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41.
Short hospitalizations for patients undergoing coronary artery bypass grafting (CABG) require continuous nursing evaluation of patients' discharge education. Six institutions collaborated in surveying 300 postoperative patients with CABG to identify learning priorities and patients' perceptions of the effectiveness of discharge education. Data analysis from the self-administered questionnaire demonstrated consistent patient priorities across institutions. Differences in teaching methods and content did not affect perceived preparedness or importance scores. Regional experience demonstrates that variable teaching efforts meet patients' priorities and provide high overall patient preparedness for discharge. Patients with the shortest hospitalizations had higher preparedness scores.  相似文献   
42.
In experiments on male rabbits with the lack of insulin it is been revealed violations after the past immobilization the intensivity and duration of neutrophilic leukocytosis decrease, contents of lysosomes in neutrophils, activity of acid phosphatase. By lysosomal ferments don't determine the can observer discordance of processes of coagulation, fibrinolysis, kininogenesis.  相似文献   
43.
Over 378,000 m3 (100 million gal) of radioactive waste is being stored in hundreds of tanks at several U.S. Department of Energy (DOE) sites. The environment within the tanks is highly radioactive and chemically harsh. The waste typically consists of a heterogeneous sludge layer covered by a layer of supernatant. A few of the tanks have leaked to the environment, while others are corroding. Removing the waste from the tanks and processing it to a stable final form are desired to prevent any additional contamination of the environment. The tanks vary in size and geometric shape and do not have systems for removing the sludge waste.

Mobilization and mixing studies were conducted with a surrogate sludge (e.g., kaolin clay) using submerged jets in two sizes of horizontal tanks with nominal capacities of 0.87 m3 (230 gal) and 95 m3 (25,000 gal). Mobilization efficiencies and mixing times were determined for single and bidirectional jets in both tanks with the discharge nozzles positioned at various locations in the tanks. Approximately 80% of the surrogate sludge was mobilized in the 95-m3 tank using a fixed bidirectional jet (inside diameter = 0.035 m) and a jet velocity of 6.4m/s (21 ft/s). The effective cleaning length, which is defined as the distance between the jet and the edge of the remaining sludge bank, was approximately 3.2 m (10 ft) on each side of the bidirectional jet.  相似文献   
44.
MATERIALS AND METHODS: In the period 1986-1994, 2950 patients with cardiovascular diseases were surgically treated. In 2104 cases we placed biological or synthetic grafts to maintain vascular continuity. The most common has turned out to be abdominal aortic aneurysm. We treated 783 cases in emergency conditions. Staging and localization of infection has been the first aim in patients with synthetic vascular grafts. We studied signs and symptoms related to infections. In all cases we discovered the microorganism responsible of infection we started antibiotic therapy. RESULTS: Surgical infection incidence is 4.9% (154 cases). Series analysis has evidenced a decrease in infection incidence in the period 1986-1994. The most frequent infections are: the urinary tract infection (59 cases, 38.5%) followed by surgical wound infection (37 cases, 24.1%), respiratory tract infection (27 cases, 17.5%), vascular graft infection (23 cases, 14.4%). All patients underwent a preoperative antibiotic prophylaxis with 2 degrees-3 degrees generation cephalosporines. We noted a higher graft infection incidence in patients treated with aortobifemoral reconstruction. We handled surgical infection following two main directions: 1-antibiotic therapy, 2-surgical treatment and antibiotic therapy. CONCLUSIONS: We noted surgical technique improvement and correct application of an antibiotic prophylaxis form has turned out to be the "gold standard" in order to reduce cardiovascular surgical infections. To reduce sepsis or graft infection we can work on either of the following: 1) antibiotic therapy; 2) operative time reduction; 3) try to limit vascular surgery in case of concomitant gastrointestinal surgical disease; 4) using alloplastic vascular grafts with high biological compliance; 5) patency time reduction of invasive diagnostic technique.  相似文献   
45.
Associations between coping responses, drinking motivations, expectations of meeting social and academic goals, and family of origin problem drinking and measures of college students' quantity/frequency of alcohol use and social complications of alcohol use were investigated in a sample of 218 college students. Positive associations were found between "emotion-focused" forms of coping such as detachment and the criterion measures, whereas "problem-focused coping" was not significantly associated with quantity/frequency of alcohol use or drinking complications. Positive correlations were also found between drinking motives, goal attainment expectancies and family models measures and the criterion measures. Regression models constructed for alcohol quantity/frequency and drinking complications implicated the total number of drinking motives, family models of problem drinking and the coping strategy of self-blame as strongly related to criterion measures. Positive social drinking motives and coping by seeking social support were implicated as possible protective factors.  相似文献   
46.
Current methods used clinically to assess myocardial perfusion are invasive and expensive. As the technology of ultrasound imaging improves, CE may provide a relatively inexpensive, noninvasive means of quantitating myocardial perfusion. Issues regarding stability of microbubble contrast agents must be studied more closely under physiologic conditions. As such, encapsulated microbubbles may provide more stability under physiologic pressures than free gas microbubbles. Introducing high concentrations of contrast, either by hyperconcentrating the contrast agent or by increasing the injection rate, may provide greater stability under physiologic conditions. Further, before quantitative statement of tissue perfusion can be made, the relationship between tracer concentration and system response must be established. Further, a "linear" postprocessing ultrasound setting does not eliminate this requirement as data must still undergo nonlinear transformation during log compression and time-gain compensation. Additionally, issues regarding "electronic thresholding" must be explored more extensively in vivo. Commercial ultrasound scanners, in their present form, may not offer adequate sensitivity for absolute quantitative studies. Further development of modified ultrasound systems may provide sufficient sensitivity for quantitative perfusion imaging. CE offers a potentially powerful tool in the clinical management of patients with ischemic heart disease. Conventional coronary angiography provides information on the size of a lesion, but accompanying tissue perfusion distal to the lesion cannot be determined. Doppler ultrasonography determines velocity of blood flow in large vessels but does not offer the potential to quantitate tissue perfusion. Clearly, CE has a place in the future of diagnostic imaging. The recent work of Ito et al. demonstrated the qualitative potential of CE in the identification of "areas at risk" in patients who had undergone thrombolysis or percutaneous transluminal coronary angioplasty after an acute myocardial infarction. With further improvement in the ultrasound imaging techniques and microbubble stability, CE may offer an inexpensive, noninvasive means of assessing myocardial perfusion.  相似文献   
47.
In response to Michael Morris, I attempt to refute the crucial second premise of the argument, which states that the formality condition cannot be satisfied non-stipulatively in computational systems. I defend the view of representation urged in Meaning and Mental Representation against the charge that it makes content stipulative and therefore irrelevant to the explanation of cognition. Some other reservations are expressed.  相似文献   
48.
To investigate the feasibility of using tissue obtained from human tumor xenografts for in vitro screening of antineoplastic agents, we grew human tumor colony-forming units (CFU) in semisold agar from xenografts serially passaged in nude mice. Growth of human tumor CFU was accomplished from nine xenografts representing five different histological tumor types (ovarian carcinoma, adenocarcinoma of the colon, malignant melanoma, epidermoid carcinoma of the lung, and malignant astrocytoma). Cloning efficiency ranged from 0.04 to 0.1% and showed significant variability both between tumor types and between individual animals bearing the same type of xenograft. A high percentage of tumor CFU was in S phase [47 +/- 20% (S.D.)] as determined by the thymidine "suicide" technique. The number of tumor CFU observed increased linearly with increasing numbers of cells plated. In vitro drug sensitivity of the tumor CFU was assessed to Adriamycin, cis-platinum, and melphalan. The patterns of drug sensitivity were found to be reproducible and stable over a period of 9 months. Drug sensitivity curves to Adriamycin for five xenografts representing four tumor types showed complex patterns with plateau portions similar to those described for tumor CFU from primary tumors. The rank order of sensitivity of the tumors was compared to that of normal granulocyte-macrophage progenitors and, with the exception of the melanomas, was found to correlate well with clinical experience (order of sensitivity = colon less than ovary less than bone marrow). Growth of human tumor CFU from xenografts represents a reproducible and stable means for the study of the biology of tumor CFU and has potential applications as a means for screening new anticancer agents.  相似文献   
49.
The authors compared longitudinal treatment outcomes for depressed substance-dependent veterans (N = 206) assigned to integrated cognitive–behavioral therapy plus standard pharmacotherapy (ICBT + P) or 12-step facilitation therapy plus standard pharmacotherapy (TSF + P). Drug and alcohol involvement and depressive symptomology were measured at intake and at 3-month intervals during treatment and up to 1 year posttreatment. Participants in both treatment conditions showed decreased depression and substance use from intake. ICBT + P participants maintained improvements in substance involvement over time, whereas TSF + P participants had more rapid increases in use in the months following treatment. Decreases in depressive symptoms were more pronounced for TSF + P than ICBT + P in the 6 months posttreatment. Within both treatment groups, higher attendance was associated with improved substance use and depression outcomes over time. Initial levels of depressive symptomology had a complex predictive relationship with long-term depression outcomes. Early treatment response predicted long-term substance use outcomes for a portion of the sample. Although both treatments were associated with improvements in substance use and depression, ICBT + P may lead to more stable substance use reductions compared with TSF + P. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   
50.
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