparative oncological outcome data for patients undergoing CRS in combination with IPC vs systemic chemotherapy alone.The primary indication for treatment was CPM in 96%of cases(2714/2838)and recurrent CPM(rCPM)in the remaining 4%(124/2838).In the majority of included studies(20/27)CRS was combined with hyperthermic intraperitoneal chemotherapy(HIPEC).In 3 studies HIPEC was used in combination with early post-operative intraperitoneal chemotherapy(EPIC),and 2 studies used EPIC only,following CRS.Two studies evaluated comparative outcomes with CRS+HIPEC vs CRS+EPIC for treatment of CPM.The delivery of IPC was performed using an'open'or'closed'abdomen approach in the included studies.CONCLUSION:The available evidence presented in this review indicates that enhanced survival times can be achieved for CPM after combined treatment with CRS and IPC.Reza Mirnezami Brendan J Moran Kate Harvey Tom Cecil Kandiah Chandrakumaran Norman Carr Faheez Mohamed Alexander H Mirnezami 2014World Journal of Gastroenterology2014,20,38:6
15An Alzheimer's Disease-Relevant Presenilin-1 Mutation Augments Amyloid-Beta-Induced Oligodendrocyte Dysfunction显示文摘研究表明,家族性阿尔茨海默病(FAD)患者处于无症状或临床前阶段时,脑白质即出现病理改变。此种改变在髓鞘破坏及阿尔茨海默病(AD)病理生理中的作用有待进一步研究阐明。笔者前期研究证实,三重转基因AD小鼠(人淀粉前体蛋白基因的Swedish突变,早老素-1 M146V(PS1M146V)敲入突变及tauP301L突变)表现出类似FAD患者的髓鞘破坏,Aβ1-42促进了白质病变。本研究离体实验证实,PS1M146V变异导致小鼠少突胶质前体细胞在分化过程中易出现类似Aβ1-42诱导的变化。PS1M146V的表达损伤少突胶质前体细胞的功能并影响髓鞘碱性蛋白的分布,暴露于Aβ1-42加重此影响。由PS1M146V及Aβ1-42导致的髓鞘破坏及髓鞘碱性蛋白在亚细胞结构中的误定位可被TWS119(糖原合成激酶(GSK)-3β抑制剂)抑制,提示GSK-3β激酶活动在此病理过程中有重要作用。综上所述,本研究有助于增加对AD早期无症状阶段,由PS1M146V及Aβ1-42导致少突胶质细胞功能异常及髓鞘损伤的机制的理解,并提供了针对少突胶质细胞预防AD相关白质病变的新的治疗靶点。MAYA K.DESAI BRENDAN J.GUERCIO WADE C.NARROW WILLIAM J.BOWERS 2011神经损伤与功能重建2011,6,2:6
16Sieving characteristics of cytokine-and peroxide-induced epithelial barrier leak:Inhibition by berberine显示文摘AIM:To study whether the inflammatory bowel disease(IBD)colon which exhibits varying severity and cytokine levels across its mucosa create varying types of transepithelial leak.METHODS:We examined the effects of tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ),interleukin-1-β(IL1β)and hydrogen peroxide(H_2O_2)-singly and in combinations-on barrier function of CACO-2 cell layers.Our focus was on the type(not simply the magnitude)of transepithelial leak generated by these agents as measured by transepithelial electrical resistance(TER)and transepithelial flux of ^(14)C-D-mannitol,3H-Lactulose and ^(14)C-Polyethylene glycol as radiolabeled probe molecules.The isoquinoline alkaloid,berberine,was then examined for its ability to reduce specific types of transepithelial leak.RESULTS:Exposure to TNF-α alone(200 ng/mL;48 h)induced a 50% decrease in TER,i.e.,increased leak of Na^+ and Cl--with only a marginal but statistically significant increase in transepithelial leak of ^(14)C-mannitol(Jm).Exposure to TNF-α + IFN-γ(200 ng/mL;48 h)+ IL1β(50 ng/mL;48 h)did not increase the TER change(from TNF-α alone),but there was now a 100% increase in J_m.There however was no increase in transepithelial leak of two larger probe molecules,~3H-lactulose and ^(14)C-polyethylene glycol(PEG).However,exposure to TNF-α + IFN-γ + IL1β followed by a 5 h exposure to2 mmol/L H_2O_2 resulted in a 500% increase in ^(14)C-PEG leak as well as leak to the luminal mitogen,epidermal growth factor.CONCLUSION:This model of graded transepithelial leak is useful in evaluating therapeutic agents reducing IBD morbidity by reducing barrier leak to various luminal substances.Katherine M DiGuilio Christina M Mercogliano Jillian Born Brendan Ferraro Julie To Brittany Mixson Allison Smith Mary Carmen Valenzano James M Mullin 2016World Journal of Gastrointestinal Pathophysiology2016,7,2:6
17AKT/PKB Signaling: Navigating Downstream显示文摘Brendan D. Manning Lewis C. Cantley 2007Cell2007,,7:6
18Developmental DNA methyltransferase expression in the fire ant Solenopsis invicta显示文摘Sasha Kay Daniel Skowronski Brendan G. Hunt 2018Insect Science2018,25,1:4
19英国考文垂大学成人护理专业方向本科课程设置及启示显示文摘该文介绍了英国考文垂大学成人护理专业方向本科课程设置,包括课程设置目标、课程设置的结构和内容、课程安排,并对其课程设置特色进行分析,以期为我国护理本科人才培养和课程改革提供参考。秦芳 张立力 罗晨玲 Brendan Greaney 史蕾 2020中华护理教育2020,17,2:4
20Adherence to surveillance endoscopy following hospitalization for index esophageal variceal hemorrhage显示文摘AIM To investigate patient adherence to surveillance endoscopy after index esophageal variceal hemorrhage and the extent to which adherence influences outcomes.METHODS We reviewed the records of patients with cirrhosis admitted to the medical intensive care unit between 2000 and 2014 for first time esophageal variceal hemorrhage treated with endoscopic variceal ligation who were subsequently discharged and scheduled for surveillance endoscopy at our medical center. Demographic and clinical data were obtained through the medical records, including etiology of cirrhosis, completion of variceal obliteration, attendance at surveillance endoscopy, zip code of primary residence, distance from home to hospital, insurance status, rehospitalization for variceal hemorrhage, beta-blocker at discharge, pharmacologically treated psychiatric disorder, and transplant free survival. RESULTS Of 99 consecutive survivors of esophageal variceal bleeding, the minority(33) completed variceal obliteration and fewer(12) adhered to annual surveillance. Completion of variceal obliteration was associated with fewer rehospitalizations for variceal rebleeding(27% vs 56%, P = 0.0099) and when rehospitalizations occurred, they occurred later in those who had completed obliteration(median 259 d vs 207 d, P = 0.0083). Incomplete adherence to endoscopic surveillance was associated with more rehospitalizations for variceal rebleeding compared to those fully adherent to annual endoscopic surveillance(51% vs 17%, P = 0.0328). Those adherent to annual surveillance were more likely to be insured privately or through Medicare compared to those who did not attend post-hospital discharge endoscopy(100% vs 63%, P = 0.0119).CONCLUSION Most patients do not complete variceal obliteration after index esophageal variceal hemorrhage and fewer adhere to endoscopic surveillance, particularly the uninsured and those insured with Medicaid.Brendan T Everett Steven D Lidofsky 2018World Journal of Gastrointestinal Surgery2018,10,4:4
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