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排序方式: 共有1130条查询结果,搜索用时 15 毫秒
1.
Robert J Derksen Fred C Bakker Emil A Heilbron Pieter C Geervliet Irma M Spaans Elly S M de Lange-de Klerk Bart Veenings Peter Patka Henk J Th M Haarman 《European journal of emergency medicine》2006,13(1):3-8
OBJECTIVES: In the quest for a cost-effective and quality-preserving solution to manage crowding in the emergency department, the possibility of deploying regular emergency nurses for the treatment of acute ankle injuries was investigated. The aim of this study is to compare the diagnostic accuracy of emergency nurses with that of senior house officers in interpreting ankle and foot radiographs. METHODS: A prospective study comparing the assessment of 60 radiographs (30 feet and 30 ankles) by 16 emergency nurses before and after an educational session was performed. Each subset of 30 radiographs contained 12 fractures, hand-picked by a radiologist to represent everyday traumatology in the emergency department. The control group consisted of eight senior house officers representing everyday expertise. The outcome of the diagnostic assessment, represented as the pooled sensitivity and specificity for both groups, was compared using Z-statistics. RESULTS: Before the training session, the specialized emergency nurse group showed a sensitivity of 0.87 (confidence interval 0.83-0.91) compared with 0.93 (confidence interval 0.88-0.96) for the control group (P = 0.05). The specificity of specialized emergency nurses was 0.87 (confidence interval 0.81-0.92) compared with 0.93 (confidence interval 0.89-0.95) for the senior house officers (P < 0.05). After the training session, specialized emergency nurse diagnostic parameters did not differ significantly from the control group, displaying a sensitivity of 0.89 (confidence interval 0.86-0.92) and specificity of 0.92 (confidence interval 0.87-0.95). CONCLUSION: Before the training session, the specialized emergency nurse group showed a significantly lower accuracy than the SHO group. After training, however, the diagnostic accuracy did not differ significantly between groups. Therefore, we conclude that emergency nurses are able to accurately interpret foot and ankle radiographs after a short educational session. 相似文献
2.
J D Oosting R H Derksen T M Hackeng M van Vliet K T Preissner B N Bouma P G de Groot 《Thrombosis and haemostasis》1991,66(6):666-671
The effect of sera and purified IgG isolated from plasma of 46 patients with systemic lupus erythematosus (SLE) and 9 healthy donors on the endothelial cell (EC) mediated protein C activation was investigated. Out of the 46 SLE sera used, 19 were antiphospholipid antibodies (aPL) positive. From 12 patients IgG was isolated, of which 6 contained aPL. EC were first incubated with IgG (7 mg/ml) or serum (1:1 diluted) for 1 h and then tested for their ability to promote protein C activation by thrombin, with the cells either in a monolayer or in a suspension. The normal range (mean of control values +/- 2 SD) of protein C activation was 80-120%. In contrast to others, we could not detect an inhibition of protein C activation by any of the patient IgG's or sera. The recently described cofactor for binding of antiphospholipid antibodies to phospholipids, beta 2-glycoprotein I, was purified and added to the purified IgG's. A combination of these two components did not inhibit the EC mediated protein C activation by thrombin. This study suggests that the inhibition of the protein C activation, mediated by EC, is not a general mechanism by which aPL related thrombosis can be explained. 相似文献
3.
E J Derksen J A Eykelhoff K E Schenk P Patka H J Haarman 《Acta orthopaedica Belgica》1992,58(3):297-300
Retrosternal dislocation of the clavicle is an uncommon injury which may affect the mediastinal structures in a life-threatening way. Therefore, computed tomography is mandatory. Manipulation in the acute situation is the treatment of choice. In case of failure or old dislocation, open reduction with stabilization of the joint is required. The literature on this subject has been reviewed and an additional two cases are reported. 相似文献
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6.
Silber SJ; Nagy Z; Devroey P; Tournaye H; Van Steirteghem AC 《Human reproduction (Oxford, England)》1997,12(11):2422-2428
The aim of the study was to determine whether a prior diagnostic testicle
biopsy can predict success or failure of testicular sperm extraction (TESE)
with intracytoplasmic sperm injection (ICSI) in patients with
non-obstructive azoospermia caused by testicular failure, and what is the
minimum threshold of sperm production in the testis which must be surpassed
for spermatozoa to reach the ejaculate. Forty- five patients with
non-obstructive azoospermia caused by testicular failure underwent
diagnostic testicle biopsy prior to a planned future TESE-ICSI procedure.
The diagnostic testicle biopsy was analysed quantitatively, and correlated
with the quantitative findings of spermatogenesis in patients with normal
spermatogenesis, as well as with the results of subsequent attempts at
TESE-ICSI. Men with non- obstructive azoospermia caused by germinal failure
had a mean of 0-6 mature spermatids/seminiferous tubule seen on a
diagnostic testicle biopsy, compared to 17-35 mature spermatids/tubule in
men with normal spermatogenesis and obstructive azoospermia. These findings
were the same for all types of testicular failure whether Sertoli cell
only, maturation arrest, cryptorchidism, or post-chemotherapy azoospermia.
Twenty-two of 26 men with mature spermatids found in the prior testis
biopsy had successful retrieval of spermatozoa for ICSI, 12 of their
partners became pregnant, and are either ongoing or delivered. The study
suggests that 4-6 mature spermatids/tubule must be present in the testis
biopsy for any spermatozoa to reach the ejaculate. More than half of
azoospermic patients with germinal failure have minute foci of
spermatogenesis which are insufficient to produce spermatozoa in the
ejaculate. Prior diagnostic testicle biopsy analysed quantitatively (for
the presence of mature spermatids) can predict subsequent success or
failure with TESE-ICSI. Incomplete testicular failure may involve a sparse
multi-focal distribution of spermatogenesis throughout the entire testicle,
rather than a regional distribution. Therefore, it is possible that massive
testicular sampling from many different regions of the testes may not be
necessary for successful TESE-ICSI.
相似文献
7.
β-Lactoglobulin was isolated from infant formulae that were ultra high temperature (UHT) -treated, sterilized or spray-dried. The effect of the isolated β-lactoglobulin on SfaII-fimbriae-mediated adhesion of Escherichia coli to human ileostomy glycoproteins was studied in vitro. β-Lactoglobulin isolated from sterilized formulae was found to perform significantly less well than preparations from spray-dried formulae (p = 0:05). Great heterogeneity was observed in the adhesion inhibitory capacity of β-lactoglobulin isolated from UHT-treated formulae. Therefore, no significant difference was observed between UHT-treated and sterilized formulae or spray-dried formulae (p < 0:10). It can be hypothesized that β-lactoglobulin from spray-dried and some UHT-treated infant formulae may affect the colonization of mucous membranes by E. coli strains causing neonatal septicaemia and meningitis. 相似文献
8.
Mutations in the retinal guanylate cyclase (RETGC-1) gene in dominant cone-rod dystrophy 总被引:3,自引:0,他引:3
Kelsell RE; Gregory-Evans K; Payne AM; Perrault I; Kaplan J; Yang RB; Garbers DL; Bird AC; Moore AT; Hunt DM 《Human molecular genetics》1998,7(7):1179-1184
The dominant cone-rod dystrophy gene CORD6 has previously been mapped to
within an 8 cM interval on chromosome 17p12-p13. The retinal- specific
guanylate cyclase gene (RETGC-1), which maps to within this genetic
interval and previously was implicated in Leber's congenital amaurosis, was
screened for mutations within this family and in a panel of small families
and individuals with various cone and cone- rod dystrophy phenotypes. A
missense mutation (E837D) was identified in affected members of the CORD6
family, as well as a second missense mutation (R838C) in three other
families with dominant cone-rod dystrophy. RETGC-1 is only the fourth gene
to be implicated in cone-rod dystrophy and this is the first report of
dominant mutations in this gene.
相似文献
9.
Van de Velde H; De Vos A; Joris H; Nagy ZP; Van Steirteghem AC 《Human reproduction (Oxford, England)》1998,13(11):3160-3164
In human in-vitro fertilization (IVF), the oocytes are surrounded by
cumulus and corona cells at the time of insemination so that their maturity
cannot easily be evaluated. The best IVF results are obtained if the
oocytes are inseminated 2-6 h after retrieval. In the intracytoplasmic
sperm injection (ICSI) procedure, the oocytes are denuded by enzymatic and
mechanical treatment in order to be able to perform the injection. As a
consequence, the nuclear maturity of the oocytes can be evaluated and only
those that have extruded the first polar body are injected. However,
metaphase-II oocytes that have not yet reached cytoplasmic maturity cannot
be recognized. The purpose of this study was to investigate the effect of
different timing of cumulus- corona cell removal and injection on the
outcome of ICSI. For this we allowed the oocytes to complete in-vitro
cytoplasmic maturation in two different culture conditions: (i) surrounded
by their cumulus and corona cells or (ii) totally denuded. We performed
three different studies on sibling oocytes obtained after a standardized
buserelin/human menopausal gonadotrophin (HMG) protocol. We investigated
the effect of early (1-2 h after retrieval) and late (5-6 h after
retrieval) oocyte denudation and injection on the survival and
fertilization of the injected oocytes and on embryo cleavage after
fertilization. We found no statistically significant differences between
early and late injection, indicating that after a standardized
buserelin/HMG protocol the metaphase-II oocytes do not need time for
further cytoplasmic maturation. Furthermore, a different timing of
cumulus-corona cell removal has no effect on the outcome of ICSI,
suggesting that the surrounding cells are not necessary for survival,
fertilization and cleavage after ICSI.
相似文献
10.
Novero V; Camus M; Tournaye H; Smitz J; Verheyen G; Joris H; Derde MP; Van Steirteghem AC; Devroey P 《Human reproduction (Oxford, England)》1997,12(1):59-63
Serum follicle stimulating hormone (FSH) is routinely measured when
evaluating the infertile male for intracytoplasmic sperm injection (ICSI).
However, among the sperm parameters, only its relationship with sperm
concentration is well documented. Few investigations concern the
relationship between FSH and sperm motility and morphology, and the results
of ICSI. A retrospective study of 316 couples who underwent ICSI was
carried out to determine the relationships between serum FSH concentrations
in the male and (i) standard sperm parameters_(concentration, motility and
morphology) and (ii) fertilization, cleavage, pregnancy and implantation
rates after ICSI. There was an inverse correlation with sperm concentration
and total motility but no relationship was found with progressive motility
and sperm morphology. Neither was any relationship found between serum FSH
and fertilization, cleavage, pregnancy and implantation rates, and the
results of ICSI. These findings suggest the need to review the routine
measurement of serum FSH in the infertile male when ICSI is the planned
treatment procedure.
相似文献