检索结果-南通市图书馆

丙泊酚联合应用咪达唑仑和（或）芬太尼对肠镜检查后早期认知功能障碍的影响

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

麻醉与镇痛 2011年第6期7卷 87-96页

作者： Usha Padmanabhan mbbs, FANZCA kate leslie, mbbs, MD, MEpi, FANZC/~ Audrey SingYi Eer Paul Maruff, PhD Brendan S. Silbert, mbbs, FANZCA 刘伍（译）李士通（校） Department of Anaesthesia and Pain Management Royal Melbourne Hospita Department of Pharmacology University of Melbourne CogState Ltd Centre for Neurosdence University of Melbourne Centre for Anaesthesia Department of Surgery University of Melbourne Melbourne Australia 不详

背景对于镇静药如何联合应用可以使认知功能障碍最小化并提供良好的术中镇静状态，目前尚未有定论。我们希望确认的是：对于择期门诊肠镜检查的患者来说，与丙泊酚联合应用咪达唑仑和（或）芬太尼相比，单用丙泊酚麻醉在患者出院时是否... 详细信息

背景对于镇静药如何联合应用可以使认知功能障碍最小化并提供良好的术中镇静状态，目前尚未有定论。我们希望确认的是：对于择期门诊肠镜检查的患者来说，与丙泊酚联合应用咪达唑仑和（或）芬太尼相比，单用丙泊酚麻醉在患者出院时是否能够减轻认知功能障碍。方法选择200例门诊肠镜检查的成年患者，随机分为静脉镇静单用丙泊酚组和丙泊酚联合咪达唑仑和（或）芬太尼组。在给予镇静药之前使用计算机化CogState测验（CogstateTM．，Melbourne，Auslralia）检测患者的基础认知功能。整个过程记录镇静药的用量、镇静深度（通过双频指数和警觉镇静评分判定）、并发症和可治疗性。患者从镇静状态恢复后立即询问可回忆出的内容，并在患者出院时重复测试一次，记录患者的恢复时间、恢复质量以及护理满意程度。结果在丙泊酚加辅助药组，84例接受芬太尼50μg（25-100）[中位数（范围）]和57例接受咪达唑仑2mg（0．5。10）。患者出院时认知功能不如基准水平。而两组在出院水平和基准水平之间认知功能的变化上，组间无显著差异。出院时，18．5％的患者认知功能受损的程度相当于血液中含有0．05％乙醇浓度。丙泊酚联合咪达唑仑和（或）芬太尼比单用丙泊酚能使手术镇静状态更好，手术时间更短。两组在恢复时间、唤醒、梦境、恢复质量和患者对护理的满意度也相似。应用咪达唑仑大于2mg是预测患者出院时出现认知功能障碍的一个因素。结论在择期的门诊肠镜检查时，患者出院时普遍存在认知功能障碍。丙泊酚联合咪达唑仑和（或）芬太尼镇静并没有比单独使用丙泊酚产生更严重的认知功能障碍。此外，添加辅助药使结肠镜检查更轻松，且不增加并发症的发生率，不延长恢复时间。

关键词：认知功能障碍结肠镜检查咪达唑仑联合应用丙泊酚芬太尼检查后成年患者

B-Aware试验中BIS监测对远期生存率的影响

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

麻醉与镇痛 2012年第2期8卷 88-96页

作者： kate leslie, mbbs Paul S. Myles Andrew Forbes Matthew T. V. Chan 何欣（译）翁莹琪（校）郭曲练（校） Department of Anaesthesia and Pain Management Royal Melbourne Hospital Department ofPharmacology University of Melbourne Department of Anaesthesia and Perioperative Medi- cine Alfred Hospital Academic Board of Anaesthesia and Perioperative Medicine Monash U-niversity Melbourne National Health and Medical Research CouncilCanberra Department ofEpidemiology and Preventive Medicine Monash University Melbourne Australia Departmentof Anaesthesia and Intensive Care The Chinese University of Hong I（ong Hong I（ong People＇sRepublic of China

背景当使用脑电双频指数（bispectral index，Bis）监测指导麻醉药用量时，通常仅需要较低剂量的镇静药，如果用较低剂量的麻醉药，术中低血压和器官毒性作用也许能避免。然而，这是否能减少严重并发症和术后死亡率还存争议。***试验将2... 详细信息

背景当使用脑电双频指数（bispectral index，Bis）监测指导麻醉药用量时，通常仅需要较低剂量的镇静药，如果用较低剂量的麻醉药，术中低血压和器官毒性作用也许能避免。然而，这是否能减少严重并发症和术后死亡率还存争议。***试验将2463例术中知晓高危的患者随机分为BIS指导麻醉组和常规麻醉组。我们假设使用BIS指导麻醉组患者死亡、心肌梗死（myocardial infarction，MI）和卒中的风险都低于常规麻醉组患者。方法对术后30天尚存活的所有患者的医疗记录进行回顾，记录他们的死亡日期、死亡原因以及心肌梗死或卒中的发生情况．然后对所有存活的点者主牛行由话随访．本研究的主要终点是存活。结果随访时间中位值4．1年（全距：0－6．5年），参加试验的患者中有548例（22．2％）术后死亡，220例（8．9％）发生了心肌梗死，115例（4．7％）发生卒中。BIS监测组与常规麻醉组的死亡风险没有显著差异{危害比=0．86[95％可信区间（CI）：0．72-1．01]；P=0．07]。但是，倾向性评分分析显示，BIS值〈40、持续时间〉5分钟的患者与其他BIS监测组的患者相比，死亡的危害比为1．41（95％CI：1．02-1．95；P=0．039），并且心肌梗死的优势比（OR）为1．94（95％CI：1．12-3．35；P=0．01），卒中的优势比为3．24（95％CI：1.29-8．07；P=0．01）。结论在B-Aware试验患者中，采用了BIS指导麻醉且从未出现BIS值低于40并持续超过5分钟，与存活率的增加及并发症的减少相关。

关键词： BIS监测 e试验远期生存率麻醉药用量术后死亡率严重并发症心肌梗死脑电双频指数

B-Aware研究中术中知晓患者的创伤后应激障碍

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

麻醉与镇痛 2011年第5期7卷 68-74页

作者： kate leslie, mbbs, MD, MEpi, FANZCA Matthew T. V. Chan, mbbs, FANZCA Paul S. myles, mbbs, MD, MPH, FANZCA, FCARSCI, FRCA Andrew Forbes, MSc, PhD Timothy J. McCulloch, mbbs, BSc （Med）, FANZCA 谢珺田（译） Department of Anaesthesia and Pain Management Royal Melbourne Hospital Department of Pharmacology University of Melbourne Melbourne Australia Department of Anaesthesia and Intensive Care The Chinese University of Hong Kong Hong Kong People＇s Republic of China Department of Anaesthesia and Perioperative Medicine Alfred Hospital Academic Board of Anaesthesia and Perioperative Medicine Monash University Melbourne National Health and Medical Research Council Canberra Department of Epidemiology and Preventive Medicaine Monash University Melbourne Department of Anaesthetics University of Sydney Department of Anaesthetics Royal Prince Alfred Hopital Sydney Australia 不详

背景术中知晓的长期影响差异巨大，部分患者没有任何长期影响，而另一些患者则可导致严重和持久的心理障碍。本研究比较了随机化B—Aware研究中，发生明确术中知晓患者与未发生明确术中知晓患者创伤后应激障碍（postlraumaticstressdiso... 详细信息

背景术中知晓的长期影响差异巨大，部分患者没有任何长期影响，而另一些患者则可导致严重和持久的心理障碍。本研究比较了随机化B—Aware研究中，发生明确术中知晓患者与未发生明确术中知晓患者创伤后应激障碍（postlraumaticstressdisorder，PTSD）的发生率。方法我们采用配对群体设计，旨在随访发生明确术中知晓的13例患者。每1例发生术中知晓的患者均按年龄、性别、手术类型、手术日期及手术医院配比4例对照。以临床术后应激障碍评分对每1例术中知晓及对照患者进行面对面的访谈。结果本研究收集数据资料的时间从2006年6月到2007年3月，随访的中位数时间5．3年（范围4．3-5．7年）。其间发生明确术中知晓的13例患者中6例去世，7例患者中的5例（71％）与25例对照中的3例（12％）在随访时点表现符合PTSD的诊断标准（校正的比值比=13．3[95％的可信区间为1．4-650]，P=0．02）。症状出现时间中位数时间为术后14天（范围7-243天），症状持续时间的中位数为4．7年（范围4．4-5．6年）。结论PTSD在B-Aware研究中有明确术中知晓的患者中常见而且持久。全麻下应强化预防患者术中知晓的措施。

关键词：创伤后应激障碍术中知晓患者手术类型 PTSD 中位数心理障碍数据资料

Change in Functional Status from Preoperative to One Year Postoperative in Patients Who Have Undergone Elective Open-Heart Surgery: A Repeated-Measures Study

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Cardiovascular Diseases 2024年第6期14卷 421-433页

作者： A. kate MacPhedran David Barker Mark Marbey Kieran Fogarty Physical Therapy Program Morosky College of Health Professions and Sciences Gannon University Erie PA USA Interdisciplinary Health Sciences PhD Program College of Health and Human Sciences Western Michigan University Kalamazoo MI USA Organizational Learning and Leadership PhD Program College of Humanities Education and Social Sciences Gannon University Erie PA USA Cardiac Surgery Services AHN Saint Vincent Health Center Erie PA USA

Purpose: Although patient-related factors affect surgical outcomes, preoperative functional status is not measured by any cardiac risk score. Functional status can, however, be objectively measured using validated outcome tools such as the Late-Life Function and Disability Instrument (LLFDI). The purpose of this study was to determine 1) if there was a change over time in functional status, as measured by the LLFDI, in patients who underwent elective cardiac surgery, and if so, 2) what specific aspect(s) of functional status changed. Methods: A prospective longitudinal study of one year was conducted on elective cardiac surgery patients (n = 43) using the self-reported LLFDI, which measures Disability Frequency (frequency of participation in social tasks), Disability Limitation (ability to participate in social tasks) and Function Total (ease in performing routine activities). Higher scores indicate increased function and decreased disability. LLFDI scores were compared at three times (preoperative, six-week and one-year postoperative) using repeated measures ANOVA. Post hoc pairwise comparison was conducted for specific interactions. Results: Both Function Total and Disability Frequency significantly changed over time (p = 0.047 and p = 0.013, respectively). Specifically, patients’ function level was significantly higher one-year postoperative compared to preoperative (M difference = +3.48, SE = 1.48, p = 0.026). Likewise, Disability Frequency scores were significantly higher (i.e. more active) at one-year postoperative versus preoperative (M difference= +5.98, SE = 2.19, p = 0.033). Disability Limitation scores were not significantly different between any time points (p > 0.05). Conclusion: By one-year postoperative, patients demonstrated increased ease in their routine physical activities and were more participatory in social life tasks. Individuals who underwent elective cardiac surgery took more than six weeks to detect notable improvement in functional status,

关键词： Functional Status Elective Cardiac Surgery Late-Life Function and Disability Instrument

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

爱尔兰潜藏着的教育实力

教师博览（上旬刊） 2024年第5期 46-47页

作者： kate 不详

与英国隔海相望的爱尔兰,有着“欧洲硅谷”的美誉,每年迎来送往的全球商人络绎不绝。更让人感到不可思议的是,这还是一个盛产美国总统的国家——在46任总统中,近一半是爱尔兰裔或有着爱尔兰血统,其中也包括美国现任总统拜登。

关键词：现任总统爱尔兰不可思议美国

The Experience and Impact of a Fitbit-Based Physical Activity and Sleep Hygiene Intervention for Older Adults Experiencing Cognitive Decline

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Advances in Aging Research 2024年第3期13卷 41-59页

作者： kate Walker Chris Griffiths Jen Yates Louise Birkett-Swan Farah Hina Chee Siang Ang Research and Innovation Department Northamptonshire Healthcare NHS Foundation Trust Northampton UK Institute of Mental Health University of Nottingham Nottingham UK Dementia and Older People’ s Psychology Provision Northamptonshire Healthcare NHS Foundation Trust Northampton UK School of Computing University of Kent Canterbury UK

Objectives: This study aimed to understand the experience and impact of a physical activity and sleep wrist-worn tracker (Fitbit)-based healthy lifestyle intervention for older patients attending a memory assessment service, who are experiencing cognitive impairment but do not receive a dementia diagnosis. Methods: A qualitative design was employed. Semi-structured interviews were conducted with a purposeful sample of thirteen participants recruited from a memory assessment service. Thematic analysis, that was data driven and inductive, was undertaken to analyse the data. Results: Two global themes were developed. “Understanding exercise and sleep as part of my lifestyle” was made up of themes representing how participants viewed exercise and sleep as part of their lifestyles in terms of acknowledging the positive impacts and the barriers to exercise and sleep. The second global theme “Understanding my experience of the healthy lifestyle intervention” was made up of themes that identified the positive impact of the intervention regarding improving health and wellbeing, enabling validation of proactive behaviours and motivation to engage in healthy lifestyle behaviours, so promoting positive behaviour change. Conclusion: Patients experiencing age-related cognitive impairment, applied and benefited from a healthy lifestyle Fitbit-based intervention to facilitate and promote physical activity, better sleep hygiene and healthy lifestyles.

关键词： Cognitive Impairment Healthy Lifestyle Intervention Fitbit Health and Wellbeing Behaviour Change

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

相关的人和事

英语角 2024年第20期 14-15页

作者： kate 张霞(画) 不详

从东汉未年到三国时期,纷争不断。乱世给予谋士们更多大展拳脚的机会和舞台。你对这一时期的历史事件和人物关系了解多少呢?一起来看看吧。

关键词：三国时期乱世谋士

A One Health approach to fight antimicrobial resistance in Uganda: Implementation experience, results, and lessons learned

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Biosafety and Health 2024年第2期6卷 125-132页

作者： Reuben Kiggundu J.P.Waswa Niranjan Konduri Hassan Kasuja Marion Murungi Patrick Vudriko Harriet Akello Eric Lugada Cecilia Muiva Esther Were Dinah Tjipura Henry Kajumbula kate Kikule Emmanuel Nfor Mohan P.Joshi USAID Medicines Technologiesand Pharmaceutical Services ProgramManagement Sciences for HealthKampala 256Uganda USAID Medicines Technologiesand Pharmaceutical Services ProgramManagement Sciences for HealthArlingtonVA 22203USA College of Veterinary Medicine Animal Resources and BiosecurityMakerere UniversityKampala 256Uganda Ministry of Health Uganda Kampala 256Uganda USAID Strengthening Supply Chain Systems Activity Management Sciences for HealthKampala 256Uganda USAID Medicines Technologiesand Pharmaceutical Services ProgramManagement Sciences for HealthNairobi 254Kenya Department of Microbiology College of Health SciencesMakerere UniversityKampala 256Uganda

Uganda has been implementing the Global Health Security Agenda(GHSA)since 2015 to build its capacity according to World Health Organization(WHO)Benchmarks on International Health Regulations *** country remains prone to outbreaks,with more than 20 disease outbreaks reported in the past five years,including Ebola virus disease,Crimean-Congo haemorrhagic fever,Marburg haemorrhagic fever,measles,yellow fever,coronavirus disease 2019(COVID-19),and *** resistance(AMR)is an ongoing *** scored capacity level 3 on infection prevention and control(IPC)and antimicrobial stewardship(AMS)in the 2017 Joint External Evaluation(JEE)*** gaps were being addressed after a self-assessment in *** paper describes the technical assistance approaches provided to Uganda by the Medicines,Technologies,and Pharmaceutical Services Program,funded by the United States(U.S.)Agency for International Development,and implemented by Management Sciences for *** program,through a One Health approach,supported systematic capacity strengthening based on the JEE's capacity advancement framework for global health security,specifically relating to *** program's interventions impacted 32 WHO benchmark actions(7 for AMR multisectoral coordination,16 for IPC,and 9 for AMS),contributing to Uganda's strengthened GHSA *** success built on the AMR platform,the program trained 745 health workers in IPC for the Ebola virus and provided support for simulation exercises by eight district IPC *** program also worked with the Ministry of Health to coordinate IPC for the COVID-19 response in five health regions,covering 45 districts and reaching 5,452 health workers at 858 health facilities.

关键词： One health Antimicrobial resistance Antibiotic resistance Jointexternal evaluation Global health security Uganda Africa WHO Benchmarks for International Health Regulations Capacities

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

银色辫子

中学生英语 2024年第3期 12-17页

作者： kate E.Anderson 杨舟(译) 不详

真是个错误。在一场大型比赛中,我与步行者和慢跑者一起从后面起跑,这让我陷入了长达一英里的人流拥堵中。在穿过奥格登半程马拉松赛中一片宽阔的绿色山谷后,我已经有了一种失落感。然而这还只是第一英里。

关键词：半程马拉松步行者失落感起跑慢跑者