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1.
Conall T. Morgan Brigitte Mueller Varsha Thakur Vitor Guerra Callaghan Jull Luc Mertens Mark Friedberg Fraser Golding Mike Seed Steven E.S. Miner Edgar T. Jaeggi Cedric Manlhiot Lynne E. Nield 《The Canadian journal of cardiology》2019,35(4):453-461
Background
The purpose of the study was to evaluate the association between fetal echocardiographic measurements and the need for intervention (primary coarctation repair, staged coarctation repair, or catheter intervention) in prenatally diagnosed coarctation of the aorta.Methods
A single-centre retrospective cohort study (2005-2015) of 107 fetuses diagnosed with suspected coarctation of the aorta in the setting of an apex-forming left ventricle and antegrade flow across the mitral and aortic valves.Results
Median gestational age at diagnosis was 32 weeks (interquartile range, 23-35 weeks). Fifty-six (52%) did not require any neonatal intervention, 51 patients (48%) underwent a biventricular repair. In univariable analysis, an increase in ascending aorta (AAo) peak Doppler flow velocity (odds ratio [OR], 1.40 [95% confidence interval [CI], 1.05-1.91] per 20 cm/s; P = 0.03) was associated with intervention. No intervention was associated with larger isthmus size (OR, 0.23; P < 0.001), transverse arch diameter (OR, 0.23; P < 0.001), and aortic (OR, 0.72; P = 0.02), mitral (OR, 0.58; P = 0.001), and AAo (OR, 0.53; P < 0.001) z-scores. In multivariable analysis, higher peak AAo Doppler (OR, 2.51 [95% CI, 1.54-4.58] per 20 cm/s; P = 0.001) and younger gestational age at diagnosis (OR, 0.81 [95% CI, 0.70-0.93] per week; P = 0.005) were associated with intervention, whereas a higher AAo z-score (OR, 0.65 [95% CI, 0.43-0.94] per z; P = 0.029) and transverse arch dimension (OR, 0.44 [95% CI, 0.18-0.97]; P = 0.05) decreased the risk of intervention.Conclusions
In prenatally suspected coarctation, the variables associated with intervention comprised smaller AAo and transverse arch size, earlier gestational age at diagnosis, and the additional finding of a higher peak AAo Doppler. 相似文献2.
Brigitte Belmont Eric Plaisance Aliette Vérillon 《ALTER. European Journal of Disability research, Journal europeen de recherche sur le handicap》2009,3(4):320-339
Coinciding with the present period of unemployment, a corps of school assistants – assistants de vie scolaire (AVS) – has been created in order to meet the demand for in-school assistance raised by the development of schooling for children with special needs. This paper reports on a questionnaire-based survey carried out among 151 AVS working in the Seine Saint-Denis department. It aims at describing their working conditions considering the precariousness of their status (temporary jobs, poor pay) and the nature of their assignment. The main question bears on whether these conditions enable the assistants to develop the capabilities necessary for dealing with their tasks. Results could contribute to the present issue of reorienting government action in order to improve these jobs in terms of professional development. Notably, they reveal that AVS's training is usually brief and that their opportunities for developing workplace professional relationships are scant even though these are needed for them to collaborate with the other workers concerned by schooling children with special needs. 相似文献
3.
Burkhard H. A. von Rahden Brigitte Stigler Wolfgang Weiß Hubert J. Stein 《Journal of gastrointestinal surgery》2007,11(7):945-947
Management of upper gastrointestinal bleeding because of erosion of vessels by esophageal cancer may be challenging. We present
herein the angiographic images of a 49-year-old patient who was admitted with massive bleeding from a tumor-eroded inferior
thyroid artery. Attempts to control the bleeding by means of flexible endoscopy and insertion of a Sengstaken–Blakemore tube
had failed. The diagnosis was impressively demonstrated by multislice computed tomography with intravenous contrast in the
arterial phase and multiplanar reconstructions (computed tomography angiography) and by digital subtraction angiography. The
bleeding was successfully treated with superselective catheterization and coiling of the eroded vessel. 相似文献
4.
5.
Chretien Marie Francoise; Lebouvier Brigitte; Denis Alain; Chappard Daniel 《Human reproduction (Oxford, England)》1998,13(10):2767-2771
A cytomorphometric analysis of superficial vaginal cells inwomen in three groups of different types of hormonal concentrationwas made. There were 15 women in each group. Group I was studiedduring a natural cycle, group II under oral contraceptive therapyand group III during an in-vitro fertilization (IVF) stimulationprotocol. Morphometric parameters were measured on an imageanalyser. The area, perimeter and several form factors weremeasured separately for nuclei and cytoplasm. The nucleus:cytoplasmicratio was also determined. The cytoplasmic area was significantlyreduced in group II and was associated with a statisticallysignificant reduction of the nuclear area. The nucleus:cytoplasmicratio appeared significantly increased in group II and reducedin group III. Low oestradiol impregnation obtained with an oralminidosed contraceptive interfered with vaginal cell maturation.High oestradiol concentrations obtained during IVF protocolsinduced marked nuclear pycnosis but did not induce supra-physiologicalcell enlargement. Maximal cell size is genetically regulatedaccording to Driesch's law of volume invariance and hormonalover-stimulation has no effect on cell size. The nucleus:cytoplasmicratio appears to be a powerful parameter reflecting the oppositeeffects of hormones on cell compartments. 相似文献
6.
7.
Edwin D. Boudreaux PhD Brian L. Cruz MD Brigitte M. Baumann MD 《Academic emergency medicine》2006,13(7):795-802
Objectives: The authors reviewed the evidence on performance improvement methods for increasing emergency department (ED) patient satisfaction to provide evidence-based suggestions for clinical practice.
Methods: Data sources consisted of searches through MEDLINE, CINAHL, PSYCHINFO, Cochrane Library, and Emergency Medicine Abstracts and a manual search of references. Articles were included if they reported a performance improvement intervention targeting patient satisfaction in the ED setting. Articles on studies not conducted in the United States or that failed to provide enough details to allow critical evaluation of the study were excluded. Two authors used structured evaluation criteria to independently review each retained study.
Results: Nineteen articles met all selection criteria. Three studies found varying levels of support for multicomponent interventions, predominantly focused on implementation of clinical practice guidelines for specific presenting complaints and process redesign. Sixteen studies evaluated single-component interventions, with the following having at least one supportive study: using alternating patient assignment to provider teams rather than "zone"-based assignment, enhancing provider communication and customer service skills, incorporating information delivery interventions (e.g., pamphlets, video) that target patient expectations, using preformatted charts, and establishing ED-based observation units for specific conditions such as asthma and chest pain.
Conclusions: There is modest evidence supporting a range of performance improvement interventions for improving ED patient satisfaction. Further work is needed before specific, evidence-based recommendations can be made regarding which process changes are most effective. Recommendations are made for improving the quality of performance improvement efforts in the ED setting. 相似文献
Methods: Data sources consisted of searches through MEDLINE, CINAHL, PSYCHINFO, Cochrane Library, and Emergency Medicine Abstracts and a manual search of references. Articles were included if they reported a performance improvement intervention targeting patient satisfaction in the ED setting. Articles on studies not conducted in the United States or that failed to provide enough details to allow critical evaluation of the study were excluded. Two authors used structured evaluation criteria to independently review each retained study.
Results: Nineteen articles met all selection criteria. Three studies found varying levels of support for multicomponent interventions, predominantly focused on implementation of clinical practice guidelines for specific presenting complaints and process redesign. Sixteen studies evaluated single-component interventions, with the following having at least one supportive study: using alternating patient assignment to provider teams rather than "zone"-based assignment, enhancing provider communication and customer service skills, incorporating information delivery interventions (e.g., pamphlets, video) that target patient expectations, using preformatted charts, and establishing ED-based observation units for specific conditions such as asthma and chest pain.
Conclusions: There is modest evidence supporting a range of performance improvement interventions for improving ED patient satisfaction. Further work is needed before specific, evidence-based recommendations can be made regarding which process changes are most effective. Recommendations are made for improving the quality of performance improvement efforts in the ED setting. 相似文献
8.
Roland D Chapurlat Monique Arlot Brigitte Burt-Pichat Pascale Chavassieux Jean Paul Roux Nathalie Portero-Muzy Pierre D Delmas 《Journal of bone and mineral research》2007,22(10):1502-1509
We sought whether microdamage could rise in postmenopausal osteoporotic women on long-term bisphosphonates, as suggested by recent animal studies. We found few microcracks in iliac bone biopsies, despite a marked reduction in bone turnover. INTRODUCTION: Animal studies suggest that bisphosphonates (BPs) could increase microdamage frequency in a dose-dependent manner, caused by excessively suppressed bone turnover. However, there is limited data in humans receiving BP therapeutic doses for >3 yr. MATERIALS AND METHODS: We measured microcrack frequency and histomorphometry parameters on transiliac bone biopsies in 50 postmenopausal osteoporotic women (mean age = 68 yr) who had received BP therapy (3 on intravenous pamidronate, 37 on oral alendronate, and 10 on oral risedronate) for at least 3 yr (mean treatment duration = 6.5 yr). We compared these results with transiliac bone biopsies obtained from 12 cadavers. We used bulk staining with green calcein as a fluorochrome. The microcracks were quantified in three 100-microm-thick sections using optic microscopy and were confirmed by laser confocal microscopy. Microcrack frequency (number of microcracks/mm2 of bone tissue) was compared between treated women and controls using nonparametric tests. We also explored predictors of microcrack frequency, including age, duration of BP therapy, and activation frequency. RESULTS: Among treated women, cancellous bone microcrack frequency was low (mean, 0.13 microcracks/mm2) and did not differ significantly from that observed in controls (0.05 microcracks/mm2; p = 0.59). Of note, 54% of the treated women and 58% of the controls had no observable microcracks. There was no association between microcrack frequency and the duration of BP therapy (for microcracks/mm2 and duration, Spearman r = 0.04, p = 0.80) and between patients' ages and the number of microcracks (Spearman r = -0.09, p = 0.61). Although bone remodeling parameters were suppressed in treated women, we found no relationship between microcrack density and activation frequency (Spearman r = -0.003, p = 0.99). Also, microcrack frequency was not increased in women with prevalent vertebral fracture compared with those without fractures. CONCLUSIONS: Among postmenopausal osteoporotic women on long-term BPs, microcrack frequency in the iliac bone is low, despite a marked reduction of bone turnover. 相似文献
9.
Brigitte Schurch 《Acta endoscopica》2004,34(4):583-584
10.
Coras Brigitte MD Hohenleutner Ulrich MD Landthaler Michael MD Hohenleutner Silvia MD 《Dermatologic surgery》2005,31(3):331-333
BACKGROUND AND OBJECTIVES: Two absorbable polydioxanone threads are compared regarding intraoperative handling qualities, scar dehiscence, and possible side effects. METHODS: In 30 excisions, half of each suture was performed with PDS II (Ethicon GmbH, Norderstedt, Germany), whereas the other half was closed with Serasynth (Serag-Wiessner, Naila, Germany). Clinical evaluation for scar spreading, spitting of the sutures, hypertrophic scarring, or suture granuloma was performed 3 and 6 months after surgery. RESULTS: No significant difference in scar spreading, hypertrophic scarring, or the incidence of suture granuloma was noted. A significantly lower frequency of spitting was seen with Serasynth than with PDS. The handling and suturing properties of SerasynthM were estimated to be slightly superior compared with those of PDS. CONCLUSION: Our study shows that PDS and Serasynth provide equal cosmetic results when applied in an appropriate suturing technique. Possibly owing to its better pliability, the frequency of spitting was lower with Serasynth. 相似文献