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1.
Improvement in Tricuspid Annular Plane Systolic Excursion with Pulmonary Hypertension Therapy in Pediatric Patients 下载免费PDF全文
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Emese Mayhew Bryony Beresford Alison Laver‐Fawcett Fiona Aspinal Rachel Mann Kathleen Bechtold Mona Kanaan 《Health & social care in the community》2019,27(3):777-787
Patient or user engagement with health and social care interventions is receiving increased attention and interest within practice settings and research. An English evaluation of three reablement services wished to include a measure of user‐engagement so as to explore its association with outcomes. As no measure of reablement engagement existed, an existing measure designed for use with physical rehabilitation patients (the Hopkins Rehabilitation Engagement Rating Scale) was adapted and its psychometric properties were tested. The adapted version was completed by reablement staff at the time an individual (n = 129) was discharged from one of the three reablement services. Outcomes data (Barthel Index, Nottingham Extended Activities of Daily Living Scale, General Health Questionnaire‐12) collected by the evaluation study at baseline (that is, at entry into reablement), discharge and 6 months postdischarge was used for some psychometric testing. Internal consistency and construct, predictive and discriminant validity were investigated. The adapted scale measured a single construct and had good internal consistency. Tests of predictive and discriminant validity were positive. Findings from a separate, small‐scale (n = 31) test–retest study offer an early indication that this is acceptable. There was, however, evidence of a ceiling effect and we consider ways this may be ameliorated. The Hopkins Rehabilitation Engagement Rating Scale – Reablement Version offers a means by which user engagement in reablement can be measured using a staff‐completed instrument. The association between engagement and reablement outcomes, revealed when testing for predictive validity, supports the argument for greater attention and investment in research on user engagement in reablement. More broadly, researching engagement within the context of an intervention often delivered by multiple practitioners offers the opportunity to further understand this concept which, in the past, has particularly focused on interventions delivered by a single practitioner. In addition, future work should include developing a companion measure completed by service users. 相似文献
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Infarction of prolactin-secreting or growth hormone-secreting pituitary adenomas is not unusual. However, Infarction of ACTH-secreting
adenomas has rarely been reported. Cyclical course of Cushing's syndrome alternating with adrenal insufficiency due to recurrent
infarction of an ACTH-secreting pituitary adenoma has not been reported. We report here a 20-year-old lady who presented with
florid signs of Cushing's syndrome but was found to have adrenal insufficiency on biochemical evaluation. Magnetic resonance
imaging (MRI) of the pituitary gland showed that she had infarction of an ACTH-secreting macroadenoma. Over the next 6 years,
her disease ran a cyclical course characterized by periods of hypercortisolism alternating with adrenal insufficiency due
to repeated episodes of infarctions of the ACTH-secreting pituitary macroadenoma with corresponding changes in the pituitary
adenoma on serial MRIs. The case alerts clinicians to this possibility when a patient presents with clinical picture of Cushing's
syndrome but has adrenal insufficiency on biochemical testing. It also suggests that silent or subclinical infarction of pituitary
adenomas is not uncommon and is probably under diagnosed. 相似文献
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Redha Souilamas Jihane I Souilamas Khalid Alkhamees Jean-Pierre Hubsch Jean-Claude Boucherie Reem Kanaan Yves Ollivier Mauricio Sauesserig 《Journal of cardiothoracic surgery》2011,6(1):52
Extracorporeal membrane oxygenation (ECMO) is used in severe respiratory failure to maintain adequate gas exchange. So far,
this technique has not been commonly used in general thoracic surgery. We present a case using ECMO for peri-operative airway
management for pulmonary resection, using a novel single-site, internal jugular, veno-venous ECMO cannula. 相似文献
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Christophe Picard Julie Di Cristofaro Doua F. Azzouz Sami B. Kanaan Jean Roudier Nathalie C. Lambert 《Human immunology》2013
Embryos during pregnancy and organs during transplantation, express high levels of soluble HLA-G (sHLA-G) molecules for successful implantation and protection against maternal immune cells or recipient’s cells. We and others have shown that women with scleroderma (SSc) carry cells/DNA arising from pregnancy, so-called fetal microchimerism (Mc) more often and in higher quantities than healthy women decades after delivery. 相似文献