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Education-based approach to addressing non-evidence-based practice in preventing NSAiD-associated gastrointestinal complications

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World Journal of Gastroenterology 2009年第47期15卷 5953-5959页

作者： Angel Lanas Juan v Esplugues Javier Zapardiel Eduardo Sobreviela Service of Digestive Diseases University Hospital University of ZaragozaInstituto Aragonés de Ciencias de la Salud(IACS)Centros de Investigación en Red de Enfermedades Hepáticas y Digestivas(CIBERehd)C/San Juan Bosco 15 50009 ZaragozaSpain Department of Pharmacology University of ValenciaCIBERehdAv.Vicent Andrés Estellés s/n46100 BurjassotValenciaSpain Department of Medical AstraZeneca Farmacéutica SpainParque NorteEdificio RobleC/Serrano Galvache 5628033 MadridSpain MediClin-Quintiles c/Sardenya no 541-54308024 BarcelonaSpain

AiM:To evaluate an evidence-based educational program for improving strategies for prevention of non-steroidal anti-inflammatory drug(NSAiD)-associated gastrointestinal(Gi)complications. METHODS:Four hundred and fifty-six specialists replied to a questionnaire that covered issues related to NSAiD-induced adverse *** also collected data from their last five consecutive patients before and after they had attended an evidence-based seminar on Gi prevention strategies. RESULTS:Four hundred and forty-one of 456 specialists(96.7%)participated in the survey,and 382(83.7%)in the education-based study that recorded data from 3728 *** specialists overestimated the risk of Gi complications with NSAiDs,underestimated the Gi safety profile of coxibs,but were aware of the risk factors and of the current prevention *** pump inhibitors were co-prescribed with NSAiDs in>80% of patients with and without risk *** educational program had little impact on prescribing ***:Specialists are informed of advances in NSAiD-associated adverse effects and have high rates of Gi-prevention *** educational program did not alter these rates.

关键词：教育计划胃肠道并发症消炎药类固醇基础证据非甾体抗炎药

Formal Auditory Training with individuals after Traumatic Brain injury

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Health 2017年第6期9卷 975-986页

作者： andréa Tortosa Marangoni ítalo Capraro Suriano Ana Karina Lima Buriti Daniela Gil Universidade Federal de Sã o Paulo—UNiFESP S&#227 o Paulo Brazil

Purpose: Establishing the effects of a formal auditory training program on individuals, after a traumatic brain injury by means of behavioral and electrophysiological tests. Study Design: Longitudinal study. Setting: Study conducted at the electrophysiology clinic of the Federal University of São Paulo. Patients: Nine individuals with normal hearing, 20 to 37 years old, who were exposed to severe traumatic brain injury (score of 3 - 8 on the Glasgow Coma Scale upon hospital admission), 6 - 24 months earlier (11 months on average) and had imaging tests showing diffuse axonal injury with or without associated focal lesion. intervention(s): subjected to a formal auditory training program in an acoustic booth involving eight 45-minute sessions aiming at training the auditory temporal order judgment (frequency and duration of sounds), auditory closure, and figure-ground separation skills for verbal and nonverbal sounds in monotic and dichotic listening tasks. The sessions and activities, in each session, were organized in increasing order of complexity to challenge the auditory system. in order to establish the efficacy of the auditory training, all participants were subjected to behavioral and electrophysiological assessments of the auditory processing, before and after the formal auditory training. Results: On the electrophysiological assessment, the absolute latencies of waves iii and v, and of interpeak interval i-v decreased after the auditory training. However, the P300 did not exhibit a significant difference in either the latency or the amplitude parameters. Regarding the behavioral assessment of the auditory processing, it was verified that adequacy of the auditory figure-ground skills for verbal sounds, and the temporal order judging skills. Conclusions: individuals with diffuse axonal injury following a severe traumatic brain injury exhibited an improvement of central auditory processing after formal auditory training, as manifested on electrophysiologica

关键词： Hearing Evoked Potentials Auditory Neuronal Plasticity Brain injuries

Physical activity and cardiovascular risk factors in university students in the city of Leon, Mexico

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Health 2013年第11期5卷 1861-1865页

作者： Maciste H. Macías-Cervantes victoriano Pérez-vázquez Antonio E. Rivera-Cisneros andrés Martínez-Rivera Joel Ramírez-Emiliano Carlos Kornhauser Clínica SAiN 2000 University DeLa Salle Bajío León México Department of Medical Sciences University of Guanajuato León México Division of Health Sciences University of Guanajuato León México

Objectives: Recent changes in life style have increased obesity, smoking and sedentary habits in the entire population. Obesity and overweight frequency have trebled in Mexico in the last few decades. The presence and frequency of cardiovascular risk factors were determined in students at the Universidad DeLa Salle Bajío, both newly admitted and in advanced years. Material and methods: Anthropometric variables, serum glucose, total cholesterol levels, blood hemoglobin and hematocrit were obtained and assessed in 4814 students, 1507 recently admitted and 1507 advanced students. Results: The prevalence of obesity was 15.3%, sedentariness 33.8%, hypercholesterolemia 8.16%, smoking habits 15.8%, and alcohol consumption 12.1%. Body mass index (BMi) (23.5 ± 4 vs. 22.7 ± 4), waist/ abdomen index (0.84 ± 0.06 vs. 0.83 ± 0.06) and serum cholesterol (3.54 mmol/L ± 0.79 vs. 3.98 mmol/L ± 0.77) were greater in the advanced students

关键词： Cardiovascular Risk Factors University Students Smoking Physical Activity

Fighting Poor Quality Medicines: Development, Transfer and validation of Generic HPLC Methods for Analyzing Two WHO Recommended Antimalarial Tablets

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American Journal of Analytical Chemistry 2015年第2期6卷 127-144页

作者： Jérémie Kindenge Mbinze Achille Yemoa Pierre Lebrun Pierre-Yves Sacré védaste Habyalimana Nicodème Kalenda andré Bigot Eugène Atindehou Philippe Hubert Roland Djang’eing’a Marini University of Liege (ULg) Department of Pharmacy CIRM Laboratory of Analytical Chemistry Li&egrave ge Belgium Laboratoire d’Analyse des Mé dicaments D&eacute partement de Galé nique et d’Analyse des Mé dicaments Universit&eacute de Kinshasa Kinshasa XI Democratic Republic of Congo UFR Pharmacie Facult&eacute des Sciences de Santé Universit&eacute d’Abomey Calavi Cotonou B&eacute nin Rwanda Biomedical Center Medical Procurement and Production Division Butare Rwanda Université Fé lix Houphouet Boigny Abidjan C&ocirc te d’ivoire

As serious but neglected public health problems, poor quality medicines, i.e. for antimalarial medicines, urged to be fought. One of the approaches is to consider the analytical chemistry and separative techniques. in this study, a generic liquid chromatographic method was firstly developed for the purpose of screening 8 antimalarial active ingredients, namely amodiaquine (AQ), piperaquine (PPQ), sulfalene (SL), pyrimethamine (PM), lumefantrine (LF), artesunate (AS), artemether (AM) and dihydroartemisinine (DHA) by applying DoE/DS optimization strategy. Since the method was not totally satisfying in terms of peak separation, further experiments were undergone applying the same development strategy while splitting the 8 ingredients into five groups. Excellent prediction was observed prior to correlation between retention times of predicted and observed separation conditions. Then, a successful geometric transfer was realized to reduce the analysis time focusing on the simultaneous quantification of two WHO’s recommended ACTs in anti-malarial fixed-dose combination (AM-LF and AS-AQ) in tablets. The optimal separation was achieved using an isocratic elution of methanol-ammonium formate buffer (pH 2.8;10 mM) (82.5:17.5, v/v) at 0.6 ml/min through a C18 column (100 mm × 3.5 mm, 3.5 μm) thermostated at 25℃. After a successful validation stage based on the total error approach, the method was applied to determine the content of AM/LF or AS/AQ in seven brands of antimalarial tablets currently marketed in West, Central and East Africa. Satisfying results were obtained compared to the claimed contents.

关键词： Antimalarial ACT Simultaneous Determination Poor Quality Substances Design of Experiments Design Space Method Transfer Accuracy Profile

Open versus laparoscopic cholecystectomies in patients with or without type 2 diabetes mellitus in Spain from 2003 to 2013

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Hepatobiliary & Pancreatic Diseases international 2016年第5期15卷 525-532页

作者： JoséM de Miguel-Yanes Manuel Méndez-Bailón Rodrigo Jiménez-García valentín Hernández-Barrera Napoleón Pérez-Farinós Fernando Turégano Nuria Munoz-Rivas Ana López-de-andrés internal Medicine Department Hospital General Universitario“Gregorio Maranón”46Doctor Esquerdo28007MadridSpain internal Medicine Department Hospital Clínico San CarlosCalle Profesor Martín Lagos28040MadridSpain Preventive Medicine and Public Health Department Health Sciences FacultyRey Juan Carlos UniversityAvenida de AtenasAlcorcón28292MadridSpain Spanish Agency of Alimentary Safety and Nutrition Ministry of HealthSocial Policy and Equality56Alcalá28071MadridSpain internal Medicine Department Hospital Infanta Leonor80Avenida Gran Vía del Este28031MadridSpain Surgery Department Hospital General Universitario“Gregorio Maranón”46Doctor Esquerdo28007MadridSpain

BACKGROUND: This study aimed to compare the rates of open and laparoscopic cholecystectomies and outcomes in patients with or without type 2 diabetes mellitus (T2DM) in Spain from 2003 to 2013. METHODS: We collected all cases of open and laparoscopic cholecystectomies using national hospital discharge data and evaluated the annual cholecystectomy rates stratiifed by T2DM status. We analyzed tendency for in-hospital mortality (iHM). We also analyzed the impact of T2DM on iHM in patients who underwent cholecystectomies. RESULTS: We identiifed 611 533 cholecystectomies (71.3%laparoscopic) in the patients, in whom 78 227 (12.8%) patients had T2DM. The rates of open cholecystectomies were 3-fold higher (130.0/105 vs 41.1/105) in patients with T2DM than in those without T2DM, and the rate of laparoscopic cholecys-tectomies was almost 2-fold higher (195.2/105 vs 111.8/105) in patients with T2DM. The annual rate of laparoscopic pro-cedures showed an 11-year relative increase of 88.3% (from 117.0/105 to 220.3/105) in T2DM and 49.2% (from 79.2/105 to 118.2/105) in patients without T2DM (Pive decrease of 27.6% in patients with T2DM and 37.9% in those without T2DM (Pic cho-lecystectomy was increased in the 11 years, whereas the rate of emergency open cholecystectomies was decreased (both Pivariate analysis revealed that older age, higher comorbidity and emergency cholecystectomy were associated with a higher iHM. Compared with patients without T2DM, patients with T2DM demonstrated a lower iHM after open cholecystectomy [OR=0.82 (0.78-0.87)], but a higher iHM after laparoscopic cholecystectomy (OR=1.18 (1.03-1.35))Time-trend analyses showed a signiifcant reduction in iHM in patients with or without T2DM after the two procedures. CONCLUSiON: The rate of cholecystectomy was higher in patients with T2DM, and laparoscopic cholecystectomy was p

关键词： diabetes mellitus cholecystectomy mortality in-hospital mortality

视网膜色素瘤和残余中心视野患者的全视野视网膜电图、多焦视网膜电图及多焦诱发电位研究

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世界核心医学期刊文摘（眼科学分册） 2005年第5期1卷 18-19页

作者： Ponjavic v. andr'Gr■asson S. L. Granse 程燕 Department of Ophthalmology University Hospital of Lund S-221 85 Lund Sweden Dr.

Purpose: To evaluate (with three different electrophysiological methods) the r esidual retinal function in a selected group of patients with retinitis pigmento sa and remaining small central visual fields. Methods: Fourteen patients from se veral different genetic subgroups, who had been followed with visual acuity and visual field testing for periods up to 32 years, were examined. Ophthalmological examination included full-field electroretinography (ERG), multifocal electror etinography (mfERG) and multifocal visual evoked potential (mfvEP). Results: The ERGs were severely reduced in all patients. The mfERGs demonstrated the residua l central retinal function in five of the patients. The mfvEPs showed measurable amplitudes centrally in most of the patients. The follow-up examinations demon strated the slowly progressive course of the disease with preservation or only s light further loss of visual fields over a period of 7-32 years. Conclusion: Pa tients with retinitis pigmentosa may not always follow the typical natural cours e with progressive loss of visual fields, which may in some patients remain unaf fected over several decades. Multifocal ERG and mfvEP may be clinically useful f or evaluating remaining visual function in these patients.

关键词：视网膜电图中心视野诱发电位视网膜功能眼科检查视功能电位波幅电生理方法临床评估亚组

Clinical and electrocardiographic characteristics of acute pulmonary embolism with ST elevation in the right precordial leads

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South China Journal of Cardiology 2017年第2期18卷 114-119页

作者：詹中群易园 Kjell C.Nikus andrés Ricardo Pérez-Riera Department of Cardiology Shenzhen Guangming Central Hospital Department of Cardiology Heart CenterTampere University Hospitaland School of MedicineTampere University Post graduation mastermind of Scientific Methodology discipline ABC Faculty of MedicineABC Foundation

Background ST-segment elevation （STE） in the right precordial leads is an ECG manifestation of acute pul- monary embolism （APE） and some patients present with concomitant STE in the inferior leads. This clinical enti- ty apparently deserves careful attention. Methods We included 42 APE patients presenting with i〉 0.1 mv STE in leads v1-v3/v4. Clinical and ECG characteristics in 15 patients with and 27 without STE in the inferior leads were included for comparison. Results Of the 42 patients, 98% were classified as high or intermediate risk patients, 79% showed ECG signs of right ventricular strain （RvS） and 83% showed the maximal amplitude of STE in leads v1-v2. The patients with STE in the inferior leads presented with faster heart rate （131±30 vs. 108_＋21 beats/min, P=0.015）, lower systolic blood pressure （107±22 vs. 123_＋26 mmHg, P=0.043）, higher incidence of ele- vated troponin （87% vs. 56%, P=0.040） and need to intensify therapy （73% vs. 33%, P=0.013）. Conclusions STE in the right precordial leads is an ECG manifestation of intermediate to high risk in APE patients. The ECG characteristics include the maximal amplitude of STE in leads v1-v2 and the RvS pattern. Simultaneous STE in the inferior and right precordial leads is associated with hemodynamic instability and need for intensified therapy.

关键词： acute pulmonary embolism ECG ST-segment elevation myocardial infarction

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U型潜艇

模型世界 2019年第5期 40-45页

作者： andrés Montiel

SPECiAL NAvY出品的ⅡA型U型潜艇编号:SH72002套件内包含68个灰色塑料件、1 3个米色树脂件、28个白色金属件、2个可动金属件、1套镀镍蚀刻片、1份说明书、1套水贴和包含4种涂装的上色指南。2A型U型潜艇:下文简称:U艇)是在第二次世界大... 详细信息

SPECiAL NAvY出品的ⅡA型U型潜艇编号:SH72002套件内包含68个灰色塑料件、1 3个米色树脂件、28个白色金属件、2个可动金属件、1套镀镍蚀刻片、1份说明书、1套水贴和包含4种涂装的上色指南。2A型U型潜艇:下文简称:U艇)是在第二次世界大战爆发前秘密研发的。一共有50艘不同改型的2型U艇被建造,其中6艘为2A型。它们都在1935年开始服役,并且经历了整个二战。纳粹计划将这型U艇作为近岸潜艇,发展自Cv-707潜艇,由荷兰公司Nv ingenieur-skantoor voor Scheepsbouw den Haag(i.v.S)进行研发(此公司由德国在一战后设立,用来逃避凡尔赛条约的限制从而维持和继续发

关键词：潜望镜指挥塔

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欧洲猛禽和鸮类监测:现状以及未来的需求

AMBiO－人类环境杂志 2008年第6期37卷 390-394页

作者： andrás Kovács Ubbo C.C.Mammen Chris v.Wernham 丁莉匈牙利鸟类与自然保护协会巴伐利亚鸟类保护协会英国鸟类学基金(BTO)

欧洲现有的56种猛禽和鸮类中有64%保护状况不佳。除了其自身需要保护以外,猛禽和鸮类还是更广泛的环境"健康"的哨兵,因为它们是广泛分布的顶极食肉动物,相对易于监测,而且对多种地理尺度内的环境变化敏感。随着全球越来越意识到生物多... 详细信息

欧洲现有的56种猛禽和鸮类中有64%保护状况不佳。除了其自身需要保护以外,猛禽和鸮类还是更广泛的环境"健康"的哨兵,因为它们是广泛分布的顶极食肉动物,相对易于监测,而且对多种地理尺度内的环境变化敏感。随着全球越来越意识到生物多样性损失的加快,而欧盟也制定了相关的具有前瞻性的生物多样性政策,这都迫切需要增加泛欧洲范围内国家监督猛禽种群的计划的合作。本文我们描述了对这个目的有贡献的现有项目,特别是现有的"MEROS"项目,对欧洲22个鸟盟成员国的国家猛禽监测现有状况的问卷调查的结果,一个增强的泛欧洲猛禽监测计划所面临的挑战,以及一些有效获得有助于该计划的专家意见的建议方式。

关键词：猛禽欧洲监测生物多样性环境变化食肉动物国家监督问卷调查