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51.
Javier Lucas Ramos Cristina Suárez Ferrer Joaquín Poza Cordón María Sánchez Azofra Jose Luis Rueda García Eduardo Martin Arranz Jorge Yebra Carmona Irene Andaluz García Maria Dolores Martín Arranz 《Gastroenterologia y hepatologia》2021,44(5):337-345
IntroductionThe dose of thiopurine drugs in combined treatments with anti-TNF in inflammatory bowel disease (IBD) has not been clearly established. The purpose of this study is to assess whether the dose of azathioprine influences clinical and biochemical response/remission rates, and anti-TNF drug levels/antibody formation.Material and methodsPatients with IBD on combined maintenance treatment with azathioprine and infliximab or adalimumab were selected. Based on the dose of azathioprine, two groups were defined (standard: 2–2.5 mg/kg/day; and decreased: less than 2 mg/kg/day).ResultsIn the IFX group, there were no statistically significant differences (p = 0.204) in the rates of remission (39% vs 41.3%), response (10% vs 21.7%) or failure (51.5% vs 37%) depending on the dose of thiopurine drugs. No differences were found between AZA-dose dependent IFX levels (2.46 vs 3.21 μg/mL; p = 0.211). In the adalimumab group, there were no statistically significant differences (p = 0.83) in the rates of remission (66% vs 56%), response without remission (15.38% vs 25%) or failure (18% vs 18%) depending on the dose of thiopurines. With respect to ADA-levels, no differences were found in both groups (7.69 vs 8.23 μg/mL; p = 0.37).ConclusionIn our experience, no statistically significant differences were found in either anti-TNF levels or clinical-biological response/remission rates based on doses of azathioprine. 相似文献
52.
《Vaccine》2015,33(35):4307-4312
Polio is expected to be eradicated within only a few years from now. Upon polio eradication, the use of oral polio vaccines, which can cause circulating and virulent vaccine derived polio viruses, will be stopped. From this moment onwards, inactivated polio vaccines (IPV) will be used for worldwide vaccination against polio. An increased demand for IPV is thus anticipated. As a result, process development studies regarding the IPV production process, developed in the 1960s, have intensified. Studies on yield optimization aiming at costs reduction as well as the use of alternative polio viruses, which are more biosafe for manufacturing, are actual. Here our strategy to setup a new IPV production process using attenuated Sabin polio virus strains is presented. Moreover, aspects on reduction of the costs of goods and the impact of process optimization on sIPV costs are reviewed. 相似文献
53.
Karina de Oliveira Azzolin Dayanna Machado Lemos Amália de Fátima Lucena Eneida Rejane Rabelo-Silva 《Revista latino-americana de enfermagem》2015,23(1):44-50
OBJECTIVE:
to assess patient knowledge of heart failure by home-based measurement of two NOC Nursing Outcomes over a six-month period and correlate mean outcome indicator scores with mean scores of a heart failure Knowledge Questionnaire.METHODS:
in this before-and-after study, patients with heart failure received four home visits over a six-month period after hospital discharge. At each home visit, nursing interventions were implemented, NOC outcomes were assessed, and the Knowledge Questionnaire was administered.RESULTS:
overall, 23 patients received home visits. Mean indicator scores for the outcome Knowledge: Medication were 2.27±0.14 at home visit 1 and 3.55±0.16 at home visit 4 (P<0.001); and, for the outcome Knowledge: Treatment Regimen, 2.33±0.13 at home visit 1 and 3.59±0.14 at home visit 4 (P<0.001). The correlation between the Knowledge Questionnaire and the Nursing Outcomes Classification scores was strong at home visit 1 (r=0.7, P<0.01), but weak and non significant at visit 4.CONCLUSION:
the results show improved patient knowledge of heart failure and a strong correlation between Nursing Outcomes Classification indicator scores and Knowledge Questionnaire scores. The NOC Nursing Outcomes proved effective as knowledge assessment measures when compared with the validated instrument. 相似文献54.
Marcos Barragan da Silva Miriam de Abreu Almeida Bruna Paulsen Panato Ana Paula de Oliveira Siqueira Mariana Palma da Silva Letícia Reisderfer 《Revista latino-americana de enfermagem》2015,23(1):51-58
AIM:
to evaluate the clinical applicability of outcomes, according to the Nursing Outcomes Classification (NOC) in the evolution of orthopedic patients with Impaired Physical MobilityMETHOD:
longitudinal study conducted in 2012 in a university hospital, with 21 patients undergoing Total Hip Arthroplasty, evaluated daily by pairs of trained data collectors. Data were collected using an instrument containing five Nursing Outcomes, 16 clinical indicators and a five point Likert scale, and statistically analyzed.RESULTS:
The outcomes Body Positioning: self-initiated, Mobility, Knowledge: prescribed activity, and Fall Prevention Behavior presented significant increases in mean scores when comparing the first and final evaluations (p<0.001) and (p=0.035).CONCLUSION:
the use of the NOC outcomes makes it possible to demonstrate the clinical progression of orthopedic patients with Impaired Physical Mobility, as well as its applicability in this context. 相似文献55.
Background
Real time 1:1 videoconferencing (VC) has the potential to play an important role in the management of orthopaedic pathologies. Despite positive reporting of telemedicine studies uptake in clinical practice remains low. Acceptability to patients is an important element of system take-up in telemedicine and a focus towards qualitative methodology may explore the underlying reasons behind its acceptability. In this paper we have systematically reviewed qualitative studies that include evidence about patient responses to VC services in an orthopaedic setting.Objectives
To determine whether real time 1:1 videoconferencing is acceptable to patients in an orthopaedic setting.Data sources
MEDLINE, AMED, PsychINFO, CINAHL, SCOPUS, Cochrane Database, Evidence Search and Open Grey were searched with forwards and backwards reference screening of eligible papers.Eligibility criteria
Qualitative studies exploring the acceptability of VC in an orthopaedic setting were included.Study appraisal and synthesis methods
Studies were appraised using the CASP tool. A Directed Content Framework Analysis was conducted using Normalisation Process Theory.Results
Four studies were included for review. The themes for the four studies did not overlap and did not report clinician acceptability of VC. The Directed Content Analysis of these papers using Normalisation Process Theory highlighted factors which contribute towards its acceptability.Conclusions
All studies concluded that the use of VC was acceptable. Further qualitative research exploring both patient and clinician acceptability is required utilising a theoretical framework to allow for repeatability and generalisability.Systematic Review Registration Number: PROSPERO CRD42015024944. 相似文献
56.
李迎娟 《中华医学图书情报杂志》2015,24(4):21-24
阐述了云计算的原理及优点,并针对网络医学信息资源及其利用存在的问题,提出了构建云计算环境下网络医学信息资源服务模型。该模型可有效整合异构环境的资源、实现资源优化配置、优化网络医学信息资源服务、避免重复建设医学信息资源、减少人力财力的浪费、提高资源共享与利用。 相似文献
57.
58.
Bommena Hanumantha Rao Inti Venkata Subramanyeswara Rao Vysyaraju Ravi Kanth Korrapati Venkata Vara Prasada Rao K. Balamurali Krishna Bethanabatla Syama Sundar 《Scientia pharmaceutica》2015,83(3):465-478
Drug product purity and potency are of most significance in the regulatory market as we notice many recalled batches worldwide, particularly in the US and Japan. Olmesartan Medoxomil is an anti-hypertensive drug. The present invention relates to a process for the preparation of Olmesartan Medoxomil with 99.9% purity in an overall 62% yield. The synthesis includes three isolations and one purification with easy plant operations. This process describes the formation and control of each individual impurity in all stages. This process for Olmesartan Medoxomil and its intermediates is competent for industrial production in very short reaction time intervals with an appreciable yield and high purity. 相似文献
59.
Michelle Phoenix 《Scandinavian journal of occupational therapy》2015,22(4):318-321
AbstractBackground: Client-centredness is a central theme within occupational therapy; however, its application within clinical practice has not been thoroughly examined within the literature. Aim: The aim of this practice reflection is to provide a critical perspective on client-centredness in occupational therapy practice with children. Methods: Two action points of the Canadian Practice Process Framework (CPPF): Set the Stage and Agree on Objectives and Plan are applied to examine the concept of client-centred practice using a common practice example. Results: There are multiple benefits to using a client-centred approach to goal setting and developing a therapy plan. Practical challenges to client-centred practice include a lack of time, organizational support, and professional autonomy. Therapists may exert power over clients by enforcing institutional policies that prioritize the client diagnosis and organizational processes. Conclusion: The authors support a client-centred approach to occupational therapy practice with children but suggest that therapists may feel conflicted in trying to apply these principles within the current context of rehabilitation for children. Occupational therapists are encouraged to identify opportunities where they can advocate for a client-centred approach to services. 相似文献
60.
卫生法学作为医学人文学科的重要课程,在医学院校的课程体系中越来越受到重视。但由于我国卫生法学教育起步较晚,无论是课程的设置、教材的建设还是师资的培养都存在诸多问题。该研究从卫生法学教学的现状和问题入手,提出优化和改革策略,以期为高校的卫生法学教学提供依据。 相似文献